Language Disorder In Schizophrenia Patient: A Case Study Of Five Schizophrenia Paranoid Patients In Simeulue District Hospital
CHAPTER I
INTRODUCTION
1.1 Background of study
Language is a system of signs which is used by human to interact through
communication with other. Language is one of the most crucial and important
aspects in human life. As Gleason (1998: 2) mentions that language is so basic to
the existence of human that life without words is difficult to envision.
Furthermore, language also becomes an essential need in human life which makes
human becomes able to express thoughts, needs, emotions and desires through
language.
Chaer (2009: 148) said that “to communicate (to use language) is a process
to deliver what’s in your mind and your feelings (from your mind) orally, in the
form of words or sentences”. He also added that people with normal brain
function and speech organs, certainly can use language effectively. However,
people with abnormal brain function and speech organs may have some problem
to use language, whether it is expressive or receptive. Chaer (2009: 159) also said
that verbal expression is a reflection of thought. Therefore, he concluded that
disordered verbal expression results from or caused by disordered thought. Verbal
expression impairment may include dementia, schizophrenia, and depressive.
National Institute of Mental Health (NIH) stated that schizophrenia is a
chronic, severe, and disabling brain disorder that has affected people throughout
history (www.nimh.nih.gov). People with schizophrenia may hear voices that
1
other don’t hear. They may believe other people are reading their minds,
controlling their thoughts, or plotting to harm them. One of the most common
symptoms of schizophrenia that makes they are different from normal people is
their language abnormality. The study on language disorder in schizophrenia is
always become an interesting topic to analyzed.
Schizophrenia is a social phenomenon because one out of every hundreds
persons suffers from this illness (Wróbel, 1989: 1). Silber (2014: 93) said that one
of the central features of schizophrenia is interplay between disordered thought
and language used to express that thought. Language disorder in schizophrenia is
the abnormal speech produced by some patients. This disturbance is
heterogeneous and has traditionally been termed ‘thought disorder’ (Kuperberg &
Caplan, 2003: 444).
A variety of names have been given to the problem relates to language
abnormalities, including language impairment, language disability, language
disorder, language delay, language deviance, and childhood or congenital aphasia
or dysphasia. At certain points in the history of language pathology, some terms
have predominated, whereas others were used less commonly. From this
statement, it can be concluded that the term language disorder may refers to any
language impairment in mother tongue (Paul, 2007: 8).
According to Chaer (2009: 148) language disorder divided into two major
divisions; (1) language disorder due to medical factor and (2) language disorder
due to social factor. The language disorder results from medical factor including
2
abnormalities in brain functions and speech organs.
And the social factor
including unnatural environment, such as separated or isolated from normal social
life.
Language disorder due to medical factors differentiated into three groups.
Sidharta (1984) said that medically, language disorder can be divided to three
groups: Speech disorder, Language disorder, and Thought disorder (Chaer, 2009:
148). In fact, the terms “thought disorder”, “speech disorder” and “language
disorder” are often interchangeably in psychiatric literature (Radanovic et al.,
2012: 56).
The analysis about language disorder in schizophrenia patients becomes an
interesting topic because language disorder due to thought disorder in
schizophrenia is one of common signs and symptoms found in schizophrenia
patients. Identifying schizophrenia signs and symptoms earlier help people to seek
help without delay and help assessment of the schizophrenia as well. This analysis
is going to try to describe subtypes of language disorder or schizophrenia speech
found in schizophrenia paranoid patients by using Andreasen’s theory. Language
disorder due to thought disorder found in schizophrenia paranoid patients are
various. Therefore, this analysis is going to try to find out some types of language
disorder found in schizophrenia patient, especially in paranoid subtypes.
This analysis is expected to serve an understanding to common people
about language disorder occurred in schizophrenia paranoid patient. And this
analysis is also expected to encourage other people who interested in this subject
3
to do further research which will lead to further understanding to describe the
problem of language disorder in other subtypes of schizophrenia i.e.,
disorganized, catatonic, residual, and undifferentiated schizophrenia.
As the data source of this analysis, five patients suffering from paranoid
schizophrenia are selected randomly by the responsible Nurse in Simeulue District
Hospital. Schizophrenia paranoid patients are being chosen because paranoid
subtype is the most common subtype and the paranoid patients are more
communicative than other patients suffering from other subtypes of schizophrenia.
As Bengston, (2015) said that schizophrenia paranoid is the most common
subtypes. He also added that people with this subtype may be more functional in
their ability to work and engage in relationship than other people with other
subtypes of schizophrenia.
In addition, it is important to know that in the first observation of
schizophrenia patients in Simeulue District Hospital on 4th February 2015, the
writer consulted with the responsible Doctor, Dr. Emir Abdullah, sp.Kj and Nurse,
Ms. Otriana, and they agree to cooperate with the writer in doing the research in
the hospital. The Doctor suggested that in collecting the data, the writer will be
helped by the responsible nurse because schizophrenia patients will be less
communicative to the stranger. Therefore, in this analysis the Nurse will be the
writer assistant’s in collecting the data.
1.2 Problem of the Study
4
Language is one of the characteristics of human. Problem with language is
a crucial problem. This analysis is going to try to find out the language disorder
due to thought disorder in schizophrenia paranoid patient. Thought disorder refers
to disorganized thinking as evidenced by disorganized speech of the patient. And
accordance with the focus of this analysis about schizophrenia patient speech,
there are three problems that are going to be analyzed in this analysis:
1. What are the types of schizophrenic speech found in schizophrenia
paranoid patients?
2. Which dominant type of schizophrenic speech is found in schizophrenia
paranoid patients?
3. Which patient has the most severe language disorder?
1.3 Significance of the Study
The significance of this study is to expand knowledge of the readers about
language disorder due to thought disorder in schizophrenia paranoid patients,
especially for those who are interested in this subject. Beside that, the result of
this analysis will be useful for medical workers in classifying schizophrenia
patients as well as to common people to recognize signs and symptoms of
schizophrenia.
5
1.4 Objective of the Study
This analysis is going to try to find out the types of language disorder due
to thought disorder found in schizophrenia paranoid patients. Based on the
problem of the study above, the objective of this analysis are:
1. To find out the types of schizophrenic speech found in schizophrenia
paranoid patients.
2. To find out the most dominant type of schizophrenia speech found in
schizophrenia paranoid patients.
3. To find out which patient has most severe language disorder.
1.5
Scope of the Study
It is important to make a scope in this study in order to get a clear
explanation about the topic. This analysis of language disorder in schizophrenia
patients limited only on language disorder due to disorder of thought or also
known as “thought disorder” which are found among the five selected
schizophrenia paranoid patients in District Hospital of Simeulue.
This analysis uses Andreasen’s theory to find the types of language
disorder found in schizophrenia paranoid patients’ speech. Andreason (1979)
distinguished schizophrenic speech or language disorder due to thought disorder
in schizophrenia into 18 types, they are; poverty of speech, poverty of content of
speech, pressure of speech, distractible speech, tangentiality, derailment,
incoherence,
illogicality,
clanging,
neologism,
word
approximations,
6
circumstantiality, loss of goal, perseveration, echolalia, blocking, stilted speech,
and self-reference.
7
INTRODUCTION
1.1 Background of study
Language is a system of signs which is used by human to interact through
communication with other. Language is one of the most crucial and important
aspects in human life. As Gleason (1998: 2) mentions that language is so basic to
the existence of human that life without words is difficult to envision.
Furthermore, language also becomes an essential need in human life which makes
human becomes able to express thoughts, needs, emotions and desires through
language.
Chaer (2009: 148) said that “to communicate (to use language) is a process
to deliver what’s in your mind and your feelings (from your mind) orally, in the
form of words or sentences”. He also added that people with normal brain
function and speech organs, certainly can use language effectively. However,
people with abnormal brain function and speech organs may have some problem
to use language, whether it is expressive or receptive. Chaer (2009: 159) also said
that verbal expression is a reflection of thought. Therefore, he concluded that
disordered verbal expression results from or caused by disordered thought. Verbal
expression impairment may include dementia, schizophrenia, and depressive.
National Institute of Mental Health (NIH) stated that schizophrenia is a
chronic, severe, and disabling brain disorder that has affected people throughout
history (www.nimh.nih.gov). People with schizophrenia may hear voices that
1
other don’t hear. They may believe other people are reading their minds,
controlling their thoughts, or plotting to harm them. One of the most common
symptoms of schizophrenia that makes they are different from normal people is
their language abnormality. The study on language disorder in schizophrenia is
always become an interesting topic to analyzed.
Schizophrenia is a social phenomenon because one out of every hundreds
persons suffers from this illness (Wróbel, 1989: 1). Silber (2014: 93) said that one
of the central features of schizophrenia is interplay between disordered thought
and language used to express that thought. Language disorder in schizophrenia is
the abnormal speech produced by some patients. This disturbance is
heterogeneous and has traditionally been termed ‘thought disorder’ (Kuperberg &
Caplan, 2003: 444).
A variety of names have been given to the problem relates to language
abnormalities, including language impairment, language disability, language
disorder, language delay, language deviance, and childhood or congenital aphasia
or dysphasia. At certain points in the history of language pathology, some terms
have predominated, whereas others were used less commonly. From this
statement, it can be concluded that the term language disorder may refers to any
language impairment in mother tongue (Paul, 2007: 8).
According to Chaer (2009: 148) language disorder divided into two major
divisions; (1) language disorder due to medical factor and (2) language disorder
due to social factor. The language disorder results from medical factor including
2
abnormalities in brain functions and speech organs.
And the social factor
including unnatural environment, such as separated or isolated from normal social
life.
Language disorder due to medical factors differentiated into three groups.
Sidharta (1984) said that medically, language disorder can be divided to three
groups: Speech disorder, Language disorder, and Thought disorder (Chaer, 2009:
148). In fact, the terms “thought disorder”, “speech disorder” and “language
disorder” are often interchangeably in psychiatric literature (Radanovic et al.,
2012: 56).
The analysis about language disorder in schizophrenia patients becomes an
interesting topic because language disorder due to thought disorder in
schizophrenia is one of common signs and symptoms found in schizophrenia
patients. Identifying schizophrenia signs and symptoms earlier help people to seek
help without delay and help assessment of the schizophrenia as well. This analysis
is going to try to describe subtypes of language disorder or schizophrenia speech
found in schizophrenia paranoid patients by using Andreasen’s theory. Language
disorder due to thought disorder found in schizophrenia paranoid patients are
various. Therefore, this analysis is going to try to find out some types of language
disorder found in schizophrenia patient, especially in paranoid subtypes.
This analysis is expected to serve an understanding to common people
about language disorder occurred in schizophrenia paranoid patient. And this
analysis is also expected to encourage other people who interested in this subject
3
to do further research which will lead to further understanding to describe the
problem of language disorder in other subtypes of schizophrenia i.e.,
disorganized, catatonic, residual, and undifferentiated schizophrenia.
As the data source of this analysis, five patients suffering from paranoid
schizophrenia are selected randomly by the responsible Nurse in Simeulue District
Hospital. Schizophrenia paranoid patients are being chosen because paranoid
subtype is the most common subtype and the paranoid patients are more
communicative than other patients suffering from other subtypes of schizophrenia.
As Bengston, (2015) said that schizophrenia paranoid is the most common
subtypes. He also added that people with this subtype may be more functional in
their ability to work and engage in relationship than other people with other
subtypes of schizophrenia.
In addition, it is important to know that in the first observation of
schizophrenia patients in Simeulue District Hospital on 4th February 2015, the
writer consulted with the responsible Doctor, Dr. Emir Abdullah, sp.Kj and Nurse,
Ms. Otriana, and they agree to cooperate with the writer in doing the research in
the hospital. The Doctor suggested that in collecting the data, the writer will be
helped by the responsible nurse because schizophrenia patients will be less
communicative to the stranger. Therefore, in this analysis the Nurse will be the
writer assistant’s in collecting the data.
1.2 Problem of the Study
4
Language is one of the characteristics of human. Problem with language is
a crucial problem. This analysis is going to try to find out the language disorder
due to thought disorder in schizophrenia paranoid patient. Thought disorder refers
to disorganized thinking as evidenced by disorganized speech of the patient. And
accordance with the focus of this analysis about schizophrenia patient speech,
there are three problems that are going to be analyzed in this analysis:
1. What are the types of schizophrenic speech found in schizophrenia
paranoid patients?
2. Which dominant type of schizophrenic speech is found in schizophrenia
paranoid patients?
3. Which patient has the most severe language disorder?
1.3 Significance of the Study
The significance of this study is to expand knowledge of the readers about
language disorder due to thought disorder in schizophrenia paranoid patients,
especially for those who are interested in this subject. Beside that, the result of
this analysis will be useful for medical workers in classifying schizophrenia
patients as well as to common people to recognize signs and symptoms of
schizophrenia.
5
1.4 Objective of the Study
This analysis is going to try to find out the types of language disorder due
to thought disorder found in schizophrenia paranoid patients. Based on the
problem of the study above, the objective of this analysis are:
1. To find out the types of schizophrenic speech found in schizophrenia
paranoid patients.
2. To find out the most dominant type of schizophrenia speech found in
schizophrenia paranoid patients.
3. To find out which patient has most severe language disorder.
1.5
Scope of the Study
It is important to make a scope in this study in order to get a clear
explanation about the topic. This analysis of language disorder in schizophrenia
patients limited only on language disorder due to disorder of thought or also
known as “thought disorder” which are found among the five selected
schizophrenia paranoid patients in District Hospital of Simeulue.
This analysis uses Andreasen’s theory to find the types of language
disorder found in schizophrenia paranoid patients’ speech. Andreason (1979)
distinguished schizophrenic speech or language disorder due to thought disorder
in schizophrenia into 18 types, they are; poverty of speech, poverty of content of
speech, pressure of speech, distractible speech, tangentiality, derailment,
incoherence,
illogicality,
clanging,
neologism,
word
approximations,
6
circumstantiality, loss of goal, perseveration, echolalia, blocking, stilted speech,
and self-reference.
7