Schizophrenia used to be called dementia praecox which means youthful insanity because it tends to develop in adolescence or early adulthood . Although schizophrenia may occur ay any age , the highest rate of first time admissions to mental hospitals for this disorder occyrs among the people in their late teens and early twenties , schizophrenia , one of the most common psychotic disorder is also one of the most crippling
Different types of schizophrenia are identified as DSM 111one of them , the disorgsnised type is characterized by incoherent thinking but no systematic delusions . Schizophrenia involves various kinds of of severe psychomotor disturbances . For example, the person may assume a fixed body posture –sometime a painful looking statue like position – and maintain it for periods lasting several minutes even hours . During such periods the person is usually mute and the body assumes a waxy flexibility – meaning that if someone else repositions the persons arms or leg , the limb will remain in the new position . At the other extreme the catatonic may have periods of agitation –with arms flapping or swinging and excessive talking , shouting of even animal sounds . the hall mark of the paranoid type of schizophrenia is the presence of hallucinations or delusions . both tends to involve themes of persecution or wildly grandiose ideas of one’s own importance or influence . for example a paranoid schizophrenic may believe that the devil is torturing him by shouting profanities at him through the television set THEORIES AND EVIENCE OF SCHIZOPHRENIA AND ITS CAUSES
Because schizophrenia is so widespread and so handicapping , heorists and researchers have tried for years to understand its characterstics and causes. In the following sections, one will examine some of the resulting theories and findings
Life experience and family interaction in schizophrenia are likely to have had at least one parent with same diagnosis . this means that many schzophrenia to processes of modeling or instrumental conditioning , blame family conflict , especially marital schism a conflict in which each parent tries to to form alliance with the child against the other the other parent and a marital skew , a conflict in which one parent passively submits to the bizarre behaviour of the other.
Still other theories have focused on communication patterns in the family . One theory , for example , maintains that schizophrenic behaviour behaviour results from constant double bind communication.
For example, a young man to grow up , move into his own place and leave his mother all alone . In this single sentence , the mother managed to tell her son that it was both wonderful thing for a for a young man to grow up move it to his own place and leave his mother
In other cases the verbal content of a communication may conflict with the physical or emotional content
For example a young man whose mother visited in his mental hospital was delighted seeher . he put his arm but then she asked don’t you love me any more , confused and embarrassed he bushed and his mother said , dear you must not be so easily embarrassed
In other cases, the verbal content a communication may conflict with the physical or emotional content.
She said that he doesn’t love me any more, had become confused and embarrassed , he blushed and his mother said dear you must not be so easily embarrased and afraid of your feelings For example a young man whose mother visited him in his mental hospital was delighted to see her . he put his arm around her at which point she stiffened . in response , he withdrew his arm but then , recent evidence does indicate that people diagnosed as schizophrenic often grew up , in other words , does this mean that these mean that , the unusual life and family patteron or the schizophrenia , in most of the research , thus far this question has been hard to answer
Biological factors and schizophrenia , while the study of life experience and family patterns continues , other investigator have turned their attention to the role of the biological factors . some of these factors may be hereditary , as will discuss below , but others may result from injury or disease , particularly during pregnancy complications , low birth weight and oxygen deprivation at birth all of which put children at risk . the risk posed by such problems are varied of course , it may well that schizophetia is just one of several of several possible include such disorders as mental retardation and cerebral palsy
Much of the research on biological factors in schizophrenia may be the research of excess dopamine activity in certain areas of the brain . you may recall that dopamine is one of the substances that help transmit information across synspasis in the central nervous system . in other words , dopamine is one of the neurotransmitters
Several lines of evidence now suggest that excess dopamine activity may indeed play in schizophrenia , one clue is that the behaviour is that the behaviour seen in paranoid schizophrenia –confusion , delusions and often hallucinations – is strikingly similar to the behavoiour demonstrated by people who have taken large doses of amphaetamines or speed . these amphetamine psychosis are in fact sometimes misdiagnosed as paranoid schizophrenia , this may be important because the drug amphetamines activates cells that use dopamine as a transmitter .
Several lines of evidence now suggest that excess dopamine may indeed play a role in schizophrenia , confusions , delusions and often hallucinations –is strikingly similar to the behavior demonstrated by people who have taken large doses of amphetamines or speed these amphetamine psychoses are in fact sometimes misdiagnosed as paranoid schizophrenia . this may be important because of the drug amphetamine activates cells that use dopamine as a transmitter , further more , the drugs more . One group of these drugs –the phenothiazines, appears to work by a blocking dopamine activation of cells in the brain . this suggests that –one group of these drugs –the phenothiazines appears to work by blocking dopamine activation cells in the brain . this suggests that excess dopamine may be a big part of the problem in schizophrenia
the dopamine hypothesis is still a loose fabric . researchers gradually weaving threads of evidence together , but no firm and final proof has yet been offered . still many see this as one of the brain itself . Some of this research centers have helped make this possible , using successive x-rays of very thin sections of the brain . the studies have shown some impairment of about 20-35%of people diagnosed as schizophrenics
there are many different kinds of impairment , but one of the most common is enlargement of the cerebral; but one of the most common is enlargement in about ‘ one team of researchers reports that the cases with small ventricles are likely to be emotionally flat and unambitios
as this illustrates the research on brain structure is pointing us towards a very plausible area ; different forms of schizophrenia may involve different biological abnormalities .1
Genetic influence and schizophrenia , a consensus is forming on one major point , genetic factors play a role , one group of studies that has involved identical and fraternal twins . Identical twin pairs have identical heredity , fraternal twins pairs do not . So if schizophrenia is strongly influenced when interviewed at length revealed that her support for his story was actually based on what he had told her not her own independent experience – except for two incidents that seemed like possible harrassments but had perhaps been coincidences , she also reported that Mr. x had grown increasaingly preoccupied and isolated in recent years an observation also made mr.x ‘s commanding officer . confronted with the findings of the investigation . mr. x outwardly calm but then gradually , began to describe , now evidence of harassment by the underworld figures during his stay in the hospital.
The above account illustrates that the delusions involved in paranoia are often so logical and believable that intelligent people , sometimes even mental health experts are tempted to buy them , instead of or in addition to, persecutory delusional jealously. They may believe unjustly that their lovers or spouses have been faithful and collect evidence in the form of rumpled clothing , spots on the sheets or cigarette butts on the porch or they may show delusions of grandeur, except for their elaborate delusional jealousy, paranoid people typically show no thinking disorder . They appear normal until some thing happens to activate their delusions . In general, their delusional systems are well worked out and they do not have hallucinations . Such intact thinking and logical delusions contrast sharply with the disorder thinking and hallucinations seen in cases of paranoid schizopherenia
PARANOID THINKING VERSUS PARANOIA
The logical nature of paranoid thinking as a dimension involving ; perhaps it is best to think of paranoid thinking as a dimension involving different levels or degrees . most people occasionally have suspicious thoughts , but not to a degree that clashes sharply with rocial norms , undermines adaptation or causes severe distress . further along the patterns of thinking . this in turn reminds us of how difficult it is to distinguish between normalcy and psychological disorder . perhaps it is best to think of paranoid thinking as a dimension involvingdifferent levels or degrees , most people occasionally have suspicious thoughts , but not to a degree that clashes sharply with racial norms , undermines adaptation or causes severe distress . further along paranoid – thinking dimension are people who are habitually and wrogly suscpicious of others and overly sensitive to what they see as hidden motives or secret meanings in the behaviour of other people . if such patterns pervade a person’s daily living but do not include full fledged delusions ,
DSM-IH ,applies the term paranoid’s personality disorder , personality disorders are life style patterns involving inflexible , persistant and mala adoptive personality traits – suspiciousness and jealousy in this case
It is only when paranoic thinking involves an extreme , well organized delusional system with emotions and behavior that are logically appropriate . the sample of mr. x illustrates this extreme level , mr. x b well organized delusional system dominated his life , provoked him into changing his identity and posing as a woman and caused both mr. x and his wife to live in fear of the underworld
ORIGINS OF PARANOIA
Casual explanations of paranoia have been debated for years , but research on casual factors has been hampered by the rarity of identical cases , one theory focuses on the fact that people who are diagnosedas having paranoia seem to show , life long patterns of finding fault with every one but themselves ; trusting no one , they withdraw socially and emotionally . when a real threat or stressful situations arises , they are isolated just when they need most to confide in friends who might help them see their problems more obsectively . with no one to change their minor false beliefs , they gradually reconstruct their perceptions of the world to fit their own views . ordinary frustrations are taken personally , people showing this disorder perceive the rest of the world as paying special attention to them amd being out get them . this false belief explains many situations for them ; the explanation may be comforting and rein forcing because it makes sense out of an otherwise confusing world thinking such as the following
A 80 year old widow who seemed alert and aware became upset because , for unknown reasons , her neighbours were secretly putting lint in her washer and dryer , she took her complaint to the police . no one her daughter included , could convince her that neighbours were innocent . in most respects , she continued to get along quite well andbehave normally . on wash days , however , she grew , suscpious and her accusations began again
Another example of paranoid thinking is given by Carson
An elderly woman in mid western town complained about the boys in a near by college dormitory . they were , she said using electric waves to give her to her multiple orgasms and the orgasms were disrupting her sleep . her psychiatrist prescribed some antioorgasm tablets and the problem disseappeared
Examples like these can also be used to support other theoretical explanations of paranoid thinking . the fact that the delusional behavior charecterstic of paranoia in most common in the elderly and particularly in conjunction with physical deterioration has led some to believe biological factors can play a role . people who hypothesize biological causes also note that delusions occur frequently in people taking drugs such as amphetamines as we pointed out earlier
IS PARONIA PSYCHOLOGICAL DISORDER
But as a style of information processing – a style developed by people given above might well be seen as efforts to project blame –for lint lint and orgasms –onto others . A similar arguments could be made in more extreme cases . like that of mr. x . does that mean that paranoia should be viewed only as an extreme self protective style of thinking not as a true psychological disorder . this idea has growing support , but not ofcourse among the authors DSM111
Disorders of affect ;;
Just as many of us show occasional changes in affect or mood . at times we can be unusually sad or down ; at other times , we may be especially elated or up . in some people at some times , these mood states spiral out of control, becoming so extreme moods are combined with particular patterns of mal adaptive thinking and behavior , they are diagnosed as one of the affect ke disorders . we discuss two such disorders here , beginning with major depression
MAJOR DEPRESSION;
To be diagnosed as suffering from major depression , a person must have had one or more major depressive episodes – periods that involved more than just sadness
Characterstics of a major depressive episode . in a major depressive sad feelings are accompanied by persistant problems in other areas of life – problems such as an appetite change ; loss of interest or pleasure in usual activities , include sex , loss of energy , diminished ability to think or concentrate ; feelings of worthlessness or self approach , or suicidal thoughts or acts . during a depressive episode , the person’s mood and thought patterns may be strikingly negative . the depressed person often appears lost , vulnerable , detached ,, unable to find joy in any aspect of of daily life , life seems to have lost its vitality on the verge of tears . thoughts amount self are likely to be overwhelmingly negative , the person may feel unattractive , inferior to others , incompetent as a spouse or parent and unsuccessful at school or work . the future may seem almost completely hopeless and this ofcourse is one reason that suicide tacornes a risk
An estimated 20 percent of American and European women have experienced a major depressive episode at some time , for men the figure is about 10 percent . some 6 percent of women and 3 percent of men have had episodes serious enough to require to require hospitalization , an estimated 46 percent of college students are thought to have experienced depressions serious enough , at some point to have warranted professional help . many depressed people are treated as out patients , but itlany others suffer in silence and solitude . one example of the of the many forms depressive episodes can take is the case of mr. x
Mr.A a middle aged reaitor , strongly valued financial success . it helped him deal with feelings of inadequacy stemming from his lack of a college education . During one short period , he lost out on three important business deals that he had counted oil , he grew pressed , morose and despondent and began to drink more than before . he began talking vaguely about changing carriers and he seemed to have trouble making decisions . his children had left home , he and his wife had grown a part psycho;ogically , and there had been almost no sex for several years . mrs. A grew concernic about her husbands sleeplessness , loss of appetite and general hopeless attitude , one day she con’sued a physian , who said have more activity . on the same day . mr. A spent several hours
Certainly not all major depressive episodes end in suicide , but some do . even in cases where the end is not this tragic , the pain and suffering endured by the depressed can be intense . the intensity , the intensely painful nature of this disorder , and its high incidence , have spurred many to study depression and its causes
Depression like mr,A’s occurring in middle age and after a series of set back –may have different causes than a middle causes , than a milder case , bearing in mind that different kinds .A depression that is severe enough to result in suicide may have different causes than a milder case . bering in mind that different kinds of depression may have different causes , let us examine some of the major casual theories and some of the evidence for them
LIFE EXPERIENCE, LEARNING AND SOCIAL INTERACTION IN DEPRESSION IN PSYCHOANALYTIC:
Theory , depression is seen as resulting from an overly demanding superego – one that standards too high for the person to live up to –and from early loss of attachment figures . for example , the adult on whom a child is most dependent , usually the mother , may be lost through death or parental separation . or there may be a serious disruption in the dependency relationship , such that the chilij comes to fear or fantasize such a loss . losses of this sort can set in motion a prolonged and exaggerated grief reaction – one that includes feelings o guilt and a self blame and a loss of self esteem . this in turn , can set the stage for the development of depression of depression in adult hood , at least among women , however most research has not found strong support for this idea
A better –validated theory attributes depression to process of rein orcement and social , peeterlewinson and his research team found that depressed people often have had especially high frequencies of un pleasant tan do non , depressed people also experience adverse events as more than do non , depressed people . because of the low level of un inforcement they have received , depressed people tend to invest less hope and less energy in their activities , including their social interactions .is mturn makes them less rewarding to be around . thus others tend to avoid depressed people and this inturn , deepens their depression Coyne illustrated the negative impact depressed people can have on others
Coyne had 45 non depressed people carry on phone conversations with people receiving treatment for depression , people receiving
Treatment for other disorders or non disturbed people not receiving treatment . After the conversations , rating indicated that talking to the depressed people had been considerably less rewarding than talking to the others groups . After talking to depressed people , non depressed experimental subjects were more anxious , more hoj tile , more depressed and less interested in talking to the same people again than were subjects who had spoken to the other groups
Coyne found that depressed people try to cope with stress full situations by seekings emotional support from others , a dependent style that may contribute to the discomfort others feel around them . when others do offer their support or aid and the depressed person does not improve , irritation may be the result . others may then combine their reassurance and statements of support with increasing avoidance of the depressed person , thus leaving the person confused and of course –still depressed . this body of theory and research has been useful by helping to stimulate new ideas on how to help depressed people recover . for example , depressed people might be trained to interact with others in ways that others will find rewarding rather than punishingand others who want to help depressed people shake their depression might learn how to communicative in ways that would not be confusing or threatening
Cognitive processes and depression , one jprorninent model holds thai depression involves a kind of giving up pr. Learned helplessness , the idea is that people some times experience a series a series of set backs or failure , conclude from the cues available that the situation is one they can not control and simply stop trying to make things better . according to this model , depression can result when people expect bad things to happen to them and assume that they will not be able to prevent or control them . if people attribute this lack of control to personal causes their self esteem will be impaired . if they believe the causes are stable , then their depression will be long lasting . if they their lack of control . in other words , depression is colored by cognitions , some studies support this model , showing that beliefs like those outlined above the causes of my failure are personal , stable and present in many situations are more common in depressed than in non depressed psychiatric clients , also , people who show these cognitive patterns but are not depressed tend to get depressed later , when bad things to happen to them
Aaron Beck is another theorist who emphasies the cognitive thought aspects of depression depression primarily as a thought disorder and only secondarily as a mood disorder . according to Beck , depressed people experience major distortions of logical thought . these distortions include
1] Arbitrary inference , drawing a conclusion based on too little evidence or no evidence at all
2] selective abstraction , drawing a conclusion by concentrating on one detailed aspect of a situation
3] overgeneralizfition unjustified generalizing from limited evidence . A student who receives a low grade on a single assignment is sure that he or she is failing the course and will never graduate or get a job
4] magnification and minimization , exaggerating or limiting the significance of information
In contrast to Beck’s view , some recent research has suggested that depressed people may actually make more accurate assessments of them selves and certain situations than non depressed people . For example in one study , observes rated the social competence of several depressed and non depressed , people all of whom also rated themselves . the self ratings of the non depressed people gave them selves ratings quite close to those the observers gave them . perhaps even more intriguing was the finding that as depressed people grew less depressed during treatment , their self ratings became more inflated compared to those made by observers . in other words reduced depression may go hand in hand with exaggerated self perception . perhaps one way many of us stave off depression is by being bit unrealistic about ourselves –adopting a warm glow , that keeps us focused on our strengths and successes rather than our weaknesses and failures . depression may be in part of a breakdown of this processes .
We should add one cautionary note about these cognitive processes showed that the major models each have some scientific support but one has strong support . Evidently , different depressed people in different studies do some what different things , cognitevily speaking , there may be some truth in each model ; but there may also be several ways of thinking that can go along svith being depressed .
Biological geneiic factors and depression , whatever cognitive –learning or life experience factors may be involved in depression , many investigators believe that biological factors also play a role
Schizophrenia can be treated by Natrum sulph , Calcarea carb , Aurum mur , Aurum met, Pulsatilla , Sepia, Anacardium, Hyoscyamus, etc.
