Interview - Goldstein Flashcards
What is the Goldstein study generally about?
-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
Aims of Goldstein (3)
- See if gender diffs regarding number of re-hospitalisations and lengths of stays between males and females with SZ
- Study pre-morbid factors to see if had impact on number and lengths of rehospitalisations regarding gender
- Looked at DSM 2 and DSM 3 to see if there’s differences
Procedure
-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
What happened after 10 years?
-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
What did the re-diagnosis using the DSM 3 reveal?
-30 deemed not to have SZ according to DSM 3
-169 who were re-diagnosed with SZ with DSM3 showing DSM is reliable.
What did the study gather info on (main part of the study)
-symptoms
-pre-morbid functioning
-course of the illness
Who was the sample?
-90 out of 169 who were whittled down due to certain age range, no other mental health issues
Symptoms
-rated by trained interviewers, developed questions giving idea abt characteristics of SZ
Pre-morbid functioning
Measured by questionnaire administered by interviewer, abt isolation peer relationships and interests. Overall ratings for pre-morbid found so assessed retrospectively
Course of the illness
-number of rehospitalisations and lengths of stays in hospitals over 10 years. Data from New York State department of mental health
Results (number of rehospitalisations)
Males: 0-5yrs = 1.40. 0-10years = 2.24
Females: 0-5yrs = 0.59. 0-10yrs = 1.12
Results for length of stays (males and females)
Males: 0-5 = 267. 0-10 = 418
Females: 0-5 = 140. 0-10 = 207
What do the results suggest?
-On avg the number of rehospitalisations is higher for males in 5 and 10 years
-males had longer stays in hospital than females
Other results
-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
Conclusion
-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
Studies to support Goldstein
-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
Gen
-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
Reliability
-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
Applications
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.
Validity
-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
Ethics
-confidentiality: looked at past hospital records. Hosp gave out records so they broke the ethics
-competence
