Schizophrenia and Behaviorism

Schizophrenia and behavior is difficult to predict as this is a complicated disease and the aberrant behavior is specific to individuals. Even though there are subcategories of schizophrenia: paranoid, catatonic,  hebephrenic, undifferentiated and residual, not all patients in each subcategory exhibit the same type of behavior when presented with environmental stimuli. The assumption is that when a schizophrenic is in the midst of a psychotic episode their perception of reality is distorted and skewed. While this is true, if the schizophrenic is measured against testing results that were obtained from a base under normal conditions with subjects that do not experience mental illness, the assumption should be that since schizophrenics  are not categorized with these testing measures they are reacting to conditional or unconditional stimulus within their own perceptions. The question becomes do schizophrenics experience conditional or unconditional responses under the behaviorism theories posed by Pavlov and Skinner?

When Pavlov developed his behaviorism theory the original data was gathered by test results from animal behavior in the laboratory; he concluded that since there was no differentiation between animal and human behavior the results obtained were pervasive and he concluded that the resultant behavior was as controlled as the environment in which it was conducted. Pavlov’s test results with domesticated dogs were not measured against animals that displayed aberrant behavior, thus excluding any animal, be it human, which was not operating under normal/controlled conditions.   He did not take into account the influences of unpredictability in the environment that cannot be controlled. A schizophrenic has a higher sensitivity to the environment; they either escalated or closed down internally. As with a normal subject that is conditioned by a stimulus; their favorite song results in a feeling of euphoria, their hatred for an untidy household results in a depressed mood, even these conditioned responses can be delayed or extinguished by a bombardment of unpredictable stimuli; the phone call that a relative that was in an automobile accident, a neighbor’s house is on fire. With the normal individual the conditioned response will be delayed or extinguished by these unpredictable factors. Now, if those same set of examples are presented to an individual in a schizophrenic state, the unpredictability of their response could be interpreted the same as the individual that reacted to the house on fire or the phone call regarding the family member. The expected result from a pleasurable or non-pleasurable stimulus would be delayed or extinguished by whatever is it that distorted their perception of it.

Pavlov concluded that repeated stimuli under normal repeatable conditions produced the exact conditioned response. The weakness of this assumption when attempting to predict a schizophrenic’s reaction to the environment is that their behavior while unpredictable should be that their response may be conditional, but not  discernable by the usual testing methods; it is present, but not observable upon first glance.Skinner agreed with Pavlov on the behavior of conditional and unconditional responses. It was Skinner that said, “The consequences of behavior determine the probability that the behavior will occur again.”

Skinner, as with Pavlov, adhered to the scientific method which promotes reproducibility by stimulus from the environment ; once behavior is established, it will repeat with the proper stimulus. Skinner built upon Pavlov’s behaviorist theory by stating that behavior is determined by rate of response. While Skinner never directly tested schizophrenics, his theory of rate response could pose as a testing method for them. With the use of reinforcements -positive and negative and the dependent variable of rate response a schizophrenic could follow the predictive behavior consistently. This behavior most probably would not be predictable in the sense that when a bell rings they will salivate, but the rate of response of their behavior under certain circumstances would occur.  Then the conclusion could be drawn that schizophrenics follow the conditioning of behaviorism with the use of positive or negative reinforcement.

While Skinner focused on the controlled environment and the resultant behavior associated with it, he did pose the possibility of the unpredictability of stimulus from the environment which would lead to an explanation of a schizophrenic’s behavior under certain environmental stimuli.

While the diagnosis of schizophrenia is that they receive internal signals from their psychotic episodes, this is not disputed in regards to the behaviorist theories. To Skinner and Pavlov internal signals were present in all individuals, but the resultant behavior did not plug into the thought processes; the observable behavior was environmentally induced only. The argument is posed how could a schizophrenic in a heightened state of anxiety clearly displaying abnormal outward behavior be able to act on recurrent stimuli from the environment with repeatable actions?

For example, a paranoid schizophrenic displays anxiety from what was proposed as their internal distortions of reality; in this instance the visual hallucination. Their outward behavior displays an individual cowered in the corner of the room, watching the ceiling for whatever image is displayed across their mind. Their involvement in this state of psychosis removes them from the details of the room they are occupying while receiving mental bombardment of images. When an environmental stimulus is added, the opening and closing of the door, the schizophrenic startles in reaction to being brought from their agitated state to the awareness of the noise. When each time the door opens and closes the unconditioned response of startling occurs. Then, in Pavlovian fashion, if a stimulus is introduced concurrently with the opening and closing of the door a conditioned response will develop. 
If each time the door opens or closes and the individual is offered a blanket to hide under and they hide under it consistently to avoid the actions of the door; a conditioned response has been formed. This resultant behavior will depend on the degree of the psychotic state of the schizophrenic and their ability to perceive the outlying environmental stimulus that will remove them from their internal focus.
  
This example of the opening and closing a door to alert a schizophrenic in a state of psychosis to prove that a behaviorist theory applies to them is unethical, without question. Exposing a paranoid schizophrenic to a stimulus that raises their already heightened anxiety could provide a stronger internal struggle instead of bringing their awareness into the room. The instability of their mental state is not linear. Yet, some form of bombardment to the schizophrenic occurs in a natural setting that does alter their mental state and they will react to their environment.

  This theoretical scenario of the door and the blanket is used as an example on how to observe a schizophrenic in a natural setting and discern the environmental stimulus they consistently react to. This type of observation does not follow the traditional methods of scientific testing. The schizophrenic would have to startle when the door opens and closes every time the action was performed; then they would have to hide under the blanket to their response consistently.  Also, these conditioned/unconditioned responses would need to be observable in all schizophrenics with paranoid hallucinations.

However, if instead of predicting what type of behavior will occur when an environmental stimulus is presented; the prediction of response time to the environmental behavior regardless of the outward manifestation would become reproducible if the response times correlated. For example, one paranoid schizophrenic will begin to bite their arm when someone enters the room, another paranoid schizophrenic will begin to rock back and forth, and the third individual will cradle their head in their hands. For response time testing the measurement should begin when the individual is aware of the intruder; then gauge when the outward behavior occurred. If the three paranoid schizophrenics display their individual reactions/behavior within a thin margin of time the deduction is they have all exhibited the unconditioned response even if their behaviors were not the same.

All of these behaviors are observable and may or may not be anxiety induced, but if the behavior ceases when the intruder leaves the room; the conclusion would then be the behavior is an unconditional response as proposed by Pavlov and Skinner which in turn would lead to the hypothesis that a conditioned response could be introduced which could lessen the severity of behavior displayed by the paranoid schizophrenic. A self comforting conditioned response could be offered each time the paranoid schizophrenic has become agitated by their environment that would deescalate their destructive behavior.

While this example illustrated the proposed behavior of a paranoid schizophrenic the same type of observations could occur with schizophrenics with auditory hallucinations, undifferentiated, or residual areas of the disease. Once again, the state of psychosis is paramount as to the measure of an environmental response, but the concept of testing remains the same; their outward behavior to an environmental stimuli.
The one area where the behaviorist theory could not be applied is the catatonic schizophrenic where interaction with a reality based environment is nonexistent.

Pavlov and Skinner developed their behaviorist theories primarily in the laboratory with animal testing. From the results obtained, they concluded that the environment was responsible for outward behavior in animals as well as humans. While they only considered mentally healthy human beings, their theories may be adapted to a mentally ill individual with schizophrenia.

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