Schizophrenia:
Abnormal Psychology Paper
(Name Omitted)
AP Psychology
Mr. Koch Hour 1
March 15, 2013
Schizophrenia is a psychotic disorder which can affect an individual's behaviors, thinking
patterns, and emotions (DMS-IV TR Online). Schizophrenia is considered to be one of the most
disabling mental illnesses (Schizophrenia, 2007). According to the DSM-IV TR, the Diagnostic
and Statistical Manual of Mental Disorders, in order for a patient to be diagnosed with
schizophrenia, they must show at least two of the following symptoms: delusions, hallucinations,
disorganized speech, disorganized behavior, or negative symptoms such as apathy or alogia.
Positive symptoms involve adding complications, such as hallucinations, delusions, or
disordered thought. Individuals with negative symptoms are typically unresponsive and express
little to no emotion, and sometimes display catatonic behavior (Flanagan, pg 379, 2012).
Schizophrenia sufferers have a highly altered sense of reality and often have an extremely
difficult time performing seemingly simple tasks. The DSM also states that a patient with
schizophrenia would perform at lower levels than they did prior to onset in daily activities such
as work, hygiene, or relationships. The duration of signs of schizophrenia must persist for about
6 months with at least one month revealing characteristic symptoms (DSM-IV TR). The
DSM-IV TR classifies schizophrenia in a general way, but also identifies several unique
subtypes of the disorder.
The DSM recognizes multiple subtypes of schizophrenia. Subtypes of schizophrenia
identified by the DSM-IV TR include catatonic, disorganized, paranoid, residual, and
undifferentiated schizophrenia. The DSM classifies catatonic schizophrenia as including at least
two of the following symptoms: motoric immobility, excessive motor activity, extreme
negativism, peculiarities of voluntary movement, echolalia (mocking sounds), and echopraxia
(imitating movement). Catatonic schizophrenics may either practice excessive, purposeless
movement, or may maintain rigid postures. The DSM states that in order for a patient to be
diagnosed with disorganized schizophrenia, they must exhibit all of the following: disorganized
speech, disorganized behavior, and inappropriate affect. Paranoid schizophrenia is classified by
having preoccupation with multiple delusions, frequent auditory hallucinations, and no
disorganized schizophrenic behavior is present (DSM-IV TR). Patients diagnosed with
paranoid schizophrenia are relatively intact on a cognitive level. Residual schizophrenia lacks
dominant hallucinations and disorganized speech, but there is still evidence of disturbance and
negative symptoms (DSM-IV TR). Finally, the DSM classifies undifferentiated schizophrenic
patients as unable to be classified by the other subtypes, but clearly suffer from schizophrenia.
Research has revealed many potential causes of schizophrenia. Subtle biological
abnormalities in the brain are known to cause schizophrenia (Schizophrenia, 2007). Although
the exact cause of schizophrenia is unclear, recent studies have suggested individuals with this
disorder manufacture extra high amounts of dopamine in the brain (Wexler, 2010).
Most
antipsychotic medications are meant to regulate levels of dopamin produced in an individual
brain. Studies have been done on schizophrenic patients and their parents suggesting that
individuals with autoimmune disorders or a family history of autoimmune disorders put people at
a 45% increased risk of developing schizophrenia (Richard, pg 758, 2012). Some research has
suggested "an association between schizophrenia and a number of neuroanatomical
abnormalities" (Richard, pg 758, 2012). The list of possibilities is seemingly endless, and
researchers have had a difficult time narrowing in on a single underlying cause to this bizarre and
disabling disorder. Although the exact cause of schizophrenia is unclear, there is new research
bringing light to new ideas or possiblities as to what causes this awful disorder.
The article "Schizophrenia" in World of Scientific Discovery (2007) states that persons
have a 40% chance of developing schizophrenia if both parents have it, 10% if one parent or
sibling has it, and only a 1% chance if there is no familial history of the disorder. This suggests
that schizophrenia has very strong genetic links and has very high heredity rates and familial
patterns. Research strongly suggests genetic susceptibility poses a very high risk for developing
schizophrenia (Wexler, 2010). A number of studies have been done that suggest an association
between maternal infection during pregnancy and birthing schizophrenic offspring (Richard, pg
758, 2012). Research reveals a high genetic risk of developing schizophrenia, however
pinpointing the exact gene has proven to be extremely difficult (Richard, pg 761, 2012). This
research suggests that individuals who are genetically predisposed to schizophrenia have a
substantially higher risk of developing the disorder.
Schizophrenia suffers often run into complications with other mental illness. People
with schizophrenia are often diagnosed with depression as well. Schizophrenics have such a
severe altered perception of reality that they often see life as meaningless and are at high risk for
committing suicide. They may not consciously be wanting to inflict self-harm or other related
problems, but the hallucinations and delusions often drive them to do these things.
Schizophrenics are also prone to abuse alcohol, drugs or other substances as an effort to escape
the constant bombardment from the voices. Schizophrenia and bipolar disorder also share
common links and overlaps (Ogundipe, 2013). Also, patients with schizophrenia are often
confused with those who have dissociative identity disorder (formerly known as multiple
personality disorder). Individuals with each of these disorders have a tendency to blurt out
unorganized rants that typical people fail to understand. Also, people with each of these
diseases hear voices in their minds. The difference between schizophrenia and multiple
personality disorder is that schizophrenics have auditory hallucinations or voices that seemingly
control them, while in dissociative identity disorder, individuals experience these thoughts as if
they become a new person to experience these thoughts. While there are many disorders that
link to schizophrenia, this disorder is very unique and disabling in many aspects of life.
Schizophrenia is classified by the DSM-IV TR as a psychotic disorder. Similar to other
disorders in this category, schizophrenia removes the individuals sense of reality. According to
the DSM-IV TR, individuals with psychotic disorders typically experience hallucinations,
delusions, and disorganized speech or behavior. In brief psychotic disorder, individuals suffer
from severe hallucinations, delusions, and disorganized behavior according to the DSM-IV TR.
While there are similarities between them, schizophrenia differs from other psychotic disorders
in that it is an ongoing and persistent disorder, often lasting a lifetime (DSM-IV TR). In brief
psychotic disorder, patients typically suffer from the illness for as little as a day to a month,
whereas schizophrenia is an ongoing disorder. Schizophrenia is a horrible disorder that takes
over the lives of it's sufferers, and is considered to be one of the most disabling of mental
diseases.
Treatment options typically involve the use of antipsychotic medications which act on
serotonin, norepinephrine and/or dopamine receptors in the brain. (Schizophrenia, 2007).
Antidepressants and psychotherapy are often used in addition to antipsychotic drugs
(Schizophrenia, 2007). Therapeutic relationships are highly valuable in treating schizophrenia:
it allows doctors and nurses to gain the trust of their schizophrenic patients, enabling them to
help the patients do what is necessary for improvement. Research shows that although
antipsychotic medication helps some schizophrenic patients, it often isn't enough on its own
(Eack, 2012). Recently, a new approach known as cognitive remediation is being practiced
(Eack, 2012). Cognitive remediations are psychosocial interventions that utilize target cognitive
training to improve cognition in schizophrenic patients (Eack, 2012). There are now two types
of antipsychotic medication known as First Generation Antipsychotics (FGAs) and Second
Generation Antipsychotics (SGAs). Research suggests that SGAs are far more effective on
patients with negative symptoms of schizophrenia than those with positive symptoms (Hartling,
pg 506, 2012). Although the use of antipsychotics is common for schizophrenic patients, it isn't
always effective and can have serious side effects causing other major problems (Wexler, 2010).
A case study involving schizophrenia was found in "The International Journal of
Nursing," in which a 17 year old male, identified as MR, was diagnosed with paranoid
schizophrenia. MR's parents brought him to a psychiatric unit when he said the voices told him
to jump out the window (Kotowski, pg 41, 2010). He displayed many of the common
symptoms of schizophrenia such as auditory hallucinations, disorganized yelling, insomnia, and
a decrease in hygiene, appetite, and social interaction (Kotowski, pg 41, 2010). Once admitted
to the psychiatric unit, MR was kept on a daily routine in which he received assistance for
completing many every day tasks such as bathing or feeding (Kotowski, pg 42, 2010). The unit
of staff set short goals for MR to meet and this helped him to feel successful whenever he was
able to reach these goals (Kotowski, pg 42, 2010). In order to assist MR in getting better, he
established therapeutic relationships with the nurses to help create more effective communication
(Kotowski, pg 42, 2010). With the help of these therapeutic relationships, MR was able to
express his hallucinations to his nurses and developed trust (Kotowski, pg 43, 2010). MR was
also placed on an antipsychotic, Risperadone, which was noted to decrease his sensory
disturbances (Kotowski, pg 43, 2010). With the combination of therapeutic relationships and
antipsychotic medication, he improved. MR was able to complete daily tasks such as hygiene,
his appetite returned to normal, and he was able to manage his auditory hallucinations fairly
effectively (Kotowski, pg 43, 2010).
Famous people throughout history were thought to have had schizophrenia. Eduard
Einstein, son of physicist Albert Einstein, developed schizophrenia at 20 years old.
(Schizophrenia.com). He checked himself into a psychiatric sanatorium in Zurich until he died.
Famous for winning a Nobel Prize and co-discovering DNA, Dr. James Watson's son was
considered to be schizophrenic. Other famous individuals with schizophrenia include Peter
Green (guitarist for Fleetwood Mac), Syd Barrett (from the band Pink Floyd), Mary Todd
Lincoln (President Abraham Lincoln's wife), and the well-known author Jack Kerouac
(Schizophrenia.com).
There are some controversies surrounding schizophrenia along with other diseases.
Many argue that mental health disorders aren't really disorders at all, and that an individual with
mental illness has some power as to what happens to them (Epwright, pg 723, 2010). Another
argument is that individuals abuse the term and idea of mental health by using it to plead insanity
in the court system. While this does occur, it is uncommon and typically does not work unless
the suspect is diagnosed from a psychiatric perspective (Epwright, pg 725, 2010). Controversies
are present with schizophrenia, but there are criticisms about many other mental illnesses as well.
Schizophrenia is an extremely disabling disease. The DSM-IV TR classifies it as
disturbing cognition and interfering dramatically with daily life. Common symptoms of
schizophrenia are hallucinations, delusions, paranoia, or little to no emotional expression. The
DSM-IV TR identifies several subtypes of schizophrenia, each with a unique combination of
typical schizophrenic symptoms. While there is treatment options for schizophrenia, many of
them aren't nearly as effective as necessary for dealing with this horrific disorder.
Schizophrenics have a difficult time doing even the simplest of tasks, and are constantly
bombarded by their seemingly endless, tormenting thoughts, and hopefully new research will
discover the necessary tools to help these individuals see though reality’s eyes again.
References
American Psychological Association. Schizophrenia Web. BehaveNet DSM-IV TR. Retrieved
from http://www.behavenet.com/schizophrenia
Eack, Shaun M. "Cognitive Remediation: A New Generation of Psychosocial Interventions for
People with Schizophrenia." Social Work 57.3 (2012): 235+. Student Resources In
Context. Web. 9 March 2013.
Epwright, Carmela M. "Conundrums and Controversies in Mental Health and Illness." Journal of
Law, Medicine, and Ethics. 2010.
"Famous People and Schizophrenia." Schizophrenia.com The Internet Mental Health Initiative.
Web. 12 March 2013.
Flanagan, Elizabeth H. "The Personal Experience of Schizophrenia in Relation to the DSM-IV
TR Criteria." Psychiatry 75.4. 2012. 8 March 2013.
Hartling, Lisa PhD. "Antipsychotics in Adults With Schizophrenia: Comparative Effectiveness
of
First-Generation Versus Second-Generation Medications." Annuls of Internal Medicine
Vol 57.7 (2012) 10 March 2013.
Kotowski, Abigail. "Case Study: A Young Male With Auditory Hallucinations in Paranoid
Schizophrenia." International Journal of Nursing Knowledge. Nanda 2010.
Ogundipe, Sola. "Common Mental Health Diseases Share Genetic Link." Africa News Service.
March 2013. Web. 13 March 2013.
Richard, Michelle D. "Schizophrenia and the immune system: Pathophysiology, Prevention, and
Treatment." American Journal of Health-System Pharmacy. Vol 69. May 2012.
"Schizophrenia." World of Scientific Discovery. Gale, 2007. Student Resources In Context. Web.
10 March 2013.
Wexler, Barbara. "Mental Health and Illness." Health and Wellness: Illness Among Americans.
2010. Detroit: Gale 2010. Student Resources In Context. Web 10 March 2013.