Interview with a Psychology student

For this blog entry, the author has interviewed a college student majoring in psychology. Their answers to the following questions are based on their knowledge and opinion, which may sound biased to some audiences.

To establish a safe online presence, the interviewee’s name and school have not been disclosed.

 

(Without stating name) do you know anyone with schizophrenia?

• “No, I do not.”

when do you think the onset age is for schizophrenia?

• “Late adolescence, or early to mid-twenties.”

 

Pertaining to question above, why do you think onset is at that age?

• “It comes down to the diathesis-stress model – individuals must first have an inclination for schizophrenia, which is then brought out through stress. Late adolescence and early adulthood can be considered very stressful periods during a person’s life (new responsibilities, etc).”

 

Why does this blog matter?

This blog and its interviews are for the sole purpose of informing audiences that mental disorders are not as strange as they sound; that those with mental disorders still experience daily life like those without mental disorders.

The entries in this blog inform and compare the symptoms of Schizophrenia to everyday situations in attempt to prove this point, along with literature as references for support.

All individuals have burdens to bear, whether it is through projects at work or studying for tests through school, and those with mental disorders still experience the same strife and challenges in society as well as others without mental disorders.  

 

Interview with a professor

Recently the author interviewed a professor with a PhD in Cognitive Neuroscience.
Cognitive neuroscience looks at the ways the brain works at a neural level, along with studying what parts of the brain make a person function as they do.
For anonymity, the professor’s name will not be mentioned, nor where they work.

These are the questions and responses from the interview:

What is cognitive neuroscience? What does it look for in studies?

“Cognitive neuroscience attempts to provide a knowledge about the interface between thinking processes, reasoning processes, memory processes, and physiological (brain) processes. It also simultaneously look at neural processes”

What are the understandings so far of what Schizophrenia is in the world of Neuroscience?

“Schizophrenia is a complex phenomenon that involves both physiological changes in brain, changes in cellular function and gross anatomy.”

Are there any physical differences between a brain of a person with schizophrenia than a brain of a person without?

“Schizophrenic patients tend to have reduced frontal lobes in particular compared to non schizophrenic patients or healthy individuals.”

Pertaining to the question above, are the only physical differences?

“It also has pharmacological changes, particularly changes in the chemical Dopamine that also function differently. All these changes add up to the complex set of symptoms that we call schizophrenia is still very much under study... enlarged ventricles are only a reflection of cortical loss”

Are any studies in cognitive neuroscience being done to help those with schizophrenia or other mental disorders?

“there are broadly attempts at pharmacological interventions that try to mediate but there not really any strong hypotheses about them at this point”

Lastly, can there be cases of schizophrenia receiving ‘bad rap’ that cognitive neuroscience can clarify?

“I think the notion that an individual chooses to have a lifestyle like that reminds me of the idea people thought back in the eighties that ‘homeless people choose to be homeless’. Those ideas are really more ‘self-serving’ ideas for people who don’t want to support things like housing for homeless people and so forth.
But I think people are relatively sophisticated today and understand that people who who don’t behave the same as others sometimes have an illness.”

Some public views of Schizophrenia

Here is a podcast of some public opinion of schizophrenia from college students. This is to show what some people may think schizophrenia is today.

There may be bias from those interviewed in this podcast.

For the interview the author asked this question:

“What do you think schizophrenia is in your opinion?”

Public view podcast

Guest Post: A Layman’s View of Schizophrenia

For a class project, the author of Schizohuman and another blogger decided to guest blog for the other for one post.

Below is the guest blog from blogger Azuelas of the nanotech analysis blog.

All words written below are from this guest blogger and the sources they used to make this blog post possible.

 

Before reading this blog, I had a very rudimentary understanding of the mental disorder Schizophrenia. Although I have never met a person with the disorder, my negative bias toward the disorder likely would have stained any relationship I would have had with such a person. Much of this stigma is created through dramatizations of the disorder in popular culture.

Negative Cultural References to Schizophrenia

 There is a common misconception “that schizophrenia is the same thing as ‘split personality’ or ‘multiple personality disorder’” (Lilienfeld, 2011). This misconception has been carried over to the big screen in movies such as Me, Myself, and Irene, starring Jim Carrey. The main character supposedly suffers from schizophrenia (according to the film), yet he actually suffers from a dissociative identity disorder, one calm and peaceful and the other aggressive and violent.

Violent natures and actions are also commonly associated with those suffering from schizophrenia. Persons with the disorder “are unstable [and] attack people for no reason” (Site Administrator, 2006). The screaming naked man from The Sixth Sense is a perfect example of this behavior, unpredictable and potentially dangerous to those that may cross this person’s path. Unfortunately, many movies regarding this disorder are in the horror genre (typically with the sufferer playing the role of the antagonist).

Realistic Cultural References to Schizophrenia

There is no positive spin one can take on the schizophrenia. Movies have tried to give a view into the minds of those suffering from the disorder within a realistic light. In A Beautiful Mind, “Jonathan Nash struggles with the symptoms of paranoid schizophrenia (including delusions) as he lives his life and watches the pain it brings to his family” (Schizophrenia Awareness Group, 2010). Nash is not a violent threat to his family or others throughout the movie.

Another movie focusing on schizophrenia is Donnie Darko, where we follow the titular Donnie discovering the meaning behind his delusions and hallucination. While presented as a social deviant in some respects, Donnie is never shown to be a threat to his family or friends, simply suffering from the delusions brought on by his condition.

Personal View of Schizophrenia

Schizophrenia is one of the saddest disorders that I have researched. To be bombarded all day, every day with voices would be intolerable, in my opinion. Hallucination and delusions over which you have no control would be more than I could imagine handling. However, research shows that many suffering from schizophrenia do well on medications and can (and do) lead normal lives. They are not a threat to society so long as they are given the proper help to cope with the negative effects of the disorder.

 

Author

Azuelas of http://nanotechcatalysis.wordpress.com

Referenes

 Lilienfeld, S.O., et. al. (2011). 50 Great Myths of Popular Psychology: Shattering Widespread Misconceptions about Human Behavior. Retrieved from http://books.google.com/books?id=8DlS0gfO_QUC&dq=schizophrenia+pop+culture&source=gbs_navlinks_s on April 25, 2012.

Schizophrenia Awareness Group. (2010). Schizophrenia in Pop Culture. Schizophrenia Awareness [blog]. Retrieved from http://schizophreniaawareness.blogspot.com/2010/05/schizophrenia-in-pop-culture.html on April 25, 2012.

Site Administrator. (2006). Psychiatry Vs. Pop Culture [blog]. Retrieved from http://www.grahamazon.com/over/2006/05/psychiatry-vs-pop-culture/ on April 25, 2012.

 

Other Psychotic Disorders related to Schizophrenia

Note that the author is writing only about the disorders people have, not what they think or feel. The author writes with the utmost delicacy and acknowledgement of such in each entry.

There are many sub-types of psychotic disorders people can have. This does not mean that they do not think or feel outside of the disorder. Here are a few related disorders that pertain to schizophrenic symptoms.

Delusional Disorder

This disorder’s title, like that of Brief Psychotic Disorder, is also more straightforward than other psychology terms. According to Nolen-Hoeksema, delusional disorder includes some symptoms (but not all) that stray different from that of Schizophrenia:

• Non-bizarre Delusions that may occur in real life, yet still however cause distress in the individual suffering from this disorder
• The well-known criteria for Schizophrenia (Delusions, hallucinations, etc.) have never been met before
• The symptoms do not entirely disrupt the individual from their life in school, work, etc.
  (Nolen-Hoeksema, 2011).

This disorder previously had another name. According to Amal Chakraburtty from the Web MD website, delusional disorder was “previously called paranoid disorder, [and] is a type of serious mental illness called a “psychosis” in which a person cannot tell what is real from what is imagined” (Chakraburtty,2009).

This doesn’t mean that they do not know what is going on or what is happening; just because someone has a disorder doesn’t mean they are not aware of it.

Although this disorder’s requirements are less demanding compared to the other schizophrenic disorders, it does not mean that this disorder is not bothersome to people who have it.

Schivani Chopra states that “the individual may rarely seek psychiatric help, remain isolated, and often present to internists, surgeons, dermatologists, policemen, and lawyers rather than psychiatrists” due to how ‘mild’ this disorder is compared to its psychotic disorder relatives (Chopra, 2011).

Shared Psychotic Disorder

This disorder relates to the theory of mental disorders as contagious. Shared Psychotic Disorder is a disorder with symptoms of developing a delusion from being in a close relationship or affiliation with a person who already has a delusion on their own. To meet the requirement of having this disorder, the delusion must be similar to that of the other person -who has a delusion on their own- and not due to any other psychotic disorders, drug substances or other medical issues.

To clarify, John Grohol from the Psych Central website states, “Individuals who come to share delusional beliefs are often related by blood or marriage and have lived together for a long time, sometimes in relative social isolation” (Grohol, 2010).

However scary this may seem, this does not mean someone can develop delusions or ‘catch schizophrenia’ just by being around someone who has it. The Cleveland Clinic Website states that “The delusions [of Shared Psychotic Disorder] are induced in the secondary case and usually disappear when the people are separated…Aside from the delusions, the thoughts and behavior of the secondary case usually are fairly normal” (Cleveland Clinic Website, 2009).

Glossary

1) Schizoaffective Disorder- is “a mix of schizophrenia and a mood disorder” (Nolen-Hoeksema, 2009).
2)  Schizophreniform Disorder- overlaps symptoms of Schizophrenia, such as having delusions and hallucinations, but lasting less than 6 months.
3) Brief Psychotic Disorder- requires the symptoms of Schizophrenia (Delusions, hallucinations, etc.) but in the time frame of at least 1 day but less than 1 month, returning to normal functioning afterwards.
4) Delusional Disorder- includes symptoms that include non-bizzare delusions that can occur in real life, that the well-known symptoms of Schizophrenia are not present, that the disorder does not entirely disrupt the person from their daily life, and that any mood episodes are brief compared to other schizophrenic disorders. Delusional Disorder would be seen as ‘mild’ at face value, and is normally not brought to psychologists and psychiatrists due to how mild it seems.
5) Shared Psychotic Disorder- is a disorder with symptoms of developing a delusion from being in a close relationship or affiliation with a person who already has a delusion on their own.

References:

1)  (2009). In Cleveland Clinic Foundation. Retrieved March 31, 2012, from http://my.clevelandclinic.org/disorders/psychotic_disorder/hic_shared_psychotic_disorder.aspx
2)  Chopra, S. (2011, March 10). In Medscape Reference. Retrieved March 31, 2012, from http://emedicine.medscape.com/article/292991-overview
3) Nolen-Hoeksema, S. (2011). (ab)normal psychology (5th ed., pp.238-240). New York, NY: McGraw-Hill.
4) Chakraburtty, A. (2009). In WebMD. Retrieved April 5, 2012, from http://www.webmd.com/schizophrenia/delusional-disorder
5) Grohol, J. M. (2010, October 16). In Psych Central . Retrieved April 5, 2012, from http://psychcentral.com/disorders/sx54.htm

 

Psychotic Disorders related to Schizophrenia

Note that the author is writing only about the disorders people have, not what they think or feel. The author writes with the utmost delicacy and acknowledgement of such in each entry.

Slightly different from the sub-types of Schizophrenia are the other related schizophrenic disorders in the mental disorder spectrum. This entry will explain the different burdens those with Schizophrenia must bear. These have schizophrenic symptoms, but with symptoms from other mental disorders. With these types of disorders, this does not mean that they do not know what is going on or what they are dealing with.  These different types related to Schizophrenia are:

Schizoaffective disorder
Schizophreniform
Brief Psychotic Disorder
Delusional Disorder
Shared Psychotic Disorder

Schizoaffective Disorder

According to Nolen-Hoeksema, Schizoaffective Disorder is “a mix of schizophrenia and a mood disorder” (Nolen-Hoeksema, 2011). The Fourth Edition of the Diagnostic Statistical Manual of Mental Disorders, or the DSM-IV, names requirements that must be met in order for a person to be diagnosed with this disorder. Only some are mentioned here:

• An uninterrupted period of time where they must be in a depressive, manic, or a state of both along with having symptoms meeting requirements of schizophrenia
• The person must have had delusions/ hallucinations for as little as two weeks without mood symptoms
• The symptoms meeting requirements for a mood episode are present for most of the duration of the period of the illness taking place.
• The onset of the disorder not caused by other factors such as substances or  medical conditions

Diagnosis of this disorder is very hard. According to the Mayo Clinic website, “Schizoaffective disorder is not as well understood, or defined, as are other mental health conditions. This is largely because schizoaffective disorder is a mix of multiple mental health conditions that may run a unique course in each affected person” (MayoClinic, 2010).

Schizophreniform Disorder

Schizophreniform Disorder also overlaps symptoms of Schizophrenia, with similar requirements as well as new ones. The requirements that must be met to be diagnosed with this disorder are:

• Having Delusions,
• Hallucinations,
• Disorganized speech and behavior,
• Catatonic behavior,
• Not meeting requirements of Schizoaffective and mood disorders (mentioned in heading ‘A’ above)
• The onset of the disorder is not due to other factors such as drugs or other medical issues.

There is one requirement for Schizophreniform that needs to be met compared to Schizophrenia: Ravinder Bhalla states that “schizophreniform disorder requires -among other features- a rather rapid period from the onset of prodromal symptoms to the point at which all criteria for schizophrenia (except duration and deterioration) are met (within 6 months)” (Bhalla,2011).

Joseph Goldberg of the WebMD website states that there is a fine line between the difference of Schizophreniform and Schizophrenia.  “Although schizophrenia is a lifelong illness, Schizophreniform disorder involves symptoms that are present for less than six months… When symptoms persist longer than six months, the diagnosis is typically changed to schizophrenia” (Goldberg, 2012).

Brief Psychotic Disorder

The title of this mental disorder is more straightforward than the others mentioned above. Brief Psychotic Disorder requires the symptoms of Schizophrenia (delusions, hallucinations, etc.) but in the time frame of at least 1 day but less than 1 month, returning to normal functioning afterwards. It must also not be caused by other factors such as drugs or medical issues, like that of the other psychotic disorders mentioned above.

Like Schizophrenia, the onset of Brief Psychotic Disorder is around young adulthood. The MedicineNet website states that Brief Psychotic Disorder “generally first occurs in early adulthood (20’s and 30’s), and is more common in women than in men” (MedicineNet, 2008).

Joseph Goldberg of the WebMD website states that the onset of Brief Psychotic Disorder is “shortly after and often in response to a trauma or major stress…Most cases of brief psychotic disorder occur as a reaction to a very disturbing event” (Goldberg, 2012).
Because of this, Brief Psychotic Disorder can be confused with Post Traumatic Stress Disorder, otherwise known as PTSD. The author would describe the symptoms of PTSD here in this blog to clarify the differences, but fears that the information of Schizophrenia is too much to stray from at this time.

Glossary

1) Schizoaffective Disorder- is “a mix of schizophrenia and a mood disorder” (Nolen-Hoeksema, 2011).
2)  Schizophreniform Disorder- overlaps symptoms of Schizophrenia, such as having delusions and hallucinations, but lasting less than 6 months.
3) Brief Psychotic Disorder- requires the symptoms of Schizophrenia (Delusions, hallucinations, etc.) but in the time frame of at least 1 day but less than 1 month, returning to normal functioning afterwards.
4) Delusional Disorder- includes symptoms that include non-bizzare delusions that can occur in real life, that the well-known symptoms of Schizophrenia are not present, that the disorder does not entirely disrupt the person from their daily life, and that any mood episodes are brief compared to other schizophrenic disorders. Delusional Disorder would be seen as ‘mild’ at face value, and is normally not brought to psychologists and psychiatrists due to how mild it seems.
5) Shared Psychotic Disorder- is a disorder with symptoms of developing a delusion from being in a close relationship or affiliation with a person who already has a delusion on their own.

References:

1) (2008). In MedicineNet. Retrieved March 13, 2012, from http://www.medicinenet.com/brief_psychotic_disorder/article.htm
2) (2010, December 21). In Mayo Clinic. Retrieved April 5, 2012, from http://www.mayoclinic.com/health/schizoaffective-disorder/DS00866
3) Bhalla, R. M. (2011, June 10). In Medscape Reference. Retrieved April 5, 2012, from http://emedicine.medscape.com/article/2008351-overview
4) Goldberg, J. (2012, February 14). In WebMD. Retrieved March 31, 2012, from http://www.webmd.com/schizophrenia/guide/mental-health-schizophreniform-disorder?page=2
5) Nolen-Hoeksema, S. (2011). (ab)normal psychology (5th ed., pp.238-240). New York, NY: McGraw-Hill.

 

Other sub-types of Schizophrenia

Note that the author is writing only about the disorders people have, not what they think or feel. The author writes with the utmost delicacy and acknowledgement of such in each entry.

There are other sub types of Schizophrenia. To mention a few, here are the schizophrenic sub-types catatonic schizophrenia, undiferentiated schizophrenia, and residual schizophrenia.

 Catatonic Schizophrenia

Catatonic Schizophrenia is a mental disorder where the behaviors include unresponsiveness to the world around. The person may feel like they need to sit still for long periods, or may not feel the need to move at all for any reason.  Related to one of the symptoms of the general form of Schizophrenia, there is another section of behavior in the catatonic category, called Catatonic excitement. Catatonic Excitement is the behavior of having the need to move excessively.

Catatonia is not just related to Schizophrenia. The CNN website states that “Some of the health problems that can lead to catatonia include other mood disorders, such as depression and bipolar disorder, and medical conditions that affect the central nervous system” (CNN, 2010).

According to Catatonic Schizophrenia website, unlike other schizophrenic disorders, Catatonic Schizophrenia has symptoms concerning the physical, not the mental or social (Catatonic Schizophrenia.net, 2012)

•  Comparison to a situation deemed normal: Sometimes, we feel too tired or unmotivated to do anything, such as procrastinating on homework or chores, and would rather sit and relax or do nothing instead. Or, in our busy lives, we may feel rushed and have the need to perform many tasks at once and constantly move around to do so.

Undifferentiated Schizophrenia

This type of Schizophrenia can be hard to treat. This is due to the fact that Undifferentiated Schizophrenia meets requirements of the general form of Schizophrenia, but do not meet the requirements of its sub-types. According to Dr. Michael Bengston of the Psych Central website, “The symptoms of any one person can fluctuate at different points in time, resulting in uncertainty as to the correct subtype classification” and therefore, Undifferentiated Schizophrenia is diagnosed in order for the person to still get treatment (Bengston, 2006).

As stated at the beginning of this entry, the subtypes of Schizophrenia are there to help the those in the psychology field diagnose a patient properly and provide them proper treatment under those specifics. Because the symptoms of Schizophrenia can be vague in themselves due to what type of symptoms people show, the person’s lifestyle, the similarity to other mental disorders, and other factors that make diagnosis difficult, subtypes help organize to understand the type of treatment people need.

•  Comparison to a situation deemed normal: There are many factors in our lives that influence our behavior. These factors can cause confusion over what is actually the cause. As stressful day could make us want to sit and do nothing just to relax, or have us become tongue-tied or scatter-brained in our words. Undifferentiated Schizophrenia is the same, with symptoms that may or may not overlap with others and be a clear distinction between what type of Schizophrenia the person has.

 Residual Schizophrenia

Like Undifferentiated Schizophrenia, this sub-type can be hard to treat. Residual Schizophrenia explains when a person has had an acute episode of the symptoms of Schizophrenia in order to qualify for the mental disorder, but do not show any prominent symptoms afterwards.

Residual Schizophrenia may look like a ‘phase’ that may pass, but like every symptom of every mental disorder the experience is no less real. According to another article from Bengston of the Psych Central website, “Hallucinations, delusions or idiosyncratic behaviors may still be present, but their manifestations are significantly diminished in comparison to the acute phase of the illness” (Bengston, 2006).

This is the type of mental disorder that is commonly assumed as ‘just some episode that will pass’, making it hard for people to understand that it can be a problem and to look for help to solve it.

We all have had our moments that can look like a mental disorder on the surface, but these ‘moments’ become problem that can’t be ‘gotten over’ or ignored, seeking help is the best option. With this, it can be hard for others without a mental disorder to understand what is a ‘phase’ and what is a real problem, and sympathize with those who must live with mental disorders.

•  Comparison to a situation deemed normal: Certain events in our lives may make us act in ways that look like disorders, as mentioned above. These can include feeling scatterbrained from trying to multitask or due to overwhelming responsibilities.

These sub-types help professionals in the psychology field understand what type of Schizophrenia people have out of all the factors that create the onset of the disorder, and out of the differences between people and their lives.

Without these sub-types, the confusion between the degrees of the symptoms make it hard to tell what type of treatment people need. For treatments to be successful, they must be tailored as much as possible to the person who has the mental disorder, regardless of what type.

Glossary

1) Paranoid Schizophrenia is a sub-type of Schizophrenia that includes “delusions and hallucinations with themes of persecution and grandiosity” (Nolen-Hoeksema, 2009).
2) Disorganized Schizophrenia is a sub-type of Schizophrenia that is disorganized in speech, behavior and affect (emotion), and cognition. A person with this mental disorder is like the ‘disorganized speech’ section of the general form of Schizophrenia; they speak in ‘word salads’ and their sentence structure can get mixed up. Along with ‘word salads’, they can show the wrong emotion for the wrong situation.
3) Catatonic Schizophrenia is a mental disorder where the behaviors include unresponsiveness to the world around. The person may feel like they need to sit still for long periods, or may not feel the need to move at all for any reason.
4) Catatonic Excitement is the behavior of having the need to move excessively for no purpose whatsoever.
5) Undifferentiated Schizophrenia meets requirements of the general form of Schizophrenia, but do not meet the requirements of its sub-types.
6) Residual Schizophrenia explains when a person has had an acute episode of the symptoms of Schizophrenia in order to qualify for the mental disorder, but do not show any prominent symptoms afterwards.

  References:

1)      (2012). In CatatonicSchizophrenia.net. Retrieved March 30, 2012, from http://catatonicschizophrenia.net/catatonic-schizophrenia/

2)      (2010, December 17). In CNN. Retrieved April 5, 2012, from http://www.cnn.com/HEALTH/library/catatonic-schizophrenia/DS00863.html

3)      Bengston, M. (2006). In PsychCentral. Retrieved March 31, 2012, from http://psychcentral.com/lib/2006/residual-schizophrenia/

4)      Bengston, M. (2006). Undifferentiated Schizophrenia. Psych Central. Retrieved on April 6, 2012, from http://psychcentral.com/lib/2006/undifferentiated-schizophrenia/

5)      Nolen-Hoeksema, S. (2011). (ab)normal psychology (5th ed., pp.235-236). New York, NY: McGraw-Hill.

The Sub-types of Schizophrenia

We have covered so far the types of symptoms of the general form of Schizophrenia. Like the different types of symptoms Schizophrenia has, there are different types of the mental disorder itself.  The subtypes of Schizophrenia are there to help the Psychologist and Psychiatrists diagnose a patient properly and provide them proper treatment under those specifics.

Simply diagnosing a person with Schizophrenia may seem too vague when it comes to understanding what treatment the patient needs in order to help them.

These different types are:

• Paranoid Schizophrenia
• Disorganized Schizophrenia
• Catatonic Schizophrenia
• Undifferentiated Schizophrenia
• Residual Schizophrenia

Like the different personalities of people, everyone has different characteristics with some overlaps to others. These different types of Schizophrenia are the same in such concept.

Many of these symptoms overlap with each other and with the general form of Schizophrenia. Let’s go over each one with a comparison to situations that would be deemed normal to someone without a mental disorder:

Paranoid Schizophrenia

Paranoid Schizophrenia is a sub-type of Schizophrenia that includes “delusions and hallucinations with themes of persecution and grandiosity” (Nolen-Hoeksema, 2011). In the past two entries, we covered that delusions are irrational thoughts about people, places, and things and hallucinations as things a person claims to see that no one else sees.

We also covered that delusion of persecution is the thought of being watched or spied on and grandiosity as feelings of importance or superiority above others. According to Nolen-Hoeksema, this mental disorder is the ‘best known and most researched type’ (Nolen-Hoeksema).

•  Comparison to a situation deemed normal: some would relate this mental disorder to book characters whose personalities would change as the plot progresses. For example, Willy Loman of the book Death of a Salesman

 This disorder does not have some of the symptoms that the general form of Schizophrenia has. According to Merrill and Zeive of the Medline Plus Medical Encyclopedia, “Paranoid schizophrenia usually does not involve the disorganized speech and behavior that is seen in other types of schizophrenia” (Merrill and Zeive, 2010).

However, regardless if it has less of some symptoms than others, the disorder requires just as much attention for treatment. According to the Medical News Today website, “a person with paranoid schizophrenia has fewer problems with memory, dulled emotions and concentration compared to individuals with other subtypes; usually allowing them to think and function more successfully…Nevertheless, paranoid schizophrenia is a chronic (long-term, lifelong) condition which may eventually lead to complications, including suicidal thoughts and behavior” (Medical News Today, 2010).

Disorganized Schizophrenia

Disorganized Schizophrenia does not mean that whoever has this disorder has a messy room, workspace or lifestyle. Although that this mental disorder’s name seems to portray that, this is not the case. Disorganized Schizophrenia is a sub-type of Schizophrenia that is disorganized in speech, behavior and affect (emotion), and cognition.

A person with this mental disorder is like the ‘disorganized speech’ section of the general form of Schizophrenia; they speak in ‘word salads’ and their sentence structure can get mixed up. Along with ‘word salads’, they can show the wrong emotion for the wrong situation, such as laughing in situations where people are supposed to act sad, and be sad in happy situations.

Disorders of Schizophrenia, as well as other mental disorders, are important and require attention in order to get treatment. Disorganized Schizophrenia, according to CNN website, requires such attention; “Disorganized schizophrenia is considered a more severe type of schizophrenia because people with this condition may be unable to carry out routine daily activities” (CNN, 2010).

According to another article of Merrill and Zeive of the Medline Plus Medical Encyclopedia, “Some of these symptoms are also seen in other types of schizophrenia. The main difference is that in disorganized schizophrenia, there is a lot of strange, aimless behavior and often speech that does not make sense” (Merrill &Zeive, 2012)

• Comparison to a situation deemed normal: at some points in our lives, with all the responsibilities that we have and all the thoughts we think to keep us going, we can become tongue-tied and our thoughts may come out in an unusual order. With that, we may feel disorganized in thought due to our busy lives that we seem to be unable to keep up.

Glossary

1) Paranoid Schizophrenia is a sub-type of Schizophrenia that includes “delusions and hallucinations with themes of persecution and grandiosity” (Nolen-Hoeksema, 2011).
2) Disorganized Schizophrenia is a sub-type of Schizophrenia that is disorganized in speech, behavior and affect (emotion), and cognition. A person with this mental disorder is like the ‘disorganized speech’ section of the general form of Schizophrenia; they speak in ‘word salads’ and their sentence structure can get mixed up. Along with ‘word salads’, they can show the wrong emotion for the wrong situation.
3) Catatonic Schizophrenia is a mental disorder where the behaviors include unresponsiveness to the world around. The person may feel like they need to sit still for long periods, or may not feel the need to move at all for any reason.
4) Catatonic Excitement is the behavior of having the need to move excessively for no purpose whatsoever.
5) Undifferentiated Schizophrenia meets requirements of the general form of Schizophrenia, but do not meet the requirements of its sub-types.
6) Residual Schizophrenia explains when a person has had an acute episode of the symptoms of Schizophrenia in order to qualify for the mental disorder, but do not show any prominent symptoms afterwards.

  References:

1) (2010, December 10). In CNN. Retrieved April 5, 2012, from http://www.cnn.com/HEALTH/library/disorganized-schizophrenia/DS00864.html
2) (2010, June 23). In Medical News Today . Retrieved April 5, 2012, from http://www.medicalnewstoday.com/articles/192621.php
3) Merrill, D. B., & Zieve, D. (2010, February 7). In Medline Plus Medical Encyclopedia. Retrieved April 5, 2012, from http://www.nlm.nih.gov/medlineplus/ency/article/000936.htm
4)  Merrill, D. B., & Zieve, D. (2012). In Medline Plus Medical Encyclopedia . Retrieved March 30, 2012, from http://www.nlm.nih.gov/medlineplus/ency/article/000937.htm
5) Nolen-Hoeksema, S. (2011). (ab)normal psychology (5th ed., pp.235-236). New York, NY: McGraw-Hill.

Other Negative Symptoms and Diagnostic Symptoms of Schizophrenia

Diagnosis of Schizophrenia  

As we have discussed in the third entry of this blog “Diagnosis of a Mental Disorder”, with the meeting the qualifications of the “Four D’s of Abnormality”, Schizophrenic Diagnosis has other qualifications in order to determine if a person has that specific disorder.

Diagnostic Statistical Manual of Mental Disorders states that some of the symptoms of Schizophrenia must be present for as little as 6 months, with one of those 6 months with the symptoms severe enough to disrupt the person’s life, work, or school (Nolen-Hoeksema, 2011).

However, the symptoms do not just appear in a snap. Symptoms of Schizophrenia can come gradually in small stages before becoming a full-fledged mental disorder. Researchers Tonya White, Afshan Anjum, and S. Charles Schulz of the Psych Central website state that “the constellation of symptoms in the schizophrenia prodrome tends to be nonspecific, especially in the early stages. Thus, prodromal symptoms are not deterministic from a prospective point of view”. (White et al., 2006).

Diagnosis of the mental disorder from the symptoms can come in two forms, Prodronal Symptoms and Residual Symptoms.

• Prodromal Symptoms are symptoms that are present before the person goes into the acute phase of the mental disorder. This means that there are some symptoms of the disorder present within the 6 month period, before the ‘one month of acute symptoms’ takes place in order to fully qualify for diagnosis.

For example, they could have some symptoms of the disorder, such as delusions or hallucinations, but not have them in the most severe form just yet in order for the disorder to be disruptive to them.
It can be considered as a mild case before the acute onset.

But not all symptoms of a mental disorder last. According to Michael Bengston of the Psych Central website state that “Most will have a waxing and waning course” from their mental disorder (Bengston, 2011).

• Residual Symptoms are symptoms that are present after the person has emerged from the acute phase of the disorder. They have met qualifications to be diagnosed, but the symptoms and their severities have ‘died down’ or have ‘faded’. It can be considered as a mild case after the acute onset.

For example, if a person has been diagnosed with Schizophrenia, and experiences of delusions and hallucinations have become less frequent since the acute phase, they have Residual Symptoms.

According to Dean Haycock of the Netplaces website, residual symptoms are ““watered down” versions of psychotic symptoms…These symptoms differ from those seen in other types of schizophrenia because they are not as severe, incapacitating, organized, or persistent” (Haycock, 2009).

As mentioned in prior entries, the onset of Schizophrenia is around the early adult years, or college years, of a person. Both men and women are susceptible to having Schizophrenia, regardless of race or ethnicity. According to the New York Times, the onset of Schizophrenia is around “teen years or young adulthood, but may begin later in life. [And]It tends to begin later in women, and is more mild” (New York Times).

There is a sub type of Schizophrenia, called Childhood –Onset Schizophrenia. With the onset approximately at the age of five years, it can be difficult to tell if the child’s behavior is due to the disorder, or to other factors. This case is very rare.

We have now covered the positive symptoms and negative symptoms of Schizophrenia, describing how these symptoms can relate to everyday situations in their varying degrees. In the next entry, we will discuss the sub-types of Schizophrenia, and how their symptoms not only overlap those of Schizophrenia, but how their symptoms relate to everyday situations as well.

Glossary-

1) Negative Symptoms- the behaviors lost during the onset of the mental disorder
2) Affective flattening- the absence or ‘flattening’ of emotion or emotional response to the world
3) Alogia– a lack in speech or speaking to others
4) Avolition– lack of willingness or ability to pursue goals or tasks that need completion
5) Prodronal Symptoms are symptoms that are present before the person goes into the acute phase of the mental disorder. This means that there are some symptoms of the disorder present within the 6 month period, before the ‘one month of acute symptoms’ takes place in order to fully qualify for diagnosis. It can be considered as a mild case before the acute onset.
6) Residual Symptoms are symptoms that are present after the person has emerged from the acute phase of the disorder. They have met qualifications to be diagnosed, but the symptoms and their severities have ‘died down’ or have ‘faded’. It can be considered as a mild case after the acute onset.

References:

1)      Bengston, M. (2011). Types of Schizophrenia. Psych Central. Retrieved on April 7, 2012, from http://psychcentral.com/lib/2006/types-of-schizophrenia/

2)     Haycock, D. (2009). In Netplaces. Retrieved April 6, 2012, from http://www.netplaces.com/schizophrenia/what-type-of-schizophrenia-are-you-dealing-with/undifferentiated-and-residual-schizophrenia.htm

3)     Nolen-Hoeksema, S. (2011). (ab)normal psychology (5th ed., pp.233-235). New York, NY: McGraw-Hill.

4)     Schizophrenia. New York Times. Retrieved March 23, 2012, from http://health.nytimes.com/health/guides/disease/schizophrenia/overview.html

5)     White, T., Anjum, A., & Schulz, C. (2006, March 1). In Psychiatry Online: American Journal of Psychiatry. Retrieved April 6, 2012, from http://ajp.psychiatryonline.org/article.aspx?Volume=163&page=376&journalID=13

Negative symptoms and Diagnostic Symptoms of Schizophrenia

So far, we have recapped on what the symptoms are of Schizophrenia as a whole, as well as its positive symptoms; the behaviors that are gained during the onset of the mental disorder. We now come to discuss the ‘Negative Symptoms’ of Schizophrenia, the behaviors lost during the onset of the mental disorder

Negative Symptoms of Schizophrenia

Compared to the Positive symptoms of the disorder, the negative symptoms are far less in amount, yet are still important in order to help the person find treatment. These symptoms are:

• Affective flattening- the absence or ‘flattening’ of emotion or emotional response to the world
• Alogia– a lack in speech or speaking to others
• Avolition– lack of willingness or ability to pursue goals or tasks that need completion

Although the positive symptoms mentioned in the previous entry seem more important for treatment -due to the number of symptoms and their subtypes- the Harvard Medical School website claims that “negative symptoms are the main reason patients with schizophrenia cannot live independently, hold jobs, establish personal relationships, and manage everyday social situations. These symptoms are also the ones that trouble them most” (Harvard medical School, 2006).

These symptoms do not seem as prominent as the positive symptoms of Schizophrenia due to how similar they are to other mental disorders. The National Institute of Mental Health (NIMH) website states that negative symptoms are “harder to recognize as part of the disorder and can be mistaken for depression or other conditions” (NIMH, 2009).

These symptoms are also more common and more persistent, making them just as important as positive symptoms in Schizophrenia.  The University of Maryland Medical Center website states that negative symptoms “tend to be more common than positive symptoms in older patients and typically persist after positive symptoms have been treated” (UMMC, 2011).

To look at this in another light, we sometimes  want to not respond to the world due to our exhaustion of our busy life, wanting to just ‘get away from it all’ and ‘just do nothing’. Schizophrenia’s negative symptoms seem as such, but are in no way a type of relief from the stressful world.

The Emotion is Still There

While people experiencing negative symptoms mental disorder seem to show that they don’t have emotion at all or seem to ‘not care’, they still can feel emotion even if they do not physically express it. In a study stated by Nolen-Hoeksema, Schizophrenic patients and patients without the disorder were shown films that expressed high emotion, and their physiological arousal and facial expressions were recorded.

Results showed that “people with Schizophrenia showed less facial responsiveness to the films than did the normal group, but they reported experiencing just as much emotion and showed even more physiological arousal” (Nolen-Hoeksema, 2011).

Not everyone shows emotion in the same way, and sometimes do not show it for reasons such as pride or embarrassment. For those with negative symptoms of Schizophrenia, emotions of the person are still there, but cannot express it in the way they want to show others.

The Cognitive Deficits of Schizophrenia

Due to the author’s past about being stereotyped as mentioned in the first entry of this blog, the author believes that the term ‘cognitive deficits’ is a strong one, and decided to touch upon this topic as delicately as possible.

As everyone thinks in ways different than others, one can say that some things are more obvious to people than they are to others. If that is the case, than the term ‘cognitive deficits’ cannot be used subjectively to one person’s opinion.

Cognitive deficits refer to lack of cognitive skills such as social cues or facial expressions. Although anyone can be susceptible of misreading someone’s facial expression as something else, the symptoms of Schizophrenia prove this difficult for those who must live with the disorder.
This does not mean that they do not have the ability to socialize with others, but that the attention and memory disruption associated with the symptoms can make recognizing social cues as somewhat difficult.

According to Gopal and Variend of the Advances in Psychological Treatment website, cognitive deficits “can manifest as an inability accurately to recognize social cues or to retrieve appropriate responses. Consequently, patients have difficulty acquiring social and interpersonal skills” (Gopal and Variend, 2012).

Imagine talking to an actor who is highly experienced in portraying facial expressions. As they use their hands to talk, they change variation in the tone of their voice to match their facial expression. Figuring out what emotion they feel can seem easy.

Now imagine again that actor, but in a busy, loud, and distracting atmosphere, and any delusions or hallucinations causing distractions and making everything except the actor seem interesting. Trying to depict the person’s emotion and social cues can be difficult in that situation with all those distractions.
With Schizophrenia, this may be the challenge they have to face every day.

For a continuous of this entry, see Post 5B) Negative Symptoms and Diagnostic Symptoms of Schizophrenia.

Glossary- a combination of posts 5 A and 5 B.

1) Negative Symptoms- the behaviors lost during the onset of the mental disorder
2) Affective flattening- the absence or ‘flattening’ of emotion or emotional response to the world
3) Alogia– a lack in speech or speaking to others
4) Avolition– lack of willingness or ability to pursue goals or tasks that need completion
5) Prodronal Symptoms are symptoms that are present before the person goes into the acute phase of the mental disorder. This means that there are some symptoms of the disorder present within the 6 month period, before the ‘one month of acute symptoms’ takes place in order to fully qualify for diagnosis. It can be considered as a mild case before the acute onset.
6) Residual Symptoms are symptoms that are present after the person has emerged from the acute phase of the disorder. They have met qualifications to be diagnosed, but the symptoms and their severities have ‘died down’ or have ‘faded’. It can be considered as a mild case after the acute onset.

References:

1) (n.d.). In Harvard Medical School Family Health Guide: Negative Symptoms of Schizophrenia . Retrieved March 23, 2012, from http://www.health.harvard.edu/fhg/updates/update0706c.shtm
2) (2009, September 8). In National Institute of Mental Health. Retrieved April 6, 2012, from http://www.nimh.nih.gov/health/publications/schizophrenia/what-are-the-symptoms-of-schizophrenia.shtml
3) (2011). In University of Maryland Medical Center. Retrieved April 6, 2012, from http://www.umm.edu/patiented/articles/what_emotional_intellectual_social_consequences_of_schizophrenia_000047_5.htm
4) Gopal, Y. V., & Variend, H. (2005). First-episode schizophrenia: review of cognitive deficits and cognitive remediation. In Advances in Psychiatric Treatment. Retrieved March 23, 2012, from http://apt.rcpsych.org/content/11/1/38.full
5) Nolen-Hoeksema, S. (2011). (ab)normal psychology (5th ed., pp.233-235). New York, NY: McGraw-Hill.