SCHIZOPHRENIA

Chizophrenia is a group of disorders characterized by thought distrurbance and often accompanied by delisions, hallucinations, attention deficits, and bezirre motor activity. In the example that opened this chapter, we met a man with schizophrenia whose contact with reality was radically impaired. His inability to meet even the ordinary demands of life demonstrates that schizophrenia is a psychotic disorders, one that is characterized by a generalized failure to function adaptively. Schizophrenia is more common than most of us realize. Between 1 and 2 percent of people in the United States have had or will have at least one schizophrenic episode (Robins et al., 1984).

Types of Schizophrenia
Schizophrenia manifests itself in different ways. Since no one person shows all the symtoms described in the following section, clinicians have sorted the disorder into five major subtypes described in Table 18.3. The devinisions, which are based on the predominant symptom displayed, make it possible for researchers to study groups of patients with similar symptoms. Only this approach offers hope of discovering whether and how the causes of different symptoms differ, and whether different kinds of schizophrenia respond best to different treatments. Researchers have suggested that patients dominant symptoms may identify those with a good chance of recovery (Strauss, Carpenter, and Bartko, 1974; andreasen and Olsen, 1982). Generally, patiens with predominantly positive symptoms (those involving the presence of something delusions or hallucinations, for example) are more likely to develop this pattern than are women (Lewin, 1981). Not only are men more likely to be seriously affected, but they also tend to develop the disorder early before the age of twenty five. This distinctions has led some researchers to speculate that there may be only two kinds of schizophrenia, with the variety marker by positive symptoms more closely linked with biochemical abnormalities and thus more responsive to medication that the kind marked by negative symptoms (Haracz, 1982).

Table 18.3 Five Types of Schizophrenia Type

Disorganized (hebephrenic) schizophrenia

Description
Individual live on private worlds dominated by hallucination, delucions, and fantasy. Most severe disintegration of personality. Individual shows either excessive, sometimes violent, motor activity or a mute, unmoving, stuporous state. Some catatonic schizophrenics alternate between these two extremes, but often one or the other behavior pattern predominates. Individuals have delucions of persecution, grandeur, or both. Paranoi schizophrenics trust no one and are constantly watchful, convinced that others are plotting against them. May seek to retaliate against supposed tormentors. Individuals are schizophrenics but do not meet the above criteria, or else they shows symptoms of several subtypes Individuals are not in active phase of schizophrenia, but show residual symptoms.

Catatonic schizophrenia

Paranoid schizophrenia

Undifferentiated schizophrenia

Residual schizophrenia

Symptoms of Schizophrenia
No schizophrenic displays all the symptoms of schizophrenia at all times, and some schizophrenics may display only some of the symptoms on occasion. Although the schizophrenic person generally displays a variety of abnormalities, thought disorders are often the most apparent symptoms. Disorders of Thought A schizophrenics thought may be disordered in form or in content.

Problems with the form of thought

In some schizophrenics, particularly those labeled disorganized, there is a split among various ideas or between ideas and amotions. Instead of linking concepts and symbols to establish logical connections between ideas, they jump from one mental track to another, so that their speech often becomes incoherent. Concepts, ideas and symbols may be thrown together merely because of their sounds. Such a series of rhyming or similar sounding words is called a clang association. Besides disrupting logical connections between their words, schizophrenic patients sometimes repeat the same word or phrase over and over, seemingly unable to move their thoughts onward a symptom know as perseveration. More often, their speech shows loosening of association, in which each sentence is generated from some mental stimulus in the previous sentence and wanders further from the sentral idea. Problems with the content of thought

The dissociation of concepts frequently produces delusions, irrational beliefs that are maintained despite overwhelming evidence that they have no basis in reality. Delusions take several forms. Some are delusions of grandeur, in which a person believes that she or he is some famous person like Martha Washington or Jesust Christ. Some are delusions of persecutions, in which the person believes the others, perhaps extraterrestrial beings or secret against, are plotting against her or him. Some are delusions of sin and guilt, in which the person believes that he or she has commited some terrible deed or brought evil onto the world. Some are delusions of control, in which the person either exaggerates his or her control over events and people or else feels under the power of other people or mysterious forces. Finally, one of the most common delusions among schizophrenics of the delusion that their thoughts are being tampered with. They may feel that their thoughts are broadcast (heard by others), withdrawn (stolen by others), or inserted in their minds by others. *Clang Association an illogical speech pattern characteristic of schizophrenics, in which word are used together simply because they rhyme or sound similar. *Perseveration the tendency for schizophrenic speech to dwell on the primary association to a given stimulus. *Loosening of association the tendency for schizophrenic speech to lose the logical thread so that each sentence is generated by associations to some word in the previous sentence. *Delusion an irrational belief that is maintained despite overwhelming evidence that it has no basis in reality. References Bootzin, Richard R., Bower, Gordon H., Crocker Jennifer., and Hall Elizabeth. (1991). Psychology Today: An Introduction. 7th ed.

MENTAL HEALTH
SCHIZOPHRENIA

BY :

NINDYA UTAMI AJENG DEWI A. S DITA MUSTIKA SARI HENNY T. I

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