Schizophrenia is a disorder that has been misunderstood and its symptoms misinterpreted by many. Since the disorder was first recognized at the end of the 19th century, there has been no consensus on the mechanism to diagnose the disorder (Halgin & Whitbourne, 2010). It is also not clear as to what causes the disease, and as such, different theories have been put forward to explain its cause. This is a disorder the symptoms of which are varied, and as such, it is difficult to identify specific symptoms of the disorder. Many appear to associate schizophrenics with delusions or hallucinations, but apparently, those are not the only symptoms. In additions, the symptoms also appear in different intensities ranging from mild to severe. Due to the complex nature of schizophrenia, it forms a good basis for research in comprehending the causes of the disorder, its symptoms, those it affects, the parts of the brain that it impairs, and which population is more likely to be affected. This knowledge will be instrumental in making us understand better those people whom we interact with daily.
The objective of the research to be critiqued was to examine whether cognitive models explain schizophrenia and how it is affected by the stress. The study was meant to establish whether the syndrome develops in response to stress, and whether accumulation of more stressors can increase the risk of schizophrenia (Riso, 2007). The study hypothesized that schizophrenia can be explained using the cognitive theory of the disorder, which holds that people respond emotionally to events according to how they interpret those events. This implies that peoples’ thoughts lead to emotions, and, consequently, to their ensuing behavior. The cognitive model defines disorders as a result of a combination of psychological, cognitive, and environmental factors (Beck et al, 2009). This model, thus, is suitable for explaining the development of schizophrenia, because it offers a holistic approach to the disorder.
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According to Maj & Sartorius (2008) schizophrenia is a disorder with an unknown etiology. Over the years, various signs and symptoms have been proposed to describe the disorder and make it distinct from other disorders. Although there have been multiple attempts in the recent past to identify clinically useful laboratory tests that might affirm the presence of the disorder, the diagnosis still remains vested in essentially clinical criteria. Russell and Jarvis consider schizophrenia as a group of psychotic disorders that are characterized by major disturbances of thought, emotion and behavior (Russell & Jarvis, 2008). A patient suffering from this disorder often withdraws from people and reality, where his life turns into a fantasy of delusions and hallucinations. Schizophrenia affects about one out of every one hundred individuals and is equally distributed in both genders. However, the disorder starts early in men in their mid twenties, while, in women, it begins in their early thirties (Weinberg & Harrison, 2011).
Schizophrenia was first termed as dementia praecox or youthful insanity by Kraeplin in 1896, and since then, there has been no consensus on the diagnosis of the disorder with different diagnostic systems being adopted. The cause of schizophrenia is not known, but most psychologists and mental health professionals hold that it has a biological basis and is triggered by psychosocial factors (Maj & Sartorius, 2008). As a result, many psychiatrists refer to the disorder as a disease. However, schizophrenia is not a disease in the strict medical sense, because it does not have a set of symptoms that have an established cause. Therefore, a more befitting term for the disorder is a syndrome, since it has signs and syndromes that appear to occur together, and which are likely to have the same cause. The disorder is not influenced by race, culture, gender or social status, and as such, it can affect anyone, anywhere around the globe (Veague & Levitt, 2007).
One of the challenges that have been facing the diagnosis of schizophrenia is the presence of numerous signs and symptoms. Consequently, it is difficult to find two schizophrenic patients with the same symptoms. This variety of symptoms has made the search for the causes of the disorder difficult. According to Veague & Levitt (2007), there are three types of schizophrenic symptoms, which include positive, negative and disorganized. A positive symptom is not good behavior but implies a symptom that is present in the patient, but should be absent. One of the defining positive symptoms of schizophrenia is hallucinations. The patient hears voices that are talking to them or commenting on their actions. Another positive symptom is delusions, whereby patients perceive that an outsider is controlling whatever they are doing. Patients also experience thoughts that are coming into their mind from an outside source (Russell & Jarvis, 2008).
The negative symptoms are those symptoms that are not there, but should be present as in the case with a normal person. Among them is the poverty of speech whereby patients tend to respond using the minimum number of words possible. Patients suffering from this disorder have also withdrawn from family and friends and refuse the company of other people. They also lack facial and voice expression. Schizophrenic patients may appear as if they lack feelings, but the fact that they cannot show their affection does not imply that they do not have feelings (Maj & Sartorius, 2008). People working with schizophrenic patients should always consider and be sensitive to avoid hurting them. The disorganized symptoms refer to odd and confused thinking, speech, and behavior. For instance, the patient may dress contrary to the prevailing weather. This disorder is also linked with changes in cognition and may have difficulties in remembering things. Patients may lack attention for a long time and have no motivation and zeal in life (Russell & Jarvis, 2008).
Despite the wide array of symptoms that have harbored the standardization of schizophrenia diagnosis, there are two major diagnostic classification systems used today in diagnosing schizophrenia. These include ICD-10 developed by WHO and the Diagnostic and Statistical Manual, fourth edition (DSM-IV), developed by the APA. The ICD-10 is mainly used in most parts of Europe while DSM-IV is used mainly in the US (Weinberg & Harrison, 2011). The two systems are alike in that they entail a primary list of symptoms. At least one must be present for one a diagnosis to be made. The two systems also consist of a second group of symptoms, of which at least two symptoms ought to be present to diagnose the disorder. However, the two systems differ in that, in the case of DSM-IV, the symptoms must have present for most of the time for one month, whereas, in ICD-10, the symptoms should persist for at least six months (Tsuang, Faraone & Glatt, 2011).
Although the cause of schizophrenia remains unclear, there is some documented evidence to suggest that it may be influenced by genetic factors. Studies conducted among twins indicate if one identical twin is affected by the disorder, the other one has a 40-60 percent likelihood of getting the disorder (Beck et al, 2009). On the other hand, if one of the non-identical twins suffers from the disorder, the chance that the other one will develop schizophrenia is 17 percent. Although this may point out the genetic factors contribution to the cause of the disorder, other factors are also important. The cognitive model explains the disorder in terms of the diathesis-stress (Veague & Levitt, 2007). This implies that genetic abnormalities make one vulnerable to the disorder, but it only develops as a response to stress. The stressors may be biological in nature such as prenatal viral infection, psychosocial, such as living in an urban setting, or psychological, such as a traumatic experience. The model stipulates that an increase in the accumulation of stressors results in an increase in the risk of developing schizophrenia (Tsuang, Faraone & Glatt, 2011).
Schizophrenia affects various parts of the brain. Patients suffering from this disorder depict a number of neuroanatomical abnormalities. These include enlargement of the lateral ventricles, a reduction in the brain mass, smaller hippocampus, as well a reduction in the density of pyramidal cells of the prefrontal cortex. In the study of the parts of the brain reduced in schizophrenia, Goldstein (2007) found out that the greatest differences in size were in the paralimbic cortex and the middle frontal gyrus. The neuroanatomical deficits may give rise to cognitive deficits due to a poor functioning of the brain. A smaller hippocampus may be due to a pre or post-natal exposure to viruses, or a traumatic experience during one’s childhood (Beck et al, 2009). Patients with a small hippocampus are bound to have an exaggerated HPA response, implying that there will be an overproduction of cortisol if such patients are exposed to stress. Excess cortisol further reduces the size of the hippocampus; hence, exaggerating the HPA response (Weinberg & Harrison, 2011).
In addition to controlling the HPA response, the hippocampus is also important in controlling the mesolimbic dopamine pathway. This is an area of the frontal lobes involved in motivation and pleasure. A reduction of the hippocampus volume results in excessive dopamine activity, thus, increasing cognitive resources and sets the patient on the way to psychosis. Based on the above discussions, it is evident that one of the strengths of the cognitive model of schizophrenia offers a holistic approach to the disorder (Russell & Jarvis, 2008). Other theories are likely to ignore influences that are beyond their own discipline, but this model offers a holistic perspective of the development of the disorder (Tsuang, Faraone & Glatt, 2011). The model also recognizes the varying nature of the disorder’s symptoms from one patient to the other one, a fact that may be due to the biological nature, cognitive schemas, and attitudes. The model also explains why the incidence rates of the disorder are so varied around the globe (Beck et al, 2009). The disorder is caused by an interplay of various psychosocial, biological, and psychological factors. However, the cognitive model does not explain why the disorder is not common, in childhood, although this can be attributed to the notion that in childhood, life is less stressful (Weinberg & Harrison, 2011).
Data for the research study was gathered through literature search, which entailed searching information from media, the internet, as well magazines with relevant issues on the disorder. It also included personal interviews with patients who had the disorder. In addition, telephone, email, and internet surveys were used (Riso, 2007). The research does not specify whether the sample taken was random or not. It would have been appropriate to clarify whether the sample was randomly selected or not, as this may rule out the possibility of enlisting participants from the same game setting, which may tarnish the results validity. The study does not mention any statistical test used in analyzing the data, which is important to indicate the interactions of the results.
The study found out that schizophrenia develops because of stress. This occurs when the patient is predisposed to genetic abnormalities. According to the study, the accumulation of more stressors causes a rise in danger of the disorder development. The study also found out that the disorder could be rehabilitated through stimulating new learning for the patient by improving their function, and by creating environments that reduce stress, thus, lowering the risk of the disorder (Halgin & Whitbourne, 2010). Since the development of the disorder is tied not only to stress, the study should have included genetic predisposition and its relationship to the disorder as one of the research questions.
The study has merit, but its presentation mode needs to be re-evaluated in order to be rendered more scholarly. Specification of sample size is important. The validity of the study can be increased by indicating the statistical tests used. The hypothesis and research questions should incorporate genetic predisposition in order for it to offer a holistic approach to the cause of the disorder as per cognitive model. Further, the study would mention details of the participants such as their place of residence, race and gender in order to determine whether these factors play a role in the development of schizophrenia. Without incorporating these, it would amount to linking schizophrenia to stress alone, whereas that is not the case.
Schizophrenia is no doubt one of the most crucial health concerns in the world today. Due to its early onset and its subsequent tendency to persist chronically, it produces great anguish for patients together with their families. Moreover, a disorder is conceptually challenging owing to its diverse symptoms. Even today, there is no consensus on how best to define the phenotypes of schizophrenia, yet the definition of the concept and its phenotype must provide a basis for both the study of the syndrome mechanisms and the expansion of improved approaches to treatment and prevention. Nevertheless, various theories have been put forward to explain the development of this disorder. The cognitive model of schizophrenia is probably one of the most dependable of the schizophrenic models since it offers a holistic approach to the issue. Through studies from various researchers, this model holds that the disorder develops due to a predisposition of genetic abnormalities, and accumulation of stressors.
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