Classification of SZ Flashcards
What is SZ characterised by
and what are the 4 ways it affects a patient
SZ is characterised by a profound disruptions of cognition and emotion which affects language, thought, perception and sense of self
What is meant by psychosis
psychosis is when patients have a loss of contact with reality
How is SZ classified
name the 2 systems used to diagnose SZ
Classifications are used to organise the symptoms into categories
1. Diagnosis using DSM-10
2. Diagnosis using ICD
Outline what the prevalence is for SZ
Prevalence of SZ is that men are more likely to develop SZ earlier in life, than females
Does the Concordance rate for both genders differ for SZ
No males and females have a similar concordance rate
What is a prognosis
a prognosis is the process leading to an end result
Recall the ‘rule of thirds’ for SZ prognosis
1/3 recover
1/3 have episodic impairment
1/3 have a chronic decline
what environment does a SZ prognosis have a better result
Prognosis is better in a non-industrialised society as it is less intense in a rural area
What symptoms occur at type 1 SZ
Positive symptoms that are episodic
what symptoms occur at type 2 SZ
Negative symptoms mainly chronic
Outline what a pos symptoms is for SZ patients
Positive symptoms in SZ patients occur when there’s an excess of normal functions
Outline what a neg symp is for SZ patients
Negative symptoms in SZ patients occur when there’s a loss/deficit of normal functions
List the Positive symptoms of SZ
- delusions
- disorganised speech
- hallucinations
- grossly disorganised/ catatonic behaviour
List some negative symptoms of SZ
- Speech poverty
- Avolition- reduced interests and desires in reaching goals
- Anhedonia- loss of interest in all activities
- Affective Flattering- decreased range of emotional expression
Name and explain the two researches that show how symptoms were identified in the past
Schneider 1959 - developed the diagnosis of using First Rank Symptoms (FRS) which he used to identify characteristics of SZ based on verbal reports.
Slater and Roth 1969 - Found symptoms from observations
Evaluation of the validity of diagnosing and the classification of sz
Rosenham + that C + D lacks ecological validity
Evidence- 8 ppts admitted into hospital after stating they hear voices
No staff noticed, even when they acted normal the whole time in there- not allowed out average 19 days
Schneider= not appropriate way to classify SZ as it is more complex than first impressions
Evaluating the reliability of diagnosis and classification of sz
C + R lacks I-R reliability bc clincians don’t come to same conclusions when diagnosing same patient
e.g. Kappa score for the DSM-v is 0.46, demonstrating how it lacks reliability as 0.7 and above is accepted
List the 3 points to discuss for reliability
- Inter-rater reliability
- unreliable symptoms
- cultural differences when diagnosing Sz
List the 3 points that can be discussed for validity
- Gender bias research support when diagnosing
- Co morbidity and consequences of it
- Differences in prognosis
Explain how co-morbidity can evaluated in relation to validity of d + c of SZ
what is it
how is validity reduced
Co-morbidity= disorder exists alongside the primary diagnosis (sz, depression)
- reduced validity= clinicians’ cannot separate the illnesses
eg. research found that 50% of Sz patients have another illness
Explain how culture can be evaluated in relation to reliability of d + c of SZ
- Hearing voices= accepted -african culture,
- Rosenham - lacks generalisability so reduces reliability = Us ppts (individualistic culture)
- Cultural bias= Afro- Caribbean have have a higher genetic predisposition, than west indie culture
- Different area of the world use different diagnosis systems ICD Europe, DSM-v other
- 69 % of US psychiatrists diagnosed the SZ patient the same but only 2% of UK psychiatrists were the same
Explain how gender bias can be evaluated in relation to validity of
C + D of Sz
-strength of rosenham is there was not a gender biased sample
- Research found in 1980s more m were diagnosed than f
– Above raises questions about the validity of D + C
Is diagnosis gender bias to males?
Are males more gentically vulnerable
Reasons females aren’t diagnoses as frequently:
- better at masking symptoms
- have higher functioning ability
Explain how symptom overlap can be evaluated in relation to reliability of D + C of Sz
Reduced reliability of D + C of SZ because pos (delusions) and neg (avolition) symptoms overlap with SZ and bipolar
depression and SZ - neg symptoms (speech poverty and avolition)
This limits the reliability as DSM-v could diagnose bipolar but ICD diagnoses depression
Suggests the overlap means there are not different mental health disorders
Examples and meaning of Positive Symptoms of SZ
Delusions
Disorganised speech- due to abnormal thought processing
Grossly disorganised/ Catatonic behaviour- inability to finish a task
Examples and meaning of Negative Symptoms of SZ
Avolition- reduced interests in goals
Affective flattering- reduced range of emotional expression
Speech poverty- lessened fluency
Anhedonia- Loss of pleasure in activities leading to loss of reactivity to pleasurable stimuli
