Psychological: Family Dysfunction Theories of Schizophrenia (AQA A Level Psychology)
Revision Note
Written by: Claire Neeson
Reviewed by: Lucy Vinson
The schizophrenogenic mother
The schizophrenogenic mother (SM) explanation of schizophrenia (Fromm-Reichmann, 1948) has at its basis (you guessed it) the idea that a toxic, negative, dysfunctional mother is a major (if not the) factor in her child’s development of schizophrenia
The SM theory depends as well on the passive, ineffectual nature/behaviour of the father as another key factor
The SM is a psychodynamic explanation of schizophrenia as it is based on a patient’s current internal conflict having its roots in aversive childhood experience
The SM is cold,rejecting and controlling and creates a family atmosphere which is characterised by tension and secrecy
This toxic behaviour from the SM is theorised to lead to distrust, paranoia delusions and ultimately to the development of schizophrenia in the child
The schizophrenogenic mother: just another example of a misogynistic stereotype?
Double-bind theory
Proposed by Bateson et al. (1956), double-bind theory describes a situation in which no matter what a child does, they can't win as they receive mixed messages and unpredictable/inconsistent standards are imposed on them e.g. When I didn’t tidy my room last time I was yelled at, but when I tidied it today I was told that I was wasting my time…
It is thought that a child caught in a double-bind may develop schizophrenic symptoms such as paranoia and disorganised thoughts e.g. Am I doing the right thing? Is someone going to tell me I’m wrong? Do I even know what’s right and what’s wrong?
Parents may withdraw their love and approval as a punishment for perceived wrongs which may result in the child feeling fearful and confused about how to be themselves in what appears to be an unpredictable world
Double-bind is a risk factor in the development of schizophrenia, Bateson did not claim that it was the sole reason behind a child becoming schizophrenic
Examiner Tips and Tricks
If you are writing about family dysfunction in the exam don’t be tempted to use examples from your own life or that of other people you know - keep the focus and tone of your response detached, impartial and evidence-based.
Expressed emotion
Expressed emotion (EE) refers to how a family member communicates their thoughts and feelings towards the schizophrenic person in their family
There are several elements to EE, some of which are:
Hostility towards the schizophrenic person e.g. showing anger and resentment
Criticism of the schizophrenic person e.g. being openly judgemental of them
Over-involvement in the life of the schizophrenic person e.g. playing the ‘martyr’ in their presence
High EE is associated with an increased risk of relapse in the recovering schizophrenic person
Low EE is more likely to produce an atmosphere of of warmth, support and care that will help to facilitate recovery and prevent relapse
EE could be one of the reasons that a vulnerable person develops schizophrenia i.e. it is another risk factor
People with schizophrenia walk a fine line between what they perceive as reality and what is fantasy - their family situation can help or hinder them in this struggle.
Research which investigates family dysfunction
Hartwell (1996) argues that the schizophrenogenic mother concept was developed during a time of tension over women's changing position and roles in American society as a way of reclaiming psychotherapy as a purely male domain
Sojit (1971) - An observation of the parents of schizophrenics interacting with their children compared with other groups e.g. parents of young offenders, supported double-bind theory i.e. the parents of the schizophrenic were more likely to send messages to their child than the other parents
Amaresha & Venkatasubramanian (2012) - the theory of EE undermines positive attitudes towards schizophrenic family members so it is important that future studies should focus on the protective factors as well as risk factors for schizophrenia
Evaluation of family dysfunction
Strengths
Purely biological explanations cannot fully account for the array of factors that contribute to the onset of schizophrenia so the family dysfunction explanation fills that gap, demonstrating that close-knit relationships can be toxic as well as life-enhancing
Robust research findings such as that by Kavanagh (1992) show that there is a high relapse rate (48% in the case of Kavanagh’s meta-analytical study) for schizophrenic patients who live with high EE families (compared to 21% for those who live with low EE families)
Weaknesses
The concept of the SM is a dangerous stereotype and a product of 'blame-culture' which has no basis in scientific fact and which may have caused a great deal of harm over the years (Neill, 1990)
Shuhman (1967) questions the very existence of double-bind theory as a risk factor for schizophrenia as it is almost impossible to differentiate double-bind from more ordinary, everyday forms of family communication within a specific family dynamic which means that the theory lacks reliability as it cannot be operationalised and validity as it cannot offer a complete explanation for the onset of schizophrenia
Link to Issues & Debates:
The schizophrenogenic mother theory clearly shows acute gender bias as it suggests that women/mothers play a key, destructive role in the onset of schizophrenia in a child (alpha bias as it assumes key differences based on gender).
This topic is socially sensitive which means that there are ethical implications as to how the findings of research in this field should be presented so as to avoid further bias, prejudice and discrimination
Worked Example
Briefly discuss two strengths of the family dysfunction explanation of schizophrenia.
[6]
AO3 = 6 marks
For 4-6 marks the answer should give two clear and relevant strengths of the family dysfunction explanation, using a good level of detail. Effective use of examples should be given to support the points made. There should be confident use of terminology. Evaluation should be effective and should focus squarely on family dysfunction.
For 2-4 marks the answer should give two relevant strengths with some detail involved. There may be some lack of expansion or development of ideas. There should be some use of terminology. Evaluation will be present but may lack depth or range.
For 1-3 marks the answer will be only partially successful in offering two strengths (only one strength may be given). Terminology will be sparse and there may be some vagueness or ambiguity to the response. Evaluation is likely to be sparse or absent altogether.
Possible answer content could include:
Research support from Read et al. (2005) showing that well over half of men in the study and even more women with schizophrenia suffered some form of abuse in childhood
Berry et al. (2008) linked schizophrenia to an insecure attachment style, highlighting the importance of stable and loving family environments when growing up
Purely biological explanations cannot fully account for the array of factors that contribute to the onset of schizophrenia so the family dysfunction explanation fills that gap
There is some prospective evidence linking family dysfunction to the onset of schizophrenia in later life, particularly with regard to positive symptoms (Jeppesen et al., 2015)
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