A2 - schizophrenia

Question 1

what is schizophrenia?

Answer 1

a psychotic disorder where people interpret reality abnormally. It is marked by severely impaired thinking, emotions, and behaviour

Question 2

what are positive symptoms?

Answer 2

symptoms which are an excess or a distortion of normal functions. In addition to normal experience

Question 3

what is a negative symptom?

Answer 3

a diminution or loss of normal symptoms
1/3 of patients suffer from significant negative symptoms

Question 4

what are examples of positive symptoms?

Answer 4

delusions
hallucinations
catatonic or disorganised behaviour

Question 5

what are examples of negative symptoms?

Answer 5

affective flattening
alogia
avolition
anhedonia

Question 6

what are delusions and outline 3 types

Answer 6

set of beliefs with no basis in reality e.g. paranoia that they are being stalked

1. persecutory
2. gandeur
3. reference

Question 7

what are hallucinations and different types?

Answer 7

distorted view/ perception of stimuli
can be auditory, visual, tactile

Question 8

what is psychomotor behaviour?

Answer 8

stereotypical rocking back and forth, twitches and/or repetitive behaviours

Question 9

what is disorganised speech?

Answer 9

rapid, loss of focus ‘word salad’ incoherent sentences ‘derailment’

Question 10

what is affective flattening?

Answer 10

lack of showing emotion, characterised by an unchanging facial expression and little to no change in tone, strength, pitch

Question 11

what is alogia?

Answer 11

abnormally low level of the frequency and quality of speech

Question 12

what is avolition?

Answer 12

lack of motivation - inability to cope with the normal pressures and motivations associated with everyday tasks

Question 13

what is anhedonia?

Answer 13

loss of pleasure - not finding joy in anything

Question 14

what are the 2 main diagnostic tools for schizophrenia?

Answer 14

DSM-V
ICD-11

Question 15

what is the criteria on the DSM-V for schizophrenia

Answer 15

symptoms for at least 1 month - requires at least 2 or more of: delusions, hallucinations, disorganised speech, and catatonic behaviour

Question 16

what is the criteria on the ICD-11 for schizophrenia?

Answer 16

1 month + symptoms - the clinical picture is dominated by relatively stable, often paranoid delusions, usually accompanied by hallucinations

Question 17

what is reliability?

Answer 17

the extent to which a finding can be consistent

Question 18

what are the 2 ways reliability can be tested

Answer 18

1. test-retest
2. inter-rater reliability

Question 19

what is schizophrenia’s KAPA score?

Answer 19

0.46

Question 20

what was found about cultural differences in diagnosis?

Answer 20

Copeland et at gave a description of the same patients to 134 US and 194 UK psychiatrists and
69% of US diagnosed them but only 2% of the UK did

Question 21

what was found about the different variations of ‘hearing voices’ by Luhrman et al

Answer 21

He interviewed 60 adults, 20 from Ghana, India, and US each. The Indians and Ghanaians said they heard playful, advice diving voices. Whereas the Americans reported voices as being violent and hateful. Indicative of being ‘sick’

Question 22

Evidence that DSM-V shows low reliability AO3

Answer 22

P - despite claims of better reliability as the DSM has been regularly updated since the DSM-III, 30 years ago, there is still little evidence that DSM-V is used reliably by clinicians
E - Whaley found inter-rater reliability correlations in diagnosis as low as 0.11/ For results to be reliable, there must be a 0.7 KAPA score, or a 0.8 inter-rater reliability.
E - these findings suggest, with the lack of objective measures used by other branches of medicine, there continues to be low reliability in the diagnosis of SZ

Question 23

define validity

Answer 23

the extent to which we are measuring what we are intending to measure

Question 24

how does Rosenhan’s research demonstrate a lack of validity in the diagnosis of schizophrenia?

Answer 24

Pseudo patients reported hearing voices saying ‘hollow, empty, thud’ at several US psych hospitals.
11/12 times fake patients were diagnosed as insane, showing a lack of validity as they were all fave patients and none had SZ

Question 25

how does gender bias affect the validity of diagnosis for schizophrenia

Answer 25

critics of the DSM diagnostic criteria argue that some diagnostic categories are biased towards diagnosing one gender rather than the other, therefore lack validity

Question 26

supporting evidence for how gender bias affects the validity of diagnosis for schizophrenia AO3

Answer 26

E - Loring and Powell randomly selected 290 male and female psychiatrists to read patiend behaviour. Then, were asked to give their diagnosis using a standard criteria.
E - when said to be male or no gender, 56% were diagnosed with SZ
when they were said to be female, only 20% were diagnosed
E - this gender bias did not appear to be evident amongst the female psychiatrists. This suggests that diagnosis is influenced not only by the gender of the patient but the gender of the clinician. It may be that men are more likely to be diagnosed due to gender bias with women’s issues not being taken seriously

Question 27

what is symptom overlap?

Answer 27

the extent to which symptoms of schizophrenia are also found in other disorders e.g. old, depression, bipolar disorder

Question 28

AO3 of how symptom overlap can cause problems with making a valid diagnosis of SZ

Answer 28

P - symptom overlap can cause problems with making a valid diagnosis of SZ
E - this suggests that many people diagnosed with sz have enough symptoms of other disorders that they could receive an incorrect diagnosis
E - Ketter identified that misdiagnosis due to symptom overlap can lead to years of delay in receiving correct treatment, during which time further suffering can occur.
L - focussing on resolving this could save money for the NHS and lives of patients

Question 29

what is co-morbidity?

Answer 29

the extent that 2 or more conditions can occur at the same time

Question 30

example (Buckley) of co-morbidity

Answer 30

suggested co-morbid depression occurs in 50% of patients with SZ and 47% experience substance abuse