Diagnosis and Classification

Question 1

What is classification?

Answer 1

The attempt to:
Universally catergorise the different types of mental disorders
- based on a cluster of symptoms

Question 2

Classification Systems

Answer 2

DSM-V
- more specfic diagnosis criteria
- requires 2 or more of delusions, hallucinations, disorganised speech and catronic behaviour

ICD-10
-takes a broader approach to diagnosis
‘the clinical picture is dominated by relatively stable, often parnoid delusions, usually accompanied by hallucinations

Question 3

What is diagnosis?

Answer 3

The attempt to:
Recognise and identify mental illnesses by its signs and symptoms

Question 4

Validity in Diagnosis and Classification

Answer 4

Validity- the extent to which SZ is a unique syndrome with characteristics, signs and symptoms

For the classification system to be valid it should be meaningful and classify a real pattern of symptoms, which result from a real underlying cause

Question 5

Reliability in Classification and Diagnosis

Answer 5

For classification system to be reliable, different clinicans using the same system (DSM) should arrvie at the same diagnosis for the same individual
- the level of agreement on the diagnosis by different psychiatrists across time and cultures; stability of diagnosis over time given no change in symptoms

Question 6

Positive Symptoms

Answer 6

represent an excess or distortion of normal functions

e.g- delusions, experiences of control, hallucinations, disordered thinking

Question 7

Negative Symptoms

Answer 7

represent a withdrawal or lack of function that you would usually expect to see in a healthy person

E.g- avolition, reduced emotional expressions, reduced speech

Question 8

A03- Clinical Explanations
(Gender Bias)

Answer 8

Longnecker (2010)- since the 1980s, more men than women have been diagnosed- due to genetic vulnerability of men

Cotton et al (2009)- women tend to function better than men, providing an explanation for why some women may not have been diagnosed with SZ where men with similar symptoms may have been

Issues and Debates:
Socially Sensitstive Reasarch- Alpha Bias- men are more prone to the illness
Social Implications- underdiagnosis of women, exaggreates differences between men and women

Question 9

A03- Clinical Explanations
(Co-Morbidity)

Answer 9

Morbidity- refers to a medical conditions or how common it is
Co-Morbidity- phenonemum that two or more conditions occur together

SZ is commonly diagnosed with other conditons
Peter Buckely et al (2009)- around 1/2 of people with a diagnosis of SZ also have depression or substance abuse (47%). PTSD- 29%. OCD- 23%

Suggests its a challenge for both classification and diagnosis of SZ. Terms of diagnosis, if half those have depression maybe we’re just bad at telling the difference between the two

Issues and Debates
Nomothetic- can create general laws because of it

Question 10

A03- Clinical Explanations
(Cultural Bias)

Answer 10

People from Afro-Carribbean origin= several times more likely than white people to be diagnosed with SZ
- not due to genetic vulnerability, but cultural differences instead

• Many positive symptoms (hearing voices)= acceptable in African cultures and may be seen as** irrational and bizarre** when reported to a psychiatrist from a different culture background

Javier Escobar (2012)- white psychiatrist tend to over-interpret symptoms and distrust honesty of Afro-Carribeans- multiple misdiagnoses

-Decreases Validity- confounded by cultural beliefs or racial distrust of black paitents by mental health practioners