While there remain various theories about the causes of schizophrenia the biological explanation remains the most support. However, the psychological and sociocultural factors may also play a role in either the development or successful recovery of schizophrenia (Comer, 2008).
Biological theorists hold that there is a genetic predisposition for developing schizophrenia for those who have a family history of the illness. Under this diathesis-stress perspective any person who experiences extreme stress during the adolescent or early adult years, who has had a family member diagnosed with schizophrenia, has the increased chances of developing the disorder under these highly stressful periods (Comer, 2008). In addition, this theory suggests biochemical abnormalities related to the dopamine neurotransmitters may also contribute to the illness as the brains neurotransmission of the dopamine is too frequent in occurrence (Comer, 2008). There have also been study results of CAT and MRI scans which show schizophrenia tends to involve abnormal brain structuring. Enlarged ventricles seem to hinder social adjustment capabilities and cognitive processes in the schizophrenia patient (Comer, 2008). In addition, these theorists further believe there may be some connection to poor nutrition, fetal development or birth complications, faulty immune responses or toxins which may contribute to the onset of the disorder. Further theorizing suggests exposure to certain viruses prior to birth may result in the brain abnormalities seen in those with schizophrenia (Comer, 2008).
The psychological explanation of schizophrenia is based on the belief presented by Freud. Freud held that schizophrenia was developed from two psychological processes involving regression and attempts to re-establish control over the ego resulting from cold or un-nurturing parents. Another theory was brought forth by Frieda Fromm-Reichmannwho similarly to Freud believed early child-parent relationships may contribute to the development of schizophrenia. This theory was based on the belief that cold, dominating and uninterested mothers, or schizophrenogenic mothers, may set the stage for later development of the illness. However, these theories are often rejected based upon research results which show the majority of schizophrenia patients did not, in fact, have these types of parent-child relationships (Comer, 2008).
Cognitive theorists, who agree with the biological theories, hold that the hallucinations experienced in schizophrenia are connected to biological factors. In addition, these theorists explain that as the patient attempts to understand their unusual thoughts and sensations which are dismissed as unreal by others the symptoms intensify as this dismissal from others allows feelings of persecution to develop (Comer, 2008).
Sociocultural theories further attempt to develop an understanding as to the cause or course of schizophrenia. These views suggest social labeling fosters the features and symptoms of schizophrenia. In addition, the sociocultural view suggests family stress and dysfunction, or those with high levels of expressed emotion including criticism, disapproval and hostility, hinder the schizophrenic persons ability to recover (Comer, 2008).
In the early part of the twentieth century schizophrenia patients were often institutionalized in mental hospitals. This institutionalization was done in attempt to restrain patients, provide food and shelter, and to ensure basic needs of the patient were met. Due to the failure of patients to respond to therapy available at this time the goal shifted from treating the patients illness to merely meeting these basic needs and immoral restraint of the patient (Comer, 2008).
Currently patients may still find themselves in an inpatient facility. However, these hospital-type settings implement milieu therapy which fosters social skills, self-respect and responsibility. In the attempt to closely resemble normal living conditions this type of treatment facility treats the patient with respect and offers moral treatment of the individual living with schizophrenia. In addition, some token economy programs provide rewards to the patient for acceptable behaviors. In this type of treatment the use of operant conditioning has been shown, to some extent, to teach the individual how to maintain self-control, increase responsibility and perform regular tasks while reducing psychotic episodes and behavior (Comer, 2008).
The discovery of antipsychotic medications brought new hope in treating schizophrenia. By reducing excess dopamine activity these drugs reduce positive schizophrenia symptoms rather rapidly. However, these antipsychotic medications also have a plethora of undesirable side effects which include movement abnormalities which resemble those experienced with neurological disorders. Due to the side effects, atypical antipsychotics are more commonly prescribed as the more effective treatment option. In addition, the atypical antipsychotics tend to address both the positive and negative symptoms of the illness with less troublesome side effects (Comer, 2008).
Psychotherapy is often used in addition to medication in treating schizophrenia. Insight therapy, family therapy, and social therapy has proven successful when implemented along with antipsychotic medication thus creating increased patient response and fostering higher levels of functioning in the schizophrenic patient (Comer, 2008).
Community treatments also aid in successful treatment and recovery of the schizophrenia patient. Such programs help in coordinating care of the individual and provide occupational training. Halfway homes and day care centers offer the patient the opportunity to foster social relationships and enhance social skills in a comfortable and appropriate environment (Comer, 2008).
Reference
Comer, R.J. (2008). Fundamentals of abnormal psychology (5th ed.). New York: Worth Publishers.