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Uncategorized

Companionship During Quarantine

The impact pets have on the lives of their owners is no secret, supporting them through both joyous moments and difficult times. This has remained true throughout the Covid-19 pandemic, with pet adoptions skyrocketing as people are forced to stay home (Hedgpeth, 2021). However, do pets truly impact our mental health in the way that we assume they do? A study focused on human-pet interactions in Malaysia wanted to test how pets can be used to treat mental health and general well being problems during prolonged periods of social isolation, as was the case with Covid-19 (Grajfoner et al., 2021).

The adverse effects of isolation in response to Covid-19 have been well documented over the past year or so, with many people reporting feeling anxious, depressed, bored, or lonely. In order to combat this feeling, many decided to turn to pet companionship when human interactions were not possible. In studying the effect that this decision had on the humans, especially when compared to those who did not have pets, Malaysia was chosen as the area of focus because there is relatively little data about human-animal interactions in Southeast Asia in general. The information gathered would be providing a new outlook into a certain idea, one potentially affected by social and cultural norms in that region.

From a total pool of 920 responses, 224 pet owners and 224 non-pet owners were chosen (Grajfoner et al., 2021). Of the pet owner’s, 122 were dog owners and 80 were cat owners. It should be noted that the sample is inconsistent with the actual ratio of types of pets owned, as of the 50% of Malasians households that owned pets, 71% of them had cats while less than 1.3% owned dogs (Grajfoner et al., 2021). That inconsistency aside, the individuals were from all over Malaysia and of varying ages, genders, marital status, education, etc., representing a diverse group of people.

The study had these individuals fill out various surveys rating their mental health and general wellbeing. The results reported that there were statistically significant differences between pet owners and non-pet owners, especially when it came to coping, self-efficacy, positive emotions, and psychological well-being, leaning in favor of pet owners (Grajfoner et al., 2021). The difference wasn’t large, but they did show that having pets improved the owner’s life in various areas of life, at least to a certain degree. Certain groups, such as those 65 and older, had to be removed from the study due to not having enough data to form a reliable conclusion from their responses. The outcome, however, remains the same, with pets improving daily life in certain aspects, although interaction with them did not result in a noticeable decrease in mental illnesses such as anxiety and depression. In fact, the prevalence of those illnesses within both sample groups remained roughly the same.

Interestingly enough, the studies done within groups focusing on pet owners and the different types of pets showed the most variations when it came to general wellbeing. Studies done in the UK and the United States claimed that owning dogs would result in the greatest benefit, as the physical act of walking a dog and other associated acts would lead to an improvement in wellbeing overall. This study done in Malaysia, however, found the opposite to be true, with the few cat owners present in this study reporting greater psychological wellbeing than the numerous dog owners (Grajfoner et al., 2021). The authors theorized that the act of feeding the cats, petting them, and overall engaging with them on an emotional level held more benefits for their owners than the physical activity that a dog could provide for its owner. Regardless, isolation during this pandemic has been difficult, and any form of respite, whether it be a walk with your dog or napping with your cat, is welcome.

 

References

Grajfoner, Ke, G. N., & Wong, R. M. M. (2021). The Effect of Pets on Human Mental Health and Wellbeing during COVID-19 Lockdown in Malaysia. Animals (Basel), 11(9), 2689–. https://doi.org/10.3390/ani11092689

Hedgpeth, D. (2021, January 7). So many pets have been adopted during the pandemic that shelters are running out. The Washington Post. Retrieved December 1, 2021, from https://www.washingtonpost.com/dc-md-va/2021/01/06/animal-shelters- coronavirus-pandemic/. 

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Uncategorized

Queer and Here: Mental Illness with the LGBTQ+ Community

Mental health issues are widespread in this day and age, but within minorities, these issues are more prevalent, with members having higher rates of mental illness than seen in the general population. This remains true when examining the LGBTQ+ community, which has been marginalized for centuries. Studies involving queer or questioning individuals, both on their own and in comparison to their heterosexual counterparts, have shown this to be true.

A large part of the difference in the rates in mental illness stems from stigma and discrimination based on sexual orientation and gender identity, as the LGBTQ+ community has been clearly designated as “other” in the eyes of society (Veltman & Chaimowitz, 2014). This outsider status leads to fear and concern for safety, as individuals can experience verbal taunts, exclusion, and sometimes violence in very public areas such as parks, colleges, and restaurants (Vaccaro & Mena, 2011). All of this can lead to the presence of a wide range of mental illnesses, the most common among them being depression and anxiety.

Potential stressors aren’t located just outside the individual’s communities, however.  Individuals who identify as both queer and as people of color have stated that when it comes to racism, they feel well supported by their communities, with a support system in place if something were to ever happen (Vaccaro & Mena, 2011). However, although they can turn to others when it comes to racial issues, they do not have the same support exploring their sexual and gender identities and the problems that could arise if they were to freely attempt to express them. Part of this may be due to cultural and religious beliefs that being queer is a sin, or simply attempts to conform to societal standards as a minority group, one that faces threats of its own (Vaccaro & Mena, 2011).

Whatever the case may be, this leaves queer individuals of color without proper rolemodels, people who can guide them through what they are going through and provide advice specific to their experience as both a queer individual and a person of color, as the general experiences of the LGBTQ+ community does not factor in specific cultures and nationalities. These experiences, added on top of the strugge to figuring out your identity and undergoingthe process of living life, ultimately build up the stress queer individuals face. 

With this in mind, it’s no surprise that 26% of queer students report severe psychological distress, as opposed to 18% of non-queer students, and were 1.87 times more likely to use the mental health resources offered by their college than other students (Dunbar et. al, 2017). It is also interesting to note that different racial groups responded differently to the issues arising from mental health, with their coping strategies different from one another. In this particular study, queer black students reported more engagement in religious activities, while queer Latino students had higher levels of social activity (Vaccaro & Mena, 2011). What remained the same, however, was the importance of a social support system in handling mental illness, especially as an individual belonging to multiple marginalized groups.

 

References

Dunbar, Sontag-Padilla, L., Ramchand, R., Seelam, R., & Stein, B. D. (2017). Mental Health Service Utilization Among Lesbian, Gay, Bisexual, and Questioning or Queer College Students. Journal of Adolescent Health, 61(3), 294–301. https://doi.org/10.1016/ j.jadohealth.2017.03.008

Vaccaro, & Mena, J. A. (2011). It’s Not Burnout, It’s More: Queer College Activists of Color and Mental Health. Journal of Gay & Lesbian Mental Health, 15(4), 339–367. https://doi.org/ 10.1080/19359705.2011.600656

Veltman, & Chaimowitz, G. (2014). mental health care for people who identify as lesbian, gay, bisexual, transgender, and (or) queer. Canadian Journal of Psychiatry, 59(11), 1–8.

Categories
Neurocognitive Disorders Neurodegenerative Disorders Uncategorized

Neurogenesis: Remembering or Forgetting

Neurogenesis refers to the process of developing new nerve cells from multipotent neural stem cells, and it is essential during embryonic and infant brain development. While it also occurs throughout adulthood, it is restricted to specific parts of the brain as we age. These areas include the ventricular-subventricular zone (V-SVZ) and the subgranular zone (SGZ) of the dentate gyrus, a hippocampal structure important for episodic memory formation.  Episodic memories are long-term memories characterized by conscious recollection of past events and experiences.

As we learn from experiences throughout life, our brains are predominantly developing through the formation of new synaptic connections rather than increasing in number of neurons. In healthy brains, old connections are also pruned over time to ensure proper brain functioning if they are no longer necessary. However, the number of neurons becomes pertinent when we take neurodegenerative conditions such as Alzheimer’s and dementia into consideration, wherein abnormally configured beta amyloid proteins accumulate in the brain. This forms sticky plaques which are thought to contribute to brain atrophy by disrupting synaptic transmission, eventually eliciting cell death. In simpler terms, conditions that involve neuronal cell death highlight the importance of processes that increase the number of neuronal cells. Thus, studying adulthood neurogenesis in brain areas related to memory in order to see what promotes this proliferation may provide insight into how we can maximize brain and memory maintenance. 

Some studies done on mice suggest that exercise, and particularly aerobic exercise results in the incorporation of new neurons into hippocampal pathways. A molecule called brain derived neurotrophic factor, or BDNF, plays an integral role in this process. As exercise duration and intensity increase, so does BDNF concentration. Periodic moderate exercise over prolonged periods of time was determined to be optimal for increasing neurogenesis (Liu, 2018). 

Since exercise and neurogenesis appear to promote brain health, one would assume they protect against episodic memory deterioration as well. However, the opposite is true: neurogenesis also plays a key role in forgetting, and studies involving infantile amnesia showcase this interesting phenomenon. Contrary to Sigmund Freud’s reasoning that we have repressed early childhood memories because they are unacceptable or traumatic, one study posits that the formation of new neuronal cells during infancy is the reason why most of us can’t remember anything from that period of our lives. In the study, both adult and infant mice were trained and then tested to assess the maintenance of their memory. Under baseline conditions, the infants appeared to retain the memory of the training experience for a short time, but that memory was not maintained over a longer duration, as opposed to the adult mice which had no problems with their recall. However, when the adult mice were provided with exercise wheels, increased neurogenesis created weaker, shorter-lasting memories of the training experience (Ackers, 2014).

A group of infant mice were then treated with a drug called temozolomide (TMZ) which is known to prevent neurogenesis by preventing mitotic cell division. Surely enough, blocking neurogenesis in the infant mice resulted in stronger memories, essentially undermining infantile amnesia. Like humans, when mice are born they are unable to remember anything without such a treatment. However, there are similar rodent species that are precocial, meaning they are born more developed. Thus, for instance, when guinea pigs were tested, there was no difference between memory maintenance in adults and infants, as both groups had already completed most of their neurogenesis. Also as expected, exercise decreased their memory maintenance and induced infantile amnesia by promoting neurogenesis. This converging evidence therefore suggests that neurogenesis can also play a role in forgetting under certain conditions. The fact that neurogenesis may be involved in both remembering and forgetting processes may seem counterintuitive, but it does link neurogenesis to infantile amnesia, despite its long-standing association with memory promotion (Ackers, 2014).

 

References

Akers, K. G., Martinez-Canabal, A., Restivo, L., Yiu, A. P., De Cristofaro, A., Hsiang, H.-L. (L., et al. (2014). Hippocampal neurogenesis regulates forgetting during adulthood and infancy. Science, 344(6184), 598–602. doi:10.1126/science.1248903 

Josselyn, S. A., & Frankland, P. W. (2012). Infantile amnesia: A neurogenic hypothesis. Learning & Memory, 19(9), 423–433. doi:10.1101/lm.021311.110 

Liu, P. Z., & Nusslock, R. (2018). Exercise-mediated neurogenesis in the hippocampus via BDNF. Frontiers in Neuroscience, 12(7). doi:10.3389/fnins.2018.00052

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Uncategorized

Student Support: How It Relates to Everyday Life

The importance of a support system has long been understood, with many of the relationships and experiences we undergo informing our outlook on life and the way we interact with the world. In times of great difficulty, these are the people we lean on, the individuals who get us through rough patches, and make us feel loved and cared for in the process. The effects of this support system are especially helpful for those with mental illness. In fact, studies have shown that the presence of proper support improves anxiety or management of illness. Meanwhile, the absence of those who provide support results in increased anxiety, which ties into other factors as well.

Conceptually, this makes sense. As stated above, support during a difficult time makes the experience more manageable, if not easier. In the context of mental health, the individual is aware that their support system understands what they are going through and are ready to lend support when needed or asked for. Just the knowledge that this is an option, that you have that possibility, can decrease stress related to mental health in certain aspects. Rather than focusing on how others might be affected by your situation and how difficult or burdensome you are, you can focus on the problem at hand, fully aware that you have the support of those who matter.

One excellent example of this was done in relation to academics, where parental support of children was examined in the context of there being a potential connection between various academic stressors and the presence of anxiety (Leung et al, 2009). Split into different focus groups, students were polled on the various types of support they received from their parents, ranging from information, such as aid given when doing homework, to emotional, with students being able to go to their parents at times of difficulty, to time spent together. They were asked questions related to 28 anxiety items from a list, in which higher scores from this list indicated higher levels of anxiety (Leung et al, 2009). When further analyzed, the various support variables had a negative correlation with student anxiety, and that maternal support was found in higher levels than paternal support was, keeping in line with previous findings on this topic.

However, the effectiveness of parental support in lessening the effects of academic stress and reducing the rate of academic anxiety is not just due to the reassurance of love and care. It is also tied to culture, and the idea of what your parents’ support means. In Hong Kong, filial piety is a large part of societal norms and the parent-child relationship is heavily influenced by Confucian ideology (Leung et al, 2009). For the students in the experiment to know that their academic achievements didn’t necessarily equate to how good of a child they were, or for the parents to understand that a child’s progress isn’t a reflection of how they were raised, that is a large weight off of their back in terms of societal expectations and the chains that bind them. With the time put into this relationship and their support made clear, anxiety due to academics decreased, allowing both students and parents to focus on what was truly important to them. The same thought process can be applied to other aspects of life, allowing individuals to prioritize what truly matters and do so with those they care about by their side.

 

Reference

Leung, G. S. M., Yeung, K. C., & Wong, D. F. K. (2009). Academic Stressors and Anxiety in Children: The Role of Paternal Support. Journal of Child and Family Studies, 19(1), 90–100. https://doi.org/10.1007/s10826-009-9288-4

Categories
Schizophrenia

Child & Adolescent Schizophrenia

Though schizophrenia is more commonly seen among adults, it can also be present in children and young adults. It must be noted, though, that the only difference between childhood schizophrenia and adult schizophrenia is that the former shows up earlier in a person’s life than the latter does. Early onset schizophrenia comes on before a person is eighteen years old, and is rarely seen in someone before they are thirteen years old. Most schizophrenia symptoms fall under three kinds: Behavior, Emotions, and Thinking.

Behavioral symptoms may include a person having difficulty sleeping, isolating oneself from those closest to them, being violent, and not having the incentive to do daily tasks such as showering or doing school work. Emotional symptoms can include being depressed, being suspicious of other people, and not showing any emotions. Thinking symptoms may include believing fiction to actually be reality and not being able to think logically. These are some symptoms, but as one gets older and the disorder progressives, the symptoms can get relatively worse. 

Worsening symptoms of schizophrenia can be the onset of hallucinations, the start of misinterpretations of social behaviors, and being scatterbrained. Hallucinations involve a person seeing things or hearing voices that are actually not real. These tricks of the mind can seem very real to the person experiencing them. A person with schizophrenia may experience hallucinations which cause them to misjudge how others feel about them. This perception a person with schizophrenia can have about those around them is one of the most common symptoms. Another symptom is a person becoming absentminded which can include not being able to concentrate or fidgeting around a lot. While all these symptoms can be very overwhelming to go through, and schizophrenia is chronic, it is very treatable (Mayo Clinic Staff, 2021).

The first step in childhood schizophrenia being treated is going to a psychiatrist. From there they can help with an official diagnosis and then begin to make a treatment plan. One option is for a patient to go on a low dose of an antipsychotic drug. This can help with any hallucinations one may be experiencing. Another alternative is going to therapy to help talk out what one is feeling. This therapy can be great for a child because they can get a better understanding of schizophrenia and how it affects them. Children with schizophrenia can also go to different classes or training to help them feel more comfortable. The classes can be on subjects like learning how to build healthy relationships in connection to their schizophrenia. And if symptoms get extremely severe, a child can be hospitalized to get the special care they need to feel better (Schizophrenia, 2021). 

While schizophrenia, especially among children, can be very difficult, it is very treatable, especially when families make some of the accommodations mentioned. People can acknowledge and work through their schizophrenia symptoms.

 

Resources

Mayo Clinic Staff. “Childhood Schizophrenia.” Mayo Clinic, 19 May 2021, https://www.mayoclinic.org/diseases-conditions/childhood-schizophrenia/symptoms-causes/syc-20354483.

“Schizophrenia .” Boston’s Children Hospital, 2021, https://www.childrenshospital.org/conditions-and-treatments/conditions/s/schizophrenia/diagnosis-and-treatments.

Categories
Schizophrenia

Schizophrenia and Religion

The relationship between religion and schizophrenia is often studied by psychologists because of the similar nature between religious experiences and psychotic episodes. Positive symptoms of schizophrenia (symptoms that appear after the onset), such as auditory and visual hallucinations and delusions, are often the experience of many who practice religion. Thus a stigma exists that schizophrenia patients and highly religious people are crazy and out of line with society. However, results from studies go in two completely different directions, suggesting that religion can be both a risk and a protective factor for schizophrenia. 

Some studies focus on the intersection between religious practice and inpatients of schizophrenia. According to a paper written by Grover et al., the prevalence of religious delusions and hallucinations varies across countries, with rates ranging from 6 to 63.3 percent. Cultural differences also exist across religions, with Christian patients having more religious delusions when compared to Buddhist and Muslim patients. Common themes amongst religious delusions include: persecution, influence (being controlled by the spirits), and self-significance (delusions of sin/guilt or grandiose). Interestingly, the same paper states, “Data also suggest that patients with religious/spiritual delusions value religion as much as those without these types of delusions, but patients presenting delusions with religious content report receiving less support from religious communities” (Grover et al., 2014). This highlights that stigma exists for those who experience religious delusions. 

With the high amount of overlapping qualities between religious delusions and schizophrenia symptoms, it is important to study the effects of religious practice on the outcomes of schizophrenia. Some studies have suggested that religious practice in schizophrenia patients is associated with positive outcomes, such as “Increased social integration, reduced risk of suicide attempts, reduced risk of substance use, decreased rate of smoking, better quality of life, lower level of functioning, and better prognoses.” Nevertheless, some studies contest otherwise and stress that religiosity, or strong religious beliefs, has negative impacts on schizophrenia patients, such as higher risk of suicide and poorer treatment adherence (Grover et al., 2014). 

Studies have also been conducted on how religious beliefs influence the treatment adherence of schizophrenia patients. According to the paper written by Borras et al., “Thirty-one percent of nonadherent patients and 27% of partially adherent patients underlined an incompatibility or contradiction between their religion and taking medication, versus 8% of adherent patients.” This demonstrates that schizophrenia patients who are religious are less likely to follow instructions on medications due to contradiction with their religious beliefs. The same paper also points out, “Fifty-seven percent of patients had a representation of their illness directly influenced by their spiritual beliefs (positively in 31% and negatively in 26%).” This suggests that research holds contradictory results to whether religions positively or negatively affect individuals with schizophrenia. 

Although there is a lot of overlap between schizophrenia symptoms and religious experiences, there is not a lot of medical literature that covers religiosity, and religious delusions are seldom diagnosed. According to Living With Schizophrenia, “A review of four major psychiatric journals carried out in the US in 1982 found that only 2.5% of the articles even mentioned religiosity and that in most cases the mention was just cursory.” In order to destigmatize the experience of schizophrenia and religious delusions and improve treatment adherence, there should be more studies in the future so that schizophrenia patients can obtain a balance between practicing their faith and falling in line with their treatment. 

 

Resources

Borras, L., Mohr, S., Brandt, P. Y., Gilliéron, C., Eytan, A., & Huguelet, P. (2007). Religious beliefs in schizophrenia: their relevance for adherence to treatment. Schizophrenia bulletin, 33(5), 1238–1246. https://doi.org/10.1093/schbul/sbl070

Grover, S., Davuluri, T., & Chakrabarti, S. (2014). Religion, spirituality, and schizophrenia: a review. Indian journal of psychological medicine, 36(2), 119–124. https://doi.org/10.4103/0253-7176.130962

Religious and Spiritual Delusions in Schizophrenia. (2019). Living With Schizophrenia. livingwithschizophreniauk.org/religious-spiritual-delusions-schizophrenia/.

Categories
Addiction Schizophrenia

Schizophrenia and Crime

Many countries have a law that defends individuals from being responsible for the crimes they committed while under the influence of mental illnesses. This is known as the insanity defense, which the media often blame for an increase in violent crime rates. One infamous incident that comes to mind is the “2016 Taipei Neihu Murder,” where a man who previously sought treatment from a psychiatric hospital committed a brutal random murder of a four-year-old girl in front of her mother in broad daylight. The man eventually received a life sentence instead of the death penalty, leaving Taipei City fearful and resentful of the fact that many murderers would face abolished responsibility. The purpose of this article is not to discuss the moral or legal implications of the insanity defense. Rather, it is to explore the stigma that surfaces from these cases: violent crimes are often committed by people with mental illnesses. Even though there is an association between crimes and schizophrenia, it can be explained by a mediator: substance abuse.

An earlier study conducted by Lindqvist et al. investigated the connection between crimes and schizophrenia patients, as well as the types of crime committed by those patients compared to the general population. It found that female schizophrenia patients alone are twice as likely as the general population to commit crimes; but for male schizophrenia patients, there was no difference in crime rate compared to the general male population. Additionally, the rate of violent crimes is four times higher among schizophrenia patients. The results specifically showed that 13% of the violent offenders in the study were women, which is higher than the five to ten percent female contribution in national figures of corresponding crimes. In terms of criminal activity after conviction, only “one of the women in the cohort committed two or more violent offences during the follow-up period, whereas seventeen received two verdicts of violence, and three men were guilty of three violent offences each” (Lindqvist et al., 1990).  The study not only pointed to higher crime rates in the population with schizophrenia, but also a gender disparity in crimes committed by schizophrenia patients. 

While earlier studies aimed to find the association between crime and schizophrenia, recent studies focus on mediating the relationship between the two variables. Substance abuse is thought to be one of the strongest mediators. A study conducted by Fazel et al. investigated the severity of the crimes committed by persons with schizophrenia. They found it to be 4 to 6 times the level of those committed by persons without schizophrenia, and this can be explained by a comorbidity of substance abuse. According to the paper, “The rate of violent crime in individuals diagnosed as having schizophrenia and substance abuse comorbidity (27.6%) was significantly higher than in those without comorbidity (8.5%)” (Fazel et al., 2009). This shows that comorbid substance abuse is associated with higher violent crime rates in individuals with schizophrenia. 

One explanation for comorbid substance abuse as a mediator of the relationship between crime and schizophrenia is that, similar to schizophrenia, substance intake can also have a toll on a person’s cognitive ability. Common symptoms experienced by schizophrenia patients, such as hallucinations and delusions, may be present after alcohol and drug consumption, making substance abuse a risk factor for violent or criminal behavior. An article written by Tsimploulis et al. contests with the previous studies that substance use disorder can increase the risk of offending in persons with schizophrenia, especially among women. Moreover, the study found, “The percentages of substance abuse among NGRI [not guilty by reason of insanity] subjects with schizophrenia ranged from 35.7% to 74%” (Tsimploulis et al., 2018), demonstrating that there is an inverse relationship between criminal responsibility and schizophrenia patients with substance abuse problems. 

Altogether, many studies have established a link between schizophrenia and rates of criminal offences higher than the general public. More recent studies point to substance abuse as a mediating factor that contributes to this increased rate. The effect of schizophrenia itself on criminal offences is more obvious in women, and so is the effect of substance abuse on offending patients diagnosed with schizophrenia. Nevertheless, this association does not justify the stigma that all individuals with schizophrenia are dangerous. Similar to the effects of drugs and alcohol abuse, hallucinations and delusions can cause a person to behave abnormally. We should have compassion for the individuals struggling with these pathologies to achieve destigmatization. 

 

Sources

Fazel, S., Långström, N., Hjern, A., Grann, M., & Lichtenstein, P. (2009). Schizophrenia, substance abuse, and violent crime. JAMA, 301(19), 2016–2023. https://doi.org/10.1001/jama.2009.675

Lindqvist, P., & Allebeck, P. (1990). Schizophrenia and Crime: A Longitudinal Follow-up of 644 Schizophrenics in Stockholm. British Journal of Psychiatry, 157(3), 345-350. doi:10.1192/bjp.157.3.345

Tsimploulis, Georgios MD*; Niveau, Gérard MD, PhD†; Eytan, Ariel MD, PhD*; Giannakopoulos, Panteleimon MD, PhD*; Sentissi, Othman MD, PhD* Schizophrenia and Criminal Responsibility, The Journal of Nervous and Mental Disease: May 2018 – Volume 206 – Issue 5 – p 370-377 doi: 10.1097/NMD.0000000000000805

Categories
Schizophrenia

Childhood Schizophrenia

Schizophrenia in school-aged children is rare but not unheard of. Childhood schizophrenia essentially appears the same as schizophrenia in adults, except that the onset starts early in life and can have a profound impact on the child’s development and behaviors. The affected child may experience a combination of hallucinations, delusions, and disordered thoughts, making it difficult for them to interpret reality. It is a severe and chronic disease that requires lifelong treatment and early discovery to have positive outcomes.

Schizophrenic symptoms typically appear in an adult’s mid-to-late 20s. Early-onset in children can occur from as early as 13 years old to age 18. It is hard to diagnose children with schizophrenia because the symptoms in early phases may pass as other disorders such as ADHD. Some of the early signs of schizophrenia may include delay in language and walking as well as unusual motor behaviors such as rocking or arm flapping (Mental Health America). Symptoms in teenagers are difficult to recognize as well because some of these behaviors are common for the age group, including withdrawal from peers and family, a drop in performance at school, trouble sleeping, mood swings, lack of motivation, substance use, etc (MayoClinic.org). 

There have been studies conducted to compare the academic performance of children who were later diagnosed with schizophrenia and their peers. One case-control study done by Helling et al. found no significant correlation between underachievements in school and early onset of schizophrenia; the teenagers with schizophrenia performed almost as well as their peers. This is supported by the study’s results that at age 9, there was no difference in performance; at age 12, some patients with schizophrenia tended to excel in the arts and language; at age 15, some remained proficient in the arts but performance in PE dropped. Overall, this study concluded that it is hard to spot a young patient with schizophrenia completely based on their grades in school.

However, another study done by Jundong et al. (2011) suggested a contradiction. Using longitudinal data in Sweden, they found that offsprings of schizophrenia patients have overall poorer performance in school compared to offsprings of non-schizophrenia parents. This study also suggested that genetic factors (vs. environmental causes) causing cognitive deficits account for poorer academic performance in school-aged children whose parents have schizophrenia. With these findings came the conclusion that early detection of signs of schizophrenia and intervention is important for a better prognosis.

Aside from academic performances in school, there is also research demonstrating that some children with schizophrenia may experience severe emotional disturbances (SEDs). According to an article by Chen et al., “[Children] with histories of SED are among the lowest-performing special needs students, especially when they have additional comorbid learning and psychiatric conditions.” SEDs are also associated with poor impulse control and other disruptive behaviors in school, thus requiring special educational services. Nevertheless, according to the same article, these additional services are often underprovided and rarely incorporate instructional goals to help with social skills. Hopefully, in the future, the needs of children with schizophrenia will be better accommodated so that children growing up and living with a chronic disease like schizophrenia can experience more positive outcomes.

 

References

Chen Y-L, Rittner B, Manning A, Crofford R. Early Onset Schizophrenia and School Social Work. Journal of social work practice. 2015;29(3):271-286. 

Childhood schizophrenia. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/childhood-schizophrenia/symptoms-causes/syc-20354483

Helling I, Öhman A, Hultman CM. School achievements and schizophrenia: a case-control study: School performance and schizophrenia. Acta psychiatrica Scandinavica. 2003;108(5):381-386.

Jundong J, Kuja-Halkola R, Hultman C, Långström N, D’Onofrio BM, Lichtenstein P. Poor school performance in offspring of patients with schizophrenia: what are the mechanisms? Psychological medicine. 2012;42(1):111-123. 

Psychosis (Schizophrenia) In Children And Youth. Mental Health America. https://www.mhanational.org/psychosis-schizophrenia-children-and-youth

Categories
Anxiety and Anxiety Disorders Uncategorized

Steps to Take with CBT

Those who have anxiety can sometimes feel as if they are alone with their struggles, going through a unique situation that no one has the answer to, every day another hurdle to jump over. However, anxiety disorders are very common, with about 18% of the population suffering from its effects (Facts & statistics, n.d.). This is why a great variety of treatments have been designed and tested out to combat the major symptoms (Facts & statistics, n.d.). The goal of these treatments isn’t to completely erase any symptoms of anxiety, rather to improve the overall quality of life; once an individual learns how to manage them, their symptoms will interfere less in their life. A wide variety of treatments have been suggested, from natural ones such as exercise or tea, to more medical ones, such as exposure therapy. However, the most used treatment is Cognitive Behavioral Therapy (CBT), recommended by therapists and medical professionals alike (Hunley, 2019).

There are different ways to approach CBT, varying depending on which technique the therapist or medical professional prefers, but almost all of them have two parts: cognitive and behavioral. Cognitive refers to the mind and behavior refers to behaviors. Put into the context of anxiety disorders, CBT evaluates how a person’s thoughts and behaviors heighten their anxiety levels, as opposed to the event or situation itself (Treating anxiety, 2016). Identifying those key aspects will help to alter those reactions to have a more positive outlook on the situation, attempting to lessen the stress and negative connotations associated with that moment.

CBT identifies what situations or triggers cause the feeling of anxiety in the first place, with some people experiencing general feelings of avoidance to stressful situations while others may have specific phobias (Treating anxiety, 2016). The cognitive aspect becomes significant when determining how your mind reacts to that trigger, evaluating the overall thoughts, feelings, and emotions associated with it (Smith et al., 2020). In this approach, an individual’s thoughts, not their external environment, affect their feelings and actions.

You can take a common anxiety-inducing event, such as a public presentation, as a model of how CBT works. Under normal circumstances, an individual might feel worried or scared, fretting over the fact that they will do bad and be embarrassed in front of a large audience (Treating anxiety, 2016). These thoughts themselves cause the person to put off preparing the presentation or practicing for it, ultimately actualizing those fears due to their own negative thoughts. Someone practicing CBT, however, will make a conscious effort to remain positive, and if unable to do that, think realistically. Rather than wasting time worrying, they’ll attempt to do what they can and prepare themselves for the presentation, doing their part to alleviate worries of failure. Just the thought that the individual is competent and well-prepared for the presentation will help to stave off the worst of anxiety’s side effects. Of course, CBT won’t alleviate all of its effects, but it can minimize them enough that the individual is able to live their life without becoming stressed at every turn. 

The behavioral aspect of CBT operates in the same frame of reference, addressing an individual’s behavior and actions when they’re faced with their anxiety-inducing triggers (Smith et al., 2020). Instead of the thoughts, it’s the behaviors themselves that are examined and then worked through, looking into why a certain reaction occurred and how that can be slowly changed for a reaction that either better deals with the situation or minimal to no reaction at all. This is where CBT begins to overlap with exposure therapy, in which you consistently expose yourself to your fears and triggers (Treating anxiety, 2016). Once nothing happens, or something does happen but to a lesser extent than you expected, the anxiety and fear surrounding the scenario slowly begin to decrease. However, it’s impossible to create methods in which you can address every source of anxiety. The behavioral portion of CBT will most likely support the cognitive portion, which will make up the bulk of the work regarding the slow management of anxiety disorders.

It’s important to note that while in theory, thinking positive thoughts instead of negative ones might sound easy, reality is much different. It takes conscious effort and consistent work to be effective and the result might take a long time to show. These small steps may not appear to be much, but they can in fact help with managing anxiety. They aid in confronting the issue head first rather than avoiding it, which is a key symptom of anxiety (Treating anxiety, 2016). This is important because in the long term, consistent avoidance will worsen an individual’s overall sense of anxiety.  When the mind looks at a situation, it decides that avoidance is better than handling it in a calm, rational manner. This brings short term relief to the person, potentially causing more stress than before (Treating anxiety, 2016). The more a situation is avoided and the more frequently it is done, the amount of anxiety associated with the situation will subsequently increase. CBT might be difficult in the moment, requiring the individual to manage their triggers and actively think about handling the situation. However, it can improve overall health, serving to lessen the stress from anxiety in the future.

Being proactive and taking small and consistent steps is the key to managing anxiety with CBT in mind. While therapy is relatively short-term, with individuals reporting improvement within eight to ten therapy sessions, the practices themselves must be done daily and effort must be expended to combat negative thoughts or behaviors (Smith et al., 2020). Even if the time or resources are not available to see a therapist or medical professional to discuss CBT, practicing the basic ideology might be a good step towards progress. Whether it be a journal for your thoughts and feelings, a step-by-step plan for how to tackle a problem, or simply an activity to help you destress at difficult times, it’s important to have methods to manage your symptoms, turning the moment from a potential source of worry to a situation you have at least some control over. With time and some effort, your levels of anxiety will decrease, and you will find yourself handling anything thrown your way.

 

References

Facts & statistics: Anxiety and Depression Association of America, ADAA. (n.d.). Retrieved March 22, 2021, from https://adaa.org/understanding-anxiety/facts-statistics

Hunley, S. (2019, September 12). Cbt for anxiety – cognitive behavioral therapy for anxiety. Retrieved March 22, 2021, from https://www.anxiety.org/what-is-cognitive-behavioral- therapy-cbt

Smith, M., Segal, R., & Segal, J. (2020, September). Therapy for anxiety disorders. Retrieved March 22, 2021, from https://www.helpguide.org/articles/anxiety/therapy-for-anxiety- disorders.htm

Treating anxiety with cbt (guide). (2016, April 18). Retrieved March 22, 2021, from https://www.therapistaid.com/therapy-guide/cbt-for-anxiety

Categories
Schizophrenia

Hallucinations in Schizophrenia

We often see pop artists refer to themselves as “delusional” in songs about lost love or characters in mainstream shows saying to one another, “You’re just hallucinating, that never happened,” blurring the line between imagination and disordered psychosis. While a person imagining is aware that their occurring thoughts are “just thoughts,” it is difficult for people with schizophrenia to tell a psychotic episode apart from reality. Positive symptoms of psychosis are not usually present before the onset of the disorder, such as delusions and hallucinations. Delusions are false beliefs or thoughts, whereas hallucinations are usually in the form of seeing or hearing things when there is no such stimulus present. They are two of the most common symptoms of schizophrenia. Approximately 70% of individuals with schizophrenia experience them, especially hearing voices (Hugdahl et al, 2008), but not everyone is distressed by them or feels the need to seek help. The fact that these experiences feel so real to the patients and that they are covert and idiosyncratic, which may factor into the difficulty of diagnosing schizophrenia. 

Scientists have been trying to explain what is happening to people’s brains when they experience auditory hallucinations. One study used functional magnetic resonance imaging, or fMRI, to scan the patients’ brain activity, then later asked them to report whether they experienced hallucinations during each interval of scanning. They found that multiple areas of the brain, including the inferior frontal/insular, anterior cingulate, temporal cortex bilaterally, right thalamus and inferior colliculus, and the left hippocampus and parahippocampal cortex, were active when the patients reported hearing voices (Shergill et al, 2000). Another study used the dichotic listening test to present two consonant-vowel syllables simultaneously, one in each ear and had the participants report the syllable identified best on each trial. The results demonstrated that there is an inverse relationship between auditory hallucinations and right ear performance, which suggests that “auditory hallucinations interferes with the perception of an externally presented speech sound, localized to the left temporal lobe” (Hugdahl et al, 2008).

Many people with schizophrenia shared their unique experiences with hallucinations in interviews. According to healthtalk.org, one patient, Nikki, described the voices she heard as coming from multiple different people simultaneously, known or unknown. Other patients, Lucy and Emily, recalled that the voices were persecutory, persuading them into self-harm or even suicide. Although auditory hallucinations are common among people with schizophrenia, some people experience visual hallucinations more, such as Joe, who has experienced hallucinations about hurting his loved ones. For some patients, auditory and visual hallucinations can go hand in hand, as seen in Dominic’s case, where he visualized hurting others and heard voices commanding him to do so. Each of these accounts of experiencing hallucinations is covert and distinct in each person’s case. Unless the patients themselves or the people around them realize that what they are struggling with is a serious psychological disorder, it is difficult for the patients to receive professional intervention. 

Even though researchers cannot pinpoint the exact cause of hallucinating episodes for each person yet, they have identified a few possible factors. Environmental and genetic dispositions may trigger the onset, as well as life stressors. With these discoveries, scientists have then come up with rehabilitation methods for patients with schizophrenia. For example, psychosocial therapy is a widely used treatment method to help patients cope with stress and establish a support system within the patient’s family to reduce the chances of relapse. Overall, though hallucinations are very pervasive, they can be controlled with the right interventions. 

 

References

Felix Torres (2020). What Is Schizophrenia? American Psychiatric Association. 

Psychosis (young people). Healthtalk.org.

Hugdahl, K., Løberg, E. M., Specht, K., Steen, V. M., van Wageningen, H., & Jørgensen, H. A. (2008). Auditory hallucinations in schizophrenia: the role of cognitive, brain structural and genetic disturbances in the left temporal lobe. Frontiers in human neuroscience.

Shergill SS, Brammer MJ, Williams SCR, Murray RM, McGuire PK. (2000). Mapping Auditory Hallucinations in Schizophrenia Using Functional Magnetic Resonance Imaging. Arch Gen Psychiatry. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/481670