Classifying Schizophrenia

Question 1

What’s the difference between positive and negative symptoms?

Answer 1

Positive symptoms are behaviours concerning a loss of touch with reality, they respond well to drugs
Negative symptoms are behaviours concerning a disruption of normal emotions/actions, they don’t respond well to drugs

Question 2

What’s the difference between Type I and Type II classifications?

Answer 2

Type I is an acute type, mainly positive symptoms, more likely to recover
Type II is a chronic type, mainly negative symptoms, less likely to recover

Question 3

What are the 3 sub-types of schizophrenia?

Answer 3

Paranoid (powerful delusions + hallucinations)
Hebephrenic (mainly negative symptoms)
Catatonic (mobility disturbances)

Question 4

What are the 2 forms of diagnosis criteria?

Answer 4

DSM-5 (USA)
ICD-10 (world health organisation)

Question 5

What’s the difference between the two classification systems?

Answer 5

DSM-5 requires 2 symptoms from a list to be present for 6 months, seen as more reliable
ICD-10 only requires one month and still used sub-types

Question 6

What were Schneider’s first rank symptoms? What year?

Answer 6

1-Passivity experiences and thought disorders
2-Auditory hallucinations
3-Primary delusions
1959

Question 7

What are Slater and Roths 4 added symptoms? what year?

Answer 7

1-disturbances of effect
2-thought process disorders
3-psychomotor disturbances
4-avolition
1969

Question 8

What are the 5 ‘axes’ (turned into 3) that the DSM-5 classification system uses?

Answer 8

1-(1-3)clinical disorders, personality disorders, physical health
2-environmental factors
3-global assessment of functioning

Question 9

What are the 2 ways of assessing reliability in schizophrenia diagnosis?

Answer 9

1- test-retest method
2- inter-rater method

Question 10

2 pieces of research on reliability of diagnosis

Answer 10

Read et al 2004 (against)- American vs UK diagnosis (69% vs 2%)
Jakobsen et al 2005 (for) - Danish patients

Question 11

What are the 4 ways of assessing validity?

Answer 11

1-reliability
2-predicitive validity
3-descriptive validity
4-aetiological validity

Question 12

what do the following mean?
1-internal validity
2-external validity
3-ecological validity
4-population validity
5-temporal validity

Answer 12

1-does it measure what it claims to?
2-the extent to which the results can be generalised
3-can the findings be generalised to other settings?
4-can the findings be generalised to other people?
5-can the findings be generalised over time?

Question 13

What are the 4 further questions to assess validity?

Answer 13

1-face validity - does it measure what it claims to?
2-concurrent validity - is there a good correlation between the scores of this and those we know to be valid?
3-predictive validity - does it accurately predict future behaviour?
4-temporal - will the findings remain over time?

Question 14

Briefly describe Rosenhan’s classic research on validity

Answer 14

used the DSM-5 system, 8 participants without mental illness went to psych hospitals claiming to hear voices, took between 7-52 days to be released, normal behaviours were interpreted as abnormal, sh0ws the diagnosis system lacks validity (1973)

Question 15

2 pieces of research on the validity of schizophrenia diagnosis

Answer 15

Birchwood + Jackson 2001 - predictive validity is low, 20% fully recover but 10% commit suicide
Kendell + Jablensky 2007 - diagnostic criteria give an agreed framework which can lead to developing effective therapies

Question 16

How does symptom overlap relate to schizophrenia?

Answer 16

makes it difficult for clinicians to decide what disorder someone has
can occur with autism, cocaine abuse and bipolar disorder

Question 17

2 pieces of research on symptom overlap

Answer 17

Serper et al 1999 - considerable overlap with cocaine abuse, but its possible to make an accurate diagnosis
Ophoff et al 2011 - assessed genetic material from 50k participants, found 3/7 gene locations for schizophrenia overlapped with bipolar disorder

Question 18

What is Co-morbidity and how does it relate to schizophrenia?

Answer 18

when 2 or more diseases occur simultaneously
it creates problems wit reliability of diagnosis (what are you diagnosing?) and validity (is schizophrenia a separate lone disorder?)

Question 19

2 pieces of research on co-morbidity in relation to schizophrenia

Answer 19

Sim et al 2006 - 32% of hospitalised patients had another disorder too
Jeste et al 1996 - people with additional disorders are often excluded from research yet make up most of schizophrenia patients, which effects generalisation and treatment

Question 20

How does culture bias relate to schizophrenia?

Answer 20

in Britain, afro-Caribbean people are more likely to be diagnosed and securely hospitalised (probably because of racism as most psychiatrists are white)
could be because racism/poverty increases stress levels, triggering the onset
Cochrane - 7x more likely (1977)

Question 21

what was Fernando’s 1988 evaluative point on culture bias? how did Cochrane 1983 differ?

Answer 21

Fernando said ethnic minorities experience more racism which could trigger the onset
Cochrane said all ethnic minorities experience racism, but only afro-Caribbean are over diagnosed. could be because they have little immunity to the flu (Murray 1996 flu research)

Question 22

2 pieces of research on culture bias in relation to schizophrenia

Answer 22

Whaley 2004 - ethnic differences in symptom expression are overlooked/misinterpreted
Rack 1982 - cultural differences in behaviour expectations, e.g. in some cultures its normal to hear voices

Question 23

How does gender bias relate to schizophrenia?

Answer 23

its possible men are up to 50% more vulnerable, and yet women are over-diagnosed
men suffer more negative symptoms
females have better recovery rates
difference in age onset; men = 18-25, females = 25-35
men have 2 age peaks, women have 3

Question 24

2 pieces of research on gender bias in relation to schizophrenia

Answer 24

Lewin et al 1984 - when a clearer diagnosis criteria was applies, female diagnosis was much lower
Kulkarni et al 2001 - female sex hormone, estradiol, was effective in treating schizophrenia in women when combined with antipsychotic therapy