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Language Disorder In Schizophrenia Patient: A Case Study Of Five Schizophrenia Paranoid Patients In Simeulue District Hospital

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1 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

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2 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

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3 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

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4 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.

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5 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

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6 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,

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7 circumstantiality, loss of goal, perseveration, echolalia, blocking, stilted speech,

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