A qualitative investigation of the subjective experience of crises and life changes in the family which precede the onset and diagnosis of schizophrenia

Abstract

This study set out to explore the subjective experience of crises and life changes in the family which precede the onset of schizophrenia. The motivation for it arose from the vulnerability-stress model of schizophrenia which proposes that environmental factors such as stressful life events may help to trigger the onset or exacerbation of symptoms in people who have a genetic vulnerability for the condition. Related research suggests that crises and life changes in the family can contribute to the stress experienced by those who go on to become psychologically disturbed. This has led to an increased interest in accessing the subjective experience of schizophrenia as shared by individuals and their families through the use of narratives to provide alternative perspectives on the condition. Indeed, a growing body of evidence from research conducted with people diagnosed with schizophrenia suggests that the content of their actions and statements can be construed as meaningful and logical in the context of their family and life situations. Four individuals who had been diagnosed with schizophrenia and their families participated in this study. In each case study, two interviews were conducted, one with the individual participant and a second interview with the individual and those members of their family that were willing to attend. The interviews were guided by a semistructured interview schedule and data from the interviews was analysed using content analyses and the most prominent themes were discussed in relation to the literature. The themes in the data describe the participants’ subjective experience of the many crises and life events and change in psychological functioning that precedes the onset of florid psychotic symptoms. These findings suggest that the schizophrenic symptoms of the participants in this study helped to absorb the impact of family stressors and played a fundamental role in keeping the family systems intact. The associated behaviour appeared to sustain the roles in the family as well as long-standing patterns of interaction between the family members. The numerous interacting influences and sheer variation in the experience of just four families indicates that much still needs to be understood about the experience of schizophrenia. It is recommended that future research investigate how the subjective understanding of schizophrenia affects the lives of those affected. Copyright