intro to schizophrenia Flashcards
what is SP
‘-schizo’, meaning ‘split’, and ‘phrena’ meaning ‘mind’
-The ‘split’ between a person’s thought processes and reality.
what is psychosis
-where the individual loses
contact with reality (unlike neurosis where the
individual is aware that they have problems)
key points ab SP
-in most countries is
1% of the population over 18.
-diagnosed between 15 and 35.
- commonly diagnosed in males, city dwellers and lower socio-economic groups.
where is DSM-5 used
america
where is ICD-11 used
europe
what is positive symptoms when diagonising SP
Atypical symptoms
experienced in addition
to normal experiences.
e.g An excess/distortion of
normal function
what is negative symptoms when diagnosing SP
Atypical experiences
that represent the loss of
a usual experience such
as a loss of clear thinking
or a loss of normal levels
of motivation.
what are the positive symptoms of SP
-halluncinations and delusions
what is asscoiated w halluncinations
- no rs between what senses are picking up from env
-e.g voices heard or commentry on someone else (criticising them)
-e.g see distroted facial expressions or animals or people that arent there
what are delusions
-paranoia
-irritational beliefs
-important histroical, political , religious figured e.g jesus also involve gov , aliens , having superpowers
-may believe someone has external control of them
-may behave in certain way thats more bizarre to others
what are the negative symptoms
speech poverty and avoilition
what is speech poverty
-reduction in amount of quality of speech
-delay verbal responses
-speech disorganisation where speech becomes incoherent
-speaker changes topic mid senetence (positive in DSM-5 and speech poverty is negative)
what is avoiliton
-apathy
- hard to keep up or begin with a goal directed activity
-e.g actions performed to achieve a result
-reduced motivation to carry out activities
what are 3 signs of avoilition that andreasen found out
-poor hygiene and grooming
-lack of persistence in work or RD
-lack energy
strengths
(good reliability)
-reliable when different diagnosing clinicians reach the same diagnosis for the same individual (inter-rater reliability) and when the same clinician reaches the same diagnosis for the same individual on two occasions ( test-retest reliability).
-Reliability for Schizophrenia was low but has improved with the introductionm of DSM-5.
-Osorio et al (2019) report excellent reliability for the diagnosis of Schizophrenia in 180 individuals using the DSM-5. Pairs of interviewers achieved inter-rater reliability of +.97 and test-retest reliability of +.92.
weaknesses
(low validity)
-Cheniaux et al (2009) had two psychiatrists independently assess the same 100 clients using the ICD-10 AND DSM-V criteria and found that 68 were diagnosed
with schizophrenia under the ICD system and 39 under DSM.
- suggests that Schizophrenia is either over or under diagnosed according to the diagnostic system and that criterion validity is low.
(co mobirdity)
-occurrence of two illnesses or conditions together.
-calls into question the validity of their diagnosis and classification because they might actually be a single condition.
-SP is commonly diagnosed with other conditions.
-Buckley et al found that half of those diagnosed with SP also had a diagnosis of depression or substance abuse.
- problem for classification because it means SP
may not exist as a distinct condition and some people diagnosed with SP may have unusual cases of conditions like depression.
(gender bias)
-men diagnosed with SP more commonly than women ( a ratio of 1.4:1, Fisher and Buchanan 2017).
-women are less vulnerable than
men due to genetic factors.
- but women are underdiagnosed because they have closer
relationships and get support (Cotton et al. 2009). This leads to
women with Schizophrenia functioning better than men.
- underdiagnosis is a gender bias means women may not
therefore be receiving
(culture bias)
particularly hearing voices, have different meanings in different cultures.
-in some Afro-Caribbean societies voices may be attributed to
communication rom ancestors.
-Afro-Caribbeans living in the UK are up to ten times as likely to
receive a diagnosis than white
-culture bias in diagnosis of clients
by psychiatrists from a different cultural background.
-overinterpretation of symptoms in black people (Escobar 2012).
(symptoms overlap)
SP and bipolar both involve positive symptoms like delusions and negative symptoms like avolition.
-In terms of diagnosis it means that schizophrenia is hard to distinguish from bipolar disorder.
-SP may not exist as a distinct condition and even if it does it is hard to diagnose. So both it’s
classification and diagnosis are flawed.
what is the counterpoint to low validity
In Osorio’s study there was excellent agreement between clinicians when they used two measures to diagnose SP both derived from the DSM system.
-suggests that the criterion validity for diagnosing schizophrenia is actually good provided it takes place within a single diagnostic system.
key difference of DSM-5 and ICD -10
DSM-5 = one or more positive symptomms for diagnosis
-ICD-10 two or more negative symptoms are suffcient
