Diagnosis and classification of schizophrenia Flashcards
what does classification mean
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 does diagnosis mean
Diagnosis refers to the assigning of a label of a disorder to a patient. The ICD-10 (only negative symptoms need to be present) is used worldwide and the DSM-5 (only positive symptoms need to be present) is used in America.
How is schizophrenia diagnosed
In order to diagnose Schizophrenia the Mental Health Profession developed the DSM (Diagnostic and Statistical Manual) still used today as a method of classifying mental disorders (particularly in the USA).
what are hallucinations
a symptom of schizophrenia. Means perceiving things around us that are not real. Can involve any of the five senses
what are delusions
a symptom of schizophrenia. irrational beliefs about the world that are firmly held onto
what is avolition
a symptom of schizophrenia. A persistent lack of motivation or energy to complete normal everyday tasks
what is speech poverty
a symptom of schizophrenia. Minimal speech and the lack of spontaneous, unprompted speech
what are positive symptoms of schizophrenia
- symptoms that involve abnormal , additional experiences that people dont normally have
- eg hallucinations and delusions
what are negative symptoms of schizophrenia
- symptom that involve absence of experience that people normally have
- eg speech poverty and avolition
how is schizophrenia diagnosed
using a book called the DSM. To be diagnosed patients need to display at least 2 of the main symptoms for at least 6 months
what is catatonic behaviour
positive symptom of schizophrenia. group of symptoms that usually involve a lack of movement and communication, and also can include agitation, confusion, and restlessness.
positives of classification and diagnosis
Classification and diagnosis does have advantages as it allows doctors to communicate more effectively about a patient and use similar terminology when discussing them. In addition, they can then predict the outcome of the disorder and suggest related treatment to help the patient.
what is a reliable disagnosis
- for one patients whose symptoms remain the same, different doctors give the same diagnosis consistently
- for different patients with the same symtoms, doctor gives all patiets the same diagnosis consistently
when a study is internally valid
it measures what it claims to be measuring
when is a diagnosis valid
- the doctor doesnt incorrectly diagnose people who dont have a particular illness
- the criteria used to make the diagnosis allow us to correctly identify people who have a particular illness
Question. Azriel faked some symptoms of a common disorder, described these symptoms to the doctor and received a diagnosis. He then saw a different doctor, who gave a different diagnosis.
Explain why Azriel’s diagnosis was neither reliable nor valid.
Reliability of diagnosis requires diagnoses to be consistent between doctors, or between patients with the same symptoms. As Azriel’s two doctors were not consistent, his diagnosis is not reliable. Azriel does not have a disorder at all, so his diagnosis was not valid either. Validity means that the disorder is correctly diagnosed, which in Azriel’s case it was not.
what is inter rater reliability
when multiple people make the same measurement to see how similar their measurement are
what was rosenhans method
- got 8 volunteers to pretend that they had schizophrenia admitted into hospital
- rosenhan conducted an observation study
- rosenhan tested how ling it took doctors to declare that volunteers are healthy
what was rosenhans results
- it took the doctors between 7 and 52 days to realise that the diagnosis was wrong and that the volunteers were healthy
- the study showed that the diagnosis of schizophrenia can lack valdidity
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what is cultural bias
researchers misrepresent the differences between cultures
ethnocentric bias
assume other cultures behave the same as their own
what is the consequence of cultural bias in diagnosing disorders
- doctors might be more likely to diagnose someone from a different culture with a mental disorder
- two doctors with two different cultural backgrounds might give the same patient a different diagnosis
- cultural bias reduce the reliability and validity of the diagnosis
what was Cochranes study which is support for cultural bias for schizophrenia
- conducted a review of the rates of schizophrenia diagnosis
- they found that afro-Caribbean people were 7 times more likely to be diagnosed when living in Britain
- Cochrane found that the differences were found due to cultural bias by British doctors
what is gender bias
when the differences between men and women are misrepresented
how can gender bias affect the diagnosis of schizophrenia
- when real differences between men and women are ignored or exaggerated
- both type of bias can lead to over or under diagnosis
what was the method used in loring and powells study in support of gender bias affecting schizophrenia
- they gave male and female identical descriptions of a patients symptoms
- they varied the patients gender
what was loring and powerlls findings in the study in support of gender bias affecting schizophrenia
- when a patient was described as female
, 20% of doctors diagnosed the girl wth schizophrenia - when the pateint was described as male, 56% of the doctors diagnosed the patient with schizophrenia
- indicates may be alpha bias in the diagnosis of schizophrenia
Dr Ellis is a doctor in Yorkshire. She is assessing a female Caribbean patient, who is displaying strange behaviours that she does not normally see in her Yorkshire patients. Dr Ellis applies what she knows from her experience of her local patients from Yorkshire to diagnose her new patient. She assumes that her patient will show the same behaviours as other females from the local community.
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Question $1a.$ Which of the following is Dr Ellis displaying?
When someone assumes that other cultures behave the same as their own, this is a type of cultural bias called ethnocentric bias. Dr Ellis is showing this, because she assumes that the patient from the Caribbean will behave in the same way as her patients from Yorkshire.
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Cultural bias is when researchers misrepresent the differences between cultures, and therefore assumes that the patients behaviour is more abnormal because it does not fit with local social norms. Dr Ellis is displaying this because she assumes the two cultures are similar.
Explain how cultural bias affects the reliability of a diagnosis
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.
when are illnesses comorbid
two or more illnesses occur together in the same
how can comorbid illnesses affect the reliability and valdidty of schizophrenia
- If patients have comorbid illnesses than doctors are more likely to ignore some symptoms. so doctors may give the same patients different diagnosis, reducing the reliability of the diagnosis
- if two illnesses, are often comorbid, the criteria for diagnosing the two illnesses might be incorrect - might not actually be two separate conditions, so the diagnosis might lack validity
what is the research support for how comorbid illneses in schizophrenia
- Buckley investigated how many schizophrenic patients had a comorbid mental disorder
- he found that 50% of patients had depression and schizophrenia, 47% had an addiction and schizophrenia and 23% of patients had OCD and schizophrenia
so comorbidity is a issue which can affect reliability and validity of schizophrenia
what is true about symptom overlap
- the symptoms of schizophrenia considerately overlap with the symptom’s of other disorders
- patient’s might be diagnosed with the wrong disorder, reducing the validity of the diagnosis
- different doctors might diagnosis a patient with a different disorder, reducing the reliability of the diagnosis
how is Ellason and ross study research support for how symptoms overlap
- symptoms of schizophrenia patients with those of dissociative identity dis order patients
- found that patients with dissociative identity disorder displayed more schizophrenic symptoms than patients with schizophrenia
How does comorbidity affect reliability of diagnosis?
If a patient has a comorbid illness, then doctors are more likely to ignore some of the symptoms, therefore different doctors may give the same patient different diagnoses. This therefore reduces the reliability of diagnosis.
name a study which is an example of inter rater reliability for schizophrenia
- if the inter- reliability is very low may result in invalid conclusions about the cause of he illness and/or treatment
- beck et al found that agreement on diagnosis for 153 patients (where each was assessed by two psychiatrists from a a group of 4) was only 54%
- this was often due to vague criteria for diagnosis and inconsistences in techniques to gather data - inter- rater reliability
what is argued about schizophrenia and subtypes
crow (1985) believes that Sz is too broad term because at least two very different conditions exist. Type I are positive symptoms and type II are negative. Also further evidence shows that type 1 and type 2 respond very differently to treatments
what are the problems with crows research
- people do not fit neatly into one or the other categories
- blurred distinction between some subtypes, some people diagnosed in one category later develop symptoms from another weakness reliability
evidence for stigma for schizophrenia (culture bias )
In Japan as Sz literally translates to ‘disease of the disorganised mind’. Kim and Berrios researched this and found that in japan the idea of a ‘disorganised mind’ is so stigmatised that psychiatrists are reluctant to tell patients there condition. As a result only 20% of those with schizophrenia are actually aware of it 80% left undiagnosed
