Page 493 - Encyclopedia of Nursing Research

460 n SChIzOphRenIA

exaggeration of the relationship between the Diagnostic and Statistical Manual (4th edition,
dependent and independent variable depend- text revision) requires that at least two of the
S ing on the location of the excluded cases. In following be present for a significant por-
the more common multivariate situation, we tion of time during a 1-month period: delu-
cannot predict whether the relationship we sions, hallucinations, disorganized speech,
seek to identify is attenuated or exaggerated, grossly disorganized or catatonic behavior,
but we do know it will be misspecified. For and negative symptoms that refer to cogni-
this reason, sampling on one’s dependent tive deficits such as alogia, poverty of speech,
variable should never be done. avolition, and flattening of affect. For a sig-
nificant portion of the time since the onset
Lauren S. Aaronson of the disturbance, one or more major areas
of functioning, such as work, interpersonal
relations, or self-care, is markedly below the
level achieved before the onset. Continuous
Schizophrenia signs of the disturbance must persist for at
least 6 months. Diagnostic criteria require
that medical and substance abuse etiology be
Schizophrenia, the most serious and per- ruled out.
sistent of the brain diseases in psychiatry, The difficulty with the current diagnos-
strikes about 1.3% of the population world- tic criteria is that two different people with a
wide regardless of race, ethnic group, gen- combination of these various symptoms can
der, or country of origin (national Institute each be diagnosed with schizophrenia, yet
of mental health, 2010). Research and tech- have a totally different symptom configura-
nological advances over the past 25 years has tion. none of these symptoms is unique to
redefined schizophrenia as a major neurobi- schizophrenia alone as each of these symp-
ological disease, a concept in psychiatry that toms can be found in many other psychiatric
now replaces outdated psychological theo- diagnoses. A more recent approach to symp-
ries of causation, yet schizophrenia remains tom clusters includes three categories of
the most stigmatized illness of all medi- symptoms: positive, negative, and cognitive.
cal diagnoses. Worldwide there are at least positive symptoms refer to symptoms that
450,000,000 persons with mental health result from an exaggeration of normal brain
diagnoses, yet more than 80% do not receive functions and include delusions and halluci-
treatment (World health Organization, nations. negative symptoms are those that
2004). Approximately 2,200,000 people in result in a loss of normal functioning and
the United States suffer from schizophrenia include apathy, emotional flatness, loss of
and the accompanying stigma. In three out the ability to initiate speech, loss of pleasure
of four cases, the illness begins between the in activities that normally result in enjoy-
ages of 17 and 25 years, robbing its victims ment, inability to initiate movement, inabil-
of their most productive young adult years. ity to motivate self, and inability to sustain
The disease typically strikes males at a youn- attention. Cognitive symptoms refer to loss
ger age than females. The average life span of of ability to understand the source of symp-
a person with schizophrenia is 20% shorter toms, loss of executive functioning includ-
than that of the general population due to ing judgment, orientation, communication,
the frequent occurrence of comorbid medical memory, and ability to prioritize and orga-
and psychiatric conditions (Carney, Jones, & nize thoughts.
Woolson, 2006). Approximately 400,000 acute episodes
The criteria for diagnosis in the occur annually in the United States and three
American psychiatric Association’s (2000) million occur worldwide. Complete recovery