Evolution of Representations Regarding Family Relations in the Development and Course of Schizophrenia

1899

Abstract

The study considers the scientific views on the role of family relationships in the development and progress of schizophrenia, which have undergone a serious transformation during the last century. Earlier on, adepts of the psychoanalytic approach considered certain patterns of early interactions with the mother and significant others as a pathogen contributing to the development of schizophrenia in children, which caused stigmatization and significant distress of the patients’ relatives. According to the modern approach, close relatives of the patients are viewed firstly as people suffering in their situation and requiring psychological support, and secondly as one of the main factors defining the patient’s rehabilitation potential. The modern views refer to the fact that adequate family relationships can positively influence the opportunities of social adaptation of the patient, reduce the disease recurrence and contribute to an increased compliance. At the same time, negative relationships produce the opposite effect. Thus, examining the peculiarities of the patient’s family relations can be considered an undoubtedly important task, together with developing and implementing specialized psychosocial family interventions.

General Information

Keywords: schizophrenia, family interventions, schizophrenogenic mother, double bind, main caregiver, family burden

Journal rubric: Research Reviews

Article type: scientific article

DOI: https://doi.org/10.17759/cpp.2019270104

For citation: Getmanenko I.A., Trusova A.V. Evolution of Representations Regarding Family Relations in the Development and Course of Schizophrenia. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2019. Vol. 27, no. 1, pp. 48–63. DOI: 10.17759/cpp.2019270104. (In Russ., аbstr. in Engl.)

References

  1. Gurovich I.Ya., Shmukler A.B. Praktikum po psikhosotsial’nomu lecheniyu i psikhosotsial’noi reabilitatsii psikhicheski bol’nykh [Workshop on psychosocial therapy and psychosocial rehabilitation of mentally ill]. Moscow: Medpraktika, 2007. 179 p.
  2. Konovalova A.Kh., Kholmogorova A.B., Dolnykova A.A. Reprezentatsii roditel’skoi sem’i u bol’nykh shizoaffektivnymi rasstroistvami i shizofreniei [Representations of the parental family in patients with schizoaffective disorder and schizophrenia]. Konsul’tativnaya psikhologiya i psikhoterapiya [ Counseling Psychology and Psychotherapy], 2013, no. 4, pp. 70—95. (In Russ., abstr. in Engl.).
  3. Rychkova O.V. Issledovaniya sotsial’nogo poznaniya pri shizofrenii [Modern investigations of social cognition in schizophrenia]. Konsul’tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2013, no. 1, pp. 63—89. (In Russ., abstr. in Engl.).
  4. Rychkova O.V., Kholmogorova A.B. Osnovnye teoreticheskie podkhody k issledovaniyu narushenii sotsial’nogo poznaniya pri shizofrenii: sovremennyi status i perspektivy razvitiya [The main theoretical approaches to the study of disorders of social cognition in schizophrenia: current status and prospects of development]. Konsul’tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2014. Vol. 22 (4), pp. 30—43. (In Russ., abstr. in Engl.).
  5. Kholmogorova A.B., Volikova S.V., Sorokova M.G. Standartizatsiya oprosnika “Semeĭnye emotsional’nye kommunikatsii” [Standardization of the test “Family Emotional Communication”]. Konsul’tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2016. Vol. 24 (4), pp. 97—125. doi:10.17759/cpp.2016240405. (In Russ., аbstr. in Engl.).
  6. Kholmogorova A.B. Psikhoterapiya shizofrenii za rubezhom [Psychotherapy of schizophrenia abroad]. Moskovskii psikhoterapevticheskii zhurnal [ Moscow Psychotherapeutic Journal], 1993, no. 1, pp. 77—112.
  7. Kholmogorova A.B., Konovalova A.Kh. Reprezentatsii roditel’skoi sem’i u bol’nykh shizofreniei [Representations of the parental family in patients with schizophrenia spectrum disorders]. Konsul’tativnaya psikhologiya i psikhoterapiya [Counseling Psychology and Psychotherapy], 2013, no. 1, pp. 90—113. (In Russ., аbstr. in Engl.).
  8. Bateson G., Jackson D., Haley J., et al. Toward a Theory of Schizophrenia. Behavioural Science, 1956. Vol. 1 (4), pp. 251—264. doi:10.1002/bs.3830010402
  9. Bauer R., Koepke F., Sterzinger L., et al. Burden, Rewards, and Coping The Ups and Downs of Caregivers of People With Mental Illness. The Journal of Nervous and Mental Disease, 2012. Vol. 200 (11), pp. 928—934. doi:10.1097/NMD.0b013e31827189b1
  10. Bernard J., Gallagher I., Brian J. Neglect and hereditary risk: Their relative contribution to schizophrenia with negative symptomatology. International Journal of Social Psychiatry, 2016. Vol. 62 (3), pp. 235—242. doi:10.1177/0020764015623974
  11. Bland R., Darlington Y. The nature and sources of hope: perspectives of family caregivers of people with serious mental illness. Perspective Psychiatric Care, 2002. Vol. 38 (2), pp. 61—68. doi:10.1111/j.1744-6163.2002.tb00658.x
  12. Bove E. Cognitive performance and basic symptoms in first-degree relatives of schizophrenic patients. Comprehensive Psychiatry, 2008. Vol. 49 (4), pp. 321—329. doi:10.1016/j.comppsych.2008.01.001
  13. Bowen M. A Family Concept of Schizophrenia. In Jackson D.D. (ed.). The Etiology of Schizophrenia. Oxford, England: Basic Books, 1960, pp. 346—372. doi. org/10.1037/10605-012
  14. Bowen M. Family relationships in schizophrenia. In Auerback A. (ed.). Schizophrenia — An Integrated Approach. New York: The Ronald Press, 1959, pp. 147—178.
  15. Brown G., Birley J. Crises and life changes and the onset of schizophrenia. Journal of Health and Social Behavior, 1968. Vol. 9 (3), pp. 203—219. doi:10.2307/2948405
  16. Chae S., Minyoung S., Mijeong L., et al. Multivariate Analysis of Relationship between Childhood Trauma and Psychotic Symptoms in Patients with Schizophrenia. Psychiatry Investigations, 2015. Vol. 12 (3), pp. 397—401. doi:10.4306/pi.2015.12.3.397
  17. Cechnicki A., Bielańska A., Hanuszkiewicz I., et al. The predictive validity of Expressed Emotions (EE) in schizophrenia. A 20-year prospective study. Journal of Psychiatric Research, 2013. Vol. 47 (2), pp. 208—214. doi:10.1016/j. jpsychires.2012.10.004
  18. Chou K. Caregiver burden: a concept analysis. Journal of Pediatric Nursing, 2000. Vol. 15 (6), pp. 398—407. doi:10.1053/jpdn.2000.16709
  19. Doane J. Family Interaction and Communication Deviance in Disturbed and Normal Families. Family Process, 2004. Vol. 17 (3), pp. 357—376. doi:10.1111/ j.1545-5300.1978.00357.x
  20. Freud S. Inhibitions, symptoms and anxiety. In Strachey J. (ed.). The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XX (1925— 1926): An Autobiographical Study, Inhibitions, Symptoms and Anxiety, The Question of Lay Analysis and Other Works. London: Hogarth Press, 1959, pp. 87—157.
  21. Fromm-Reichmann F. Psychoanalytic Psychotherapy and Thought in Schizophrenia: Collected With Psychotics. Psychiatry, 1943. Vol. 6, pp. 277—279.
  22. Klein M. The Psychoanalysis of Children (Vol. 2). London: Hogarth Press, 1946. 221 p.
  23. Kumar C., Suresha K., Thirthalli J., et al. Caregiver burden is associated with disability in schizophrenia. International Journal of Social Psychiatry, 2015. Vol. 61 (2), pp. 157—163. doi:10.1177/0020764014537637
  24. Kymalainen J., Weisman A., Rosales G., et al. Ethnicity, expressed emotion, and communication deviance in family members of patients with schizophrenia. Journal of Nervous & Mental Disease, 2006. Vol. 194 (6), pp. 391—396. doi:10.1097/01. nmd.0000221171.42027.5a
  25. Lauber C., Eichenberger A., Luginbuhl P., et al. Determinants of burden in caregivers of patients with exacerbating schizophrenia. European Psychiatry, 2003. Vol. 18 (6), pp. 285—289. doi:10.1016/j.eurpsy.2003.06.004
  26. Leff J. Working with the families of schizophrenic patients. British Journal of Psychiatry, 1994. Vol. 164 (1), pp. 71—76.
  27. Mackay C., Pakenham K. A stress and coping model of adjustment to caring for an adult with mental illness. Community Mental Health Journal, 2012. Vol. 48 (4), pp. 450—462. doi:10.1007/s10597-011-9435-4
  28. Maga A., Goldstein J., Karno M., et al. A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatry Research, 1986. Vol. 17 (3), pp. 203—212. doi:10.1016/0165-1781(86)90049-1
  29. Maurin J., Boyd C. Burden of mental illness on the family: a critical review. Archives of Psychiatric Nursing, 1990. Vol. 4 (2), pp. 99—107. doi:10.1016/0883- 9417(90)90016-E
  30. Miklowitz D. Family risk indicators in schizophrenia. Schizophrenia Bulletin, 1994. Vol. 20 (1), pp. 137—149. doi:10.1093/schbul/20.1.137
  31. Parabiaghi A., Lasalvia A., Bonetto C., et al. Predictors of changes in caregiving burden in people with schizophrenia: A 3-year follow-up study in a community mental health service. Acta Psychiatrica Scandinavica, 2007. Vol. 116 (s437), pp. 66—76. doi:10.1111/j.1600-0447.2007.01094.x
  32. Rajkumar R. The Impact of Childhood Adversity on the Clinical Features of Schizophrenia. Schizophrenia Research and Treatment, 2015. Vol. 2015, pp. 1—7. doi:10.1155/2015/532082
  33. Read J., Findk P., Rudegeair T., et al. Child maltreatment and psychosis: a return to a genuinely integrated bio-psycho-social model. Clinical Schizophrenia Related Psychoses, 2008. Vol. 2 (3), pp. 235—254. doi:10.3371/CSRP.2.3.5
  34. Sanders S. Is the glass half empty or full? Reflections on strain and gain in caregivers of individuals with Alzheimer’s disease. Social Work Health Care, 2005. Vol. 40 (3), pp. 57—73. doi:10.1300/J010v40n03_04
  35. Seeman M. The changing role of mother of the mentally ill: From schizophrenogenic mother to multigenerational caregiver. Psychiatry: Interpersonal and Biological Processes, 2009. Vol. 72 (3), pp. 284—294. doi:10.1521/psyc.2009.72.3.284
  36. Thompson M., Kingree J., Lamis D. Associations of adverse childhood experiences and suicidal behaviors in adulthood in a U.S. nationally representative sample. Child: Care, Health and Development, 2018. Vol. 45 (1), pp. 121—128. doi:10.1111/ cch.12617
  37. Varese F., Feikje S., Drukker M., et al. Childhood Adversities Increase the Risk of Psychosis: A Meta-analysis of Patient-Control, Prospective- and Cross-sectional Cohort Studies. Schizophrenia Bulletin, 2012. Vol. 38 (4), pp. 661—671. doi:10.1093/ schbul/sbs050
  38. Wang X., Chen Q., Yang M. Effect of caregivers’ expressed emotion on the care burden and rehospitalization rate of schizophrenia. Patient Preference and Adherence, 2017. Vol. 11, pp. 1505—1511. doi:10.2147/ppa.s143873
  39. Wearden A., Tarrier N., Barrowclough C., et al. A review of expressed emotion research in health care. Clinical Psychology Review, 2000. Vol. 20 (5), pp. 633—666. doi:10.1016/S0272-7358(99)00008-2
  40. Weisman A., Duarte E., Koneru V., et al. The development of a culturally informed, family focused, intervention for schizophrenia. Family Process, 2006. Vol. 45 (2), pp. 171—186.
  41. Weisman A., Gomes L., Lopez S. Shifting blame away from ill relatives: Latino families reactions to schizophrenia. Journal of Nervous & Mental Disease, 2004. Vol. 191 (9), pp. 574—581. doi:10.1097/01.nmd.0000087183.90174.a8

Information About the Authors

Iana A. Getmanenko, Clinical Psychologist, Department Specializing in First Episode Psychosis, St. Petersburg Psychiatric Hospital №3 named after I.I.Skvortsov-Stepanov, St.Petersburg, Russia, e-mail: Yana.getmanenko@gmail.com

Anna V. Trusova, PhD in Psychology, Associate Professor, Department of Psychology, Division of Medical Psychology and Psychophysiology, St. Petersburg State University, Researcher, Department of Addictions, V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St.Petersburg, Russia, ORCID: https://orcid.org/0000-0002-0921-4203, e-mail: anna.v.trusova@gmail.com

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