Reliability and validity of diagnosis/classification

Question 1

reliability includes (2)

Answer 1

inter-rater reliability, cultural differences

Question 2

inter-rater reliability is measured using a…

Answer 2

kappa score

Question 3

Reiger et al found an inter-rater reliability score of…

Answer 3

0.46

Question 4

culture bias: Copeland gave a patient description to _ UK psychiatrists and _ US psychiatrists. _% of US said the patient had Sz, compared to _% from UK

Answer 4

194 UK, 134 US

69% US, 2% UK

Question 5

Luhrmann et al found culture differences between…

Answer 5

voices heard

Question 6

culture bias: Luhrmann interviewed… and found…

Answer 6

20 Ghana, 20 Indian, 20 US schizophrenics,

African and Indians reported positive experiences with voices, Americans had negative experiences

Question 7

validity includes (3)

Answer 7

gender bias, symptom overlap, comorbidity

Question 8

gender bias comes from _, a criticism of the _ is that some categories _ one gender and not the other

Answer 8

stereotypes, DSM, pathologise

Question 9

gender bias: who found psychiatrists equated healthy adult behaviour to mentally healthy male behaviour

Answer 9

Broverman et al

Question 10

symptom overlap: who found people with DID have more Sz symptoms than schizophrenics

Answer 10

Ellason and Ross

Question 11

symptom overlap: Read found many people with Sz also…

Answer 11

have sufficient symptoms of other disorders so they could receive another diagnosis

Question 12

what is comorbidity

Answer 12

when 2/more conditions occur in a patient

Question 13

Buckley: found _% of patients have comorbid _ and _% have comorbid -

Answer 13

50% have comorbid depression and 47% have comorbid substance abuse

Question 14

comorbidity: _% of the population have Sz, _% have OCD, they are two very _ conditions however, who? found _% of Sz patients fulfill OCD criteria and _% show symtoms

Answer 14

1% have Sz, 2-3% have OCD, two very different conditions, Swets et al found 12% Sz p’s fulfilled OCD criteria and 25% show symptoms

Question 15

Validity Evaluation: research support for gender bias - who? randomly selected - male+females psychiatrists to read 2 patient vignettes. he found if it said ‘male’ _% said Sz, if it said ‘female’ _% said Sz. also gender bias was not evident with _ psychs. so diagnosis is influenced by…

Answer 15

Loring and Powell randomly selected 290 male+females psychs to read 2 patient vignettes. he found if it said male, 56% said Sz, if it said female 20% said Sz. also gender bias wasn’t evident with female psychs. so diagnosis is influenced by gender of patient and psych

Question 16

Validity Evaluation: consequences of comorbidity - who? looked at nearly _ million hospital discharge records to calculate comorbidity rates. psychiatric and behaviour related diagnosis accounted for _% of comorbidity. he found many comorbid p’s who had Sz and a _ problem. p’s received lower standard _ care which then affects _ of Sz.

Answer 16

Weber et al looked at nearly 6 million hospital discharge records to calculate comorbidity rates. psychiatric and behaviour related diagnosis accounted for 45% of comorbidity. he found many comorbid p’s who had Sz and a medical problem. p’s received lower standard medical care which then affects prognosis of Sz.

Question 17

Validity Evaluation: differences in prognosis - no evidence to say p’s _ prognosis. it varies e.g. _% recover previous level of functioning, _% achieve lasting improvement and _% show improvement with small relapses. therefore it has very little _ validity.

Answer 17

no evidence to say p’s share prognosis. it varies e.g. 20% recover previous level of functioning, 10% achieve lasting improvement and 30% show improvement with small relapses. therefore it has very little predictive validity.

Question 18

Reliability Evaluation: what did Whaley find inter-rater reliability for Sz to be

Answer 18

0.11 - very low

Question 19

Reliability Evaluation: why may symptoms be unreliable

Answer 19

only 1 symptom has to be required if ‘delusions are bizarre’, but how do we know what is and isn’t bizarre?

Question 20

Reliability Evaluation: unreliable symptoms - when 50 psychs were asked to differentiate between non-bizarre and bizarre symptoms the inter-rater reliability was…

Answer 20

0.40 - low, therefore it is a very subjective way of diagnosing Sz, reducing reliability

Question 21

Reliability Evaluation: cultural differences - what did Barne find

Answer 21

cultural and racial differences in diagnosis

Question 22

Reliability Evaluation: cultural differences - how many Sz p’s did Brekke and Barrio study and what were the two groups

Answer 22

184, 2 non-white minority groups (African-Americans and Latinos) 1 white American majority group

Question 23

Reliability Evaluation: cultural differences - what did Brekke and Barrio find

Answer 23

majority members were more symptomatic then minority members who received better prognosis

Question 24

Reliability Evaluation: cultural differences - what is the ethnic culture hypothesis and how does it link to Brekke and Barrio’s findings

Answer 24

minority experience less distress in mental disorders due to protective characteristics and social structures in their cultures, supported by their findings