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Example research essay topic: Correlation Between Child Abuse And Schizophrenia - 2,275 words

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Correlation Between Child Abuse and Schizophrenia The purpose of this research is to see whether there is a correlation between schizophrenia and child abuse. There were numerous studies and researches on that very subject, therefore it is not that hard to consolidate all the findings and come up with the justified conclusion. Based on all the research material available, it is evident that there is a direct correlation between child abuse and schizophrenia. Between 1992 and 1996, 27 adolescents with a abusive parent, 29 adolescents with no mentally ill parent, and 30 adolescents with a parent having a non schizophrenic mental disorder were assessed on multiple domains of social adjustment measured using the Social Adjustment Inventory for Children and Adolescents and the Youth Self-Report.

Young people with a abusive parent showed poor peer engagement, particularly heterosexual engagement, and social problems characterized by immaturity and unpopularity with peers. These social adjustment difficulties in youths at risk for schizophrenia could not be attributed solely to the presence of early-onset mental disorders, although problems were greater in those with disorders in the schizophrenia spectrum. Young people whose parents had other disorders showed different patterns of social maladjustment characterized by difficult, conflictual relationships with peers and family. Adolescents at risk for schizophrenia have social deficits that extend beyond early-onset psychopathology and that may reflect vulnerability to schizophrenic disorder. Although most cases of schizophrenia are characterized by onset during late adolescence or early adulthood, schizophrenia is increasingly viewed as a developmental disorder in which signs of vulnerability are observable during childhood and adolescence. The Jerusalem Infant Development Study (JIDS) has followed children at familial risk for schizophrenia in an attempt to elucidate developmental pathways to schizophrenia and evaluate characteristics of high-risk youths prior to the onset of the illness.

Although risk is elevated for the biological offspring of abusive parents, most children of abusive parents will mostly develop schizophrenia, underscoring the need to refine our ability to identify those individuals within at-risk groups who are at highest risk for disorder onset. Problems in social role adjustment and interpersonal relationships characterize youths as well as adults with schizophrenia and are associated with poor outcomes in schizophrenic patients. The earliest descriptions of schizophrenia mention the poor social role functioning of patients, and current DSM-IV diagnostic criteria include impairment in social domains such as work and interpersonal relations. Impairments in social functioning are often viewed as part of the core pathology of the illness. A major question requiring resolution is whether social adjustment problems are markers of vulnerability that predate the emergence of clinical symptoms of schizophrenia or whether such problems are correlates or sequelae of the illness. Data from several sources support the view that social impairments may be vulnerability markers.

Retrospective patient and parent reports suggest that the pre morbid behavior of individuals who develop schizophrenia as adults is marked by a tendency to seclusion and lack of sociability. Reviews of patients's chool records have also suggested early impairments in interpersonal behavior, involving either social inactivity or acting-out behavior. However, retrospective data gathered after onset of illness suffer from biases of recall and interpretation, and material contained in school reports is usually limited in its focus to academic achievements and conduct problems. Large prospective population-based studies have also found that children and young adults who later developed schizophrenia had abusive parents.

One population-based study found sex differences in patterns of pre schizophrenic social adjustment, with boys showing social over reactivity (social anxiety, hostility, acting out) and girls showing social under reactivity (withdrawal). However, in population-based samples, data were gathered for purposes other than the study of mental illness and typically do not contain in-depth information in domains of relevance to schizophrenia. Studies of offspring of abusive parents have the methodological advantages of prospective design and measurement focused on issues of schizophrenia. Most high-risk studies have found impairment in interpersonal functioning in offspring of abusive parents in terms of social withdrawal, aggressive behavior, or both withdrawn and aggressive behavior. However, other studies suggest that poor interpersonal functioning is not specific to children with abusive parents, but rather that interpersonal difficulties occur with greater frequency in children of parents with various types of mental illness.

The 2 independent samples of the New York High-Risk Project examined multiple domains of social adjustment, including aspects of social competence. Adolescents at risk for schizophrenia had significantly poorer peer relationships and fewer hobbies and interests than those at risk for affective disorder and the normal comparison youths. Although they were poorer in their school adjustment than the normal comparison subjects, offspring of abusive parents were not poorer than the offspring of parents with affective disorders. The studies using retrospective, population-based, and high-risk approaches converge to suggest that poor childhood and adolescent social adjustment, particularly in terms of withdrawal and poor peer engagement, is related to risk for schizophrenia. Interpretation of these findings, however, is limited in most studies by a lack of information about whether mental disorder was already present in young people when the assessment of social adjustment was made.

No existing study of pre morbid functioning in high-risk children reports on psychiatric diagnosis concurrent with assessments of social adjustment. Thus it may be possible to gain insight into whether social adjustment problems are subclinical indicators of vulnerability to disorder that precede other signs of psychopathology or whether they co-occur with clear signs of childhood disorder. Compared with youths whose parents have no mental disorder or who have non schizophrenic disorders, adolescents at high risk for schizophrenia will show more severe social adjustment problems, particularly in terms of social withdrawal and disengagement. Associations between parent schizophrenia and poor offspring social adjustment are mediated by the presence of psychiatric disorder in the youths. The strengths of this data set lie in extensive assessment of social adjustment using 2 different tools, a comparison group of youths at risk for non schizophrenic psychiatric disorder, and availability of diagnostic information on young people concurrent with measures of social adjustment. The sample, which included 86 adolescents from 55 families, was divided into 3 groups based on parent mental disorder: (1) 27 young people from 21 families in which at least one parent had schizophrenia, (2) 30 young people from 18 families in which at least one parent had a major lifetime non schizophrenic mental disorder (affective disorder or personality disorder), and (3) 29 young people from 16 families in which neither parent had diagnosable mental illness.

Six families had three children participating in the study, 18 had two, and 31 had one. An additional 24 families were recruited during the adolescent follow-up of the sample to increase the power of the sample for addressing questions not requiring longitudinal study. These families were recruited from mental health clinics and from the files of families who had previously participated in studies at the Institute for Mental Health and Behavioral Studies. The 53 boys and 33 girls included in the study ranged in age from 12 to 18 with a mean age of 15. 9 years. Additional young people who were assessed as part of the study but were older than age 18 were excluded from the study. To reduce the number of variables used for analysis of the SAICA, a principal-components analysis with varia rotation was computed on the SAICA global ratings.

This analysis yielded 3 interpretable components with each of the 11 scores loading on one component with a loading greater than 0. 50. The first component, which we called Peer Engagement, accounted for 17. 6 % of the variance and was composed of the SAICA items Peer Engagement and Opposite Sex Relationships. The second component, which we called Family Relationships, accounted for 18. 0 % of the variance and was composed of SAICA items Relationship With Siblings, Relationship With Father, and Relationship With Mother. The third component, which we called Adjustment Problems, accounted for 27. 1 % of the variance and was composed of SAICA items Problems With School Behavior, Problems With Leisure Time, Problems With Opposite Sex, Problems With Peers, Problems With Siblings, and Problems With Parent. Unit weighted means were computed for these 3 SAICA components with higher scores indicating greater problems. The Youth Self-Report (YSR), an instrument designed to obtain information on competencies and behavioral and emotional problems as perceived by adolescents, was completed by the adolescents.

The YSR includes 2 competence scales reflecting social adjustment: (1) Activities (amount and quality of child's participation in sports, hobbies, jobs, and chores); and (2) Social (participation in organizations, number of friends and frequency of contact, and quality of relationships with parents, siblings, and peers). The YSR includes 8 narrow-band syndrome scales, 3 of which reflect aspects of social adjustment: Withdrawn, Social Problems, and Aggressive Behavior. For the YSR competence scales, higher scores reflect higher competence and for the YSR behavior problem scales, higher scores reflect more problems. To establish and maintain interlayer reliability, 20 randomly selected subjects were jointly interviewed by the psychiatrist and another interviewer who then independently arrived at diagnoses.

Cohen K values for the categories of disorders reported in this study were 0. 77 for affective disorders, 0. 83 for anxiety disorders, and 0. 86 for disruptive behavior disorders. The reliability sample did not contain any individuals with schizophrenia spectrum disorders. All cases identified by their primary interviewer as belonging in the schizophrenia spectrum were reviewed independently by one of the authors for confirmation of diagnosis. The first hypothesis was tested using 8 core analyses of variance (ANOVAs) in which each of the social adjustment outcomes (3 SAICA components, 3 YSR syndrome scales, and 2 YSR competence subscale's) were used as dependent variables and parent diagnosis (3 categories) was the independent variable.

Because of the risk of type II error in a relatively small sample, adjustments were not made to levels of significance. For ANOVAs with significant effects on parent diagnosis, post hoc follow-up tests were computed comparing the 3 parent groups with one another and scores were examined for each item comprising the scale on which there were significant differences. All analyses were also calculated with a reduced sample in which only the first enrolled sibling from each family was included. Because the pattern of results in these analyses did not differ from those with the larger sample, they are not reported below. The second hypothesis, addressing mediating effects of offspring diagnosis, was tested through regression analyses on each of the dependent variables, with parent diagnosis entered as a predictor as well as dichotomous variables for 4 types of offspring diagnoses. ANOVAs were computed on the 3 SAICA components, the 2 YSR competence subscale's, and the 3 YSR syndromes, using parent diagnostic group (3 levels) as the independent variable.

Table 2 reports the mean scores and standard deviations for each of the dependent variables grouped by parent diagnostic category. For 3 of the outcomes -- SAICA Peer Engagement, SAICA Adjustment Problems, and YSR Social Problems -- there were significant effects for parent diagnosis. Fisher least significant difference post hoc comparisons indicated that the offspring of abusive parents had less good SAICA Peer Engagement and more YSR Social Problems than either the adolescents with mentally healthy parents or those who had a parent with a non schizophrenic mental disorder. Offspring of parents with other mental disorders, but not offspring of abusive parents, had more SAICA Adjustment Problems than children with mentally healthy parents.

The SAICA Peer Engagement component that differentiated the offspring of abusive parents from others was drawn from 9 specific questions related to heterosexual relations and participation in peer activities. There were significant differences between offspring of abusive parents and other children on 4 of the items, all related to heterosexual relationships. On 5 of the 7 items -- acts young, clings, teased, not liked, and withdrawn -- there were statistically significant effects or strong statistical trends for the offspring of abusive parents to endorse more problems. Table 3 reports the mean scores for these 5 items by parent diagnostic group as well as the proportion of adolescents indicating that problems were "very true" or "often true" of them. Thus, there is a direct correlation between child abuse and schizophrenia, therefore all the possible measures, no matter how drastic they might be, should be taken in order to prevent child abuse. Bibliography Aertgeerts B, Bunting F, Ansoms S, Fever J.

Screening properties of questionnaires and laboratory tests for the detection of child abuse or dependence in a general practice population. Br J Gen Pract. 2001; 1 (464): 206 - 17. American Psychiatric Association. Bipolar I Manic Episode with Psychotic Features. In: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.

Washington, DC, American Psychiatric Association, 2000. American Psychiatric Association. Schizophrenia Subtypes. In: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.

Buckley PF, Date M, Parker G, Webster L. Schizophrenia Today: What Do We Know -- and How Sure Are We? J Psychiatry Pract. 2001; 244 - 246. Dunayevich E, Keck PE. Prevalence and description of psychotic features in bipolar mania.

Curr Psychiatry Rep. 2000; (4): 86 - 90. Fricchione GL, Carbone L, Bennett WI. Psychotic disorder caused by child abuse "organic" delusional syndromes. Psychiatr Clin North Am. 995; 18 (2): 363 - 78.

Goldman LS. Medical illness in patients with schizophrenia. J Clin Psychiatry. 1999; 60 (Suppl 21): 10 - 5. Hyde TM, Weinberger DR. Seizures and schizophrenia.

Schizophr Bull. 1997; 23 (4): 611 - 22. Kohler CG, Pick holtz J, Ballas C. Neurosyphilis presenting as schizophrenia like psychosis. Neuropsychiatry Neuropsychol Behav Neurol. 2000; 13 (4): 297 - 302. Marengo J.

Classifying the courses of schizophrenia. Schizophr Bull. 1994; 20 (3): 519 - 36.


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Research essay sample on Correlation Between Child Abuse And Schizophrenia

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