classification of schizophrenia

Question 1

what are positive symptoms?

Answer 1

these reflect an excess/distortion of the environment that have no basis in reality

Question 2

what are hallucinations?

Answer 2

bizarre, unreal perceptions of the environment that have no basis in reality

Question 3

what are the 4 types of hallucinations?

Answer 3

auditory (hearing voices, often hostile and critical)
visual (lights, objects, faces)
olfactory (smelling things)
tactile (feeling bugs crawling on or under your skin)

Question 4

what is usually related to the symptoms?

Answer 4

sometimes related to the environment and what the senses are picking up

Question 5

what are delusions?

Answer 5

bizarre beliefs that seem real to the person with SZ, but are not real

Question 6

how are paranoia and delusions linked?

Answer 6

sometimes these delusions can be paranoid in nature (persecutory)

Question 7

how are inflated beliefs and delusions linked?

Answer 7

delusions may also involve inflated beliefs about the persons power and importance (of grandeur)

Question 8

what is a common form that delusions may also take?

Answer 8

individuals may feel like part of themselves are under external control

Question 9

what are negative symptoms?

Answer 9

they reflect a reduction or loss of normal functions which persist during periods of low positive symptoms

Question 10

what is poverty of speech?

Answer 10

alogia, this is characterised by the lessening of speech fluency and productivity

Question 11

what is the result of alogia/poverty of speech?

Answer 11

verbal responses during conversations are often delayed

Question 12

what do the delayed verbal responses reflect?

Answer 12

it reflects slowing or blocked thoughts

Question 13

what is avolition?

Answer 13

the reduction of, or inability to initiate and persist in goal-directed behaviour (e.g. sitting in the house for hours everyday, doing nothing)
it is often mistaken for apparent disinterest

Question 14

what is the DSM-V?

Answer 14

it is the diagnostic statistical manual developed by the American psychiatric association

Question 15

what is the ICD-10?

Answer 15

the international classification of disease developed by the world health organisation

Question 16

what symptoms does the DSM-V require to diagnose SZ?

Answer 16

at least one positive symptom to be present for at least 1 month duration

Question 17

what symptoms does the ICD-10 require to diagnose SZ?

Answer 17

at least one positive symptom to be present for at least 1 month duration, but can also result from the presence of 2 or more negative symptoms

Question 18

what do we mean by the reliability of the classification and diagnosis of schizophrenia?

Answer 18

when making a diagnosis, questionnaires, scales, cognitive tests are administered to base some of the judgement on.

Question 19

how is test-retest used to look at the reliability of the classification and diagnosis of schizophrenia?

Answer 19

are such tests reliable in their results? how are they interpreted? how are they used to feed into a diagnosis?

Question 20

how is inter-observer reliability used to look at the reliability of the classification and diagnosis of schizophrenia?

Answer 20

since the publication of the DSM-III, psychologists such as CARSON (1991) have claimed that the system for the classification and diagnosis of SZ was reliable. this was intended to give more agreement over who did/didnt have SZ, particularly between psychiatrists.

Question 21

to what extent do 2 mental health professionals arrive at the same diagnosis for the same patient?

Answer 21

CHENIAUX ET AL (2009) investigated the reliability of the diagnosis of SZ according to the DSM and ICD. such comorbidity creates difficulties in the diagnosis of a disorder and also in deciding which treatment to advise. 2 psychiatrists were asked to diagnose 100 patients using both the DSM and ICD. inter-rater reliability was poor and the reliability across the two classification systems was also low.
psychiatrist 1: diagnosed 26 with DSM and 44 with ICD
psychiatrist 2: diagnosed 13 with DSM and 24 with ICD.

Question 22

what do we mean by the validity of the classification and diagnosis of schizophrenia?

Answer 22

to what extent does a diagnosis represent something that is real and distinct from other disorders. to what extent does a classification system measure what it claims to measure?

Question 23

what is validity in terms of a diagnosis of SZ?

Answer 23

validity is how accurate a diagnosis is and how closely symptoms relate to the ICD-10 or DSM classification systems.

Question 24

how can we look at concurrent validity for the classification and diagnosis for schizophrenia?

Answer 24

do the different assessment systems arrive at the same diagnosis for the same patient. when looking at CHENIAUX’s study we can see that SZ is more likely to be diagnosed with the ICD than the DSM.

Question 25

how can we look at predictive validity for the classification and diagnosis of schizophrenia?

Answer 25

whether particular treatments are successful. why does this reflect validity? biological treatments are based on biological explanations so tend to be fairly effective, however, they don’t work for everyone.

Question 26

what is comorbidity?

Answer 26

when 2 or more conditions occur together

Question 27

how is ‘comorbidity’ an issue to the reliability and validity in the classification and diagnosis of schizophrenia?

Answer 27

if conditions occur a lot together, it leads us to challenge the validity of diagnosis because they may be one single condition. SZ is usually diagnosed with other conditions.
BUCKLEY ET AL (2009), estimated that comorbid depression occurs in 50% of patients, 47% also have a lifetime diagnosis of comorbid substance abuse. in such cases is the label ‘SZ’ rendered meaningless? it undermines the classification and diagnosis of SZ as a reliable and valid process. such comorbidity creates difficulties in the diagnosis of a disorder and also in deciding what treatments to advise.

Question 28

how is ‘gender bias’ an issue to the reliability and validity of the classification and diagnosis of schizophrenia?

Answer 28

LONGNECKER ET AL (2010) reviewed studies that considered the prevelance of SZ and found that men were diagnosed with SZ more than women. are they genetically more vulnerable to developing SZ? or is it gender bias?
COTTON ET AL (2009) suggested women are more likely to function better than men meaning they don’t often receive the diagnosis of SZ.

Question 29

how is ‘culture bias’ an issue to the reliability and validity of the classification and diagnosis of schizophrenia?

Answer 29

african-american and those in the UK of Afro-carribean descent are more likely to be diagnosed with SZ than their white counterpart. however, rates are not higher in Africa/West Indies, meaning not genetic vulnerability, so its likely to be a result of culture bias.
ESCOBAR (2012) pointed out that psychiatrists (largely white) tend to over-interpret symptoms of black people during diagnosis so there more likely to receive a diagnosis of SZ.

Question 30

how is ‘symptoms overlap’ an issue to the reliability and validity of the classification and diagnosis of schizophrenia?

Answer 30

the fact that many of the symptoms of SZ are found in other disorders means that the reliability and validity of the classification and diagnosis of SZ is undermined. this is because they can’t be taken as a reliable indicator of an individual having SZ.
ELLASON & ROSS (1995) found people with dissociative identity disorder actually have more symptoms of SZ than individuals with an SZ diagnosis