Schizophrenia Stephanie Renee Huston PSY 326 Research Methods Instructor: Keisha Keith 11/23/2015

Schizophrenia
Introduction
Schizophrenia is a serious brain disorder that gives a misleading or false account of the way a person thinks, behave, communicate their feelings, realize or understand, and relates to others. Schizophrenia has been considered as one of many chronic and disabling conditions for people that suffers with a major mental illness. People with schizophrenia often have problems fulfilling a task in the general population, at work, at school, and in relationships leaving an individual not wanting to communicate with other people and frightened. Schizophrenia suffers will live with it the rest of their life, it cannot be cured but treatments are available and controllable with proper and advance treatments. Contrary to popular belief, schizophrenia is not a split or multiple personality. Schizophrenia is a psychosis, a type of mental illness in which a person cannot tell what is real from what is imagined. In writing this paper on Schizophrenia I will show how popular belief, has an antithesis of what is really Schizophrenia? Is it really a split or multiple personality or a psychosis considered by popular belief? I will introduce why Schizophrenia was chosen as my research topic, and the field of studies of the process methods used to regulate and control schizophrenia as a disease. Schizophrenia has been considered as one of many chronic and disabling conditions for people that suffers with a major mental illness.The article and research about the everyday life that an individual goes through that suffers from this chronic and disabling condition. Not being able to control their own thoughts and feelings not in the world of reality but that of the mental illness. Schizophrenia is a lonely and frightening illness, data says that 10 percent of people with schizophrenia commits suicide. Sad world even though there are many treatments and drugs that are being used to help these individuals some just can’t cope with the situation (Funk & Wagnall’s 2014).
Literature Review: About 1 percent of the world’s population is affected with this mental illness. Schizophrenia affects men and women equally. It occurs at similar rates in all ethnic groups around the world. Symptoms such as hallucinations and delusions usually start between ages 16 and 30. Men tend to experience symptoms a little earlier than women. Most of the time, people do not get schizophrenia after age 45. Schizophrenia rarely occurs in children, but awareness of childhood-onset schizophrenia is increasing. It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a change of friends, a drop in grades, sleep problems, and irritability—behaviors that are common among teens. A combination of factors can predict schizophrenia in up to 80 percent of youth who are at high risk of developing the illness. These factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In young people who develop the disease, this stage of the disorder is called the "prodromal" period (Nicolson, Lenane, Hamburger, Fernandez, Bedwell, & Rapoport). Genes and environment is one of several factors that experts believe that causes schizophrenia. Scientists have long known that schizophrenia runs in families. The illness occurs in 1 percent of the general population, but it occurs in 10 percent of people who have a first-degree relative with the disorder, such as a parent, brother, or sister. People who have second-degree relatives (aunts, uncles, grandparents, or cousins) with the disease also develop schizophrenia more often than the general population. The risk is highest for an identical twin of a person with schizophrenia. He or she has a 40 to 65 percent chance of developing the disorder (Harrison, &Weinberger, 2005).
Because the causes of schizophrenia are still unknown, treatments focus on eliminating the symptoms of the disease. Treatments include antipsychotic medications and various psychosocial treatments. Antipsychotic medications have been available since the mid-1950. The older types are called conventional or "typical" antipsychotics. Some of the more commonly used typical medications include: Chlorpromazine (Thorazine), Haloperidol (Haldol), Perphenazine (Etrafon, Trilafon) and Fluphenazine (Prolixin). In the 1990's, new antipsychotic medications were developed. These new medications are called second generation, or "atypical" antipsychotics.
One of these medications, clozapine (Clozaril) is an effective medication that treats psychotic symptoms, hallucinations, and breaks with reality. But clozapine can sometimes cause a serious problem called agranulocytosis, which is a loss of the white blood cells that help a person fight infection. People who take clozapine must get their white blood cell counts checked every week or two. This problem and the cost of blood tests make treatment with clozapine difficult for many people. But clozapine is potentially helpful for people who do not respond to other antipsychotic medications. Psychosocial treatments can help people with schizophrenia who are already stabilized on antipsychotic medication. Psychosocial treatments help these patients deal with the everyday challenges of the illness, such as difficulty with communication, self-care, work, and forming and keeping relationships. Learning and using coping mechanisms to address these problems allow people with schizophrenia to socialize and attend school and work.
Patients who receive regular psychosocial treatment also are more likely to keep taking their medication, and they are less likely to have relapses or be hospitalized. A therapist can help patients better understand and adjust to living with schizophrenia. The therapist can provide education about the disorder, common symptoms or problems patients may experience, and the importance of staying on medications. (Gogtay, & Rapoport, 2008). It is really sad that in the world of Pharmacotherapy there many medications that are supposed to help but can also harm and leave a person with many side effects.
One of the most common misconceptions about schizophrenia is that it is “split personality,” which is completely false. The word “schizo” does mean “split,” but Eugen Bleuler, who coined the term schizophrenia in 1920s was describing the rupture in the person’s thinking process and emotional response. Psychiatrists consider “thought disorder” to be one of the hallmarks of schizophrenia and more specific to schizophrenia than auditory hallucinations or paranoid delusions, which can occur in other psychiatric disorders. Multiple personality is an old term for what is now officially called “dissociative identify disorder,” or DID. It is characterized by the presence of two or more distinct identities, which recurrently take control of the person’ behavior. Persons with DID are often unable to recall important personal information, and this memory loss is too extensive to be explained by ordinary forgetfulness, and is not due to alcohol intoxication( blackouts) or a medical disorder such as epilepsy. While it is possible for an occasional schizophrenia patient to exhibit symptoms of DID, the vast majority do not. It is well-known that schizophrenia, which is a pervasive brain disease, may result in symptoms of other psychiatric disorders such as depression, anxiety or obsessive compulsive disorder. However, after treating thousands of people with schizophrenia according to (May, 2008) Schizophrenia Does Not Mean Spilt Personality? He could only recall one individual who fulfilled the diagnostic criteria for DID within the 25 years of his work and studies.

METHODS
Designs:
In a quasi-experimental design, subjects are not randomly assigned to treatment; there is no randomization. Like experimental designs, quasi- experimental designs may be improved by the use of a control group, measuring moderators and incorporating them into the analysis, or matching participants on factors that relate to be measured outcomes. In a quasi-experiment design, the researcher lacks control over the assignment to condition and/ or does not manipulate the casual variable of interest. A quasi- independent variable is not manipulated by the researcher but rather is an event that occurred for other reasons (Gliner & Morgan, 2000). One type of quasi-experimental research design is the time series design, in which many observations are made overtime, both without intervention and with intervention (Gliner & Morgan, 2000). For instant several observations are used to establish a baseline that shows a strong level of the outcome of interest over time. In week 2 discussion when we were ask to develop a drug for schizophrenia this is similar in our research. Multiple observations are made during intervention, showing a change due to intervention. Then the treatment may be withdrawn, again in an attempt to isolate the relationship of treatment to observe outcome. This could be used with or without a control group.
Participants:
When comparing and identifying the methods of schizophrenia in different groups of participants there were 72 middle-aged and older frail individual living with schizophrenia or schizoaffective disorder in a community dwelling. Within those 72 participants Fifty-eight of them were randomly enrolled in a clinical trial where the ability and intent was to produce a desired or intended results of psychosocial skills-based interventions for improving functioning in those diagnosed with a schizophrenia. The remaining 14 met the same inclusion criteria although they were not enrolled in the randomized clinical trial. There were some participants at the age of 35 years of age, with a chart Diagnostic and Statistical Manual of Mental Disorders (4th American Psychiatric Association, 1994) diagnosis of schizophrenia or schizoaffective disorder, and were psychiatrically stable. The participants were older, not the most disturbed or disabled among people with schizophrenia, and were voluntarily participating in an intervention study; therefore, the sample may not be representative of the general schizophrenia population. If the participants were diagnosed with dementia, thought to be high risk for suicide, could not continue with and complete the assessment battery, or have been or currently a participate in another psychosocial intervention or drug research at the time of intake they were dismissed from the studies and not used. The studies of all the patients was approved by the University of California, San Diego, and Alliant International University institutional review boards, and all participants provided written, informed consent prior to participating. Procedure/Measures:
Within the method study protocol of defining ways to use skills-based interventions for determining what would be helpful in functioning in those diagnosed with schizophrenia, several primary study measures were addressed. Performance-based measures of everyday and social functioning: Everyday living skills were assessed with the UCSD Performance-Based Skills
Assessment (UPSA; Patterson, Goldman, McKibbin, Hughs, & Jeste, 2001). This skill is to performance-based measure of functional capacity designed for use with the severely mental ill and assesses functioning through a series of role plays in five domains: planning/organization, finances, communication skills, transportation, and household chores. By using props (e.g., telephone, bus schedule) and skills that an individual without a mental illness uses everyday these particular props and skills will aid in allocating the participates in society In this article, we discuss some of the challenges associated with the measurement of functional outcome among severely mentally ill individuals living in the community, describe the limitations of previous approaches to measuring outcomes, argue for the inclusion of performance-based outcome measures, and present preliminary data on the development of a new performance-based measure. There are at least five approaches to measuring outcomes in terms of everyday functioning: (1) self-reports, (2) proxy (e.g., confidant, caregiver) reports, (3) clinician ratings, (4) direct observations of behavior in settings where patients live, and (5) performance-based measures that utilize tasks in clinical settings(Patterson, Goldman, McKibbin, Hughs, & Jeste, 2001).
According to (Greig, Zito, Wexler, Fiszdon, & Bell; 2007). Schizophrenia Research Article rehabilitation emphasizes social and vocational training to help people with schizophrenia function better in their communities. Because schizophrenia usually develops in people during the critical career-forming years of life (ages 18 to 35), and because the disease makes normal thinking and functioning difficult, most patients do not receive training in the skills needed for a job. Rehabilitation programs can include job counseling and training, money management counseling, help in learning to use public transportation, and opportunities to practice communication skills. Rehabilitation programs work well when they include both job training and specific therapy designed to improve cognitive or thinking skills. Rehabilitation programs can include job counseling and training, money management counseling, help in learning to use public transportation, and opportunities to practice communication skills.
Rehabilitation programs work well when they include both job training and specific therapy designed to improve cognitive or thinking skills. Programs like this help patients hold jobs, remember important details, and improve their functioning. Although relatively uncommon in health care research, qualitative research is now receiving recognition and is increasingly used in health care research with social and cultural dimensions. Unlike quantitative research, which is deductive and tends to analyze phenomena in terms of trends and frequencies, qualitative research seeks to determine the meaning of a phenomena through description. It aims to develop concepts that aid in the understanding of natural phenomena with emphasis on the meaning, experiences and views of the participants. The aim is not to act as a practical guide on how to conduct qualitative research, but is an attempt to give an introduction to qualitative research methods and their use in health-related issues (Chenail, R. J. 2011).
Data Analysis
Penny Farrelly looks at quantitative research methods, including: Surveys, structured and semi- structured interviews, experiments, quasi-experiments and randomized controlled trials. By using these merits and uses of quantitative research methods it will help to understand broad questions that are ask and the collection of word data from participants. The researcher looks for themes and describes the information in themes and patterns exclusive to that set of participants, not necessarily with a view to generalizing those finding to a wider population. Conversely, a quantitative researcher ask a specific, narrow question and collects numerical data from participants to answer the question. The researcher analyses the data with the help of statistics and hopes the number will yield an unbiased results that can be generalized to a larger population. Depending upon the desired outcome of the research, social scientists may choose between quantitative or qualitative designs. Since they seek to explain events from different perspectives, both are valid ways to evaluate a phenomenon in the proper context. By examining the current situation, the research question, and the critical factors of each design, the researcher can make a more informed choice and enhance both reliability and validity of the study (Farrelly, 2013). Ethical Issues
With all the treatment and studies that is developing every day we still have to be aware of the ethical issues of the individuals that suffers with this disease . The article importance or moral sensitivity when including persons with dementia in qualitative research, Nursing Ethics, (Heggestad, A., Nortvedt, P. & Slettebo, A. 2013). Best describes the important issues is the understanding of schizophrenia and within the field of psychiatry. There are many issues from the past years that have not been resolved. Ethical concerns about schizophrenia research have been raised, for the most part because of concerns about how participants are treated. Today researchers must abide by basic ethical norms and behavior when conducting experiment and research. There is a lot to take in consideration; especially the undo harm of the human or individual doing the study. Clinicians who treat patients with schizophrenia may encounter a variety of ethical issues related to both psychiatric and medical treatment of patients. While informed consent is a crucial aspect of the care of all patients, it may present special challenges for patients with schizophrenia. Schizophrenia is a severe mental illness that is frequently accompanied by neuro psychological deficits. These impairments as well as psychotic symptoms and lack of insight, can affect patients’ abilities to make fully informed decisions about their own care. Ensuring that consent for treatment is informed, voluntary, and competent can thus become a more difficult endeavor. The ethical principles underlying treatment of these patients, however, are the same as those guiding treatment of all patients. Informed consent, as an embodiment of these ethical principles, represents the expression of individual rights in both clinical and research contexts. Attention to the process of informed consent as an ongoing dialogue strengthens the clinician-patient relationship, improves adherence, and help the patient clarify options, values, and preferences. In the researched setting, psychiatric researchers are increasingly concerned with maximizing the abilities of individuals with severe mental illness such as schizophrenia to provide meaningful informed consent for protocols. This review addresses decision-making abilities of people with schizophrenia in both treatment and research contexts.
Conclusion
The outlook for people with schizophrenia continues to improve. Although there is no cure, treatments that work well are available. Many people with schizophrenia improve enough to lead independent, satisfying lives. Continued research and understanding in genetics, neuroscience, and behavioral science will help scientists and health professionals understand the causes of the disorder and how it may be predicted and prevented. This work will help experts develop better treatments to help people with schizophrenia achieve their full potential. Families and individuals who are living with schizophrenia are encouraged to participate in clinical research. In conclusion while primarily focusing on the research study and literature review, the methods used, the results and a discussion was presented. Coping with Schizophrenia is not an easy task to deal with as an individual. Caring for a person that suffers from schizophrenia is considered a hard task and can be considered mentally draining. Millions of people suffer with this disorder every day, and many researchers are coming up with advance treatments to help if not all but part of this crippling disease of the mind, body and soul. Control it day by day. The behavior of people with schizophrenia may be very strange and even shocking. On the contrary People with schizophrenia can take an active role in managing their own illness.
Once patients learn basic facts about schizophrenia and its treatment, they can make informed decisions about their care. If they know how to watch for the early warning signs of relapse and make a plan to respond, patients can learn to prevent relapses. Patients can also use coping skills to deal with persistent symptoms. It is important that family members know as much as possible about the disease. With the help of a therapist, family members can learn coping strategies and problem-solving skills. In this way the family can help make sure their loved one sticks with treatment and stays on his or her medication. Families should learn where to find outpatient and family services.

References:

Chenail, R. J. (2011). How to conduct clinical qualitative research on the Patient’s Experience. The qualitative report, 16(4).Retrieved from: EBSCOhost.Com proxy .library
Farrelly, P. (2013). Choosing the right method for a quantitative study...fourth article of a series .British Journal of School Nursing, 8(1), 42-44 3p. Retrieved from: EBSCOhost.Com proxy .library
Funk & Wagnall’s (2014). Schizophrenia: New World Encyclopedia (1p.) Retrieved from: EBSCOhost.Com proxy .library
Gogtay N and Rapoport J. Clozapine use in children and adolescents. Expert Opinion on Pharmacotherapy. 2008; 9(3):459-465.
Gliner, A. J., & Morgan, G. A. (2000). Research Methods in Applied Setting: An Integrated Approach to Design and Analysis. Mahwah, N.J: Lawrence Erlbaum. Greig TC, Zito W, Wexler BE, Fiszdon J, Bell MD. Improved cognitive function in schizophrenia after one year of cognitive training and vocational services. Schizophrenia Research. 2007 Nov; 96(1-3):156-161.
Harrison PJ and Weinberger DR. Schizophrenia genes, gene expression, and neuropathology: on the matter of their convergence. Molecular Psychiatry. 2005; 10(1):40-68.
Heggestad, A., Nortvedt, P. & Slettebo, A. (2013). The importance or moral sensitivity when including persons with dementia in qualitative research, Nursing Ethics, 20(1), 30-40. Retrieved from: EBSCOhost.Com proxy .library
May, A .C .W. (2008). Schizophrenia Does Not Mean Spilt Personality? Nature. January 10, 2008, Vol, 451 issue7175, p127, 1p. Retrieved from: EBSCOhost.Com proxy .library
Newman, M. (2011).Research methods in psychology. San Diego, CA; Bridgepoint Education, Inc.
Nicolson R, Leanne M, Hamburger SD, Fernandez T, Bedwell J, Rapoport JL. Lessons from childhood-onset schizophrenia. Brain Research Review. 2000; 31(2-3):147-156.
Patterson, T. L., Goldman, S., McKibbin, C. L., Hughs, T., & Jeste, D. V. (2001). USCD performance-based skills assessment: Development of a new measure of everyday functioning for severely mentally ill adults. Schizophrenia Bulletin, 27(2), 235-245. Retrieved from EBSCOhost.Com proxy .library