New theory: Child abuse can cause schizophrenia

University of Manchester researcher Paul Hammersley is to tell two international conferences, in London and Madrid on 14 June 2006, that child abuse can cause schizophrenia.

The groundbreaking and highly contentious theory, co-presented by New Zealand clinical psychologist Dr John Read, has been described as “an earthquake” that will radically change the psychiatric profession.

Clinical psychologist and writer Dr Oliver James commented: “The psychiatric establishment is about to experience an earthquake that will shake its intellectual foundations [and] may trigger a landslide.”

Mr Hammersley, Programme Director for the COPE (Collaboration of Psychosocial Education) Initiative at the School of Nursing Midwifery and Social Work, said: “We are not returning to the 1960s and making the mistake of blaming families, but professionals have to realize that child abuse was a reality for large numbers of adult sufferers of psychosis.”

He added: “We work very closely in collaboration with the Hearing Voices Network, that is with the people who hear voices in their head. The experience of hearing voices is consistently associated with childhood trauma regardless of diagnosis or genetic pedigree.”

Dr Read said: “I hope we soon see a more balanced and evidence-based approach to schizophrenia and people using mental health services being asked what has happened to them and being given help instead of stigmatizing labels and mood-altering drugs.”

Hammersley and Read argue that two-thirds of people diagnosed as schizophrenic have suffered physical or sexual abuse and thus it is shown to be a major, if not the major, cause of the illness. With a proven connection between the symptoms of post-traumatic stress disorder and schizophrenia, they say, many schizophrenic symptoms are actually caused by trauma.

Their evidence includes 40 studies, which revealed childhood or adulthood sexual or physical abuse in the history of the majority of psychiatric patients and a review of 13 studies of schizophrenics found abuse rates from a low of 51% to a high of 97%. Psychiatric patients who report abuse are much more likely to experience hallucinations – flashbacks which have become part of the schizophrenic experience and hallucinations or voices that bully them as their abuser did thus causing paranoia and a mistrust of people close to them.

They admit not all schizophrenics suffered trauma and not all abused people develop the illness, but believe less traumatic childhood maltreatment, rather than actual abuse, may be an important difference. In their review of the 33,648 studies conducted into the causes of schizophrenia between 1961 and 2000, they found that less than 1% was spent on examining the impact of parental care. Still, they say, there have been enough studies to suggest negative or confusing early care may be an important addition to abuse as a cause.

Genes may still have a role to play but other evidence Hammersley and Read cite shows that genes alone do not cause the illness. A recent study compared 56 adoptees born to schizophrenic mothers with 96 adoptees whose biological parents did not have the illness. The families were observed extensively when the children were small and all the adoptees were assessed for psychiatric illness in adulthood. It was found that if there was a high genetic risk and it was combined with mystifying care during upbringing, the likelihood of developing schizophrenia was greater – genes alone did not cause the illness.

In addition a recent review revealed that, apart from for Alzheimer’s, not a single gene has been shown to play a critical role in any mental illness, while sociological studies show that schizophrenia poor people are several times more likely than the rich to suffer schizophrenia and urban life increases the risk.

Finally, they argue, if patients believe their illness is an unchangeable genetic destiny and that it is a physical problem requiring a physical solution, they will readily accept a drug prescribed to them when in fact they require other therapy. Worse, those who buy the genetic fairytale are less likely to recover, and that parents who do so are less supportive of their offspring. They recommend that all patients be asked in detail about whether they have been abused, anti-psychotic drugs no longer be doled out automatically and psychological therapies offered more often.

Hammersley and Read will propose the motion ‘Tears on my pillow, voices in my head: This house believes child abuse is a cause of schizophrenia’ at a public debate at the Institute of Psychiatry in London on 14 June 2006. They will also be speaking at 15th ISPS Symposium for the Psychotherapy of Schizophrenia and other Psychoses in Madrid on the same day.

From University of Manchester

11 COMMENTS

  1. Not new reply;

    Your daughter wasn’t abused in any way that you know of. If the other theory is correct, then you must have schizophrenia as well. It’s so hard for parents to accept that their children are not always under their control. At young ages, they are taken away to school, left with family members, etc. I’m not trying to make you paranoid, or to send you on a witch hunt of your daughters past. However, we are talking about the onset of hallucinations in an otherwise healthy mind.

  2. MEDIA RELEASE October 18, 2006

    PUBLIC REJECTS ILLNESS MODEL OF SCHIZOPHRENIA

    The November edition of a prominent scientific journal, Acta Psychiatrica Scandinavica, includes a review of international studies of how the public understands the causes of schizophrenia. The review, of 37 studies from 17 countries (including Australia, New Zealand and Britain), concludes that:

    “Internationally, the public, including patients and carers, have been quite resilient to attempts to promulgate biogenetic causal beliefs, and continue to prefer psychosocial explanations and treatments”.

    The causes cited most often include stress, poverty, family problems and child abuse and neglect. This contrasts with biological psychiatry’s belief that schizophrenia is a brain disease with a strong genetic component.

    Dr Read will present the findings of the review at mental health conferences in Auckland and Los Angeles (www.issd.org) in November.

    The other significant finding is that in the rare instances that lay people do adopt a medical model, “Biogenetic causal beliefs and diagnostic labelling by the public are positively related to prejudice, fear and desire for distance”.

    Currently many destigmatisation programmes, often funded by pharmaceutical companies, try to teach the public to adopt an illness model. The reviewers conclude, however, that:

    “An evidence-based approach to reducing discrimination would seek a range of alternatives to the ‘mental illness is an illness like any other’ approach”, adding that “Destigmatisaion programmes may be more effective if they avoid decontextualised biogenetic explanations and terms like ‘illness’ and ‘disease’, and increase exposure to the targets of the discrimination and their own various explanations”.

    The paper’s first author is Dr John Read, editor of the controversial book ‘Models of Madness”, which argues that schizophrenia is an understandable response to adverse life events and documents the role of the pharmaceutical industry in promulgating a simplistic biological approach. Last year Acta Psychiatrica Scandinavica published his review of the fast growing number of studies showing that child abuse is a cause of schizophrenia.

    Dr Read: “What these two papers suggest, taken together, is that the public may have a better grasp of the causes of hallucinations and delusions than some of us mental health experts”. “All the social causes cited by the public have recently been substantiated by well designed international studies”

    “There are two major implications to be drawn. Firstly, all the efforts to educate the public to adopt a biological ideology about mental health have been at best a waste of money and, more probably, extremely damaging in terms of increasing stigma and prejudice. Secondly, mental health services need to move away from the rigidly biological emphasis on drugs and shock therapy and embrace a more evidence-based, balanced and humane approach to understanding and treating human distress”.

    “Prejudice and schizophrenia: A review of the ‘mental illness is an illness like any other’ approach”. Acta Psychiatrica Scandinavica, 2006, 114, 303-318.
    John Read. (Department of Psychology, The University of Auckland)
    Nick Haslam (Department of Psychology, The University of Melbourne)
    Liz Sayce (Disability Rights Commission, London)
    Emma Davies (Institute of Public Policy, Auckland University of Technology)

    Dr Read: +64 9 373 7599 (ext 85011); +64 021 039 7168 [email protected]
    http://www.psych.auckland.ac.nz/staff/Read/Read.htm

    ————————————— end ———————————————————–

  3. I remember hearing this “new theory” years ago. Anyway, Read doesn’t accept that schizophrenia is an illness – and even puts the word in quotation marks in the title of Chapter 1 of Models of Madness: Psychological, Social and Biological Approaches to Schizophrenia (2004). My daughter, who has schizophrenia, ran into people like Read while she was studying for her BA in psychology. When she wrote in an assignment that compulsory treatment with anti-psychotic medication is necessary in some cases of schizophrenia – remembering that only this had succeeded in bringing her out of psychosis – she was marked incorrect. Crazy! And no, she was not abused in any way as either a child or a young adult.

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