Schizophrenia: Different Psychological Perspectives
Schizophrenia is often misunderstood and is confused with Multiple Personality Disorder (MPD). Although Schizophrenia’s simplified meaning is “split mind”, it is associated and described as a fragmented pattern of thinking. This syndrome has many different symptoms and people who suffer with Schizophrenia will never display the same symptoms. These symptoms are split into three categories which are Positive, Negative and Cognitive.
It is said that everyone has normal human physiological processes such as a normal beating heart or a normal body temperature. Positive symptoms of Schizophrenia are classed as new, which means they do not have a normal physiological process to compare to. The main examples of Positive symptoms of the syndrome are delusions, hallucinations, disorganised speech, disorganised behaviour and catatonic behaviour. When diagnosing Schizophrenia, a patient must display two of these listed symptoms, however one of the symptoms must include delusions, hallucinations or disorganised speech. A patient must display these symptoms for at least six months following the Prodromal, Active and Residual phases of the syndrome. These symptoms also cannot be linked to another possible condition like substance abuse. The Prodromal phase is where the patient is very withdrawn from their surroundings. The following phase on the cycle is the Active phase, this phase is the most severe, as this is when a patient will display their Positive Symptoms. Finally, the Residual phase consists of the inability to concentrate, often showing signs of being withdrawn again. When also diagnosing Schizophrenia, the patient must experience the Active phase for a minimum of one month.
Negative symptoms often defer from a normal process, usually resulting in a loss of interest or a lack of emotion. The main examples of the Negative symptoms are Flat Affect, Alogia and Avolition. Flat Affect will be an inappropriate response to a surprising or shocking scenario. Alogia is described as the lack of speech content, this can be shown when the patient is asked a question. A patient’s response to a question would be a simple one worded answer rather than a sentence. And then Avolition is the decrease in motivation to meet goals (Frankenburg, 2020).
Cognitive symptoms are classed as being more subtle and are often harder to detect compared to the Positive and Negative Symptoms of Schizophrenia. The symptoms affect the minds cognitive process including how memories are created, processed or perceived. It also affects the ability of the patient learning and understanding new things. These symptoms are often shown in the residual phase when a patient may have the inability to concentrate. When it comes to the diagnosis of Schizophrenia the Cognitive symptoms are not required because of the very specific tests needed to detect them. Also, Cognitive symptoms can be linked to other various illnesses, syndromes and diseases meaning they are not always accurate or specific. The Cognitive approach suggests that Schizophrenia is linked to disorganised thinking. The Attention Deficit Theory, Frith (1979) suggests that the syndrome is a result of a faulty attention system which is then unable to filter thoughts correctly. This leads to the mind focusing on insignificant information that is usually filtered and also explains Positive Symptoms like delusions and hallucinations (Fletcher, McKenna, Friston, Frith & Dolan, 1999).
When it comes to the cause of Schizophrenia there is said to be no known exact cause. But this is when the other psychological perspectives come into play. The Biological approach can be seen to be the most supported theory when it comes to Schizophrenia. In most cases, antipsychotic medications are prescribed to treat the syndrome. These medications do not cure symptoms but just simply reduces their severity. Antipsychotic medications prescribed often block the dopamine receptor D2 which decreases the levels of dopamine and neurons produced. This has led to the beliefs of Schizophrenia being directly related to an increased dopamine level produced by the brain (Lally & MacCabe, 2015). Studies have shown men are more likely to suffer from Schizophrenia rather than women, and the theory behind this is because woman produce oestrogen which regulates their levels of dopamine produced (Ochoa, Usall, Cobo, Labad & Kulkarni, 2012). Antipsychotic medications may not always be the most effective way to treat the syndrome, and they do not always work for the people being treated for Schizophrenia. Side effects of the medications can in some cases outweigh their benefit of decreasing the symptoms. Other factors have been investigated and it is also been suggested that prenatal infection and auto immune disorders such as Celiac has been linked to Schizophrenia (Anderson, 2020). Twin studies have also supported the theory of the syndrome being genetic, although no specific gene has been conclusively linked to prove this theory further. This adds to confusion and suggests there are other relevant perspectives other than the Biological model.
Although the Psychoanalytic approach has often been criticised for its lack of scientific evidence, it suggests that people with Schizophrenia show Positive symptoms as a result of being raised in a dysfunctional family. A child being influenced by a mother or father figure that has shown signs of control, passiveness or rejection over a long period of time can affect a child’s development. The tension and stress created within the home atmosphere is said to trigger psychotic thinking often leading to Schizophrenic paranoia and delusions (Dodge, 1990). The Expressed Emotion theory was supported by Butzlaff and Hooley, who analysed 27 studies that support Schizophrenia being twice as more common in families that followed these three following communication styles. Exaggerated involvement would indicate a child as a burden often associating to self-sacrifice. A parent often displaying criticism and control of the child’s behaviour, and also displaying hostility towards the child including physical, verbal or emotional rejection (Butzlaff & Hooley, 1998). Tienari (2004) also supported these evaluations, he studied the biological children of Schizophrenic mothers who had been adopted by other families. He found 5.8% of the children adopted into healthy families developed Schizophrenia compared to a higher result of 36.8% of children that were raised in a dysfunctional family (Buckley, 2006).
Alternatively, the Humanistic approach would suggest there are different methods of diagnosis and treatment. Carl Rogers created a positive outlook on the patient’s mental illness with the belief that they are still capable of reaching personal goals in life. This perspective would encourage patients to try harder and change faster, rather than simply taking medications. Reality checks would often be done to ensure the patient can determine the difference between reality and their own delusions and hallucinations. This can be successful as patients can start to distinguish when they are starting to experience positive symptoms and then could begin to learn how to contain them more sufficiently. There are arguments however that this approach is not substantial because of its lack of evidence, it also does not value the successfulness of medications that treat the disorder (Olson, 2020).
The case of Jani Schofield is well known for Jani’s severe case of Schizophrenia that was diagnosed at the age of six and is said to be one of the most severe cases of child Schizophrenia. Jani Schofield also has a younger brother named Bodhi. Over the years it has been recorded that Jani has suffered with extreme delusions and hallucinations, and would have long withdrawn episodes, accompanied with violent outbreaks. As the years have gone on Jani’s brother Bodhi started to develop the same symptoms of Schizophrenia (Donaldson James, 2020). Now this example could support to views of the Behavioural approach. It can be suggested that the influence of Jani’s presence in Bodhi’s environment and upbringing has helped construct the development of the same symptoms that Jani has portrayed. The Behavioural model could suggest that Jani is the stimuli in the environment that helps create Bodhi’s conditioned reactions. This theory would help establish if Bodhi’s behaviour has been learnt. The question is, could removing Jani from his environment help reduce his symptoms? With Jani and Bodhi being siblings, it could also support the theory within the Biological approach and that it is in fact genetics that have caused them to have these symptoms.
When comparing all five approaches and their methods of diagnosis or treatments of schizophrenia it is hard to depict a “correct” approach. But the reason behind this is that there is no definitive answer or theory that can be applied to the complex illness. All five perspectives are unique, some give clear evidence to help build their reliability where other theories are based more so on opinions. In conclusion to this, the psychological approaches to Schizophrenia will continue to be argued by psychologist and scientists in the future as it is impossible to apply one single approach.