Question

Mary believes that while she sleeps at night, space creatures are attacking her and invading her uterus, where they will multiply until they are ready to take over the world. Mary was chosen for this task, she believes, because she is the only one with the power to help the space creatures succeed. Mary would most likely be diagnosed as ____ schizophrenic. A. paranoid B. catatonic C. disorganized D. undifferentiated

Short answer

Answer: A. Paranoid schizophrenia

Step-by-step solution

Understand the Different Types of Schizophrenia

It is important to know the characteristics of the four types of schizophrenia to determine the most appropriate diagnosis for Mary. Here's a brief overview: A. Paranoid schizophrenia: Characterized by delusions and hallucinations, often involving persecution or conspiracy, but with relatively preserved cognitive functioning and emotional responsiveness. B. Catatonic schizophrenia: Involves extreme motor disturbances, ranging from complete immobility to excessive and purposeless activity or repetitive movements. C. Disorganized schizophrenia: Marked by disorganized thinking, incoherent speech, bizarre behavior, and blunted or inappropriate emotions. D. Undifferentiated schizophrenia: A mix of symptoms from the other subtypes but not fitting neatly into one of them.

Analyze Mary's Beliefs and Symptoms

Based on the description, Mary believes that space creatures are attacking her and invading her uterus while she sleeps. She thinks she was chosen for this task because she possesses unique powers to help the creatures succeed. These beliefs seem to point towards delusions of persecution and grandiosity.

Match Mary's Symptoms with the Correct Schizophrenia Type

Considering the characteristics of the different types of schizophrenia and analyzing Mary's beliefs, the most likely diagnosis for her would be paranoid schizophrenia as her symptoms primarily involve delusions of persecution and grandiosity.

Answer:

Mary would most likely be diagnosed as paranoid schizophrenic (Option A).

Key concepts

Paranoid Schizophrenia

Paranoid schizophrenia is the subtype most often highlighted in popular culture, perhaps due to its dramatic symptoms. Individuals with paranoid schizophrenia are predominantly plagued by delusions of persecution and grandiosity, in addition to auditory hallucinations. These delusions involve a belief or fear that others are plotting against or targeting the person. For example, a paranoid individual may believe they are being spied on by government agencies without substantial evidence.

Despite these challenging symptoms, people with paranoid schizophrenia often have relatively preserved cognitive functions and can exhibit appropriate emotional responses. However, their trust in others is usually severely compromised due to their paranoid delusions. In the case provided, Mary's belief that she has been uniquely chosen by extraterrestrial beings to facilitate their world domination aligns with the classic symptoms of paranoid schizophrenia.

Catatonic Schizophrenia

Catatonic schizophrenia is characterized by a significant disturbance in a person's movements and behavior. It can manifest in two extremes: catatonic stupor and catatonic excitement. In a catatonic stupor, the individual might be immobile and unresponsive, maintaining rigid postures for extended periods.

On the other hand, catatonic excitement represents the opposite end of the spectrum where the individual may exhibit uncontrolled and excessive movements. They might engage in repetitive, purposeless gestures or mimic the speech and movements of others, a phenomenon known as echolalia and echopraxia. It's important to note, however, that catatonic symptoms can also occur in other psychiatric disorders and are not exclusively seen in schizophrenia.

Disorganized Schizophrenia

Disorganized schizophrenia, previously known as hebephrenic schizophrenia, is often considered one of the more debilitating subtypes. Those affected present with disorganized speech and behavior accompanied by inappropriate or flat emotions. This disorganization makes it difficult for them to perform routine daily activities and they may struggle to communicate effectively.

Behaviors might seem erratic or random, and emotional responses may not match the situation, such as laughing in response to sad news. Speech can be incoherent and scattered, making it hard for the listener to follow. Such patterns of disorganization extend to thinking processes as well, rendering some individuals with disorganized schizophrenia unable to function independently.

Undifferentiated Schizophrenia

Undifferentiated schizophrenia is a classification used when an individual's symptomatology does not specifically align with the criteria for the other subtypes of schizophrenia, or when they exhibit a blend of symptoms from various types.

This 'catch-all' category provides mental health professionals with the flexibility to diagnose people who experience prominent symptoms of schizophrenia without a clear boundary between paranoid, catatonic, or disorganized features. The term 'undifferentiated' can sometimes lead to confusion as it suggests a lack of distinct features, but individuals under this subtype can still face significant challenges due to their symptoms, which might include a mix of delusions, hallucinations, motor issues, and disorganized speech or behavior.