Rasmussen College Psychotic Disorders Psychopathology and Counseling Paper

Question Description

Predictors of the Development of a Psychotic Disorder

As a social worker, it is important to look at a clients family history, demographics, past treatments, and background. A research article, by author Young et al., (2004) illustrated that there are few known factors that predict having psychosis symptoms. Their research demonstrated that ones family history of psychic symptoms can be a risk factor to predict having a psychotic disorder. Another predictor these authors discussed is a decrease in life functioning skills, which they found can lead to psychotic disorders.

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As social workers, we need to examine our clients individually and their symptoms. We need to focus on their strengths and identify areas of growth. It is essential for social workers to be ethically and culturally sensitive while reviewing clients psychotic symptoms and disorders. Researcher, Padma (2014) studied the difference between people experiencing psychotic symptoms in different countries. Padma concluded the social and cultural context effect the person experiencing the disorder. This is important information for social workers to have while working with patients experiencing mental health disorders. Being culturally sensitive and learning how ones family and cultural background impact their condition is critical. From a social work perspective, it is necessary to look into the context of ones family history and childhood upbringing. Looking at ones demographics will give the social worker an insight into what the patient is experiencing and why.

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Compelling Hypothesis

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Robin Murrary discussed his experiences working in psychiatry and how there are few rock solid answers in what schizophrenia is and how it is diagnosed. Mr. Murray discussed how it has not been proven schizophrenia is biological and genetic. Mr. Murray states how he wishes schizophrenia was viewed and diagnosed on a continuum, similar to how weight is viewed. After reading the materials, I find Mr. Murrays hypotheses are most compelling because viewing prognosis of schizophrenia on a spectrum helps to not stigmatize the symptoms and explains the symptoms in a way individual will comprehend (Murray, 2013).

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Social Works Role in Services

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After reading and analyzing the class readings I saw common theme so miscommunication between providers, and insurance coverage issues causing obstacles to client care. Client want strength based, and patient center care but not all providers are educated that way like social workers are trained. Authors, Lietz et al., (2014) discussed the importance of recognizing the impact providers have of limiting their patients self-sufficiency and self-esteem can have on their recovery and treatment. When a provider tells a patient, they are going to need medication forever this is an example of limiting a clients ability to have control of their care and esteem. One micro effect of miscommunication on services between providers is a patient will get too much different information, impacting their treatment negatively. Providers dont communicate or have different ideas of recovery this can impact their clients successes. One macro effect of this is hospitals having less room for patients due to clients not recovering and being discharged than returning to the hospital. This can cause hospitals to limit the length of stays at the hospital if they dont have enough room for their patients.

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References

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Lietz, C., Piel, M., Lacasse, J., & Chueng, J. (2014). The role of services in mental health.

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Recovery. J ournal of the society for social work and research, 5 (2).

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Murray, R. (2013). 100 years of schizophrenia enough. Youtube.

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Padma, T.V. (2014). Developing countries: the outcome paradox. Nature, 508, 1-4.

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Yung, A., Philips, L., Yuen, H., & McGomery, P. (2004) Risk factors of psychosis in an ultra high risk group: psychology and clinical features. Schizophrenia research, 67 (2), 131-142.

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Angelina Abbate

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Mar 18, 2021 at 4:52 PM

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Predictors of a psychotic disorder

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The ability to identify predictors of a psychotic disorder early on could be important for the overall progression of the illness. Looking throughout childhood is an important place to start, as there are some predictors that could show young and result in a diagnosis later in life. Some early predictors include problems in social adjustment around the ages of five or six, emotional symptoms at school age, and severe neurobiological symptoms. It is crucial to start looking at these predictors before school age, especially in children whose parents have been diagnosed with a psychotic disorder, as the most likely to be noticed predictor is the problems with social adjusting around five years old (Niemi et al., 2005).

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Prognosis

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One would think that the more developed countries have better outcomes when it comes to illnesses and diseases, and they would typically be right. But Padma (2014) explains that that may not be the case when it comes to schizophrenia. When comparing outcomes from developing countries, like India, and already developed countries like the United States or the United Kingdom, India’s outcomes are most successful. Despite the limited resources compared to other nations, it is believed that potentially a slower pace in rural life could be what is benefiting the schizophrenia outcomes. A more relaxed lifestyle could help with lessening the stressors put on people that could escalate their symptoms. Another potential part that could play a role in the better outcomes is the implementation of yoga. Yoga is a widely used practice in India, which has shown to have beneficial effects on this disorder. Physical exercise and exercise of the mind can help with the symptoms of schizophrenia, which are both parts of a practice like yoga. Implementing yoga into ones daily routine could have eased the symptoms of schizophrenia (Padma, 2014). I find this hypothesis regarding a slower-paced life and implementing a practice like yoga to be fascinating. It is not something you think about daily, that something so simple could help, but these theories have shown it is possible. All the hypotheses out there indicate that clearly, there is no definite answer on the prognosis of schizophrenia and that any one factor could be playing a part.

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Obstacles to providing help

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Providing services to our clients to overcome mental illness is an integral part of our jobs as social workers, yet there still are some barriers to providing that help. Clients have previously expressed concerns of oppression from the diagnosing process, trouble with their interaction with clinicians, and generally not being heard by their providers. Recovery-orientated services were called to be adopted in 2003, which is a strengths-based approach that supports client empowerment. But, clinicians have not fully embraced this, and it is still not as widely used as necessary to help make a significant change. At a micro level, clinicians have had problems with moving towards this model as they do not want to give clients false hope. Most clients clinicians see those who have not yet recovered, so they may not see recovery as possible. Those who are recovered are most likely not seeing a clinician currently, so the clinicians’ views can be skewed. At the Macro level, the social work field as a whole needs to adopt this recovery model in order to help those at the micro-level (Lietz et al., 2014). Mainly, clinicians need to be willing to help their clients in the ways recommended to best help them and know that recovery is possible. A good client-clinician relationship is necessary for good work to be done, and that is impossible if a client is not being given the level of service they need.

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References

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Lietz, C. A., Lacasse, J. R., Hayes, M. J., & Cheung, J. (2014). The Role of Services in Mental Health Recovery: A Qualitative Examination of Service Experiences Among Individuals Diagnosed with Serious Mental Illness. Journal of the Society for Social Work and Research, 5(2), 161-188. doi:10.1086/675850

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Niemi, L. T., Suvisaari, J. M., Haukka, J. K., & Lönnqvist, J. K. (2005). Childhood predictors of future psychiatric morbidity in offspring of mothers with psychotic disorder. British Journal of Psychiatry, 186(2), 108-114. doi:10.1192/bjp.186.2.108

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Padma, T. V. (2014). Developing countries: The outcomes paradox. Nature, 508(7494). doi:10.1038/508s14a

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Ayana Archer

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Mar 18, 2021 at 9:07 PM

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discussion 2021.docx Psychosis predictors

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There are several predictors that can be used to identify the development of psychosis. These predictors range from social factors to biological factors. In 100 Years of Schizophrenia- Is This Enough?” Murray (2012) reveals that voting patterns can be used as predictors for psychosis. He uses North and South London as an example due to their differences in voter turnout. While South London is densely populated, fewer people take part in the voting process. This is because they feel insecure and are sceptic about their environment. Consequently, Murray (2012) says that social conditions, such as unemployment and insecurity, are significant contributors to psychosis.

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Sterzer et al. (2018) say that genetic factors are also a significant contributor to psychosis and other mental conditions. They note that children whose parents have schizophrenia are ten times more likely to experience the condition. Additionally, family relationships are equally an important predictor of psychosis. This is because people exposed to recurring family wrangles and violence are more prone to psychosis as they are more sensitive to such factors. The Department of Health (2007) mentions stress as another predictor for schizophrenia. Notably, stress, anxiety, and difficulties in concentration precede the onset of schizophrenia. Lastly, Murray says that drug consumption makes one susceptible to psychosis. People using alcohol and cannabis are more likely to suffer psychosis.

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The paradox when assessing prognosis in schizophrenia.

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According to Padma (2014), there is a great paradox in the prognosis of schizophrenia. He says that while doctors in developed countries have better outcomes in testing and treating diseases, schizophrenia conveys different results. The World Health Organization in the 1960s was the first to identify this phenomenon in a study conducted in Sri Lanka and Mauritius. The study found out that patients in less developed countries experienced lower rates of hallucinations and delusions; they had less disorganized speech and were more active members of society. Similar studies by the IPSS in three developing countries and six developed countries established more compelling evidence. IPSS found high success rates for psychosis patients in poorer countries compared to their counterparts in developed nations.

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Parmanand Kulhara (2009), who was skeptical of the findings, conducted his research only to get similar findings. This success rate has explained by the high integration of psychosis patients into society in developing nations compared to developed countries. Notably, the literature review identifies that patients are more likely to recover from schizophrenia if society accepts and treats them with dignity. This is contrary to Developed countries where schizophrenic people are stigmatized and secluded from society.

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Role of Services in treating Mental illnesses.

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Lietz et al. (2014) reveal that the social worker plays a significant role in patient recovery. The study reveals that the form of treatment, largely defined by social aspects, will determine if a patient will recover or not. They establish self-determination, hope, self-esteem, and individualized and humanizing approach as critical components for patient recovery. However, a couple of challenges might hinder the healthcare attendant from offering this kind of treatment.

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One, an individualized form of treatment requires significant resources in terms of time and money. The social worker must take enough time to understand the patient’s background before developing an appropriate treatment program for them. Besides, such treatment might call for other varied tests and procedures, including biological examinations, which inflates the cost of treatment. Government facilities have many patients and few attendants, thus making it more difficult to offer individualized treatment. Additionally, many social workers lack the appropriate training and education to help them develop such a treatment program. This challenge can be attributed to the inefficient curriculum used to train mental health workers.

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References

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Lietz, C. A., Lacasse, J. R., Hayes, M. J., & Cheung, J. (2014). The role of services in mental health recovery: A qualitative examination of service experiences among individuals diagnosed with serious mental illness. Journal of the Society for Social Work and Research, 5(2), 161-188.

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Padma, T. V. (2014). Developing countries: The outcomes paradox. Nature, 508(7494), S14-S15.

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Robin Murray (2013). 100 Years of Schizophrenia: Is This Enough? https://www.madinamerica.com/2013/03/100-years-of-schizophrenia-is-this-enough/

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Sterzer, P., Adams, R. A., Fletcher, P., Frith, C., Lawrie, S. M., Muckli, L., … & Corlett, P. R. (2018). The predictive coding account of psychosis. Biological psychiatry, 84(9), 634-643.

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The Department of Health (2007). What causes schizophrenia? https://www1.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-w-whatschiz-toc~mental-pubs-w-whatschiz-cau

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Abby Boston

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Mar 18, 2021 at 10:43 PM

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Predictors

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When evaluating the predictors of a psychotic disorder, social work professionals should embrace all of the information available while working with a client. Social workers should note family history, socioeconomic demographics, the clients environment, their mental health history/treatment, recent and past trauma, substance abuse involvement, and the social norms in which they live. Montemagni and colleagues discuss different predictors for psychosis to include clinical, biological, neurocognitive, and environmental (2020). Like many other studies we covered throughout this course, there is no one way to predict a psychotic disorder best. Montemagni and colleagues suggest focusing on symptomatology and functioning is a good predictor of a psychotic disorder (2020). Meaning evaluating positive symptoms, bizarre thinking, sleep disturbances, a schizotypal disorder, level of functioning in the past year, and years of education. A study with 81.1% positive predictive validity consisted four variables which include disorganized communication, suspiciousness, verbal memory de?cits, and decline in social functioning during follow-up (Montemagni et al., 2020). In relation to the clients disorganized communication, their language may harbor signs of future mental illness, one study advises (Rezaii, Walker, and Wolff, 2019). The study discovered the appearance of psychosis was foreseen by speech with low levels of semantic density and an amplified propensity to talk about voices and sounds (Rezaii et al., 2019). When combined, these two predictors allow for a high level of accuracy when predicting psychosis.

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Compelling Hypotheses

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Murray discusses how 9% of the population has reported psychotic experiences or beliefs, but most of these experiences or beliefs were not problematic of the individual (Mad in America, 2013). Murray advises that research indicates there is no distinct schizophrenia but suggests there is a continuum of psychosis. Research has not documented or noted a social, genetic, or imaging link between an individual and psychosis (Mad in America, 2013). Murray looks to destigmatize psychosis, indicating not all individuals who experience psychosis are problematic or are a stain on society, as many people believe.

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Although most patient outcomes in more developed countries are increased when evaluating most diseases, when patients are diagnosed with schizophrenia, there appears to be a difference (Padma, 2014). Studies have discovered that the socio-cultural environment in developing countries has a higher dependence on family members for care and support and better social support and social networking (Padma, 2014). Individuals in rural areas also have improved outcomes (Mad in America, 2013). With these positive outcomes in developing countries, they have also researched the practice of yoga. Yoga has shown encouraging outcomes for patients with schizophrenia. Padma (2014) discusses that both psychotherapy and physical exercise, which includes mindfulness techniques, can lessen the symptoms of schizophrenia.

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Social Work

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When working with clients with severe mental health disorders, one would assume some of the most critical functions of a clinician would be no-brainers, but studies have found not all clinicians are following the strengths-based approach. Clients report the following characteristics facilitated the process of recovery: establishing safety, facilitating self-determination, offering individualized treatment, foster hope, provide validation, promote positive self-esteem, and peer support (Lietz, Lacasse, Hayes, & Cheung, 2014). On a micro level, clients want that individualized care and treatment. Often mental health is seen as a revolving door of just pushing clients out and not providing genuine individualized care for each client. Embracing the aspects identified by Lietz and colleagues create an environment where clients can have positive outcomes. Those outcomes can also change the way society views mental health and the stigma surrounding it. I believe the micro and macro level obstacles are intertwined as one impacts the other. On the macro level, there needs to be a change in the way clinicians are practicing as a whole. Best practices should be enforced and promoted to ensure to best possible care for clients. Clinicians who refuse to incorporate the strengths-based approach into treating mental health disorders are only creating a deeper wedge. As social work professionals, it is crucial to embrace these approaches, stay apprised of developing research, and educate others when deficiencies are witnessed.

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References

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Mad in America. (2013, March). Robin Murray- 100 years of schizophrenia: Is this enough? [Video]. https://www.madinamerica.com/2013/03/100-years-of-schizophrenia-is-this-enough/

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Montemagni, C., Bellino, S., Bracale, N., Bozzatello, P., & Rocca, P. (2020, March). Models predicting psychosis in patients with high clinical risk: A systematic review. Front Psychiatry, 11(223). https://doi/org.10.3389/fpsyt.2020.00223

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Padma, T. V. (2014, April). Developing countries: The outcome paradox. Nature, 508 (S14-S15). https://doi.org/10.1038/508S14a

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Rezaii, N., Walker, E., & Wolff, P. (2019). A machine learning approach to predicting psychosis using semantic density and latent content analysis. npj Schizophrenia, 5(9). https://doi.org/10.1038/s41537-019-0077-9

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Brittany Best

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Mar 18, 2021 at 10:53 PM

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Predictors of a psychotic disorder

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There are several predictors that amplify the risk of developing a psychotic disorder. Some of these predictors are genetics, drug use, diagnosis of schizotypal personality disorder and environmental factors such as culture or stressors (Yung & McGorry, 2007). It is difficult to determine which factors are the strongest predictors of psychosis because no one truly knows what causes psychotic disorders. Even if an individual is strongly, genetically predisposed to develop a psychotic disorder they may not if they possess reliance, or if their environment offers protective factors (2007). It appears that many factors need to align for an individual to develop a psychotic disorder (2007). In some instances, it feels like a roll of the dice.

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Hypotheses on schizophrenia

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I learned that there is much to discover about the schizophrenia spectrum and the outcomes of individuals diagnosed. I found it difficult to read through research articles because the language used in the articles was unclear and flimsy. I could not find a definite answer anywhere. Within the articles that I read this module, the hypothesis that struck me as the most interesting was that patients who reside in countries where there is a greater emphasis on family and social support have fewer cases of schizophrenia as well as better outcomes for those who have been diagnosed with schizophrenia (Padma, 2014). Within these countries, there is less focus on individualism (2014). Interestingly, these cultural values are often correlated with poorer, or less developed countries (2014). This may be because of the less rigid nature of rural life or because of the greater availability of employment and marriage in these poorer countries (2014). The statement that individuals with schizophrenia may fare better in instances where there is a less rigid nature of life resonated with me because my sister has been diagnosed with schizophrenia. My family has always said that she would be happy with a simple life, free to wander and stay close to the beach. I truly believe that my sister would have better outcomes if she had a slower pace of life with less demands and stressors. In developed nation the individual demands are high. Individuals who exhibit socially unacceptable behaviors are stigmatized, ostracized and strongly encouraged to be medicated into a functional state in order to maintain employment, pay bills and survive the fast pace of life.

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Obstacles to providing helping

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I think that some of the major obstacles to providing the help that clients desire is clinicians lack of education and understanding about schizophrenia. From the article the rule of services in mental health treatment, it appears that clients simply want to be treated with compassion and respect, instead clinicians often dehumanize those suffering from severe mental illness (Lietz, Lacasse, Hayes, & Cheung, 2014). I can see how a clinician could get frustrated while working with a client that is currently in the middle of a psychotic episode. From the clinicians point of view, the client may be difficult to work with, and since there is little knowledge about disorders such as schizophrenia, it may be hard to offer support or encourage a client in the throws of psychosis to seek self-determination.

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When my sister experienced her first psychotic episode 10 years ago, the doctors told my family that she would never get better, they explained that the disorder was degenerative and would get worse over time. My sister is still struggling, but over the past 10 years she has exhibited varying degrees of psychosis and possibly some lengths of remission. My family has always felt the need to coerce her into getting help or taking medication, because they were told by a doctor that medication was the only hope for her to lead a normal life. If the clinicians had approached my family in a different way and created a positive narrative, my sister may have had better outcomes and my family would not feel so helpless. On a macro level, I think that stigma over severe mental illness needs to be addressed. Advocates need to address the systematic dehumanization that individuals with mental illness experience (2014). One way to do this would be to spread awareness over social media outlets. On a micro level, clinicians should make an effort to treat clients who are experiencing severe mental illness with respect and dignity (2014).

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References

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Padma, T. V. (2014). Developing countries: The outcomes paradox. Nature, 508(7494), S14- S15.

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Yung, A. R., & McGorry, P. D. (2007). Prediction of psychosis: Setting the stage. British Journal of Psychiatry, 191(S51). doi:10.1192/bjp.191.51.s1

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