Goldstein 1988 Flashcards
Goldstein 1988
High reliability
The study is reasonably
high in generalisability.
For example…the original sample was mode up of 199
males and females, ages ranging from 18-45.
90 of these
were then selected for further investigation, following rediagnosis using the DSM 3.
This is a strength because findings regarding schizophrenia Causes can be generalised more widely
to inform
psychiatrists of the impact of pre morbid functioning, gender
and reliability of diagnostic systems.
Goldstein 1988
Low Gen
The study is low in
generalisability.
For example, no participants were over the age of 45 at the
start of the study which may cause gender bias.
This is a weakness because there are a significant % of women
who have their first episode of schizophrenia after the age of
45
which is subsequently more severe in nature (Levine, 1981)
meaning that the findings, which imply that men have a
more severe course of schizophrenia, may not be 100% factual
as they were not representative of diagnoses in
women across the population.
So Low in Gen to Older Women with SZ
Goldstein 1988
High inter Rater Reliability
The study is high in interrater reliability.
when testing for reliability of diagnosis,
Goldstein herself re diagnosed clients before two other
experts re diagnosed 8 patients at random.
Findings
showed a 0.8 agreement between them
showing that only
1 psychiatrist disagreed with Goldstein one on singular
case.
This is a strength because it shows that Goldstein’s findings
were re assessed with results indicating a high degree of
psychiatric agreement
meaning findings regarding the DSM is
are highly credible and reliable
Goldstein 1988
High test retest
The study is high in test
re test reliability.
Angermeyer (1987)
confirmed Goldstein’s
findings that pre morbid functioning was important in
predicting the severity of the disorder.
This is a strength because it shows how Golstein’s study can be replicated and the same trends are observed
thus
demonstrating how occupation, isolation and relationships
prior to diagnosis are an important contributor to SZ’s Cause (Prognosis)
Goldstein 1988
Objective (credible reliable)
One strength of the
study is that the data
collected was highly
objective.
For example, data gathered regarding symptoms was
attained through use of a structured interview using ranked
scale questions and yes/ no responses.
+ data
gathered regarding rehospitalisations and length of stay
was gained from the New York State Department of Mental
Health.
This is a strength because secondary data and quantitative
data eliminate researcher bias, increasing the credibility of
Goldstein’s results. :D
Goldstein 1988
Application 1
One strength of the
study is that it has
positive implications for
understanding gender
differences in the cause and severity
of schizophrenia.
For example…males were found to have double the
amount of re hospitalisations than females after 10 years,
with this difference being even more significant after only 5
years.
This is a strength because it emphasises the need to consider
gender disparities in causes and severity
which can then inform
treatment and interventions for males aged 18-45 with a
schizophrenia diagnosis
:D
so nice aplication
Goldstein 1988
Aplication 2
One strength of the
study is that is has
positive application to
society
Cuz informs it us about the reliability of
the DSM when diagnosing
schizophrenia.
As it was established that there was a 0.8 level
of agreement between psychiatrist after re diagnosing
169/199 with schizophrenia using the DSM 3.
This is a strength because it shows that the DSM 2 and 3 were highly reliable systems
as if diagnosed using the DSM 2, rediagnosis was likely using DSM 3
good application
Goldstein 1988
Matched pairs = control good
Int Val
One strength of the
study is it had a matched
pairs design
the 199 ppts in study one
and therefore the 90 males (58) and females (32) aged 18-45 were matched on
marital status, education, age, religion and social class. All
were also from New York and from a similar cultural
background.
This is a strength because participant variables are reduced
meaning that any variables such as socio economic status were
not to compromise the validity of the study.
Giving the study high Internal Validity
Goldstein 1988
Primary and secondary data = Strength for Validity and Reliability apparently
primary data was gathered through use of:
questionnaires used to measure pre morbid functioning
interviews used to assess symptoms.
secondary data, regarding rehospitalisation rates and lengths of stay, were gathered using the New York State
Department for Mental Health records.
This is a strength cuz multiple sources were used to
investigate Goldstein’s aims, increasing internal validity and reliability
of the study.
Goldstein 1988
Ethics +
One strength of the
study is that ethical
guidelines were followed
no harm was caused to participants- with
some data being retrospective.
Primary data was gathered
from patients using trained interviewers
and participants
were aware of the study’s intentions.
This is a strength because it shows that Goldstein’s procedure
was ethical and had positive applications to society to show the reliability of:
diagnostic tools, gender differences in cause and severity
and impact of
premorbid functioning.
Thus making the study Highly Ethical
Goldstein 1988
Key Q
Do SZ women have less severe experiences than SZ men?
Goldstein 1988
Aims
See if Gender diff in Rehospitalise SZ ppl and length of Hospital stay
Consider social Factors, Mainly b4 diagnosis, to see if had an impact on the course of the dissorder regarding Gender
Look at DSM II and DSM III diagnsis to see if there were diff + test Reliability and Valididty
Goldstein 1988
Study 1
199 ppts male and Female
all rediagnosed 10 yrs later with DSMIII
data collected in mid 70s at private Psychiatric teaching hospital in NY
aged 18-45
patients Rediagnosed with DSM III
Single blind procedure used ( Psychiatrist blind to Hypotheseis)
Goldstein herself carried our Rediagnosis and was not blind to hypothesis
the 2 experts who were also carried out Rediagnosis on a random sample of 4 men and 4 women
they acheived a 0.80 agreement with Goldstein.’s diagnosis
with only 1 in a single case disagreeing
this was to test reliability
169/199 patinets who were diagnosed with SZ with DSM II, rediagnosd with SZ with DSM III
Goldstein 1988
STUDY 2
90 of the 169 rediagnosed PPts selected
58 M 32 W
mean age is 24
All have high lvl of ED
and 87/90 were Non-hispanic White and Middle Class
Whole sample had lots of diff types of SZ
Goldstein gathered info abt symptoms, Functioning b4 diagnosis (PreMorbid Functioning) and the Course of the illness using Interviews and Questionaires
Goldstein 1988
Study 2: Symptoms
Symptoms were rated by trained master lvl interviewers
using an instrument developed specificaly for og Study
Areas covered: Halluciantions, Formal thought dissorders, Paranoia, grandosity, isolation, withdrawal, anxiety ect
all give idea of SZ characteristics
its assumed Goldstein used the trained interviews to rate symptoms using Specialy developed Questions
that interviews would been Structured using Rating scales and Perhapse Yes/no Answeres (Closed Qs)
