EBP on Schizophrenia Introduction

Schizophrenia is a chronic disorder of the brain that affects the ability of an individual to interpret reality normally. An active schizophrenia reveals symptoms such as lack of motivation, hallucinations, delusions, difficulty with concentration and thinking. Although there is no cure for schizophrenia, various studies have been conducted to determine the causes of the disease and develop new and more effective therapies to the address the causes that exacerbate the symptoms. The causes of schizophrenia such as environmental, mental, genetic, and social factors vary significantly between individuals as well as the symptoms. These are risk factors that contribute to the onset and course of the disorder. Because of these multiple factors that contribute to the development of the disorder, it has made it difficult to identify specifically the exact cause of the disease in individual cases. The clinical question to be discussed in this paper includes, “What are the social, mental and environmental causes that exacerbate hallucinations in a patient diagnosed with schizophrenia?

Literature Review

According to the study conducted by McCarthy-Jones and Longden, 2015), the auditory verbal hallucination (AVH), which involves ‘hearing voices’ is a schizophrenia disorder linked with earlier exposure to emotionally or traumatic events that were overwhelming. The study suggests that these events may be recurring and if these memories form the basis of AVH, then changing an individual’s current perspectives and beliefs may alter memories that they create and causes their ability to contrast voices to arise from these events. Based on the study results, evidence suggests that there is a direct relation between trauma and hallucination. All these evidence indicate that a subsection of individuals with schizophrenia disorder have earlier experiences of trauma in their life and a subset of these traumas has associations with their hallucinations.

The implementation of this evidence in practice requires a trans-diagnostic strategy of treatment (Garwood, Dodgson, Bruce & McCarthy-Jones, 2015). Implementation of trauma-based interventions for AVH that are based on trauma is crucial to improving patient outcome. The trauma specialized interventions have proved to be appropriate for many patients. They change the negative content of voices thus have beneficial consequences and improved outcomes for many patients. Sariaslan et al. (2016) point out that various systematic reviews have shown that neighborhood contributes to the etiology of schizophrenia. Evidence indicates that based on interpretation of social causation, systematic reviews have revealed that early experiences of adverse neighborhood stressors over a period of time contribute to the development of schizophrenia. Neighborhoods that are socially disorganized are characterized by ethnic heterogeneity, marital instability, poverty, and residential mobility.

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The study findings indicated that the risk for development of schizophrenia and neighborhood deprivation was statistically significant. Although the results were inconsistent and inconclusive, it is evident that social factors have an influence on the social drift of patients with schizophrenia based on the social selection interpretation. The implementation of clinical and policy interventions in the treatment of patients with schizophrenia associated with social causation will contribute significantly towards the identification of the possible causal factors between socioeconomic courses and cognitive functions thus leading to improved outcomes.

Wright, Peters, Ettinger, Kuipers, and Kumari, (2016) conducted a study to determine the impact of environmental factors such as noise on the cognitive function of patients diagnosed with schizophrenia. Cognitive impairment is a common symptom related to poor functional outcomes in schizophrenia, especially the executive and memory function areas. Schizophrenia patients have been observed to have the oversensitivity to sensory stimuli and it is possible that environmental factors such as noise could exacerbate cognitive impairment especially those residing in urban environments (Bristow et al., 2014).  The study suggests that environmental noise has an adverse impact on various cognitive areas in healthy adults as well as those with schizophrenia. The results of the study revealed that environmental noise contributes to further cognitive impairment.

The study assessed the comprehensive cognitive battery in healthy participants such as measuring verbal learning and memory, executive functioning, attention, and psychotic speed. These measures were conducted under three major environmental conditions including social noise, for instance, the foots