The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes Schizophrenia as a severe and conceivably disabling cognitive disorder (APA, 2013). With a known heritable component, Schizophrenia is most likely to have notable development during young adulthood and is symptomatically evident by periods of remission and relapse throughout the individual’s lifespan (APA, 2013).
During the relapse episodes that are experienced, a manifestation of symptoms include several deficits in reality testing, two or more of the following positive symptoms which must be present for at least one month; •”delusions which are outlandish beliefs, ideas which are resistant to rational or logical dispute, and are a contradiction from others, •hallucinations that are typically auditory or visual, • disorganized speech that often is of incoherent and irrational content, • and, disorganized or catatonic behaviors that are displayed through repetitive, senseless movements, or adopting a pose which may be maintained for hours” (APA, 2013).
There are other indications individuals with this diagnosis experience that are considered to be negative symptoms which include flat affect, a lack of motivation, a lack of energy, and often failure to maintain hygiene (APA, 2013). Additional criteria outlined by the DSM-5 include that the symptoms must be persistent at least six months, of which, a positive symptom must also be present for at least on month (APA, 2013). Disorders such as schizoaffective, depressive, or bipolar disorder with psychotic features also must have been previously ruled out.
Contemporary Cognitive Behavioral Theory The Contemporary Cognitive Behavioral Theory provides a prospective that emphasizes the role of inaccurate beliefs and errors in thinking that were largely accessible to conscious introspection (Beck, 2006). With these founding premises of the cognitive theory, Aaron Beck formulated principles of change that developed into what is best known today as Cognitive Behavioral Therapy (CBT). As the generally considered founder of the Contemporary Cognitive Behavioral Theory, his cognitive theory of change served as a trail blazer in the psychoanalytical field for interventions proven to have high levels of efficacy.
One of the main concepts in Becks cognitive theory is the notion that the majority of the presenting symptoms individuals were discussing were a result of a systematic inclination to perceive their meaningful environments in a negative and biased manner (Beck, 2006). As he further explored this concept, Beck developed the model that he introduced as the negative cognitive triad which included the negative views about the self, the world, and the future (Beck, 2006). He further elucidated the causal implications of schemas, internal beliefs, and tendencies in regards to how individuals process information that serve to solidify their existing beliefs (Beck, 2006). He also introduced the fundamentals of the basic approaches for coaching individuals how to explore the accurateness of their own beliefs through challenging the biasing effects of their schema-driven thought processing (Beck, 2006).
By accomplishing this, he developed significant advances in cognitive psychology that provided an evidentiary foundation in assessing the way existing beliefs could become impressionable preconceptions on the way information is processed and how these developed set of clinical procedures could offset those tendencies (Beck). After nearly three decades of succeeding exploration of Becks early theoretical findings, the studies he has conducted are now the empirical support of these early claims (Beck, 2006). Cognitive Behavioral Therapy is now one of the most widely recognized interventions that is substantiated by empirically supported data for its level of psychosocial treatment (Hollon, Stewart, & Strunk, 2006). Furthermore, the efficacy of its evidence is one of the leading interventions that is able to extend the approach to a broad spectrum of disorders, including Schizophrenia (Hollon, Stewart, & Strunk, 2006).
With the foundational CBT techniques theoretically built to be used primarily in the treatment of mood and anxiety disorders, it has since been effectively adapted to be utilized with individuals who have been diagnosed with more severe mental disorders (Hollon, Stewart, & Strunk, 2006). The principal symptoms of schizophrenia that have exhibited to be resistant to pharmaceutical treatment alone are proven to have successful treatment with CBT (Hollon, Stewart, & Strunk, 2006). The deficiencies in major role functioning that are associated as negative symptoms in schizophrenia can be addressed with CBT as a way to mend international conflict (Hollon, Stewart, & Strunk, 2006).
Further, by using CBT to address Beck’s theoretical concepts of the negative cognitive triad, the associated comorbid mood and anxiety disorders, including past traumas can be effectively treated. In addition to addressing role functioning social and neuropsychological insufficiencies, the adaptation of CBT for schizophrenia has expanded to the development of protocols to address irrational beliefs that also contribute to the positive symptoms associated with schizophrenia (Hollon, Stewart. & Strunk, 2006). This would include symptoms such as delusions, hallucinations, or psychosis (APA, 2013). This was discovered through a series of behavioral experiments that individuals with schizophrenia were able to change their delusional beliefs (Hollon, Stewart, & Strunk, 2006).
As CBT has been comprehensively applied as a primary interventions for Schizophrenia, significant improvements in the overall presentation of the disorder have proven that CBT as a therapeutic intervention, can effectively target and treat multiple mental health areas of concern. Neurobiology Significant developments have been made in gaining further understanding regarding the neurobiology of schizophrenia. Through advance imagery technology, studies have suggested dopaminergic dysfunction (Ross, Margolis, Pletnikov, & Coyle, 2006). These studies have also depicted that structural brain changes are present during the onset of the disorder. There is also emerging indications that there is an existence of several susceptibility genes that are proven to contribute to the neurodevelopmental schizophrenia (Ross, Margolis, Pletnikov, & Coyle, 2006).
However, while there have been significant advancements in understanding the neuropathology schizophrenia, further research is needed to assess how the hereditary and environmental factors correlate with the neurobiological concerns. Much of the emphasis in the treatment of schizophrenia presently involves a broad category of interventions referred to as psychiatric rehabilitation. This approach draws on decades of research from diverse areas such as social skills deficits, neuropsychological deficits, functional impairments, and cognitive interventions for distorted beliefs.
Early work in behavior therapy focused on social skills training as a model of rehabilitation, with reinforcement of prosocial behaviors, as well as incremental gains in functional behavior, through token economies (i. e. O’Brien & Azrin, 1972). The work in cognitive remediation, which is aimed to address neuropsychological deficits such as memory and executive functioning impairments, show small but significant effect sizes in improving the target functional domains as well as small effect sizes for symptom reduction (McGurk, Twamley, Sitzer, McHugo, & Mueser, 2007). Diversity In assessing the diversity aspects of this disorder, research has provided indications that schizophrenia is more prevalent among urban areas rather than in rural communities (Bhugra. 2005).
It is suggested that the primary reason schizophrenia is more prevalent in urban areas is because the individuals are oving to communities that can meet the health care needs that are associated with the disorder (Bhugra, 2005). However, even with some slight variations in the prevalence within cultures, the rate of Schizophrenia is remarkably similar across varied cultural areas (Bhugra, 2005). The prevalence of schizophrenia is about one percent of the general population. (APA, 2013). Within this population, studies have shown that there are common risk factors that can be associated with the affected demographics (Brown & Patterson, 2011). One of the risk factors that is associated with schizophrenia is an interesting correlation with the individual’s birth month (Brown & Patterson, 2011).
When conducting assessments, there has been a parallel connection with late winter through early spring birthdays and this disorder (Brown & Patterson, 2011). These birth months are also typically associated with the flu season, which leads to another risk factor of maternal influenza. Studies have provided a direct link of influenza during the third trimester as being an implicated, causative risk in developing schizophrenia (Brown & Patterson, 2011). Other heritable influences associated with risk for schizophrenia include: pregnancy and labor complications with hypoxia, older paternal age at time of conception, stress, early aged infections, malnourishment, and maternal diabetes (Brown & Patterson, 2011).
The occurrence of Schizophrenia typically develops during early adulthood, however, has been noted to happen throughout an individual’s life span (Stone, 2013). In the rare cases that schizophrenia develops at an early age, it is likely that the peaks of symptoms are reached between the ages of sixteen and twenty-five (Stone, 2013). Also there are different patterns of predisposition in developing schizophrenic symptoms among genders. Males tend to be most vulnerable for emerging the symptoms of schizophrenia between the ages of eighteen and twenty-five years old (Stone, 2013). Whereas female tend to become most vulnerable during two age periods, the first being between twenty-five and thirty, and then again around the age of forty (Stone, 2013).