Schizophrenia

Assignment: DSM-IV Evaluation: Personality Disorders Connie Grubb PSY/270 April 01, 2011 Miles Castle Personality disorders do not discriminate. They may develop in an individual regardless of race, ethnicity, age, socioeconomic status, or gender. Individuals suffering from a personality disorder often find their lives influenced by the disorder. Some may withdraw from society while others find that society avoids them and their behaviors. Personality disorders exist as dissociative and somatoform disorders, “odd” personality disorders, “dramatic” personality disorders, and “anxious” personality disorders (Corner, 2005). The causes of personality disorders have many different theories. Therapists usually adhere to one or more theory to explain a personality disorder. Treatments also vary and depend on the therapist’s model of theory. Case Study 1 Case study 1 of Appendix H involves an individual suffering from a schizoid personality disorder. Schizoid personality disorder falls under the “odd” personality disorder category. Individuals suffering from a schizoid personality disorder prefer to remain alone and seldom engage in social activities. One’s behavior and thinking becomes odd. Such individuals rarely display emotion and others often view them as loners. The psychodynamic theory perspective of psychology believes that schizoid personality disorder results from an unsatisfied need for human contact during developmental years. Because of emotional coldness or abuse from caregivers, the individual does not have the ability to give or receive love (Corner, 2005). Cognitive theorists believe that schizoid personality results from a lack of development in thinking and perceptual skills. Such individuals do not have the ability to process the emotional signals received from their environment. As a result, the individual does not respond to emotions or have a need for socialization. Traditional psychodynamic therapy does not prove effective for schizoid personality disorder because of the social withdrawal exhibited by most sufferers. Cognitive and Behavioral theorists attempt to teach the individual appropriate emotions and social responses. The therapist places emphasis on an individual keeping track of enjoyable activities and thoughts. Group therapy helps some individuals experience safe social contact. Although drugs exist to treat schizoid personality disorders, the success depends on the cooperation of the patient and has limited applications. The individual may receive some relief from severe symptoms that prevent a meaningful quality of life. Case Study 2 Case study 2 of Appendix H involves an individual with Narcissistic Personality Disorder. Narcissistic Personality Disorder falls under the “dramatic” personality disorder category. An individual with this disorder often displays an inflated self-worth, craves and demands attention, and lacks empathy for other individuals (Corner, 2005). Psychodynamic theorists believe that this disorder results from cold, uncaring caregivers in infancy. Such individuals have an underlying sense of rejection and unworthiness that causes them to seek out attention. Cognitive and behaviorist theorists believe that the disorder results from an overabundance of positive reinforcement during developmental years. Such individuals develop a greater sense of self-worth and wish to inform others of how important they are. Sociocultural theorists believe the disorder results from a change in the values and morality of society. Such changes create self-centered, egotistical individuals who have no regard or concern for others. Treatments include psychodynamic therapy to help the individual recognize and change the underlying beliefs that cause the disorder. Cognitive therapy attempts to teach the individual to recognize the needs and concerns of others and to focus less on his or herself. Narcissistic personality disorder does not respond well to most attempts at treatment. Most individuals refuse to believe that they have anything wrong with them. Case Study 3 Case study 3 of Appendix H involves a Somatoform Disorder, Conversion Disorder. An individual with a somatoform disorder exhibits physical symptoms that have no proven medical basis. The underlying psychological issues manifest as physical ailments. The individual believes the ailment exists and does not fake or make-up symptoms. Somatoform disorders often occur after a sudden, traumatic experience. Unable to cope with frustration or guilt, the individual begins to experience the physical ailments. Psychodynamic theorists believe the disorder results when an individual unconsciously wishes to suppress emotions. Such an individual receives further reinforcement in the form of sympathy for the seemingly physical ailment, taking attention away from the psychological issues. Behaviorist theorists believe that the attention received from the seemingly physical ailments teaches the individual to further display the symptoms. The individual receives a reward, attention, from the behavior. Cognitive theorists believe that the seemingly physical symptoms convey the suppressed emotions of the individual. The individual does not verbally convey the emotions, so he or she physically does. A somatoform disorder such as the one in case study three, a conversion disorder, would receive treatment in the form of therapy. The individual would receive encouragement and insight into uncovering suppressed thoughts and emotions. Individuals receive encouragement that the physical symptoms will disappear. Therapists will also discourage the behaviors associated with an individual having a physical ailment. The individual will need to realize the physical ailment has a psychological basis, not a physiological one. Antidepressants bring some relief to those who suffer from a somatoform disorder (The Mayo Clinic, 2010). Case Study 4 Case study 4 of Appendix H involves an individual suffering from a Dissociative Disorder, specifically, localized Dissociative Amnesia. An individual experiencing localized dissociative amnesia will not remember an important, personal, recent, and life-altering event. The inability to remember has no physical basis and appears suddenly within a few days of the events occurrence. The localized amnesia ends, usually with the help of some form of treatment. Psychodynamic theorists believe that cases of dissociative amnesia result from the individual’s extreme desire to repress the traumatic event. The individual does not possess the coping mechanisms necessary to handle the overwhelming pain and emotions of the event. As a result, the event becomes blocked and the individual has no conscious memory of the trauma. Behavioral theorists believe that the individual receives relief from the traumatic event when he or she lets his or her mind drift from the memory. As the individual subconsciously learns that this behavior brings some relief, he or she learns not to remember the event. Treatment for dissociative amnesia may involve hypnosis, drug therapy, or psychodynamic therapy. Psychodynamic therapists encourage the individual to free associate and discover forgotten events. Repressed memories often come to the forefront during psychodynamic therapy. Some therapists use hypnosis to help the individual remember the traumatic event. Drugs known as “truth serums” have had some success with dissociative amnesia. Such drugs allow the individual to feel calm and permit the painful, blocked memories to surface. While none of the treatments have success alone, when used together the patient usually recovers. Case Study 5 Case study 5 of Appendix H involves Schizophrenia. Unlike a schizoid personality disorder, schizophrenia symptoms include delusions, hallucinations, and breaks with reality. The symptoms disturb the individual’s ability to function normally. The symptoms of hallucinations, delusions, and lack of focus become so severe the individual does not function well alone. The persistent, unrealistic thoughts that obsess the individual take priority in his or her life. Individuals with schizophrenia often develop an attachment to unusual objects or wear an odd collection of clothing. Very often with schizophrenia, the individual displays a lack of personal caretaking and hygiene. Causes of schizophrenia include genetic predispositions, birth defects, and chemical imbalances in the brain (Pinel, 2009). Many theories attempt to explain the cause of schizophrenia, but no definitive cause has surfaced. Treatment for schizophrenia includes typical and atypical antipsychotic drugs medications, individual therapy, and family therapy. The drugs relieve some of the severe symptoms of delusions and hallucinations associated with schizophrenia. Therapy helps the individual and his or her families understand the disorder. Conclusion Understanding the causes and treatments associated with psychiatric and personality disorders may help researchers and therapists develop better diagnosis methods and treatments. Individuals who suffer from a disorder do not suffer alone. The families, friends, and caretakers who handle the day-to-day issues of a sufferer also suffer. While the causes of such disorders exist as theories, the search goes on to discover real answers. Awareness of psychiatric disorders helps others to understand and develop empathy for sufferers. Appendix H DSM-IV Cautionary Statement Review the cautionary statement located at the following Web site: http://behavenet.com/capsules/disorders/cautionary.htm DSM-IV Case Studies Use the links below to review the following DSM-IV mental disorders. Then, match the disorders to the case studies below. DSM-IV Mental Disorders DSM-IV: Dependent Personality Disorder http://behavenet.com/capsules/disorders/dependentpd.htm DSM-IV: Dissociative Disorders http://behavenet.com/capsules/disorders/dissocdis.htm DSM-IV: Somatoform Disorders http://behavenet.com/capsules/disorders/somatoformdis.htm DSM-IV: Narcissistic Personality Disorder http://behavenet.com/capsules/disorders/narcissisticpd.htm DSM-IV: Schizoid Personality Disorder http://behavenet.com/capsules/disorders/schizoidpd.htm DSM-IV: Obsessive Compulsive Disorder http://behavenet.com/capsules/disorders/o-cd.htm DSM-IV: Schizophrenia http://behavenet.com/capsules/disorders/schiz.htm Case Studies Match the disorders above with the case studies below. Once you determine which disorder is being described, provide possible causes and a potential treatment for the disorder. Post your answers in a separate Microsoft® Word document as an attachment. Case Study 1 Josephine is a 47-year-old single woman. The hardest times of the year for Josephine's family are holidays and family gatherings; Josephine never seems to enjoy herself. She seldom smiles, laughs, or reacts to people and events around her. She remains detached and often goes into a room and plays video games or watches TV by herself, even when the rest of the family is eating. Her family members say that she is rude and do not want her around. Josephine lives by herself. She has held several jobs, but lost them because of her inability to interact with others. Her cool demeanor makes her difficult to approach. Josephine has no significant relationship in her personal life and cannot name any close friends. Schizoid Personality Disorder Case Study 2 When 38-year-old Luis enters a room, everyone knows it. Shortly after making an entrance, Luis is sure to let everyone know about his successful business ventures, his many ideas for new inventions, and his latest expensive purchase. At the last office party, Luis sought out the CEO of the company and monopolized her time with accounts of his valuable contributions to the company. Luis has no patience with others and is often described by his coworkers as a man who uses people to get what he wants. Although he has been an office assistant for 10 years, Luis is always impeccably dressed because he often says that one day he will be the CEO, and he insists on looking the part now. Narcissistic Personality Disorder Case Study 3 Two years ago, 23-year-old Anissa survived a horrific car accident in which two passengers of the car she was driving were killed. Her car was hit broadside by a drunk driver. Anissa was thrown from the car on impact. She was treated for cuts, bruises, and a broken arm, but recovered quickly and appeared otherwise unhurt. Three months after the cast on her arm was removed, Anissa began experiencing numbness in both hands. Extensive neurological tests eventually ruled out medical reasons for the numbness. Anissa was surprised when her neurologist referred her to a psychiatrist. Somatoform Disorder (Conversion Disorder) Case Study 4 Larry and Karen have always wanted a family. After 4 years of marriage, Karen gave birth to Austin, a healthy baby boy. Austin developed normally, walking at 13 months and saying "dada," "mama,” and "mid" (for milk) by 14 months. At 15 months, Austin caught what appeared to be a cold. Over a 2-day period, his cold rapidly worsened, and he was hospitalized with acute respiratory distress. He was placed on a ventilator, but the infection progressed too quickly and Austin died on the second day of hospitalization. His funeral and burial took place 3 days later. In the span of 1 week, Larry and Karen had changed from being a happy family to burying their only son. The day after the burial, Karen woke up, went to Austin's room, and panicked when she did not find him in his crib. She did not know that Austin had died, and she could not remember the events of the previous week. Dissociative Disorder (Dissociative Amnesia) Case Study 5 Tony was a straight-A student in high school. He entered college on a full scholarship, and moved into the freshman dorm. He did well during his first semester, but his roommate noticed a change in Tony during the second semester of their freshman year. Tony slept very little, was inconsistent about grooming and hygiene, and seemed preoccupied with his own thoughts, often talking to himself in a worried whisper. He was observed muttering to himself during class, prompting two professors to ask him to leave. When Tony became verbally abusive to the second professor, he was escorted off the premises by security and was required to meet with the dean. Tony appeared at this meeting unshaven and in wrinkled, unwashed clothes. He told the dean that the professors did not understand "the pressures of his new duties as an FBI agent." During their conversation, Tony often paused and tilted his head, as if listening to voices or sounds; the dean did not detect any sounds. The dean suspended Tony and recommended his parents come get Tony and seek psychiatric help for him. Schizophrenia References Corner, R. J. (2005). Fundamentals of abnormal psychology. (Chpt. 6 & 13). New York: Worth. Retrieved from: University of Phoenix eBooks Pinel, J. P. J. (2009). Biopsychology. Boston, MA: Pearson. Retrieved from: University of Phoenix eBooks The Healthy Place. (2007). Schizophrenia. Retrieved from: http://www.healthyplace.com/thought-disorders/schizophrenia.htm The Mayo Clinic. (2010). Antidepressants. Retrieved from: http://www.mayoclinic.com/health/antidepressents.htm