Issues Associated With It’s Classification

Question 1

How is reliability an issue associated with the classification of SZ

Answer 1

Reliability refers to the consistency of research a measuring instrument. An example is inter rated reliability - where two or more diagnosticians agree with the same diagnosis for the same individual. (This diagnosis would’ve been separate). When classifying SZ, Whaley found inter rated reliability to be as low as +0.11 when using the DSM.

Another study by Cheniaux - two psychiatrists independent diagnosed 100 patients with DSM and ICD. Inter rated reliability was poor. One diagnosing 26 with SZ for DSM and 44 to ICD, and the other person doing 13 DSM and 24 ICD

Question 2

How is validity an issue with diagnosing and classifying SZ

Answer 2

Are we diagnosing SZ correctly based on symptoms used in the manuals? This can be checked with criterion validity (when different systems arrive at the same diagnosis for the same patient). According to cheniaux’s study, ICD seems to diagnose more than DSM. Suggesting that either ICD over diagnoses or DSM under diagnoses. Either way poor validity

Question 3

What is do morbidity

Answer 3

The idea that two or more mental disorders occur together - if this the case, then we can question the validity of diagnosis for SZ. SZ is commonly diagnosed with other conditions

This poses challenges for diagnosing SZ and depression as they are often co morbid. It may be hard to distinguish between the different disorders and someone could get wrongly classified. Therefore comorbidity is a weakness of diagnosis and classification

Question 4

What is symptom overlap

Answer 4

When there is considerable overlap between symptoms of SZ and other conditions like depression and bipolar disorders. Ellison and Ross found that people with dissociative identity disorder actually had more SZ symptoms than SZ sufferers. This overlap could question the validity of the classification of SZ under the ICD.

Question 5

What is gender bias in classification

Answer 5

Is there gender bias in classification? Longenecker reviewed SZ cases since the 1980s and found men to be more likely diagnosed with SZ than women. There could be a gender bias as women seem to function better than men, having good relationships and more likely to work. Therefore it is less likely to be diagnosed with SZ because women show better interpersonal skills than men

Question 6

Cultural bias in classification

Answer 6

Is there a cultural bias? African American and English people of Afro Caribbean are 9x more likely to be diagnosed with SZ. Why? It may be because positive symptoms in manuals like auditory hallucinations may be acceptable in African because of cultural beliefs in communication with ancestors which are not warranted to a diagnosis in Africa. Or it could be in western cultures we doubt the honesty of black people

Question 7

Evaluation diagnosis issues classification

Answer 7

Communication is shorthand: a patient with a mental disorder often has numerous symptoms. It is simpler to incorporate these symptoms into a single diagnosis and this makes communication between mental health professionals much easier

Treatments are often specific to certain disorders - e.g. symptoms of schizophrenia respond well to some anti psychotics but not anti anxiety. A reliable diagnosis can point to a therapy that will alleviate symptoms

Although there is variation - there are many underlying biological abnormalities seen in SZ patients. It is hoped that a greater understanding of these abnormalities will lead to an even more effective treatment