One of the best known family theories of schizophrenia is double-bind hypothesis (Bateson 1978). This theory suggests that parents repeatedly communicate ‘pairs of mutually contradictory messages’ that place children in so called double-bind-situations.(Comer 2004) for example if one person says to another “I’m glad to see you,” yet frowns and avoids eye contact, the two messages are incongruent. When children are given conflicting messages form parents, who express care, yet at the same time appear critical it can lead the child to be confused, doubtful in self and eventually withdrawal. Many children adopt strategies to deal with the situation; one is by ignoring primary communication (verbal communication) and responding only to metacommunications (non-verbal communication) the second is to be more suspicious about what any one is saying (not just the parent)and to wonder about the true meaning of what is being said.
According to Comer (2004) people who respond to verbal communication in these ways may have a possibility of progressing towards paranoid schizophrenia.
Other psychologists believe that some people inherit the disease by the way they were raised as a child. The environment that a child is raised in can affect the disease because the child may have a hard time adjusting or dealing with the negative influences in his or her life. If the parents have the disease, then they are more likely to raise the child in a way that he or she will most like develop it. By the way the child is nurtured or the nature in which they are raised is a major factor in whether or not the child will develop schizophrenia.
Another area in the of study sociocultural factors is that of the clinical theorist R.D. Laing (1967, 1974, & 1959) he combined existential philosophy with sociocultural principles, he argued that schizophrenia was a constructive process “in which people try to cure themselves of the confusion and unhappiness caused by their social environment.”(Comer 2004) Laing believed that if schizophrenic people were left alone to complete the process they would have a healthy outcome (Laing 1967).
Although societal and family forces are considered important in the development of this disorder there are many Sociocultural theorist that believe that the characteristics of schizophrenia are influenced by the diagnosis it self (Modrow, 1992). In their opinion, people who are called or labeled schizophrenic are viewed and reacted to as “crazy”. Once the label is assigned, justified or not it becomes ‘a self-full filling prophecy’ that promotes the development of many schizophrenic symptoms.
This is supported by the work of Rosehan (1973) in his study of eight individuals who did not have symptoms of schizophrenia, but presented themselves at various mental hospitals, complaining they had been hearing voices saying the words “empty” and “thud”. They were all diagnosed of being schizophrenic and all eight individuals were hospitalized. Although theses eight then dropped all symptoms and behaved normally, they had difficulty getting rid of the label and gaining release from the hospital. When in hospital they were treated like they were invincible, they described feeling bored, uninterested and helpless (Comer, J, 2003). This research shows that the labeling of a person as ‘schizophrenic’ can have a negative affect on both how individuals are viewed and how they feel and behave.
The biological aspect of schizophrenia falls in to three sub categories- genetics, biochemical and neurodevelopment. A great deal of research has been done in order to show genetics is a component in schizophrenia. Family studies have been conducted since the 1900s in an attempt to identify a genetic link with schizophrenia. Kendler et al (1985) have shown that first-degree relatives of those with schizophrenia are 18 times more at risk then the general population. Unfortunately the family studies done cannot differentiate between genetic and environmental influences.
The two major kinds of study to show a link between genetics and schizophrenia are those involving twins and those involving adopted children. One of the most famous studies carried out was done by Gottesman & Shields (1972); they looked at the history of 45,000 individuals treated at two London hospitals between 1948 and 1064. Gottesman & Shields identified 57 schizophrenic twins who could be located and who agreed to participate in the study. Using diagnosis and hospitalization as the criteria for schizophrenia, the researchers reported a concordance rate of 42% for monozygotic (identical twins) and 9% for fraternal (non- identical twins) (Cookson 1996).
Weinberger and Hirsch (1995) suggested that People who have a close relative with schizophrenia are more likely to develop the disorder than are people who have no relatives with the illness. For example, a monozygotic twin of a person with schizophrenia has the highest risk – 40 to 50 percent – of developing the illness. A child whose parent has schizophrenia has about a 10 percent chance. By comparison, the risk of schizophrenia in the general population is about 1 percent (Jackson, 1960).
In adoption studies, children born to parents, of whom one or both are schizophrenic, are adopted early in life into a ‘normal’ family and these children are compared either with biological children of the adoptive parents or other adopted children whose biological parents are not schizophrenic. One study using the latter method was that of Heston (1966) - he compared 77 adopted children of schizophrenic mothers with 50 with non-schizophrenic mothers the results showed that the first group was five times as likely to hospitalized with schizophrenia then the second group.
The second area of the biological theory is the biochemical aspects. It has been proposed that what directly causes schizophrenic symptoms is an excess of the neurotransmitter dopamine. Grilly (2002) proposed that the neurotransmitter dopamine transmit too many messages, therefore produce symptoms of the disorder.
The evidence for this proposal comes from two main sources: the first, “post mortems of schizophrenics show usually high level of dopamine, especially in the limbic system, (Iversen, 1975);” secondly, the prescribed drugs for schizophrenia (such as chlorpromazine) work by binding to dopamine receptor sites. However others believe that even though schizophrenics may have higher then natural levels of dopamine; this may be the result of having the schizophrenia not having the high level of dopamine (Lloyd et al 1984). Even though dopamine were found to be a causative factor, this could be due to other factors such as, abnormal; family circumstances
Some scientists believe that schizophrenia may be a neurodevelopmental disorder in which the brain fails to develop normally. There are now vast amounts of evidence of structural abnormalities in the brains of schizophrenics, which Johnson described as ‘powerful evidence that schizophrenia is a brain disease’.
Stevens (1982) found in his study that many people with schizophrenia display symptoms that clearly indicate neurological disease, especially in relation to eye movement. (Symptoms included decreased rate of eye blinking poor visual pursuit movements and papillary reactions to light).
A second line of evidence are post –mortems conducted by Stevens which suggested the disease occurred earlier in life and had partially healed or one that was slowly progressing at the time of death. There is evidence to suggest that at least some schizophrenics have undergone difficult births in which the brain might have suffered a lack of oxygen (Harrison, 1995).
The psychological theory can be categorized in three areas including psychodynamic, behavioral and cognitive perspectives. The psychodynamic explanation of schizophrenia which has been led by Freud (1924, 1915) proposes that schizophrenia develops from two different psychological processes, the first is the regression to the ego stage the second the effort to reestablish ego control. ‘Initially, regressive symptoms occur, and the individual may experience delusions of self importance’ (Gross et al 2004). Fantasies become confused with reality, which gives delusions and hallucinations as the ego attempts to regain reality.
More simply stated- the disorder results from an ego that has difficulty in distinguishing between the self and the external world. Freud believed that schizophrenia occurred when a person’s ego either became overwhelmed by the demands of the id or was overwhelmed by unbearable guilt from the superego.
According to the behavioral model, schizophrenia can be explained in terms of condition and observational learning. Supporters of the behavioral model argue that people show schizophrenic behavior when it is more likely than normal behavior to receive reinforcement. For example Ullman and Krasner (1969) suggested that in “psychiatric institutions hospital staff may unintentionally reinforce schizophrenic behavior by paying more attention to those who display the characteristics of the disorder.” Other patients can ‘acquire’ the characteristics of schizophrenia by observing schizophrenic patients that are being reinforced for behaving bizarrely, in the same way children who disrupt classes get more attention from the teacher then those children that are non-disruptive.
The cognitive model proposes that schizophrenia may be the result in a break down in the ability to selectively attend to material. The characteristic evident in schizophrenia in relation to the cognitive aspects are those involving thought, perception, attention and language. Maher (1968) sees ‘the bizarre use of language in schizophrenia as a result of a fault in the way in which information is processed.’
A leading cognitive explanation of schizophrenia agrees with the biological view that ‘during hallucinations and related perceptual difficulties the brains of people with schizophrenia produce “strange and unreal” sensations that are triggered by biological factors. According to the cognitive explanation though, further features of the disorder occur when individuals attempt to understand their unusual experiences’ (Comer 2004).
Researchers have found that people with schizophrenia do indeed experience perceptual and sensory problems. Many of them have hallucinations and have problems keeping their attention focused (Elkins & Cromwell, 1994).
In conclusion although the severity of any disorder is specific to the individual, most individuals would agree that schizophrenia is probably the most serious of all mental disorders. Scientists and researchers have studied many factors in schizophrenia, but still it has not been proven beyond doubt that schizophrenia is a disease entity which only has just one single cause, but however has a range of causes (Jackson, 1960). It appears that the interaction of a number of factors, including genetic factors, complications of pregnancy and delivery that may affect the developing brain, and biological psychological and social stresses, all play a role in the development of the illness (Weinberger & Hirsch, 1995).
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