UBC Mental Health Awareness Club

If you ask people to describe someone who best fits the traditional, stereotyped idea of “crazy”, chances are most people will describe something like schizophrenia. But exactly how much do you know about schizophrenia?

When it comes to mental disorders, a rough line could be drawn between neurosis and psychosis. Unlike neurosis, which is described by Sigmund Freud to be the exaggeration of the otherwise “normal” emotions (such as depression as an exaggerated form of sadness), psychosis was first described by the German psychiatrist Karl Canstatt in 1841, as an alternative to insanity. It is characterized by losing touch with reality and, basically, being “insane”. It is therefore only natural that schizophrenia, a most prevalent form of psychosis, is surrounded by misunderstandings. In this article I try to list a few myths that are more or less uniquely attached to schizophrenia.

Myth #1: schizophrenia is the same as “split personality”.

Truth: schizophrenia, a psychotic disorder, is different from dissociative personality disorder (formerly known as multiple personality disorder), a dissociative disorder, in almost every possible way. The term “schizophrenia”, meaning “split mind”, refers to the mismatch between the person’s thought and feeling, which, in turn, refers to a common symptom found in patients with schizophrenia where they have mismatched emotion and affect (such as telling a sad story with smile on their face). A person with schizophrenia may lose touch with reality, appearing as if they are talking about multiple things at the same time, but the symptoms are fundamentally different from that of a person with dissociative identity disorder.

Myth #2: people with schizophrenia are violent and dangerous.

Truth: while it is possible that some people with schizophrenia can have violent outbursts, the vast majority of them are non-violent, and instead tend to be more aloof and withdrawn. On the other hand, schizophrenia often co-morbid with substance abuse, which tend to make them more violent. Around 10% people with schizophrenia commit suicide, making it one of the two mental disorders with the highest suicide rate (the other is bipolar disorder). Conversely, people with schizophrenia are in greater danger of being victimized than the general population.

Myth #3: people with schizophrenia never recover.

Truth: some types of schizophrenia are harder to treat than others. (And yes, there are different types of the disorder.) But people generally do well over time, at least better than the common portrait in popular media. Symptoms may come and go in response to life stressors (just like a lot of other mental disorders), but most can be managed by medicine and/or psychotherapy. In fact, there is a fairly big chance that somewhere in your life you have already encountered a person with schizophrenia, whose symptoms are so well managed and monitored that you never suspected a thing.

Myth #4: people with schizophrenia have sub-normal intelligence.

Truth: people with schizophrenia are just as smart as the rest of the population. In fact, there are some evidence show that schizophrenia is linked with creativity and genius.

Myth #5: schizophrenia is caused by child abuse, terrible parenting, or other forms of childhood trauma.

Truth: although neglect or abuse has not been shown to play an important factor in causing schizophrenia, the disorder is the result of an interaction between genetics and environment. Environmental stressors also tend to make the symptoms worse.

Further reading:

http://www.peoplesayimcrazy.org/schizophrenia/myths

http://www.everydayhealth.com/schizophrenia/schizophrenia-myths-and-facts.aspx

Autism spectrum disorder is a neurodevelopmental disorder characterized primarily by impaired speech, communication skills and interests, and repetitive, stereotyped behaviors. It is mostly found in young children and infants, although it is also possible for the disorder to go undiagnosed until later in a person’s adulthood. The cause of autism is still unclear, but it is believed to be a combination of both genetics (most likely interaction among multiple genes), and prenatal conditions. There are a variety of interventions, most of which involve applied behavioral analysis and use of reward to encourage prosocial behaviors.

One of the most prominent characteristics of autism, at least in the Western world, is lack of eye contact. What first tips the parent off that something might be wrong with a child is probably the lack of interest the child displays in looking into the parent’s eyes. In normal social situations, a person who talks only to our shoulders is likely to be considered odd. As a result, a lot of childhood interventions target eye contact as an important part of developing an acceptable social behavior.

However, showing politeness by maintaining eye contact is not a universal phenomenon. In fact, there are a lot of places where eye contact, especially when talking to an elderly, is considered rude. A child is taught from a very young age not to look others in the eye while having a conversation.

Naturally, you can imagine a western psychologist being very confused when dealing with children from another culture and are raised with a completely different set of social rules. And eye contact is only a part of the picture: children with autism are likely to have ill defined personal space (such as too much or too little bodily contact), but as we all know, the “ideal degree” of personal space varies from culture to culture. Children with autism may have trouble starting conversation with strangers, while people from some cultures do not talk to anyone unless introduced to by a friend. There are more examples, but you get the idea.

So what is the lesson here? Well, obviously it is very difficult to diagnose autism in other cultures while the vast majority of studies and models are based on western samples. What’s more, using the same intervention programs in different cultures can also be problematic, while a healthy, social western child can be easily considered ill mannered or even behaviorally challenged by another culture. In the cosmopolitan society that we live in today, it has been more and more important for people to think cross culturally about, well, just about everything.

Some examples of cross cultural attempts at understanding autism:

Egyptian Autism Society

Dubai Autism Center

New England Center for Children – Abu Dhabi