Family Dysfunction Explanation of Schizophrenia

• A person develops schizophrenia because they have been raised in a dysfunctional family environment 
• The family is dysfunctional because of the way its members communicate or interact with each other

• Parents communicate contradictory messages to their children 
• They say one thing but their tone or gestures or tone communicate the opposite 
• One message is conveyed on the verbal level but another is conveyed on the non verbal level

A parent tells her son she loves him whilst turning away in disgust

• The longer it goes on, the more the child will misinterpret the contradictory messages and the more confused they will get
• The child will assume they can do nothing but displease the parent and this will affect their ability to respond to them 
• Eventually the child's sense of reality is distorted leading to schizophrenic symptoms such as hallucinations

Schizophrenia development is augmented when someone is in a negative emotional climate

• Criticism (frequent critical comments made by the family)
• Hostility (statements of dislike or contempt made towards the person by the family)
• Emotional over involvement (over protectiveness by the parents/family)

Expressed emotion is a stress factor possibly causing or contributing to the development of schizophrenia

• Over 20 studies of expressed emotion were reviewed 
• 70% of schizophrenics in such families relapsed within a year 
• 30% of schizophrenics with families not displaying EE relapsed

• Only family communications and the environment are focussed on 
• Other factors such as biological factors are ignored

• It reduces a complex disorder such as schizophrenia down to only nurture 
• This implies that family communications and EE cause and determine our behaviour meaning we are helpless and have no control over our actions
• This is too simplistic and many who are brought up in a family with negative communication patterns do not become schizophrenics

• Evidence supporting the theory is flawed as it is based on self reports
• The theory is based on correlations, schizophrenia could cause someone to interpret communication as double bind

Schizophrenics reported a higher level of double bind than non schizophrenics

• The blame is placed on the mother, she can even be labelled as a schizophregenic mother meaning she can create a schizophrenic child by her communication 
• Does not account for children raised by their father

• Adopted children in Finland with schizophrenic parents were more likely than a control group with non schizophrenic parents to become schizophrenics themselves
• This difference only occurred when the adopted family was judged to be disturbed or dysfunctional
• This supports the diathesis stress model

There was no difference in patterns of communication in families with a schizophrenic child and families without

In a review of family studies, no evidence of a contradiction in verbal and non verbal messages between children with schizophrenia and parents

• EE play an important part in schizophrenia relapse
• The extent of emotional expression in families is a strong predictor of relapse rates amongst discharged patients
• 51% in high EE homes
• 13% in low EE homes

Families can be educated in controlling and reducing levels of EE which is effective in reducing relapse rates

• Studies are always carried out after the child has been diagnosed 
• The trauma of this diagnosis may cause the family to change their communication with parents leaving jobs to care for the children 
• EE could be caused by schizophrenia, not the other way around 

• It places blame on the family and focusses on early relationships with the mother as the cause
• This causes guilt and can be destructive to families that are already experiencing trauma after a diagnosis 

Family interactions may act as a trigger rather than a cause for schizophrenia 

Diathesis (biological vulnerability) + Stress (trigger caused by social or psychological factors) = Disorder (mental illness or schizophrenia)