Schizophrenia (AO2) Flashcards
1
Q
What are the main issues in diagnosis of SZ and why?
A
Reliability - Consistent diagnosis
Validity - Do the diagnosis measure what they are designed to?
Co-morbidity - Occurrence of two illnesses together which confuses diagnosis and treatment
2
Q
What does culture bias have to do with SZ diagnosis? (PEI)
A
- P: Classifying and diagnosing SZ also suffers from culture bias
- E: In England, African Americans or English people of Afro-Caribbean descent are much more likely to be diagnosed with schizophrenia than others. This may be due to several factors such as these cultures believing in the dead being able to communicate with relatives who are alive and therefore accepting/acknowledging these experiences. This is a positive symptom of schizophrenia and means psychiatrists from another culture may see this as bizarre or an irrational thought process.
- I: Such a cultural bias therefore decreases the population validity of the diagnosis and classification of schizophrenia.
3
Q
Is diagnosis of SZ reliable? (PEI)
A
- P: However, the reliability of diagnosis and classification is an issue.
- E: When analysing the inter-rater ability of two separate psychologists who used the DSM and ICD each, Cheniaux at al (2009) found that this was incredibly low. This was even lower when they used the other classification and diagnosis system.
- I: This highlights the poor reliability of the assessment of those with schizophrenia, which weakens it.
4
Q
Is diagnosis of SZ valid? (PEI)
A
- P: Another weakness of the diagnosis and classification is validity.
- E: One can analyse the the validity of diagnosis by looking at its criterion validity. When looking at Cheniaux at al’s 2009 work, using the ICD caused more diagnoses to be made. This means that either the ICD over-diagnoses patients with schizophrenia or DSM under-diagnoses
- I: This suggests that systems used to diagnose schizophrenia have low validity, further weakening them
5
Q
Comment on the Bio’s use of correlational data (PEI)
A
P: Research suffers from being correlational data only.
- E: Although there is much research support, the data it provides does not specifically highlight that these are the causes of SZ. Can we be sure that brain abnormalities cause SZ or is it the other way round.
- I: Therefore, correlational data cannot answer these questions and only suggest possibilities which decreases internal validity.
6
Q
Does the bio approach have research support? (PEI)
A
- P: A strength of the biological approach is that there is research which supports its notions.
- E: Gottesman (1991) demonstrates how the more similar one’s genetics are to other family members, the more vulnerable they are to SZ. MZ twins have a 48% chance of both developing the disorder.
- I: This increases the explanation’s reliability as it supports the idea that people’s genetics can make them more vulnerable to developing SZ
7
Q
Comment on the claim that ‘the biological approach ignores other factors’?
A
- P: However, one issue with biological approach is that it ignores other factors that can contribute to the development of SZ.
- E: For example, the role of environment one grew up in is ignored by the approach. Studies have suggested a vital contribution is quality of family during childhood and can also explain why MZ twins were the most likely to both develop it as shown by Gottesman as they were raised in the same environment.
- I: This decreases the internal validity as it demonstrates how the biological approach is not wholly explanatory.
8
Q
Is there research support for the dopamine hypothesis?
A
- P: There is also research to support the dopamine hypothesis as a predictor for SZ vulnerability.
- E: Antipsychotic drugs which reduce dopamine levels have been shown to have a positive impact on SZ by reducing its symptoms as shown by Tauscher et al (2014).
- I: This further increases the reliability.
9
Q
Comment on evidence for familial explanations?
A
- P: There may be a wide variety of support for the notion of familial explanations, yet this does not mean the evidence it recipes is sufficient or strong.
- E: There is none to support the notion of the schizophrenogenic mother and the double bind theory. If there is, it is only through case studies which is now trusted less due to extraneous variables.
- I: This decreases the explanations internal validity.
10
Q
Is there support for the role of the dysfunctional family?
A
- P: There is support for role of dysfunctional family in the development of SZ.
- E: Adults categorised with insecure attachments to their parents were more likely to have SZ. Another study reviewed the diagnoses of patients with SZ and found that both the majority of men and women had been the victims of child abuse, whether it be physical or sexual or both.
- I: Increases reliability.
11
Q
What about research for dysfunctional information processing?
A
- P: There is strong evidence for cognitive explanations of SZ that involve dysfunctional information processing.
- E: Stirling et al (2006) found that when completing the Stroop Test, that ppts who have SZ took at least twice as long.
- I: This further increases the reliability of dysfunctional thought processes as an explanation for SZ.
12
Q
What weakness do psych. explanations that is similar to bio ones?
A
- P: A problem with these explanations is that despite there being research, it does not necessarily mean that these are causations.
- E: It still remains unclear whether the cognitive factors cause SZ, or they are a symptom of the condition.
- I: Weakens internal validity.
13
Q
What research is there for typical antipsychotic effectiveness?
A
- P: There is evidence which supports the effectiveness of the use of antipsychotics to treat SZ or to relieve SZ symptoms.
- E: Studies were reviewed which involved independent groups take Chlorpromazine or a placebo form. It was found that those who actually took the drug improved functioning and reduced symptom severity. In other trials, relapse rates were much slower when the drug was taken.
- I: Increases reliability
14
Q
What research is there for atypical antipsychotic effectiveness?
A
P: There is evidence which supports the effectiveness of the use of atypical antipsychotics to treat SZ or to relieve SZ symptoms.
- E: There are also studies which demonstrate the effectiveness of atypical antipsychotics. Clozapine was found to be more successful than typical antipsychotics and is effective to 30-50% of treatment-resistant cases where typical antipsychotics were administered.
- I: Increases reliability
15
Q
Comment on drug therapy side effects
A
- P: An issue regardless however, is that these medications can cause serious side-effects.
- E: These can include dizziness, weight gain as well as more serious ones such as tardive dyskinesia which cause quality of life to decrease. Furthermore, long time taking can cause fatal conditions such as NMS and as typical dosages have decreased over time, the rarity of the condition has increased. However, antipsychotics are also not perfect, such as Clozapine which can cause agranulocytosis.
- I: Although uncommon, this still reduces such medication’s effectiveness as a treatment for patients with SZ. However, this does depend on the individual as if there are no side effects, then clearly it is effective for them specifically
