schizophernia- classification and reliability

Question 1

what is a classification

Answer 1

cluster of symptoms that often appear together and therefore thought to eeflect the presnece of one particular mental disorder.
schizophrenic classification created by bleuler.
he also distinguished between pos and neg symptoms
‘schizophenia’ split mind

Question 2

definition of positive symptoms +

Answer 2

additional experiences beyond those of ordinary experience.
presence of abnormal behaviour
feeling/behaviours that aren’t normally present
generally occur in accute episodes

Question 2

what is schizphernia classified as

Answer 2

severe mental disorde3r characterised by the lack of contact with reality and disconnection of thought process.

Question 3

definition of negative symptoms

Answer 3

(taken away from life)
absence of normal behaviours
loss of usual abilities and experience
lack of feeling/behaviours that are usually present
generally occur in chronic episodes

Question 4

positive symptoms

Answer 4

-hallucinations
-delusions
-disorganised speech

Question 5

negative symptoms

Answer 5

-avolition
-alogia
-affective flattening
-catatonic behaviour

Question 6

hallucinations

Answer 6

unusual sensory experiences
-auditory
-olfactory
-visual
-tactive (touch)
-gustory (taste)

Question 7

delusions

Answer 7

paranoia/irrational beliefs
false beliefs firmed dispute being completely illogical
-delusions of persecution
-delusions of grandur
-delusions of control
somatic delusions- false beliefs about body being infected

Question 8

disorganised speech

Answer 8

inability to speak properly, characterised by lack of ability to produce fluent words

rambling on
word ‘salad’
derailment- going off on tangent

Question 9

alogia

Answer 9

speaks less or only in response to others
- short utterences
-one word answers
-repetivie context
- neologisms (making words up)
- echolalia- repetisise words

Question 10

avolition

Answer 10

finds it difficult to keep up with goal directed activities.
- sitting in house for hours not doing naything
-poor hygiene and grooming.

Question 11

affective flattening

Answer 11

emotional expressions not showing
-speak in flat dull voice
-face may not change
-,ay have trouble understanding emotions in other people

Question 12

catatonic behaviour

Answer 12

grimacing
waxy flexibility
catalepsy

Question 13

what are the two main classification systems used

Answer 13

DSM and ICD
diagnostic and statistical manual of psychiatric disorders
international classification of diseases

Question 14

what is the current DSM for schizphrenia

Answer 14

DSM-5 mostly used usa
-in order to be diagnosed, individual must have at least two :
-delusion
-hallucinations
-disorganised speech
-grossly disorganised or catatonic behaviour
-negative symptoms such as diminished emotional expression.

ATLEAST ONE MUST BE FROM TOP 3 AND HAVE BEEN PRESENT FOR ONE MONTH .. general disturbances at least 6 months

Question 15

rosenhans study- reliability and validity in classification of schizophrenia

Answer 15

aim was to see if pschiatrists could distinguish between mentally ill people and non mentally ill.
involved 8 pseudo patients, including rosenhan.

Question 16

reliability in schizo

Answer 16

-consistancy of results
-interrater relaibility- when two or more clients arrive at same diagnosis for same patient
test-retest reliability- clinician makes same diagnosis on separate occasions for same patient.

beck found only 54% concordance rates in 153 patients

Question 17

validity in schizo

Answer 17

accuracy
when a patient diagnosed with schizo actually does suffer from the disorder and treatment will lead to an improvement in symptoms.

rosenhan found that all 8ps were admitted and all imposters were identified. all genuine patients were said to be imposters when they weren’t.

Question 18

what affects reliability and validity of a valid diagnosis of schizophrenia

Answer 18

-co morbidity
-culture bias
-gender bias
-symptom overlap

Question 19

culture bias

Answer 19

clinicians from different cultural backgrounds often disagree on a diagnosis of schizophrenia. similarly, patients can display same symptoms but receive different diagnoses because of their ethnic background.

eg. afro carribean and afro American are up to 9 times more likely to be diagnosed with schizophrenia compared to 0.32% of general population

Question 20

ao3 cultural bias
supporting evidence

Answer 20

-supporting evidence
-Blake found that clinicians are more likely to diagnose a patient with schizophrenia if the description referred to them as African ame4rican compared to white. this could be because cultural definition of schizophrenia may not be applicable to non western cultures. hearing the voice of angel would be viewed as an example of auditory hallucinations by western clinic but an afro carribeans clinician, may interpret this as a religious experience.
-this means that a diagnosis for schizophrenia can be unreliable and invalid which can implement treatments

Question 21

gender bias

Answer 21

males and females are equally Able to be diagnosed for schizo but some differences are
-males diagnosed earlier (15-25)
-women have more positive symptoms and mqintain a better family relationship, more likely to work and have better functionality.
males have higher levels of co morbidity substance abuse
more aggressive symptoms

Question 22

ao3 gender bias

Answer 22

-sup evidence
-loring and power give psychiatrists patient are stories and asked them to offer their judgement regarding diagnosis using standard criteria. when patient was described as male 56% gave diagnosis of schizo, compared to only 20% when described as female.
futhermore, this gender bias was no seen across female psychiatrists.
this means that a diagnosis fro schizo can be unreliable and invalid which can have implications for treatments.

Question 23

co morbidity

Answer 23

suffering from more than one medical condition at the same time

schizo and depression

Question 24

ao3 co morbidity

Answer 24

-sup evidence
-buckley identified that 50% of schizo patients had depression and 29% had ptsd and 23% had old. when 2 disorders are diagnosed together, it calls into question the validity of the classification of both illnesses. we need to consider if they should be treated as two sep conditions or diagnosed as single disorder- SCHIZOAFFECTIVE.
-therefore diagnosis can be unreliable and invalid which can have implications for treatments

Question 24

symptom overlap

Answer 24

-there are a number of disorders that have similar symptoms
- bc schizophrenia doesn’t have nay pathognoimic symptoms, they are exclusive to schizo, ir can be hard for clinicians to tell it apart from other conditions.

Question 24

a03 symptom overlap

Answer 24

-sup evidence
-ketter, misdiagnosis due to symptom overlap can lead to years of delay in recienveing treatment during which time suffering and futher degeneration can occur as well as high levels os suciude rate. focus on this could save lives and money
- therefore can be unreliable and invalid which has implications fro treatments.