Introduction to schizophrenia Flashcards
Schizophrenia is/isn’t a serious mental disorder
is
True/False: Symptoms of schizophrenia can interfere severely with everyday tasks
True
Many people with schizophrenia end up…
homeless or hospitalised
Schizophrenia is experienced by about what % of the world’s population?
1
Schizophrenia is most commonly diagnosed in men/women
men
Schizophrenia is most commonly diagnosed in city-dwellers/people in rural areas
city-dwellers
Schizophrenia is most commonly diagnosed in higher/lower socio-economic groups
lower
What is meant by positive symptoms of schizophrenia?
Additional experiences beyond those of ordinary existence
Hallucinations are an example of a positive/negative symptom of schizophrenia
positive
Delusions are an example of a positive/negative symptom of schizophrenia
positive
Hallucinations
Unusual sensory experiences e.g. voices heard either talking or commenting on a person, often criticising them
What can hallucinations be related to?
Events in the environment
True/False: Hallucinations are always related to events in the environment
False: some have no relationship to what the senses are picking up from the environment
Hearing voices either talking or commenting on a person, often criticising them is an example of which positive symptom of schizophrenia?
Hallucinations
True/False: Hallucinations can be experienced in relation to any sense
True
Someone with schizophrenia seeing a distorted facial expression is an example of which positive symptom?
Hallucinations
Someone with schizophrenia seeing people or animals that aren’t there is an example of which positive symptom of schizophrenia?
Hallucinations
What are delusions also known as
Paranoia
Delusions
Irrational beliefs that can take a range of forms
Being an important historical, political or religious figure is an example of a common what experienced by people with schizophrenia?
Delusion
Delusions commonly involve being __________, perhaps by government or aliens
persecuted
If a person with schizophrenia is experiencing the irrational belief of having superpowers, what is this symptom called and is it positive or negative?
Delusions, positive
True/False: A class of delusions in regards to schizophrenia involve concerns of the body
True
A person with schizophrenia may believe they are under internal/external control
external
Delusions can make a person behave in ways that make sense to them but seem…
bizarre to others
What do negative symptoms of schizophrenia involve?
The loss of usual abilities and experiences
Give an example of a positive symptom of schizophrenia
Hallucinations or delusions
Give an example of a negative symptom of schizophrenia
Speech poverty or avolition
Schizophrenia is characterised by changes in patterns of ______
speech
Speech poverty is an example of a positive/negative symptom of schizophrenia
negative
Avolition is an example of a positive/negative symptom of schizophrenia
negative
Why is speech poverty seen as a negative symptom of schizophrenia?
The emphasis is on the reduction in the amount and quality of speech
True/False: Speech poverty is sometimes accompanied by a delay in the person’s verbal responses during a conversation
True
Speech disorganisation
Speech becomes incoherent or the speaker changes topic mid-sentence
Nowadays there is more emphasis on speech _______________ compared to speech poverty
disorganisation
In the DSM-5, speech disorganisation is classified as a positive/negative symptom
positive
Although speech disorganisation is classified in the DSM-5 as a positive/negative symptom, speech poverty remains a positive/negative symptom
positive, negative
Which negative symptom of schizophrenia is sometimes called ‘apathy’?
Avolition
Avolition
Finding it difficult to begin or keep up with goal-directed activity
Goal-directed activity
Actions performed in order to achieve a result
People with schizophrenia often have sharply increased/reduced motivation to carry out a range of activities
reduced
Who identified three stages of avolition?
Nancy Andreasen (1982)
What were the three stages of avolition identified by Andreasen?
Poor hygiene and grooming, lack of persistence in work or education and lack of energy
According to the medical approach, in order to diagnose a specific disorder, we need to…
distinguish one disorder from another
How do we distinguish one disorder from another?
We identify clusters of symptoms that occur together and classify this as one disorder
When we identify clusters of symptoms that occur together and classify this as one disorder, diagnosis is then possible by…
identifying symptoms and deciding what disorder a person has
What are the two major systems of classification of mental disorder?
ICD-10 and DSM-5
The ICD-10 is the International Classification of Disease used by…
the World Health Organisation
How many symptoms are required for diagnosis of schizophrenia under the ICD-10, and which type of symptoms is this?
Two or more negative symptoms
How many symptoms are required for diagnosis of schizophrenia under the DSM-5, and which type of symptoms is this?
Two or more symptoms, one of which needs to be positive
True/False: The ICD-10 and DSM-5 are the same when it comes to classification of schizophrenia
False: they differ
True/False: Previous editions of the ICD-10 and DSM-5 recognised subtypes of schizophrenia
True
In previous editions of the ICD-10 and DSM-5, which subtype of schizophrenia involved mainly powerful hallucinations and delusions?
Paranoid schizophrenia
Why did the ICD-10 and DSM-5 drop the recognition of different subtypes of schizophrenia?
They tended to be inconsistent - someone with a diagnosis of paranoid schizophrenia wouldn’t necessarily show the same symptoms a few years later
A psychiatric diagnosis is said to be reliable when…
different clinicians reach the same diagnosis for the same individual
Different clinicians reaching the same diagnosis for the same individual is an example of which type of reliability?
Inter-rater reliability
The same clinician reaching the same diagnosis for the same individual on two occasions is an example of which type of reliability?
Test-retest reliability
Prior to DSM-5, reliability for schizophrenia diagnosis was high/low
low
What did Osório et al. report regarding the diagnosis of schizophrenia?
Excellent reliability for the diagnosis of schizophrenia in 180 individuals using the DSM-5
Osório et al. report excellent reliability fore the diagnosis of schizophrenia in how many individuals using the DSM-5?
180
Osório et al. report excellent reliability fore the diagnosis of schizophrenia in 180 individuals using which system for classification?
DSM-5
Osório et al. reported pairs of interviewers achieving an inter-rater reliability of what using the DSM-5 on 180 individuals?
+.97
Osório et al. reported pairs of interviewers achieving a test-retest reliability of what using the DSM-5 on 180 individuals?
+.92
Osório et al.’s findings mean we can be reasonably sure that…
the diagnosis of schizophrenia is reliable and consistently applied
General validity concerns…
whether we assess what we are trying to assess
One way to assess the ________ of a psychiatric diagnosis is criterion validity
validity
Which strength of diagnosis of schizophrenia is backed up by Osório et al.’s findings?
Its reliability
What did Cheniaux et al. to?
Have two psychiatrics independently assess the same 100 clients using ICD-10 and DSM-IV criteria
Cheniaux et al. had how many psychiatrists independently assess the same 100 clients using ICD-10 and DSM-IV criteria?
two
Cheniaux et al. had two psychiatrists asses the same how many clients using ICD-10 and DSM-IV criteria?
100
Cheniaux et al. had two psychiatrists assess the same 100 clients using which criteria?
ICD-10 and DSM-IV
What did Cheniaux et al. find?
68 were diagnosed with schizophrenia under the ICD and 39 under DSM
Cheniaux et al. found that __ were diagnosed with schizophrenia under the ICD
68
Cheniaux et al. found that __ were diagnosed with schizophrenia under DSM
39
Cheniaux et al. found that more/less people were diagnosed with schizophrenia under the ICD compared to the DSM
more
What do Cheniaux et al.’s findings suggest?
Schizophrenia is either over- or under-diagnosed according to the diagnostic system, suggesting that criterion validity is low
Cheniaux et al.’s findings suggest that the criterion validity of psychiatric diagnosis of schizophrenia is high/low
low
Osório et al.’s findings oppose the suggestion that criterion validity is low as suggested by Cheniaux et al.’s study, providing that…
it takes place within a single diagnostic system
Another limitation of schizophrenia diagnosis is co-_________ with other conditions
morbidity
If conditions occur together a lot of the time then this calls into question the…
validity of their diagnosis and classification
If conditions occur together a lot of the time, why does this call into question the validity of their diagnosis and classification?
They might actually be a single condition
True/False: Schizophrenia is often diagnosed with other conditions
True
Schizophrenia is often diagnosed with other conditions. For example, one review found that around __% of those diagnosed with schizophrenia also had a diagnosis of depression or substance abuse
50
Schizophrenia is often diagnosed with other conditions. For example, one review found that around 50% of those diagnosed with schizophrenia also had a diagnosis of what?
Depression or substance abuse
Co-morbidity is a problem for classification when it comes to schizophrenia because it means…
schizophrenia may not exist as a distinct condition
Co-morbidity is a problem for diagnosis when it comes to schizophrenia because at least some people diagnosed with schizophrenia may have…
unusual cases of conditions like depression
A further limitation of schizophrenia diagnosis is the existence of gender ____
bias
Since the 1980s men/women have been diagnosed with schizophrenia more commonly than men/women
men, women
What did Fischer and Buchanan 2017 say the ratio of male:female diagnosis of schizophrenia is?
1.4:1
One possible explanation for the fact that more men are diagnosed with schizophrenia than women is that women are…
less vulnerable than men
One possible explanation for the fact that more men are diagnosed with schizophrenia than women is that women are less vulnerable than men. Why could this be?
Perhaps because of genetic factors. It seems more likely that women are undiagnosed because they have closer relationship and hence get support, leading to women with schizophrenia often functioning better than men
Why may women with schizophrenia function better than men and therefore be undiagnosed?
They have closer relationships and get support
The under-diagnosis of schizophrenia in women is a…
gender bias
The under-diagnosis of schizophrenia in women is a gender-bias and means women may not be…
receiving treatment and services that might benefit them
Why is a limitation of schizophrenia diagnosis the existence of culture bias?
Some symptoms have different meanings in different cultures
Why may there be a culture bias in symptoms of schizophrenia such as hearing voices?
For example in Haiti some people believe that voices actually are communications from ancestors
Pinto and Jones (2008) found that British people of African-Caribbean origin are up to _x as likely to receive a diagnosis of schizophrenia as white British people
9
Pinto and Jones (2008) found that British people of what origin are up to 9x as likely to receive a diagnosis of schizophrenia as white British people?
African-Caribbean
Pinto and Jones (2008) found that British people of African-Caribbean origin are up to nine times as likely to receive a diagnosis as white British people, although…
people living in African-Caribbean countries are not, ruling out a genetic vulnerability
True/False: Pinto and Jones (2008) found that people of African-Caribbean heritage are more genetically vulnerable to schizophrenia
False, they found that British people of Africa-Caribbean origin are up to nine times as likely to receive a diagnosis as white British people, although people living in African-Caribbean countries are not
What is the most likely explanation for the increase in diagnosis of African-Caribbean people in Britain compared to African-Caribbean countries?
Culture bias in diagnosis of clients by psychiatrist of a different cultural background
Escobar 2012 found that culture bias in diagnosis of clients by psychiatrists from a different cultural background appears to lead to an overinterpretation of…
schizophrenia symptoms in black British people
The fact that British people of African-Caribbean are up to nine times as likely to receive a diagnosis of schizophrenia as white British people but people in African-Caribbean countries are not means that…
African-Caribbean people may be discriminated against by a culturally-biased diagnostic system
True/False: One limitation of schizophrenia is system overlap with over conditions
True
There is considerable _______ between the symptoms of schizophrenia and the symptoms of other conditions
overlap
There is considerable overlap between the symptoms of schizophrenia and the symptoms of other conditions such as _______
bipolar
Give an example of something which is a symptom of both schizophrenia and bipolar
Positive symptoms such as delusions and negative symptoms such as avolition
In terms of classification, the considerable overlap between the symptoms of schizophrenia and bipolar disorder suggests that…
schizophrenia and bipolar may not be two different conditions
In terms of classification, the considerable overlap between the symptoms of schizophrenia and bipolar disorder suggests that schizophrenia and bipolar may not be two different conditions, and instead…
variations of a single condition
In terms of diagnosis, the considerable overlap between symptoms of schizophrenia and bipolar disorder means that schizophrenia is hard to ___________ from bipolar disorder
distinguish
As with co-morbidity, symptom overlap means that schizophrenia may not exist as a…
distinct condition
If schizophrenia exists as a distinct condition, it is easy/hard to diagnose
hard
If schizophrenia exists as a distinct condition, it is hard to diagnose. So both its what are flawed?
classification and diagnosis are flawed
