Download Schizophrenia—literally means “split mind,” but it`s not the same

SCHIZOPHRENIA
Schizophrenia—literally means “split mind,” but it’s not the same thing as a split
personality. It refers to the fragmenting of thought processes and emotions.
1 out of 100 people will get schizophrenia, and half of all inpatient mental patients have
it. It usually strikes between the late teens and mid 30s. It tends to strike men earlier and
more severely than women, but both sexes are affected in roughly equal numbers.
There are five areas of disturbance in schizophrenia, but people may not have
disturbances in all 5 areas:
1. Perceptual—senses may be blunted or they may be enhanced. People can’t
concentrate on what they choose, and sensory stimulation is distorted or jumbled.
There may be hallucinations, most commonly auditory.
2. Language—words lose their usual meanings and associations. May jump from
topic to topic or jumble words together incoherently (word salad) or create
artificial words. May echo what they hear—echolalia.
3. Thought—thoughts are disorganized and bizarre; logic is impaired. The most
common thought disturbance is psychosis—lack of contact with reality. Delusions
are common—persecution, grandeur, control, reference (delusion of reference is
when the person things two unrelated events are given special significance.).
4. Affect—Emotions may be exaggerated and fluctuate rapidly. At other times,
emotion may be blunted. Some people have flattened affect—almost no
emotional response of any kind.
5. Behavior—A person with schizophrenia may hurt others, but they are more
commonly destructive toward themselves and suicidal. They may also become
cataplectic and maintain an immobile stance for a long period of time.
Positive vs. Negative Schizophrenia: Positive symptoms (additions to or exaggerations
of normal thought and behaviors, including delusions and hallucinations) are more
common when schizophrenia develops rapidly. Negative symptoms (absence of normal
thought processes and behaviors, including impaired attention, limited or toneless speech,
flat affect, and social withdrawal) are more common when schizophrenia onset is gradual.
Causes of schizophrenia:
Probably has multiple biological and psychosocial bases. Biological causes may include
prenatal viral infections, birth complications, immune responses, maternal malnutrition,
and advanced paternal age. Most biological theories focus on genetics, neurotransmitters,
and brain abnormalities.
People with schizophrenia have been observed to have increased dopamine production,
larger cerebral ventricles, and a lower level of activity in the frontal and temporal lobes
(involved in language, attention, and memory). The lower level of brain activity and the
schizophrenia itself may result from an overall loss of gray matter.
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In identical twins, if one twin has schizophrenia, the other twin has a 48% chance of
having it. Obviously, environmental factors must contribute the other 52%.
There are at least two psychosocial factors that may contribute to schizophrenia:
1) Stress—may trigger a schizophrenic episode in people with a predisposition to
schizophrenia.
2) Disordered communication in families—unintelligible speech, fragmented
communication, and parents’ frequently sending severely contradictory messages
to children. Critical, hostile families also contribute to relapses.
PERSONALITY DISORDERS
Personality disorders are considered to be stable and incurable. They represent a
personality that is so inflexible and maladaptive that a person cannot function properly.
Antisocial personality disorder: sociopath/psychopath. Considered by some to be the
most serious of all mental disorders because they are so far outside the ethical and legal
standards of society. These people feel no personal distress and are unmotivated to
change. Serial killers, ruthless politicians, and crooked business people are examples.
Four hallmarks:
1) Egocentrism (preoccupation with oneself and insensitivity to needs of others)
2) Lack of conscience
3) Impulsive behavior
4) Superficial charm
Antisocials act impulsively and have little to no thought of the consequences. They’re
usually poised when confronted with their destructive behavior and feel contempt for
anyone they’re able to manipulate. They change jobs and relationships suddenly, and
they often have a history of truancy from school and of being expelled for destructive
behavior. They can be charming and persuasive and have a very good insight into the
needs and weaknesses of other people.
Twin studies show a genetic predisposition. Also, studies suggest that people with
antisocial personality have abnormally low autonomic activity during stress, right
hemisphere abnormalities, and reduced gray matter in the frontal lobes.
Social factors are also implicated. The disorder is highly correlated with abusive
parenting and inappropriate modeling. Antisocials often come from homes characterized
by harsh and inconsistent discipline and antisocial parental behavior.
Borderline personality disorder: among the most commonly diagnosed personality
disorders. Core features are impulsivity and instability in mood, relationships, and selfimage. Term originally implied that the person was on the borderline between neurosis
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and schizophrenia, but modern understanding no longer supports this assumption. Still,
BPD is a very complex and debilitating disorder.
Hallmarks of BPD:
--Extreme difficulties in relationships
--Chronic feelings of depression, emptiness, and intense fear of abandonment
--Engage in destructive, impulsive behaviors (sexual promiscuity, drinking, gambling,
eating sprees
--May attempt suicide or self-mutilate
--See themselves and others in absolute terms—perfect or worthless.
--Constantly seek reassurance from others and may quickly erupt in anger at the slightest
sign of disapproval.
--Long history of broken friendships, divorces, and lost jobs.
--Frequently have a childhood history of neglect, emotional deprivation, and physical,
sexual, or emotional abuse.
--Runs in families
--Biological evidence suggests it may be the result of impaired function in the frontal
lobes and limbic system, which controls impulsive behaviors.
--General prognosis is not favorable, although some therapists have had success treating
BPD with drug and behavior therapy.
--Seven years after treatment, 50% still have the disorder. (1998 study)
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