Psychopathology:
Schizophrenia
UNIT 4: PSYA4
lcb@beauchamp.org.uk
Topic Content
In relation to their
chosen disorder:
1.
2.
3.
4.
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
Schizophrenia
Depression

Phobic disorders
OCD

Candidates should
be familiar with the
following:
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
Clinical characteristics of the chosen disorder.
Issues surrounding the classification and diagnosis of
their chosen disorder, including reliability and
validity.
Biological explanations of their chosen disorder, for
example, genetics, biochemistry.
Psychological explanations of their chosen
disorder, for example, behavioural, cognitive,
psychodynamic and socio-cultural.
Biological therapies for their chosen disorder,
including their evaluation in terms of appropriateness
and effectiveness.
Psychological therapies for their chosen disorder, for
example, behavioural, psychodynamic and cognitivebehavioural, including their evaluation in terms of
appropriateness and effectiveness.
Psychological explanations of
schizophrenia
1. Psychodynamic – Freud (1924).
2. Socio-cultural – double-bind theory
(Bateson et al, 1956) and expressed
emotion.
3. Cognitive – metarepresentation and central
control (Frith, 1992).
Psychodynamic Explanation –
Freud (1924)
 He believed that the origins of mental disorder, i.e.
schizophrenia, lie in the unresolved conflicts of
childhood which are unconscious.
 Freud’s theory of personality states that we have
three components in our personality – the id, ego
and superego – which we develop during different
stages of our life.
Id, Ego and Superego
 At birth, personality ruled by id (driven by the pleasure
principle – an innate drive to seek immediate satisfaction
– it gets what it wants).
 By age one the ego develops as a consequence of
experience with reality (it cannot always get what it
wants).
 Around age 5 the superego emerges (embodies our
conscience and our sense of right or wrong).
 These develop during different stages of our life.
Stages of psychosexual development
 Oral phase –infant obtains satisfaction from eating
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and sucking (up to 18 months).
Anal phase– child derives satisfaction from the
anal region (18-36 months).
Phallic phase– genitals become a source of
satisfaction (3-6 years).
Latency phase – boys and girls spend little time
together (age 6 to puberty).
Genital phase– genitals main source of sexual
pleasure (onset of puberty onwards).
Stages of psychosexual development
 If a child experiences severe problems or excessive
pleasure at any stage this leads to fixation (basic
energy or libido becomes attached to that stage for
many years).
 Later in life, adults who experience very stressful
conditions show regression (behaviour becomes less
mature and like that displayed during a
psychosexual stage at which they fixated as
children).
More Freud…
 Throughout life the id, ego and superego are in
conflict because each represents different motives –
pleasure, reality and ideal behaviour.
 This conflict causes anxiety.
 In order to reduce this anxiety the ego uses
unconscious ‘defence mechanisms.’
 These include repression (putting unpleasant
thoughts in the unconscious), projection (blaming
someone else), denial, displacement (venting
anger elsewhere), and regression (behaving like a
child).
Pair task
 Complete the gap-fill in your booklets of Freud’s
psychodynamic explanation of schizophrenia.
Answers
 Freud (1924) believed that schizophrenia was the result of two related processes;
regression to a pre-ego state (i.e. the id) and attempts to re-establish ego control. He
believed that most adults with schizophrenia experienced very harsh childhood
environments, often because they were raised by cold, uncaring and unsupportive
parents. This means that they often fixated at the early stages of psychosexual
development (e.g. oral stage). Schizophrenia develops when the adult regresses to the
earliest stage of development, before his or her ego had developed (i.e. to the id,
where the focus of all a person’s attention was on themselves and satisfying their own
basic needs.) As a result the person ceases to operate on the basis of the reality
principle and so loses touch with reality. The regression to very early childhood leads
to symptoms such as delusions of grandeur and the creation of neologisms (new
words). When individuals with schizophrenia find themselves reduced to an infantile
stage they try hard to regain contact with reality and attempt to re-establish ego
control. For example, the auditory and visual hallucinations were believed to be the
result of the sufferer’s attempts to regain some contact with the real world.
Evaluation (A02)
 A great deal of research has found that the parents of
the vast majority of schizophrenic sufferers are not
cold and uncaring, as Freud described them, but are
sensitive and caring individuals, scared and
devastated by their child’s illness.
 This contradicting research therefore criticises the
basis of the psychodynamic explanation of
schizophrenia according to Freud (1924).
Evaluation (A02)
 The psychodynamic explanation of schizophrenia is very complex as
it involves assumptions about defence mechanisms and stages of
psychosexual development.
 There is very little support for these assumptions as they are
abstract concepts.
 These are difficult to measure (as not actual physical things and
are unconscious).
 Therefore the theory is difficult to prove wrong (unfalsifiable - not
able to be proven false but also not necessarily true).
 This limits the validity of the theory as an explanation for
schizophrenia.
Socio-cultural explanations of
schizophrenia
 Read the information on the Double Bind Theory by
Bateson et al (1956) in your booklets.
 Answer the 7 questions in your booklets to check
your understanding of the theory.
Mischler and Waxler (1968)
 Found that mothers talking to their schizophrenic daughters were
aloof and unresponsive, but behaved in a much more normal and
responsive way with their non-schizophrenic children.
 What does ‘aloof’ mean?
Reserved, indifferent, detached.
 However it could be argued that this communication problem might
be the result of the disorder rather than the cause.
 This therefore highlights a major flaw in this theory.
 Since the schizophrenia must have been identified before the family
could be studied, the communication could be an effect of the
disorder.
Liem (1974)
 Measured patterns of parental communication in
families with a schizophrenic child and families with
a non-schizophrenic child.
 Found no difference in parental communication
between the two groups.
 Therefore there is little evidence to provide strong
support for the double bind theory of schizophrenia,
which means the theory lacks validity.
Supporting research for EE
 Linszen et al (1997) - A patient returning to a
family with high EE is 4 times more likely to relapse
than a patient who returns to a family low in EE.
 Supported by similar findings from Brown (1972).
 This suggests that a negative emotional climate (high
in EE) in these families arouses the sufferer and
leads to stress beyond their already impaired coping
mechanisms, thus triggering a schizophrenic episode
(i.e. relapse).
Exam focus
 In the exam they could ask you the following
question, although it has never come up before.
 “Outline and evaluate one psychological
explanation of schizophrenia. (8+16 marks)
 IF this question did come up, you would want to use
the umbrella term of ‘family relationships’ as your
psychological (i.e. socio-cultural) explanation. This
allows you to write about the double bind theory
AND expressed emotion. 
Attention Deficit Theory: ANSWERS
Frith (1979) suggested that schizophrenia is the result of a faulty
attentional system. Preconscious thought (i.e. thought that
occurs without awareness) contains huge amounts of information
from our senses that would normally be filtered, leaving only a
small amount to enter into conscious thought. Schizophrenia is the
result of a breakdown of this filtering process, resulting in an
overload (i.e. thoughts that would normally be filtered out as
irrelevant or unimportant are now interpreted in conscious
awareness as more significant than they really are). This means
that the individual is overloaded with external stimuli which they
are unable to interpret appropriately and so they experience the
world very differently to the rest of us. Because there is a problem
with attention, schizophrenics have difficulty focusing on
anything for a period of time, giving the impression of disordered
thought. For Frith, this accounts for the positive symptoms of
schizophrenia such as delusions, auditory hallucinations and
disorganised speech.
Attention Deficit Theory
 McKenna (1994) – schizophrenics do not seem to be
any easier to distract than non-schizophrenics when
engaged on cognitive tasks.
 This goes against the suggestion that have faulty
attentional system.
 Therefore, this lack of experimental support questions
the validity of the theory in explaining the development
of schizophrenia.
 Led Frith to propose a second cognitive explanation of
schizophrenia (1992).
Metarepresentation (Freud, 1994)
 Is the ability to reflect on our thoughts, behaviour and
experience.
 It is the mental ability that allows us self-awareness of
our own intentions and goals.
 It also allows us to interpret the actions of others.
 Problems in our metarepresentation would seriously
disrupt our ability to recognise one’s own actions and
thoughts as being carried out by ‘me’ rather than
someone else.
Brown and Birley (1968)
 Studied patients with schizophrenia who had just
recently experienced a schizophrenic episode, and
compared them with a healthy control group.
 50% of these schizophrenic patients had experienced
at least one major life event in the 3 weeks
beforehand.
 This suggests life events can trigger a schizophrenic
episode, providing support for valid theory.
Evaluation (A02)
 A criticism of this research is that it uses retrospective
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data.
This is because…it relies on patients reports of the nature
and timing of life events.
It could be argued that the timing of life events may have
been distorted by the sufferer to ‘explain’ or ‘justify’ their
schizophrenic episode.
Also, memory is not always 100% accurate so their
memory for life events may have been altered, therefore
reducing the validity of the findings.
If the research findings are not valid this weakens the
support for the theory.
Evaluation (A02)
 Another criticism is that this is correlational
research; there is a link between life events and
schizophrenia.
 This means…that it is difficult to establish cause and
effect.
 It could be that life events triggered the onset of a
schizophrenic episode (e.g. death of a loved one) OR
that the onset of a schizophrenic episode was the
cause of the life events (e.g. divorce).
Diathesis-stress model
According to this model the occurrence of
psychological disorders like schizophrenia depends on
two factors: 1. Diathesis: a genetic vulnerability or predisposition
to disease or disorder, i.e. schizophrenia.
2. Stress: some severe or disturbing environmental
event.
Diathesis-stress model
 There is clear evidence of a diathesis – i.e. genetic
vulnerability – for schizophrenia.
 However not everyone who inherits the genetic component
becomes schizophrenic (e.g. 48% concordance rate for MZ
twins, 46% for 2 schizophrenic parents).
 Therefore we could explain this in terms of the psychological
factors that trigger the disorder, such as stressful life events.
 In conclusion, it is clear that several factors play a
part in causing schizophrenia so a multi-dimensional
approach is needed in order to fully understand the
disorder.