Various psychological theories have been utilized to explain the disorder of schizophrenia. There are about four psychological theories of schizophrenia which include two on regression, one on motivation and another on cognitive functioning (Gattaz & Häfner, 2014). This paper seeks to incorporate psychological theories and current research in order to discuss the characteristics and etiology of schizophrenia as well as distinguish between different symptoms among people. It will also address the demographic aspects of schizophrenia. Lastly, it will describe the different coping mechanism as well as various treatment plans for the disorder.
In terms of cognitive theory, a normal person should have normal cognitive functioning involving proper encoding, processing, and perception. However, schizophrenics usually depict cognitive dysfunction. From motivational theory, schizophrenia is represented by extreme isolation, surrender, and panic (Gattaz & Häfner, 2014). Psychodynamic theories explain that schizophrenia results from unsettled conflict among the superego, ego, and ID which have been suppressed to insensible.
People suffering from schizophrenia depict several characteristics such as loss of insight, thought disorder, delusions as well as hallucinations (Antony & Barlow, 2016). Delusions entail beliefs which are suggestively dissimilar from consensus truth. For instance, schizophrenics can accept as true that a person is out to hurt them in a certain way and this type of delusions is known as paranoid. On the other hand, the hallucinations involve experiencing things through the sensory system of schizophrenics including olfactory, tactile, visual and auditory. According to Harvey (2017), schizophrenia is also characterized by blunted affect which indicates that they are emotionless. Another major characteristic involves cognitive deficits. This deficit entails thinking interference including short-term memory impairment, disturbed attention as well as inability to recognize facial expression which leads to social isolation as well as poor coping strategies (Antony & Barlow, 2016).
The DSM-IV-TR diagnostic criteria particularly use the following symptoms. First, the patients often hear their own thoughts enunciated aloud, other voices talking about them, somatic hallucinations, thought withdrawal delusions, thought broadcasting delusions, delusional perception as well as passivity delusions. Other characteristics include psychotic symptoms like agoraphobia, social phobia, compulsion, obsession, anxiety and depression (Harvey, 2017). The symptoms of schizophrenia are either referred as to as positive or negative. Positive symptoms are those include an increase in behaviors like hallucinations and delusions. In contrast, negative ones entail a decrease in behavior including impoverished movement and blunted effect. What fundamentally distinguish between negative and positive symptoms are the biological factors whereby the latter relates to neurotransmitter malfunction, while the former connects to structural deficits.
Much debate has been put forward concerning the etiology of schizophrenia with several influences suggested and modified. Recent scientific studies indicate that significant contributory factors of this disorder include social, psychological, neurobiology process, early environment, prenatal development as well as genetics (Gattaz & Häfner, 2014). Despite the fact that several factors have been identified to play a contributory role in schizophrenia etiology, no single factor that can be claimed to be a sole cause of this disorder.
According to Gattaz & Häfner (2014), the schizophrenia etiology is considered multifactorial where numerous environmental factors interact with few larger-effects and multiple small-effect susceptibility genes. As a result, these factors developmentally mediates changes in neuroplasticity establishing in a cataract of circuit and neurotransmitter dysfunctions as well as weakened connectivity which mostly starts at prompt adolescence. Numerous environmental influences including stressed neurodevelopment, obstetric complications, and antenatal motherly virus infections have been acknowledged to contribute lesser hippocampal volumes in etiology of schizophrenia (Harvey, 2017). On the other hand, schizophrenia is considered familial whereby studies on adoption, twin and family have given strong evidence that the disorder is heritable. Twin studies meta-analysis has scrutinized the environmental and genes impact on schizophrenia liability and found that 81% represents genetic heritability while 11% denotes shared environmental effects (Lieberman & Murray, 2015). Studies involving Geno-wide association indicate that schizophrenia genetic architecture normally entails several common factors which are of a small effect yet they act together to raise the disease developmental risks. The genes of architectures also include vastly penetrant independently infrequent variations.
Despite the fact that women and men can get schizophrenia, the disorder normally contains numerous dissimilar symptoms which make it be a group of disorders; and hence it is considered a decidedly individualized disorder. As such, each patient experiences schizophrenia differently from another person. In fact, schizophrenia not only depicts individual differences but also feels and looks dissimilar for women and men (Lieberman & Murray, 2015). Although women and men must have both negative and positive symptoms for them to be considered diagnosed with schizophrenia, the kinds of symptoms experienced by women and men are totally different. In that case, the symptoms that men experience are normally severe than those experienced by women. As such, the men usually experience more negative symptoms than the positive ones. Men usually experience disorganization of both speech and behavior, obsessive-compulsive symptom’s, social and cognitive impairments. Conversely, women experience more positive symptoms than the negative ones. They are usually diagnosed with positive symptoms such as delusions and hallucinations as well as effective moods like irritability, fatigue, anxiety, and depression. As demonstrated, women and men suffering from schizophrenia depict different symptoms which in turn affect their life differently. Despite the fact that any schizophrenia symptom is totally upsetting and disturbing, men mostly undergo more and serious difficulties than women.
According to Harvey (2017) men generally develop maladaptive behavior including antisocial conducts, isolations and substance abuse due to the type of schizophrenia symptoms they undergo. As a result, they become homeless, unemployed, troubled family members and friends. The reason behind this difference is because schizophrenia illness creates cognitive problems like inability to complete tasks, decide, and plan as well as lack of drive and motivation. Contrary to men, women can experience a superior worthy life regardless of living with the disorder. The reason behind this is that women have a high probability of marrying and having kids as well as maintaining their employment. The fact that women experience higher social functioning capability enables them to live with schizophrenia in a different way. Another reason as to why men and women experience different symptoms and quality of life is due to the way schizophrenia damages their brain differently.
Schizophrenia habitually develops in late adolescence where new social life, work, and education roles begin. As such, this disorder is particularly associated with high financial, social and individual cost (Lieberman & Murray, 2015). The demographic factors related to the cognitive impairment of schizophrenia include sex, ethnicity as well as educational attainment. Most of the schizophrenics have low education attainment levels in addition to reduced cognitive abilities. Despite the fact that schizophrenia is similarly widespread in both women and men, there are differences in symptoms and onset of the disorder in the two genders. For instance, the negative syndrome is more prevalent and severe in poor and low intelligent men than in women. On the other hand, women tend to show more positive and affective symptoms which have been discussed in the previous paragraphs. In terms of onsets, the illness in women usually peaks between the age of twenty-five and thirty-five while men peak earlier between the age of fifteen and twenty-five. Moreover, some of the culturally independent symptoms include lack of insight. According to () poor insights result to the development of acute schizophrenia in several areas and cultures which World Health Organisation had surveyed. Another study indicates that the occurrence of schizophrenia is almost equal across race, ethnicity, and class despite the fact that there are specific presentation differences which are significant in full comprehension of this disorder.
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According to Lieberman & Murray (2015), there are two main mechanisms designed to cope with the schizophrenia disorder including the emotion-focused and problem-focused. The emotion-focused mechanism involves managing the distressing emotions which are frequently induced by the traumatic circumstances. Contrariwise, the problem-focused mechanism is intended to take action and remove the stressing sources as well as resolve the problem being experienced. The discrete factors related to emotion-focused mechanism include review or denial of the stressor seriousness, turning to religion, accepting the circumstance reality as well as looking for emotional support (Lieberman & Murray, 2015). On the other hand, problem-focused involves information, advice, and assistance seeking from social support instruments, planning, direct action and active coping. While emotional-focused mechanisms are normally applied when individuals realize that the stressor is too hard to overcome, control or manage, the problem-focused ones are often effective as a result of persons recognizing that it is inside their ability to deal positively with the stressing circumstance. Another coping mechanism involves ‘denial’ which is very significant in those experiencing serious and major mental disorder (Lieberman & Murray, 2015). Other strategies which are maladaptive but less useful entail mental or behavioral disengagement, ventilation of affect and focusing on emotional matters. As such these approaches avoid dealing and acknowledging the difficult.
A treatment plan entails a document involving treatments intended to bring outcome goals. For a treatment plan to be operational valuable, it should stipulate the measurements of the progress toward the outcomes as well as covering all the parts that the management are anticipated to affect (Harvey, 2017). Since schizophrenia is a multifaceted and chronic disease, responsibilities of treatments are generally allocated among several providers while urgencies shifted according to the disorder’s phase. The plans should be dynamic as a way of giving coordinated and integrated treatment over time. The goals and needs of a particular person should match with the particular treatments as well individuals should participate in designing their treatment plans. They should also prioritize based on feasibility, criticality, and urgency of the definite treatment aims.
The different treatment plans for schizophrenia include medication adherence, positive symptoms, negative symptoms, cognitive functioning, family interaction or social functioning and daily living activities (Harvey, 2017). One of the bases of schizophrenia treatment is medication, and the regularly prescribed drugs include antipsychotic medications. They control schizophrenic symptoms through affecting and marking the neurotransmitter dopamine of the brain. The goal of this treatment plan is to efficiently manage the symptoms and signs at the lowest conceivable dose. However, medication adherence determines the effectiveness of particular treatment. As such, since there is no accurate medication plan, the psychiatrist should cooperate with the patient by trying various drugs combinations for a particular period of time to attain the anticipated result.
Since antipsychotic medications do not eliminate the positive symptoms, another treatment plan based on cognitive-behavioral approach should be undertaken. This plan helps the patient to assess the evidence of their alleged power and change associated cognitive attributions such that the symptoms create less distress even though it is present (Harvey, 2017).
Decreasing negative symptoms requires interventions focused on increasing the patient’s functioning as well as participation in recreation and leisure activities (Antony & Barlow, 2016). Another plan involves improving cognitive functioning of schizophrenic since they usually experience deficits in planning, memory, attention and psychomotor speed. Techniques involving cognitive remediation should be conducted to enhance their cognitive functioning through using memory, problem-solving, planning and attention based skills which can either be computerized or simply use of a pen and paper. Training in social skills should also be initiated in order to improve their family interaction and social functioning (Harvey, 2017). Other interventions plans should focus on daily living activities such as budgeting, shopping, hygiene and grooming to help them cope with daily functioning.
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The paper has incorporated psychological theories and current research in discussing the characteristics and etiology of schizophrenia. People suffering from schizophrenia depict several characteristics such as loss of insight, thought disorder, delusions as well as hallucinations. The schizophrenia etiology is considered multifactorial where numerous environmental factors interact with few larger-effects and multiple small-effect susceptibility genes. It has also distinguished between different symptoms among people and addressed the demographic aspects of schizophrenia. Schizophrenia not only depicts individual differences but also feels and looks dissimilar for women and men. Lastly, the paper has described the different coping mechanism as well as various treatment plans for the disorder. The different treatment plans for schizophrenia include medication adherence, positive symptoms, negative symptoms, cognitive functioning, family interaction or social functioning and daily living activities.
- Antony, M. M., & Barlow, D. H. (2016). Handbook of assessment and treatment planning for psychological disorders. New York: Guilford Press.
- Gattaz, W. F., & Häfner, H. (2014). Search for the causes of schizophrenia: Volume V. Berlin: Springer-Verlag.
- Harvey, P. D. (2017). Cognitive impairment in schizophrenia: Characteristics, assessment, and treatment. Cambridge: Cambridge University Press.
- Lieberman, J. A., & Murray, R. M. (2015). Comprehensive care of schizophrenia: A textbook of clinical management. Oxford: Oxford University Press.