Sunday, October 19, 2014

Schizophrenia, Psychosis, and Lifespan Development Disorders




     Mental disorders that begin in childhood affect the lifespan development of that person.  However, several mood and personality disorders take on the symptoms associated with psychosis and profoundly affect any normal functioning.  Although difficult to diagnose in childhood most disorders present with the same features as in later life; however, some although biologically primed in childhood may not fully manifest until later in life (Hansell & Damour, 2008).  Therefore, it is important to look at the biological, emotional, cognitive, and behavioral components of these disorders, namely, schizophrenia, psychosis, and the lifespan development disorders.     
Schizophrenia
Biological Components
     The biological components of schizophrenia are broken into to causes: proximal and distal (Hansell & Damour, 2008).  Proximal causes include brain function, structure, and neuropsychological, neurophysiological abnormalities.  With proximal causes a decrease in prefrontal cortex activity is associated with the negative symptoms of schizophrenia (e.g., lack of emotion, speech, or motivation).  In addition to decreased prefrontal cortex activity abnormal neurotransmitter systems are also of particular study as researchers have found that some antipsychotic treatments “appear to eliminate delusions and hallucinations in psychotic patients” (Hansell & Damour, 2008, p. 474). 
     Genetic, environmental, and fetal injury factors focus on the distal causes of schizophrenia; for example some neurodevelopmental abnormalities (e.g., schizotaxia) occur early in life but do not manifest into symptoms until later in life.     
Emotional Components
     A number of psychodynamic theorists from the 1940s, 50s, and 60s, specifically Fromm-Reichmann, originally suggested psychological origins of schizophrenia and that it “can be caused by mothers who were alternately or simultaneously cold, overprotective, and demanding” (Hansell & Damour, 2008, p. 495).  However, since that time psychodynamic theorists have begun to identify with the principle of multiple causality, in that schizophrenia is a combination of biological, behavioral, cognitive, and emotional factors.     
Cognitive Components
     Impaired sensory gating is one of several cognitive theories that focus on dopaminergic abnormalities leading to the inability to cope with stress possibly leading to psychotic symptoms (Hansell & Damour, 2008).  In addition to overattention, whereby individuals cannot block out irrelevant stimuli, underattention leads to “withdrawal and apathy” (Cadenhead & Braff, 1999; Dawson, et. al., 2000; Moser, et. al., 2000; as restated by Hansell & Damour, 2008)
Behavioral Components
     Learning takes on a key role according to behavioral theorists’.  Not that schizophrenia is caused by conditioning but that specific behaviors are reinforced through the principles of operant conditioning, thus behaviorists’ argue that reinforcement-based interventions (e.g., token economy) can be helpful to increase appropriate behaviors, thereby decreasing inappropriate ones.
Psychosis
Biological Components
     Referred to as a psychotic disorder organic causes of psychosis can include neurological, metabolic, and endocrine conditions, renal failure, electrolyte imbalance, or autoimmune disorders (Ford-Martin, 2002).  Psychosis also can be brought on as a complication of recreational drugs (e.g., PCP, cocaine, marijuana, or alcohol) or as a reaction during use or withdrawal of these or other prescription medications. 
Emotional Components
     Stress is considered to be one of the leading factors to brief psychotic disorders.  Death of a family member, natural disasters, or other major life-changing events compounds one’s ability to express effectively his or her fear and sadness about the event, thus creating the delusion as a coping mechanism.    
Cognitive Components
     Neuropsychological impairments affect every individual who experiences psychotic episodes; however, it is not known to what extent only that it is worse for those who suffer from schizophrenia.  Regardless, negative cognitive triad plays a role in maintaining psychotic symptoms.  Therefore, psychodynamic interventions can have a positive effect by helping individuals to express their fears, hopes, and conflicts to improve personal adjustment and increase ongoing treatment, as indicated by Hansell and Damour (2008).       
Behavioral Components
     Substance abuse is one of the risky behaviors known to initiate the onset of psychosis.  However, it is also one of the only disorders that people intentionally initiate for its hallucinogenic properties.  However, depending on the specific behaviors and family systems, most individuals who experience psychosis can reconnect with the outside world. 
Lifespan Development Disorders
Biological Components
     Although the exact causes of pervasive developmental disorders (mental retardation, learning disorders, and autism) are unknown, experts continue to look at the genetic components: genetic makeup and observable characteristics.  However, there is a positive correlation between pregnancy and birth complications associated with the mental retardation and autistic disorders.  With attention deficit and disruptive behavior disorder (ADD/ADHD) “parents are 2 to 7.5 times more likely to have ADHD themselves than parents of children without ADHD” (Faraone & Biederman, 2004; as restated by Hansell & Damour, 2008, p. 522).  Thus it is easy to identify the perpetuating genetic attributes of adult phobic anxieties that manifest in children as separation anxiety.   
Emotional Components
     Children are very sensitive to their socioeconomic status and develop mentally based on the level of interaction between the parent and the child and the academic stimulation he or she receives.  The level of emotional support the child and normalization a child has aims to promote normal functioning.  Fear and anxiety during childhood is normal; however, if a child is not allowed or cannot express his or her emotions it can turn quickly to depression.
Cognitive and Behavioral Components
     The fear and anxiety of depression often perpetuates learning and attentional disorders in children can be exhibited through symptoms of anger, withdrawal, inattention, hyperactivity, clinginess, etc.  At times a child’s projection can make it difficult to identify the exact purpose for his or her exhibited behaviors.  With cognitive-behavioral interventions children learn based on his or her capability to think more positively and are rewarded for appropriate behavior aimed at reducing his or her anxiety.        
Conclusion
     As can be seen by searching the components of schizophrenia, psychosis, and lifespan development disorders the pervasiveness of these disorders is multi-causal with biological, emotional, cognitive, and emotional aspects.  It is also through these multi-causal relationships that effective forms of treatment can be applied to these profound disorders.    



 

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