Psychological: Family Dysfunction (AQA A-Level Psychology): Revision Notes
Psychological: Family Dysfunction
Overview
Family dysfunction is a psychological explanation for schizophrenia that suggests maladaptive relationships and communication patterns within families act as sources of stress that can cause or influence the development of schizophrenia. This approach views the disorder as resulting from environmental and interpersonal factors rather than purely biological causes.
This psychological explanation shifts focus away from purely biological models to consider how family environments and relationship dynamics might contribute to the development and maintenance of schizophrenia.
Characteristics of dysfunctional families
Research has identified three main types of dysfunctional characteristics commonly found in families of people with schizophrenia:
- High levels of interpersonal conflict - frequent arguments and disputes between family members
- Difficulty communicating with each other - poor communication patterns and misunderstandings
- Being excessively critical and controlling - parents who are overly harsh in their judgements and attempt to control their children's behaviour
These patterns create a stressful family environment that may contribute to the onset or maintenance of schizophrenic symptoms. The stress from these dysfunctional patterns is thought to act as a trigger for those who may be vulnerable to developing schizophrenia.
Double bind theory
Double bind theory, developed by Bateson and colleagues (1956), describes contradictory situations that children may be placed in by their parents. This occurs when a verbal message is given but the opposite behaviour is exhibited by the parent.
Example of Double Bind Communication:
A parent might tell a child to "be more spontaneous", but when the child acts spontaneously, they become confused and uncertain because they are being told to do something that, by definition, cannot be forced. This creates a no-win situation for the child.
The theory suggests this leads to:
- Negative reactions and social withdrawal
- Lack of emotional expression as a way to escape these contradictory situations
- Confusion and uncertainty in the child
Expressed emotion
Expressed emotion refers to families that persistently exhibit criticism and hostility. This has a particularly negative influence on people recovering from schizophrenia. When individuals return to their families and encounter expressed emotion, they often react by relapsing into an active phase of the disorder, experiencing severe positive symptoms such as hallucinations and delusions of persecution.
Expressed emotion is one of the strongest predictors of relapse in schizophrenia, making it a critical factor in understanding both the maintenance and recovery process of the disorder.
Research evidence
Several studies provide support for the family dysfunction explanation:
Research Study: Tienari et al. (2004) - Adoption Study
- Found that schizophrenia levels in adopted individuals who were biological children of schizophrenic mothers was 5.8% when adopted by healthy families
- This compared with 36.8% for children raised in dysfunctional families
- This supports both the family dysfunction theory and suggests that those with genetic vulnerability are more affected by environmental stressors
Research Study: Patino et al. (2005) - Migration Study
- Established seven problems associated with family dysfunction: poor adult relationships, lack of warmth between parents and child, visible disturbance in mother-child/father-child/sibling relationships, parental overprotection, and child abuse
- Found that migrants who had experienced at least three of these problems had four times the normal level of vulnerability to developing schizophrenia
- Those not experiencing family dysfunction had double the level of risk, suggesting family dysfunction increases the likelihood of life stressors triggering schizophrenia onset
Research Study: Bateson (1956) - Case Study Evidence
- Reported on a patient recovering from schizophrenia who was visited in hospital by his mother
- When he embraced her warmly, she stiffened, and when he withdrew his arms she asked "Don't you love me any more?"
- When he blushed, she commented "you must not be so easily embarrassed and afraid of your feelings"
- He then assaulted an aide and had to be restrained, providing support for the double bind concept
Research Study: Kavanagh (1992) - Meta-Analysis
- Reviewed 26 studies on expressed emotion
- Found that the mean relapse rate for people with schizophrenia returning to high expressed emotion families was 48%
- This compared with 21% for those returning to low expressed emotion families
- Supported by Butzlaff & Hooley (1998) who found people with schizophrenia in high expressed emotion environments experienced more than twice the average rate of symptom return
Evaluation
Strengths
- Research support: Therapies that focus on reducing expressed emotions within families show lower relapse rates compared with other therapies, providing practical validation
- Environmental evidence: Research consistently shows that family dysfunction plays a role in maintenance of the disorder, even if not necessarily causative
Weaknesses
- Direction of causality: Having a family member with schizophrenia can be problematic and stressful for family relationships. Rather than family dysfunctions causing schizophrenia, it could be that having someone with schizophrenia leads to family dysfunctions
- Incomplete explanation: The theory fails to explain why all children in dysfunctional families do not develop schizophrenia - there must be additional factors involved
- Research bias concerns: Bateson's double bind theory was initially popular among clinicians, but some critics accused him of selective bias, focusing only on aspects of interviews that supported his claims while ignoring contradictory evidence
- Limited causal evidence: Although there is a lack of general support for family dysfunction as a causal factor, research evidence does suggest it plays a major role in maintenance of the disorder
The evaluation highlights a key debate in psychology - whether family dysfunction is a cause or consequence of schizophrenia, and emphasises the importance of considering multiple factors in understanding complex mental health conditions.
Key Points to Remember:
- Family dysfunction focuses on maladaptive relationships and communication patterns as stress sources that contribute to schizophrenia development
- Three key dysfunctional characteristics are high conflict, poor communication, and excessive criticism/control
- Double bind theory describes contradictory parental messages that create confusion and withdrawal in children
- Expressed emotion (criticism and hostility) significantly increases relapse rates in people recovering from schizophrenia
- Research shows family dysfunction affects both development and maintenance of schizophrenia, particularly in those with genetic vulnerability