Therapeutic intervention and biopsychosocial causes of schizophrenia

Therapeutic Intervention of Schizophrenia

Identify the Scope of the Disorder

Schizophrenia manifests as a mental disorder marked by thinking that is not normal, chronic disturbances and exaggerated or diminished emotional expression. The condition affects up to 26 million people or more, globally. The condition affects double that number indirectly- including carriers (World Health Organization, 2004). Approximately five million people are affected by psychotic disorders in the EU (Wittchen et al. 2011). Statistical data from the USA shows that up to 2.4 million Americans are affected by the schizophrenia illness. This figure represents about approximately 1.1% of the U.S. adults (National Institute of Mental Health, 2013). It is also reported that one person out of 4000 is diagnosed with schizophrenia (Fleischhacker et al. 2014).

Usually Schizophrenia is diagnosed in early adulthood or during adolescence. It is known to affect one\'s quality of life throughout their existence. Schizophrenia has been picked out by the World Health Organization as one of the 10 most notorious causes of disability worldwide (Fleischhacker et al. 2014). The term prevalence of Schizophrenia refers to the ratio of people affected by the condition in a given population at any one time compared to the total population. The estimate figures are guided by the distribution of age among a population. If, for instance those who are too young to be factored in the risk group are included, the proportion will definitely be lower (Messias, Chen & Eaton, 2007).

b. Explain the Cause of the Illness using a Biopsyschosocial Perspective

There is no known cause of schizophrenia. However, it is increasingly apparent that the ailment comes about as a result of a combination of both genetic and environmental factors.

Genetic Causes of Schizophrenia

The condition shows strong genetic elements. If someone has a first line relative with schizophrenia, they stand a 10% chance of developing the ailment. This contrasts with the 1% chance that the general population stands to develop the condition. It is worth noting that the condition is not caused by genetics but is only influenced by it. Although the condition tends to run in families, up to 60% of those with schizophrenia do not have family members with the condition. Moreover, those who are genetically predisposed to the risk of developing the condition don\'t always develop it. This is a sign that genetics is not really the determinant (Smith & Segal, 2016).

Environmental Causes of Schizophrenia

According to adoption and twin studies, genetic inheritance makes one vulnerable to schizophrenia. Such vulnerability is often triggered to actual schizophrenia by environmental factors. A lot of research points to stress as a major environmental factor that triggers the condition. In particular, the stress that has been seen to influence such a condition is if it occurs during pregnancy or later in the development process. A lot of stress is strongly believed to lead to schizophrenia through increased production of cortisol hormone (Smith & Segal, 2016). Available research attributed a range of factors to stress such as prenatal exposure to viral infection, reduced levels of oxygen at birth, virus exposure at infancy, losing parents early, separation, and sexual or physical abuse in childhood (Smith & Segal, 2016)

Abnormal Brain Structure

Apart from the abnormal and unusual chemistry in the brain, abnormal structure of the brain may contribute to the incidence of schizophrenia. There is evidence of enlarged brain ventricles on some victims of Schizophrenia. This shows a deficit in the amount of brain tissue. Some findings have shown an abnormally low amount of activity in the frontal lobe of the brain. This is the part of the brain that is responsible for reasoning, planning, and making decisions. Abnormalities in the temporal lobe have been shown by some studies to be linked to the incidence of schizophrenia. Amygdala and Hippocampus have also been linked to the occurrence of schizophrenia. Despite the observation that brain abnormalities are part of the signs, there is still good reason to believe that the condition is triggered by a range of factors (Smith & Segal, 2016).

c. Describe Changes in Behavior, Cognition, Mood, Physical Functioning or Communication that may be Experienced.

Delusions

A delusion is an idea that one holds firmly despite the evidence that it does not exist in reality. Schizophrenia victims frequently manifest delusions. Indeed, 90% of those with schizophrenia experience delusions. The delusions usually constitute bizarre and illogical thoughts or even fantasies (Smith & Segal, 2016). The delusions commonly associated with schizophrenia include:

Persecution Delusions: a false belief that there are people out to harm them. Persecutory delusions come with a range of bizarre thoughts and plots.

Reference Delusions: An environmental occurrence that is supposed to be neutral ordinarily is given a special meaning and significance. For example, a schizophrenic might believe that some TV personality or someone on a billboard is out to harm them or sends messages that are specifically med at them.

Grandeur Delusion: Sometimes, a schizophrenic may believe that they are very important people. Delusions of grandeur may also involve a schizophrenic thinking that they posses extraordinary powers such as the ability to try flying.

Control Delusions: These ones are about believing that one\'s actions and thoughts are influenced by extra ordinary forces. Some of these include broadcasting of thought, thought insertion and thought withdrawal (Smith & Segal, 2016).

Hallucinations

Hallucinations are thoughts and sounds that exist in one\'s mind. While hallucination deploys any of the five human senses, auditory hallucinations including hearing sounds or people\'s voices are common occurrences in schizophrenia. The incidences of visual hallucinations are not uncommon. Research findings show auditory hallucinations, when the victims misinterpret wrongly their own self-talk in the inner part of external voices. A lot of times, the so called voices are often of someone they know well. The schizophrenic hallucinations mean something to the one experiencing them. The voices they claim are often vulgar abusive or critical. Hallucinations tend to worsen when one is left alone (Smith & Segal, 2016).

Disorganized Speech

Schizophrenia symptoms also manifest as fragmented thinking patterns. External signs include the manner in which one speaks. Schizophrenia victims often have difficulty maintaining a train of thought. They may respond to prompts with irrelevant answers or start a sentence on a given topic and end somewhere totally different from where they started. They often utter illogical things or speak incoherently.

Common Signs of Disorganized Speech in Schizophrenia include:

Loose Association: victims often shift quickly from one subject of focus to another without connecting their thoughts.

Neologisms: They make up expressions and words that are only meaningful to the victims.

Perseveration: they repeat statements and words.

Clang: they rhyme words without meaning; e.g. He fled on the shed for red and head to the tedd wed (Smith & Segal, 2016).

Disorganized Behavior

The condition disrupts activity that is goal directed. This leads to inability by one to take care of oneself, render productive work and mingle with others. Disorganized behavior manifests as a deterioration of one\'s overall daily operations. It also leads to emotional responses that can be deemed inappropriate. There is a manifestation of bizarre behavior and poor inhibition and control of impulses.

Negative Symptoms

The phrase refers to the absence of normal conduct that is common with healthy beings. Common symptoms of schizophrenia include:

Absence of expression: emotionally, a flat voice, a face that does not express anything, few facial expressions and lack of eye contact.

Listlessness: poor or lack of self-care. Absence of motivation

No interest in the world: lack of awareness of what goes on around; withdrawal from social engagements

Speech abnormalities and difficulties: inability to sustain a conversation. It may be brief and often disjointed irrelevant responses to questions and talking in monotones (Smith & Segal, 2016).

PART B

a. Select one Intervention (Pharmacological or non-pharmacological) that is Available to Help

Manage/Treat the Disorder. Briefly Explain the Intervention.

There is increased evidence that psychological intervention work well in relieving the patient\'s of their psychotic symptoms. They improve their functioning and thus inform the recommendations that they indeed, be included in the treatment schedule and also be made part of the therapy regime for promoting the recovery of the patients. One of the key psychological interventions is cognitive behavioral therapy (CBT). Psychosocial interventions have been praised to have two-prong effectiveness. They deal with a wide range of the needs of patients including the reduction of symptoms, adherence to treatment and relapse. They are also considered the most cost-effective strategy compared to standard therapeutic practices for treating schizophrenia (Gutierrez-Recacha et al. 2004). CBT has the advantage of being highly standardized and structured. The standardized therapies assist schizophrenia patients to cope with the symptoms they experience through analyses and reevaluation of their experiences, perceptions and thoughts (Chien, Leung, Yeung & Wong, 2013).

b. Draw on the Evidence-based Literature to Discuss the Effectiveness of the Intervention and any

Disadvantages of the Intervention to the Consumer

Intervention Effectiveness

CBT has been seen as an effective therapy for treating depressive disorder for decades. This therapy, along with the reputed techniques it applies, has finally come to be applied as effective treatment for people with schizophrenia whose symptoms are not influenced by medication (Haddock et al. 1999). The intervention can only work if the therapist accommodates the perception of reality. It determines how the misinterpretation can be used to assist victims to effectively manage their condition (Jones et al. 2011). CBT encourages the patient to participate actively and checks the evidence supporting or against the distressful belief and challenges the habitual trains of thought regarding the belief. It uses the power of reason and personal experiences to develop rational acceptable thought processes and coping interpretations, self-management of the conditions and the symptoms. Even if CBT meant for schizophrenia was crafted with treatment for the individual, there is some proof that delivery among groups is equally effective (Chien, Leung, Yeung & Wong, 2013).

Research on CBT shows that it is helpful to people with schizophrenia. The therapy option is recommended in both the USA and UK to be included among the main therapeutic procedures for dealing with schizophrenia (Dixon et al. 2010). Although there are differences in the duration it takes to complete treatment, the number of sessions one attends, outcomes and comparative treatment in trials that are controlled, recent reports of the trials show a positive effect of CBT on schizophrenia patients over a period of treatment of 6 to 12 months follow up sessions compared to the standard treatments for schizophrenia. CBT can yield a huge effect in persistent residual positive signs soon after the intervention (size effect and 0.65). A 1-year course (size effect, 0.93) (Chien, Leung, Yeung & Wong, 2013)

Drawbacks

Although there are studies that have shown CBT to be more effective over a 9 to 12 months\' treatment compared to standard procedures and some psychological methods, it has shown little evidence of reducing the negative persistent psychotic symptoms experienced by those with schizophrenia; especially in the long-term (Chien, Leung, Yeung & Wong, 2013).