Goldstein Flashcards
What was Goldsteins aim
To see if there were gender differences with regard to the number re hospitalisations and the lengths of those stays between males and females with SZ.
Also to study premorbid factors to see if they had any impact on the lengths of re hospitalisations with regard to gender
What was Goldsteins procedure
199 participants, aged 18 - 45, who had been diagnosed with schizophrenia in 1970’s and had spent at least 6 months in a psychiatric hospital. All from New York and of a similar cultural background. Matched pairs design was used, (matched on marital status, education, age, religion and social class). They were re-diagnosed 10 years later with the DSM III hospital records gave detailed history for re diagnosis and a single blind technique was used with the psychiatrist who rediagnosed the patients
What technique was used for re diagnosis?
Single blind technique Goldstein carried out re diagnosis and two other experts were used to undertake diagnosis of a random sample of patients to test for reliability
What were the results found?
.30 patients were misdiagnosed initially
.169 were diagnosed with schizophrenia and 52 of these were first time admissions and 38 had had one previous hospitalisation in the early 70s
.Sample of 90 (58 men 32 women)
Men hospitalised on average 2.24 times over 10 years women 1.12
Mean number of days spent in hospital for men was 417 for women 206
What was the conclusion?
Females with schizophrenia experienced fewer hospitalisations and shorter length of stay over 10 years compared to males.
Gender differences seemed to start early in the disorder and pre-morbid functioning accounted for 50% of the effect of outcome if a one-year outcome was done . Only one. 9% on a 10 year outcome suggesting that other factors become more prominent than pre-morbid functioning as the illness progresses.
There is a gender difference in SZ
How was information gathered?
.Symptoms rated by interviewers using specially developed questionnaires
.Pre-morbid functioning questionnaire administered by interview dealing with isolation peer relationships and interests
.Course of illness data obtained from New York State department of mental health secondary data
High generalisability
Original sample consisted of 199 participants. 169 patients were diagnosed with schizophrenia by DSM III and 90 out of 169 was selected to be part of the sample. This is a large sample.
And there was a large sample of men (58)and women (32)
Low generalisability
No participants were over the age of 45 which is not representative or an accurate representation of women with SZ as there are a significant amount of women who have their first episode of schizophrenia after 45 which is much more severe according to Levine 1981. therefore the conclusion that men with schizophrenia have a rough time may be false as the sample was not representative of women of all ages
High reliability
Data is gathered from the participants in a standardised way. symptoms are gained by trained interviewers using specially developed questionnaires pre-morbid functioning by questionnaire administered by an interviewer and course of illness by data obtained from the NYS of mental health study can be replicated
High validity
Matched pairs design was used males and females matched on marital status education age social class and religion. This increases the validity as all extraneous variables are controlled for which increases accuracy.
High validity
Single blind technique used which reduces subjectivity and experimental bias as the other two researchers were unaware of the hypothesis and we’re just given a sample of participants to diagnose
High ethics
No ethical guidelines broken participants have the right to withdraw
Application
Positive implications for understanding gender differences in prognosis and reliability of the DSM is high
