PlusFour Solutions: Guidance through Assessment

Emotional and Behavioral Assessment


Schizophrenia is a chronic, severe, and disabling brain disease. Approximately 1 percent of the population develops schizophrenia during their lifetime; more than 2 million Americans suffer from the illness in a given year. Schizophrenia affects men and women with equal frequency, although it often appears earlier in men, usually in the late teens or early twenties. Women are generally affected in their twenties to early thirties.

Symptoms of Schizophrenia

  • Hearing internal voices not heard by others
  • Paranoia (believing that other people are reading their minds or controlling their thoughts or plotting against them)
  • Disorganized speech
  • Disorganized behavior
  • Hallucinations and illusions
  • Delusions
  • Emotionally blunt or “flat”

The first signs of schizophrenia often appear as confusing, or even shocking, changes in behavior. The sudden onset of severe psychotic symptoms is referred to as an “acute” phase of schizophrenia. “Psychosis,” a common condition in schizophrenia, is a state of mental impairment marked by hallucinations, which are disturbances of sensory perception, and/or delusions, which are false yet strongly held personal beliefs that result from an inability to separate real from unreal experiences. Less obvious symptoms, such as social isolation or withdrawal, or unusual speech, thinking, or behavior, may precede, be seen along with, or follow the psychotic symptoms.

Distorted Perceptions of Reality
People with schizophrenia may behave very differently at various times, sometimes seeming distant, detached, or preoccupied and other times moving about constantly—always occupied, appearing wide-awake, vigilant, and alert.

Hallucinations and Illusions
Hallucinations are perceptions that occur without connection to an appropriate source. Although hallucinations can occur in any sensory form, hearing voices that other people do not hear is the most common type of hallucination in schizophrenia. Illusions occur when a sensory stimulus is present but is incorrectly interpreted by the individual.

Delusions are false personal beliefs that are not subject to reason or contradictory evidence and are not explained by a person’s usual cultural concepts. People suffering from paranoid-type symptoms often have delusions of persecution, or false and irrational beliefs that they are being cheated, harassed, poisoned, or conspired against. In addition, delusions of grandeur, in which a person may believe he or she is a famous or important figure, may occur in schizophrenia.

Disordered Thinking
Schizophrenia often affects a person’s ability to “think straight.” Thoughts may come and go rapidly; the person may not be able to concentrate on one thought for very long and may be easily distracted, unable to focus attention. The person may be unable to connect thoughts into logical sequences, with thoughts becoming disorganized and fragmented.

Emotional Expression
People with schizophrenia often show “blunted” or “flat” affect. A person with schizophrenia may not show the signs of normal emotion, perhaps may speak in a monotonous voice, have diminished facial expressions, and appear extremely apathetic. The person may withdraw socially, and motivation can be greatly decreased, as can interest in or enjoyment of life.

Available treatments can relieve many symptoms, but most people with schizophrenia continue to suffer some symptoms throughout their lives. However, this is a time of hope for people with schizophrenia and their families. Research is gradually leading to new and safer medications and unraveling the complex causes of the disease. Scientists are using many approaches from the study of molecular genetics to learn about schizophrenia.

Additional information about Schizophrenia: