Issues with the classification and diagnosis of Schizophrenia

Question 1

what are the 2 key issues with classification and diagnosis of schizophrenia

Answer 1

Reliability and validity

these can be split further into smaller issues

Question 2

who investigated the issues of classification and diagnosis of schizophrenia

Answer 2

Rosenhan (1972)

Question 3

What was Rosenhan procedure when investigating issues with classification and diagnosis of SZ

Answer 3

8 individuals - 5 M 3 F called ‘pseudo-patients’.
He had people with no current or past symptoms of serious psychiatric disorders admitted to psychiatric hospitals
They had to report to a psychiatrist that they heard a weird voice saying ‘empty’ , ‘hollow’ and ‘thud’
All of them were admitted, 7 diagnosed with Sz, 1 diagnosed with manic depression.
ONce admitted they had to act normal. all were relaesed after a stay between 7-52 days, avg beeing 19 days.

In a follow up study:
Rosenhan instructed one of the hospitals who were aware of his results that he would send one or more psuedo-patients , in the next 3 months and staff were asked to rate the likelihood that pateints were pseudo-patients.
In reality no pseudo-pateints were sent by Rosenhan.

results:
- 19 were thought by a psychiatrist and one other member of staff to be pseudo-patients
- 23 were thought by at least one psychiatrist to be pseudo-patients
- 41 were thought by at least 2 members of staff to be pseudo-patients

Question 4

what are the 3 issues that Reliability can be split into

Answer 4

inter-rater reliability
test-retest reliability
culture

Question 5

what are 3 issues that validity can be split into

Answer 5

gender
symptom overlap
comorbidity

Question 6

what is inter-rater reliability

Answer 6

this refers to whether different raters or assessors agree in a diagnosis. Sometimes, there is a big difference between raters in their diagnosis of the same symptoms

Question 7

how can inter-rater reliability relate to Rosenhans research

Answer 7

rosenhan shows that even though presented the same symptoms, 1 was diagnosed with a diff disorder

Question 8

what is test-retest relaibility

Answer 8

this refers to if we tested the same person again, we should get the same outcome.

e.g when assessing Sz however, this is not always the case

Question 9

how can test-retest reliability relate to Rosenhans research

Answer 9

Rosenhan found it took diff amounts of time to release the pseudo-patients

Question 10

what is culture in terms of reliability

Answer 10

this idea suggests that theres a tendency to over-diagnosis members of other cultures.

Question 11

how can culture relate to schizophrenia research by Copeland

Answer 11

Copeland gave 134 us and 194 uk psychologists a description of a patient.
69% of US diagnosed Sz
2% of british said the same

Question 12

what is gender in terms of validity

Answer 12

the stereotypical beliefs about an individual gender may cause a difference in diagnosis as the DSM gives equal criteria for men and women and doesn’t distinguish between the 2. Therefore there may be differences in diagnosis.

Question 13

how can gender relate to schizophrenia research by castle

Answer 13

found there were a greater frequency of positive and affective symptoms in women and a greater frqeuncy of negative symptoms in men

Question 14

what is symptom overlap

Answer 14

one issue with the diagnosis of schizophrenia is that many of the symptoms of this disorder also overlap with other mental and physical illness

Question 15

who researched symptom overlap

Answer 15

Konstrantareas and Kewitt compared 14 autistic patients with 14 sufferers of schizophrenia. None of the schizophrenics had autistic symptoms, however 7 of the autistics had schizophrenic symptoms

Question 16

what is comorbitiy

Answer 16

this impacts validity as it refers to the extent that two or more conditions co-occur. THis would mean that another condition occurs alongside sz making it hard to diagnose

Question 17

how can buckleys comorbidity research relate to schizophrenia

Answer 17

buckley et al found these these co-morbid rates:
- 50% had co-morbid depression
- 15% had co-morbid panic disorder
- 29% had co-morbid PTSD
- 23% had co morbid OCD
- 47% had co-morbid substance abuse

Question 18

what is a evaluation of issues with diagnosis of schizophrenia

Answer 18

P: There is gender and cultural bias present in the diagnosis of schizophrenia.
E: Men are far more likely to be diagnosed, potentially because women are able to cope better with the symptoms, and people of African origin are also more likely to be diagnosed.
E: Perhaps this is due to the cultural significance of ‘hearing voices’, which may be seen by white Western psychiatrists as unusual or bizarre.
L: These factors support that the classification of schizophrenia lacks validity and reliability.