The following is a first draft of a review that I will develop for publication.
The last 60 years of research with families of schizophrenics have produced some reliable observations that are worth thinking about and worth considering their implications for how we think about the development of severe psychopathology and then its course after it has emerged.
It is no coincidence that both genetics researchers and researchers of psychosocial factors have studied families of schizophrenics. The result has been that both types of researchers have found reliable observations that support their preferred model of etiology. On the genetics side, relatives of schizophrenics have both more schizophrenia and also more schizophrenia spectrum disorders than would be expected from the rates in the general population. And other researchers of the genetics persuasion have identified endophenotypes of the spectrum diagnoses and schizophrenia; putative intermediate manifestations of the underlying genetic vulnerability.
On the psychosocial side, parents with high communication deviance are more likely to have children who develop a schizophrenia spectrum disorder, especially when the child has a higher genetic risk, i.e. more of the endophenotype vulnerabilities.
Furthermore, it has been consistently observed that after the schizophrenia has emerged, high parental EE(expressed emotion criticism and over involvement) will predict more relapses in the patient. And at least one project suggests that EE-like parental criticism behavior plays a role in the emergence of schizophrenia spectrum disorders, along with parental CD.
The Finnish adoption studies suggest how this melange of factors might fit together. A high genetic risk adopted kid together with adoptive parents who have CD tends to produce more SSD offspring.
Other history factors contribute some to the prediction. Childhood sexual or physical abuse, low SES, putative chronic anxiety, and perhaps birth injury and intrauterine events.
Jim Edd,
Bringing together research and data from many disciplines is so important for getting the whole multivariable picture on schizophrenia. In his blind man/elephant metaphor, I believe Bowen was saying that the family emotional system would be one of many parts of the puzzle. It is interesting to see the progression of your thinking since last FESTwg, and how you are building on your early work.
And I have taken as my task(which nobody asked me to do) to get a larger grasp on that puzzle, aiming for a point of view that takes all those angles into consideration.
Jim Edd,
Very interesting, and I look forward to learning from you regarding this topic. One of my own speculations about schizophrenia is that it allows an individual and family to survive a high stress period in the context of low DoS that might otherwise result in death from suicide, physical illness, drug overdose, or accident. My understanding is that a certain percentage of individuals who carry the diagnosis eventually recover–is that your understanding or not? Thanks for this.
Yes, that is my understanding.