Craig LaRotonda/Revelation Art
I
n 1930, female quadruplets were born in a small Mid-
western city. All four survived, which at that time was
remarkable. This set of quadruplets (or quads) was also
remarkable in two other ways: All four developed from a
single fertilized egg and so basically were genetically iden-
tical. In addition, all four went on to develop symptoms of
schizophrenia as young adults. In the psychological litera-
ture, the quadruplets came to be known by pseudonyms
they were given to protect their privacy: Nora, Iris, Myra,
and Hester Genain.
The quads were born to parents of limited fi nancial means. Their
father, Henry, was abusive, violent, and alcoholic. He also exhibited
some symptoms of schizophrenia. Their mother, Maud, had been a
nurse. Maud was very strict with the girls, but she was a better parent
than Henry.
By the time the quads were in their early 20s, three had been
hospitalized for schizophrenia at least once, and the fourth was
exhibiting symptoms of schizophrenia. Also around that time,
Mrs. Genain was recovering from bladder surgery, and it was be-
coming increasingly difficult for her to care for the young women.
The family’s problems were brought to the attention of research-
ers at the National Institute of Mental Health (NIMH), and the
family was invited to move to a research and treatment facility in
Washington, DC. At the facility, the sisters were treated, studied,
and written about extensively. In fact, the pseudonyms the quads
were given related to the initials of NIMH: Nora, Iris, Myra,
and Hester. Their false last name, Genain, means “dire birth”
in Greek.
The fact that all four of the Genain sisters developed symptoms
of schizophrenia was by no means an inevitable result. For identi-
cal twins, the chance of both twins’s developing schizophrenia is
about 48%. For identical quads, the odds of all four developing
schizophrenia are about one in six, or 16% (Rosenthal, 1963). The
quads’ story offers possible clues about why all four of them de-
veloped schizophrenia and provides some understanding of what
causes the disorder. In this chapter, we discuss the symptoms of
schizophrenia, what is known about its causes, and current treat-
ments for this disorder.519CHAPTER
12
Schizophrenia and Other
Psychotic Disorders
Chapter Outline
What are Schizophrenia and Other
Psychotic Disorders?
The Symptoms of Schizophrenia
Subtypes of Schizophrenia
Distinguishing Between Schizophrenia
and Other Disorders
Schizophrenia Facts in Detail
Understanding Schizophrenia
Neurological Factors in Schizophrenia
Psychological Factors in Schizophrenia
Social Factors in Schizophrenia
Feedback Loops in Action: Schizophrenia
Treating Schizophrenia
Targeting Neurological Factors in Treating
Schizophrenia
Targeting Psychological Factors in Treating
Schizophrenia
Targeting Social Factors in Treating
Schizophrenia
Feedback Loops in Treatment:
Schizophrenia