Lesson 1

Question 1

schizophrenia

Answer 1

a serious mental psychotic disorder characterised by a profound disruption of cognition and emotion, affecting a persons language, thought and perception, emotions and their sense of self

Question 2

affects…

Answer 2

1% of the population, 4 in 1000
onset between 15-35
men more than women
cities rather than the countryside
working class than middle class

Question 3

diagnosing

Answer 3

The Diagnostic and Statistical Manual of Psychiatric Disorders, devised by APA, fifth edition
The International Classification of Diseases, devised by WHO, eleventh edition

Question 4

DSM V

Answer 4

used in America
needs to show at least two or more positive symptoms, or one positive and one negative, for a period of one month
extreme social withdrawal for at least six months

Question 5

ICD

Answer 5

used in Europe and other parts of the world
need to show one positive and one negative symptoms, or two negative symptoms for at least one month

Question 6

types of SZ

Answer 6

Crow (1980) made a distinction between two types
-type 1 characterised more by positive symptoms (those which are an addition to an individuals behaviour), better prospects for recovery
-type 2 characterised more by negative symptoms (reduction or loss of normal behaviours), poorer prospects for recovery

Question 7

positive symptoms

Answer 7

-hallucinations: sensory experiences of stimuli that have either no basis in reality or are distorted perceptions of things that are there (auditory, visual, olfactory, tactile)
-delusions: irrational bizarre beliefs that seem real to the person, take a range of forms and may involve the body

Question 8

negative symptoms

Answer 8

-speech poverty/alogia: reduction in amount and quality of speech, sometimes accompanied by delay in the sufferers verbal response, less complex syntax
-avolition/apathy: difficulty in beginning or keeping up with goal-directed activity, often show sharply reduced motivation to carry out a range of activities

Question 9

issues associated with classification and diagnosis of SZ

Answer 9

reliability, validity, co-morbidity, symptom overlap, gender bias, culture bias

Question 10

reliability

Answer 10

-consistency of measuring instrument, eg. DSM/ICD
-inter-rater reliability: when two or more diagnosticians agree with the same diagnosis for the same individual
-Cheniaux et al (2009), two diagnosticians independently diagnose 100 patients using both DSM and ICD criteria, one diagnosed 26 with DSM and 44 to ICD, other diagnosed 13 with DSM and 24 to ICD
-Whaley (2001) found inter-rater reliability between diagnosticians as low as +0.11 using the DSM

Question 11

validity

Answer 11

-the extent to which we are measuring what we intend to measure, diagnosing sz correctly based on the symptoms used in the manuals
-criterion validity: different assessment systems arrive at the same diagnosis for the same patient
-Rosenhan (1973), 8 pseudo patients admitted into psychiatric hospitals with symptoms of hearing voices such ‘hollow, thud’, behaved normally during their stay, all stayed for 7-52 days, all but one discharged with sz in remission, however study is aged and diagnosis has improved since
-Mason (1997) found that the use of newer classification systems has improved predictive validity of diagnosis, eg 6 month criteria rather than 1 month

Question 12

co-morbidity

Answer 12

-the idea that two or more mental disorders or conditions occur together, sz is commonly diagnosed with other conditions
-Buckley et al (2009), 50% of sz patients also have a diagnosis of depression, 47% substance abuse, 29% PTSD, 23% OCD
-suggests we are unable to distinguish between between disorders very well

Question 13

symptom overlap

Answer 13

-considerable overlap between the symptoms of sz and other conditions
-Ellason and Ross (1995), point out people with dissociative identity disorder having more sz symptoms than people diagnosed with sz
-Read (2004), most diagnosed with sz have sufficient symptoms of other disorders could receive at least one other diagnosis

Question 14

gender bias

Answer 14

-Longenecker (2010) reviewed sz studies since 1980s, found men more likely to be diagnosed than women
-Cotton (2009), could be a gender bias in diagnosis as women seem to have better functioning family relationships than men, women less likely to be diagnosed as they show better interpersonal functioning

Question 15

culture bias

Answer 15

-Pinto and Jones (2008), African American/British Afro Caribbean are nine times more likely to be diagnosed with sz
-may be because cultural beliefs in communication with ancestors mirrors positive symptoms, auditory hallucinations, not warranted as a sz symptom
-Escobar (2012), in western cultures the honesty of a black person is more likely to be doubted

Question 16

advantages of C and D

Answer 16

-communication is easier: a patient with a mental disorder often has multiple symptoms, easy to incorporate these symptoms into one diagnosis
-treatment: treatment is specific to certain disorders, reliable diagnosis can lead to correct treatment to alleviate symptoms
-biological abnormalities in people with sz: hoped that a greater understanding of these abnormalities will lead to more effective treatment