Schizophrenia: 4 Symptoms

Schizophrenia Symptoms:

According to the American Psychiatric Association, symptoms are classified as positive and negative. Positive symptoms, (abnormal experiences), manifest an excess´-or-distortion of normal -function-s, whereas negative ones, (abnormal behaviors), denote their diminution´-or-loss-;- (Pratt, Gill, Barrett & Roberts, 2007). Negative symptoms are harmful and characterized by the absence of something that is normally present-;- such as avolition which means lack of free willpower and anhedonia which means not in pursuit of pleasure´-or-inability to experience pleasure. Negative symptoms include losses´-or-deficits in the range and intensity of emotional expression (flat effect), the fluency and productivity of thought and speech (alogia), and the initiation of goal--dir-ected behavior (avolition). However, positive symptoms are more blatant signs added to the person’s experience as a result of the disease, such as hallucinations, delusions and most thought disorders. Thus positive symptoms include distortions´-or-exaggerations of thinking and ideas (delusions), perception and sensations (hallucinations and illusions), and language and communication (disorganized´-or-bizarre speech)-;- (Pratt, Gill, Barrett & Roberts, 2007). Frith, a psychologist and psychiatrist, has concluded that various schizophrenic features are “reflections of different impairments in the single cognitive mechanism of metarepresentation” which is “a fundamental process central to conscious experience”-;- (Burke, Gates & Hammond 1995).

Positive symptoms, as mentioned, are characterized by the manifestation of patently absurd´-or-false thoughts, behaviors,´-or-feelings. Positive symptoms are also called cognitive symptoms which are the most obvious, and often the most disturbing ones. They include hallucinations, delusions and disturbed thinking and attentional processes-;- (Burke, Gates & Hammond 1995). Hallucination and delusions are the most common and intensely-mildly fluctuating two types of psychiatric symptoms. “Between 25% and 50% of people with schizophrenia experience some of these persistent psychotic symptoms-;-” (Mueser & Gingerich, 2005).

Hallucinations are false perceptions-sensations. They include hearing, seeing, feeling, tasting and smelling things that are not present in the environment. Hallucinations are sounds´-or-other sensations experienced as real, but only exist in the persons mind. Hallucinations can be any of the five senses but the most common is an auditory hallucination which is hearing voices. Visual hallucinations are relatively common as well in schizophrenia. Research suggests that auditory hallucinations occur when people misinterpret their own inner self-talk as coming from an outside source which is also related to delusions of control. In most cases the voices are of people they know and are vulgar, abusive, and critical. A person may hear voices that give instructions,´-or-criticize the individual in some way. Sometimes they can be recognized as the person’s own internal voices, and occasionally the voices may be those of other important persons´-or-character-;- (Burke, Gates & Hammond 1995). If a person with auditory hallucinations acts on the voices, he´-or-she may be dangerous to others-;- but in most cases he/she is more dangerous to himself/herself-;- (Burke, Gates & Hammond 1995).

There are other types of hallucinations that schizophrenics may experience. They include tactile, somatic, olfactory, and visual hallucinations. Tactile hallucination manifests itself in a phenomenon called formication which occurs when a person feels that something, such as ants, is crawling over his/her skin-;- other patients feel something occurring inside their bodies,´-or-may experience tingling´-or-burning. Some patients smell things that are clearly not present, such as perfumes´-or-someone else’s body odor-;- (Burke, Gates & Hammond 1995). A friend of mine once told me that her schizophrenic uncle, who lost his wife, always told them that whenever he got into his bedroom, he always smelt what he called “the smell of death”. In visual hallucinations, persons may see things that are not there´-or-have distorted impressions of objects that are present-;- (Burke, Gates & Hammond 1995)
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Delusions are false´-or-not shared beliefs. In other words “delusions are false belief systems that are held by an individual without any basis in fact”-;- (Burke, Gates & Hammond 1995). Delusions include other types such as persecutory (paranoid) delusions where schizophrenics continue to hold the false belief systems even though there is strong evidence that refutes these false beliefs. The problem with individuals with those potent false beliefs is that they may act upon them, hence leading to self-inflicted damage´-or-damage to others. For example, in persecutory delusion, individuals believe that others intend to harm them in some way´-or-another. Such paranoid delusion may cause the afflicted persons to be very guarded and over-cautious in what they say to others-;- the thing that can result in social isolation and avoidance of contact with others. In delusion of reference, the afflicted person may see significant signs everywhere. For example, the way a person opens a briefcase may indicate that this person is being spied on´-or-that a special message is about to be delivered. Delusion of control is the fixed belief that one’s behavior is entirely -dir-ected by another person, group of people,´-or-external force. For example, a person cowers whenever a brown delivery truck passes his house. He believes the trucks contain machines which govern his behavior. Grandiose delusion makes the afflicted person believe that he has a mission in life to control´-or-regulate the behavior of others, and attach a special significance to events that most people would regard as quite ordinary. Some individuals who have the delusion of identity believe that they are famous characters-;- and they act as they believe that person should´-or-would have acted-;- (Burke, Gates & Hammond 1995).

Disorganized speech is when the person has trouble concentrating and maintaining a train of thought. There are four common signs of disorganized speech: loose association, neologisms, preservation, and clang. Loose association is shifting from topic to topic without the topics connecting. Neologisms are made up words´-or-phrases that only have a meaning to the person. Preservation is saying the same word´-or-phrase over and over. Clang is meaning use of rhyming words. Disorganized behavior is a lack of overall daily -function-, odd emotional responses, behaviors that appears strange and have no purpose, and no impulse control-;- (Mueser & Gingerich, 2005), and (Pratt, Gill, Barrett & Roberts, 2007).

In addition to delusions and hallucinations, thought disorders are considered prominent schizophrenic symptoms. Thought disorders are associated with cognition´-or-thinking´-or-the way the mind and brain process information. These are also considered other types of delusions such as thought broadcasting (people can hear a person’s thoughts), thought insertion (others put intrusive thoughts in a person’s mind), racing thoughts (a person’s thinking moves too fast to cope with), somatic delusion (person’s brain is rotting away), and delusions of guilt (a person has committed a terrible crime)-;- (Mueser & Gingerich, 2005), and (Pratt, Gill, Barrett & Roberts, 2007).

On the contrary, negative symptoms are harder to identify as indications to illness because they are characterized by the absence of normal thought, behavior´-or-feelings, found in healthy individuals. Negative symptoms tend to be fairly stable over time, whereas psychotic symptoms may fluctuate more. There are four negative symptoms: lack of emotional expression, lack of interest´-or-enthusiasm, seeming lack of interest in the world, and speech difficulties and abnormalities. To be more precise, it can be restated that negative symptoms include blunted/flat affect which means lack of noticeable facial´-or-vocal expressiveness of emotion. In other words Lack of emotional expression is inexpressive face, including a flat voice, lack of eye contact, and blank´-or-restricted facial expressions. Alogia means little speech´-or-poverty of speech. It also means speech difficulties and abnormalities. A person with alogia cannot carry out a conversation-;- and if he speaks, he does in monotone-;- and if he answer questions, he gives short´-or-disconnected answers. Apathy denotes lack of motivation to work towards personal goals´-or--function- more independently, reflecting discouragement´-or-hopelessness about the future, little energy, easy fatigue. A person with apathy may suffer from problems with motivation-;- and manifests lack of self-care, and lack of interest in the world-;- the thing that may result in social withdrawal and unawareness of the environment. and finally anhedonia which is the decreased ability to feel pleasure´-or-enjoyment-;- (Mueser & Gingerich, 2005). A person with anhedonia may not enjoy anything in life that can be a very strong incentive for enjoyment and pleasure for normal´-or-healthy individuals.

Although it is difficult to -dir-ectly compare mental disorders across cultures because people tend to express mental disorders in a wide variety of ways, schizophrenia seems to have a large biological component and the general symptoms tend to be shared by almost all cultures. However, culture can have strong impact on abnormal behavior according to four aspects-;- prevalence, form, onset and prognosis. According to prevalence, schizophrenia occurs occurs in all countries and cultural groups. But there are some differences within these cultures. For example, in Norway, men men tend to develop the disease 3 to 4 years earlier than women, with more hospitalization and poorer social -function-ing-;- (Huffman, 2010), ( Combs et al., 2008-;- Raesaenen et al., 2000). The form and symptoms of the disease vary across cultures. For example, in Nigeria, intense suspicion of others, accompanied by bizarre thoughts of personal danger is considered a major symptom there-;- (Huffman, 2010), (Katz et al., 1988). In western cultures, auditory hallucinations are the major symptom, and their sources have changed with the technological advances-;- (Huffman, 2010), (Brislin, 2000). The onset of the disease can result from stress. Cross-cultural research in countries such as Algeria, Asia, Europe, South America, the USA, and other cultures supports the relationship between stress and schizophrenia. (Huffman, 2010), (Al-Issa, 2000-;- Browne, 2001-;- le Roux et al., 2007-;- Neria et al., 2002-;- Torrey & Yolkn, 1998). The prognosis´-or-prediction for recovery from schizophrenia also varies according to cultures. In non-industrialized countries, the prognosis of recovery for people with schizophrenia are better than in industrialized countries despite trained professionals and drugs because the core symptoms of schizophrenia (poor rapport with others, incoherent speech, etc.) make it more difficult to -function- in highly industrialized countries. Besides, individualism is highly encouraged in most industrialized nations. Thus, families and other support groups are less likely to feel responsible for relatives and friends with schizophrenia-;- (Huffman, 2010), (Brislin, 2000-;- Lefley, 2000).

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