Schizophrenia Flashcards
(45 cards)
Definition of Schizophrenia
Severe mental disorder where contact with reality and insight are impaired, an example of psychosis
Difference between Type 1 Acute Schizophrenia & Type 2 Chronic Schizophrenia
Acute: Obvious positive symptoms appear suddenly after stressful events
Chronic: Illness takes many years to form and gradual changes of withdrawal and increased disturbance. Characterised by negative symptoms.
Types of schizophrenia according to ICD-10
- Disorganised: Delusions, hallucinations, incoherent speech and mood swings
- Catatonic: Immobility, rocking
- Paranoid: Delusions
- Undifferentiated: Not fitting into other categories
- Residual: Had it in the past
- Simple Schizophrenia: Negative symptoms, no delusions
- Post Schizophrenia depression
Criterion A for DSM-V
Need two or more of: Delusions, Hallucinations, Disorganised Speech, Catatonic behaviour, Negative Symptoms.
Only one of the criteria may be present if the delusion/hallucinations are bizarre and extreme.
Criterion B (Social/occupational dysfunction) for DSM-V
Since the onset of schizophrenia, one or more areas of functioning will be negatively affected, e.g. work/interpersonal/self-care
Criterion C (Duration) for DSM-V
Continuous signs of disturbance will be present for 6 months or more.
Symptoms from criterion A must be present for one month. During non-active periods, disturbance might be limited to negative symptoms only, or two or more symptoms from criterion A.
What does DSM-V stand for and when was it updated?
Diagnostic Statistical Manual 5th Edition, May 2013
What does ICD-10 stand for and when was it published?
International Classification of Diseases 10th edition,, 1992
Define ‘positive symptoms’ of schizophrenia
Excesses, symptoms that have been added to the patient’s personality because they now have the illness of schizophrenia. E.g. hallucinations, delusions, disorganised speech
Define ‘negative symptoms’ of schizophrenia
Reduction/loss of normal functioning. The person loses the ability to do certain things because of the illness. E.g. speech poverty, avolition, apathy
When does reliability in diagnosis and classification of schizophrenia occur?
When the ICD-10 and DSM-V show a good consistency of diagnosis of schizophrenia over a period of time and between different psychologists (inter-rater reliability).
Why is the DSM-V more reliable than the ICD-10?
The symptoms for schizophrenia in DSM-V are outlines for each category and are more specific.
Hoe has the classification and diagnosis of schizophrenia improved in validity and reliability over time?
The DSM-V and ICD-10 are updated every few years.
What does validity mean in relation to the classification and diagnosis of schizophrenia?
This means that a diagnostic system (ICD/DSM) assesses what it claims to be assessing (schizophrenia). If the DSM and ICD are valid we can be confident that the patient diagnosed has schizophrenia and not another.
What is content validity?
The extent to which an assessment covers the range of symptoms of schizophrenia. E.g. interviews/checklist that covers all the symptoms
What is co-morbidity?
This refers to the extent that two or more illnesses occur simultaneously in a patient. This is an important validity issue when classifying & diagnosing schizophrenia.
Describe some research/facts that support co-morbidity.
- A psychologist states that 1% of the population will suffer from schizophrenia and 2.5% from OCD. However, 12% of schizophrenic patients meet the diagnostic criteria to also be suffering from OCD (co-morbid). This causes the problem of classifying the illness as schizophrenia, and not another psychological illness.
- Boundaries between schizophrenia and mood disorders are blurred as they share many symptoms
- Depression (mood disorder) is co-morbid (occurs alongside) schizophrenia.
How to give correct and valid diagnosis in the case of co-morbidity?
Psychologist should do a full consultation using the DSM and ICD in order to get the correct and valid diagnosis.
- Evaluation of co-morbidity
- DSM and ICD can be seen as lacking validity because there is too much overlap between schizophrenia, mood disorders and OCD. Clinicians might diagnose a patient as having depression and schizophrenia or they may seek a second opinion to get around the problem.
- Diagnosis can be invalid and unreliable. 32% of 142 hospitalised schizophrenic patients were co-morbid.
- Schizophrenic patients have used alcohol, cannabis and cocaine and suffer from substance abuse before diagnosis. This makes it difficult to give a reliable and valid diagnosis.
- Psychologist found that schizophrenic patients with co-morbid illnesses were often excluded from research, but the majority of patients suffer with other psychological illnesses. Research findings cannot be generalised and are invalid.
Luhrmann’s research that found auditory hallucination can be influenced by culture. How? (reliability)
60 adults with schizophrenia (20 from Ghana, 20 from India and 20 from USA) were interviewed. All the patients reported they heard voices but the patients from USA reported the most negative experiences with the voices, e.g. the voices were violent and harmful. Therefore culture has an influence on the reliability of diagnosing schizophrenia.
Cochrane (1977) investigation into culture bias in classifying and diagnosing schizophrenia
West Indies and Britain had a prevalence rate of 1%. Afro-Caribbean people living in Britain were 7 times more likely to be diagnosed with schizophrenia than a white patient. This means either Afro-Caribbean people have more stressors that cause schizophrenia, or their diagnosis of schizophrenia was invalid due to culture bias.
+ Evaluation of Culture Bias
+ Research evidence has found support for cultural relativism. Afro-Caribbean ppl have little immunity to flu, and children born to mothers who had flu when they were pregnant in their second trimester, have an 88% increased chance of developing schizophrenia. There might be a cultural vulnerability which means Afro-Caribbean’s might be more at risk from developing schizophrenia than the white population.
+ The Ethnic Culture hypothesis predicts that ethnic minorities experience less distress if they suffer with the illness of schizophrenia, because they have protective characteristics and social structures that exist in their culture. 184 individuals with schizophrenia were investigated from African American, Latino or White American cultures. It was found that Americans had more symptoms than the other 2 cultures because they had less protective and supportive features in their culture (social support)
- Evaluation for culture bias
- Cochrane (1995) found research evidence to suggest that diagnosing schizophrenia can be invalid for immigrants. Clinicians might wrongly attribute the diagnosis of schizophrenia to ethnicity, rather than to the stressors that have occurred in the patient’s life. This is connected with labelling, whereby some clinicians wrongly label immigrants with a mental disorder which is invalid (misdiagnosis).
- Cultural relativism. Psychologists may not understand the patient’s symptoms correctly due to not understanding their cultural background - can lead to incorrect judgements and misdiagnosis. E.g. ppl from African backgrounds would be seen as gifted in their culture if they say they heard the voice of God but in western countries this would be seen as auditory hallucination.
Gender bias (validity): Differences between genders
- Male sufferers tend to show more negative symptoms and suffer more from substance abuse
- Males have an earlier onset (18-25) years than females (25-35 years) and different peak ages (21 & 39 for men and 22, 37 and 62 for women)
- Accuracy can vary due to clinicians having stereotypical beliefs about gender.
- Critics of DSM argue that healthy adult behaviour is linked more to healthy males than females. The DSM can be viewed as gender biased.
