classification and diagnosis Flashcards
Approximately what % of the population suffers from schizophrenia?
1%
What gender is more commonly diagnosed with schizophrenia?
male
How are schizophrenics diagnosed?
ICD (made by WHO) or DSM (made in USA)
What class is more likely to be diagnosed with schizophrenia?
middle-class
What are two main issues surrounding the diagnosis and classification of schizophrenia?
-validity
-reliability
What does validity mean in terms of schizophrenia diagnosis and classification?
-refers to how accurate the diagnosis of SZ is and whether we assess what we are trying to assess
What does reliability mean in teems of schizophrenia diagnosis and classification?
-refers to the consistency of measurement and affect diagnosis in two ways
In what two ways does reliability affect schizophrenia diagnosis?
-inter rater reliability
-test-retest reliability
How does inter-rater reliability affect schizophrenia diagnosis?
-the extent to which two or more mental health professionals arrive at the same diagnosis of SZ for the same patients when they are independently assessing them
How does test-retest reliability affect schizophrenia diagnosis?
-occurs when a clinician makes the same diagnosis on separate occasions from the same information
Evaluate validity of schizophrenia classification and diagnosis
-Cheniaux (2009) found 66/100 of the same clients were diagnoses with schizophrenia under the ICD, and 39/100 under the DSM
-However, diagnosing schizophrenia may be valid provided it takes place using a single diagnostic system- studies have shown excellent agreement between clinicians using tow measures both from DSM
Evaluate reliability of schizophrenia classification and diagnosis
-although reliability for schizophrenia diagnosis was low priori to DSM-5 it has npw improved
-Osorio et al (2019) reported excellent reliability for the diagnosis of the SZ in 180 individuals using the DSM-5
-Pairs of interviewers achieved inter-rater reliability of +0.97 and test retest reliability of +0.92
-higher correlation coefficient than 0.8 which is threshold for accepting reliability
What are the issues that can reduce the validity/ reliability of the classification and diagnosis of schizophrenia?
-gender bias
-cultural bias
-co-morbidity
-symptom overlap
Explain gender bias in relation to schizophrenia (AO1)
-men are more likely to be diagnosed, but are not necessarily more susceptible
-Alpha-bias- exaggerated differences between ,ales and femasles
-may be that proportions are the same but female sufferers function better/ do not go to the GP
Evaluate gender bias in relation to schizophrenia (AO3)
-one possible explanation is that it appears female patients typically function better than man- more likely to work and have good family relationships.
-This high functioning may explain how some women have nit been diagnosed with SZ, where men with similar symptoms might have been, as women’s better interpersonal functioning may bias practitioners to under-diagnose SZ
-Gender bias also occurs due to clinicians failing to consider that males suffer more negative symptoms than women, and have higher levels of substance abuse or females have better recovery and lower relapse rates
-these misconceptions could be affecting the validity of a diagnosis as clinicians are not considering all symptoms
Explain cultural bias in relation to schizophrenia (AO1)
-refers to the tendency to over-diagnose members of some cultures as suffering from SZ
-e.g afro-Caribbeans
Evaluate cultural bias in relation to schizophrenia (AO3)
African Americans and English people of Afro-carribbean origin are 10x more likely than white British people to be diagnosed with sz
positive symptoms such as hearing voices may be more acceptable in African cultures, thus people are more ready to aknowledge such experiences when reported to a psychiatrist from a different cultural tradition these are likely to be seen as bizzare + irrational
research has pointed out that white psychiatrists are more likely to overinterpret symptoms in diagnosis
this brings validty of diagnosis of sz into question
Explain co-morbidity in relation to schizophrenia (AO1)
-co-morbidity is where one or more additional disorders or diseases occur simultaneously with schizophrenia and can create problems with validity of diagnosis, as there may be confusion over which actual disorder is being diagnosed
-schizophrenics often suffer from forms of depression at the same time.
Evaluate co-morbidity in relation to schizophrenia (AO3)
-Buckley (2009) found that:
-50% of individuals with SZ also had depression
-47% had substance abuse
-23% had OCD
-it could be that findings are due to psychiatrists not being able to tell the difference between the two conditions
-In terms of classification, it may be that, if very severe depression looks a lot like SZ and vice versa, then they might be better seen as a single condition
-This research illustrates the difficulties that co-morbidity can create in achieving a valid diagnosis of schizophrenia
Explain symptom overlap in relation to schizophrenia (AO1)
-there is considerable overlap between the symptoms of schizophrenia and other conditions
-for example both SZ and BPD involve positive symptoms like delusions and negative symptoms like avolition
Evaluate symptom overlap in relation to schizophrenia (AO3)
-Using the ICD, a patient mat be diagnosed as schizophrenic, however, many of the same patients would receive a diagnosis of BPD according to the DSM. This is unsurprising given the symptom overlap
-it even suggests that SZ and BPD may not be two different conditions, but one.
-This questions the validity of both classification and diagnosis of SZ
