Problems with reliability of diagnosis Flashcards
Reliability of diagnosis
-The degree to which diagnosis of schizophrenia is reliable, classification systems consistently produce the same result/diagnosis for the same symptoms for it to be accurate
-Requires test-retest reliability, one practioner diagnosing the same patient with the same disorder at a different time
-Inter rater reliability-the degree to which two practioners diagnose the same client with schizophrenia using the same classification system.
Beck-1960s-Reliability of diagnosis
Only found a 54% concordance rate of two practioners diagnosing the same patient with schizophrenia using the same classification system-diagnosis is unreliable and lacks inter rater reliability.
-Outdated, reliability has improved
-Jakobson (2005)
-Found a 94% concordance rate of two practioners diagnosing the same patient using the same classification system w the DSM in 2005 suggesting that accuracy of diagnosis has improved over time, other research suggests other means of classification are more reliable than others.
Co-Morbidity
Schizophrenia is often co-morbid with other disorders like substance abuse, depression or bipolar disorder, this suggests that diagnosis of schizophrenia may be invalid as it may not be a distinguished disorder, symptoms may be the result of the other disorder present
-Also makes it difficult to create an accurate diagnosis as it cannot be established which symptoms are from which disorder-innacurate diagnosis
+Buckley et al found that 50% of schizophrenia patients also had co-morbidities such as depression and substance abuse disorder, this suggests the validity may be limited and it is not a distinct disorder, diagnosis may be innacurate
Symptom overlap
-Schizophrenia shares symptoms with other disorders, for example bipolar disorder also leads to hallucinations and avolition as well as psychotic depression, this suggests that schizophrenia may not be a distinct disorder but the symptoms may be the result of another disorder-it also means it is hard to diagnose and diagnosis may be innacurate
-Serper found that whilst schizophrenia has symptom overlap with cocaine intoxication it is possible to distinguish the disorders and do an accurate diagnosis-schizophrenia is a legitimate diagnosis.
Who found accurate diagnosis is possible despite symptom overlap
Serper
Culture bias
-The diagnosis of gender may be culture bias, black patients are significantly more likely to be diagnosed and institutionalised than white patients in the UK, it is suggested this is because practioners have cultural bias, subconsciously viewing black people as more dangerous and abnormal than white people, they may also interpret their cultural norms as abnormal leading to over-diagnosis.
+Cochrane found that black people are 7 more likely to be diagnosed in the UK than the west indes suggesting the diagnosis of schizophrenia is culturally biased
-Could be argued that other factors make black people more likely to be diagnosed, it may be that black people have a genuine disposition to schizophrenia due to genetic factors and things such as racism, poverty etc act as stress triggering the onset of the disorder-it may be that schizophrenia is more common and over-representation isnt due to cultural bias but is an accurate diagnosis.
Who found black people are more likely to be diagnosed with schizophrenia than white people (7X)
Cochrane
Gender bias
-Men are more likely to be diagnosed with schizophrenia than women, men are more likely to have severe negative symptoms whereas women are more likely to have positive symptoms, classification systems are gender biased as they overlook gender differences in schizophrenia and thus lead to underdiagnosis of women and practioners not taking womens experiences seriously
+Powell et al found that women are more likely to be under-diagnosed by practioners when the gender of the case study was changed to female showing cultural bias.
Who found women are under diagnosed
Powell et al.
Who found 50% of patients with schizophrenia had co-morbid depression or substance abuse disorder
Buckley
