Hence
Recent research = based on expressed emotion; originally by Brown (’72) then lower showed patients with schizophrenia relapse higher than in homes with high expressed emotions.
Characteristics of high expressed emotions include: hostility, criticism and over concern.
Patients’ recall maybe affected by their schizophrenia. Other studies are less supportive.
Hall and Levin (’80) analysed data various previous studies no difference families with and without a schizophrenic verbal and non verbal communication were in agreement.
Subsequent research: strong relation – blur relapse and living with high expressed emotions relatives.
HOWEVER, co relational may just reflect consequences of living with a severely disturbed individual and may not have any casual significance.
High expressed emotion families also of depression and eating disorders hence not only characteristics of schizophrenia.
Also expressed emotions measured- may only use one observation or interview which maybe insufficient to give accurate picture.
Kalifi and Torabi (’96) found out that the high prevalence of EE in Iranian culture (over protective mothers and rejective fathers) was one of the main causes of schizophrenic relapses.
Expressed emotion much more universal empirical support than the double bind theory. However it is unsure whether EE is a cause or an effect of SZ. But it has led to an effective form where high EE relatives our shown to reduce levels of EE.
Hogarty et al (’91) found this therapy significantly reduce relapse rates. However, as with all therapies, EE intervention key element or other aspects family intervention may have helped.
Although some problems family environment has a role in the onset and especially course of schizophrenia.
Prospective studies found high risk kids who develop schizophrenia compared to those who don’t are more likely to be from families that have negative relationships.
→ Study: Israeli-high risk study
Found here from high risk grip (one parent schizophrenia) that had good parenting developed schizophrenia or other disorders.
Underlying vulnerability in some people interacts with environment ……… =gives rise to onset schizophrenia.
Cognitive
Acknowledges the role of biological factors initial sensory experiences of schizophrenia, claims further features disorder appear individuals attempt understand experiences. First experience voices other sensory experiences turn to others confirm validity. Other people fail confirm experiences schizophrenic believe others hiding truth. Reject feedback those around them develop delusional beliefs being manipulated persecuted by others.
COGNITIVE EXPLANATIONS
Physical basis for the cognitive deficits associated with schizophrenia. A link between excess dopamine in the prefrontal cortex, working memory. Machine, virtual hallucinations, TV tell you to kill yourself. Intention is to show their hallucinations are not real. As yet no evidence that this will provide a successful treatment.
Socio-cultural factors
Life events and schizophrenia
Higher risk of schizophrenia episodes is the occurrence of stressful life events. Discrete stresses, death of close relative or break up of a relationship. Brown and Birley (’68) prior to a schizophrenic episode, patients previously experienced schizophrenia twice many stressful life events compared healthy control group. Mechanisms through which stress factors trigger schizophrenia are not known, high levels of physiological arousal associated with neurotransmitter changes are thought to be involved (Fallon et al., ’96).
FREUD
THERE IS NO RESEARCH EVIDENCE TO SUPPORT FREUD’S SPECIFIC IDEAS CONCERNING SCHIZOPHRENIA, EXCEPT FAMILY PATTERNS.