Diagnosis and classification of SZ Flashcards
(10 cards)
What is schizophrenia?
-A severe mental disorder where contact with reality and insight are impaired and is an example of psychosis
What percentage of people are diagnosed with schizophrenia and who is more commonly diagnosed?
-1% of the pop.
-more diganosed in: men, city-dwellers and lower socio-economic groups
What is the difference between how ICD and DSM’s classifications for diagnosis?
-DSM needs 1 positive symptom to be diagnosed with schizophrenia
-ICD allows 2 negative symptoms for a diagnosis of schizophrenia
What are positive symptoms of schizophrenia and examples?
-Atypical symptoms experienced in addition to normal experiences
-Hallucinations: sensory experiences that are not rooted in reality
-Delusions: irrational beliefs that are not rooted in reality
What are negative symptoms of schizophrenia and examples?
-Negative symptoms are the loss of usual abilities and experiences.
-Speech Poverty: reduced frequency and quality of speech
-Avolition: dysfunctional lack of motivation
What did Nancy Andreasen (1982) identify as 3 signs of avolition?
-poor hygiene and grooming
-lack of persistence in work and education
-lack of energy
What is a strengths of classification and diagnosis of schizophrenia?
-Reliability: Prior to DSM-5 consistency of schizophrenia diagnoses was poor but this has now changed. Osorio (2019) reported that excellent reliability for the diagnosis of 180 individuals using DSM-5. Pairs of interviewers achieved an inter-rater reliability of +.97 and test-retest reliability of +.92. This means that we can be reasonably sure the diagnosis of schizophrenia is consistently applied
What are issues of classification and diagnosis of schizophrenia?
-Gender Bias in diagnosis: Men are more likely to be diagnosed with schizophrenia than women with a ratio of 1.4:1 (Fischer and Buchanan). Cotton (2009) states It is likely that women are underdiagnosed with schizophrenia because they have closer relationships and get support. This leads to women dealing with schizophrenia better than men. This underdiagnosis means women will go untreated and will therefore deal with schizophrenia.
-Culture Bias in diagnosis: Hallucinations, such as hearing voices, can have different meanings in different cultures. For example, people from Haiti claim that voices are ancestors communicating. British people of African-Caribbean origin are 9x more likely to be diagnosed with schizophrenia than white British people (Pinto and Jones). Most likely explanation is cultural bias in diagnosis from psychiatrists from a different cultural background. Escobar (2012) suggests this can lead to an over-interpretation of symptoms in black British people. Therefore, African-Caribbean people may be discriminated against by a culturally bias system.
-Low validity: Cheniaux (2009) had two psychiatrists independently assess the same 100 clients using the DSM and ICD and found that 68 were diagnosed with ICD and 39 using DSM. This suggests that schizophrenia is either over or under diagnosed according to the diagnostic system. This means that it has low criterion validity.
However Osorio reported excellent validity if the DSM was used with both trials with different clinicians.
How is comorbidity an issue with classification and diagnosis of schizophrenia and what is it?
-Co-morbidity: the occurrence of someone having two conditions or disorders.
-If this is a frequent occurrence it calls into question the validity of the diagnosis as they might instead be one condition
-50% of people who have schizophrenia, have depression
-Therefore an issue with diagnosis as SZ might not exist as a distinct condition and an issue with classification is that some cases of SZ might just be an aytpical case of depression
Why is symptom overlap an issue with classification and diagnosis of schizophrenia and what is it?
-Symptom overlap: When two conditions have the same symptoms
-There is symptom overlap between SZ and bipolar disorder as both have delusions
-Problem for classification as they may not be two different conditions
-Problem for diagnosis as difficult to distinguish
