How Do People with Schizophrenia Develop Professionally and Socially - Research Paper Example

How do people with schizophrenia develop professionally and socially? 2 June Introduction Schizophrenia is a complicated and oftentimes disabling mental illness. Since schizophrenia literally means “split mind,” it is frequently confused with split or multiple personalities (Barnett & Veague, 2007, p.1). Schizophrenia, on the contrary, is a psychotic disorder that produces severe mental illnesses that impair thinking, speech, and behavior (Doughty & Done, 2009). Information from first person narratives (Barker, Lavender, & Morant, 2001), structured interviews (Landrø & Ueland, 2008), and formal assessments (Platz et al., 2006) proposed that numerous patients with schizophrenia spectrum disorders endure problems in coping with everyday and unpredicted stress (Lysaker, Tsai, & Hammoud, 2009). They may have difficulties in identifying objects/people, verbal fluency (Landrø & Ueland, 2008), and in planning and initiating activities, which altogether affect basic social skills and behaviors at the workplace (Liddle, 2000, p.12). Because of these cognitive and social deficits, schizophrenics tend to disregard stressors through repression (Scholes & Martin, 2010), or no longer try alternative and productive measures of handing their problems (Lee & Schepp, 2011). This paper examines the effects of schizophrenia on the identities of people with this disorder. Several sources showed that though people with schizophrenia struggle with their mental condition during their lifetime, with proper treatment and support, they can live productive and independent lives (Liberman, & Silbert, 2005; Lysaker, Tsai, & Hammoud, 2009). Schizophrenia and Social Development Social impairments are considered as major parts of schizophrenia and poor social functioning is one of the symptoms needed to diagnose this mental illness (Birchwood, Birchwood, & Jackson, 2001, p.108). People with schizophrenia often suffer from semantic memory problems, which can affect their understanding of reality, as well as their social interactions and relationships (Doughty & Done, 2009). Doughty and Done (2009) conducted systematic review and meta-analyses to understand if people with schizophrenia generally suffer from problems with semantic memory, to determine the distinctive profile of the impairment across the variety of different tests of semantic memory, and to know how the semantic memory impairment interacts with other symptoms, especially the Formal Thought Disorder. They identified 91 relevant papers and findings showed that participants had impaired abilities in naming, word- picture matching, verbal fluency, associations, priming, and categorization; semantic knowledge is not damaged in schizophrenia; a dependable profile of impairment has been suggested to elucidate a decline of stored knowledge in neurodegenerative conditions; and that Formal Thought Disorder is connected to semantic memory impairment (Doughty & Done, 2009, pp. 492, 495, 496). Furthermore, verbal fluency studies give evidence to the existence of primary executive impairment in schizophrenia, which is accountable for diminished level of verbal fluency performance (Doughty & Done, 2009, p.493). Cognitive impairments affect language and memory, which can also impact the development of social skills among people with schizophrenia. Landrø and Ueland (2008) confirmed that adolescents with schizophrenia suffer from impaired verbal memory and verbal fluency. They compared the results of test scores for verbal learning and memory and verbal fluency between 21 adolescents with schizophrenia and 28 healthy adolescents. Findings showed that the patient group suffered from impairments in verbal fluency, frequency estimation task, and memory, particularly delayed memory recall (Landrø & Ueland, 2008, p.658). The study demonstrated no differences between the two groups, however, in recognition, retention, implicit memory, or vulnerability to interference, where patients suffered from delayed recall, but they still remembered what they learned (Landrø & Ueland, 2008, p.659). Landrø and Ueland (2008) concluded that adolescents with schizophrenia spectrum disorders displayed impairments in verbal learning and verbal fluency, which can affect their daily functioning. Liddle (2000) studied cognitive impairment in schizophrenia and its effects on social functioning. He examined cohort studies and evidence from brain imaging studies. Findings showed that executive function deficits, as well as poor abilities in verbal memory, vigilance, and working memory tests are significant predictors of poor community experiences and difficulties in skills learning. Liddle (2000) concluded that chronic cognitive impairment is the most relevant predictor of social disability. He stressed that brain function problems that are related to executive deficits are not essentially irremediable and may be managed through drug therapy. Aside from these impairments, socialization problems occur due to paranoia and delusions in schizophrenia. Barker, Lavender, and Morant (2001) interviewed clients and their families regarding their development of schizophrenia. Clients expressed their anxiety over experiences of hearing voices and increased paranoia (Barker, Lavender, & Morant, 2001, p.204). Many people with schizophrenia use coping mechanisms to deal with these difficulties, but some of these mechanisms are seen as maladaptive. Barker, Lavender, and Morant (2001) noted that clients believed that schizophrenia helped them deal with the chaos inside their minds. They knew that they needed help and so they could access clinical help, as well as support from their family and friends. These are clients who adapted positive coping mechanisms to handle their mental illness. Scholes and Martin (2010) examined the possible connection between individual coping style, principally repressive coping style and stress vulnerability in schizophrenia. Through secondary source research, they learned that the stress vulnerability model (SVM) presented a partial model of patient experience and did not provide adequate aetiological data. Nevertheless, Scholes and Martin (2010) believed that repression can help explain coping mechanisms with stress for people with schizophrenia. Lee and Schepp (2011) studied the ways of coping and its relationship with particular stress responses in adolescents with schizophrenia. Forty patients and a control group of 30 people participated in their study. Findings showed that patients used emotion-focused coping more than problem-focused coping at baseline timeline and after six weeks (Lee & Schepp, 2011, p.162). Subjects further stated higher stress than controls and employed emotion-focused coping when dealing with emotional stress responses (Lee & Schepp, 2011, p.162). Lee and Schepp (2011) concluded that these coping strategies may persevere until adulthood, unless clinicians introduced new coping skills. Lysaker, Tsai, and Hammoud (2009) investigated if people with schizophrenia can be distinguished through their coping profile and if these groups differentiated in the anticipated course on objective evaluations of wellness and function. They collected data on coping from 133 persons with schizophrenia. Findings showed five distinctive coping profiles: “Acting only (n = 27), Considering only (n = 24), Acting and Considering (n= 17), No Preference (n = 39) and Resigning (n = 26)” (Lysaker, Tsai, & Hammoud, 2009, p.197). The researchers also tested the variables of hope, self-esteem, symptoms and social function. Findings showed that patients who used the coping profile of considering and acting had considerably greater levels of hope and self-esteem than groups with the other four coping profiles, and that the group who preferred resigning had lower hope, self-esteem and more depressive symptoms than other groups Lysaker, Tsai, & Hammoud, 2009). These diverse studies indicate that schizophrenia impairs social skills, but through proper medication and support, patients can cope with this illness and maintain social relationships. Schizophrenia and Workplace Skills People with mental disabilities are shown to have more problems in finding and retaining employment (Marwaha & Johnson, 2004). Marwaha and Johnson (2004) conducted a literature review on the employment trends for people with schizophrenia. Findings showed that the employment rate in schizophrenia is commonly lower than rates in other psychotic disorders, where the “United Kingdom employment rate in schizophrenia over the last 20 years ranges from 4% to 31%, with most samples reporting a rate between 10% and 20%” (Marwaha & Johnson, 2004, p.346). The general population, on the contrary, has an employment rate of 75% to 80% (Marwaha & Johnson, 2004, p.346). Marwaha and Johnson (2004) noted a greater prevalence of employment among first-episode patients. They stated that the barriers to being employed comprise of stigma, discrimination, apprehension of loss of benefits and a lack of proper professional help. They stressed that working is connected with positive outcomes in social functioning, symptom levels, quality of life and self esteem, although a strong causal relationship has not been proven. Marwaha and Johnson (2004) concluded that low employment rates are not central to schizophrenia, but can affect the social and economic pressures that patients hurdle. Bruni (2007) interviewed Andy, who has schizophrenia. Andy admitted that his delusions cost him his job, but medication, setting realistic work and life goals, and staying positive helped him find a job where he excelled (Bruni, 2007). Learning potential is vital to social functioning, as well as acquiring and maintaining a stable job. Vaskinn et al. (2009) reviewed literature on neurocognitive performance and several studies showed that learning potential, or the ability to gain knowledge and/or skills from feedback and instruction, mediates the association between basic neurocognition and functional results (p.406). They noted that for people with schizophrenia, learning potential can also affect their choices of treatment. Tsang et al. (2010) studied predictors for employment outcomes for schizophrenia (Tsang et al., 2010). Findings showed that cognitive functioning served as the strongest predictor, followed by education, negative symptoms, social support and skills, age, work history, and rehabilitation service. Rehabilitation includes restoration of community functioning and well-being through the help of occupational therapists, psychiatrists, psychologists, social workers and other mental health professionals (Tsang et al., 2010). Liberman and Silbert (2005) highlighted the importance of developing community re-entry skills for patients with schizophrenia, especially after their first admission. They provided case studies, where assisted patients, through case managers and supportive community individuals, helped them develop skills and knowledge, so that they can manage social and work responsibilities. Films do not always accurately represent the diverse symptoms, as well as social and professional experiences of people with schizophrenia; nevertheless, they portray certain accurate aspects of this mental illness. The film, A Beautiful Mind, produced and directed by Howard (2001), illustrated the true-to-life story of a gifted schizophrenic, John Nash. Despite suffering from schizophrenia, Nash managed to finish his graduate studies at Princeton University, and for a while, he taught at the Massachusetts Institute of Technology (MIT). Because of his mental illness, however, he suffered from delusions, where he created the characters of Charles, Marcee and Parcher, as well as his so-called Department of Defense assignment. He lost his job and endured further mental lapses. He frequently withdrew from reality, especially when interacting with his friends during his hallucinations. Still, his wife stayed with him and Nash took new medicine to reduce his psychotic episodes. Soon, Nash regained his teaching post and won the Nobel Memorial Prize in Economics for his work on game theory. In Me, Myself & Irene, produced and directed by Farrelly and Farrelly (2000), at Charlie repressed his anger against people who abused him, so he developed schizophrenia. Due to this illness, his mind created an alter ego, Hank, who sought to avenge Charlie from his tormentors. Though split personality is not symptomatic of schizophrenia, it can be considered as part of experiencing delusions. Withdrawal and apathy to people’s concerns are several behaviors of some people with schizophrenia. These films showed the symptoms of apathy, hallucination, withdrawal, and delusions that some people with schizophrenia endure. They demonstrate how schizophrenia affects people’s identities, because it influences how they see and respond to real and hallucinatory entities in their lives. These films also portray that it is not impossible for people with schizophrenia to have work and family life, as long as they have sufficient health care treatment, education and skills training, and social support. Conclusion This paper illustrated that people with schizophrenia suffer from cognitive deficits that affect their communication, social skills, memory, and learning skills. Nevertheless, these patients and clinicians attested that the former can establish and maintain social relationships, as well as learn employability skills. These patients also use productive coping mechanisms and have medicinal treatment to help them deal with anxiety, paranoia, and delusions. Studies also stressed the role of skills training for people with schizophrenia, so that they can successfully reintegrate into their communities and find employment. Hence, that schizophrenics are violent, split-type individuals with no hope for productive functioning is a myth. Many afflicted individuals learn to deal with this mental illness, retain jobs, and develop supportive social relationships. References Barker, S., Lavender, T., & Morant, N. (2001). Client and family narratives on schizophrenia. Journal of Mental Health, 10 (2), 199-212. Barnett, H. & Veague, P.L. (2007). Schizophrenia. New York: Infobase Publishing. Birchwood, M.J., Birchwood, M., & Jackson, C. (2001). Schizophrenia. Philadelphia: Psychology Press, Ltd. Bruni, C. (2007, December 5). An interview with Andy. Health Central. Retrieved from http://www.healthcentral.com/schizophrenia/c/120/17382/andy Doughty, O.J. & Done, D.J. (2009). Is semantic memory impaired in schizophrenia? 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Review on vocational predictors: A systematic review of predictors of vocational outcomes among individuals with schizophrenia: An update since 1998. Australian & New Zealand Journal of Psychiatry, 44 (6), 495-504. Vaskinn, A., Sundet, K., Friis, S., Ueland, T., Simonsen, C., Birkenaes, A.B.,Engh, J.A., Jonsdottir, H., Opjordsmoen, S., Ringen, P. A., & Andreassen, O.A. (2009). Using the Wisconsin Card Sorting Test to assess learning potential in normal IQ schizophrenia: Does it have potential? Nordic Journal of Psychiatry, 63 (5), 405-411. Read More