Schizophrenia Flashcards
(34 cards)
Schizophrenia overview
Schizophrenia is a mental disorder. It is characterised by disruption in psychological functioning and loss of contact with reality. Schizophrenia affects about 1% of the population.
Symptoms first show in mid to late adolescence.
How do the two main classification systems classify schizophrenia?
DSM-5 (Diagnostic and Statistical Manual BY APA): One or more positive symptoms needed
ICD-10 (International Classification of Disease by WHO): Two or more negative symptoms
Why did DSM-5 and ICD-10 drop subtypes of schizophrenia?
They tend to be inconsistent and diagnoses of subtypes may change over time
What are positive symptoms of schizophrenia?
Additional experiences beyond those of ordinary existence, such as hallucinations and delusions
What are negative symptoms of schizophrenia?
The loss of usual abilities and experiences, such as speech poverty and avolition.
What are hallucinations?
Unusual sensory experiences, such as hearing voices. May be experienced in any sense. Can be related to events in the environment or have no relationship to it.
What are delusions?
AKA paranoia; irrational beliefs. Common delusions include being an important figure, like Jesus, or being persecuted, or having superpowers. Delusions make a person behave in ways that make sense to them but are bizarre to others.
What is speech poverty?
Changes in patterns of speech, reducing the quality of speech. Sometimes accompanied with verbal response delay.
Speech poverty classification variations
ICD-10 categorises speech poverty as a negative symptom because of the reduction in the amount and quality of speech, as well as a delay in verbal response during conversations.
DSM-5 places emphasis on speech disorganisation, rather than speech poverty. Speech can often become incoherent if the speaker changed topic mid-sentence.
DSM-5 classifies disorganised speech as a positive symptom.
What is avolition?
AKA apathy; finding it difficult to begin or continue with goal-directed activities. Reduced motivation to carry out a range of activities. Andreasen (1982) identified 3 signs - poor hygiene, lack of persistence in work/education, and lack of energy
How do we diagnose a specific disorder, according to the medical approach?
We identify clusters of symptoms that occur together and classify this as a disorder, so that diagnosis is possible through identifying symptoms and determining what disorder a person has.
Evaluation for diagnosis and classification - reliability.
Good reliability (consistency). Osorio et al (2019) reports excellent reliability in diagnosis of schizophrenia in 180 individuals. Means we can be reasonably confident that diagnoses is consistently applied.
Osorio et al findings
Excellent reliability in diagnosis of schizophrenia in 180 individuals using DSM-5. Pairs of interviewers, inter-rater of +.97 and test-retest of +.92
Evaluation for diagnosis and classification - validity.
Low validity between diagnostic systems/ Cheniaux et al (2009) had psychiatrists assess clients using ICD-10 and DSM-5 and found differences. Suggests schizophrenia is either over or under diagnoses depending on diagnostic system, suggesting low criterion validity.
Cheniaux et al (2009) findings
100 clients, 2 psychiatrists (1 DSM-5 and one ICD-10). ICD diagnosed 68, DSM diagnosed 39.
Evaluation for diagnosis and classification - gender bias.
Men diagnosed 40% more than women (Fischer and Buchanan). Could be that women genetically less vulnerable, but Cotton 2009 suggests it is because women have closer relationships and thus better support. So women function better. Underdiagnosis is a gender bias, women may not be receiving treatments and services.
Evaluation for diagnosis and classification - culture bias.
Symptoms like hearing voices have different meanings culturally. In Haiti, some people believe voices are communications from ancestors. Pinto and Jones (2008) African-Caribbean research. Most likely explanation for culture bias is diagnosis by psychiatrists from different cultural background - over-interpretation of symptoms in black Brits. Means African-Caribbean people may be discriminated against by culturally-biased system.
Evaluation for diagnosis and classification - symptom overlap.
Considerable overlap between symptoms of sz and other symptoms - ie bipolar involves positive and negative symptoms (delusions and avolition). Suggests bipolar and sz could be variations of a single condition - the terms of diagnosis means they are hard to distinguish. Classification and diagnosis flawed.
Evaluation for diagnosis and classification - co-morbidity.
Commonly diagnosed with other conditions. (Buckley et al) found half of sz people studied also had depression or substance abuse. Means sz may not exist as a single distinct condition. Very severe depression could in cases prevent as schizophrenia.
Explain how symptom overlap might lead to problems with the classification of schizophrenia.
Shared symptoms may lead to an unreliable/incorrect diagnosis as the person may exhibit a symptom which is associated with schizophrenia but could have a different condition associated with that symptom such as bipolar.
Outline what is meant by co-morbidity in the context of schizophrenia.
Co-morbidity is where two conditions are likely to co-exist, for example Buckley et al found 50% of individuals he studied with sz also suffered from depression or substance abuse.
What term is used by psychologists to describe when a person has two or more disorders at the same time.
co-morbidity
What term is used by psychologists to describe when two different disorders have a symptom in common.
symptom overlap
Rosenhan (1973) Pseudopatients method
Field experiment. IV was made-up symptoms of 8 pseudooatients, DV was psychiatrist admission and diagnostic label. Also involved participant observation (patients kep written records of ward and treatment). Patients phones hospitals and reported symptom of hearing a voice saying ‘thud, empty, or hollow’
