Diagnosis and Classification Flashcards

Question

What are the types of delusions?

Answer 1

Delusions of control - belief that other people are controlling our thoughts Nihilistic delusions - belief in things that don't exist Delusions of grandeur - belief that they have special powers, talents or abilities. For example, the belief that they are an important historical, political or religious figure Persecutory delusions - belief that they are being tormented, followed, tricked, spied or ridiculed. For example, the government or aliens were after them

Answer 2

Loss of usual abilities and experiences. They include speech poverty and avolition.

Answer 3

Though delusions can make a person behave in ways that make sense to them but seem bizarre to others, the majority of people with delusions aren't aggressive and are more likely to be victims than perpetrators but some can lead to aggression.

Answer 4

This is a negative symptom of depression which is classed as changes in patterns of speech. It is a negative symptom because of the reduction in the quantity and quality of speech. They may be accompanied by a delay in verbal responses during a conversation.

Answer 5

Nowadays, there is more emphasis placed on speech disorganisation in which speech becomes incoherent or the speaker changes topic mid-sentence.

Answer 6

In the DSM-5 it is classed as a positive symptom whereas in the ICD-10 it is a negative symptom.

Answer 7

This is sometimes refereed to as apathy and finding it difficult to begin or keep up with goal-directed activity. People with scizophrenia often have sharply reduced motivation to carry out a range of activities.

Answer 8

Anderson identified three signs of avolition. - Poor hygiene - Grooming - Lack of persistence in work or education and lack of energy

Answer 9

Whether or not there is a real difference between illnesses. If so such illnesses should exhibit symptoms that distinguish themselves from one another.

Answer 10

That suggests it is not a real disorder.

Answer 11

Concerned with the fact that if we do find a real difference between illnesses, and so the diagnosis is valid, then we should be able to consistently distinguish between the illnesses based upon such differences.

Answer 12

P - One strength of the diagnosis of schizophrenia is its reliability due to its consistency. E - A psychiatric diagnosis is reliable when different clinicians conclude the same diagnosis for the same individual. This can be done through inter-rater reliability. A diagnosis can also be made when the same clinician reaches the same diagnosis for the same individual on two occasions, which can be done through test-retest reliability. E - Before the DSM-5, reliability for schizophrenia diagnosis was low but has now improved. Osorio et al, report excellent reliability for the diagnosis of schizophrenia in 180 individuals using the DSM-5. Pairs of interviewers achieved inter-rater reliability of +.97 and test-retest reliability of +.92 L - This means that we can be reasonably sure that the diagnosis of schizophrenia is consistently applied.

Answer 13

P - One limitation of schizophrenia diagnosis is that it may be influenced by cultural bias. E - Some symptoms of schizophrenia, particularly hearing voices, have different meanings in different cultures. For example in Haiti some people believe that voices actually are communications from ancestors. E - British people of African-Caribbean origin are up to nine times more likely to be diagnosed than white British people, according to Pinto and Jones. Whilst this may suggest genetic vulnerability, the most likely explanation for this is cultural bias in diagnosis of clients by psychiatrists from a different cultural background. Escobar states that it seems there is an over-interpretation of symptoms in black British people. L - This suggests that British African-Caribbean people may be discriminated against by a culturally-biased diagnostic system.

Answer 14

P - A limitation of the diagnosis of schizophrenia is that there is low validity. E - Validity concerns whether we assess what we are trying to assess. E - Criterion validity is used to assess the validity of psychiatric diagnosis. Cheniaux et al had two psychiatrists independently assess the same 100 clients using ICD-10 and DSM-4 criteria and found that 68 were diagnosed under the ICD and 39 under the DSM. L - This suggests that schizophrenia is either over or underdiagnosed according to the diagnostic system, which makes the criterion validity low.

Answer 15

P - However, the diagnostic issue of low validity of schizophrenia can be overcome. E - Osario et al reported there was an excellent agreement between clinicians when they used two measures to diagnose schizophrenia both derived from the same DSM system. L - This means that criterion validity for diagnosing schizophrenia is high, only if it uses a single diagnostic system.

Answer 16

P - Another limitation of schizophrenia diagnosis is its co-morbidity and similarity with other conditions may decrease the validity of classification. E - If conditions occur together too often, then this questions the validity of their diagnosis and classification because they might actually be a single condition. One review by Buckley et al, found that about 1/2 of those diagnosed with schizophrenia also had a diagnosis of depression or substance abuse. E - This is a problem for classification because it means schizophrenia may not exist as a distinct condition, and is a problem for diagnosis as at least some people diagnosed with schizophrenia may have unusual cases of conditions like depression. L - This therefore decreases the validity of classification of schizophrenia, which in turn also affects that diagnosis.

Answer 17

P - A further limitation of schizophrenia diagnosis is that it may be influenced by gender bias E - Since the 1980s men have been diagnosed with schizophrenia more commonly than women. There was a ratio of 1.4:1 according to Fischer and Buchanan. This is because of genetic factors. E - However Cotton et al believes it is more likely that women are undiagnosed because they have closer relationships which allows them to get support. L - This under-diagnosis is a gender and means women may not therefore be receiving treatment and services might benefit them.

Answer 18

P - A final limitation of schizophrenia diagnosis is symptom overlap with other conditions. E - This is because there is a considerable overlap between the symptoms of schizophrenia and the symptoms of other conditions. For example, schizophrenia and bipolar disorder both involve positive symptoms and negative symptoms. E - In terms of classification this suggests that schizophrenia and bipolar disorder may not be two different conditions but variations of a single condition. In terms of diagnosis it means that schizophrenia is hard to distinguish from bipolar. L - This means that schizophrenia may not exist as a distinct condition and that even if it does, it is hard to diagnose. Therefore this makes classification and diagnosis are flawed.

Answer 19

Co-morbidity is the occurrence of two disorders or conditions together, whereas symptom overlap is when two or more conditions share symptoms.