Classification Of SZ

Question 1

What is schizophrenia

Answer 1

A mental psychotic disorder characterised by a profound disruption of cognition and emotion

Question 2

The onset of the disorder is between (…) and (…) years of age

Answer 2

15
35

Question 3

In the past, sz was more commonly diagnosed in what groups of people

Answer 3

Men > women
Cities > countryside
Working class > middle class

Question 4

What are the 2 classification systems used to diagnose SZ

Answer 4

• the DSM 5
• the ICD 11

Question 5

Where is the DSM used?

Answer 5

America

Question 6

Where is the ICD 11 used?

Answer 6

Europe

Question 7

How many types of SZ are there

Answer 7

2

Question 8

Who made a distinction between the two types of SZ

Answer 8

Crow

Question 9

What is type 1 syndrome characterised by

Answer 9

More positive symptoms (which are an addition to an individuals behaviour) e.g. visual or auditory hallucinations, or delusions of grandeur

Question 10

Which type of SZ has better prospects for recovery

Answer 10

Type 1

Question 11

What is type 2 syndrome characterised more by

Answer 11

Negative symptoms e.g. loss of appropriate emotion of poverty of speech
Generally poorer prospects for recovery

Question 12

What are the two types of symptoms of SZ

Answer 12

Positive and negative

Question 13

What are the positive symptoms of SZ (4)

Answer 13

1. Hallucinations
2. Delusions
3. Disorganised speech
4. Grossly disorganised or catatonic behaviour

Question 14

Wdym by hallucinations

Answer 14

These are sensory experiences of stimuli that have either no basis in reality or are distorted perceptions of things that are

Question 15

What are the 4 diff types of hallucinations you can have

Answer 15

• auditory (hearing voices making comments or criticising)
• visual (seeing things not real e.g distorted facial expressions on animals)
• olfactory (smelling things not real)
• tactile (touching or feeling things not there e.g. bugs)

Question 16

What are delusions (aka paranoia)

Answer 16

Irrational, bizzare beliefs that seem real to the person
Common delusions e.g. being persecuted by the government, or aliens, or being an important figure e.g. Jesus

Question 17

What’s disorganised speech

Answer 17

• individual has problems organising their thoughts therefore may slip from one topic to another (derailment)

Question 18

What is grossly disorganised / catatonic behaviour

Answer 18

The inability / motivation to imitate or even complete a task

Question 19

What does it mean by negative symptoms of SZ

Answer 19

Those that appear to reflect a reduction or loss of normal functions which often persist during periods of low (absent) positive symptoms

Question 20

What are the negative symptoms of SZ

Answer 20

1. Speech poverty (alogia)
2. Avolition
3. Affective flattening
4. Anhedonia

Question 21

What is speech poverty (alogia)

Answer 21

SZ is characterised by changes in patterns of speech - the emphasis is on the reduction in the amount and quality of speech
This is sometimes a delay in verbal responses during conversation
Speech poverty may also be reflected in less complex syntax e.g. shorter utterances

Question 22

What’s avolition (aka apathy)

Answer 22

Finding it difficult to begin or keep up with gosl-directed activity e.g. actions performed in order to achieve a result

Question 23

Signs of avolition

Answer 23

Poor hygiene
Grooming
Lack of persistence in work or education and lack of energy

Question 24

What’s affective flattening

Answer 24

A reduction in the range and intensity of emotional expression, including facial expression, voice tone, eye contact and body language
Individuals who are schizophrenic have fewer body and facial movements and smiles, and less co-verbal behaviour
Patients may also show a deficit in prosody (e.g. intonation, tempo, loudness & pausing), which gives cues to the emotional content of the conversation

Question 25

What’s anhedonia

Answer 25

A loss of interest or pleasure in all / most activities, or a lack of reactivity to normally pleasurable stimuli
Physical anhedonia is the inability to experience pleasure from physical pleasures e.g. food, bodily contact
Social anhedonia is the inability to experience pleasure from interpersonal situations like interacting with others

Question 26

What are the 6 issues associated with the classification and diagnosis of SZ

Answer 26

1) reliability
2) validity
3) co-morbidity
4) symptom overlap
5) gender bias
6) cultural bias

Question 27

How is reliability an issue for the diagnosis of SZ (like what evidence was there for it)

Answer 27

Whaley (2001) found the interrater reliability between diagnosticians as low as +0.11 (using the DSM)
The Cheniaux et al study where psychiatrists independently diagnosed SZ patients

Question 28

Findings of Cheniaux et al (2008)

Answer 28

• 100 sz patients diagnosed independently by 2 diff psychiatrists
• inter rated reliability was poor with
  one psychiatrist diagnosed 26 with SZ according to the DSM, and 44 with the ICD
• other psychiatrist diagnosed 13 with the DSM and 24 according to the ICD

Question 29

What studies are evidence for the validity of SZ diagnosis being weak

Answer 29

Rosenhans study of pseudo patients sneaking into asylums

Question 30

What was Rosenhans (1973) study thatt showed how poor diagnosis was of SZ

Answer 30

• 8 fake patients able to get admitted into psych hospitals
• did this by faking symptoms of hearing voices etc
• all patients stayed for 7-52 days, and acted normally during their stay
• all but 1 patient charged with schizophrenia in remission

Question 31

Con of Rosenhans study

Answer 31

Old so ofc diagnosis was much poorer then because the DSM wasn’t reliable

Question 32

What does the use of newer classification systems improve

Answer 32

Predictive validity of diagnosis

Question 33

What is co-morbidity

Answer 33

Co-morbidity is where two conditions co-exist in the same individual at the same time/have a tendency to co-exist alongside each other
So a person with SZ might also at the same time be suffering from another condition, e.g. personality disorder, depression, alcoholism

Question 34

Evidence for co-morbidity (what did Buckley find out)

Answer 34

Out of the patients diagnosed with SZ
(50% = also diagnosed with depression)
(47% = also diagnosed with substance abuse)

Question 35

What’s symptom overlap?

Answer 35

Considerable overlap between the symptoms of SZ and other conditions legal depression & bipolar

Question 36

How does symptom overlap question the validity of sz diagnosis etc

Answer 36

Under the ICD, a person may be diagnosed with SZ, but under the DSM, may be with bipolar - maybe the two diff disorders are just one thing?

Question 37

Gender bias in sz?

Answer 37

Men more likely to be diagnosed with it
Why tho? Is it bc of genetic vulnerability or women being able to function better as they form more family relationships

Question 38

Cultural bias in SZ diagnosis

Answer 38

Pinto & Jones - 2008 - afro carribean origin or African American people 9 times more likely to be diagnosed with SZ
Maybe because auditory hallucinations are more acceptable there than here e..g thinking hearing voices is communication with ancestors or smth

Question 39

What are the advantages of the classification and diagnosis of SZ

Answer 39

Treatments are often specific to certain disorders so a reliable diagnosis can point to an effective treatment
E.g. specific drugs only work for certain disorders like anti-psychotic for sz, but not anti-anxiety
Easier to incorporate a bunch of the symptoms into a single diagnosis to make communication between professionals easier