Download Schizophrenia - Undifferentiated Type

SCHIZOPHRENIA
Directions: Read the accompanying case study about Margaret Willoughby and answer the questions listed below.
READ THIS FIRST! Margaret is given the diagnosis of Schizophrenia: Undifferentiated Type. Schizophrenia is a
very severe mental disorder that is characterized as a “psychotic disorder”. The term psychotic suggests that the
person has lost touch with reality. Schizophrenia may involve characteristic disturbances in thinking (delusions),
perception (hallucinations), speech, emotions, and behavior. Unfortunately schizophrenia strikes most people from
the ages of 16 – 25. Most modern theories suggest that the illness is has a heavy genetic component and is
probably very much related to biochemical imbalances in the brain which may be triggered and aggravated by
environmental stresses. Schizophrenia can disrupt a person’s perception of the world, the way he or she thinks,
speaks, and moves and almost every aspect of daily functioning. And despite important advances in treatment, a
complete recovery from schizophrenia is rare. This illness takes a devastating toll on the individual and the
immediate family. Swiss psychiatrist Eugen Bleuler (1908) first used the term “schizophrenia”. The term is derived
from the combination of the Greek words for “split” (skhizen) and “mind” (phren), signifying Blueler’s belief that
underlying all the unusual behaviors shown by people with this disorder was an associative splitting of the basic
function of personality (which is to help you deal with reality). The concept of associative splitting or “breaking of
associative threads” referred to destruction of the forces that connect one function to the next. Furthermore, these
individuals had a difficult time keeping a consistent train of thought, and Bleuler believed that this problem was
characteristic of all persons with schizophrenia and led to the many and diverse symptoms they displayed.
Unfortunately, this concept of “split mind” has led to the common but erroneous use of the term schizophrenia to
mean split or multiple personality. They are two different disorders.
There are a number of different sub-types of schizophrenia:
Paranoid Type: symptoms primarily involve delusions and hallucinations while speech and motor and emotional
behavior are relatively intact. Their delusions and hallucinations usually have a theme, such as persecution by
others or being someone important.
Disorganized Type: features disrupted speech and behavior, disjointed delusions and hallucinations, and flat or
silly affect (emotional responses).
Catatonic Type: including the unusual motor responses of remaining in fixed positions, engaging in excessive
activity, and being oppositional by remaining rigid. In addition they sometimes display odd mannerisms with their
bodies and faces, including grimacing. They often repeat or mimic the words of others (echolalia) or movements of
others (echopraxia).
Undifferentiated Type: for those who do not neatly fit into other subtypes. They have the major symptoms of
schizophrenia but do not meet the criteria for paranoid, disorganized, or catatonic types.
Residual Type: category for people who have experienced at least one episode of schizophrenia and who no
longer display its major symptoms but still show some bizarre thoughts or social withdrawal. They still display
some residual or leftover symptoms, such as some of the negative beliefs, or they continue to have unusual ideas
that are not fully delusional.
Questions: Answer in full sentences using your own words.
1. When we first meet Margaret, what kind of behaviors would lead you to diagnose her as schizophrenic?
2. Cite two behaviors from her childhood that are clues to oncoming illness.
3. What evidence from her adolescence begins to confirm a diagnosis of schizophrenia?
(OVER)
4. Give an example of Margaret’s behavior that illustrates the following typical schizophrenic characteristics:
Auditory hallucinations
Delusions (especially thought insertion)
Disorganized speech
Inappropriate emotional responses
Social Withdrawal
Disorganized thought
5. What clues from the start do you have that her marriage to Ray wasn’t going to be a good marriage?
6. What do you think of the people in her church pressuring her to give up her medications?
7. What DSM-IV criteria must one meet to be diagnosed as “undifferentiated” schizophrenia?
8. Regarding the genetic component of the heritability of schizophrenia, what did the most authoritative study done
by Fisher find?
9. What is the diathesis-stress model of schizophrenia? And how might this model best explain Margaret getting
schizophrenia and not any of her siblings?
10. What kinds of treatments are and have been available for schizophrenics? And give the names of two
medications used.
11. What are three major problems and limitations associated with the use of antipsychotic drugs?
12. Since we don’t know what happened to Margaret, speculate what you think happened to her and her family.