Posted: May 24th, 2022
Schizophrenia & Delusional Disorders
Case Study of Sally
Of the many psychiatric disorders, schizophrenia and paranoia are two that are perhaps most commonly known to the general public. Whether this is due to the rate of incidence or to the ease of characterizing the disorders in print, dramatizations, or media, is difficult to say. These two disorders are categorically similar and are taxonomically considered to be psychoses. There are three main classes of psychoses: Mood or Affective Disorders, Schizophrenic Disorders, and Paranoid or Delusional Disorders. The DSM-IV_TR definitions of Schizophrenia and Paranoia are long and complicated, though somewhat redeemed by the intriguing histories of the discovery and definition of the disorders — and by the associated lore.
Schizophrenia. The term schizophrenia means split mind and it was first applied to the disorder by Bleuler in 1911, who thought the brains of schizophrenics developed an inability to integrate emotions, thoughts, and contact with reality (Acocella, 1999). Bleuler diagnosed the Polish / Russian ballet dancer Vaslav Nijinsky with the disorder at age 29 when, after three years of suffering from symptoms, Nijinsky had a complete breakdown and was sent to Switzerland to be treated by Bleuler (Acocella, 1999). The most fascinating aspect of Nijinsky’s deterioration was that he wrote a diary over a period of six weeks in 1919 as he was descending into psychosis — it is perhaps the only sustained account of its kind by an artist that is not a retrospective, and it has been published (Acocella, 1999).
For someone to receive a diagnosis of schizophrenia, The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) stipulates that a person must manifest two of the major symptoms of the disorder: “(1) delusions, (2) hallucinations, (3) grossly disorganized or catatonic behavior, (4) disorganized speech, or (5) negative symptoms” (American Psychiatric Association, 2000). Negative symptoms include flat affect, inability to speak, and profound lack of interest in goals, desire, or motivation. That said, if the “delusions are bizarre” or the “hallucinations involve voices commenting consistently or voices conversing with each other,” then a diagnosis of schizophrenia can be given on the basis of only one of those two symptoms. To rule out single episodes that could easily be attributed to other causes, the constellation of symptoms must be present for at least a month, and there must be continuity of behavioral manifestation for at least six months. Symptoms that are precursors to (prodromal) or follow (residual) an active phase are common in the disorder. The types of behavioral and cognitive manifestations of the disorder that might be evidenced include, “somatic delusions, delusions of being controlled, thought broadcasting, and grandiose delusions” (Meyer, et al., 2009). Five subtypes of schizophrenia have been identified: “Paranoid, Disorganized, Catatonic, Undifferentiated, and Residual.” (American Psychiatric Association, 2000).
The Case of Sally
Sally’s early family life was a bit precarious (Meyer, et al., 2009 ) Her mother smoked and was seriously ill with a virus while carrying Sally (Meyer, et al., 2009 ) Sally’s maternal grandfather was eccentric and somewhat of a loner (Meyer, et al., 2009 ) Sally exhibited a degree of hyperactivity, but talked and walked late (Meyer, et al., 2009 ) Her parents were combative and conducted a “long-term conflict-habituated marriage” (Meyer, 2009, p. 89). Her father was largely absent, and overly critical when present (Meyer, et al., 2009 ) Her mother maintained a “symbiotic relationship” with her daughter (Meyer, et al., 2009 ) Despite being quite bright, Sally’s study efforts seemed always a bit disconnected so she did not receive good grades in school (Meyer, et al., 2009 ) Sally was not good at making and keeping friends, and this was exacerbated by her mother’s possessiveness — potential friends were subtly driven away (Meyer, et al., 2009 ) More and more of Sally’s time was spent in the company of her mother or alone — Sally developed increasingly odd mannerisms and interests as a result (Meyer, et al., 2009 ) Sally’s schizophrenia reached an acute active stage when she went away to college (Meyer, et al., 2009 )
Behavioral components. Sally began having conversations with herself in her dorm room, causing the roommate assigned to her to move out (Meyer, et al., 2009 ) Sally withdrew into a catatonic state — she sat unresponsive in a chair and just stared at the floor (Meyer, et al., 2009 ) If someone moved her arms or legs, they would stay as arranged (Meyer, et al., 2009 ) Her condition was labeled “waxy flexibility (Meyer, et al., 2009 )” After this serious acute attack, and a period of hospitalization, Sally recovered enough to go back to school (Meyer, et al., 2009 )
Sally’s attendance in college classes became erratic and she became more reclusive (Meyer, et al., 2009 ) Sally evidenced a second acute phase and was re-hospitalized at the insistence of her father (Meyer, et al., 2009 ) Sally was able to obtain and keep a low-paying, low-demand job for a time (Meyer, et al., 2009 ) When not working, Sally stayed alone in her room or did jobs around the house (Meyer, et al., 2009 )
Apparently, in response to her mother’s needy behavior, Sally did not come directly home from work but began to wander the streets and neighborhoods (Meyer, et al., 2009 ) Sally’s behaviors become more deviant, until one day she was picked up by the police — Sally had been wading in the shallow part of a pond in a park in town (Meyer, et al., 2009 ) She was heard muttering to herself (Meyer, et al., 2009 ) Sally was hospitalized and then transferred and admitted to a hospital for mentally ill patients (Meyer, et al., 2009 )
Biological components. Genetically at risk for odd or eccentric behavior (Meyer, et al., 2009 )
Cognitive components. The second acute episode caused Sally to exhibit a hebephrenic pattern in which she rocked or was unresponsive or burst out giggling (Meyer, et al., 2009 )
Emotional components. Parenting manifested attributes of a strained and combative marriage with varying degrees of competition for Sally’s attention and compliance (Meyer, et al., 2009 ) The mother, in particular appeared to substitute hyper-focused attention on her daughter for expected and normal harmonious interactions with her husband (Meyer, et al., 2009 )
After her acute episode at college, Sally’s mother brought her home (Meyer, et al., 2009 ) Sally’s condition worsened (Meyer, et al., 2009 ) The cycle of Sally getting better, Sally being taken home by her mother, and Sally’s mother “taking care of her” repeated (Meyer, et al., 2009 ) Sally’s mother did not help Sally stay on her outpatient therapeutic regimen (Meyer, et al., 2009 )
Shortly after moving back home and working at a part-time job, Sally’s father died from a heart attack (Meyer, et al., 2009 ) Following the death of her husband, Sally’s mother exhibited more neediness and dependence on her daughter (Meyer, et al., 2009 )
Published in 1959, an article by argued that schizophrenic patients — presumably young people — act as mediators of a sort between emotionally disparate parents, albeit unsuccessfully (Bowen, et al., 1959). The authors suggest — though their sample is admittedly small — that the most frequent relationship pattern in the family is “an intense two-some between the mother and patient which excludes the father and from which he permits himself to be excluded’ (Bowen, et al., 1959). The parents in this reciprocal relationship are “separated from each other by an emotional barrier which, in some ways, has characteristics of an ’emotional divorce’” (Bowen, et al., 1959). The tack taken in this article is characteristic of the times when parents were “blamed” for all types of problems with their children. A well-known example is Bruno Bettelheim’s accusation of the refrigerator mother being the cause of her child’s autism. What is completely absent from these theories is the impact of a child’s or youth’s disorder on the interactions of family members, which — particularly when observed after the symptoms have become acute — devolve into adaptive behaviors that are reasonably atypical.
That said, a study conducted in Finland with children who were at high genetic risk for schizophrenia and who were adopted into non-biological families found that health families do make a difference (Tienari, et al., 2004 ) Their findings indicate that “there appears to be a protective effect in having been reared in a ‘healthy’ adoptive family (with a low risk rating) (Tienari, et al., 2004 ) Disordered childrearing of adoptees without schizophrenia-spectrum disorders but at high genetic risk predicted the disorder at follow-ups at 21-years of age (Tienari, et al., 2004 ) The authors argue that adoptees who are at high genetic risk for schizophrenia-spectrum disorders are more sensitive to adverse (or protective) environmental effects in an adoptive rearing environment than are adoptees at low genetic risk (Tienari, et al., 2004 ) The research hypothesis that there is an interaction between environment and genotype was supported (Tienari, et al., 2004 )
Acocella, J. (1999, January 14). Secrets of Nijinsky. [Review of the book Secrets of Nijinsky]. The New York Review of Books: 1-23.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed. text revision [DSM-IV-TR]. Washington, DC: American Psychiatric Association.
Bowen, M., Dysiner, R.H., and Basamania, B. (1959) The role of the father in families with a schizophrenic patient. American Journal of Psychiatry, 115, 1017-1020.
Meyer, R.G., Chapman, K., and Weaver, C.M. (2009). Chapter 6: The schizophrenic and delusional (or paranoid) disorders. [In Case Studies in Abnormal Behavior, 8th ed. New York, NY: Allyn & Bacon].
Tienari, P., Wynne, L.C., Sorri, A., Lahti, I., Laksy, K., Moring, J., Naarala, M., Nieminen, P. And Wahlberg, K-E. (2004). Genotype-environment interaction in schizophrenia-spectrum disorder: Long-term follow-up study of Finnish adoptees. The British Journal of Psychiatry, 184, 216-222. doi: 10.1192/bjp.184.3.216
Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?
Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.
Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.
Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.
While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
There is a very low likelihood that you won’t like the paper.
Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.
We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.
You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.
We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.
You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.
Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.
You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.
The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.
PLACE THIS ORDER OR A SIMILAR ORDER WITH US TODAY AND GET A PERFECT SCORE!!!
Place an order in 3 easy steps. Takes less than 5 mins.