Schizophrenia: The Case of Max
Human well being is an integral part of personal development. It is important point out that human health affects his or her behavior, social interaction as well as consciousness. However, the solution of any health problem can only be critically analyzed and solved by close knowledge of the problem. Close analysis of the case of Max clearly demonstrates that he is suffering from mental problem. In this case, psychology is important in the analysis of Max behavior. Max is said to hear voices which tell him evil things among some other symptoms stated in the case of max. Based on analysis of Max case, he is suffering from schizophrenia. This paper takes a comprehensive analysis of schizophrenia, its cause and available treatment. In addition, it examines how phenomenology, cultural psychology, structuralism and functionalism relate to Max case which is schizophrenia. This case is related to psychology in that both deals with a human mind and since we live in the society the aspect of phenomenology, structuralism and functionalism is involved in the study of schizophrenia.
Schizophrenia is a serious health problem throughout the world. It is a chronic, severe, and disabling brain disorder that affects and has affected people throughout history. This mental illness strikes young people at the very time they are establishing their independence and can result in lifelong disability and stigma. In terms of personal and economic costs, schizophrenia has been described as among the worst disorders afflicting humankind in resent time. In addition, it is estimated that it is the 9th leading cause of disability worldwide (Vonnegut, 2003).
Cause of Schizophrenia
Schizophrenia is a biologic problem, not entirely caused by poor parenting or a mentally unhealthy environment (Sartorius, Leff & Okasha, 2005). It is found that people who have a parent or sibling with schizophrenia have about a 10% risk of developing the disorder, compared with a 1% risk among the general population. An identical twin whose co-twin has schizophrenia has about a 50% risk of developing schizophrenia (Vonnegut, 2003). These statistics suggest that heredity is involved to a greater extent. Other causes may include problems that occurred before, during, or after birth of a child, such as critical influenza in the mother during pregnancy, oxygen deprivation at birth, and incompatibility of the mother’s and infant’s blood type which result into genetically complications
The start of schizophrenia in an individual may be sudden, over a period of time. Although the severity and types of symptoms vary among different affected people, the symptoms are usually sufficiently severe as to interfere with the ability of an individual to work. Hirsch, and Weinberger, (2003), suggest that schizophrenia symptoms fall in four major categories: Positive symptoms, Negative symptoms, Disorganization, Cognitive impairment. Research study however reveals that one may have on or a combination of these symptoms.
Positive symptoms involve an excess or a distortion of normal functions of and individual.
They include the following:
- Hallucinations sight, smell, of sound, taste, or touch may occur, although hallucinations of sound are most common the affected people. These patients may hear voices in their head, conversing with one another, or making critical and abusive comments.
- Delusionsare false beliefs that usually involve a misinterpretation of perceptions facts or experiences. For instance, affected people may have persecutory delusions, believing that they are being tormented, followed, tricked, or spied on as in the case of Max.
Negative symptoms involve a reduction in or loss of normal functions in the affected people.
They include the following:
- Anhedoniarefers to a reduced capacity to experience pleasure. Affected people may take little interest in previous activities and spend more time in purposeless ones.
- Asociality refers to a lack of interest in cooperation and relationships with people. This negative symptom leads to a general loss of motivation, sense of purpose, and goals in life.
- Blunted affect refers to lack of emotions. Affected people make little or no eye contact and lack emotional expressiveness. Events that may make them laugh or cry produces no response them
- Poverty of speech refers to a decreased amount of speech in the affected person. In this case he or she answers questions in brief say in one word.
Disorganization this involves thought disorders and bizarre behavior in the affected person
- Thought disorder refers to disorganized thinking process in the affected person, which becomes apparent when speech is rambling or shifts from one topic to another. In this case the affected person may give a speech which is mild, disorganized and completely incoherent.
- Bizarre behavior may take the form of childlike agitation, silliness, or inappropriate appearance, hygiene, or conduct. Catatonia is an extreme form of bizarre behavior in which people maintain a rigid posture and resist efforts to be moved from this condition.
Cognitive impairment refers to difficulty in concentrating, remembering, organizing, planning, and problem solving. Some people are unable to concentrate sufficiently to read and write, follow the story line of a movie or television show.
In treatment of schizophrenia, there are a number of treatment alternatives these includes: Antipsychotic drugs, rehabilitation and community support activities and programs, and psychotherapy are the major components of treatment given for schizophrenia disorder (Vonnegut, 2003).
This treatment involves the use of Thorazine, Fluanxol and Haloperidol for positive symptoms.
This is a psychotherapy which involves behavioral treatment for schizophrenia. Cognitive therapy will help an individual suffering from schizophrenia to cope well in the society.
Use of Glycine Supplements
This treatment involves the use of amino acid which helps reduce negative effects of schizophrenia. The relationship of phenomenology, cultural psychology, structuralism and functionalism schizophrenia. Schizophrenia is a mental disorder therefore it has got a strong relationship with phenomenology since it affect an individual consciousness which the discipline of phenomenology analyses. In addition, cultural psychology which also studies the mind set of people. Furthermore, structuralism and functionalism feature prominently in solving Schizophrenia problem this is because it is a societal problem.
Critique of the Dopamine Hypothesis of Schizophrenia
Recent scientific discoveries have proofed that the etiology of schizophrenia has various links to the dopaminergic over activity. For instance drugs such as amphetamines have been known to increase the levels of dopamine; in addition, they also increase the psychotic symptoms of schizophrenia. (Abi-Dargham, 2004). Despite the ignorance in its underlying neuronal correlations, the key feature to psychosis distortion are mainly characterized by delusions and hallucinations, However, a study on schizophrenic patients has enriched “the reality of auditory verbal hallucinations(AVH) during functional magnetic resonance imaging (fMRI)” (Nature, June 24, 1976). Binding studies on the dopamine receptors through the positron emission tomography(PET scans) and Postmortem studies have led to conclusions that a disturbance of centralD1 dopamine receptor does exist in schizophrenia. Karlsson et al., (May 2002) on their study, using PET scans, to compare how D1 receptor function between, schizophreniapatients and healthy subjects, concluded that; “binding to D1 receptors did not differ significantlybetween subjects with schizophrenia and healthy subjects inany of the brain regions or for any of the binding measuresstudied.” Their results therefore concluded that there was no major replication to previous postmortem and PET findings which had involved altered central dopamineD1 receptor binding in schizophrenia. Moreover, their findings motivatefurther D1 ligand studies with higher signals in the corticalregions.
Besides, dopamine hypothesis on amphetamine initiated psychosis had long been recognized,that the use of amphetamines or other central dopamine agonistscan mimic the active symptoms of schizophrenia during the acuteintoxication phase, even among individuals without a geneticdiathesis for schizophrenia. (Connell, 1958, Bell, 1973). Therefore, investigations inboth animals and humans study models, on the acute behavioral effects which thesedrugs induce, has been a cornerstone of the dopamine hypothesis ofschizophrenia. (Snyder, 1974). Astudy onPCP by Hajszan (2006) and Kehrer et al. (2008) in animal modelsof Schizophrenia, and other PCP-like compounds as an alternative treatment of brain ischemia further cited the fact that PCP produces a syndrome that is similar to schizophrenia. Besides, PCP being an N -methyl-D-aspartate (NMDA) antagonist “can worsen the psychotic symptoms in schizophrenic people. This implies that PCP blocks the action of glutamate and aspartate, excitatory amino acid CNS neurotransmitters. This argument therefore clarifies that PCP does not act on dopamine. Besides, they also found out that PCP is highly anticholinergic in nature.
The National Institute of Mental Health has concluded from their mice model studies that, recurrent genetic etiology of schizophrenia impairs communications between the brain’s memory and decision-making hubs this lead deficits in working memory. The Institute’s research further showed that, neuroimaging studies had discovered “abnormal connections between the prefrontal cortex, the executive hub, hippocampus and the memory hub, having been linked to impaired working memory.” (Sigurdsson, 2010). The Institute has further showed that molecular abnormalities result in schizophrenic brain. This has been achieved through studying the connections of the cortical-striatal circuitry and the hippocampal-entrohinal in humans. Data analysis on the molecular changes has also been determined showing neonatal damage of the hippocampus or prefrontal cortex in animal models of schizophrenia. A further finding by Pearlson et al on Nervous and Mental diseaseexplains that data obtained from the Computer axial Tomography (CT scans), Positron Emission Topography (PET scans) and Magnetic Resonance Imaging (MRI) show that defects in the morphology of the brain and its physiology are associated with the development of schizophrenia. PET scan studies have further discovered an increased number of neuronal receptors for dopamine in some areas of the brains of people with schizophrenia. Prior, work done earlier by Rapoport et al. (1999) revealed prospective longitudinal brain (MRI) studies of the NIMH COS population as having showed an increasing ventricular volume while on the other hand a decreasing total cortical, frontal, medial temporal and parietal GM volumes at 2- to 6-year follow-up” during adolescent years, as they later confirmed in New perspectives for child psychiatry, (2001).
Both Creese and Seeman (1972) had commented on the move to prescribe Dopamine-D2 by psychiatrists in addition to other blockingdrugs so as to alleviate the positive symptoms of schizophrenia discussed above, hallucinations and delusions. But despite such blockers diminishing most psychotic symptoms, Hyman (1995) remarked that they caused side effects such as stiffness and otherneuromotor effects. This further questions the dopamine hypothesis as in its blocking mechanisms. In the ‘90s, four new antipsychotic drugs, olanzapine, quetiapine, clozapine and risperidone, were introduced. These drugs alleviated positivesymptoms of schizophrenia, without causing the neurological side effects associatedwith the former drugs. To explain the positive symptoms, Arnold et al proposed that positive patients have two defects: One, defect in a schizophrenia gene which is involved in regulating the activity of the dopaminergic compensatory system cannot turn itself down but by pharmacologically neuroleptics. Two, Negative-symptom patients get little benefit from neuroleptics, since their dopaminergic system can reduce itself spontaneously. This therefore implicates that typical neuroleptics have minimal effects. Earlier results by America psychiatrists had that these positive symptoms were related to positive schizotypy,social dysfunction, and BPD symptoms. This indicates that schizophrenia etiologically may be related to severityof illness, rather than specific symptom dimensions. This may explain the reason behind the delayed effects of neuroleptics by the dopamine blockers. The information which is emerging from new scientific studies, is therefore proofing that other non-dopamine hypothesis and explanations play a crucial etiological role in schizophrenia: showing that the dopamine hypothesis may not be very relevant today given that most research findings are proofing contradictory evidence in relation to the once domineering dopamine theory of schizophrenia
Mental disorders like in the case of Max pose a great health problem to the world population thereby inhibiting global development. However, this is a societal problem and should be embraced with the full attention it requires. In this regard, people with schizophrenia disorder should never be discriminated in the community but should be rehabilitated and treated so as to live a normal life.