Clinical Psychology
Social explanations of schizophrenia;
Validity – different types
Sociocultural explanations
• People diagnosed with
schizophrenia tend to be the lower
socioeconomic groups and live in
the poorest areas of cities – can you
think of any reasons for this?
• Thus social and psychological
factors may be important
Sociocultural explanations
• Sociogenic hypothesis - poor social
conditions create stresses that trigger
schizophrenia in some people
• Stressful life events
• Brown and Birley (1968) - about 50% of
patients experienced a stressful event in
the 3 weeks prior to an episode
• This suggests that stressful experience
may trigger the schizophrenic episode
Sociocultural explanations
• Stressful life events longitudinal study
• Hirsch et al (1996) analysed life events
experienced by 71 schizophrenic patients over 4
years and found that the cumulative effect of
stressful life events in the 12 months prior to a
schizophrenic episode has a significant effect
• This suggests that it is the total stress rather than
one stressful event that acts as a trigger
Sociocultural explanations
• Family relationships
• Some psychologists suggest that family
relationships with ‘abnormal’
communication styles may create highly
stressful environments
• McGlashan (1994) suggested that
expressed emotion (EE) comprises critical
or emotionally over-involved attitudes and
behaviours displayed by one or more
parents to their schizophrenic offspring
Sociocultural explanations
• Family relationships - evidence
• Research into EE suggests that family
dynamics are an important predictor of
relapse of positive symptoms
• Brown el al (1972) and Vaughn et al (1976)
established the detrimental effects of
ineffective medication and high face-toface contact (over 35 hours per week) on
relapse rates of patients living in high-EE
families
Sociocultural explanations
• Family relationships - cross cultural
evidence
• Leff et al (1987) found that high-EE in
Indian families is also associated with
relapse.
• Concluded that the significantly better
outcome for Indian patients compared to a
London cohort was due to the lower
proportion of high-EE relatives in the
Indian study group
Sociocultural explanations
• Family relationships - STRESS in the
family
• Levene et al (1996) assessed the stress
experienced by families coping with
schizophrenic patients
• Suggests that the “Perceived Family
Burden Scale”, an instrument measuring
patient behaviour and family stress,
demonstrates greater predictive power for
early relapse in schizophrenia than EE
Types of validity
• Criterion validity – concurrent:
• When the result of a study matches the
result from another study which has been
conducted at the same time
• Applied to the DSM – if a diagnosis using
the DSM criteria matches another
diagnosis given at the same time, the
DSM diagnosis is likely to have
concurrent validity
Types of validity
• Criterion validity – predictive:
• The same as concurrent validity –
EXCEPT results of studies conducted at
a different time are compared
• Applied to the DSM - if a diagnosis using
the DSM criteria matches another
diagnosis given at an later time, the DSM
diagnosis is likely to have predictive
validity