Schizophrenia
Quips and Quotes
Make yourself necessary to someone.
Ralph Waldo Emerson
This lesson considers schizophrenia, a condition that is
often misunderstood. In particular, this lesson highlights
the pioneering work of a Saskatchewan medical
researcher, Dr. Abram Hoffer, in terms of a biochemical
as well as a sociocultural approach to the treatment of
schizophrenia.
Lesson Objectives
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What is schizophrenia?
How are people with schizophrenia diagnosed?
What are the types of schizophrenia?
How does schizophrenia develop?
How do current psychological theories explain schizophrenia?
What is the relationship between nature, nurture and schizophrenia?
Suggested
Instructional
Strategies
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Discussion: Nature/nurture and schizophrenia
o Using the template found in the Curriculum Support Materials,
Nature/Nurture and Human Development, discuss how schizophrenia is
influenced by biological as well as environmental factors.
Discussion: Biochemistry and schizophrenia
o Read the Interactions article, Biochemistry and Behaviour: Balancing the
Equation.
o What are the implications of Dr. Hoffer’s theories?
o Design and conduct a research project that surveys people’s attitudes
towards vitamins and minerals. Should people take vitamin supplements
daily?
o The term, balancing the equation, refers to the need to consider
biochemical as well as sociocultural influences on behaviour. Discuss the
various types of influence that each of the three levels (micro-, exo- and
macrosystem) have on behaviour.
o How do we balance the equation? How do psychiatrists and
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Direct
Independent
Interactive
Indirect
Experiential
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psychologists determine what aspects of behaviour are biochemical in
nature and what aspects of behaviour are sociocultural?
Jigsaw: Theoretical perspectives on schizophrenia
o Assign one of the six theoretical perspectives to each small group of
students. Based on their theoretical perspective, how would the groups
explain schizophrenia? What treatments and therapies would they
recommend based on their interpretation of the causes of, or reasons for,
schizophrenia?
Research: Neurotransmitters
o What are neurotransmitters? What function and role do they perform?
What influence do neurotransmitters have on human behaviour?
Making Connections
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Refer to Topic 2.2.3, The Endocrine System for additional information.
Refer to Topic 2.2.2, The Nervous System for additional information.
Resources
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Interactions : Biochemistry and Behaviour: Balancing the Equation
Curriculum Support Materials: Nature/Nurture and Human Behaviour
Lesson 4.6.4: Teacher Information
What is schizophrenia?
Schizophrenia is a disorder in which personality loses its unity. It should not be confused with multiple personality disorder, in which
personality splits into two or more separate identities. Schizophrenia is a ‘splitting’ between thoughts and feelings, the consequences
being bizarre and maladaptive behaviour. Schizophrenics have an impaired ability to selectively attend to some stimuli and exclude
the rest that leads to overwhelming and disconnected ideas and sensations. The presence of one or more of the following is likely to
result in a diagnosis of schizophrenia: passivity experiences and thought disturbances, hallucinations and primary delusions.
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Passivity experiences and thought disturbances may include thought insertion (the belief that thoughts are being inserted into
the mind from outside, under the control of external forces), thought withdrawal (the belief that thoughts are being removed
from the mind), and thought broadcasting (the belief that thoughts are being broadcast or otherwise made known to others).
Hallucinations are perceptions of stimuli not actually present. While they may occur in any modality, the most common are
auditory. Somatosensory hallucinations involve changes in how the body feels. Depersonalization, in which the person
reports feeling separated from the body may also occur.
Primary delusions are false beliefs which persist even in the presence of disconfirming evidence. Delusions of grandeur,
persecution, reference (particularly personal significance) or nihilism (nothing really exists, everything is shadows) are the
most common (Gross and McIlveen, 1998, p. 586).
How are people with schizophrenia diagnosed?
People with schizophrenic disorders display sudden, significant changes in thought, perception, mood and overall behaviour. How
they think about themselves, social situations, and other peoplesocial cognitionbecomes seriously distorted. There are three basic
types of symptoms:
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Thought disorders include maintaining logical thought, ordered thinking, memory and coherent conversation. Delusions
frequently accompany the early onset of the condition.
Another sign of schizophrenic disorders is the presence of hallucinationscompelling perceptual experiences without a real
physical stimulus.
One of the most striking characteristics of schizophrenia is the display of inappropriate emotional responses (Lefton et al.,
2000, p. 551).
What are the types of schizophrenia?
There are several types of schizophrenia:
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Hebephrenic schizophrenia is the most severe type, is usually progressive and irreversible. Its main characteristics are
incoherence of language, disorganized behaviour, disorganized delusions, vivid hallucinations and a loosening of
hallucinations.
Simple schizophrenia usually appears late in adolescence and has a slow, gradual onset. Principally, the individual
withdrawals from reality, has difficulty in making or maintaining friends, is aimless and lacks drive, and shows a decline in
academic or occupational performance.
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Catatonic schizophrenia is a striking impairment of motor activity. Individuals may hold unusual and difficult positions until
their limbs grow stiff, swollen from lack of movement. However, catatonic schizophrenics often are aware of what others are
saying or doing during the catatonic episode. Another characteristic is negativism, in which the individual sits either
motionless and resistant to instructions, or does the opposite of what has been requested.
Paranoid schizophrenia has the presence of well-organized, delusional thoughts as its dominant characteristic. Paranoid
schizophrenics show the highest level of awareness and least impairment in the ability to carry out daily functions. Thus,
language and behaviour appear relatively normal. However, the delusions are typically accompanied by hallucinations that are
consistent with them (Gross and McIlveen, 1998, p. 588).
How does schizophrenia develop?
The characteristics of schizophrenia rarely appear in “full-blown form”. Typically there are three phases in schizophrenia’s
development.
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The prodromal phase usually occurs in early adolescence or in relatively well-adjusted people in early adulthood. Typically,
he/she becomes increasingly withdrawn, eccentric, emotionally flat, cares little for health and appearance, and shows lower
productivity at either work or school.
In the second or active phase, the major characteristics of schizophrenia appear. This phase varies in duration, lasting from
months to a lifetime.
If and when the active phase subsides, the person enters the residual phase characterized by a lessening of the major
characteristics and a more-or-less return to the prodromal phase. Around 25% of schizophrenics regain the capacity to
function normally, ten percent remain permanently in the active phase and 5065 percent alternate between the active and
residual phases (Gross and McIlveen, 1998, p. 589).
How do current psychological theories explain schizophrenia?
The observation that schizophrenia tends to run in families, and that schizophrenic parents have a greater chance of producing
schizophrenic offspring, suggests that genetic factors may be involved in the disorder. About one percent of the Canadian population
is schizophrenic; when one parent has schizophrenia, however, the probability that an offspring also will develop the disorder
increases to between three and 14 percent. If both parents have schizophrenia, their children have about a 35 percent chance of
developing it (Lefton et al., 2000, p. 554).
What is the relationship between nature, nurture and schizophrenia?
Although the exact causes of schizophrenia are still unknown, research suggests the following:
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The production and activity of specific types of chemical substances in the brain are associated with schizophrenia.
A connection exists between genetics and schizophrenia, although genetic factors alone cannot account for its development.
Environmental factors (such as the presence of marital conflict and placing children in a situation that offers mixed and
inconsistent messages) may contribute to the development of schizophrenia. Among these factors, early childhood
relationships may be especially important.
The most likely cause of schizophrenia may be a biological predisposition in the individual, which may be aggravated by a
climate of emotional immaturity, lack of effective communication, and emotional instability. There is, however, no evidence
to suggest that poor family relations cause the illness (Lefton et al., 2000, p. 556).