Critical Analysis of Schizophrenia
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Abstract
It is important to have an understanding of schizophrenia as it is a severe and devastating disorder which takes its toil on the lives of many, therefore, in this critical analysis essay, I will attempt to provide an in-depth understanding of schizophrenia, as well as critique research regarding each specific aspect of schizophrenia, highlighting their weaknesses and strengths, regarding the theoretical background, causes, prevalence, treatment methods, and prognosis of schizophrenia. Regarding the causes and treatment methods of schizophrenia, theories from several perspectives including the biological, social, and psychological perspectives will be provided.
Critical Analysis Essay-Schizophrenia
Schizophrenia is a psychotic disorder, in which an individual suffers disturbances in perception, thought, affect, and behavior, through symptoms such as delusions, hallucinations, and disorganized speech, which results in a deterioration in adaptive behavior (Weiten, 2010). However, despite recent advances in research and technology, the causes of schizophrenia have not been pinned-down yet. In this critical analysis, I will attempt to describe the etiology, prevalence, possible treatments, and prognosis for patients diagnosed with schizophrenia.
For schizophrenia to be diagnosed, symptoms must persist for at least 6 months, and involve an active phase, in which a person suffers from at least two of the following: delusions, hallucinations, disorganized speech, disturbed motor behavior, and negative symptoms involving functioning below normal levels (American psychiatric association, 2000). Some cases have a prodromal phase, which describes a period of progressive decline of function towards full schizophrenia. Some also have a residual phase, which is similar to the prodromal phase, and occurs after the active phase. Treatment administered should suit the patient at each phase, to maximise the efficacy of treatment (Bodenheimer, 1978).
Schizophrenia can be differentiated into five types, including the catatonic type, disorganized type, paranoid type, undifferentiated type and the residual type (Bengston, 2011).The catatonic type involves deficits in motor behaviours, while the disorganized type features a disorganization in thought processes resulting in disturbed behavior, speech and affect. The paranoid type is defined by the presences of bizarre delusions and hallucinations, without deficits in other cognitive function, while the undifferentiated type involves symptoms from any of the subtypes, but does not completely meet the criteria of each type. In the residual type, a patient does not suffer from the major symptoms of schizophrenia, but possesses less severe symptoms.
Several theories have been put forth regarding the factors which result in schizophrenia, and they fall in to three main categories, namely, biological, psychological and sociocultural factors. Biological factors emphasize genetic vulnerability, abnormalities in neurotransmitters and brain structure, and prenatal biological stressors. Psychological factors emphasize cognitive impairments as the main cause of schizophrenia, while sociocultural factors include stress from the environment.
Genetic vulnerability stresses the possibility that various genes increase a persons vulnerability to schizophrenia. Research has shown that hereditary factors play a role in the development of schizophrenic disorders (Sullivan et al., 2006). Further evidence is provided by identical twin studies conducted. When one twin contracts Schizophrenia, the other twin has a 48% chance of being afflicted with schizophrenia as well (Gottesman, 1991, 1998; Wong, Gottesman, & Petronis 2005), which highlights the importance of inherited genes as an underlying cause of schizophrenia.
Abnormalities in neurotransmitters and brain structures are alternative, possible causes of schizophrenia. A theory regarding the role of neurotransmitters in schizophrenia, the Dopamine hypothesis has mainly focused on excessive dopamine, in the brain. Research by Hirvonen et al. (2005), has found that an excess of caudate dopamine D2 receptors was associated with an increased vulnerability of schizophrenia, by studying unaffected twins of schizophrenic patients in both monozygotic and dizygotic twin pairs. Although the study conducted was a landmark study, as it was one of the first to identify specific receptors, implicating dopamine, it was found to be lacking, and critiqued as abnormalities in other neurotransmitters have been found to affect an individuals vulnerability to schizophrenia. More recent diversified views include abnormalities in glutametergic and serotegenic mechanisms as well, and that the there is more to the role of dopamine in the disorder (Carlsson, Hansson, Waters, and Carlsson, 1997).
Recent brain imaging technology has revealed that abnormalities in brain structure might result in schizophrenia. People with schizophrenia have enlarged brain cavities. These enlarged ventricles are the result of cortical atrophy, which refers to a loss of brain tissue Halgin and Whitbourne, 2009), which have been found to occur mainly in the prefrontal lobe (Molina et al., 2005), causing deficits in cognition, planning and behavior, and the temporal lobe, causing deficits in processing auditory information (Kuperberg et al., 2003). Although critics of this perspective have criticised findings of abnormal brain structure, stating that decrease in brain volume could be the result of schizophrenia, and not the cause of schizophrenia (Keller et al., 2003), recent research by Andreasen et al., (2011) has proven otherwise. Focusing on a sample of 202 schizophrenic patients, the researches observed a progressive significant decrease in both white and grey matter, using Magnetic resonance imaging technology. The loss of brain volume was also correlated with cognitive impairment, providing compelling evidence that brain abnormalities are indeed, a cause of schizophrenia.
Prenatal biological stressors indicate events which influence the development of a foetus from conception till birth. These stressors are theorized to influence vulnerability to schizophrenia, through causing brain abnormalities. Stressors can include prenatal infections such as Rubella, influenza and toxoplasmosis, as well as maternal cytokines (Brown, 2006; Brown et al., 2004), lack of nutrients such as vitamin D (McGarth, 2998),
exposure to genital or reproductive infections (Babulas, Factor-Litvak, Goetz, Schaefer and Brown, 2006), exposure to maternal stress (Van and Selten, 1998), pregnancy complications (Hultman, Ohman, Cnattingius, Wieselgren and Lindstram, 1997), and even seasonal variations in time of birth (Selten et al., 2000).
Although convincing evidence