Schizophrenia

Question 1

Schizophrenia:

Answer 1

Severe mental psychotic disorder characterised by disruption of cognition and emotion

Question 2

Psychotic:

Answer 2

Mental issues causing abnormal thinking and loss of realism

Question 3

Which 2 classification systems are used to diagnose schizophrenia?

Answer 3

• DSM 5 (America)
• ICD 11 (Europe and other parts of world)

Question 4

Positive symptoms:

Answer 4

Symptoms that reflect an excess of normal functions

Question 5

4 examples of positive symptoms:

Answer 5

• Hallucinations eg auditory, olfactory, tactile, visual
• Delusions
• Disorganised speech
• Grossly disorganised behaviour

Question 6

Hallucinations v Delusions:

Answer 6

• Delusions are irrational beliefs
• Hallucinations are

Question 7

Negative symptom:

Answer 7

Symptom that reflects reduction of normal functions

Question 8

3 examples of negative symptoms:

Answer 8

• Speech poverty (alogia) –> reduction in amount and quality of speech
• Avolition –> Loss of interest to do regular everyday tasks
• Affective flattening –> no emotional expression in their speech

Question 9

How many of each type of symptom is needed to diagnose schizophrenia according to both classification system?

Answer 9

• DSM 5 –> 2 or more positive symptoms for a month and 6 months of social withdrawal
• ICD 11 –> 1 positive and one negative symptom for a month

Question 10

Who made a distinction between two types of schizophrenia and what are each?

Answer 10

• Crow (1980)
• Type 1: Characterised more by positive symptoms
• Type 2: Characterised more by negative symptoms

Question 11

Give 6 issues with the classification and diagnosis of SZ:

Answer 11

• Reliability
• Validity
• Co-morbidity
• Symptom overlap
• Gender bias
• Cultural bias

Question 12

Give two studies showing weakness in reliability of diagnosis of SZ:

Answer 12

• Whaley (2001) found low inter rated reliability score of +0.11 (DSM)
• Cheniaux et al (2009)
• Read et al (2004)

Question 13

Cheniaux et al (2009):

Answer 13

• 2 psychiatrists independently diagnose 100 schizophrenic patients using both ICD & DSM
• One psychiatrist diagnosed 26 (DSM) and 44 (ICD) w/ SZ
• Other psychiatrist diagnosed 13 (DSM) and 24 (ICD) w/ SZ
• Low inter-rater reliability

Question 14

Read et al (2004):

Answer 14

Test-retest reliability showed 37% concordance rate of SZ diagnosis

Question 15

Give one study showing strength in reliability of diagnosis of SZ:

Answer 15

• Flavia Osario et al (2019)
• Found inter rated reliability between pairs of psychiatrists was +0.97 and test-retest reliability was +0.92 (using DSM)

Question 16

How can the validity of SZ diagnosis be assessed?

Answer 16

Using criterion validity (when different assessment systems arrive at the same diagnosis for some patient)

Question 17

What does Chiniaux’s study show about validity of SZ diagnosis?

Answer 17

• Low validity
• SZ is more likely to be diagnosed w/ ICD than DSM

Question 18

Give one study showing a reason for lack of validity in SZ diagnosis:

Answer 18

Rosenhan (1973)

Question 19

Rosenhan (1973):

Answer 19

1) 8 volunteers who weren’t suffering from SZ presented themselves to different hospitals claiming they could hear voices
2) Took between 7 and 52 days to be released, diagnosed as schizophrenics in remission (DSM) (decreased symptoms)
3) Normal behaviours were interpreted as SZ symptoms

Question 20

Rosenhan (1973) follow-up study:

Answer 20

1) Informed hospital that some number of pseudo patients would be admitted over 3 months
2) 83/193 admitted aroused suspicions of being false patients
3) No acc pseudo-patients were admitted

Question 21

Give one study showing strength in reliability of diagnosis of SZ:

Answer 21

• Osario (2019)
• Because DSM reliability is so high, validity would also be high
• Suggests ICD needs more revision

Question 22

Co-morbidity:

Answer 22

Idea that 2 or more mental disordered occur together at same time w/ same person

Question 23

Give one study showing co-morbidity in SZ diagnosis:

Answer 23

• Buckley et al (2009)
• Around half of patients w/ SZ have also been diagnosed w/ depression/substance abuse
• PTSD also occurred in 29% and OCD in 23% of cases

Question 24

Give one studies showing symptom overlap:

Answer 24

• Ellason and Ross (1995)
• Found that people with dissociative identity disorder acc have more schizophrenic symptoms than SZ diagnosed person

Question 25

Give one study showing gender bias in SZ diagnosis:

Answer 25

• Fischer and Buchanan (2017)
• Since 1980s ratio of men and women diagnosed w/ SZ is 1.4 : 1

Question 26

Give one study showing cultural bias in diagnosis:

Answer 26

• Pinto and Jones (2008)
• African American and English people of Afro-Caribbean descent are 9 times more likely to be diagnosed w/ SZ

Question 27

Give two possible reasons for increased SZ diagnoses in black people:

Answer 27

• Auditory hallucinations may be acceptable there because of cultural beliefs in communication w/ dead ancestors but this is seen as a positive symptom of SZ in UK
• Possibly racism –> doubting honesty of black people (Escobar, 2012)

Question 28

3 advantages of diagnosis of SZ:

Answer 28

• Communication shorthand –> simpler to incorporate symptoms into single diagnosis to communicate between professionals
• Easier to identify a treatment
• Many w/ SZ have underlying biological abnormalities, which can lead to more effective treatment if diagnosed

Question 29

What 2 explanations does the biological approach include?

Answer 29

• Neural correlate including dopamine hypothesis
• Genetics

Question 30

What 3 types of studies usually test genetic factors?

Answer 30

• Family
• Twin
• Adoption