discuss the issues associated with the classification and diagnosis of schizophrenia - reliability and validity Flashcards
outline 1 - validity
refers to the accuracy of diagnosis and classification
one way to assess validity of diagnosis is criterion validity: do different assessment systems (ICD-10 and DMV-5) arrive at the same diagnosis for the same patient
system overlap: symptoms shown in schizophrenia can overlap with other mental health disorders, making diagnosis inaccurate
e.g. symptoms such as auditory hallucinations can occur in disorders such as bipolar depression as well as schizophrenia, therefore an invalid diagnosis is possible as psychiatrists cannot be 100% certain symptoms shown are due to schizophrenia
gender bias: when the accuracy of diagnosis is dependent on the gender of the person being examined
this means the psychiatrist may be biased towards diagnosing one gender rather than the other, which means diagnosis may not be accurate
outline 2 - reliability
refers to the consistency in diagnosis and classification
means that clinicians must be able to diagnose schizophrenia at two different points in time (test-retest reliability) or different clinicians must reach the same conclusions (inter-rater reliability)
cultural bias: tendency for people to judge the world through a narrow view based on their own culture. this affects reliability of diagnosis as patients will get a different diagnosis from different psychologists, depending on whether the psychiatrist understands their cultural beliefs, therefore diagnosis is not consistent
e.g. if people of afro-caribbean descent are diagnosed by a british psychiatrist, they are must more likely to get a diagnosis of schizophrenia (because their cultural beliefs are mistaken for symptoms of schizophrenia)
validity peel 1
strong research evidence suggesting symptom overlap can lead to an invalid diagnosis of schizophrenia
konstantareas & hewitt
found that when comparing 14 autistic patients with 14 schizophrenics, 7 of the autistic patients also showed symptoms of schizophrenia (no emotions or flat emotions)
this suggests that the diagnosis of schizophrenia may not always be valid because the person may exhibit a symptom typical of schizophrenia but could instead have another condition with the same symptom
validity peel 2
strong research evidence to suggest gender bias exists in the diagnosis of schizophrenia
loring and powell (1988)
found that 56% of psychiatrists gave a diagnosis when given a description of a male patient, but only 20% gave a diagnosis when described as a female
this suggests that diagnosis may not always be valid as it is dependent on the gender of the patient
+ gender bias was not as evident in female psychiatrists
reliability peel
strong research evidence to suggest cultural bias can lead to inconsistencies in the diagnosis of schizophrenia
which is when a theory, model or explanation inappropriately judges behaviour from European or North American cultural norms
for example, copeland (1971) gave 134 US and 194 British Psychiatrists a description of a patient, 69% of the US psychiatrists gave a diagnosis, but only 2% of the British gave one
this suggests that diagnosis is dependent on the psychiatrist having an accurate understanding of the patients cultural background, which isn’t always likely to be the case, reinforcing that diagnosis is not always going to be consistent
wider implications
there is research to suggest that diagnosis of schizophrenia leads to labelling
rosenhan (1973)
found that a label of schizophrenia can be difficult to remove and affects other peoples attitudes towards you. it demonstrated that even when an invalid diagnosis is given, all behaviours shown by the patient are interpreted as symptoms of schizophrenia
this suggests the diagnosis of schizophrenia has long lasting, negative effects on social relationships, work prospects and self esteem which is especially unfair when diagnosis is not always valid
