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A2 - Clinical Psychology

Case Study of Schizophrenia (Aneja et.al.)

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Description of the Case

The case study involves a boy who experienced a troubled upbringing and had a history of aggression. He had unusual physical features like an elongated face and big ears. After his parents’ divorce, he lived with his grandparents, and his academic performance deteriorated. The boy exhibited symptoms of schizophrenia such as hearing voices, suspicion towards his mother, muttering and shouting at unseen individuals, social withdrawal, poor sleep, and lack of self-care. He was initially prescribed sodium valproate, a drug used for bipolar disorder, which temporarily improved his mood and behavior but later worsened. Eventually, he received a diagnosis of very early-onset schizophrenia (VEOS), leading to increased aggression and frequent hospital admissions for safety reasons.

Relevant Issues and Debates

Case Studies

The Aneja et. al. is a case study because it is a detailed investigation of a single case because it examines the life and experiences of a specific boy with a troubled upbringing and a history of aggression. It provides a comprehensive account of his background, symptoms, treatment, and outcomes. Furthermore, it qualifies as a long-term investigation as it follows the boy’s progression over time, documenting his changing symptoms, the effects of different medications, and his frequent hospital admissions for safety concerns.

Strengths of Case Studies

1. The use of a case study in the Aneja et.al. study allows for a detailed investigation of the boy’s background, experiences, and symptoms. For example, the study provides specific information about the boy’s troubled home, his parents’ divorce, living with his grandparents, deteriorating academic performance, and a range of symptoms including hearing voices, suspicion towards his mother, and social withdrawal. This level of detail helps researchers and readers gain a comprehensive understanding of the case and its complexities.

2. The case study in the Aneja et.al. study offers insights from multiple perspectives, enabling a more comprehensive analysis of the boy’s condition. For instance, it highlights the observations and assessments made by different professionals involved in his treatment, such as psychologists, psychiatrists, and other healthcare providers.

Weaknesses of Case Studies

1. The case study of the boy’s experience cannot be generalized to the entire population due to its specific and unique circumstances. The study focuses on an individual case with a troubled upbringing, aggression, and a specific diagnosis of very early-onset schizophrenia (VEOS). This limits the generalizability of the findings to other individuals with different backgrounds, behaviors, and mental health conditions.

2. The qualitative nature of the case study introduces subjectivity and potential bias in interpreting and reporting the boy’s symptoms and responses to treatment. The study relies on subjective observations, interpretations, and narratives from the researchers, which may vary between different observers or researchers. 

Individual and Situational Approach

This case study supports both an individual and a situational explanation. Individually, his physical features, such as a long face and elongated ears suggest some genetic or neurological damage. Situational factors like his parents’ divorce, living with his grandparents, and academic decline also played a role in his deteriorating mental health. 

Strengths of Individual and Situational Approaches

1. Determining that the source of the boy’s aggressive behavior and mental health issues is situational can help reduce blame on individuals and increase responsibility of society in preventing schizophrenia. For example, the boy’s troubled upbringing, including his aggressive father and the disruption caused by his parents’ divorce, contributed to his behavioral problems. 

2. Determining that the source of the boy’s behavior is an interplay of individual and situational factors can help develop multifaceted interventions to tackle complex problems. For instance, understanding the boy’s genetic predisposition for very early-onset schizophrenia (VEOS) along with the environmental factors such as his troubled upbringing and disrupted schooling allowed for a holistic approach to treatment. For example, he was given medication to manage very early-onset schizophrenia (VEOS), therapy to develop coping strategies and address family dynamics, social support and education to reduce stigma and increase awareness.

Weaknesses of Individual and Situational Approaches

1. It is challenging to separate the influence of individual factors, such as the boy’s genetic predisposition to schizophrenia, from situational factors, such as his troubled upbringing and parental aggression. Both likely interacted and contributed to the development and worsening of the boy’s condition. 

2. The study exhibits a weakness in adequately addressing situational factors. Although the study highlights the boy’s troubled upbringing and its potential impact on his behavior, it fails to delve deeper into the specific situational factors that may have contributed to his symptoms of VEOS. For example, the study does not extensively explore the influence of the boy’s school environment, peer interactions, or social support systems, which could play a significant role in his condition.

Use of Children

Strengths of Use of Children

1. One strength of using children in the Aneja et al study is that it provides valuable insights into understanding very early-onset schizophrenia (VEOS). The case study illustrates the progression of symptoms in a young boy, showcasing the challenges faced by children with VEOS. For example, the boy’s aggressive and violent outbursts increased over time, leading to frequent hospital admissions for his safety. 

2. Another strength of the study is its contribution to understanding the development of schizophrenia in children. By examining the case history, researchers can identify potential risk factors and early signs of the disorder. In this case, the boy’s troubled upbringing, parental divorce, academic decline, and the presence of specific symptoms (e.g., hearing voices, social withdrawal) offer insights into the complex interplay between environmental factors and the emergence of schizophrenia at a young age

Weaknesses of Use of Children

1. The study may raise ethical concerns regarding the well-being and consent of the child participant. In the case study, the child’s aggressive and violent outbursts increased after being diagnosed with very early-onset schizophrenia. The study’s involvement could have potentially caused additional emotional and psychological harm to the child, as they were already vulnerable due to their difficult upbringing.

2. Aneja et al’s study may face methodological limitations when studying children, such as potential biases and challenges in data collection. However, due to the child’s young age and limited verbal abilities, it may have been challenging for the researchers to accurately assess the frequency, intensity, and content of these hallucinations

Idiographic versus Nomothetic Approach

The case study by Aneja et al. supports an idiographic approach because it provides a detailed and individualized account of a specific case of schizophrenia. The description includes specific details about the boy’s troubled home, his symptoms, and the treatments he received, offering a unique understanding of his condition.

Strengths of Idiographic Approach

1. The idiographic approach in the study is more realistic as it accounts for the complexity of human behavior. By examining the specific details of the boy’s troubled upbringing, family dynamics, and personal experiences, the study captures the complex factors that contribute to his behavior, providing a more comprehensive understanding of his condition.

2.  The idiographic approach in the study can help design personalized interventions to resolve the problems of patients. By uncovering the unique factors contributing to the boy’s aggressive behavior, social withdrawal, and poor sleep, personalized interventions can be tailored to address his specific needs, such as therapy focused on trauma from his troubled home and implementing strategies to improve his sleep hygiene.

Weaknesses of Idiographic Approach

1. The idiographic approach in the Aneja et al study focuses on a single case history of a boy with very early-onset schizophrenia (VEOS). This individual case provides detailed insights into the boy’s experiences and symptoms. However, because it focuses on a specific individual, the findings may not be generalizable to a larger population. For example, the boy’s aggressive behavior and response to medication may be unique to his circumstances and condition.

2. Although the idiographic approach provides rich details about an individual’s experiences, it does not offer guidance on designing interventions that can be applied to larger groups facing similar issues. For example, the study does not explore broader treatment strategies, such as cognitive-behavioral therapy or group interventions, which could be beneficial for individuals with schizophrenia beyond the specific case examined in the study.

Generalizability of Findings

Strengths of Generalizability of Findings

1. The study demonstrates ecological validity by providing a detailed case study that reflects real-life circumstances and contexts. For example, the study includes information about the boy’s troubled upbringing, his living arrangements, and his academic struggles, which are common factors that can influence a child’s mental health. 

2. The study holds generalizability to Indian culture to an extent by focusing on a case from India and examining the specific challenges faced by individuals in this cultural context. For instance, the study discusses the boy’s experience of living with his grandparents after his parents’ divorce, which is a common arrangement in Indian families. Thus, the study’s findings can be applied to similar cases within the Indian cultural context, enhancing their generalizability.

Weaknesses of Generalizability of Findings

1. A potential weakness of the study is the small sample size, as it focuses on a single case study. This limits the generalizability of the findings, as the results may not be applicable to a larger population. For example, the study does not consider factors such as age, gender, or comorbidities that may impact treatment outcomes in a larger sample of individuals with VEOS.

2. The study by may not be generalizable because the boy’s aggressive behavior and family dynamics in the case study are unique and may not be representative of the general population with very early-onset schizophrenia (VEOS) who come from different family backgrounds or have different environmental factors For instance, the boy’s aggressive behavior may be influenced by the specific dynamics of his troubled home environment, such as the presence of an aggressive father

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