Split or altered reality

Q. Examine the limitations of the medical explanation of Schizophrenia. 10

7 thoughts on “Split or altered reality”

  1. Medical explanations being objective and scientific in approach undoubtedly play a major role in etiology and management of Schizophrenia and contributed richly through Research studies regarding Brain atrophy, specific brain areas,cytoarchitecture, genetics,neurochemistry ( dopamine hypohesis ) and neurocognitions. But we find some limitations of this approach like –

    – Medical explanation tells the physical cause and ignores psychosocial and cultural factors which play vital role here.Diathesis stress model shows that genetic predispositions can be shaped by environmental factors like prenatal exposure. Also studies showed that when children at genetic risk for schizophrenia, are adopted into healthy families do very well whereas are at increased risk if adopted in a family with maladaptive rearing style.
    – Medical research faces ethical barrier and hence not able to test several hypothesis.for ex: researchers intrested in learning about dopamine in brains of schizophrenic patients cant do so as it can be measured only in the postmortem brain and even measuring its major matabolite is potentially dangerous as it requires patient to agree to lumbar puncture .
    – also medical approach gives objective and independent medical theories whereas these are just the partial explanations and cant be taken as direct piece of evidence because schizophrenia has subjective and complex nature.
    – hallmarks of Schizophrenia include delusions and psychosis whic are an interplay of biology and psychological factors and hence psychodynamic humanistic existential and behavioral angles are also vital which are ignored in biomedical approach.
    – also strict medical approach can lead to strict categorization of symptoms and labelling which in turn can lead to social stigma and discrimination. for ex. overlapping symptoms of schizophrenia and mood disorders or even some abnormal yet unique to person traits might lead to inaccurate assessment. whereas psychological dimension of schizophrenia demands a unique and subjective approach for each patient.

    Because of these drawbacks the multidimensional approach and biopsychosocial model is more appropriate in understanding schizophenia as we need to go beyond the medicalisation of human experience for holistic understanding of this puzzling mental disorder.

    1. Your answer has enough substance. The arguments given require more coherence and clarity. Write more specifically what are limitations. 5/10

  2. Schizophrenia is disturbing psychological disorder which affects one’s way of thinking, feeling, emotions, behaving etc

    Limitation of medical explanation of schizophrenia are as follows:

    1. Dopamine hypothesis: It has been found that with increase in dopamine activity in brain increases the psychotic symptoms in schizophrenic patient. This theory stems from use of amphetamines. Amphetamines increases the activity of dopamine in brain hence the patient show increase in positive symptoms. But this theory does not explain all. It has been found that many neurotransmitters influence synaptic transmission. If antipsychotic drugs which control the level of dopamine works then schizophrenic patient can be nearly cured. However antipsychotic just manages the symptoms which shows other neurotransmitter plays equal role. It has been also found abusers of amphetamines do show similar symptoms of paranoid schizophrenic patient which means increase in dopamine activity in brain can produce similar conditions.

    Also prefrontal cortex in schizophrenic patient which is involved in planning and organisation shows low level of dopamine level. Hence, Dopamine theory cannot be accounted of symptoms of Schizophrenia.

    2. Brain Atrophy: This theory holds that schizophrenic patient shows shrinking of brain ie loss of brain cell. This leads to loss of intellect, delusions, hallucinations. However, Type1 schizophrenic patients shows positive results after have antipaychotic drugs, but Type2 does not. This concludes that schizophrenia is not just a single disorder but collection of disorder which needs to be diagnosed properly before prescribing medicine or therapy.

    3. Environmental factor: Though it has been found people with schizophrenia genetically same have greater chance of developing the disorder but it ignores the role of envrionment. Diathesis theory suggest person’s predisposition and environmental triggers play great role in the disorder. Eg irrational behaviour of the family can trigger the disorder.

    Other theories like psychodynamic explanation of regression cannot be explained through medical theories.

  3. Etiology of Schizophrenia, from the medical perspective not only provides a scientific explanation, but also validates with ample researches. Still the explanation is marred by several limitations.

    Dopamine Hypothesis: it states that psychotic activity in schizophrenia is associated with abnormal activity at the dopamine level. But it has also been found that not all patients suffer from schizophrenia, having such abnormally active dopamine.

    Family Twin and adoption studies: If highest risk of developing schizophrenia is from the blood relatives then, monozygotic twins should have developed schizophrenia as they share 100 percent of their genetic material.

    Moreover, 1st degree relatives, or twins share the same environment, thus wether role of gene or environment, is not confirmed. (Diathesis Model)

    Stress-Vulnerability Model: People with genetic makeup of schizophrenia will still not develop, until exposed to such situation at critical times in development. (Harrison and Weinberger)

    Eclectic Approach: As the explanation of schizophrenia, involves eclectic perspective, therefore following a single approach to schizophrenia, will limit the understanding itself.

    e) Structural Impairment : Some researches depends on the postmortem examinations, but the brain itself goes through huge transformation after death. Further, the availability of such sample, also adds to the limitation of the approach.

    f) Manifestation: the patient themselves are not in the situation to correctly state their testimony, not it can be accurately measured, but only inferred, thus there are chances of misdiagnosis.

  4. Medical explanation of schizophrenia is based on the hypothesis ‘ For every twisted thought, there is a twisted molecule ‘ hypothesis, which is often correct but suffers from explaining the complete picture. The limitations of medical model are as follows:-

    Biochemical perspective:- Initially it is thought that imbalances in Dopamine causes schizophrenia, but several latest research findings suggest that Dopamine is not the ‘only’ crucial factor.

    Brain structure:- It proposes that Schizophrenia patients suffer from brain atrophy and increased size of their ventricles. Recent research findings suggest that it explains Type II schizophrenia but fails to account for Type I Schizophrenia

    Incomplete picture:-

    * Like DSM model, medical model does not acknowledge the role of the environment stressors like family treatment that drives vulnerable persons to develop symptoms

    * It gives no credit to the role of cognition which plays a key role in developing psychotic symptoms like Delusions, hallucinations which all are based on irrational beliefs

    * It undermines behavioral perspective, which put forwards the idea of reinforcement and modelling during childhood in developing schizophrenia

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