SCHIZOPHRENIA 1

Diagnosis and Treatment of Schizophrenia

Author’s Name

Institution
SCHIZOPHRENIA 2

Introduction

Schizophrenia is a brain disorder that causes delusions, problems with thinking and

concentration, hallucinations and lack of motivation. This condition can be managed over time

although it has no cure. Experts have been studying genetics and behavioral research to analyze

the brain structure and function to acquire better therapy methods (American Psychiatric

Association, 2017). It has been stigmatized and is associated with crime (Takahashi et al, 2009

p.149-152). Schizophrenia should not be associated with split or multiple personality, and

schizophrenics are not violent or dangerous people. It is not caused by poor parenting, bad

childhood experiences, or a lack of willpower. Its cause is still not clear but some experts believe

that it is caused by genetics, abnormalities in the structure of the brain, or immune disorders and

viral infections (Mental Health America, 2017). The condition can lead to social withdrawal,

emotional flatness, lack of interest or enthusiasm, and lack of initiative.

There are sub types of the condition that are defined by unique indicators, such as paranoid

schizophrenia and disorganized schizophrenia (Bengston, 2016a). Others are catatonic

schizophrenia, residual schizophrenia, and schizoaffective disorder. The condition can be

considered to be abnormal because it separates a person from others emotionally and because

“normal” people consider it to be so (Sadock, Kaplan & Sadock, 2007 p.13). People with the

condition can lead productive and fulfilling lives if given appropriate treatment. Medication and

rehabilitation programs can help such a person to recover and reduce the chemical imbalances

that cause schizophrenia, while reducing the likelihood of a relapse. All medication should

however be taken under supervision of a mental professional.

SCHIZOPHRENIA 3

The concept of normality and abnormality

The National Institute of Mental Health (2001) found that more that 20% of the population could

be suffering from depression at any given time. Abnormality cannot be concisely defined

because there are many forms of abnormalities and what can seem reasonable at first glance

could turn out to be problematic. A person can be classified as abnormal by statistical

infrequency. This means that they could be considered abnormal if their behavior is rare or

statistically unusual (McLeod, 2008). In this case, a person with a low or above high IQ could be

considered to be abnormal. However, this definition does not take into account the desirable

qualities of that particular behavior. In addition, many rare behaviors, such as being left-handed,

have no bearing on abnormality.

All cultures have standards which they deem to be acceptable behavior. Members of a society

who do not follow the expected behavior could be defined as abnormal. Under this approach, a

person who violates the rules of the society or social group would be considered to be abnormal

because their behavior is different, threatening, or is not understood by everyone else (McLeod,

2008). By defining abnormality through social rules, a problem emerges because there are no set

universal standards for such rules. They differ between generations, ethnic groups, and even

socio-economic groups. These norms also change over time; therefore behavior that might have

been considered unacceptable by our great-grandparents may become acceptable later.

When an individual does not function properly in everyday life, some people may consider him

to be abnormal because he cannot adequately explain himself, or maintain a job for long periods.

Some of the characteristics of individuals who fail to function adequately are: being a danger to

themselves, being unpredictable, lose control easily, are irrational, cause discomfort to observers,

and violate moral or social rules. However, some abnormal behavior, such as an obsessive-
SCHIZOPHRENIA 4

compulsive disorder for washing hands, may make the “abnormal” individual happier and enable

them to function exceptionally well in society. On the other hand, drugs and alcohol consumption

can be harmful to an individual, but are not classified as abnormal behavior.

Normality is defined by a person having a positive self image, an ability to grow and develop,

having an accurate perception of reality, and having meaningful relationships (Jahoda, 1958).

The more the above criteria are met, the healthier the individual is perceived to be. However, it is

not possible for one individual to have all the above characteristics all the time. An individual

might be unable to meet the demands of his daily life but still be happy with his life. Many

definitions of abnormality have been coined by white, middle class people and might lead to

individuals from other groups and cultures being represented as abnormal. For example,

depression is twice as high in women internationally as it is in men, (Murray & Lopez, 1996

p.118-201) but in the UK, women make up 61% of the population that is diagnosed with

depression (Fawcett & Karban, 2013 p.40). This does not mean that they are abnormal.

Types of schizophrenia

There are several sub-classifications of schizophrenia. Patients usually display certain clusters of

symptoms (Cardwell & Flanagan, 2004 p. 195). The symptoms of the condition can be classified

into positive, negative and disorganized. The positive symptoms show signs of normal behavior

or an overload of normal behavior such as hallucinations or delusions (Durand & Barlow, 2010

p.500). negative symptoms show a deficiency in normal behavior for example in speech and

motivation. Disorganized symptoms manifest as rambling speech and erratic behavior. DSM-5

has five sub-classifications of schizophrenia: paranoid, disorganized, catatonic, undifferentiated,

and residual (World Health Organization, 1993 p.26).

SCHIZOPHRENIA 5

Paranoid schizophrenia is the main type of schizophrenia found in individuals and its biggest

symptom is delusional thoughts about the person being persecuted or about conspiracies

(Bengston, 2016a). The schizophrenic may have thoughts about events that are not actually real.

Paranoid schizophrenics usually get late diagnosis because they usually look normal to other

people. It is only after the individual experiences a huge stressful event that their paranoia can be

seen by their family members or friends, thus enabling the family to look for medical advice.

Disorganized schizophrenia is characterized by confused thoughts (Medical News Today, 2014).

The patient’s ability to think logically is compromised and the patient can mix topics during a

conversation. Disorganized behavior such as wearing clothing inappropriately is also

characteristics of this sub classification. Catatonic schizophrenia manifests as a catatonic stupor

in which the patient has very little activity and all movement may stop. It can also manifest as

catatonic excitement characterized by hyperactivity and mimicry of other people’s words or

actions (Medical News Today, 2014).

Residual schizophrenia only refers to patients who have previously suffered from schizophrenia

but the symptoms have reduced considerably (Bengston, 2016b). The patient may still have

hallucinations or paranoia, but these symptoms appear infrequently. To fall in this classification,

at least one negative symptom must be apparent and the patient must have had an attack at least

one year ago. Schizoaffective disorder is considered a mixture of schizophrenia and either

depression or bipolar disorder and is generally hard to diagnose because depression or bipolar

disorder has many symptoms. When an individual has mixed schizophrenic symptoms and does

not exhibit a dominant symptom, he may be classified with undifferentiated schizophrenia

(Mental Health Daily, 2016).

SCHIZOPHRENIA 6

There have been arguments that the fundamental issues of schizophrenia should be seen as a

spectrum of conditions (Tsuang, Stone, & Faraone, 2000 p.1041-50) or as individual

measurements where everyone has varying symptoms, rather than being diagnosed based on

normality and illness (Peralta & Cuesta, 2007 p.100-101). Some experts have criticized the

DSM-5 and ICD-10 criteria for forgoing analytical validity in order to improve reliability

artificially by overemphasizing psychosis (Andreasen, 2000 p106-112). They show that there is

very little foundation for considering DSM’s definition of schizophrenia as being factual (Tsuang

et al., 2000 p1041-1050).

Diagnosing schizophrenia

Therapists diagnose mental disorders by classifying them according to their syndromes and a set

of symptoms which occur together. This classification helps them to suggest effective treatments,

encourages grouping of research data, and helps them to make predictions. The standard

classification system is the Diagnostic and Statistics Manual of Mental Disorders (DSM-IV).

According to this system, patient evaluation is done in five axes to help the clinician determine

the most effective treatment strategy. The first axis catalogs the clinical syndromes; the second

refers to maladaptive personality behaviors; the third assesses the patient’s physical illness; the

fourth evaluates the stress in the patient’s life; and the fifth evaluates the highest level of

performance the patient has experienced over the previous year.

These classification systems are however sometimes criticized because they ignore significant

individual differences and lead clinicians to view patients according to their diagnosis rather than

their actual behavior. However, many of them are dependable, and the latent problems with their

validity are not as critical as their usefulness.

SCHIZOPHRENIA 7

ICD-10 criteria are mostly used to diagnose schizophrenia in most of the world, while DSM-5

criteria are used in the US. The fourth edition of the DSM-IV-TR asserts that for an individual to

be diagnosed with the condition, there must be characteristic symptoms, societal or work-related

dysfunction, and a significant duration of time should have passed (American Psychiatric

Association, 2000). Schizophrenia cannot be diagnosed if the symptoms of disposition confusion

are present in large quantities or if the symptoms are a result of a common medical condition or

substance such as medication.

Schizophrenia is responsible for about half of the people committed to mental hospitals. It is

highly resistant to treatment, and many schizophrenics do not recover. It is usually characterized

by a decline in behavior which results in an active phase, leading to a residual phase and then

more active phase-residual cycles. Some diseases can easily be detected, but that is not the case

for schizophrenia because it is more complicated. In addition, some psychiatric diseases have

symptoms that are similar to this condition, such as hallucinations or delusions that occur with

severe depression (Miller & Mason, 2002, p.50). Therefore, making an accurate diagnosis can

take a few days or even several months. A distinction should be made between psychosis and

schizophrenia. Psychosis describes general terms while schizophrenia is classified as a form of

psychosis. Some symptoms of psychosis are an inability to think clearly, pay attention or

concentrate, confusion, an inability to put thoughts together, hallucinations, confused speech,

disorganized behavior and extreme fear (miller & Mason, 2002, p.52). Various brain disorders,

bipolar disorder, dementia in elderly people, and untreated serious depression can all cause

psychotic symptoms. These examples show that psychosis is not the same thing as schizophrenia.

Some of its symptoms include disorder in the content of thought such as delusions, disjointed

and impoverished speech, disturbances in perception, emotions, in the sense of self, in the ability
SCHIZOPHRENIA 8

to act, in interpersonal relationships, and in motor behavior. A schizophrenic can get into a

catatonic stupor and remain that way for hours. Many schizophrenics display a split between

several ideas and emotions. Their language is disjointed as they ramble and shift from one

thought to another. They also have an unclear view of reality and hear, feel, or see things that are

unreal. Sometimes they display inappropriate or crazy behavior, or sometimes they display no

behavior at all. They tend to be withdrawn into themselves to avoid social interaction.

A thorough psychiatric evaluation should be done before arriving at a diagnosis for the condition.

This includes a physical exam, medical evaluation, appropriate laboratory tests as well as a

mental exam. A complete history of the disease should also be done that includes changes in

thinking, mood, behavior, sensory perception, and movement. The purpose of this is to exclude

other diseases that share the same symptoms as schizophrenia. Once the other diseases have been

ruled out, the physician will check for important social problems, six months of negative or

positive symptoms, and also one month of positive or negative symptoms.

Different theories propose several explanations for causes of the illness. The biological

perspective suggests that it is a result of a genetic predisposition, excessive dopamine in the

brain, unusually sensitive dopamine receptors in critical areas, or excessive dopamine receptors

in critical brain locations (Valenstein, 2002 p.113). Interpersonal theorists suggest that the illness

is related to unsuitable family functioning. When families have emotionally charged atmospheres

that are very hostile and critical, they cause schizophrenics to have higher relapse rates.

However, these relatives can be taught how to reduce their levels of emotion expression. The

diathesis-related model combined the biological predisposition and the environmental and

learned perspectives to explain schizophrenia, and suggest that these two factors must be present

for the illness to manifest.

SCHIZOPHRENIA 9

The Rosenhan theory was an important criticism of psychiatric diagnosis and was used to

determine its validity (Gaughwin, 2011 p.298-310). This experiment concluded that it is tricky to

differentiate between sane and insane people in psychiatric hospitals, and that it is dangerous to

label patients because it dehumanizes them. It suggested that community mental health facilities

that concentrate on a specific problems instead of psychiatric labels would be a better solution. It

recommended that psychiatric workers should be educated on the social psychology of their

facilities.

Critics of this theory argued that psychiatric diagnosis depends largely on how a patient reports is

experiences, therefore faking his presence does not show how there is a diagnostic problem.

They also argued that the study was not practical because psychiatrists cannot be expected to

presume that a patient is pretending to have an illness (Integratedsociopsychology.net, n.d).

The Szacz theory argues that mental disorders are a symbol of human problems in living, and

that they are a myth as much as cancer or possession by the devil (Oliver, 2006 p68-84). It argues

that there are no biological or chemical tests that can be used to verify or falsify DSM diagnoses

except in identifiable brain diseases like Alzheimer’s (Szacz, 2008 p2-5). He criticized modern

medicine and was of the opinion that the influence of medicine was like the secularization of

religion’s hold on society. According to this theory, many people usually fake their presentation

of mental disorders in order to avoid doing things they do not like, such as joining the army, or to

gain access to drugs. In addition, a person’s metal competence should not be admissible in a trial.

Kendell (in Schaler, 2005), criticized the Szacz theory by stating that this theory was ignorant of

genetics, biochemistry, and various research results on the etiology of mind disorders. Another

critic argued that the theory was dependent on perceptions acquired from the analysis of the early
SCHIZOPHRENIA 10

mid 20th century and that the theory was outdated in light of later psychiatric developments

(Shorter, 2011 p.183-184).

Treatment of schizophrenia

There is no treatment for schizophrenia; instead, different interventions are used at different

points of its clinical course. Various treatment plans and approaches are used and altered

depending on the phase in which a patient is in (Bellack, 2013 p.102). These treatments focus on

removing the symptoms of the disease. Antipsychotic medications are usually prescribed for

daily use, and both doctor and patient need to work together to find the best combination and

dosage. Psychosocial treatments include coping skills to deal with the challenges faced on a daily

basis. Coordinated specialty care (CSC) combines family involvement, medication, psychosocial

therapy, and supported education services to alleviate the symptoms and improve quality of life

(National Institute of Mental Health [NIMH], 2016).

It can be difficult to take care of and support a patient with schizophrenia because of their

inexplicable behavior. The best way to help is by understanding that this is a biological disease,

and to the patient, his hallucinations and beliefs are very real. Respect, kindness and support are

fundamental but dangerous or inappropriate behavior should not be tolerated (NIMH, 2016). If

there are any support groups in the area, join them.

The treatment of the negative symptoms of schizophrenia depends on the cause of the illness. A

patient may seem to be asocial but in actuality is just paranoid because of fear. A low drive or

apathy may be caused by sedation medication. The current available treatments for the illness

can improve a patient’s positive symptoms but it is unclear how effectively they can impact on

negative symptoms (Buchanan & Gold, 1996 pp.3-11). Therefore, many patients exhibit negative
SCHIZOPHRENIA 11

symptoms persistently even when they receive optimal clinical care. Several antipsychotics have

therapeutic effects on both positive and negative symptoms, but they have not been sufficiently

simulated. Consequently, even though there are more than 40 different antipsychotic drugs to

treat the symptoms of the illness, no molecule has been officially designated to treat the negative

symptoms.

Antipsychotic medicines can be used to reduce the acute positive schizophrenic symptoms of

delusions, bizarre behavior, hallucinations, and thought disorganization. Patients who are

experiencing their first episode of heightened symptoms usually respond well to antipsychotic

medications than those who are in recurrent episodes. These patients could also respond well to

lower doses of the medication (Lehman et al., 1998 pp.1-10). Electro Convulsive Therapy (ECT)

has also been found to reduce acute symptoms in schizophrenia. However, the effects of ECT are

usually short-term. Catatonic schizophrenia and schizoaffective disorder respond effectively to

ECT, and the affective symptoms respond selectively to the therapy (Lehman et al., 1998 pp.1-

10).

Abnormal behavior is defined in many ways and it signifies a substantial deviation from the

average or from what society expects. It also encompasses psychologically unhealthy behavior

such as emotional pain and suffering, inability to perform daily activities, behavior that is

disturbing to others, and irrationality. These definitions are not absolute because they have pros

and cons. Thus, mental health can have extremes at the normal and abnormal ends, with an

ambiguous area in between.

The biological perspective compares a psychological disorder to a physical illness as symptoms

are used to diagnose the fundamental mental illness, which results from a physical problem.

Biological researchers have strived to understand the chemistry of mentally disturbed people in
SCHIZOPHRENIA 12

order to understand the causes of their mental illness. The Freudian theory of psychoanalysis

(Boundless, 2016) suggests that unanswered sexual conflicts in early childhood or conflicts

between the ego, superego, and the id lead to psychological disorders later in life. When a

person’s ego becomes too weak, it results in abnormal behavior. Psychoanalysis can therefore be

used to probe a person’s thoughts and feelings, to gain an insight into their unconscious conflicts

and make them feel better. Both the biological and psychoanalytic models suggest that the

person’s symptoms emanate from the underlying disorders. Psychotherapy treatment promoting

regression and psychotic transference could however be harmful to patients (Lehman et al. 1998

pp.1-10). Experts strongly argue about the risks and lack of evidence of any benefits from

psychoanalytic therapy even when it is combined with effective pharmacotherapy (Scott &

Dixon, 1995 p.623).

The learning perspective is very different from the biological and psychoanalytic models. It

suggests that psychological problems result from learning abnormal responses. Thus, a mentally

ill person is treated by removing the maladaptive behavior and teaching them how to live

normally. The cognitive perspective suggests that how a person interprets an event determines

how they will interpret that event. This is in addition to the influence of the behaviors they have

learned. Cognitive therapies thus emphasize changing negative cognitions so that a person can be

free from maladaptive behaviors. Cognitive-behavioral therapy (CBT) can improve the overall

symptoms of schizophrenics by letting them engage in talking about psychotic symptoms and

their meanings, thus improving outcome (Kuipers et al., 1997 pp.319-327).

Family interventions that include support, illness education, crisis intervention, and problem

solving training in combination with the correct pharmacotherapy can reduce the relapse rate of a

schizophrenic patient. These interventions should not be limited to only families that are
SCHIZOPHRENIA 13

considered to be highly emotional. They should be used regardless of the level of expressed

emotion (Lehman et al., 1998 pp.1-10). Any schizophrenic patient who identifies competitive

employment as a personal goal, has previously worked in competitive employment, has had

limited psychiatric hospitalization, or has good work skills, should be offered vocational

rehabilitation. These rehabilitation services should include transitional employment,

prevocational training, supported employment, and rehabilitation counseling (Lehman et al.,

1998 pp.1-10).

Approaches to mental health

Patients who have mental health problems have complex lives. Most mental health problems are

a result of biological, social, or psychological factors that create a risk for, or protect against, the

expression of maladaptive responses to the environment or society (Sanislow et al., 2010 pp.631-

639). These circumstances may however vary in their ability to evoke mental health concerns.

Therefore, some people experience mental health concerns in their homes or when interacting

with peers, but not at the workplace. Mental health variations occur when there is social anxiety,

aggressive and antisocial behavior, attention and hyperactivity, or substance use (Kraemer et al.,

2003 pp.1566-1577). This might result in clinicians being unable to identify mental health

problems adequately if they do not properly account for the contextual variations. A clinician

must therefore take a broad approach that will gather information from several sources or

informants such as family, teachers, or colleagues, as well as the patient himself (De Los Reyes

et al., 2013 pp.376-386).

The clinician can then use the multiple information to assign a diagnosis and plan a treatment. A

researcher could use the multiple information to draw conclusions from empirical work results,
SCHIZOPHRENIA 14

in order to identify treatments that reduce health concerns. However discrepancies in the

information can create uncertainty in the best course of treatment for a patient or the best

conclusion to be drawn from research. The current thoughts on best practices in the assessment

of mental health assume that information from multiple sources is useful in collecting various

helpful perspectives. Psychologists and clinicians therefore need to have assessment and

treatment expertise that is suitable for mental health patients.

Alternative approaches are useful in aiding those with severe mental illnesses to cope with

fatigue, anxiety, insomnia, and any stress that accompanies the symptoms of a mental disorder.

Some of these approaches are good diet and nutrition, relaxation, expressive therapy, self-help

exercises, and stress reduction techniques. Most people suffering from mental health diseases

have to use a combination of the above approaches in order to function well. They also

incorporate medication and psychotherapy (Center for Psychiatric Rehabilitation, n.d). Other

approaches are biological, behaviorist and psychoanalytical.

Some nonconventional approaches such as quantitative electroencephalograpgy (QEEG), are yet

to be widely used in psychiatric treatment of mental health problems (Lake, 2008). Assessment

approaches that are meant to perceive slight forms of energy not described by medicine have

been applied by alternative medicine practitioners to examine patients with mental health

problems. These approaches include pulse diagnosis in Chinese medicine, and Ayurvedic

medicine (Lake, 2008). Western medicine believes that illnesses are a result of physical or

biological factors, while the above nonconventional approaches believe that complex, nonlinear

energy-information processes as well as a person’s intentions, both result in illness. Health and

illness are seen to be expressions of dynamic social, physical, psychological, biological, genetic,

and spiritual interactions in space and time (Lake, 2008).

SCHIZOPHRENIA 15

Many mental illnesses, including schizophrenia, do not have a proven bodily cause despite

efforts by researcher to prove biological etiology (Rogers, 2014 p.2). There is a vague

predisposition to people inheriting nervousness or madness, but it has not been biologically

proven. Biological treatments that are supposed to bring relief point to biological etiology, such

as using electroconvulsive therapy to remove depression, or using tranquillizers to reduce

hallucinations. Therefore, effective biological treatments cannot be said to be proof of biological

causation.

The psychoanalytical approach shows that all human beings are ill to some degree (Rogers, 2014

p.3). It offers an explanation for all aspects of how human beings behave and believes that past

thoughts can be revived or resurrected by talking to a therapist. Psychoanalysis usually

psychologizes everything (including biological methods), while the biological approach reduces

psychological phenomena to biology. According to Sigmund Freud’s analytical theory, human

behavior results from the mind’s id, super ego and the ego all interacting (Boundless, 2016).

Personality develops during childhood and becomes shaped by five developmental stages in

which a child faces conflict between his biological needs and societal expectations. If the child

successfully masters these conflicts, then he is able to become a mature personality. Freud’s ideas

have however been criticized because it is assumed that he focused on sexuality as the major

catalyst of personality development.

All human behavior can be learned and unlearned, with new behaviors taking the place of old

ones. The behavioral approach assumes that the things we can see or observe are the only real

thing because the mind, id, ego, or subconscious are invisible. We can refer to the mind or brain

through behavior. Classic conditioning means that behavior is controlled by association.

Modeling, imitation copying and contagion are all examples of observational learning. However,
SCHIZOPHRENIA 16

this approach can have some negative effects such as negative reinforcement, punishment, and

systematic desensitization.

Schizophrenia is associated with motivational shortfalls that interfere with an individual’s

intention to perform goal directed activities (Blanchard et al., 2011 p.291-299). It is a

heterogeneous condition that brings out varying motivational problems in different patients. For

example, some patients can be completely disinterested in social activities while others could be

interested in the same activities but avoid engagement because they fear rejection. Patients with a

long history of mental health disorders generally have less environmental support than those with

less serious and chronic disorders because of the strain they put on their support systems (Bedell,

Hunter, & Corrigan, 1997 pp.217-228). Their families sometimes withdraw and rely heavily on

the clinicians to manage the condition.

A mental health assessment enables a doctor to determine how well a patient feels emotionally

and cognitively. It helps to check for mental health problems and to gauge the difference between

mental and physical problems. Such an assessment is useful in evaluating a person who has been

referred for mental health treatment in order to prescribe the appropriate treatment. A physical

exam, written or oral exam, some lab tests, and an interview can be used to make this assessment

in order to get a comprehensive result. Some mental health problems can however be difficult to

diagnose and require more assessment tests before the correct diagnosis is arrived at.

Conclusion

Schizophrenia is characterized as a mental health disorder that can be disabling for patients and

their families (Lavretsky, 2008 p.3-12). The exact cause of the disease is still unknown despite

numerous researches on the issue but it is accepted that the various classifications of the disease

arise from genetic and/or environmental influences (Siever & Davis, 2004 p.398-413). In order
SCHIZOPHRENIA 17

to get a diagnosis, the doctor must assess patient-specific signs and symptoms. The goal for

treatment of schizophrenia is to target the symptoms of the disease to prevent a relapse and

increase adaptive functioning to ensure that the patient is successfully reintegrated into the

community. It is important to remember that a schizophrenic is not a mentally ill person but is an

individual who needs the support of family and society in order to function properly.

List of References

American Psychiatric Association. 2000. Diagnostic and statistical manual of mental disorders:

DSM-IV. Washington, DC: American Psychiatric Publishing, Inc. ISBN 0-89042-024-

6. Schizophrenia.
SCHIZOPHRENIA 18

American Psychiatric Association. 2017. What is schizophrenia? Retrieved from

https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia

Andreasen, N.C. 2000. Schizophrenia: the fundamental questions. Brain Res. Rev, 31(2–3):106–

12. doi:10.1016/S0165-0173(99)00027-2. PMID 10719138

Bedell, J.R., Hunter, R.H., & Corrigan, P.W. 1997. Current approaches t assessment and

treatment of persons with serious mental illness. Professional Psychology: Research and

Practice, 28(3):217-228.

Bellack, A. S. 2013. A Clinical guide for the treatment of schizophrenia.

http://dx.doi.org/10.1007/978-1-4757-8979-9.

Bengston, M. 2016a. Types of schizophrenia. PsychCentral. Retrieved from

https://psychcentral.com/lib/types-of-schizophrenia/

Bengston, M. 2016b. residual schizophrenia. PsychCentral. Retrieved from

https://psychcentral.com/lib/residual-schizophrenia/

Blanchard, J.J.,Kring, A.M.,Horan, W.P., & Gur, R., 2011. Toward the next generation of

negative symptom assessments: the collaboration to advance negative symptom

assessment in schizophrenia. Schizophr Bull, 37 (2), 291–299.

Boundless. 2016. “Freudian Psychoanalytic Theory of Personality.” Boundless

Psychology. Retrieved

from https://www.boundless.com/psychology/textbooks/boundless-psychology-

textbook/personality-16/psychodynamic-perspectives-on-personality-77/freudian-

psychoanalytic-theory-of-personality-304-12839/

Buchanan, R.W., & Gold, J.M. 1996. Negative symptoms: Diagnosis, treatment and prognosis.

Int Clin Psychopharmacol,11(2), pp.3-11.

SCHIZOPHRENIA 19

Cardwell, M., & Flanagan, C. 2004. Psychology A2: The complete companion. Cheltenham,

Nelson Thornes.

Center for Psychiatric Rehabilitation. n.d. Alternative approaches to mental health care. Boston

University College of Health and Rehabilitation Sciences: Sargent College. Retrieved

from https://cpr.bu.edu/resources/newsletter/alternative-approaches-mental-health-care

De Los Reyes, A., Bunnell, B.E., & Beidel, D.C. 2013. Informant discrepancies in adult social

anxiety disorder assessments: Links with contextual variations in observed

behavior. Journal of Abnormal Psychology, 122, 376-386. doi: 10.1037/a0031150

Duran, V. M., & Barlow, D. H. 2010. Essentials of abnormal psychology. Australia,

Wadsworth/Cengage Learning.

Fawcett, B. & Karban, K. 2013. Contemporary mental health: Theory, policy and practice.

Routledge.

Gaughwin, P. 2011. "On Being Insane in Medico-Legal Places: The Importance of Taking a

Complete History in Forensic Mental Health Assessment". Psychiatry, Psychology and

Law. 12 (1): 298–310. doi:10.1375/pplt.12.2.298.

Integratedsociopsychology.net. n.d. Key study: On being sane in insane places. Retrieved from

http://www.integratedsociopsychology.net/sane_insane-place.html

Jahoda, M. 1958. Current concepts of positive mental health.

Kendell, R. E. 2005. "The Myth of Mental Illness". In Schaler, Jeffrey. Szasz Under Fire: The

Psychiatric Abolitionist Faces His Critics (1st ed.). Illinois: Open Court. pp. 29–

48. ISBN 0812695682

SCHIZOPHRENIA 20

Kraemer, H.C., Measelle, J.R., Ablow, J.C., Essex, M.J., Boyce, W.T., & Kupfer, D.J. (2003).

A new approach to integrating data from multiple informants in psychiatric assessment

and research: Mixing and matching contexts and perspectives. American Journal of

Psychiatry, 160, 1566-1577. doi: 10.1176/appi.ajp.160.9.1566

Kuipers, E., Garety, P., Fowler, D., Dunn, G., Bebbington, P., Freeman, D. and Hadley, C.,

1997. London-East Anglia randomised controlled trial of cognitive-behavioural

therapy for psychosis. I: effects of the treatment phase. The British Journal of

Psychiatry, 171(4), pp.319-327.

Lake, J. 2008. Nonconventional approaches in psychiatric assessment. Psychiatric Times.

Retrieved from http://www.psychiatrictimes.com/articles/nonconventional-approaches-

psychiatric-assessment

Lavretsky H. 2008. History of Schizophrenia as a Psychiatric Disorder. In: Mueser KT, Jeste DV,

editors. Clinical Handbook of Schizophrenia. New York, New York: Guilford Press; pp.

3–12.

Lehman, A.F., Steinwachs, D.M. and Co-Investigators of the PORT Project, 1998. Translating

research into practice: the Schizophrenia Patient Outcomes Research Team (PORT)

treatment recommendations. Schizophrenia Bulletin, 24(1), pp.1-10.

McLeod, S. 2008. Abnormal psychology. Simply Psychology. Retrieved from

http://www.simplypsychology.org/abnormal-psychology.html

Medical News Today. 2014, September 15. "What Is Disorganized Schizophrenia (hebeprenia)?

What Causes Disorganized Schizophrenia?"

SCHIZOPHRENIA 21

Mental Health America. 2017. Schizophrenia. Retrieved from

http://www.mentalhealthamerica.net/conditions/schizophrenia

Mental Health Daily. 2016. Undifferentiated schizophrenia: Symptoms, causes and treatment.

Miller, R., & Mason, S. E. 2002. Diagnosis Schizophrenia: a comprehensive resource for

patients, families, and helping professionals. New York, Columbia University Press.

http://search.ebscohost.com/login.aspx?

direct=true&scope=site&db=nlebk&db=nlabk&AN=75547.

Murray, C.J., & Lopez, A.D. 1996. Global burden of disease. Vol. 1, pp.118-201. Boston:

Harvard University Press.

National Institute of Mental Health. 2001. Depression research at the National Institute of Mental

Health. Retrieved

from http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml.

National Institute of Mental Health. 2016. Schizophrenia. Retrieved from

https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml

Oliver, J. 2006. "The Myth of Thomas Szasz". The New Atlantis. 13 (13): 68–

84. PMID 17152134

Rogers, A. (2014). Sociology of mental health and illness. Open University Press.

http://www.myilibrary.com?id=633418.

Sadock, B. J., Kaplan, H. I., & Sadock, V. A. 2007. Kaplan & Sadock's synopsis of psychiatry:

Behavioral sciences/clinical psychiatry. Philadelphia, Wolter Kluwer/Lippincott Williams

& Wilkins.
SCHIZOPHRENIA 22

Sanislow, C.A., Pine, D.S., Quinn, K.J., Kozak, M.J., Garvey, M.A., Heinssen, R.K., Wang, P.S.,

& Cuthbert, B.N. 2010. Developing constructs for psychopathology research: Research

domain criteria. Journal of Abnormal Psychology, 119, 631-639. doi: 10.1037/a0020909

Scott, J.E., & Dixon, L.B. 1995. Psychological interventions for schizophrenia. Schizophrenia

Bulletin, 21(4):621-630.

Shorter, E. 2011. "Still tilting at windmills: Commentary on ... The myth of mental illness". The

Psychiatrist. 35 (5): 183–84. doi:10.1192/pb.bp.111.034108.

Siever, L.J, & Davis, K.L. 2004. The pathophysiology of schizophrenia disorders: Perspectives

from the spectrum. Am J Psychiatry, 161(3):398–413. [PubMed]

Szasz, T. 2008. Psychiatry: The science of lies. Syracuse University Press. pp. 2–

5. ISBN 0815609108.

Takahashi, H., Ideno, T., Okubo, S., Matsui, H., Takemura, K., & Matsuura, M., et al. 2009.

Impact of changing the Japanese term for “schizophrenia” for reasons of stereotypical

beliefs of schizophrenia in Japanese youth. Schizophr Res. 112:149–52.

Tsuang, M.T., Stone, W.S., & Faraone, S.V. 2000. Toward reformulating the diagnosis of

schizophrenia. American Journal of Psychiatry, 157(7):1041–50.

doi:10.1176/appi.ajp.157.7.1041. PMID 10873908.

Valenstein, E. 2002. Blaming the brain: The truth about drugs and mental health. Simon and

Schuster.

World Health Organization. 1993. The ICD-10 Classification of Mental and Behavioral

Disorders" (pdf). World Health Organization. p. 26