Psychology

This discussion is a response to questions from an interview in which am applying for a position of a psychologist with a top company.Specifically, the study will address Schizophrenia under which the following will be discussed the areas of the brain affected, the causal factors, the associated symptoms, the neural basis and the appropriate drug therapies. In addition, two case studies, which fall under psychological disorders, will be explored. Anorexia Nervosa in Beth and Anxiety in Tom shall be analyzed in details giving their relation to the nature-nurture issue and their drug interventions.

Schizophrenia
Schizophrenia is a mental disorder that makes it difficult to differentiate between real and unreal experiences, to think logically, have normal emotional responses and to behave normally in social situations. It can also be defined as a chronic, severe and disabling brain disease which involves a break with reality. It can also be referred to as psychosis. This disease occurs at similar rates in all ethnic groups in the world and it affects both men and women equally. About 1 of Americans suffer from this disease. The areas of the brain affected by Schizophrenia are the forebrain, hindbrain and the limbic system. (Ballas, 2008).

Research shows that schizophrenia is caused by an interaction of an infectious agent, particularly a virus with a genetic predisposition to the illness. There are several features of known viruses that might lead to the development of this disease which include the following viruses can attack certain regions of the brain leaving others intact, alteration of certain processes within a brain cell without killing the cell, infection of someone and laying dormant for long without causing disease and the viruses can also affect the neurotransmitters (Harrison, 2010)

The symptoms associated with schizophrenia can be grouped into three broad categories positive symptoms, negative symptoms and cognitive symptoms. Positive symptoms are psychotic behaviors that are not normally seen in healthy people and usually such people lose touch with reality. Positive symptoms come and go sometimes they are severe and at times hardly noticeable depending on whether the person is being treated.They include hallucinations-whereby someone sees, hears, smells or feels things that no one else does. People with schizophrenia believe in delusions even after others prove that the beliefs are not true. Thought disorders (thought block) are also common whereby someone usually has trouble organizing hisher thoughts or connecting them logically. Another positive symptom is movement disorders and usually a person with this symptom may repeat certain motions over and over or if its extreme there may be no movement at all(Harrison, 2010).

Negative symptoms of schizophrenia are associated with disruptions of normal emotions and behaviors and they are hard to recognize as part of the disorder they may be mistaken for depression or other conditions. Such conditions may include a persons face fails to move the person lacks pleasure in daily life and lack of ability to initiate and sustain planned activities. People who exhibit these symptoms require help in their everyday tasks because they often neglect even their basic personal hygiene. On the other hand cognitive symptoms are subtle and like the negative symptoms, they may be difficult to recognize as part of the disorder. Examples of cognitive symptoms include poor executive functioning, trouble paying attention and problems with working memory (Harrison, 2010).

Neurotransmitters are implicated in the development of schizophrenia and the dopamine hypothesis of schizophrenia postulates that this disease is caused by an overactive dopamine system in the brain. In addition, excessive dopamine and reduced striatal activity affects all aspects of motor, cognitive and emotional functioning hence may result in acute schizophrenic psychosis. This brain disorder was originally associated with increased activity  of the D2 class of dopamine receptors in the prefrontal cortex although reduced numbers of the D1 class of dopamine receptors may also contribute to the rise of dopamine concentration. Other neurotransmitters including serotonin, glutamate, gamma aminobutyric acid and acetylcholine may also be involved in the pathogenesis of schizophrenia (Liddle, 2001).

Since schizophrenia is a combination of thought, mood and anxiety disorder, an appropriate drug therapy may require a combination of antipsychotic, antidepressant and anti-anxiety medication. There are many antipsychotic drugs available including Seroquel, Risperdal, Zyprexa and Clozaril.Some of these may work both on the serotonin and dopamine receptors hence treating both positive and negative symptoms of schizophrenia. (Grohol, 2006).

Anorexia (Case 1)
In this case study, Beth has been diagnosed to be suffering from Anorexia.
Anorexia Nervosa is an eating disorder characterized by an intense fear of gaining weight and becoming fat and the affected individual starves herselfhimself and theres conspicuous distortion of body image. This describes exactly what is happening to Beth dieting and weight loss. This condition affects females more than males and it typically begins when an adolescent of normal weight or slightly overweight decides to diet. When weight begins to fall, the obsession of dieting increases and the affected individual may also increase physical exertion or exercise. Loss of weight and avoiding food is considered as accomplishment and success. Those who suffer from Anorexia develop biological, psychological and social consequences (Lock, 2002).

This disorder may develop as a result of interaction of cultural and interpersonal as well as biological factors though the actual cause is not known though it is partially linked to social influences. Anorexia Nervosa is a serious public health problem because it has one of the highest mortality rates out of all psychiatric disorders(Baron, 1998).Diagnosis of Anorexics is complicated and its severity varies from patient to patient hence most of them are diagnosed by pediatricians and family practitioners. Some of the symptoms of Anorexia include emaciated bodies, dry or yellowish skin, low blood pressure, amenorrhea, abdominal pain, constipation and lack of energy. Moreover the disorder may cause serious long-term health complications including heart failure, sudden death, growth retardation, dental problems, anemia and other abnormalities of the blood, kidney dysfunction and osteoporosis (Baron, 1998).

 Beths mother and father can be advised to use the following drugs in treating their daughter although there are so many other drugs that can be used in treating this disorder (a) Chlorpromazine-This is an antipsychotic drug usually given to severely obsessive, anxious and agitated patients. This drug induces hunger and weight gain although it also has side-effects which include grand malseizures and increase in development of bulimia.(b)Clomipramine-This is an antidepressant which enhances gain of body weight but has side-effects like sedation,tachycardia,dry mouth and confusion(Hoffman,1993).

For years ,Anorexia has been has been blamed with our obsession with thinness to the glorification of society  and thats why its grouped among those called social diseases but research shows that genetics also play a big role .The first sign of genetic link was from the surveys of families where anorexia appeared. These studies show that if one has a family member that had this disorder then the individual is between 7-12 times at risk for developing the same disorder and research done by others strongly show that Anorexia is a heritable condition (Avi, 2005). In conclusion, Anorexia Nervosa is a serious eating disorder and parents should be keen to identify it early enough in adolescents before it develops to severe levels .If Beths parents had noticed early enough the kind of disorder their daughter was their daughter was suffering from, then they would have come in handy to help him by getting for her the right medication and also counseling her.

Anxiety (Case 2)
In the second case, Tom is suffering from Anxiety which can be defined as a chronic condition that is characterized by an excessive and persistent sense of apprehension. There are many types of anxiety disorders and examples are as follows Panic disorder, social anxiety, obsessive compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder among others (Kelly, 2009).From the given case study, Tom is suffering from generalized anxiety disorder which is defined as worry that is excessive and unrelenting and this high level anxiety makes normal life difficult and relaxation becomes impossible. People with this type of anxiety tend to worry about the same things that other people do health issues, money, family, problems or difficulties at work but these worries are taken to another higher level. Similarly, Toms worries are based on his health, job responsibilities and money. The physical symptoms of generalized anxiety include Muscle tension, aches, trouble falling asleep, stomach problems, nausea, diarrhea, jumpiness, restleness and easy tiring. On the other hand, the psychological symptoms include irritability, feelings of dread, inability to control anxious thoughts, difficulty in concentrating and fear of losing control or being rejected (Kelly, 2009).

A number of treatments can be used in Toms condition but the most effective ones incorporate self help measures and therapies together with drugs. Therapy is as effective as medication and in this case cognitive behavioral therapy is used in treatment. It examines distortions in an individuals ways of looking at the world and hisher own in addition to helping one identify automatic negative thoughts that contribute to anxiety. There are three types of drug medication that can be prescribed for Tom and other patients having the same problem and they are discussed as follows ( a) Buspirone-This is an anti-anxiety drug whose brand name is Buspar and its generally considered to be the safest in treatment of this condition. Although it has no side effect it does not completely eliminate anxiety.
(b)Benzodiazepines-This drug acts so fast within 30 minutes providing a major benefit but it has serious drawbacks like physical and psychological dependence after few weeks hence its recommended only for severe paralyzing cases of anxiety. (c)Antidepressants-many antidepressants can be used in treating this type of anxiety but their relief is not immediate and their side effects are nausea and sleep problems (Kelly, 2009).

Anxiety is part of human nature and its also known to be a survival mechanism that has evolved to protect individuals. In regard to nature and nurture, both factors play a role in the cause of the problem. Both nature (a faulty gene, brain structure, chemical substances or disease) and nurture (the environment) can cause anxiety although they play different roles. To illustrate this genetic information passed from parent to child contains a lot including hopes and fears hence a parent who has lived with anxiety disorder will pass it to the off springs. Therefore anxiety is caused by nature. On the other hand, an example that shows that anxiety is also caused by nurture is when a parent treats a child in ways that promotes fear and anxieties in himher. This child will develop anxiety due to the environment that is subjected to himher hence making anxiety a nurture problem as well( Dixon,1996).

In conclusion, self therapy should be used first in treatment before using drug therapy. Toms wife should first use self help therapies on her husband to help him perceive that the things he is worrying about are normal to every body and thereafter introduce him to medication because this will be a perfect way to help him recover.