Intro to SZ

Question 1

Classification of mental disorder

Answer 1

the process of organising symptoms into categories based on which symptoms frequently cluster together

Question 2

Schizophrenia def

Answer 2

a severe mental disorder where contact with reality and insight are impaired, an example of psychosis

Question 3

Positive symptoms of schizophrenia

Answer 3

atypical symptoms experienced in addition to normal experiences. They include hallucinations and delusions

Question 4

hallucinaitons def

Answer 4

a positive symptom of schizophrenia. They are sensory experiences that have either no basis in reality or are distorted perceptions of things that are there

Question 5

delusions def

Answer 5

a positive symptom of schizophrenia. They involve beliefs that have no basis in reality, for example, a person believes that they are someone else or that they are the victim of a conspiracy

Question 6

Negative symptoms of schizophrenia

Answer 6

atypical experiences that represent the loss of a usual experience such as a loss of clear thinking ir a loss of motivation

Question 7

speech povert def

Answer 7

a negative symptom of schizophrenia. It involves reduced frequency and quality of speech

Question 8

avolition def

Answer 8

a negative symptom of schizophrenia. It involves loss of motivation to carry out tasks and results in lowered activity levels

Question 9

co-morbidity

Answer 9

the occurrence of 2 disorders or conditions together

Question 10

symptom overlap

Answer 10

occurs when 2 or more conditions share symptoms

Question 11

Who is most likely to get diagnosed with sz?

Answer 11

men, city-dwellers and lower socio-economic groups

Question 12

How many people experience sz?

Answer 12

1% of the world

Question 13

2 major classification systems

Answer 13

1. World Health Organisation’s International Classification of Disease (ICD-10)
2. American Psychiatric Association’s Diagnostic and Statistical Manual edition 5 (DSM-5)

Question 14

What criteria is needed for a sz diagnisis in DSM-5?

Answer 14

one of the positive symptoms has to be present for diagnosis

Question 15

What criteria is needed for a sz diagnisis in ICD?

Answer 15

two or more negative symptoms are sufficient

Question 17

hallucinations description

Answer 17

unusual sensory experiences, can be related to event in the environment or have completely no relation, eg hearing voices, can be experienced in relation to any sense, may see things that are not there

Question 18

delusions description

Answer 18

paranoia, irrational beliefs, eg belief that they are an important figure in society like the son of Jesus, commonly involve being persecuted perhaps by aliens, people may believe they are under external control, delusions can make people behave in ways that make sense to them but not to others

Question 19

speech poverty description

Answer 19

changes in speech patterns, reduction in the amount and quality of speech, delay in persons verbal responses during conversations

Question 20

speech disorganisation

Answer 20

nowadays more emphasis is placed on speech disorganisation rather than speech poverty where a speaker might change topic mid sentence

Question 21

avolition description

Answer 21

‘apathy’, finding it difficult to begin or keep up with goal oriented activity, sharply reduced motivation

Question 22

Andreasen identified 3 types of avolition

Answer 22

• Poor hygiene and grooming
• Lack of persistence in work or education
• Lack of energy

Question 23

Rosenhan’s sane in insane places aim

Answer 23

to test the hypothesis that people cannot tell when someone has a mental disorder in an institution

Question 24

Rosenhan’s sane in insane places procedure for experiement 1

Answer 24

• 8 psychologcially healthy people faked hallucinations (thud, empty, hollow) to be admitted into institute
• acted normally once inside
• only released when they admitted to disorder
• took notes while inside which one doctor saw as pathological ‘note taking behaviour’

Question 25

Rosenhan’s sane in insane places results for experiment 1

Answer 25

• inside for 7-52 days
• 35 other patients suspected sanity
• 7/8 were diagnosed with sz
• 1 diagnosed with manic depressive disorder

Question 26

Rosenhan’s sane in insane places procedure for experiment 2

Answer 26

• hospital was told that they would recieve pseudopatients within 3 month period
• none were actually sent

Question 27

Rosenhan’s sane in insane places results for experiment 2

Answer 27

• 41 patients deemed normal
• 42 seen as suspicious

Question 28

Rosenhan’s sane in insane places conclusion

Answer 28

it is difficult to tell whether people have mental illnesses when they are inplaces like institutions so perhaps they are doing more harm than good

Question 29

good inter-rater and test-retest reliability

strength

Answer 29

• Osorio et al reported 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 of +.92
  Can be sure that diagnosis of schizophrenia is consistently applied

Question 30

co-morbidity - people may just have unusual cases of depression

limitation

Answer 30

• If conditions occur together then this can challenge validity as it may actually be acting as a single condition
• People are often diagnosed with schizophrenia in conjunction to depression or substance abuse → Buckley et al
• So schizophrenia may not exist as a distinct condition

Question 31

low validity - Criterion validity may be used to assess validity (can you predict the result of test B from the result of test A)

limitation

Answer 31

• Cheniaux et al had 2 psychiatrists independently assess 100 clients using the 2 classification systems
• 68 were diagnosed with schizophrenia under ICD and 39 under DSM
  Schizophrenia is either over or under diagnosed, suggesting criterion validity is low

Question 32

counterpoint to low validity

strength

Answer 32

• Osorio et al’s study found excellent agreement between clinicians when they used 2 measures to diagnose schizophrenia both derived from the DSM system
  Criterion validity us actually good provided it takes place within a single diagnostic system

Question 33

gender bias in diagnosis leads to women not recieving treatment and services that might benefit them

limitation

Answer 33

• Since 1980, men have been more consistently diagnosed with schizophrenia more commonly than women
• Fischer and Buchanan → ratio of 1.4:1
• Perhaps women are less vulnerable than men due to genetic factors
• But it is more likely that women are underdiagnosed as they have closer relationships and hence get support - Cotton et al
• Women with schizophrenia often function better than men

Question 34

culture bias in diagnisis - Hearing voices may have different meanings in different cultures

limitation

Answer 34

• In Haiti, some people believe that voices is actually communication from ancestors
• British people of African-Caribbean descent are 9X more likely to receive a diagnosis than white brits -Pinto and Jones- but those living in African-Caribbean countries are not, ruling out genetic vulnerability
• Overrepresentation of symptoms in black british people - Escobar
  Discrimination

Question 35

symptom overlap

limitation

Answer 35

• Considerable overlap from schizophrenia to other conditions
• Eg both schizophrenia and bipolar experience delusions and avolition
• In terms of classification, they may not be separate conditions but variations of a single one
  Decreases the validity of the disorder as a concept