Issues with the classification and diagnosis of schizophrenia

Question 1

What are the key issues with the classification and diagnosis of schizophrenia?

Answer 1

Reliability and Validity

Question 2

Summarise Rosenhan’s research (1972)

Answer 2

• 8 individuals got themselves into a psychiatric hospital
• Had to report to psychiatrist they had heard words including thud - not common literature within schizophrenics
• 7 of these 8 had been diagnosed with schizophrenia, one with depression
• once in hospital they had to act normal
• All were released after an average stay of 19 days . between 7 and 52
• In a follow up Rosenhan made a hospital aware of his study that he would send psuedo students in the next 3 months, staff were instructed to assess likelihood they were psuedo-paitents
• During the 3 month period, 193 patients were admitted. 19 were thought by a psychiatrist and one other member of staff to be pseudo-patients. 23 were thought by at least one psychiatrist to be pseudo-patients. 41 were thought by at least two members of staff to be pseudo-patients.

Question 3

What are the 3 types of reliability concerned with schizophrenia?

Answer 3

Inter rater reliability
Test retest reliability
Culture

Question 4

What are the 3 types of validity concerned with schizophrenia

Answer 4

Gender
co-morbidity
Symptom overlap

Question 5

What is meant by inter rater reliability?

Answer 5

This refers to whether to different raters or assessors agree on a diagnosis. Sometimes, there is a big difference between raters in their diagnosis of the same symptoms.

Question 6

What is test - retest reliability?

Answer 6

This refers to if we tested the same person again, we should get the same outcome. We should get
the same outcome when assessing
schizophrenics however, this is not always the case

Question 7

What is cultural reliability?

Answer 7

This idea suggests that there is a tendency to over-diagnose members of other cultures.
Furthermore, there is also evidence that there appears to be a large difference between diagnosis of schizophrenia between countries.

Question 8

What is gender validity?

Answer 8

The stereotypical beliefs about an individual gender may cause a difference in diagnosis as the DSM gives equal criteria for men and women and does not distinguish between the two. Therefore, there may be differences in diagnosis.

Question 9

What is symptom overlap validity?

Answer 9

One issue with the diagnosis of schizophrenia is that many of the symptoms of this disorder also overlap with other mental and physical illnesses including: depression, autism etc.

Question 10

What is meant by co morbidity in validity?

Answer 10

This impacts validity as it refers to the extent that two or more conditions co-occur. This would mean that another condition occurs alongside schizophrenia making it difficult to diagnose

Question 11

Evaluations and implications with diagnosis of schizophrenia

Answer 11

· Careful diagnosis can lead to effective treatment programmes which would, otherwise, not be offered. Therefore, misdiagnosis can lead to being given incorrect treatment.

· There are issues with prognosis as statistics show that only approximately 20% of people diagnosed with schizophrenia fully recover. This may be down to our understanding of the disorder or caused as a result of poor diagnosis with people having different disorders. Therefore we must be more accurate in our diagnosis.

· There are issues with the definitions of the criteria as we have different definitions of the word bizarre therefore this may impact diagnosis.

· The interplay between reliability and validity means that because one is poor, the other is potentially also poor, therefore we cannot be certain which requires improvement.