Classification and Diagnosis

Question 1

Positive symptom

Answer 1

reflect an excess of normal functions

Question 2

Negative symptom

Answer 2

reflect a loss of normal functions

Question 3

Delusion

Answer 3

bizarre beliefs, seem real can be paranoid in nature. delusion of grandeur/ persecution

Question 4

Experiences of control

Answer 4

under control of external force that has invaded mind

Question 5

Hallucinations

Answer 5

bizarre, unreal perceptions of environment

Question 6

Disordered thinking

Answer 6

thoughts inserted/ withdrawn from mind

Question 7

Affective flattening

Answer 7

reduction in range and intensity of emotional expression

Question 8

Alogia

Answer 8

poverty of speech

Question 9

Avolition

Answer 9

inability to initiate in goal-directed behaviour

Question 10

Validity

Answer 10

extent diagnosis represent something distinct from other disorders and ICD/DSM measures what it claims to

Question 11

Reliability

Answer 11

consistency of diagnosis

Question 12

Inter-rater reliability - DSM-III (1980)

Answer 12

designed to be more reliable

Carson (1991): claimed it fixed the problem, should lead to greater agreement

Question 13

Test-retest reliability - Wilks et al. (2003):

Answer 13

2 forms of cognitive screening tests given to patients over varying intervals, 1-134 days
correlation of scores across 2 test periods was .84

Question 14

Co-morbidity

Answer 14

extent 2+ conditions co-occur

Question 15

Co-morbidity - Buckley et al. (2009)

Answer 15

estimate depression occurs in 50% of patients
47% have lifetime diagnosis of co-morbid substance abuse
difficulties in diagnosis and treatment

Question 16

Validity - Positive or negative symptoms?

Answer 16

assessed 489 admissions to psychiatric unit in Germany

found positive symptoms more useful for diagnosis then negative

Question 17

Prognosis

Answer 17

diagnosed, rarely share symptoms, no evidence of same outcomes
varies: 20% recover previous level functioning, 10% achieve significant and lasting improvement, 30% improve with intermittent relapses
little predictive validity

Question 18

Inter-rater reliability - little evidence

Answer 18

that DSM is used with high reliability

correlations in diagnosis .11

Question 19

Unreliable symptoms - US

Answer 19

50 psychiatrists, differentiate non- and bizarre
inter-rater reliability correlation .40
diagnosis based on ‘bizarre’ delusions not reliable method of distinguishing( non-)schizophrenic patients

Question 20

Comparing DSM and ICD

Answer 20

Cheniaux et al. (2009): inter-rater relaibility above .50

SZ more frequently diagnosed according to ICD-10

Question 21

Cultural differences - Copeland (1971)

Answer 21

US and British psychiatrist given patient description

69% US diagnosed SZ, 2% British

Question 22

Co-morbidity and medical complications

Answer 22

Weber et al. (2009): evidence of co-morbid physical disorder (e.g. diabetes, asthma)
if untreated, poorer prognosis

Question 23

Co-morbidity and suicide risk

Answer 23

attempted suicide rose from 1% to 40% for those with at least 1 co-morbid mood disorder

Question 24

Symptoms - DID

Answer 24

symptoms found in mood disorders

Ellason and Ross: people with dissociative identity disorder have more symptoms of SZ

Question 25

Ethnicity and misdiagnosis

Answer 25

rates 8x higher for African-Caribbean
result poor housing, unemployment
or diff. mannerisms - misdiagnosis

Question 26

Rosenhan - psychiatric hospital

Answer 26

normal people, sent to hospital, voices,
diagnosed and admitted, not recognised as normal
follow-up, warned of pseudopatients, 0 sent
21% detection rates

Question 27

Self-fulfilling prophecy

Answer 27

labelled with diagnosis, develop symptoms