Classification of schizophrenia Flashcards
what are the symptoms of schizophrenia ?
hallucinations, delusions, avolition and speech poverty
what are the positive symptoms of schizophrenia ?
hallucinations and delusions
what are negative symptoms of schizophrenia
speech poverty and avolition
what are hallucinations?
hallucinations can involve all five senses.
experiencing hallucinations means perceiving things around us that aren’t real. usually take the form of hearing voices that are not there, these voices are usually critical and unfriendly.
what are positive symptoms
are an excess of normal functions which represent a change in behaviour or thoughts.
what are delusions?
irrational beliefs about the world that are firmly held onto.
what are the two types of delusions?
paranoid delusions and delusions of grandeur
what are paranoid delusions
where an individual believes that something, or someone is deliberately trying to mislead, manipulative, hurt or kill them.
what are delusions of grandeur ?
where individuals believe that they have some imaginary power or authority such as thinking that they are on a mission from God and that they are secret agent.
what are negative symptoms ?
where normal functions are limited.
what speech poverty ?
minimal speech, lack of spontaneous, unprompted speech
what is Avolition?
a persistent lack of motivation or energy to completer normal everyday tasks.
what is the book called that doctors use to diagnose mental disorders
the DSM (diagnostic statistical manual)
what is classification?
Classification is the process of organising symptoms into categories based on which symptoms cluster together in sufferers. Psychologists use the DSM and ICD to diagnose a patient with schizophrenia.
what are the two most widely used classification system for diagnosis of schizophrenia ?
ICD-10 and DSM-IV
what is the DSM-IV ?
The DSM is produced by the American psychiatric association. it is the most widely used diagnostic tool in psychiatric institutions throughout America and some part of Europe
what is ICD-IV ?
international statistical classification of diseases (known as ICD)- produced in Europe by the world health organisation. it used in the UK and many other European countries.
what does reliability mean in terms of diagnosis
refers to the extent that a diagnosis represents something that is real and distinct from other disorders and the extent that a classification system such as ICD and DSM measure what it claims to measure.
to be diagnosed with schizophrenia, what do patients need to display
at least two of the main symptoms for at least 6 months
How is schizophrenia diagnosed ?
schizophrenia is diagnosed using the DSM. According to the DSM to be diagnosed with schizophrenia, patients need to have displayed at least 2 of main symptoms for at least 6 months
what is schizophrenia?
Schizophrenia is a severe mental illness where contact with reality and insight are impaired.
for a study to be reliable, the results of the study must be….
be consistent every time the study is repeated
What does it mean when a diagnosis is reliable
- for a particular patient, different doctors give the same diagnosis consistently
- Given multiple patients with the same symptoms, one doctor gives each patient the same diagnosis consistently
when is a diagnosis valid
- the doctor doesn’t incorrectly diagnosis people who don’t have a particular illness.
- the criteria used to make the diagnosis allows us to correctly identify people who have a particular illness
what is inter-rater reliability
is when multiple people make the same measurements, to see how to see how similar their measurements are
why do researchers use the inter-reliability ?
researchers use inter-reliability to asses the reliability of a diagnosis of schizophrenia
what did beck find about the reliability of schizophrenia
in 1952 Beck found that the diagnosis were 52%. in 2005, researchers found that diagnosis were 81% similar. a diagnosis of schizophrenia is becoming more reliable
what is Rosenhan’s method for his study
Rosenhan got 8 volunteers, who pretended to have schizophrenia, admitted into hospital.
Rosenhan conducted an observation study
what where the results to Rosenhan’s study
it took doctors between 7 to 52 days to realise the diagnoses was wrong, and that volunteers were healthy.
the study showed that diagnose of schizophrenia can lack reliability.
what is cultural bias
when researchers misrepresent the differences between cultures
what are social norms?
the unwritten rules for all members of a social group are expected to behave are called social norms.
what is ethnocentric bias
when someone assumes that other cultures behave the same as their own
what are the consequences of cultural bias in diagnosing disorders
- doctors might be more likely to diagnose someone from another culture with a mental disorder
- two doctors with different cultural backgrounds might give the same patient a different diagnoses
what do doctors rely on when deciding whether the patients behaviours match symptoms of schizophrenia
doctors rely on social norms of their own culture to decide whether a patient’s behaviours match symptoms of schizophrenia. this means that they are more likely to diagnose schizophrenia in patients who are from a different culture to the doctor’s own. so, culture bias reduces and decreases the validity and reliability of a diagnosis
how can cultural bias reduce the validity and reliability of schizophrenic diagnosis
- when doctors diagnose schizophrenia, they use social norms of their own culture to decide whether a patient’s behaviour match any of the symptoms of schizophrenia.
- the reliance on social norms can lead to overdiagnosis of schizophrenia in patients from a different culture to the doctor’s own culture.
in Cochrane’s study, why were afro-Caribbean people living in Britain being over diagnosed with schizophrenia due to cultural bias?
doctors in Britain were judging the patients using the social norms from their own culture
what was Cochrane’s study
- Cochrane conducted a review comparing the number of people with schizophrenia in the Caribbean and in Britain.
- the overall rate of schizophrenia was similar in the Caribbean and in Britain
what were the findings of Cochrane’s study?
- Afro-Caribbean people were 7 times more likely to be diagnosed with schizophrenia in Britain than in the Caribbean.
- Cochrane concluded that this was because of cultural bias by British doctors.
what can reduce the validity and reliability of a schizophrenia diagnosis is
cultural bias comorbidity
gender bias symptom overlap
what is gender bias
when the differences between men and women are misrepresented
what is beta bias
ignoring real differences between men and women
what is alpha bias
over exaggerating differences in men and female behaviour
what can both types of bias lead to in terms of diagnosis
both types of bias can lead to under and over diagnosis of schizophrenia in men and women
what can under and over diagnosis due to gender bias lead to
under and over diagnosis due to gender bias can reduce the reliability and validity of the diagnosis
what method was used in Loring and Powell’s study?
- they gave female and male doctors identical descriptions of the patients symptoms
- they varied the patients gender
what were the results to Loring and Powell’s study?
when patients were described as female , 20% of doctors diagnosed the patient with schizophrenia. when the patient was described as male, 56%of Doctors diagnosed the patient with schizophrenia. this indicates there may be alpha bias in the diagnosis of schizophrenia
how does cultural bias affect the validity of diagnoses
the doctor might diagnose someone with a disorder who doesn’t actually have a disorder
explain how cultural bias affects the reliability of the diagnoses
Cultural bias means that doctors might be more likely to diagnose someone from another culture with a mental disorder. This means that the same patient might get a different diagnosis, depending on the cultural background of their doctor, which would therefore reduce the reliability of the diagnosis because it would not be consistent.
how does gender bias affect the reliability of the diagnosis
patients with the same symptoms might get different diagnosis depending on their gender
explain how gender bias affects the validity of the diagnosis
if the criteria used to diagnose schizophrenia over or under exaggerate the differences between men and women, then they won’t correctly identify schizophrenia in all women and men.
what does it mean if illnesses are comorbid?
two or more illnesses occur together at the same person
if doctors are more likely to diagnose different disorders when a patient has co morbid illness, what does this decrease
the reliability
if two illnesses are often comorbid, the criteria for diagnosing the two illness might be incorrect- they might not actually be sperate conditions, so the diagnosis may lack
validity
what did Buckley find in his study on how many schizophrenic patients had a comorbid mental disorder ?
he found that 50% of patients had depression and schizophrenia, 47% of patients had an addiction and schizophrenia and 23% of patient had OCD and schizophrenia
what is the term for cycles of pronounced highs in bipolar depression?
mania
if a patient has overlapping symptoms and so tow different doctors diagnose them with different disorders, what does the diagnoses lack
reliability
if the criteria incorrectly diagnoses someone as having schizophrenia, what can we say is lacking from this diagnoses
validity
what did Weber (2009) find about the consequences of comorbidity
a large study by weber found that many schizophrenic patients also had diagnoses of medical problems (asthma). concluded that the schizophrenic. Diagnosis meant that participants received a lower standard of care.
what is symptom overlap?
the symptoms of schizophrenia considerably overlap with the symptoms of other disorders
the symptoms of schizophrenia might overlap with the symptoms of other disorders such as
OCD, depression and addiction
how could symptom overlap reduce the reliability of diagnosis?
different doctors may look at the same symptom and give a different diagnosis
how could the symptom overlap in Ellason and Ross study reduce the validity of the diagnoses in the study?
the criteria used to diagnoses schizophrenia don’t enable doctors to correctly distinguish between schizophrenia and dissociative identity disorder
what did Ellason and Ross compare to study the overlap in schizophrenia
symptoms of schizophrenia patients of those of dissociative identity disorder patients
what did Ellason and Ross’s study find
patients with dissociative identity disorder displayed more schizophrenic symptoms than patients with schizophrenia
how do researchers improve the reliability of the diagnosis
inter-rater reliability and test-retest reliability
Luhrmann (2015) reliability: Culture
Interviewed 60 adults with a diagnosis of schizophrenia, and asked about the voices they heard.
- 20 from Ghana, 20 from India, 20 from U.S
- Pps from Ghana & India reported positive experiences with their voices (playful, offered advice)
- U.S. pps reported only negative experiences (hateful, violent)
Copeland (1971) reliability: Culture
Gave 134 US and 194 British psychiatrists a description of a patient.
- 69% of the US psychiatrists diagnosed schizophrenia
- only 2% of British psychiatrists diagnosed schizophrenia
Davison & Neale (1994) reliability: Culture
in Asian cultures, a person experiencing some emotional turmoil is praised & rewarded if they show no expression of their emotions.
In certain Arabic cultures however, the outpouring of public emotion is understood and often encouraged.
Without this knowledge, an individual displaying overt emotional behaviour may be regarded as abnormal when in fact it is not.
Ellason and Ross (1995) Validity: Symptom Overlap
point out that people with dissociative identity disorder have more Schiz. symptoms than people diagnosed as being schizophrenic.
