Flashcards in Schizophrenia Deck (75)
What is the definition of schizophrenia?
A severe mental disorder where contact with reality and insight is impaired, this is an example of psychosis.
What is the DSM-5’s criteria for diagnosing Sz?
A (2+ symptoms) = disorganised speech,grossly disorganised/ catatonic bhvr, hallucinations and negative symptoms.
B = social occupation dysfunction
C (duration) = 6 months of disturbances with at least 1 month of symptoms from Criteria A
What is ICD’s criteria for diagnosing Sz?
2+ negative symptoms, this doesn’t need to have positive symptoms additionally.
What are the two classification systems used to diagnose Sz?
ICD (Europe) and DSM-V (USA)
What is positive symptoms?
A symptom that adds to the Norma experience of a person.
Excess/ distorts normal functions.
What are some examples of positive symptoms ?
What are negative symptoms?
Symptoms that take away from a person’s everyday experience. This can be present without positive symptoms.
State some examples of negative symptoms
What are hallucinations?
Sensory experiences of stimuli that are not real/ distorted
What are delusions?
Firm but false beliefs
What is Speech poverty?
A negative symptom that causes the quality of speech to lower e.g grammar
What is a strength for the the classification of SZ?
Inter-rate reliability is high IF USING A STANDARDISED METHOD = APPLICATION
Jakobsen et al (2004) = concordance rate of 98% between clinicians
What is the weaknesses of the classification of SZ?
ETHICS = Scheff (1966)
Self-fulfilling prophecy = pygamalion effect (unconsciously acting the way they believe). This is unethically wrong bc could make a person worse.
Co-morbidity = Qs validity, what if better to see it as one condition
Buckey et al = 50% depression and 47% substance abuse.
Symptoms overlap = Qs validity bc unclear what causes symptoms e.g BPD and Sz. The ICD = Sz but the DSM = BPD this is limited application
What are the differences between the DSM and ICD?
DSM = doesn’t acknowledge subtype e.g catatonic whilst ICD does = makes it easier to be diagnosed Sz under ICD
DSM = disorganised speech is positive whilst speech poverty = negative
Criteria = 2+ positive and negative symptoms with a duration over 6mths. 1 mth at least from criteria A. Whilst ICD just negative symptoms.
What are the purpose of classification systems?
To help professionals diagnose Sz and suggest treatment to alleviate symptoms.
To do this the system must be reliable AND valid. It can’t be one or the other.
How does test re-test reliability relate to the classification and diagnosis of Sz?
This means that with the same symspoms a person will get the same diagnosis.
How does inter-rater reliability relate to the classification and of Sz?
This is the agreement between clinicians over the same set of symptoms on diagnosis.
What is disorganised speech?
A positive symptom that causes incoherent speech.
Derailment is when the person keeps changing topic and this is a form of disorganised speech.
What is avolition?
The loss of motivation and ability to act. This will cause a person with Sz not care about their personal hygiene.
How does cultural differences affect reliability?
194 British psychiatrists diagnose Sz = 2%
134 US psychiatrists diagnose Sz = 69%
Shows that it can’t be used outside its culture and is limited.
How does individual differences affect the reliability of the classification and diagnosis of Sz?
Clinicians could have unconscious bias to men (bc they have a higher rate to Sz) or if a person is dressed badly. They could also have little time so they will not in-depth check their symptoms.
A patient’s clothes/ gender bias / culture bias.
How have there been improvements made to the reliability?
Standardised assessments (interview) cut the external factors that effect the diagnosis and classification of Sz.
Jakobson et al (2005) = ICD 10 and 100 Danish patients. Had a concordance rate of 98% in diagnosis.
Soderberg et al (2005) = concordance 81% using the DSM 4
How does validity relate to the diagnosis and classification of Sz?
This refers to the way Sz is measured and defined distinctly so psychiatrists can accurately diagnose Sz.
What is co- morbidity?
This is where 2 illnesses are diagnosed together. E.gE,depression and Sz.
Qs the validity bc it could be better to see it as 1 condition?
ETHICAL IMPLICATIONS = the treatment given depends on the diagnosis therefore they could get the wrong one.
BUCKEY ET AL (2009) = 50% depression, 47% substance abuse and 29% PTSD
What is symptom overlap?
2+ conditions have the same symptoms e.g Sz and BPD
Qs the validity bc we can’t differentiate what causes the symptoms. Under the ICD = Sz but under the DSM = BPD
APPLICATION = a person could get the wrong treatment
How does gender bias affect the validity of the diagnosis and classification of Sz?
This suggest that diagnosis is unobjectionable to women.
Reduces Validity bc view of normal bhvr is not reflective of both genders and distorted. This is an example of Beta bias (trying to suggest both men and women are the same)
BROVERMAN ET AL = DSM is androcentric and women may be seen as unwell because they don’t follow men.
LONGNECKER ET AL = Since the 1980s men have higher rates of diagnosis of Sz bc psychiatrists have a bias that women have good interpersonal function. This masks Sz and stops the correct diagnosis.
How does cultural bias affect the validity of the diagnosis and classification of Sz?
Reduces Validity = LIMITED APPLICATION bc can’t be used outside of cultural context.
African American + English people of Afro-Caribbean descent = more likely to be diagnosed Sz than whites people. Even though the rate of SZ is not high in Africa and the West Indies.
How does Cheniaux et al (2009) show a problem with the reliability and validity of the diagnosis and classification of Sz?
2 psychiatrists independently diagnosed schizophrenia. They both used ICD and DSM to diagnose.
Psych 1 = 26% (DSM) and 44% (ICD)
Psych 2 = 13% (DSM) and 24% (ICD)
VALIDITY PROB. = differences between criteria show there is a lack of agreement between what Sz.
RELIABILITY = lack of inter-rate reliability
What happened in the Rosenhan (1973): Sane in Insane Places study?
Investigated the diagnosis and treatment I; a mental hospital
8 pseudo patients = friends and students —> prepped for appointment by discarding their personal hygiene
Appointment = said they hear 3 words: “hollow, empty and thud.” (This is not a symptom of Sz).
Facility = acted sane but none of the staff knew. 2 months later = diagnosed and released with “Sz in remission.”
Follow up study = told the hospital they would be sending more fake patients —> hospital ‘found’ fakes.