Issues with the classification and diagnosis of Schizophrenia Flashcards
what are the 2 key issues with classification and diagnosis of schizophrenia
Reliability and validity
these can be split further into smaller issues
who investigated the issues of classification and diagnosis of schizophrenia
Rosenhan (1972)
What was Rosenhan procedure when investigating issues with classification and diagnosis of SZ
Hint: he did 2 studies relating to this issue
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
what are the 3 issues that Reliability can be split into
inter-rater reliability
test-retest reliability
culture
what are 3 issues that validity can be split into
gender
symptom overlap
comorbidity
what is inter-rater reliability
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
how can inter-rater reliability relate to Rosenhans research
rosenhan shows that even though presented the same symptoms, 1 was diagnosed with a diff disorder
what is test-retest relaibility
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
how can test-retest reliability relate to Rosenhans research
Rosenhan found it took diff amounts of time to release the pseudo-patients
what is culture in terms of reliability
this idea suggests that theres a tendency to over-diagnosis members of other cultures.
how can culture relate to schizophrenia research by Copeland
Copeland gave 134 us and 194 uk psychologists a description of a patient.
69% of US diagnosed Sz
2% of british said the same
Sz: what is gender in terms of validity
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.
how can gender relate to schizophrenia research by castle
found there were a greater frequency of positive and affective symptoms in women and a greater frqeuncy of negative symptoms in men
what is symptom overlap in terms of sz
one issue with the diagnosis of schizophrenia is that many of the symptoms of this disorder also overlap with other mental and physical illness
who researched symptom overlap
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
what is comorbitiy
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
What did buckleys comorbidity research that relates to schizophrenia find?
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
what is a evaluation of issues with diagnosis of schizophrenia
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.
