Schizophrenia: The Value of Realizing Risk Factors Before Becoming a Parent
Yesterday, The New York Times, published an interesting article relevant to our website. The article, begins with the story of a boy diagnosed with high-functioning autism and discusses the increase in psychiatric and developmental diagnoses many children are receiving and the connection of these disorders to the functioning of the parents of the diagnosed children. The article discusses the idea that when a child is diagnosed with a disorder (ranging from autism to schizophrenia), parents of the child may examine their own behavior, history and functioning and realize risk factors that increased the likelihood of their child's disorder.
In the case of the high-functioning autistic boy, the father of the boy stated that after his son was diagnosed, he himself--the father--became aware of "abnormalities" in his own behavior that his son possibly inherited. The article, however, points out both the usefulness and danger associated with this kind of thinking. This type of thinking or realization may be useful in that the child is no longer alone in experiencing the disorder, once the parent(s) realize that they also exhibit the same behavior. That is, if a parent has also gone through or goes through the same experiences the child goes through, the child, in a sense, has a "co-experiencer". On the other hand, this way of thinking is harmful in that it stresses the genetic inevitability of a disorder. Though we know that a disorder like schizophrenia has a genetic component, recent research has shown that schizophrenia is not genetically inevitable and that the environment and/or psychological components are also at play in the development of the disorder. So the realization of "abnormal" behaviors on the part of the parents would perhaps be more useful before they become parents. That is, being aware of risk factors of a disorder can help parents to-be take preventative measures such as behavior modification prior to the birth and/or development of a disorder in their child.
Full Story: Your Child’s Disorder May Be Yours, Too. (The New York Times)
Environmental Threats to Healthy Kids
How Stress Damages Young Brains
Posted by szwriter at December 10, 2007 04:45 PM
More Information on Schizophrenia Causes, Risk Factors & Prevention
This at least for me is a confusing issue. I thought that SZ was not necessarily hereditary/genetic. Also I thought it was a chemically caused illness not mental/behaviorial. Can someone please clarify & elaborate hopefully with some valid references. Thanks.
Posted by: Frank S at December 10, 2007 05:16 PM
Schizophrenia is indeed a chemical imbalance in the brain and it is also inheritable. On the front page are some links to both of these issues and what studies have shown.
Posted by: mister_lister at December 10, 2007 05:56 PM
Schizophrenia in the DSM-IV excludes diagnosis when the symptoms could be due to a general medical condition. Therefore, it is presumed to be "mental" and therefore avoidable.
Some confusion arises from the fact that cases that fit the description that are not "mental" but medical can be called such because the medical cause is not quite known. That is the case for my own child. Even when she was a young child, the doctors knew she had a biological problem and was quite mentally healthy, but they didn't know what that biological problem was.
From what I understand, the DSM-IV does have a disclaimer/warning that they have diagnoses in there that are not "mental" but are included for the purposes of communication among professionals.
One blog that has begun discussing the issue of children getting diagnoses which the general public think of as "mental" but are not (and so theoretically should NOT be diagnosed as "schizophrenia" see Misdiagnosis Issues on this website: http://www.schizophrenia.com/diag.php#misdiagnosis ) can be found on http://www.itsnotmental.com
It is very confusing indeed when medical issues do get diagnosed as "schizophrenia".
Posted by: Naomi at December 11, 2007 09:25 AM
Further confusing to me is the difference(s) between a diagnosis of SZ and a diagnosis of SZ affective disorder. Seems to me they are one and the same . I know folx who are diagnosed with each yet their symptoms, conditions, and even medecines are the same.
Posted by: Frank Saragnese at December 11, 2007 01:21 PM
I recommend you review this presentation and reading materials to get a better feel for how diagnoses that relate to cognitive (e.g. schizophrenia) and mood/affective (e.g. bipolar disorder) - the same factors apply to schizo-affective disorder - see these links:
Bipolar and Schizophrenia presentation
Unfortunately virtually all the schizophrenia researchers (educated in the last 15 years) that we talk to would likely disagree with your understanding of mental illness.
You say "Some confusion arises from the fact that cases that fit the description that are not "mental" but medical can be called such because the medical cause is not quite known."
But as yet there is no way - to my knowledge - to know what the exact cause of any mental illness (schizophrenia or bipolar or schizo-affective, etc.) for any one person is - so if the cause is not known, how can you know if its "mental" or "medical"? You seem extremely certain of the distinction between mental and medical - when the schizophrenia and neuroscience researchers we talked to on a regular basis make no such distinction and see the view you have as being outmoded and obsolete (but yes, I know - NAMI still propagates this outdated model of mental illness).
The mind impacts the development of the brain, and the brain impacts the development of the mind - to say that one person's schizophrenia is "mental" and another person's is "medical" is really missing out on the advancements in neuroscience during the past decade or so. Its impossible to make this distinction because the two are simply different models of the same thing.
Equally importantly is the message that just because its both genes/biology and psychological/social environment factors are known to influence the risk of developing schizophrenia - doesn't mean that parent's are any more to blame for either the biological/genetic factors vs. psychological/social factors.
The simple fact is that no parent could be expected to know 5 or 10 years ago that the vitamins, stress, viruses, etc. that they are exposed to during pregnancy greatly increase risk of schizophrenia for some people with specific genes.
Similarly, its a known fact in psychology that people tend to create the same type of psychological and social environments for their kids as they had as children (because we learn our parenting skills largely from our own parents) - so if the psychological/social environment in a home was stressful for children, was not nurturing as child development experts now understand is needed, or was lacking in some other factor - a parent isn't to "blame" for this - its simply one factor of many that a parent didn't know due to their own background. Nobody is responsible for what they didn't learn at some time in their past, especially if it wasn't generally known. None of us know everything and the field of child development and neuroscience and psychology are continuing to advance.
I suspect that the major fear that some parents have when they reject the idea that the psychological/social environment that a child was exposed to could in any way cause negative impacts on the child's brain development is that they feel that therefore they are somehow to blame for the disorder. For this reason they stick to a unrealistic belief that parent's can't have significant negative impact on a child's brain development (a perspective that is well known not to be true in child development research), or they believe that the factors that have been linked with increased risk for mental illness (e.g. stress during childhood, etc.) applies to all other children but their own - an equally unrealistic belief.
Millions of children get diabetes each year around the world because they eat too much high-sugar, high calorie foods and don't exercise enough. But - there isn't a major outcry by parents that this diabetes science is "blaming the parents". I'm sure no parent would have knowingly given their child diabetes, just as I'm sure no parent would knowingly contribute to mental illnesses - so I don't think anyone can reasonably "blame" parents for something they didn't know.
The research indicates that because of prenatal stresses and nutritional deficiencies, and because of genetic factors - some of our children are more sensitive to the psychological and social stresses in their environment. Its been impossible to know whether a child has this predisposition (though now we know that a history of mental illness in the family is a good indicator) - so its impossible to "blame parents". The parents of a child that develops schizophrenia may be just as nurturing or just as dysfunctional as a neighbor who's child doesn't get schizophrenia - that doesn't mean one parent is to blame and another is not.
If, as a lot of studies are showing - that there are both psychological/social and biological factors involved in development of mental illness in children who are at increased risk - and parents IGNORE this information, or fight it and think that it applies to everyone else but their family - they really are missing a chance to help the next generation of kids from developing schizophrenia and other mental illnesses. That truly would be a sad situation.
Posted by: SzAdministrator at December 11, 2007 01:51 PM
People get diagnosed, (misdiagnosed?) with "mental" illnesses until the doctors know what medical illness it is, then the diagnosis gets changed to the medical illness. Are you saying the schizophrenia researchers are saying that those medical illnesses are are actually "mental" also? That indeed would be unfortunate.
Even in the DSM IV, they list diagnoses for purposes of communication, that are medical. That does not mean they are "mental" -- they are medical conditions that can affect the brain and have "psychiatric" symptoms. Just because they are in the DSM-IV does not make them "mental", and the DSM-IV lists them for communication purposes. I am not talking about schizophrenia, since that diagnosis excludes the cases when it is due to a general medical condition... although the medical condition would have to be "known" in order to get excluded.
My own daughter, when first diagnosed with a "mental" illness was "mentally" healthy and the doctors stated it was biological but they did not know the cause.
Autism is not considered a "mental illness" either but rather, a neurodevelopmental one. Yes, it is listed in the DSM-IV, but that does not imply that autism is not biological.
Posted by: Naomi at December 12, 2007 05:14 AM
Some of the reactions to this article seem to make it very clear why there is still remains so much confusion about the nature of what society calls "mental illness".
So many people in the psychiatric community still cling to Freudian notions of this very serious brain disorder that it is no wonder that people have difficulty comprehending "mental illness". Schizophrenia is commonly described as a set of common symptoms one of which is thought disorder. Well frankly, all of the symptoms (i.e. hallucinations, grossly disorganized behavior, hearing voices (auditory hallucinations), catatonia, etc.)are all elements of thought disorder. "THINKING" describes the "mechanical" processes of the brain - controlled/regulated by neurochemicals and other regulators that operate within the mechanical structure of the brain. I think of schizophrenia as a "MECHANICAL" disorder of the thought process. That would include the whole array of symptoms. When some bodily process operates outside of the norm causing malfunction, we call it a medical problem - And so, schizophrenia is in fact a MEDICAL disorder that affects the mechanics of thought.
For thousands of years mankind's notions of the spiritual and notions of the "spirit" have shaped our interpretations of human behavior. No wonder people still cannot comprehend the notion of a medical problem of the brain that expresses itself as what we call serious mental disorder.
To me there is no confusion. Certainly, there are believed to be environmental (e.g. exposure to environment/chemical or environment/psycho-social)factors. I believe these factors are probably valid but grossly overemphasized.
"Fractoids" of the disorder, that is traces of disorder existing in other family members when the the full blown disorder exists in the family is nothing new. That is the sz spectrum. And people have probably always had instinctive thoughts that subtle epressions or abnormality existed in themselves or other family members one the full illness appeared in an offspring. This is nothing new. If anything, it should prompt well family member to consider the risks to themselves and their future offspring. There is no better genetic counseling that the full blown expression of any disease (not just sz) showing up in one's family member.
There may also be little distinction between the so-called medical disorder as it relates to root cause. A person who has thyroid disfunction or blood-sugar disorder or some metabolic disorder or even an endocrine disorder may express "schizophrenia-like" symptoms. In this state, for all we know may be a very similar biochemical state as the disorder with other unknown ("hereditary) cause. The difference is that the disfunction may be resolved more definitively if metabolic, thyroid, etc - the symptoms may not, therefore, be CHRONIC. That is why comprehsive diagnostic testing would be very important. The state of presenting disorder of thought, i.e. generically called schizoprenia is MEDICAL in either case.
Posted by: Jen at December 12, 2007 03:19 PM
Thank you Jen and nami. Prehaps Britain's health system is better than in the USA. My aunt there was in psychological therapy for her mental illness. It was a growth in the pituitary-adrenal system. It was not found until she came back home to the UK. All the great strides in research and treatment have come from the scientists and medical researchers, not from the psychologists who study the results in the brain from the physical disorders. And you are right jen. Her symptoms were chronic until treated medically. By the time she got the medical treatment she needed psychological therapy to get over the treatment from the U.S.A.
Posted by: Queue at December 13, 2007 07:39 AM