Thesis on "Schizophrenia: The Key"

Thesis 8 pages (2581 words) Sources: 6

[EXCERPT] . . . .

Schizophrenia: The Key

Schizophrenia. Perhaps one of the most often-associated images with this word is Russell Crowe's character in A Beautiful Mind; perhaps it is not necessarily the image that is associated with the word, but the feeling, the feeling of realizing that Crowe's character's friends were not real. In other movies that draw similar crowds the audience is often forced to face the realization that a character is not alive, such as the case in The Others, when the audience finds out the protagonists they have come to love are ghosts. But there is nothing that comes close to that feeling of despair when Crowe's character realizes his life is imaginary. It is worse than death because it never was.

This, in a nutshell, is schizophrenia, and because of these overwhelming feelings associated with the disease, it has been historically difficult to define. Gottesman, Shields, and Hanson (1982) call on the World Organization Classification of Mental Disorders for a definition: "schizophrenia involves a fundamental but not pathognomic disturbance of personality, a more or less characteristic disordering of the process of thought, a frequent sense of being controlled by outside forces, bizarre perceptions and delusions, and inappropriate emotions" (pg. 5). But with its clinical terminology, this definition does not do justice to the difficulty that psychologists have had in attempting to understand the disorder over the years, nor does it underline the potential significance that an understanding of schizophrenia may have for many neurological and physical fields. Even the original definition of the disorder, coined by Bleuler in 1911, fails to capture the essence of what schizophrenia really is. Bleuler used four A's -- Affect, Associations, Ambivalence, and Autism -- to describe the disease or its significance. Walters (n.d.) calls the disorder an "enigma," and suggests that understanding the disorder is not only of the utmost significance to those affected, but also that schizophrenia is the key to making sense of "the mechanisms by which the brain filters, prioritizes and processes the relentless current of information available from the richness of its internal, social and natural environments" (para. 1). But, unfortunately, much of what causes schizophrenia, what it is really like to be afflicted with schizophrenia, and methods of treatment are largely unknown. In addition, there are many types of schizophrenics, including paranoid, disorganized, catatonic, undifferentiated, and residual (Walters, n.d.). Schizophrenics must live with many stereotypes that have been applied to them because of a popular misunderstanding of the condition. They are not sufferers of multiple personality disorder, nor is there a "dissociation of personality" among schizophrenics. Still, some assume that they are prone to violent behavior, which they are not, and schizophrenics are discriminated against when it comes to many aspects of social living, such as employment or housing (Walters, n.d.). For this reason, delving into cures for schizophrenic is of the utmost importance. Through an exploration of the symptoms of schizophrenia, possible causes, and treatments, a better understanding of the disorder's massive impact on society can be gleaned.

I. Symptoms

Schizophrenia can be a difficult disease to diagnose not only because symptoms differ so greatly, but also because there are many other disorders that can result in symptoms that appear similar. The different types of schizophrenia yield very different symptoms. For instance, Sitnikova, Goff, and Kuperberg (2009) focus on the disorganized type of schizophrenia when they write that sufferers display "deficits in adaptive goal-directed behavior," in addition to "context-inappropriate commission errors that may appear bizarre and out of place" (pg. 256). This symptom can be one of the most difficult to deal with for family members and friends of schizophrenics. Indeed, Kymalainen and Mamani (2008) discuss the effects of both expressed emotion and communication deviance, suggesting that in harmony, these two problems can predict schizophrenia itself. Expressed emotion (EE) is the degree to which a person associated with a physically or mentally ill patient has a "critical, hostile, or emotionally overinvolved" attitude toward the patient (pg. 85). The authors contend that many people with high levels of EE have difficulty communicating this effectively, so it is quickly associated with communication deviance (CD) or the "degree to which a relative's communication lacks clarity and causes disruptions in the focus of attention" (Kymalainen and Mamani, 2008, pg. 86). Taken together, these issues can predict schizophrenic behavior in others, suggesting that they may have something to do with its cause. Thus, the circumstance regarding schizophrenia may be a circular one, with symptoms of schizophrenia causing EE and CD, and EE and CD associated with schizophrenia.

Another symptom of schizophrenia that may be difficult for the average person to understand is one of the A's that Bleuler identified -- Autism (Walters, n.d.). Indeed Wout et al. (2007) point out that the emotional deficit among schizophrenics is nothing new or unidentified. Schizophrenics traditionally have a difficult time recognizing emotions and processing those emotions. One of the most important and debilitating symptoms associated with this feature of schizophrenia is the inability to recognize emotional clues in facial expressions. Indeed Wout et al. (2007) discuss the fact that this can lead to difficulty functioning in society. Certainly this can lead to both EE and CD, and a misunderstanding of the schizophrenic individual. Further, this circumstance becomes even more complicated when Wout et al.'s (2007) complete findings are shared. The researchers determined that certain types of schizophrenics and certain sexes are more or less likely to identify different kinds of expressions on faces. Thus, understanding just how the schizophrenic processes emotion or the expression of emotion in others can be difficult.

All of these symptoms can be blanketed under one umbrella -- impaired social functioning. Indeed, Shur et al. (2007) suggest that the degree to which schizophrenic sufferers are impaired socially has been known for quite some time. They do not understand how to think and reason in social situations, and have difficulty reading clues from others. Another central problem in schizophrenic's ability to function in society is the lack of empathy they feel toward others. In their 2007 study, Shur et al. found that schizophrenics exhibit a profoundly lower degree of empathy than healthy individuals when both emotional and cognitive empathy is considered. The authors define emotional empathy as the ability to understand and share another person's emotions. Cognitive empathy, on the other hand, is simply the ability to understand another's circumstances. In both areas, schizophrenics were found deficient. This means that schizophrenics, through no fault of their own, simply cannot understand where others are coming from, thus, they cannot sympathize with them and are often seen as cold, unfeeling, and inappropriate in society. Thus, for schizophrenics, daily functioning in society becomes a task unmatched with many that a healthy, functioning individual can understand. The symptoms make schizophrenics prime candidates for ridicule, stereotyping, discrimination, and alienation. For this reason, understanding the causes of schizophrenia, which will lead to its treatment, is of the utmost importance.

I. Causes

The causes of schizophrenia are even more mysterious than its symptoms. The debate between nature and nurture is relevant in this discussion. Certainly, brain functioning has something to do with the disorder. For instance, Shur et al. (2007) discuss that schizophrenics' empathy deficiencies are a result of both social and neurological impetuses. Walters (n.d.) suggests that schizophrenic brains are unable to correctly process information. Certain areas of the brain, especially the mesoliabic, amygdala, ventral striatum, and prefrontal cortex, operate differently in a schizophrenic than a healthy person. Indeed, the prefrontal cortex seems to be overly active during hallucinations, suggesting a direct link between biology and the condition. Another biological explanation is that of genetics. Because Walters (n.d.) notes that schizophrenia tends to be found in family trees. The twin of a schizophrenic has about a 50-50 chance of becoming a schizophrenic him or herself, while the child of a person afflicted with this disorder has about a 10% chance of becoming afflicted. Calling these numbers "statistically high," Walters notes that some kind of genetic configuration may be responsible, though it is not the traditional configuration that leads to the genetic passing of disorders.

However, social causes can also be cited. Already mentioned is Kymalainen and Mamani's (2008) study that related levels of expressed emotion and communication dysfunction to schizophrenia, suggesting that the roots of the disorder are housed somewhere within the social aspect. In fact, the authors further stress the connection between social components and the disorder when they study the relationship between EE, CD, and culture -- including culture beliefs, values, and ethnic groups. The authors found that "high levels of EE have been found to be significantly associated with high levels of CD," and that "evidence to date also indicates that cultural factors play a substantial role in the presentation and level of EE and CD" (Kymalainen and Mamani, 2008, pg. 90). Because these characteristics have also been linked to schizophrenia, the case for a social impact on the disorder is a strong one. Furthermore, Walters (n.d.) writes that certain theories suggest other social factors that… READ MORE

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