The Effectiveness of Both the Biological and Psychological Approaches in Explaining and Treating Schizophrenia

The effectiveness of both the biological and psychological approaches in explaining and treating Schizophrenia

Bethan Boyes

When trying to determine whether or not an individual has a psychiatric disorder or abnormality, it is typical for the examiner to study the behaviour of the individual in order to discover what disordered actions and thoughts are present and to see to what extent they differ from the ‘normal’ population. However, defining normal conduct is a vague matter, as even at an intercultural level, great diversity exists between population groups in regards to values and actions. As such, when a psychiatrist in the field of abnormal psychology is trying to classify an individual as ‘normal’ or ‘abnormal,’ it is widely held that sociocultural climate of the individual’s background must be regarded when trying to identify if they are or are not exhibiting aberrant behaviour. Historically, mental abnormality has been explained and treated in a myriad different ways; from demonological influences or communication with spirits, to imbalanced ‘humours’ and physical afflictions, the passage of time has confirmed no theory as absolute. Although the supernatural explanations for psychological abnormality have become nearly obsolete in contemporary Western medicine (with the rare exception of exorcisms) much stock has been taken from the biological and psychological paradigms and their early theorists (en.wiki.org) (simplypsychology.org).

More recent classifications of abnormality include Statistical Infrequency which examines the extent to which present traits are statistically uncommon, however this approach fails to take into account the desirability of the trait, i.e. high IQ. Violation of Social Norms looks to see if and how the individual’s behaviour contravenes any social conventions, however this approach is inherently ambiguous as a) these conventions are unwritten and b) social norms can change over time and become subversive across cultures (i.e. the treatment of homosexuality 50 years ago or women in Islamic culture). There is also Failure to Function Adequately; Rosenhan and Seligman (1989) suggested a non-exhaustive list of what specifies someone as functioning ‘inadequately.’ This list includes (but is not limited to); the development of avoidant or maladaptive behaviours; unpredictability or loss of self-control; irrationality/incomprehensibility, and; being of a disposition which causes the observer discomfort. However, this approach is limited as many people might display one or more of these signs in their lifetime without it necessarily culminating in a psychotic disorder or abnormality (simplypsychology.org).

One such life-long psychotic disorder is schizophrenia, which describes a specific set or specific amalgams of disordered behaviours and thoughts. Although the disease is thought to have been identified since Egyptian times, and by prominent early psychiatrists such as Emile Kraeplin, the word itself is just over a century old and was coined in 1911 by Swiss psychiatrist Eugen Bleuler. Literally translating from Greek into ‘split-mind,’ the translation inadvertently led to a common misconception that schizophrenia was synonymous with split or multiple personality disorder. During the course of both Kraeplin’s and Blueler’s work, they subdivided the symptoms of schizophrenia into those which occurred most frequently together. This is called delineation, and since their time studying the disease, five categories of delineated schizophrenia have emerged; disorganised, catatonic, paranoid (the most common), residual and undifferentiated (the first three of which are Kraeplin’s own). These delineated forms are used in the DSM-IV-TR (or Diagnostic and Statistical Manual of Mental Disorders) which is an exhaustive effort to categorise various abnormal traits into distinctive disorders into one ongoing publication. Schizophrenia is thought to affect around 1% of the population (Gottesman 1991) with the first episode occurring in the late teens or early twenties and, according to the DSM-IV, for an individual to be diagnosed as schizophrenic they must present at least one or more symptoms, at relative levels of severity, for a period of 1 to 6 months (dnalc.org) (schizophrenia.com).