Biopsychosocial View of Schizophrenia Schizophrenia can be a debilitating condition that adversely affects the quality of life of sufferers and their families. Although clinicians in some parts of the world view schizophrenia as a brain disease that is incurable, while most practitioners in the Western world view the condition as having a genetic or organic basis that can be successfully treated with prescription medications and psychosocial interventions. To determine the fact, this paper provides a review of the relevant peer-reviewed and scholarly literature concerning schizophrenia using a biopsychosocial model. The review includes evidence supporting brain localization for schizophrenia, the genetic factors in the onset of this disorder and an evaluation of the environmental factors in the onset of this disorder.

Review and Discussion

On the one hand, some researchers have suggested that schizophrenia is a disease of the brain that is common to all human societies, and that it is a chronic condition that does not have a cure (Saleeby, 2001). On the other hand, other researchers maintain that the condition is a cultural product that has significant positive effects. For instance, Saleeby emphasizes that, "In some cultures, schizophrenia is regarded as bringing uncommon insight and power [and] as a connection to a supernatural world, or a temporary alteration of the senses and consciousness that brings with it special acumen into the very nature of things" (p. 54). From a biopsychosocial perspective, schizophrenia exists somewhere along a continuum between these two extremes. In this regard, Grover and Trevini (2014) report that a biopsychosocial view of schizophrenia is that it is "often a chronic, disabling condition, associated with impairments in multiple domains of functioning" (p. 119).

Given the significant impairments that can occur across multiple domains that are associated with schizophrenia, the biopsychosocial model would appear to represent an optimal framework for formulating efficacious interventions, but some authorities argue that the condition requires a more holistic approach to treatment that the biopsychosocial model do not provide. For example, according to Gallagher (2014), the biopsychosocial model maintains that mental disorders have genetic or organic roots and stresses the importance of both pharmacological as well as psychosocial treatments for treating schizophrenia but does not take into account other life factors. For example, the conventional interventions for schizophrenia are based on the biopsychosocial model that include pharmacological and psychosocial elements, as well as family interventions (Grover & Truvini, 2014). As Grover and Truvni point out, though, "This model of schizophrenia does not take into account the religious beliefs of the patient. However, religion and spirituality exert a significant role in the lives of people with schizophrenia" (2014, p. 119).

Notwithstanding this constraint, the biopsychosocial model does take into account environmental factors that may exacerbate the schizophrenic condition. In this regard, Bemak and Epp (2007) report that, "Schizophrenia as a biopsychological model goes beyond current biological etiology and considers psychosocial stressors that exacerbate this condition" (p. 14). Based on their analysis of environmental stressors and schizophrenia, Bemak and Epp found that high levels of dopamine may exacerbate schizophrenia due to its incitement of psychological stress. This process results in what these researchers term "loosened thought" that "contributes to the mind-body interaction and, at times, creative processes" (p. 15). This finding is highly congruent with the view of schizophrenia being an enabling condition in some cases described above. In any event and irrespective of the pharmacological intervention used, Bemak and Epp conclude that, "Psychotherapeutic interventions are considered indispensable to the treatment of schizophrenia" (2014, p. 19).

Likewise, Farmer and Pandurangi (1999) cite the usefulness of the biopsychosocial model in developing a more informed understanding of the etiology of schizophrenia in ways that can help practitioners develop effective interventions. For instance, Farmer and Pandurangi emphasize that, "In the area of major mental illness, specifically schizophrenia, excluding biological or neurological factors from research is a liability for research and clinical efforts because schizophrenia is such a complex biopsychosocial phenomenon" (1999, p. 110). Because schizophrenia can be a debilitating condition if left untreated, recognizing the multifaceted nature of the disease represents an important part of diagnosis and treatment.

Although there are organic sources of schizophrenia as noted above, there are also genetic sources that can increase an individual's risk of developing the condition. In this regard, Farmer and Pandurangi add that the vulnerability-stress model holds that rather than inheriting the disease itself, the vulnerability for schizophrenia is inherited. The genetic predisposition for schizophrenia places some individuals at much higher risk of developing a clinical case of the condition. For example, Farmer and Pandurangi conclude that, "Vulnerability, in combination with relevant stressors, leads to the development of symptoms of schizophrenia" (1999, p. 112). In sum, then, the biopsychosocial model provides a comprehensive view of schizophrenia that takes into account a wide range of factors that can...

In this regard, Farmer and Pandurangi emphasize that, "This perspective integrates biological characteristics with psychological and social aspects of human behavior, providing a biopsychosocial understanding of the variables that lead to a schizophrenic illness" (1999, p. 112).
Finally, researchers have developed a growing body of evidence of brain localization for schizophrenia. For example, a study by Posner, Peterson and Fox (2009) noted that the selective attention deficits characteristic of schizophrenia may be due to localization of cognitive functions that are affected by the condition. These researchers, though, also emphasize that more research in this area is needed to confirm these findings (Posner et al., 2009). Likewise, Fujii and Ahmed (2009) report that, "Although there is general consistency in the localization literature of schizophrenia-like psychosis, contradictory findings also exist" (p. 714). There appears to be a preponderance of evidence based on functional and structural brain-imaging research that indicates schizophrenia is associated with localization in the temporal and frontal systems at the gross neuronal as well as anatomical levels (Fujii & Ahmed, 2009).

Conclusion

The research showed that from a biopsychosocial perspective, schizophrenia is considered to have genetic or organic roots and the condition can be successfully treated using a combination of prescription medicines and biopsychosocial interventions. The research also showed that while there is not a universal consensus regarding this perspective with some researchers viewing schizophrenia as an incurable "brain disease," the biopsychosocial model does provide a useful framework in which to better understand the etiology of the condition and to formulate an optimal clinical intervention. The growing body of evidence concerning the brain localization of schizophrenia contributes further to this understanding. In the final analysis, it is reasonable to conclude that the biopsychosocial model represents a useful and evidence-based approach for clinicians who treat patients with schizophrenia.

Literature Abstract

Introduction:

Citing a paucity of relevant research as the problem, the purpose of a study by Cantor-Graae (2009) was to systematically review recent research concerning the relationship between social factors and the development of schizophrenia. The intent of this study was to demonstrate a causal relationship between social factors and the development of schizophrenia. The scope of the research extended to studies published between 1996 and 2007.

Methodology

The author used a systematic review of the relevant peer-reviewed literature dated from 1996 to 2007 using MEDLINE. The qualifying search criteria used by Cantor-Graae included studies published in the English language, and those studies that employed standardized assessment instruments for diagnosing psychotic symptoms and those studies that used standardized diagnostic criteria. Although her research was limited to studies published since 1996, these studies included historical information that extended back to the 1960s to provide benchmarks and a background and overview of trends in perspectives and views concerning schizophrenia.

Results

The author systematically reviewed 84 studies that satisfied the selection criteria. When appropriate, the author reported quantitative results or described the findings of the studies in qualitative terms. Based on her analysis of the results that emerged from this exhaustive review of the relevant peer-reviewed literature, Cantor-Graae identified the following clinical implications of these findings:

Social factors may play an etiologic role in the development of schizophrenia;

A common denominator may be chronic experiences of social defeat and (or) exclusion, exclusion, resulting in dopamine dysregulation or sensitization; and,

The implementation of interventions and preventive strategies may reduce the risk associated with social factors (2009, p. 283).

Conclusion

The researcher is an associate professor in the Division of Social Medicine and Global Health, Department of Health Sciences, Lund University, University Hospital in Malmo, Sweden who presented a thoughtful, comprehensive and systematic review of dozens of relevant studies concerning the relationship between social factors and the development of schizophrenia. The author's findings and clinical implications provide valuable insights for clinicians faced with the complex schizophrenic condition.

References

Bemak, F. & Epp, L.R. (2007, Spring). Transcending the mind-body dichotomy: Schizophrenia reexamined. Journal of Humanistic Counseling, Education and Development, 41(1), 14-

19.

Cantor-Graae, E. (2009, May). The contribution of social factors to the development of schizophrenia: A review of recent findings. Canadian Journal of Psychiatry, 52(5), 277-

Farmer, R.L. & Pandurangi, A.K. (1999, May). Diversity in schizophrenia: Toward a richer biopsychososocial understanding for social work practice. Health and Social Work,

22(2), 109-119.

Fujii, D.E. & Ahmed, I. (2009, November). Is psychosis a neurobiological syndrome? Canadian

Journal of Psychiatry, 49(11), 713-719.

Gallagher,…