Schizophrenia is not only the most dreaded psychological disorder but also one of the most heavily researched. Some important new discoveries link schizophrenia with biological factors, such as brain abnormalities and genetic predispositions.
Schizophrenia is one of the most heavily researched psychological disorders. Several factors have been proposed as causes of schizophrenia, from biochemical imbalances in the brain to faulty family relationships and socioeconomic environment. Although a great deal of interesting research has been carried out, to date no single factor has been isolated as the cause of schizophrenia.
II. The Understanding and Search for Causes Schizophrenia
a) Brain, Structure, Function and Abnormalities
Recent advances in the measurement of brain structure and function have set the stage for comparing normal individuals with those suffering from schizophrenia. One brain-imaging technique, computer-assisted tomography, or CT scan, uses many low-energy X-rays of the living brain taken at a number of different points and integrated into pictures by a computer. Studies using this technique show that many individuals with schizophrenia have enlarged brain ventricles, compared to normal persons. Some researchers believe a link sexists between the enlarged ventricles and the lower frequency of alpha waves observed among individuals with schizophrenia.
The idea that imbalances in brain chemistry might underlie schizophrenia has long intrigued scientists. Strange behaviors, they knew, can have strange chemical causes. The saying “Mad as a hatter” refers to the psychological deterioration of British hatmakers whose brains, it was later discovered, were slowly poisoned as they moistened the brims of mercury-laden felt hats with their lips (Smith, 2003). Scientists are beginning to understand the mechanism by which chemicals such as LSD produce hallucinations. These discoveries fuel hope that a biochemical key to schizophrenia might be found.
One chemical key to schizophrenia involves the neurotransmitter dopamine. When researchers examined patient’s brains after death, they found an excess of receptors for dopamine (Wong, 2000). What is more, drugs that block dopamine levels, such as amphetamine and cocaine, sometimes intensify schizophrenia victims overactive to irrelevant external and internal stimuli.
Modern brain scanning techniques reveal that many chronic schizophrenia patients have a detectable brain abnormality. Some have abnormally low brain activity in the frontal lobes (Cohen, 1999). Others, most often men, have enlarged, fluid-filled areas and a corresponding shrinkage of cerebral tissue (Andreasen, 2000).
b) Genetic Factors
A popular line of research in recent years has been the search for a genetic link in schizophrenia. Several approaches to the study of genetic relationships have been used. Overall, results of this research are consistent with a genetic basis for the disorder. For example, identical twins are more likely to share schizophrenic diagnoses than fraternal twins, whether the twins are reared apart or together. The greater the severity of schizophrenia, the more pronounced this relationship is. Furthermore, children whose parents both have schizophrenia are three times more likely to develop the disorder than are children with only one parent with schizophrenia, whether children are reared with their parents or not. Children who are reared by an adoptive parent with schizophrenia but whose biological parents are normal do not have higher rate of schizophrenia (Kestenbaum, 2001). The most convincing evidence for a genetic relationship comes from research showing a characteristic defect on chromosome 5 among family members who have some types of schizophrenia (Sherrington, 2000).
Naturally, scientists wonder whether people inherit a predisposition to these brain abnormalities. The evidence strongly suggests that some do. The 100-to-1 odds against any person’s being diagnosed with Schizophrenia become 10-to-1 among those who have an afflicted identical twin. Although there are only a dozen such known cases, it appears that an identical twin of schizophrenia victim retains that 50-50 chance whether they are reared together or apart.
Adoption studies confirm a genetic link (Gottesman, 2001). Children adopted by someone who develops schizophrenia are unlikely to “catch” the disorder. But adopted children do have an elevated risk if a biological parent is diagnosed with schizophrenia.
The genetic contribution is beyond question. But the genetic role is not so straightforward is beyond question. But the genetic role is not as straightforward as the inheritance of eye color. After all, about half the twins who share identical genes with a schizophrenia victim do not develop the disorder. Thus, behavior geneticists Susan Nicol and Irving Gottesman (2000) conclude that some people “have a genetic predisposition to the disorder but that this predisposition by itself is not sufficient for the development of schizophrenia.”
c) Psychological Factors
If, by themselves, genetically predisposed physiological abnormalities do not cause schizophrenia, neither do psychological factors alone. As Nicol and Gottesman report, “no environmental causes have been discovered that will invariably, or even with moderate probability, produce schizophrenia in persons who are not related to a schizophrenic.”
Nevertheless, if genes predispose some people to react to particular experiences by developing schizophrenia, then there must be identifiable triggering experiences. Researchers have asked: Can stress trigger schizophrenia? Can difficulties in family communications be a contributing factor?
The answer to each question is a strong, clear maybe. The psychological triggers of schizophrenia have proved elusive, partly because they may vary with the type of schizophrenia and whether it is a low-developing, chronic schizophrenia, or a sudden, acute reaction to stress. It is true that young people with schizophrenia tend to have unusually disturbed communications with their parents. But is this a cause or a result of their disorder? It is true that stressful experiences, biochemical and abnormalities, and schizophrenia’s symptoms often occur together. But the traffic between brain biochemistry and psychological experiences runs both ways, so cause and effect are difficult to sort out. It is true that schizophrenic withdrawal often occurs in adolescence or early adulthood, coinciding with the stresses of having to become independent, to assert oneself, and to achieve social success and intimacy. So is schizophrenia the maladaptive coping reaction of biologically vulnerable people?
Most of us can relate more easily to the ups and downs of mood disorder that to strange thoughts, perceptions, and behaviors of schizophrenia. Sometimes our thoughts do jump around, but we do not talk nonsensically. Occasionally we feel unjustly suspicious of someone, but we do not feat that the world is plotting against us. Often our perceptions are distorted, but rarely do we see or hear things that are not there. We have felt regret after laughing at someone’s misfortune, but e rarely giggle in response to bad news. At times, we just want to be alone, but we do not live in social isolation. However, millions of people around the world do not talk strangely, suffer delusions, hear nonexistent voices, see things that are not there, laugh or cry at inappropriate times, or withdraw into their private imaginary worlds. Because this is true, the scientific quest to solve the cruel puzzle of schizophrenia continues.
d) Environmental Stress
Approaches to schizophrenia have not been exclusively biomedical. Even studies of identical twins show that more than half these pairs do not have share diagnoses of schizophrenia. Because they do share all genetic material, there must be environmental factors that also contribute to the disorder, either by protecting constitutionally vulnerable individuals or by precipitating symptoms of the disorder (Kestenbaum, 2001). One way of conceptualizing the relationship between the environment and schizophrenia is through the concept of stress. A stress hypothesis holds that individuals are genetically vulnerable to the disorder.
Voluntary behaviors are strongly influenced by their consequences. This sample fact enables behavior therapists to reinforce desired behaviors, while withholding reinforcement for undesired behaviors. Using operant conditioning to solve specific behavior problems is called behavior modification, a therapy that has raised hopes for some cases thought hopeless. Retarded children have been taught to care for themselves. Autistic children have learned to interact. People with Schizophrenia have been helped to behave more rationally on the hospital ward.
Physical methods or therapy
This includes electroshock therapy and brain surgery. It consists of passing electric currents through the brain, producing convulsion coma.
A procedure requiring that the patient and analyst meet for hour- long sessions several times a week for many months. During these hours the analyst helps the patient bring into consciousness the repressed conflicts that have caused the illness. If the treatment is successful, the patient learns realistic methods of dealing with conflicts. The technique of free association is an important part of psychoanalysis. The patient is encouraged to talk about whatever comes to mind, without regard to apparent relevance or propriety of the material. The analyst helps the patient to understand the meaning of this material. Patients develop resistance in their efforts to talk freely, and it is the analyst’s task to help them overcome such resistance. Resistances are usually associated with feelings of guilt in regard to fantasies about hostility, dependency and sexuality.
Schizophrenia literally translated means “split mind.” Split mind refers not to a multiple-personality split, but rather a split from reality that shows itself in disorganized thinking; disturb perceptions, and inappropriate emotions and actions.
The schizophrenia victim experiences an altered world. Minute stimuli, such as the grooves on a brick or the reflections of a voice, may distract attention from the whole scene or from the speaker’s meaning. Worse, the person may perceive things that are not there.
Such hallucinations are (sensory experiences without sensory stimulation) usually auditory. The person may hear voices that seem to come from outside the head and that make insulting statements or give orders. The voices may tell that patient that she is bad or that he must burn himself with a cigarette lighter or even commit murder. Less commonly, people see, feel, taste, or smell things that are nonexistent. Such hallucinations have been compared to dreams breaking into waking consciousness. When the unreal seems real, the resulting perceptions are at best bizarre and at worst terrifying.