Slide 2 Notes
The psychological disorder of schizophrenia represents at once the misconceptions of the past, the solutions of the present, and the promise of the future. Indeed, Nevid & Rathus (2005) admit that the expression “schizophrenia” is a broad term that can be used to describe a wide variety of human behavior and psychological dysfunctioning. The variety of symptoms that represent this disorder range from hallucinations to paranoia. There are also several different types of diagnosed schizophrenia, including the catch-all category of undifferentiated schizophrenia. Furthermore, the biological, psychological, and sociocultural approaches to psychology aid in the understanding of the underlying causes associated with the disorder. Lastly, the treatment, or in some cases attempted treatment, of schizophrenia encompasses a wide range of solutions including antipsychotic drugs and in the past the use of asylums. As it is, schizophrenia is a complex disorder caused by a yet unknown combination of factors that underlie an obvious set of symptoms which can usually be treated successfully through the combination of drug therapy and psychotherapy/community treatment.
Slide 3 Notes
In laymen’s terms schizophrenia is most closely associated with what most people would consider insanity (i.e. hallucinations, delusions, etc…). Currently an estimated 2.5 million people suffer from schizophrenia in the U.S. and nearly 1% worldwide (Nevid & Rathus, 2005). Additionally, more divorced and separated people suffer from schizophrenia than single and married individuals. Of course it is difficult to ascertain whether schizophrenia is a cause or effect in a divorce or separation. Oddly enough equal numbers of both men and women are affected by schizophrenia. I say oddly enough because higher numbers of women suffer from depression and higher numbers of men suffer from substance abuse, both implicated as correlates to schizophrenia. Moreover, the most telling sign of schizophrenia is psychosis or the loss of contact with reality (Nevid & Rathus, 2005). However, before a discussion of the diagnosis and treatment of schizophrenia can progress a solid foundation of symptoms must be constructed…
Slide 4 Notes
The symptoms of schizophrenia can be categorized into three wide-ranging groups. The first group comprises the positive symptoms which are usually characterized as pathological excess (Nevid & Rathus, 2005). This group is characterized as a pathological excess because the symptoms in this group add to a person’s behavior rather than subtract from a person’s behavior. Positive symptoms include delusions; specifically delusions of persecutions, delusions of reference, delusions of grandeur, and delusions of control. The first category of symptoms also include disorganized thinking and speech expressed as loose associations (derailment), neologisms or made-up words, preservation, and clang (rhyming). Furthermore, positive symptoms can be expressed through heightened perceptions, hallucinations, and memory loss. Lastly, some that suffer from schizophrenia exhibit a behavior called inappropriate affect which is characterized by emotions that are inappropriate for a given situation. The second division of the symptoms of schizophrenia include the negative symptoms or pathological deficits. These symptoms inhibit a person’s behavior significantly and include poverty of speech (alogia), blunt and flat affect characterized by blunted emotional responses or no emotional response, loss of volition (avolition), and social withdrawal. Lastly, the category of psychomotor symptoms entail awkward movements, repeated gestures, and even catatonia. The symptoms for schizophrenia seem to be pretty straightforward; however, the diagnosis of this disorders is not always so cut-and-dry…
Slide 5 Notes
The DSM-IV allows the diagnosis of schizophrenia only after six or more months of continued symptoms (Nevid & Rathus, 2005). A decay in work, social relations, and the ability to take care of oneself must also be observed in order to issue a diagnosis of schizophrenia. There are five distinct types of schizophrenia which can be diagnosed and include disorganized schizophrenia, catatonic schizophrenia, paranoid schizophrenia, undifferentiated schizophrenia, and residual schizophrenia. The first category of disorganized schizophrenia entails the symptoms of incoherence, confusion, and inappropriate affect. On the other hand, catatonic schizophrenia is characterized mainly by either catatonic stupors or catatonic excitement. Maybe the most well known form of schizophrenia, paranoid schizophrenia includes, “an organized system of delusions and auditory hallucinations that may guide [the patient’s life]” (Nevid & Rathus, 2005, p. 360). Next, the diagnosis of undifferentiated schizophrenia is used for a person whose symptoms do not fall neatly into one of the aforementioned categories. The category of undifferentiated schizophrenia is however sometimes vaguely defined and as a result can be overused. Lastly, residual schizophrenia refers to a person whose symptoms have lessened in strength and number. (i.e. residual symptoms) Furthermore, separate from these categories someone suffering from schizophrenia can be classified with either Type I schizophrenia or Type II schizophrenia. Type I schizophrenia is reserved for those that are subject to mostly positive symptoms, and Type II schizophrenia is set aside for those that are subject to more negative symptoms. Now that the foundation of symptoms and diagnosis has been satisfied a more inclusive look at the different psychological perspectives can be appreciated…
Slide 6 Notes
As with most psychological disorders, the first person to offer an intact theoretical framework from which to understand schizophrenia was Freud (Nevid & Rathus, 2005). His psychodynamic theory suggests that schizophrenia is caused by a cycle of regression to primary narcissism and the restoration of ego control/connection with reality. However, as is the case with most psychodynamic theories Freud does a superb job of explaining the situation but has only limited success in the treatment of the disorder. On the other hand, the biological view has had great success in explaining schizophrenia through genetic factors, biochemical abnormalities, abnormal brain structure, and viral problems. Furthermore, the cognitive approach hypothesizes that most of the characteristics of schizophrenia are produced when a person tries to compute or understand the unusually sensations that usually accompany the onset of the disorder. Lastly, the sociocultural view takes into account the factors of social labeling and family dysfunctioning when considering the disorder. Of particular interest is the social labeling aspect of the sociocultural view of schizophrenia. Social labeling explains that some of the symptoms of schizophrenia might be a result of the diagnosis itself, thereby affecting how a diagnosed person views themselves and how other people treat that person. Collectively, the diathesis-stress view suggests that schizophrenia is caused by a biological predisposition coupled with certain types of stress. With an understanding of the symptoms, the possible diagnosis, and the viewpoint of different psychological perspectives in hand all that is left are the possible treatments…
Slide 7 Notes
Prior to 1793, when Pinel “unchained the insane”, those that suffered from schizophrenia were considered beyond help (Nevid & Rathus, 2008). Asylums were used before Pinel to house and take care of the insane rather than to attempt any time of rehabilitation. In fact, one of the main focuses of the asylum was to simply keep the insane off the streets. However, that all changed with the introduction of the mental hospital or state hospital. These facilities viewed those with psychological disorders as people that were to be treated with sympathy and kindness rather than just discipline and containment. Unfortunately by 1955 these hospitals were overcrowded and understaffed which led to chronic wards (basically asylums) and even lobotomies. Fortunately it was during the 1950’s and 60’s that the treatments of milieu therapy and token economy programs were developed. Milieu therapy, which is based mostly on the precepts of the humanistic approach, puts the patients in a situation where they are expected to make their own decision within the framework of an institutional organization. Token economy therapy on the other hand encourages a system of rewards represented by tokens which can be used by the patients to buy things or to purchase preferred activities. Furthermore, during this same time period antipsychotic drugs were discovered. These first antipsychotic drugs (neuroleptics or convention antipsychotics) carried with them many side-effects, such as extrapyramidal effects and tardive dyskinesia, and did not treat Type II schizophrenic symptoms well. Nonetheless, these drugs were moderately affective in treating the symptoms of and even in some cases curing schizophrenia. In recent years though new antipsychotic (atypical) drugs have been developed that have far fewer side-effects and treat a wider range of Type I and Type II schizophrenic symptoms. The success rates are also much higher with atypical antipsychotics than with conventional antipsychotics. In addition, certain types of psychotherapy, such as insight therapy, family therapy, family support groups, family psychoeducation programs, and social therapy (personal therapy), have been successful when used in conjunction with antipsychotic drugs. Lastly, a more modern extrapolation of psychotherapy and state hospitals is the community approach. By using assertive community treatments, such as coordinated services, short-term hospitalization, supervised residences, and occupational training, the number of people in institutional care in the U.S. has dropped from close to 600,000 in 1955 to 60,000 today (Nevid & Rathus, 2005). Even though these programs have their drawbacks when coupled with psychotherapy and/or antipsychotics they seem to be the most effective approach to long-term psychological disorders to date. The progression of the treatment of schizophrenia has progressed over the centuries from simple straight-jackets and beatings to long-term, community-based treatments and advanced antipsychotic drugs…
Slide 8 Notes
It is clear now, through the use of genetic linkage studies and microbiology, that schizophrenia does indeed have a biological explanation (Nevid & Rathus, 2005). However, the biological explanation is only part of the story. A yet unknown combination of intense stress, sociocultural situations, and cognitive processes may lead to the actual onset of schizophrenia aided by biological precursors. The most compelling explanation seems to be that a genetically inherited biological abnormality gives rise to hallucinations/delusions as a result of intense stress and eventually leads to other negative symptoms in reaction to the hallucinations/delusions. At any rate, the current understanding of schizophrenia explains that the symptoms, however easily identifiable, are the result of a complex interaction between nature and nurture that can be treated adequately through the use of atypical antipsychotic drugs and psychotherapy/community treatment.
Nevid, J.S., & Rathus, S.A. (2005). Psychology and the challenges of life: Adjustment in the new millennium (9th ed.). Hoboken, NJ: John Wiley & Sons.
Szasz, T. (n.d.). Retrieved September 5, 2008, from The Quotations Page Web site: http://www.quotationspage.com/search.php3?homesearch=schizophrenia&startsearch=Search