Interview - Goldstein

Question 1

What is the Goldstein study generally about?

Answer 1

-Number of parts
-Compared experiences of SZ in men and women
-also looked at reliability of DSM in diagnosing SZ
-example of a clinical interview

Question 2

Aims of Goldstein (3)

Answer 2

1. See if gender diffs regarding number of re-hospitalisations and lengths of stays between males and females with SZ
2. Study pre-morbid factors to see if had impact on number and lengths of rehospitalisations regarding gender
3. Looked at DSM 2 and DSM 3 to see if there’s differences

Question 3

Procedure

Answer 3

-Gender diffs in SZ patients in early stages, followed for 10 yrs in 70’s and 80’s
-longitudinal, 90 patients, hospitalised.
-chosen bc diagnosed with SZ using DSM 2 and were 18-45
-hospitalised less than 6 months before going home

Question 4

What happened after 10 years?

Answer 4

-Re-diagnosed using revised version of DSM (DSM3)
-given histories for re—diagnosis. Single blind proc used for the psychiatrist rediagnosing. Goldstein also did it but not blind
-2 experts undertook diagnosis of random sample to test reliability

Question 5

What did the re-diagnosis using the DSM 3 reveal?

Answer 5

-30 deemed not to have SZ according to DSM 3
-169 who were re-diagnosed with SZ with DSM3 showing DSM is reliable.

Question 6

What did the study gather info on (main part of the study)

Answer 6

-symptoms
-pre-morbid functioning
-course of the illness

Question 7

Who was the sample?

Answer 7

-90 out of 169 who were whittled down due to certain age range, no other mental health issues

Question 8

Symptoms

Answer 8

-rated by trained interviewers, developed questions giving idea abt characteristics of SZ

Question 9

Pre-morbid functioning

Answer 9

Measured by questionnaire administered by interviewer, abt isolation peer relationships and interests. Overall ratings for pre-morbid found so assessed retrospectively

Question 10

Course of the illness

Answer 10

-number of rehospitalisations and lengths of stays in hospitals over 10 years. Data from New York State department of mental health

Question 11

Results (number of rehospitalisations)

Answer 11

Males: 0-5yrs = 1.40. 0-10years = 2.24
Females: 0-5yrs = 0.59. 0-10yrs = 1.12

Question 12

Results for length of stays (males and females)

Answer 12

Males: 0-5 = 267. 0-10 = 418
Females: 0-5 = 140. 0-10 = 207

Question 13

What do the results suggest?

Answer 13

-On avg the number of rehospitalisations is higher for males in 5 and 10 years
-males had longer stays in hospital than females

Question 14

Other results

Answer 14

-13% of gender effect on rehospitalisations due to pre-morbid functioning but only 4.3% down to social functioning
-11.3% gender effect on length due to social functioning and 4.2% due to pre-morbid functioning (stress and anxiety of being a male in society)
-no of rehospitalisations affected by premorbid and length of stay affected by social functioning

Question 15

Conclusion

Answer 15

-females less rehospitalisations and shorter lengths than males, greater diffs in first 5 years. Gender diff strong enough despite small sample
-SZ males poorer outcomes than females, there is a gender diff in SZ

Question 16

Studies to support Goldstein

Answer 16

-Angermeyer et al: women less severe experience than men. Supports as Goldstein as Goldstein found less severe for females due to less rehospitalisations and shorter stays
-Goldstein findings support the studies she cites in research. Valid to suggest that women with SZ have less severe experience than men. Valid to say gender diffs

Question 17

Gen

Answer 17

-Low: ethnocentric. Most of sample from NY and similar culture, non Hispanic, white. Only used the DSM. Therefore not rep of whole of pop of SZ patients and also all diagnostic tests so can’t gen to everyone
-low gen, narrow sample. Age limit of 45. Not rep older people with SZ so can’t be applied to all
-Low: uses dsm 2 and 3, America use dsm and Europe use icd. Not gen to rest of the world who use other classification systems
-interviews specific to the ppt as they ask abt their symptoms and follow up qus based on them, can’t gen to other people

Question 18

Reliability

Answer 18

-standardisation: coded themes of symptoms pre-morbid functioning and course of illness using hospital records and interviews. Can be replicated to test for reliability
-inter rather: structured interview, closed questions, rating question, other clinicians can test, angermeyer
-interviewer effects, diff interviewers may ask diff questions. Not standardised.
-secondary data, not for the study so may not be useful

Question 19

Applications

Answer 19

Improved knowledge for treatment, men more severe so treatment for men specifically
Implications, age not considered in DSM. Don’t know if age could impact the onset for females much later.

Question 20

Validity

Answer 20

-objective as rating scale for pre-morbid eg no. Hosp and length of stays, less impact of researcher bias as scientifically credible
-retrospective data as questionnaire talked about experimenters and relationships, relies on memory so may not be valid as could be inaccurate due to distortion
-confounding variable as age limit of 45, some symptoms in women don’t show until later.
-single blind procedure: psych who rediagnosed did not know, no ext variables or bias

Question 21

Ethics

Answer 21

-confidentiality: looked at past hospital records. Hosp gave out records so they broke the ethics
-competence