Schizophrenia Theories Of

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term schizophrenia is a general label for a number of psychotic disorders with various behavioral, emotional, and cognitive features. The term was originated by the Swiss psychiatrist Eugen Bleuler (1857-1939) in 1911, who offered it as a replacement for the term dementia praecox (i.e., "precocious madness/ deterioration/insanity"). In its literal meaning, schizophrenia is a "splitting of the mind," a connotation reflecting a dissociation or separation between the functions of feeling/emotion, on one hand, and those of cognition/ thinking on the other hand. The "split" in schizophrenia implies a horizontal direction, rather than a vertical direction (as indicated in the disorder called multiple personality, which is confused, often, by laypeople with schizophrenia). In the simplest terms, multiple personality is a "split within self," whereas schizophrenia is a "split between self and others." Various categories, descriptions, and subtypes of schizophrenia have been developed (e.g., acute, borderline, catatonic, childhood or infantile autism, chronic, disorganized, hebephrenic, latent, paranoid/paraphrenic, process, reactive, residual, schizoaffective, simple, and undifferentiated), but there are certain common aspects to all types: (1) deterioration from previous levels of social, cognitive, and vocational functioning; (2) onset before midlife (i.e., about 45-50 years of age); (3) a duration of at least six months; and (4) a pattern of psychotic features including thought disturbances, bizarre delusions, hallucinations, disturbed sense of self, and a loss of reality testing. The progressive teleological-regression hypothesis (Arieti, 1974) is a theory of schizophrenia that maintains that the disorder results from a process of active concretization, that is, a purposeful returning to lower levels of psychodynamic and behavioral adaptation that - although momentarily effective in reducing anxiety - tends ultimately toward repetitive behaviors and results in a failure to maintain integration [cf., deviant filter theory -holds that patients diagnosed with schizophrenia are unable to ignore unimportant features and stimuli and, therefore, cannot attend to stimuli of greater importance in the environment; and the von Domarus principle - named after the Dutch psychiatrist Eilhardt von Domarus (dates unknown) - states that persons with schizophrenia perceive two things as identical simply because they have identical properties or predicates, and that whereas the normal person interprets events on the basis of their objective features, the schizophrenic individual interprets events in idiosyncratic and unrealistic ways; the principle is what logicians have known for over 2,000 years as the "fallacy of the undistributed middle," and is not necessarily restricted to the reasoning abilities in schizophrenics]. In general, current theories of schizophrenia focus on biochemical abnormalities, with some cases of schizophrenia appearing to be of genetic origin, perhaps triggered by environmental stresses (cf., neurodevelopmental hypothesis - holds that schizophrenia is due largely to abnormalities in the prenatal or neonatal development of the individual's nervous system, leading to deficits in brain anatomy and behavior; viral hypothesis of schizophrenia - postulates that schizophrenia may be caused, or precipitated, by a viral infection in the person; brain-spot hypothesis - refers to theories that emphasize organic factors in the etiology of mental disease; the mind-twist hypothesis - emphasizes a functional, rather than a structural, basis of mental disorders; and Sutton's law - named after the notorious Willie Sutton (1902-1980) who robbed banks because "that's where the money is," and is the principle - when applied to clinical diagnosis - that one should look for a disorder where, or in whom, it is most likely to be found and emphasizes the predisposing factors in all diseases and disorders). The major theoretical models of the etiology of schizophrenia are the specific gene theory -assumes that the disorder is caused by one or more faulty genes that produce metabolic disturbances (cf., the founder effect - relates to population genetics and the high rate of schizophrenia in residents of Sweden above the Artic Circle); psychoanalytic theory -gives primacy to aggressive impulses, and suggests that the threats of the intense id impulses may provoke schizophrenia depending on the strength of the ego; however, few data are available on the psychoanalytic position, and there is no evidence that ego impairments cause schizophrenia; labeling theory - assumes that the crucial factor in schizophrenia is the act of assigning a diagnostic label to the person where the label then influences the way in which the person continues to behave and, also, determines the reactions of other people to the individual's behavior; that is, the social role is the disorder, and it is determined by the labeling process; experiential/familial theory - assumes that one's family is a key factor in producing schizophrenic behavior in the person where - in a process called "mystification" - the parent systematically strips the child's feeling and perceptions about himself or herself and the world of all validity so that the child comes to doubt his/her hold on reality (e.g., R. Laing's theory of schizophrenia refers to a "double-bind, no-win situation;" cf., expressed emotions effect - holds that there is a high relapse rate in schizophrenia that is to be associated with critical emotions expressed toward mental patients by their families, and indicates that schizophrenia may be a somewhat "protective" device to escape from an undesirable social situation); biochemical/neurological theories - at this time, no single biochemical or neurological theory has unequivocal support [cf., Fiamberti hypothesis - named after the Italian psychosurgeon Amarro M. Fiamberti (dates unknown), is an outdated theory positing that schizophrenia results from a nervous-tissue deficiency of acetylcholine that may be secondary to an infectious/toxic condition; and the glutamate hypothesis - suggests that schizophrenia is caused by an activity deficit at the glutamate synapses]. However, there are promising, but incomplete, findings concerning areas both of brain pathology and of excess activity of the neurotransmitter dopamine regarding the incidence of schizophrenia. Other theories include: social class theory - emphasizes the consistent correlations found between lowest socioeconomic class and the diagnosis of schizophrenia; in this category, the sociogenic hypothesis states that simply being in a low social class may in itself cause schizophrenia, and the social drift theory (also called the downward drift hypothesis and social selection theory of pathology) suggests that during the course of their developing psychosis, schizophrenics may "drift" into the poverty-ridden areas of the city, or may drift downwardly to lower levels and standards of socialization and end up in pitiful circumstances; the environmental stress/family theories -view schizophrenia as a reaction to a stressful environment, or family, that presents overwhelming and anxiety-producing conditions; the diathesis-stress hypothesis - refers to a predisposition to develop a particular disorder: in this case, schizophrenia, as a result of interaction between stressful demands and personal traits; the term schizophrenogenic parent/mother hypothesis was coined [by the German-American physician Frieda FrommReichmann (1889-1957)] to refer to the cold, rejecting, distant, aloof, dominant, and conflict-inducing parent who is said to produce schizophrenia in one's offspring (cf., refrigerator parents theory - an obsolete theory of autism that characterizes the autistic child's parents as cold, unloving, intellectual, and relatively uninterested in their children). Early researchers studying schizophrenia looked for, and found, pathology in one or both parents of psychotic children; however, more current research suggests that there is no valid scientific evidence confirming the speculation that parental disorders precede and/or precipitate their children's disturbances. Another prominent early viewpoint, the double-bind theory (that is lacking, also, in empirical support) emphasizes the situation faced by a person who receives contradictory or "mixed" messages from a powerful person (usually the parent) who has difficulty with close affectionate relationships but cannot admit to such feelings. In the double-bind scenario, the parent communicates withdrawal and coldness when the child approaches but, then, reaches out toward the child with simulated love when the child pulls back from the coldness; in this way, the child is caught in a double bind: no course of action can possibly prove satisfactory, and all assumptions about what she or he is supposed to do will be disconfirmed. The constitutional-predisposition theory combines the genetic and the environmental theories and argues that a variety of disparate dispositions are inherited but that the emergence of a diag-nosable schizophrenic disorder is dependent on the degree of these dispositions and the extent to which they are encouraged by particular types of environmental conditions; this point of view has the largest number of adherents among specialists (cf., the largely discredited seasonality effect/hypothesis - states that there is a greater prevalence of schizophrenia in persons who are born in the late winter or early spring). The two-syndrome hypothesis/theory suggests that schizophrenia is composed of two separate syndromes: Type 1 that is related to dopamine sensitivity and produces symptoms such as delusions and hallucinations, and Type 2 that is related to genetics and brain abnormalities and produces symptoms such as flat effect and social withdrawal. See also LABELING AND DEVIANCE THEORY; PSYCHOPATHOL-OGY, THEORIES OF.

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