This article is about schizophrenia; but does a good job at highlighting the bi-psycho-social model currently accepted in the field of mental health, and it speaks of ‘mental illness’ generally, as well the factors seen as contributing or increasing the risk of schizophrenia.
Schizophrenia: Psychological and Social Causes and Treatments
Read more… Psycho-social Treaments · Schizophrenia Biology · Schizophrenia Causes, Risk Factors & Prevention · Schizophrenia Education
As we’ve reported in the past, research is revealing the specific aspects of family and environmental stressors that interact continually over time with a biologically predisposed brain to eventually trigger schizophrenia.
Related to this topic, Researcher William McFarlane, M.D., a Maine Medical Center-based researcher we’ve mentioned before, was recently awarded the APA/American Psychiatric Foundation 2007 Alexander Gralnick Award for Research in Schizophrenia. After receiving the award, Dr. McFarlane presented a lecture, titled “Biosocial Treatment of Schizophrenia”. In his lecture Dr. McFarlane made some interesting points on the subject of the development and outcomes in schizophrenia. Some of his points are very relevant to past findings on the causes, preventative actions, and treatments for schizophrenia we’ve covered before. Here’s a summary:
Dr. McFarlane discussed the fact that it is now known that schizophrenia is a disorder that develops overtime as a result of genetic / biological and environmental factors. So for example, if a child already has increased genetic risk due to a family history of schizophrenia and/or other mental illnesses, certain environmental stressors (such as a home environment that is frequently highly emotional, or judgemental), combine with these genetic susceptibilities and result in the development of mental disorders.
One important point that Dr. McFarlane stressed was that:
“a decade’s worth of research on microcomponents of environmental stress affirms the genetic nature of schizophrenia and does nothing to revive long-discredited theories blaming families or “schizophrenogenic” mothers.
Time and again research has shown that family and environmental stressors  encompassing very subtle interactions common to many families  work only in tandem with biological determinants to produce psychosis [and schizophrenia].”
Dr. McFarlane discussed that even until recently, environmental triggers were thought of as discrete events (for example, extreme stress due to a single event such as a loss of a mother, or extreme abuse), however current research demonstrates that some environmental triggers are continuous. (An example of a “continuous” environmental trigger might be again, a family environment where there is frequent highly emotion levels, high anxiety and conflict (or judgment and pressure) and therefore significant levels of stress in the home).
Dr. McFarlane further explained that continuous triggers can combine with inherent susceptibilities to mental disorders and result in the development and then worsening of prognosis after development of mental disorders. A model Dr. McFarlane used, that he believes does a good job of explaining this relationship, is that of a helix; that is, the cause and effect are closely entwined.
Of all the biologically determined psychosocial sensitivities believed to contribute to the development of schizophrenia and psychosis, the most subtle are negative emotional experiences.
It is especially the family with high “expressed emotion” for which there is the most research studies and data. High expressed emotion refers to the rejection, criticism, and anxious over-involvement that can occur between children and parents and other family members. It isn’t that anyone is to “blame” for this - its simply that sometimes there is a negative dynamic between parent and child that causes a great deal of stress. Its important for parents to try to avoid these situations or minimize them.
As Dr. McFarlane says, some people predisposed to schizophrenia or just developing “symptoms seem to elicit certain kinds of rejecting or anxious responses, which in themselves elicit more symptoms,” … “Who do you blame? It’s really a no-fault situationâ€â€the family is doing something, but they are only responding to the disorder. The negativity is reciprocal.”
The key message here is that the psychological and social environment affects the biology of a person and vice-versa, so that both are in constant, continual interaction. This idea brings up the issue of less controllable versus more controllable factors of a mental disorder.
For example, the genetic vulnerability to a mental disorder isn’t controllable, but certain environmental factors are: One of the most widely examined continual environmental triggers of mental illness and as mentioned above is the frequent experience of a highly emotional environment. In an attempt to combat this problem, researchers have studied preventative methods and found that adopting the growth, mindset approach is one way to effectively control stress factors in the environment. (Stress is known to increase the likelihood of the development of mental disorders.)
Dr. McFarlane also emphasized the importance of psychoeducation, stating that psychoeducational “…groups are designed to empower family members with information about the disease and the kind of social interactions that can exacerbate symptoms in the affected family member…In highly structured sessions, multifamily groups are taught specific strategies for lowering anxiety, conflict, and expressed emotion.”
Read the full Article: Psychosocial Interventions Beneficial in Schizophrenia. (Psychiatric News)
