Submitted to

Submitted by:

Hira nadeem

Roll no 37

Bs (hons) semester 5th

Session 2018_2022
Introduction:

Schizophrenia (technically known as schizophrenic disorders) is the most debilitating

mental illness, affecting about 0.5% to 1.5% of the population in the U.s. (APA, 2000).

Schizophrenia appears to know no barriers: It affects people of all races and socioeconomic

classes, but not equally. According to the American Psychiatric Association (2000), the risk of

"contracting" schizophrenia is increased if the person has one or more of the following

characteristics: They are single, they come from a Westernized or Industrialized nation, they

come from a lower socioeconomic class (they do not give the parameters), they live in an urban

area, they had problems while in utero, they were born during the winter (0, or they had recently

experienced some extreme stress (p. 313). Some researchers have discovered that ethnic

minorities (African-American and Puerto Rican in the United States) are more likely to be

diagnosed with schizophrenia. This may be due to bias and to stereotyping (Lewis, CroftJeffreys,

& Anthony, 1990).

Key features of schizophrenia

Delusions

Delusions are fixed beliefs that are not amenable to change in light of conflicting

evidence. Their content may include a variety of themes (e.g., persecutory, referential, somatic,

religious, grandiose). Persecutory delusions (i.e., belief that one is going to be harmed, harassed,

and so forth by an individual, organization, or other group) are most common. Referential

delusions (i.e., belief that certain gestures, comments, environmental cues, and so forth are

directed at oneself) are also common. Grandiose delusions (i.e., when an individual believes that
he or she has exceptional abilities, wealth, or fame) and érotomanie delusions (i.e., when an

individual believes falsely that another person is in love with him or her) are also seen. Nihilistic

delusions involve the conviction that a major catastrophe will occur, and somatic delusions focus

on preoccupations regarding health and organ function.

Hallucinations

Hallucinations are perception-like experiences that occur without an external stimulus.

They are vivid and clear, with the full force and impact of normal perceptions, and not under

voluntary control. They may occur in any sensory modality, but auditory hallucinations are the

most common in schizophrenia and related disorders. Auditory hallucinations are usually

experienced as voices, whether familiar or unfamiliar, that are perceived as distinct from the

individual's own thoughts. The hallucinations must occur in the context of a clear sensorium;

those that occur while falling asleep (hypnagogic) or waking up (hypnopompic) are considered to

be within the range of normal experience. Hallucinations may be a normal part of religious

experience in certain cultural contexts.

Disorganized Thinking (Speech) Disorganized thinking (formal thought disorder) is typically

inferred from the individual's speech. The individual may switch from one topic to another

{derailment or loose associations). Answers to questions may be obliquely related or completely

unrelated (tangential- ity). Rarely, speech may be so severely disorganized that it is nearly

incomprehensible and resembles receptive aphasia in its linguistic disorganization {incoherence

or "word salad"). Because mildly disorganized speech is common and nonspecific, the symptom

must be severe enough to substantially impair effective communication. The severity of the

impairment may be difficult to evaluate if the person making the diagnosis comes from a
different linguistic background than that of the person being examined. Less severe disorganized

thinking or speech may occur during the prodromal and residual periods of schizophrenia.

Grossly Disorganized or Abnormai iViotor Behavior (inciuding Catatonia)

Grossly disorganized or abnormal motor behavior may manifest itself in a variety of

ways, ranging from childlike "silliness" to unpredictable agitation. Problems may be noted in any

form of goal-directed behavior, leading to difficulties in performing activities of daily living.

Catatonic behavior is a marked decrease in reactivity to the environment. This ranges from

resistance to instructions {negativism); to maintaining a rigid, inappropriate or bizarre posture; to

a complete lack of verbal and motor responses {mutism and stupor). It can also include

purposeless and excessive motor activity without obvious cause {catatonic excitement). Other

features are repeated stereotyped movements, staring, grimacing, mutism, and the echoing of

speech. Although catatonia has historically been associated with schizophrenia, catatonic

symptoms are nonspecific and may occur in other mental disorders (e.g., bipolar or depressive

disorders with catatonia) and in medical conditions (catatonic disorder due to another medical

condition).

Negative Symptoms Negative symptoms account for a substantial portion of the

morbidity associated with schizophrenia but is less prominent in other psychotic disorders. Two

negative symptoms are particularly prominent in schizophrenia: diminished emotional

expression and avolition. Diminished emotional expression includes reductions in the expression

of emotions in the face, eye contact, intonation of speech (prosody), and movements of the hand,

head, and face that normally give an emotional emphasis to speech. Avolition is a decrease in

motivated self-initiated purposeful activities. The individual may sit for long periods of time and
show little interest in participating in work or social activities. Other negative symptoms include

alogia, anhedonia, and asociality. Alogia is manifested by diminished speech output. Anhedonia

is the decreased ability to experience pleasure from positive stimuli or a degradation in the

recollection of pleasure previously experienced. Asociality refers to the apparent lack of interest

in social interactions and may be associated with avolition, but it can also be a manifestation of

limited opportunities for social interactions.

Etiology

Not surprisingly, entire volumes have been written about the etiologies of schizophrenia.

For many clinicians, schizophrenic disorders are among the most fascinating mental disorders. In

the interest of space we will summarize some of the key findings and etiological information. No

discussion of schizophrenia's etiologies can begin without considering genetic influences. First,

researchers generally agree that no one single gene is responsible for producing schizophrenia.

Instead, they hypothesize that multiple genes are responsible for producing a vulnerability to

contracting schizophrenia.

Many researchers can state with authority that genes somehow play a role in making

certain people vulnerable to contracting schizophrenia. The research is just too strong to discount

this possibility (for example, Bassett, Chow, Waterworth, & Brzustowicz, 2001). Kallmann

(1938) produced a landmark study on the families of individuals with schizophrenia. He

examined over one thousand family members of people with schizophrenia and the patients

themselves. He discovered two important points. First, the more severe the schizophrenia of the

parent, the more likely the children of the parent would develop schizophrenia. More important

was this discovery:

predisposition for the various subtypes of schizophrenia. Instead, the genetic predisposition is

inherited for the schizophrenic disorders, which may manifest themselves differently from that of

the parent(s).

Treatment Plan

The most effective approach towards treating schizophrenia seems to be a combination of

pharmaceutical, behavioral, cognitive, and family therapy. Even though many psychologists and

others agree that these approaches tend to be more effective, none of them, alone or in

combination, can be said to cure schizophrenia. Effective treatments will work on the

hallucinations, delusions, and disorganized aspects of behavior and attempt to lessen these

aspects. An additional concern is that many schizophrenic patients will relapse, even if their

treatment is continuous. Needless to say this can frustrate the patients and the clinicians.

In the past anti psychotics were divided into typical and atypical classes. "Typical" were

dopamine antagonists and include the earlier medications such as Thorazine (chlorpromazine).

"Atypical" were the newer antipsychotic medications that were more effective at alleviating

positive symptoms and also appeared to work on serotonin levels as welL Drugs in this class

include Clozaril (clozapine). Because the distinction between "typical" and "atypical" is not clear

to some, some authors now use the terms "Second Generation" to refer to the newer medications

(formerly "atypical") and "Conventional" to refer to the older medications (formerly "typical")

(Bezchlibnyk-Butler & Jeffries, 2002). This can be quite confusing, so for the sake of simplicity,

and since most texts still use the former terms, we will stay consistent.
 Using antipsychotic medications is the best and only way to treat actively hallucinating

schizophrenic individuals (APA, 2000). Henry was taking Thorazine while in the hospital; some

professionals classify Thorazine as a typical antipsychotic. Typical antipsychotics seem to be

dopamine agonists, i.e., they increase the dopamine activity in a person's brain. Some of the other

medications in this group include Mellaril (thioridazine) and Stelazine (tri[Luroperazine). These

drugs have short half-lives, which means that they must be taken daily. Typical antipsychotics

will work much better on the so-called positive symptoms (such as hallucinations) rather than on

the negative symptoms (such as inappropriate or blunted affect). It is also virtually impossible to

become addicted to these medications. Oddly enough, it seems that those medications that have a

very low addiction potential also seem to have the most serious side effects. They are cheap and

generally used more on an inpatient basis where compliance is easier and it is easier to monitor

side effects.
Abstract

A neuropsychological test PANS (positive and negative syndrome scale) was administered on his

in the mayo hospital. The participant was looking anxious in her appearance. She looks

hyperactive person. And she want to talk and telling multi stories during test.

Bio data

Name: M.Y

Age: 18

No. Of siblings: 03

Birth order: 2nd

Gender: female

Marital status: unmarried

Education: 3rd year

Religion: Islam
Background info;

The patient’s is 18 years old. He has two sister and one brother. The patient was

experiencing symptoms of schizophrenia from 2 months. He is unmarried. His qualification is 3 rd

year. She there is no psychological disorder running n the family.

Test administration:

The PANS was administered to the participant in well lighted. The patient was seated

comfortably on a bad, in mayo hospital. All the instructions were given to him according to the manual.

The participant took total 35 minutes to complete the test.

Behavioral observation:

The participant was a female 18 years. She had average height and less weight. He is looking bad

in his appearance. He was looking anxious and disturb. He was not enjoying the test due to

fatigue and illness. She had poor insight about her disorder.

Quantitative analysis

Scales scores Pr. value T-value Range of score

Positive scale 36 .99 .76 Severe

Negative scale 38 76 99 Severe

Composite scale -2 50 50 moderate

G-psychopathy scale 47 58 79 Mild

Total score of all scales 123 _ _ Extreme

Qualitative analysis:
 The analysis of subject on positive and negative syndrome scale releaved that she has

scored within high range as provided by the manual . Overall score is indicated that patient have

neural malfunctioning. Positive and negative symptoms have severe level in schizophrenia. G-

Psychopathy has mild level and has 58 pr. Value ad T value 79. Total score of patient is 123 that

above from cutoff score. The level of severity of total score is extreme.

Discussion

PANS were administer on patient. Total scores of PANSS indicates that patient have extreme
level of schizophrenia. And meet all the diagnostic criteria. His problem was started from
delusion and he feels that somebody is fighting with him and hitting him. The scores in positive
scale is 36 and T score is .76 which indicates that patient have extreme level problem. Patient’s
total scores were 123 that indicated that patient diagnosed schizophrenic.

PANS (positive and negative syndrome) On normal person

Abstract

The participant was a young girl of 22 years old. She was quite healthy and neatly

dressed. PANS was administered on her in the testing lab. The participant seemed interested. She

found few items confusing but she completed it very well in 20 minutes. Her final score was

normal that showed that she is adjusted in her family. The results were also consist with her

background information which depicted that she is adjusted in her family and social

environment.
Bio data

Name: A.S

Age: 22

No. of siblings: 04

Birth order: 3rd

Gender: Female

Marital status: single

Education: B.A

Religion: Islam

Background

The name of the participant‘s is A.S, her birth was normal. She is 22 years old .she was

healthy at birth and had normal body weight. She was doing B.A. she was average student .she is

like to reading books she was very helping and understand others people.

Test Administration

The test was Administered in the department of applied psychology the participant was

seated comfortably the room was well-illuminated and ventilated but the temperature was cold

then instructions were given to her properly. She listened to them carefully and understood

quickly then test was Administered on her and she completed it in about 22 minutes.

Behavioral observation

The participant was middle heighted and slim girl of 22 year old her gait was confidant

he was wearing makeup and jewelry. Her tone of voice very polite. Her nature seem friendly.
Quantitative analysis

Scales scores Pr. value T-value Range of score

Positive scale 12 .10 .37 Mild

Negative scale 17 21 42 Mild

Composite scale -2 50 50 Moderate

G-psychopathy scale 26 99 65 Mild

Total score of all scales 57 _ _ Mild

Qualitative analysis:

The analysis of subject on positive and negative syndrome scale releaved that she has scored

within low range as provided by the manual. When the patient’s responses were analyze then it is found

that, person has low symptoms of schizophrenia. She has 12 scores in positive scale that indicates .10 pr.

value d t-value is only .37. According to the manual person have mild severity level. She has also mild

severity In negative symptoms. She is not confused during test but she feels excitement.

The client is flexible while performing daily life decision. The result indicated that the client had

no problem In neuropsychological functioning.

Conclusion

The PANS (positive and negative symptoms) result reflects the normal functioning of the

client, except the situational factors that affect her performance and she got mild severity In

positive, G-psychopath and negative scales. Overall score of test is also mild that indicated that

client is normal.
References:

Gottesman, I. I. (1991). Schizophrenia genesis: The origins of madness. New York: W. H.

Kallman, F. J. (1938). The genetics of schizophrenia. New York: Augustin

Kendler, K. S., McGuire, M., Gruenberg, A. M., O'Hare, A., Spellman, M., & Walsh, D. (1993).
The Roscommon family study: Methods, diagnosis of probands, and risk of schizophrenia in
relatives. Archives of General Psychiatry, 50, 527-540.