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本文是心理学专业的Essay范例，题目是“The Different Types of the Psychological Disorder Schizophrenia（心理障碍的不同类型精神分裂症）”，精神分裂症是一种慢性心理疾病，影响着大约1%的美国人口。统计数据显示，它对男性的影响是女性的1.5倍。它的特征是思维症状和行为问题。患有这种疾病的人说话有时讲不通，可能会产生妄想症，有时还会出现幻觉。这种心理障碍同样影响家庭和社会，因为患有这种障碍的人有时不能照顾自己，也不能坚持工作，因此严重依赖他人。这种疾病可以通过药物和心理干预治疗。研究人员正在使用了解这种疾病的原因的工具来开发更有效的药物。 Schizophrenia is one of the chronic psychological disorders affecting approximately one percent of the American population. Statistics show that it affects men one and a half times more than women. It is characterized by symptoms of thought, and behavioral problems. People who suffer this disease do not sometimes make sense when they are talking and may be delusional and sometimes experience hallucinations. The psychological disorder affect families and societies alike since the people with the disorder cannot at times take care of themselves neither can they hold on to a job thus depending heavily on others. The disorder is treatable through medication as well as psychological interventions. Researchers are using tools that understand the causes of the disorder to develop more effective medicines.
Introduction介绍 Psychological disorders can be defined as patterns of behavioral symptoms that influence various areas in people’s lifestyle and create distress on the ones affected (Laurie 142). Examples of psychological disorders include schizophrenia, phobias, anxiety disorders, obsessive compulsion, depression and post-trauma stress disorder. This paper focuses on schizophrenia. 心理障碍可以被定义为行为症状的模式，影响人们生活方式的各个方面，并给受影响的人造成痛苦(Laurie 142)。心理障碍的例子包括精神分裂症、恐惧症、焦虑症、强迫症、抑郁症和创伤后应激障碍。本文以精神分裂症为研究对象。
Schizophrenia also known as split personality disorder is a chronic and severe mental illness involving auditory hallucinations, very disturbed moods or social problems, thoughts and behaviors (Laurie 143). The problem of thoughts associated with schizophrenia is described as psychosis. A person suffering from schizophrenia has the kind of thinking that is completely out of touch with the reality. A person may for instance could be hearing nonexistent voices or seeing images that are not there. For instance in the film, “A Beautiful Mind”, the star character John Nash, experiences both visual and auditory hallucinations. He sees three characters in his life that are completely non-existent. These are: Charles (his roommate), Marcee (the roommate’s niece) and Parcher (his boss from the US Defense Department). In one scene, he leaves his son in the bathtub alone but he claims that Charles is watching over the child. This is a visual hallucination. In yet another scene, he claims that Parcher is instructing him to kill his wife Alicia. This is an auditory hallucination.
Types of schizophrenia类型的精神分裂症 There are five types of schizophrenia depending on the kind of symptoms a patient exhibits during assessment. They include paranoid, catatonic, disorganized, undifferentiated, and residual schizophrenia. 根据患者在评估过程中表现出的症状，精神分裂症有五种类型。它们包括偏执型、紧张性、无组织、未分化和残留型精神分裂症。
Under paranoid schizophrenia, a person gets preoccupied with one or more delusions or hallucinations but doesn’t get disorganized. This kind of Schizophrenia is brought out really well in the film “A Beautiful Mind”. Nash is very paranoid; he feels that Soviet agents want to kill him because he apparently assisted in sabotaging one of their plots by picking out patterns of information from newspapers and magazines.
In disorganized schizophrenia, a person is disorganized in both speech and behavior but doesn’t get worse to the extent of being catatonic. One of the speech disorders is schizophrenia is loosening of association.
Catatonic schizophrenia is a situation where a person displays two or more of the following symptoms: difficulty in moving, resistance to motion, or excessive moving around, weird movements and imitating other people’s actions (echopraxia). In an article from the journal “American Journal of Psychiatry”, it is well elaborated how pronounced motor in coordination can be in schizophrenia. Following a research, it was seen that in fact motor in coordination can be used to tell the neurodevelopment of Schizophrenia (Schiffman 1041). There could also be cognitive symptoms that are residual as in the case of the 22year-old man in an article by “Clinical Case Studies” (Sass and Nelson 489). 紧张性精神分裂症是指一个人表现出以下两种或两种以上的症状:行动困难，抵抗运动，或过度移动，奇怪的动作和模仿他人的行为(异跳症)。《美国精神病学杂志》上的一篇文章详细阐述了精神分裂症患者的运动协调能力。一项研究发现，事实上，运动协调可以用来判断精神分裂症的神经发育情况(Schiffman 1041)。“临床案例研究”(Sass and Nelson 489)一篇文章中提到的22岁男子的认知症状也可能是残留的。
In undifferentiated schizophrenia, a person will do two or more of the things or symptoms done under paranoid, disorganized, and catatonic types of schizophrenia. However such a person classified under undifferentiated schizophrenia doesn’t qualify to be diagnosed of the three former types. Lastly is the residual type of schizophrenia. Under this type, positive symptoms involving behavior that is beyond normal such as hallucinations, sensitiveness, and paranoia are absent. Instead, the patient has negative symptoms that are mainly about reduced functionalism, quietness, withdrawal and not being interested in things or events.
Causes of schizophrenia精神分裂症的原因 Schizophrenia is not an expressly hereditary mental disorder but rather a mix of genetic, psychological and environmental factors (Dryden-Edwards 232). Environmentally, the risk of developing the disorder may start prior to birth if for example a person’s mother had some infections while pregnant with the person. Other examples of factors that can lead to the development of schizophrenia disorder are: physical and/ or emotional neglect, sexual abuse, physical abuse, emotional abuse, bullying, and difficult childhood life (Walsh and Fahy 124). Another factor that has been researched on is representation of the minority in a group especially ethnically (Dryden-Edwards 235). In this case, ethnic minorities are more likely to develop schizophrenia if not well represented in a neighborhood. 精神分裂症不是一种明确的遗传性精神障碍，而是遗传、心理和环境因素的混合(Dryden-Edwards 232)。从环境上来说，如果一个人的母亲在怀孕期间有一些感染，那么这种疾病的风险可能在出生前就开始了。其他可能导致精神分裂症发展的因素的例子有:身体和/或情感忽视、性虐待、身体虐待、情感虐待、欺凌和艰难的童年生活(Walsh和Fahy 124)。另一个被研究的因素是少数群体的代表性，特别是在种族上(Dryden-Edwards 235)。在这种情况下，少数民族更有可能患上精神分裂症，如果没有良好的社区代表。
Symptoms of schizophrenia The symptoms of schizophrenia can be either positive or negative. Positive symptoms are those that are visibly psychotic such as delusions, hallucinations, disorganized speech, disorganized behaviors, and catatonic characteristics. This is clearly depicted in an article published by the journal “Clinical Case Studies” where a 53 year-old man suffering from paranoid schizophrenia presented with auditory hallucinations and persecutory delusions (Hatzipetrou and Oei 339).
Negative symptoms on the other hand are less openly psychotic such as lack of speech, less motivation and inhibited facial expressions.
Diagnosis of schizophrenia精神分裂症的诊断 Practitioners often gather comprehensive medical, family, and mental health information to diagnose this disorder. Some of the information gathered include: gender, cultural, religious and ethnic background, sexual orientation and economic well being or financial status. Physical examination and laboratory tests may be included to determine patient’s health status. 医生经常收集综合的医疗、家庭和心理健康信息来诊断这种疾病。收集的一些资料包括:性别、文化、宗教和种族背景、性取向和经济福利或财务状况。可包括体格检查和实验室检查，以确定病人的健康状况。
Treatment for schizophrenia There are medications known as antipsychotics that help in reducing the magnitude of psychotic symptoms. These medications are widely prescribed solely or combined with other psychiatric medicines. Examples of antipsychotics are Chlorpromazine (Largactil or Thorazine), Olanzapine (Zyperexa), Risperidone (Risperdal), Ziprasidone (Geodon) and Aripiprazole (Abilify). These examples are the newer versions of antipsychotics often referred to as second-generation antipsychotics that work quickly in comparison to other psychiatric medications. It is important to note that not all antipsychotics that treat adults are advisable for administering in children.
The side effects of antipsychotics include sleepiness, dizziness, increased appetite, weight gain due to high blood sugar, increased blood lipid levels and increased prolactin level. Older generation antipsychotics such as Perphenazine (Trilafon) may cause muscle stiffness and tremors. These side effects can be so serious as to interfere with patient’s daily activities. For instance, in the film “A Beautiful Mind”, some of the side effects Nash experiences include impaired emotional function which strains his marriage and decreased intellectual capacity which frustrates his work. To counter the side effects of antipsychotics, are other drugs such as 抗精神病药物的副作用包括嗜睡、头晕、食欲增加、高血糖引起的体重增加、血脂升高、催乳素增加等。老一代的抗精神病药物如奋乃静(Trilafon)可能会引起肌肉僵硬和震颤。这些副作用非常严重，甚至影响到病人的日常生活。例如，在电影《美丽心灵》中，纳什经历的一些副作用包括情感功能受损，这使他的婚姻紧张，智力下降，使他的工作受挫。为了对抗抗精神病药物的副作用，还有其他药物如
Another classification of medication is Mood-stabilizer for example Lithium, Carbamazepine (Tegretol) and Lamotriqine. They treat mood changes but may take a longer time to work compared to antipsychotics. According to National Institute of Health (2009), they require close monitoring of blood levels and may cause birth defects when administered to pregnant women.
Besides medication, psychological interventions are important in treating schizophrenia. These interventions include family psycho-education, assertive community treatment, substance abuse treatment, social skills training, supported employment, cognitive behavioral therapy and weight management. These interventions are important to avoid the risk of patient defaulting medication especially because of the side effects such as is the case of Nash in “A Beautiful Mind”. This leads to a relapse as was shown in the film. 除药物治疗外，心理干预在精神分裂症的治疗中也很重要。这些干预措施包括家庭心理教育、果断的社区治疗、药物滥用治疗、社会技能培训、支持就业、认知行为治疗和体重管理。这些干预措施对于避免病人不按时服药的风险是很重要的，特别是因为副作用，例如纳什在《美丽心灵》中的情况。正如电影中所展示的那样，这导致了复发。
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