Schizophrenia: Genetic or Environmental?

Schizophrenia: Genetic or Environmental?

About one percent of the American population suffers from schizophrenia. The term schizophrenia literally means the "splitting of psychic functions" (Pinel, 447). At the time of the early 20th century, this is what was used to describe what was assumed at that time to be the primary symptom: the breakdown of integration among emotion, thought, and action (Pinel, 447). Schizophrenia is a form of psychotic disorder which causes people to have difficulty interpreting reality. These individuals develop changes in their thinking, perceptions and even behavior. It is believed to be caused as a result of a disturbance in the development of the brain. It is still uncertain, however, whether the disorder is characterized only by genetic factors, or if it is influenced by outside environmental factors as well.

Schizophrenia is a disease that strikes young people in their prime. This disease distorts the senses, making it very difficult for the individual to tell what is real from what is not. The usual onset of this disorder is between the ages of sixteen and twenty five. With this disease they will have a disorder that will last for at least six months and includes at least one month of active phase symptoms (i.e. two [or more] of the following: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior). Only one symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the persons behavior or thoughts, and if there are two or more conversing with each other (Pinel, 449). The essential features of schizophrenia are mixtures of characteristic signs and symptoms which can be either positive or negative.

A person with Schizophrenia may be conceptualized as falling into two broad categories, positive or negative. The positive symptoms appear to reflect an excessive or distortion of normal function, whereas the negative symptoms appear to diminution or loss of normal functions (Comer 435).

The positive symptoms of schizophrenia include: delusions, disorganized thinking and speech, heightened perceptions and hallucinations, and inappropriate affect (Comer, 440). Delusions are erroneous beliefs that usually involve misinterpretations of perceptions or experiences, their content may include a variety of themes. Persecutory delusions are the most common; the person believes he or she is being tormented, followed, threatened, tricked, spied on, subjected to ridicule or deliberately attacked or victimized. Referential delusions are also common; the person believes that certain gestures or environmental cues are specifically directed to them. Grandeur delusions are characterized when the person believes themselves to be great inventors, religious saviors, or other specially empowered persons. Delusions of control occur when the person believes feelings, thoughts, and actions are being controlled by other people (Comer 441). A person with schizophrenia may not be able to think logically and speak in peculiar ways. Formal thought disorders can cause great confusion and make communications extremely difficult. Loose associations, or derailment, is the most common thought disorder and causes a rapid shift from one topic to another leaving the person believing that their incoherent statements make perfect sense. Neologisms are made up words that typically only have meaning to the person that is using them. Preservation occurs when the person repeats their words and statements over and over. Clang, another formal thought disorder, is used when the person uses rhyme to think or express themselves (Comer 442). Positive symptoms also include heightened perceptions and hallucinations. A person may feel that their senses are being flooded by all the sights and sounds that surround them. Hallucinations are perceptions that occur in the absence of external stimuli, and there are many different types. Auditory hallucinations consist of hearing sounds and voices that seem to come from outside one's head. Voices may speak directly to them, giving commands or warnings of danger, or may consist of overheard conversations. Tactile hallucinations may take form of tingling, burning or electric shock sensations. Somatic hallucinations produce vague perceptions of colors or clouds, or distinct visions of people or objects. Gustatory hallucinations occur when the person feels that their food or drink has a peculiar taste and olfactory hallucinations consist of smelling odors that no one else notices (Comer 443). It is believed that hallucinations and delusional ideas occur together. Another positive symptom is known as inappropriate affect; emotions that are unsuited to the situation, or inappropriate shifts in mood (Comer, 440-443).

The negative symptoms of schizophrenia include: poverty of speech, blunted or flat effect, loss of volition, and social withdrawal (Comer, 443). Poverty of speech, which is also known as alogia, is a reduction in speech or speech content. The person may think or say very little or convey little meaning in their conversation. Blunted and flat affect occurs when the person shows less anger, sadness, joy and other feelings than most people. Flat affect occurs when they show no emotion at all. Their faces are still, eye contact is poor, and their voiced monotonous. They may also display anhedonia, which is a general lack of pleasure or enjoyment (Comer, 440). Loss of volition is an apathetic way of looking at life, feeling drained of energy and interest in normal goals. They may also be unable to follow through on a course of action. This is common with people who have suffered from schizophrenia for many years. It may cause them to display ambivalence; conflicting feelings about most things. Social withdrawal is also prevalent in person suffering from negative schizophrenia. They may withdraw from their social environment and attend only to their own ideas and fantasies. Their ideas are usually illogical and confused, which separates them further from reality. This eventually leads to a breakdown of their social skills (Comer, 443-445).

Along with the positive and negative symptoms, there are five different types of schizophrenia (Comer 445). Paranoid type-- is the presence of prominent delusions or auditory hallucinations in the context of relative preservation of cognitive functioning and affect. Disorganized type-- have disorganized speech and behavior, flat or inappropriate affect. Catatonic type-- is a marked psychomotor disturbance that may involve motor immobility, or excessive motor activity. Catatonia is also characterized by extreme negativism, mutism, and peculiarities of voluntary movement echolalia or echopraxia. Undifferentiated type -- the presence of symptoms that meet the criteria of schizophrenia,