Lesson 1 – Classification of Schizophrenia Flashcards

Question

What is Affective Flattening

Answer 1

A reduction in the range and intensity of emotional expression, including facial expression, voice tone, eye contact and body language. Individuals who are schizophrenic have fewer body and facial movements and smiles, and less co-verbal behaviour.

Answer 2

A loss of interest or pleasure in all or most activities, or a lack of reactivity to normally pleasurable stimuli. There are two types Physical Anhedonia and Social Anhedonia

Answer 3

Reliability, Validity, Co-morbidity, Symptom Overlap, Gender Bias and Cultural Bias

Answer 4

Whaley (2001) found the interrater reliability between diagnosticians as low as +0.11 (using the DSM). Another more recent study that also showed low inter-rater reliability amongst diagnosticians was carried out by Cheniaux et al (2009). In this study, they had two psychiatrists independently diagnose 100 schizophrenic patients using both ICD and DSM criteria. Inter-rater reliability was poor with one psychiatrist diagnosing 26 with SZ according to DSM and 44 according to ICD and the other psychiatrist diagnosing 13 according to DSM and 24 according to ICD. This poor reliability is a weakness of diagnosis of SZ

Answer 5

According to Cheniaux’s study we can see the SZ is much more likely to be diagnosed using ICD than DSM suggesting that SZ is either over diagnosed in ICD and under diagnosed in DSM. Either way, this problem is a sign of poor validity

Answer 6

The idea that two or more mental disorders (or conditions) occur together at the same time with the same person. If this is the case, then we can question the validity of diagnosis for schizophrenia. Infact, schizophrenia is commonly diagnosed with other conditions. Buckley et al. (2009) concluded that around half of the patients with SZ also have a diagnosis of depression (50%) or substance abuse (47%). Post- traumatic stress disorder also occurred in 29% of cases and OCD in 23% of cases.

Answer 7

This means that there is considerable overlap between the symptoms of SZ and other conditions such as depression and bipolar disorders. For example, a person can show a symptom of SZ and this symptom will also be in another disorder. For example, Ellason and Ross (1995) point out that people with DID (Dissociative Identity Disorder) actually having more schizophrenic symptoms than people diagnosed with SZ. In fact, most people diagnosed with SZ have sufficient symptoms of other disorders that they could also receive at least one other diagnosis (Read, 2004)

Answer 8

Longenecker et al (2010) reviewed SZ studies since the 1980s and found men more likely to be diagnosed than women. Is it because men more genetically vulnerable than women? There could be a gender bias in diagnosis as women seem to function better than men having good family relationships and more likely to work (Cotton 2009). Therefore it is less likely to be diagnosed with SZ because women showing better interpersonal function than men.

Answer 9

It may be because positive symptoms of SZ such as auditory hallucinations may be acceptable in Africa because of cultural beliefs in communication with ancestors (e.g. hearing their dead ancestors talking to them) which are acceptable and not warranted to a diagnosis in Africa (as SZ rates low in Africa). However in the UK, this is more likely to be seen as a positive symptom of SZ.

Answer 10

Communication Shorthand and Treatment

Answer 11

A patient with a mental disorder often has numerous symptoms. It is simpler to incorporate these symptoms into a single diagnosis and this makes communication between mental health professionals much easier

Answer 12

Treatments are often specific to certain disorders e.g. symptoms of schizophrenia respond well to certain anti-psychotic drugs but not anti-anxiety. A reliable diagnosis can point to a therapy that will alleviate symptoms.