Schizophrenia: Classification/Positive & Negative Symptoms, Reliability & Validity in Diagnosis and Classification DP Flashcards

1
Q

Schizophrenia does not have a single defining characteristic. Instead it appears to be a…

A

collection of unrelated symptoms

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2
Q

Where is the DSM-5 used?

A

In the USA

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3
Q

Where is the ICD-11 used?

A

In the UK

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4
Q

The ICD-11 and DSM-5 are the two major systems for…

A

the classification of mental disorders

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5
Q

The two major systems for the classification of mental disorders are the…

A

ICD-11 and DSM-5

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6
Q

The ICD-11 and DSM-5 differ slightly in their…

A

classification of schizophrenia

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7
Q

In the ICD-11, how many symptoms/for how long are sufficient for diagnosis?

A

Two or more negative symptoms, for one month or longer

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8
Q

In the DSM-5, how many symptoms/for how long are sufficient for diagnosis?

A

One positive symptom, for at least one month

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9
Q

Which classification system categorises schizophrenia further into sub-types?

A

ICD-11

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10
Q

Which classification system does not recognise subtypes of schizophrenia?

A

DSM-5

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11
Q

The ICD-11 recognises subtypes of schizophrenia

True or false?

A

True

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12
Q

The DSM-5 does not categorise schizophrenia further into sub-types

True or false?

A

True

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13
Q

Positive symptoms involve an _______________ experience beyond those of ordinary existence

A

additional

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14
Q

Negative symptoms involve a _______ of usual abilities and experiencies

A

loss

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15
Q

Hallucinations are a type of which symptom?

A

Positive

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16
Q

Delusions are a type of which symptom?

A

Positive

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17
Q

Avolition is a type of which symptom?

A

Negative

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18
Q

Speech poverty is a type of which symptom?

A

Negative

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19
Q

Two examples of hallucinations are

A

Auditory and visual

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20
Q

Hallucinations are unusual ____________ experiences that have no basis in reality, they can affect any sense

A

sensory

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21
Q

Hearing voices that are not present are an example of what symptom?

A

Auditory hallucinations (positive symptom)

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22
Q

Seeing objects that are not present are an example of what symptom?

A

Visual hallucinations (positive symptom)

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23
Q

What type of beliefs are delusions?

A

Irrational/false

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24
Q

How can delusions make people with schizophrenia behave?

A

In ways that make sense to them but may be bizarre to others

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25
Q

Two examples of delusions are

A

Delusions of persecution, delusions of control

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26
Q

A false belief that you are being harassed, e.g. by the government is an example of

A

Delusions of persecution (positive symptom)

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27
Q

A false belief that you are being controlled by something external, e.g. by aliens is an example of

A

Delusions of control (positive symptom)

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28
Q

Avolition is the severe loss of ___________ to carry out everyday tasks and difficulty to begin or keep up with goal-directed activity

A

motivation

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29
Q

Which researcher identified three signs of avolition?

A

Andreason (1982)

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30
Q

Andreason (1982) identified three signs of avolition, these are

A

poor hygiene and grooming, lack of persistence in work or education and lack of energy

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31
Q

Speech poverty is a reduction in the a_________ and q________ of speech

A

amount, quality

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32
Q

What is speech poverty sometimes accompanied by?

A

A delay in the sufferer’s verbal responses during conversation or a lack of fluency

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33
Q

The positive symptoms of schizophrenia are

A

Hallucinations and delusions

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34
Q

The negative symptoms of schizophrenia are

A

Avolition and speech poverty

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35
Q

Diagnosis is the identification of the nature of an illness or other problem by…

A

examination of the symptoms

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36
Q

Someone reporting hearing voices. This is mark point 2 for

A

diagnosis definition

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37
Q

Finish the mark point -

Classification is the action or process of classifying something:

A

the classification of disease according to symptoms

38
Q

A symptom of SZ is hallucinations. This is mark point 2 for

A

classification definition

39
Q

Diagnosis is the i_________________ of the nature of an illness or other problem by e_________________ of the symptoms

A

identification, examination

40
Q

The classification of disease is according to…

A

symptoms

41
Q

Reliability refers to consistency. This refers to whether we can gain…

A

consistent results when classifying and diagnosing SZ

42
Q

The extent to which two or more health professionals would agree on the same diagnosis, regardless of time period or culture is measured by

A

inter-rater reliability

43
Q

The extent to which different classification systems agree upon how schizophrenia should be classified is measured by

A

inter-rater reliability

44
Q

Validity refers to accuracy, this means

A

the extent to which we are measuring what we intend to measure (schizophrenia)

45
Q

An example of validity in classification of schizophrenia might be

A

whether the classification systems accurately outline the signs and symptoms of schizophrenia

46
Q

Are the classification systems accurately outlining the signs and symptoms of schizophrenia? This is an example of validity in

A

the classification of schizophrenia

47
Q

An example of validity in the diagnosis of schizophrenia might be

A

whether health professionals accurately diagnose schizophrenia

48
Q

Are health professionals accurately diagnosing schizophrenia? This is an example of validity in

A

the diagnosis of schizophrenia

49
Q

Who investigated the reliability and validity in diagnosis and classification of schizophrenia?

A

Cheniaux (2009)

50
Q

How does Cheniaux (2009) show poor inter-rater reliability?

A

One psychiatrist diagnosed almost double the amount than the other psychiatrist

51
Q

What did Cheniaux (2009) do to investigate the reliability and validity in diagnosis and classification of schizophrenia?

A

Asked two psychiatrists to diagnose the same 100 patients using the DSM and ICD

52
Q

How does Cheniaux (2009) show poor reliability in the classification of schizophrenia?

A

Both psychiatrists diagnosed almost double the number of patients using the ICD than the DSM

53
Q

In Cheniaux (2009), both psychiatrists diagnosed almost double the number of patients using the ICD than the DSM. What does this show about reliability/validity?

A

Poor reliability in the classification of schizophrenia, poor validity in the diagnosis of schizophrenia

54
Q

How does Cheniaux (2009) show poor validity in the diagnosis of schizophrenia?

A

Both psychiatrists diagnosed almost double the number of patients using the ICD than the DSM

55
Q

Symptom overlap is where

A

two or more conditions share similar symptoms

56
Q

An example of symptom overlap is

A

both schizophrenia and depression involve negative symptoms such as avolition

57
Q

Name the key term -

This is where two or more conditions share similar symptoms

A

Symptom overlap

58
Q

Name the key term -

This is where two illnesses/conditions occur at the same time

A

Co-morbidity

59
Q

Co-morbidity is where

A

two illnesses/conditions occur at the same time

60
Q

What other conditions is schizophrenia commonly diagnosed with and why?

A

Depression and/or OCD as they share common symptoms, i.e. lowered motivation/mood

61
Q

An example of co-morbidity is

A

Schizophrenia is commonly diagnosed with other conditions such a depression and/or OCD as they share common symptoms, i.e. lowered motivation/mood

62
Q

Why is co-morbidity a problem?

A

It means schizophrenia may not exist as a distinct condition which may lead to misdiagnosis

63
Q

Schizophrenia may not exist as a distinct condition, which may lead to misdiagnosis. This is a problem of

A

co-morbidity

64
Q

How has gender bias been seen in the diagnosis of schizophrenia?

A

Since the 1980s men have been diagnosed with schizophrenia more often than women

65
Q

What might be a reason behind men being diagnosed with schizophrenia more often than women?

A

Men are more genetically vulnerable to developing schizophrenia

66
Q

What might be a reason behind men being diagnosed with schizophrenia more often than women?

A

Females with schizophrenia typically function better than men, being more likely to work and have good family relationships - therefore their symptoms may be masked by good interpersonal skills (Cotton et al)

67
Q

How has culture bias been seen in the diagnosis of schizophrenia?

A

English people of African origin are much more likely to be diagnosed with schizophrenia in the UK

68
Q

What might be a reason behind the higher diagnosis rates of English people of African origin in the UK?

A

Some behaviours classed as positive symptoms of schizophrenia are normal in African cultures (e.g. hearing voices as part of ancestor communication)

69
Q

Symptom overlap questions the…

A

validity and reliability of the classification and diagnosis of schizophrenia

70
Q

Why does symptom overlap question the validity and reliability of the classification and diagnosis of schizophrenia?

A

Because an individual may be diagnosed with the wrong disorder

71
Q

As a result of symptom overlap, an individual may be diagnosed with the wrong disorder. What are the consequences of this?

A

Individuals may not receive appropriate treatment

72
Q

Which researcher concluded that 50% of patients with schizophrenia are also diagnosed with depression, and 23% of schizophrenia patients are also diagnosed with OCD?

A

Buckley et al. (2009)

73
Q

As a result of co-morbidity, doctors may not be diagnosing schizophrenia correctly. What are the consequences of this?

A

Individuals may not receive appropriate treatment

74
Q

Women who share similar symptoms as men may not receive the same diagnosis as their symptoms seem mild. What is the issue here?

A

Gender bias

75
Q

What is meant by a positive symptom?

A

An additional experience beyond those of ordinary existence

76
Q

What is meant by a negative symptom?

A

A loss of usual abilities and experiences

77
Q

Define hallucinations (1m)

A

Unusual sensory experiences that have no basis in reality, they can affect any of the senses

78
Q

Define delusions (2m)

A

Irrational/false beliefs that have no basis in reality, they can make people with schizophrenia behave in ways that make sense to them bu may be bizarre to others

79
Q

What is meant by avolition?

A

Severe loss of motivation to carry out everyday tasks and difficulty to begin or keep up with goal-directed activity

80
Q

Define speech poverty (2m)

A

A reduction in the amount and quality of speech, sometimes accompanied by a delay in the sufferers’ verbal responses during conversation or a lack of fluency

81
Q

Define diagnosis (2m)

A

The identification of the nature of an illness or other problem by examination of the symptoms, i.e. someone reporting hearing voices

82
Q

Define classification (2m)

A

The action or process of classifying something: the classification of disease according to symptoms, i.e. a symptom of schizophrenia is hallucinations

83
Q

What is meant by reliability in the classification of schizophrenia?

A

The extent to which the ICD and DSM consistently agree upon how schizophrenia should be classified

84
Q

What is meant by reliability in the diagnosis of schizophrenia?

A

The extent to which two or more health professionals would consistently agree on the same diagnosis

85
Q

What is meant by validity in the classification of schizophrenia?

A

The extent to which the ICD and DSM accurately identify the symptoms of schizophrenia

86
Q

What is meant by validity in the diagnosis of schizophrenia?

A

The extent to which two or more health professionals would accurately diagnose schizophrenia, when using the classification systems

87
Q

How do findings by Cheniaux (2009) show inconsistency in diagnosis?

A
  • Psychiatrist 1 diagnosed 26 according to DSM vs. Psychiatrist 2 diagnosed 13 according to DSM
  • Psychiatrist 1 diagnosed 44 according to ICD vs. Psychiatrist 2 diagnosed 24 according to ICD
88
Q

How do findings by Cheniaux (2009) show inconsistency in classification?

A
  • Psychiatrist 1 diagnosed 26 according to DSM vs. Psychiatrist 1 diagnosed 44 according to ICD
  • Psychiatrist 2 diagnosed 13 according to DSM vs. Psychiatrist 2 diagnosed 24 according to ICD
89
Q

In Cheniaux’s research:

  • Psychiatrist 1 diagnosed 26 according to DSM vs. Psychiatrist 2 diagnosed 13 according to DSM
  • Psychiatrist 1 diagnosed 44 according to ICD vs. Psychiatrist 2 diagnosed 24 according to ICD

What do these findings show?

A

Inconsistency in diagnosis (poor reliability in diagnosis)

90
Q

In Cheniaux’s research:

  • Psychiatrist 1 diagnosed 26 according to DSM vs. Psychiatrist 1 diagnosed 44 according to ICD
  • Psychiatrist 2 diagnosed 13 according to DSM vs. Psychiatrist 2 diagnosed 24 according to ICD

What do these findings show?

A

Inconsistency in classification (poor reliability in classification)

91
Q

How much more likely are Afro-Caribbeans living in the UK to receive a diagnosis of schizophrenia compared to white Britons?

A

Ten times