{"id":92,"date":"2023-06-06T10:44:22","date_gmt":"2023-06-06T10:44:22","guid":{"rendered":"http:\/\/ciealevels.excellingpsychology.com\/?p=92"},"modified":"2023-06-06T13:32:29","modified_gmt":"2023-06-06T13:32:29","slug":"a-case-study-of-schizophrenia","status":"publish","type":"post","link":"https:\/\/ciealevels.excellingpsychology.com\/index.php\/2023\/06\/06\/a-case-study-of-schizophrenia\/","title":{"rendered":"A Case Study of Schizophrenia &#8211; Aneja et.al. (2018)"},"content":{"rendered":"\n<h2 class=\"wp-block-heading has-text-align-center\">Case Description<\/h2>\n\n\n\n<h4 class=\"wp-block-heading\">Demographics<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>14<\/strong> <strong>year<\/strong> old <strong>boy<\/strong>;<\/li>\n\n\n\n<li>remarkable physical features &#8211; <strong>elongated face<\/strong>, <strong>large ears<\/strong>;<\/li>\n\n\n\n<li><strong>middle SES<\/strong>;<\/li>\n\n\n\n<li>residing in <strong>urban area<\/strong>;<\/li>\n\n\n\n<li>attained <strong>age-appropriate developmental milestones<\/strong>;<\/li>\n\n\n\n<li>born from <strong>unplanned but wanted<\/strong> <strong>pregnancy<\/strong><\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Background <\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>exposed to <strong>father&#8217;s aggression<\/strong> from childhood;<\/li>\n\n\n\n<li>boy <strong>10 years<\/strong> old when <strong>parents divorced<\/strong> over <strong>domestic violence<\/strong> issues;<\/li>\n\n\n\n<li>started living with <strong>maternal grandparents<\/strong> from when he was <strong>11 years<\/strong> old<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Early Symptoms<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong><em>not<\/em><\/strong><em> <\/em><strong>specific to schizophrenia<\/strong><\/li>\n\n\n\n<li><strong>declining academic performance and handwriting<\/strong> starting at <strong>12 years<\/strong> of age;<\/li>\n\n\n\n<li><strong>fist fights <\/strong>and other undesirable behaviour at <strong>school<\/strong>;<\/li>\n\n\n\n<li>preference for <strong>solitary activities<\/strong>, particularly <strong>eating alone<\/strong> at <strong>home<\/strong><\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Early Treatment<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>consultation with <strong>private psychiatrist<\/strong>;<\/li>\n\n\n\n<li><strong>medicine<\/strong> given which <strong>reduced aggression and irritability<\/strong>;<\/li>\n\n\n\n<li>medicine gradually stopped<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Intermediate Symptoms<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>after 1 year <\/strong>of early treatment, <strong>schizophrenia-specific symptoms<\/strong> seen;<\/li>\n\n\n\n<li><strong>auditory hallucinations<\/strong>, hearing commanding voices;<\/li>\n\n\n\n<li><strong>paranoia<\/strong> of mother conspiring with those talking in commanding voices to tease him;<\/li>\n\n\n\n<li>eventual <strong>drop out<\/strong> from <strong>school<\/strong>;<\/li>\n\n\n\n<li><strong>talking to self<\/strong> and <strong>shouting<\/strong> at imaginary persons till late night;<\/li>\n\n\n\n<li><strong>declining socialization and self-care<\/strong><\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Intermediate Treatment<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>consultation with a <strong>different psychiatrist<\/strong>;<\/li>\n\n\n\n<li><strong>diagnosis of schizophrenia<\/strong> now achieved;<\/li>\n\n\n\n<li>prescription of <strong>antipsychotic medicines<\/strong>;<\/li>\n\n\n\n<li><strong>some improvement<\/strong> in symptoms;<\/li>\n\n\n\n<li><strong>poor compliance<\/strong> due to side effect of <strong>weight gain<\/strong>;<\/li>\n\n\n\n<li><strong>relapse<\/strong> within <strong>3 months<\/strong><\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Hospitalization<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hospitalization due to <strong>frequent aggressive episodes<\/strong>;<\/li>\n\n\n\n<li>diagnosis of <strong>very early onset schizophrenia (VEOS)<\/strong> achieved;<\/li>\n\n\n\n<li>initial improvement with <strong>antipsychotic medicines<\/strong> and subsequent <strong>discharge<\/strong>;<\/li>\n\n\n\n<li><strong>readmission<\/strong> to hospital after return of <strong>hallucinations and aggression<\/strong> <strong>after two weeks<\/strong>;<\/li>\n\n\n\n<li><strong>ECT<\/strong> (electro-convulsive therapy) now administered;<\/li>\n\n\n\n<li><strong>psychoeducation<\/strong> regarding schizophrenia and <strong>supportive psychotherapy<\/strong> provided to <strong>family<\/strong>;<\/li>\n\n\n\n<li><strong>activity schedule, occupational therapy<\/strong> and <strong>modifications for diet<\/strong> also provided to boy;<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Recovery<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>resolved<\/strong> issues post hospitalization &#8211; <strong>violence<\/strong>, <strong>hallucinations<\/strong><\/li>\n\n\n\n<li><strong>unresolved<\/strong> issues &#8211; <strong>irritability, socialization, apathy, avolition, weight gain, aversion to start school, bone marrow function<\/strong><\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-align-center\">Relevant Issues and Debates<\/h2>\n\n\n\n<h4 class=\"wp-block-heading\">Case Studies<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Justification<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>in-depth exploration<\/strong> of symptoms, treatment and recovery of schizophrenia in the body;<\/li>\n\n\n\n<li><strong>longitudinal investigation<\/strong> of the progress of schizophrenia in the boy &#8211; right from birth and childhood circumstances to treatment and recovery in the present day<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Strengths<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Comprehensive understanding of schizophrenia<\/strong>;\n<ul class=\"wp-block-list\">\n<li>investigation of aspects like difficulties in school, academic decline, challenges in the family, treatment using outpatient and inpatient treatment, use of medication and ECT, etc.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Understanding of Progression of schizophrenia<\/strong>\n<ul class=\"wp-block-list\">\n<li>changes in behaviours of boy noted overtime such as  declining academic performance, increasing social withdrawal, increasing aggression and violence, etc.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Weaknesses<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Limited generalizability of findings<\/strong>;\n<ul class=\"wp-block-list\">\n<li>the boy&#8217;s case had peculiar features, including his facial appearance, relationship with father, history of domestic violence at home, etc. which integrate to form a unique case that might not apply to child cases of schizophrenia;<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Subjectivity of Findings<\/strong>\n<ul class=\"wp-block-list\">\n<li>diagnosis and treatment of the boy was subject to the clinical judgment of different psychiatrists <\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Individual and Situational Explanations<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Case supports <strong>both explanations<\/strong>&#8211;\n<ul class=\"wp-block-list\">\n<li><strong>Individual explanation <\/strong>supported by peculiar appearance of boy and temperament;<\/li>\n\n\n\n<li><strong>Situational explanation<\/strong> supported by <strong>aggressive behaviour of father and divorce during childhood<\/strong> and <strong>exposure to various treatments<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Strengths<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Holistic perspective<\/strong>;\n<ul class=\"wp-block-list\">\n<li>inclusion of both individual and situational aspects gives a more comprehensive understanding of the disorder<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Increased Potential for Treatment<\/strong>;\n<ul class=\"wp-block-list\">\n<li>consideration of individual <em>and<\/em> situational factors enables psychiatrists better opportunity to treat patients as they can target multiple factors for improvement<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Weaknesses<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Limited exploration of Situational Explanation<\/strong>\n<ul class=\"wp-block-list\">\n<li>more situational factors such as the boy&#8217;s school environment, relationship with teachers and fellow students, etc. could be investigated further for even better understanding of the disorder<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Limited exploration of Interaction of Individual and Situational Explanations<\/strong>\n<ul class=\"wp-block-list\">\n<li>while both explanations have been investigated &#8211; their interaction &#8211; or how each compounds with the other in the progression of the disorder is not sufficiently explored, limiting understanding<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Use of Children<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Strengths<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Developmental Perspective of Schizophrenia<\/strong>;\n<ul class=\"wp-block-list\">\n<li>gradual development of schizophrenia from general symptoms in childhood to specific progression in adolescence explored<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Early Identification and Intervention<\/strong>\n<ul class=\"wp-block-list\">\n<li>a VEOS case is presented by using a child, showcasing the impact of schizophrenia in near adolescence, its identification and intervention<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Weaknesses<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Ethical Considerations<\/strong>\n<ul class=\"wp-block-list\">\n<li>the boy was too disturbed to provide informed consent to his diagnosis and treatment &#8211; and to withdraw even when he experienced severe side effects and many interventions proved ineffective<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Practical Challenges<\/strong>\n<ul class=\"wp-block-list\">\n<li>the boy was too young especially during the early phase to self-report his experiences and he might have been selected in the first place due to availability which is not the case with many children, limiting generalizability<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Idiographic versus Nomothetic<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Study largely supports an <strong>idiographic<\/strong> approach since it is a single case study<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Strengths<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Individualized Understanding<\/strong>\n<ul class=\"wp-block-list\">\n<li>unique factors to the boy &#8211; his family background, symptoms at school, physical appearance, response to medications, improvement of symptoms in response to various treatments, etc. explored to provide a deeper understanding <\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Personalised Treatment<\/strong>\n<ul class=\"wp-block-list\">\n<li>boy provided with treatments specific to his symptoms at various stages &#8211; first general medication, then antipsychotic medication, then ECT and tailored therapy, etc. resulting in probably the best outcomes<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Weaknesses<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Restricted Generalizability<\/strong>\n<ul class=\"wp-block-list\">\n<li>since specific investigation and treatment was conducted, the understanding and application may not generalize beyond the boy&#8217;s case<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Extensive use of Resources<\/strong>\n<ul class=\"wp-block-list\">\n<li>customization of treatment to the boy meant consultation with various psychiatrists, trial of different treatments, etc. over the course of several years &#8211; which is not practicable beyond research investigation<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Generalizability of Findings<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Strengths<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Longitudinal Investigation<\/strong>\n<ul class=\"wp-block-list\">\n<li>the case shows possibility of recovery from several intense symptoms of schizophrenia over the course of long-term treatments<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Multidisciplinary Approach<\/strong>\n<ul class=\"wp-block-list\">\n<li>use of a variety of methods borrowed from psychiatry, psychology and occupational therapy to treat the boy brings about the role of complex factors in schizophrenia treatment<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Weaknesses<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Focus on Single Case<\/strong> <strong>of Schizophrenia<\/strong>\n<ul class=\"wp-block-list\">\n<li>only the case of one boy of a very specific age, nationality, etc. was investigated; restricting generalizability to adults, children of other nationalities, etc.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Limited Followup of Treatment Outcomes<\/strong>\n<ul class=\"wp-block-list\">\n<li>only a 6-month long follow-up was done to study which symptoms of the disorder still persisted or did not in the boy, limiting understanding to longer term outcomes<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<p style=\"font-size:5px\">search terms &#8211; a levels psychology; schizophrenia, aneja et al, aneja et al (2018), case study of schizophrenia, 1.1.1, issues and debates, as and a psychology; psychology and organizations; paper 3; paper 4; igcse psychology; application to everyday life; strengths of application to everyday life; weaknesses of application to everyday life; gcse psychology; cie psychology; cambridge 12 psychology; a2 psychology; new syllabus; 2024-26 syllabus; 2024 9990 syllabus; 9990 curriculum; new 9990 syllabus; 9990 psychology<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In this lesson, I present a description and discussion of relevant issues and debates for the A2 clinical psychology topic, &#8220;a case study of schizophrenia.&#8221;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[7],"tags":[11,10,9],"class_list":["post-92","post","type-post","status-publish","format-standard","hentry","category-a2-clinical-psychology","tag-case-studies","tag-issues-and-debates","tag-schizophrenia"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/ciealevels.excellingpsychology.com\/index.php\/wp-json\/wp\/v2\/posts\/92","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ciealevels.excellingpsychology.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ciealevels.excellingpsychology.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ciealevels.excellingpsychology.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/ciealevels.excellingpsychology.com\/index.php\/wp-json\/wp\/v2\/comments?post=92"}],"version-history":[{"count":3,"href":"https:\/\/ciealevels.excellingpsychology.com\/index.php\/wp-json\/wp\/v2\/posts\/92\/revisions"}],"predecessor-version":[{"id":104,"href":"https:\/\/ciealevels.excellingpsychology.com\/index.php\/wp-json\/wp\/v2\/posts\/92\/revisions\/104"}],"wp:attachment":[{"href":"https:\/\/ciealevels.excellingpsychology.com\/index.php\/wp-json\/wp\/v2\/media?parent=92"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ciealevels.excellingpsychology.com\/index.php\/wp-json\/wp\/v2\/categories?post=92"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ciealevels.excellingpsychology.com\/index.php\/wp-json\/wp\/v2\/tags?post=92"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}