Where does Schizophrenia lie in the spectrum of Nature versus Nurture?
Schizophrenia and Nature versus Nurture
Abstract
To begin, my research question is ‘Where does Schizophrenia lie in the spectrum of Nature versus Nurture?’ Nature versus Nurture is an ongoing debate discussing whether the environment determines one’s behavior they are surrounded by or by the genes they inherit. My research question is more focused on how Schizophrenia is developed. Do one’s genes determine it, or does the environment play a role? I went about researching by using the Internet and found articles, videos, theories, and stories.
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Additionally, I interviewed Marwan Chatila (my father), because his brother is being diagnosed with Schizophrenia. After doing some research, I have found that each person has 46 chromosomes, and each of their genes is located on 23 chromosomes.
Each person inherits two copies of each gene, from each parent. Several genes could be associated with a risk of schizophrenia depending on whether each parent has a relative who has schizophrenia. Genetic contributions could include having first or second-degree relatives, which could increase one’s risk of developing Schizophrenia. There are several environmental contributions many of which include exposure to viruses, stressful environmental conditions, malnutrition in the womb, and early parent loss or separation.
Therefore, I have come to the conclusion that one can have genes that may play a role in the development of Schizophrenia however it is not possible to predict how it is developed by looking at a person’s genes. The genes may cause risk, however, they are unlikely to cause the disease on their own. Thus, they associate with environmental factors that trigger schizophrenia.
Introduction
Schizophrenia (from the Greek roots skizein (“to split”) and phren, phren- (“mind”)) is a mental disorder that was first recognized by a doctor named Emile Kraepelin in 1887. It was believed that it accompanied mankind long before it was first identified. It is characterized by a variety of symptoms many of which include the loss of contact with reality, hallucinations, and odd behavior. Patients who have schizophrenia are often misinterpreted as people who have multiple personalities, however, it is actually a deterioration of personality.
A Swiss Doctor named Eugen Bleuler closely observed schizophrenia in 1908 (The History of Schizophrenia). Furthermore, both doctors subdivided schizophrenia into different categories, which include disorganized, catatonic, paranoid, residual, and undifferentiated. They were classified based on “positive” and “negative” symptoms. By doing this, it was hoped that they would be able to determine the causes of this mental illness.
About 1% of the population worldwide is diagnosed with schizophrenia, and 1.2% of Americans (3.2 million) have the disorder. Additionally, 1.5 million people are going to be diagnosed with schizophrenia this year around the world. In the United States, this means that approximately 100,000 people will be diagnosed, which means that 7.2 people per 1,000 or about 21,000 people within a city of 3 million who are likely to be suffering from schizophrenia (Statistics of Schizophrenia, Symptoms & Patterns of Schizophrenia). Although it is not a tremendously common disease, it is a serious one that affects people throughout their life.
Types of Schizophrenia
The five different subtypes of schizophrenia include undifferentiated, paranoid, catatonic, disorganized, and residual schizophrenia. Firstly, Undifferentiated Schizophrenia is one of the main types of schizophrenia. The symptoms that are evident in this type of schizophrenia are incoherent speech, disorganized behavior, complex delusions, and hallucinations. Secondly, paranoid schizophrenia involves “hallucinations involving paranoid ideation” as well as delusions. Common types of delusions that are evident in paranoid schizophrenia are the Delusion of Persecution, the Delusion of Jealousy, the Delusion of Grandeur, and the Delusion of Reference.
Catatonic schizophrenia is one of the major types of schizophrenia. The symptoms that contribute to this type of schizophrenia are firm and excitable motor behavior (How Does Nature and Nurture Contribute to Schizophrenia? ). Disorganized Schizophrenia is identified when a person has disorganized speech, thinking and when someone’s behavior is silly and or when the person is withdrawn socially.
Residual Schizophrenia is when a person has had at least one schizophrenic episode but does not necessarily have symptoms such as delusions and hallucinations. They may have negative symptoms, however, that include being withdrawn from others (Undifferentiated Schizophrenia).
Schizophrenia Symptoms
As mentioned above, there are five different subtypes of schizophrenia and each of them has different symptoms and risk factors. Furthermore, all the symptoms associated with schizophrenia fall into two categories, positive symptoms and negative symptoms. Positive symptoms are symptoms, which are sometimes referred to as psychotic symptoms. They appear in a schizophrenic’s daily life. Delusions, hallucinations, and confused thoughts are examples of different positive symptoms and they are all associated with one’s brain.
A delusion is a belief that is held with complete certainty despite the fact that it is based on an unrealistic view. Delusions are positive symptoms that are very common and contribute to several different cases of schizophrenia such as paranoid schizophrenia, and undifferentiated schizophrenia. Furthermore, hallucinations are also positive symptoms, and they involve hearing voices that are not present and experiencing a perception of something that does not exist. Research has proven that “changes in the speech area of brain in people with schizophrenia when they hear voices.” Their brain may react differently to the voices than a normal brain.
Furthermore, in most cases, schizophrenics “develop delusional ideas to explain hallucinations” (Symptoms of Schizophrenia). In some cases, schizophrenics have delusional ideas that they are being followed or persecuted. In addition to delusions and hallucinations, confused thoughts are symptoms associated with positive symptoms. A schizophrenic cannot keep track with their ideas thus, they drift from one thought to another making it hard to converse with them because their thought speech is jumbled.
Negative symptoms are symptoms that represent a lack of function that a healthy person might have. A healthy person has emotions and has some kind of motivation and interest; however, schizophrenics lack that quality. Schizophrenics who have negative symptoms seem to be emotionless, and apathetic with very little motivation and concentration. On the contrary, a healthy person often has emotions and is able to react to certain situations that a schizophrenic does not react to. For example, a healthy person would probably feel happy if something good has happened in their life, however a schizophrenic would not have any emotions towards it.
Furthermore, Negative symptoms “can appear several years before the first period of schizophrenia.” Negative symptoms could possibly represent a change in sleep patterns, a lack of motivation in life and activities, and a loss of interest in other people’s feelings and emotions. (Symptoms of Schizophrenia). These are all qualities a healthy human being would not have.
Schizophrenia Phases
There are three different phases that are involved in schizophrenia, the Prodromal Phase, the active phase, and the residual phase. To start off, the Prodromal phase can be noticed during the early detection of schizophrenia. It occurs about 1 or 2 years before the first onset of psychotic symptoms such as hallucinations and delusions. Social isolation, difficulty making choices, and problems with concentration are psychotic symptoms, which can be evident before the development of schizophrenia leading to positive symptoms.
There are three subgroups involved in the Prodromal Phase. Firstly comes the Attenuated Positive Symptom Syndrome (APSS.) This subgroup occurs when a person has problems with communication, perception, and thoughts. They occur once a week and they become progressively worse over time leading to the second subgroup of the Prodromal Phase, which is the Brief Intermittent Psychosis Syndrome (BIPS.) BIPS is when the person continues to have problems with communication, perception, and psychotic thoughts and in addition to that they start to have unrealistic beliefs for a few minutes daily for at least a month.
The third subgroup comes after that, and it is also known as the genetic risk plus function deterioration group. People are usually considered part of this group if in the past year they have had declines in work, school, relationships, and general functioning in daily life (Ballas). Basically, the Prodromal Phase is a representation of the early detection of schizophrenia that hints at whether or not a person may have this disorder.
The second phase is known as the Active Phase. This phase is when schizophrenic starts to come to an understanding that something might be wrong with them and they start to become active every once in a while, or they may experience episodes. However, not all schizophrenics come to terms that there is something wrong with them. Some schizophrenics are in denial and may not admit it.
This leads to them possibly experiencing schizophrenic episodes and other symptoms that a schizophrenic has. Evident symptoms associated with this phase include delusions, hallucinations, distortions in thinking, and disturbances in behavior and feeling.
As explained above, delusions are hallucinations are positive symptoms that are associated with a schizophrenic’s daily life. Additionally, they occur in the brain and one’s thoughts. In addition to that, in the Active Phase, distortions in thinking and disturbances in behavior and feeling are also considered positive symptoms. Distortions in thinking are associated with one’s thoughts and ability to think straight, and disturbances in behavior and feeling include a person having odd behavior and not feeling right.
The third phase, which comes after the Active Phase is known as the Residual Phase. It is quite similar to the Prodromal Phase in terms of symptoms. Schizophrenics usually feel listless, lethargic and they experience trouble concentrating.
A Case of Schizophrenia
To begin, there are many different cases of schizophrenia. For example, my uncle, Ghassan Chatila is being diagnosed with Paranoid Schizophrenia. Before he reached the age of 23, Ghassan was “different” (Chatila). At a young age, he had a few qualities that differentiated him from others. He was isolated, self-conscious, lacked confidence, and he was an over-thinker. He didn’t seem like a normal boy but it didn’t worry his family because he was still young, and he was a smart kid. At the age of 23, he moved to Germany to complete his doctorate degree in organic chemistry. “He had very few friends, he started acting weird, and his way of thinking suddenly changed,” Ghassan’s brother, Marwan Chatila uttered. “Schizophrenia triggered” (Chatila).
When Schizophrenia triggered, Ghassan’s state started deteriorating. He started getting paranoid about people spying and following him, he started focusing on silly things and he imagined things beyond possibility. He began to experience some schizophrenic episodes without knowing it. He started to have distortions in his thought, and delusions that seemed very unrealistic. Although he was a successful student and a man with a lot of intelligence, as soon as schizophrenia took over, he was not able to think straight. Sadly, he failed his doctorate degree.
When his brothers were telling him something was wrong with him, he was in denial. He did not believe that his behavior was odd and he kept imagining things. He dealt with these symptoms until he started taking shots. The shots that he took helped keep him calm. However, despite the medication, he still had his own way of thinking, “he was unreachable,” said Marwan.
Ghassan’s room is his “territory,” where strange signs, languages and drawings were put up. He had paintings of unique shapes that included dark colors such as brown, grey and black. These colors are usually symbolic of fear, intelligence and mystery; which are traits evident in his personality. He has sayings written in German in nearly every corner, a language that the rest of his family would not understand. Only he could understand what was written.
This shows that although he’s taking medication, he still has a schizophrenic mind. It was undeniable that the shots that he took kept him calm and away from relapses. Additionally, they kept him from letting his thoughts jumble. However, he was still isolated, different, and definitely lacked a healthy way of living. The medication has limits, and it could only do so much.
In the family, it was unaware how Ghassan Chatila developed schizophrenia. Nobody in his family ever had this disease. However it could be possible that someone did have it, but it might not have triggered. The real question is; how does a person develop schizophrenia? Did the environment play a role or were there genetic factors that played a role?
Genetic Factors which Contribute to Schizophrenia
It has been debated that the cause of schizophrenia comes from genetic factors, which are passed from relatives, or direct families; but in some cases this disorder does not necessarily trigger unless a person is in a certain environment. Genetics does play a role in a person’s risk of developing schizophrenia; however, it has been proven that 60% of schizophrenics have no family members with this disorder.
People who have first-degree relatives with schizophrenia only have a 10% risk of developing it (Genetic factors and mental disorders – children). Each person has 46 chromosomes, and 23 of these chromosomes are inherited from each parent. It could be possible that a mother that is a carrier for schizophrenia and a father that has schizophrenia passed on a gene to one of their children leading them to have this disorder. However, this is not necessarily true. Schizophrenia is influenced by genetics but is not determined by it.
Environmental Factors which Contribute to Schizophrenia
The environment plays a huge role in the development of schizophrenia. Someone born in an “urban environment has a 50% risk of developing schizophrenia.” Additionally, a child born from a mother who has Rubella, birth complications such as malnutrition in the womb, death of a close family member, and maternal depression also increase the risk of the development of this disorder (The Causes of Schizophrenia). The environment contributes to schizophrenia in several other ways depending on the person. Additionally, an individual who is predisposed to someone who has this disease has a high risk of getting it. Exposure to viruses and diseases also play a part in the environmental contributions to schizophrenia.
Ghassan Chatila for example, was “different” when he was young; he had qualities that differentiated him from others. He preferred to be alone instead of with people, and he had very few friends. He seemed isolated and “unreachable” in the sense that he was always on his own and nobody ever really understood him. However, schizophrenia didn’t trigger until he moved from Lebanon to Germany. It is highly possible that schizophrenia was in his genes long before it triggered. However, when he moved to Germany, his genetic liability interacted with the new environment that he lived in to produce this disorder. Additionally, it is also possible that the change in environment may have caused schizophrenia to trigger because he was not used to living on his own. He was now exposed to the world, and that may have really caused him to change.
Schizophrenia Cure
Numerous treatments can be done to cure schizophrenia many of which include therapy, antipsychotic drugs, and different shots. The dosage and type of antipsychotics varies for each patient. These antipsychotics relieve symptoms of psychosis and keep a schizophrenic more steady and able to think properly. However, they do not take away schizophrenia because it is a lifelong disorder. Furthermore, many of the different antipsychotics have side effects. They may increase the risk for a movement disorder, “Tardive Dyskinesia” where repetitive movement cannot be controlled. Nevertheless, it cannot be guaranteed that all antipsychotics have side effects.
Secondly, the most important part is for the family to support the schizophrenic. By having extra support, the schizophrenic will feel have the motivation to get better and will have hope. Additionally, many different therapeutic treatments may be done such as individual and cognitive therapy and support groups.
If individual therapy is successful, it may allow a schizophrenic to be able to “differentiate between what is real and what can acquire beneficial problem-solving skills.” This in turn allows their thoughts to be more steady and less all over the place.
Cognitive therapy is a type of therapy that is also useful because it teaches people to look at their thoughts differently and determine whether their thoughts are valid or not. If cognitive therapy is successful it would also allow schizophrenics to be able to think more steadily and have less jumbled thoughts.
Support groups allow schizophrenics to be able to share experiences with others and hear other people’s experiences as well. They are a great place for different families to gather with their schizophrenic family members to give advice, and hear information. They help keep a patient calm and give the patient a lot of hope that they will get better. It is highly advised that families join support groups with their schizophrenic family members to give them support and help through their rough time. By joining support groups, schizophrenics will feel like they can talk to other people and that will keep them less isolated and alone. It will calm their thoughts and allow them to feel like they have someone to talk to.
Ghassan Chatila for example took shots every day, and that was his medication. It calmed him down, and allowed him to stop imagining things and thinking of abstract ideas such as wanting to “contact a president” or believing that people were after him or following him all the time. However, despite the medication, he still liked to be isolated and he still had his own way of thinking. But the effect of these shots was positive.
They didn’t have any side effects, and they helped his thoughts stay steady. There was one day when he didn’t take his shots, and he did have another relapse. It caused all his thoughts to jumble at once. This proves that it is possible for a schizophrenic to have another phase if they don’t take the medication they are given on time. Additionally, it proves that although there is medication; it does not take away schizophrenia. Because of these cures, schizophrenics no longer have to be hospitalized, and their thoughts are less likely to cause another relapse.
Conclusion
In conclusion, after doing all this research it was clear to me that there was no specific cause for schizophrenia, however, there are many different things that may contribute to its development. The ongoing debate about nature versus nurture (genes versus environment) both plays a role in the development of this disorder. Although there is no solid proof or scientific experiments that prove so, there has been a lot of research done on this.
Genetic contributions could include having first or second-degree relatives, which could increase one’s risk of developing Schizophrenia. There are several environmental contributions many of which include exposure to viruses, stressful environmental conditions, malnutrition in the womb, and early parent loss or separation. However, schizophrenia is a disease that is produced differently in every human being.
Each person has 46 chromosomes, and each of their genes is located on 23 chromosomes. Each person inherits two copies of each gene, from each parent. Several genes could be associated with a risk of schizophrenia depending on whether each parent has a relative who has schizophrenia.
However, this does not guarantee that the child will get schizophrenia. Although one may have a relative that has this disorder, this does not directly suggest that they will have it. And although one may not have a relative that has this disorder, this does not mean they cannot it. Relatives may be carriers of this disorder and that may lead to the ‘schizophrenia gene’ being passed on to different generations.
Schizophrenia is a lifelong disease that I believe is caused by a combination of both genetic and environmental factors. In the spectrum of Nature versus Nurture, schizophrenia lies somewhere in between Nature and Nurture. One may have schizophrenia in their genes, however, it is not until they are in a certain environment that it triggers. It entirely depends on the person and how their genes and the environment work together to produce this disorder.
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