Many psychologists agree that there are several factors outside of the patient’s wellbeing that can affect the risk of schizophrenia. These include: life events, family relationships and labelling theory.
Stress can have a major effect on the risk somebody is at from schizophrenia. We are unsure of why and how stress can increase the risk of schizophrenia, however many psychologists believe that the high arousal from stress can trigger changes in neurotransmitters, which then leads to the higher risk.
Life events, such as marriage, bereavement, divorce or job changes, can result in high levels of stress, which in turn can lead to high arousal levels. This is why many psychologists hold the view that major life events can increase the risk of developing schizophrenia.
Evaluation of Life events
Not all research agrees with the idea that life events can lead to schizophrenia. Van Os et al found no link between life events and the onset of schizophrenia.
Another weakness of this theory is that it could be that schizophrenia causes the life events, not the other way around. An example of this could be that a person starts to show schizophrenic behaviour, and because of this the person is fired from their job, which is a major life event.
There are two main theories behind how families can increase the risk of schizophrenia, the double-bind theory and expressed emotion.
Double Bind Theory – Bateson said that families can often give contradictory messages, for example a mother comforting a child whilst appearing angry. This gives the child mixed messages and can result in an ‘incoherent construction of reality’ which in the long run could lead to schizophrenic symptoms.
Expressed Emotion – Expressed emotion, or EE, is where there is a high level of emotion in a family. For example, a family who constantly argue and fight would have high EE. Although expressed emotion rarely results in the onset of schizophrenia many psychologists, for example Kalafi and Torabi, agree that high EE can result in the relapse back into schizophrenia of a recovering patient. This could be explained by the high EE resulting in high stress levels.
Evaluation of family relationships
A study by Tienari, in which he compared the concordance rate between adopted children with schizophrenic biological parents and non-schizophrenic biological parents, showed that those with schizophrenic biological parents had a much higher risk of schizophrenia that those without schizophrenic biological parents. This suggests that actually the upbringing a family gives, including the double-bind and expressed emotion theories, might not have as much important as the genetic factors.
However, there is some evidence in support of family relationships as a risk factor of schizophrenia. For example, Berger found that many more schizophrenics could recall their mothers telling them double-blind statements than non-schizophrenics.
Scheff (1999) said that social groups create rules for their members to follow. The symptoms of schizophrenia don’t fit with said rules, so society labels that person as schizophrenic. The person then fulfils this ‘label’ and starts displaying behaviour of the other symptoms of schizophrenia (self-fulfilling prophecy). So a person can start by showing on symptom of schizophrenia eventually, and due to the labelling they receive, they will become fully schizophrenic. Scheff called this the labelling theory.
Evaluation of labelling theory as a risk factor of schizophrenia
Scheff evaluated 18 studies and found that 13 of the studies were consistent with his theory, this suggests that how someone is labelled does effect the risk they are at from schizophrenia.