Schizophrenia: Classification/Positive & Negative Symptoms, Reliability & Validity in Diagnosis and Classification DP Flashcards
Schizophrenia does not have a single defining characteristic. Instead it appears to be a…
collection of unrelated symptoms
Where is the DSM-5 used?
In the USA
Where is the ICD-11 used?
In the UK
The ICD-11 and DSM-5 are the two major systems for…
the classification of mental disorders
The two major systems for the classification of mental disorders are the…
ICD-11 and DSM-5
The ICD-11 and DSM-5 differ slightly in their…
classification of schizophrenia
In the ICD-11, how many symptoms/for how long are sufficient for diagnosis?
Two or more negative symptoms, for one month or longer
In the DSM-5, how many symptoms/for how long are sufficient for diagnosis?
One positive symptom, for at least one month
Which classification system categorises schizophrenia further into sub-types?
ICD-11
Which classification system does not recognise subtypes of schizophrenia?
DSM-5
The ICD-11 recognises subtypes of schizophrenia
True or false?
True
The DSM-5 does not categorise schizophrenia further into sub-types
True or false?
True
Positive symptoms involve an _______________ experience beyond those of ordinary existence
additional
Negative symptoms involve a _______ of usual abilities and experiencies
loss
Hallucinations are a type of which symptom?
Positive
Delusions are a type of which symptom?
Positive
Avolition is a type of which symptom?
Negative
Speech poverty is a type of which symptom?
Negative
Two examples of hallucinations are
Auditory and visual
Hallucinations are unusual ____________ experiences that have no basis in reality, they can affect any sense
sensory
Hearing voices that are not present are an example of what symptom?
Auditory hallucinations (positive symptom)
Seeing objects that are not present are an example of what symptom?
Visual hallucinations (positive symptom)
What type of beliefs are delusions?
Irrational/false
How can delusions make people with schizophrenia behave?
In ways that make sense to them but may be bizarre to others
Two examples of delusions are
Delusions of persecution, delusions of control
A false belief that you are being harassed, e.g. by the government is an example of
Delusions of persecution (positive symptom)
A false belief that you are being controlled by something external, e.g. by aliens is an example of
Delusions of control (positive symptom)
Avolition is the severe loss of ___________ to carry out everyday tasks and difficulty to begin or keep up with goal-directed activity
motivation
Which researcher identified three signs of avolition?
Andreason (1982)
Andreason (1982) identified three signs of avolition, these are
poor hygiene and grooming, lack of persistence in work or education and lack of energy
Speech poverty is a reduction in the a_________ and q________ of speech
amount, quality
What is speech poverty sometimes accompanied by?
A delay in the sufferer’s verbal responses during conversation or a lack of fluency
The positive symptoms of schizophrenia are
Hallucinations and delusions
The negative symptoms of schizophrenia are
Avolition and speech poverty
Diagnosis is the identification of the nature of an illness or other problem by…
examination of the symptoms
Someone reporting hearing voices. This is mark point 2 for
diagnosis definition
Finish the mark point -
Classification is the action or process of classifying something:
the classification of disease according to symptoms
A symptom of SZ is hallucinations. This is mark point 2 for
classification definition
Diagnosis is the i_________________ of the nature of an illness or other problem by e_________________ of the symptoms
identification, examination
The classification of disease is according to…
symptoms
Reliability refers to consistency. This refers to whether we can gain…
consistent results when classifying and diagnosing SZ
The extent to which two or more health professionals would agree on the same diagnosis, regardless of time period or culture is measured by
inter-rater reliability
The extent to which different classification systems agree upon how schizophrenia should be classified is measured by
inter-rater reliability
Validity refers to accuracy, this means
the extent to which we are measuring what we intend to measure (schizophrenia)
An example of validity in classification of schizophrenia might be
whether the classification systems accurately outline the signs and symptoms of schizophrenia
Are the classification systems accurately outlining the signs and symptoms of schizophrenia? This is an example of validity in
the classification of schizophrenia
An example of validity in the diagnosis of schizophrenia might be
whether health professionals accurately diagnose schizophrenia
Are health professionals accurately diagnosing schizophrenia? This is an example of validity in
the diagnosis of schizophrenia
Who investigated the reliability and validity in diagnosis and classification of schizophrenia?
Cheniaux (2009)
How does Cheniaux (2009) show poor inter-rater reliability?
One psychiatrist diagnosed almost double the amount than the other psychiatrist
What did Cheniaux (2009) do to investigate the reliability and validity in diagnosis and classification of schizophrenia?
Asked two psychiatrists to diagnose the same 100 patients using the DSM and ICD
How does Cheniaux (2009) show poor reliability in the classification of schizophrenia?
Both psychiatrists diagnosed almost double the number of patients using the ICD than the DSM
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?
Poor reliability in the classification of schizophrenia, poor validity in the diagnosis of schizophrenia
How does Cheniaux (2009) show poor validity in the diagnosis of schizophrenia?
Both psychiatrists diagnosed almost double the number of patients using the ICD than the DSM
Symptom overlap is where
two or more conditions share similar symptoms
An example of symptom overlap is
both schizophrenia and depression involve negative symptoms such as avolition
Name the key term -
This is where two or more conditions share similar symptoms
Symptom overlap
Name the key term -
This is where two illnesses/conditions occur at the same time
Co-morbidity
Co-morbidity is where
two illnesses/conditions occur at the same time
What other conditions is schizophrenia commonly diagnosed with and why?
Depression and/or OCD as they share common symptoms, i.e. lowered motivation/mood
An example of co-morbidity is
Schizophrenia is commonly diagnosed with other conditions such a depression and/or OCD as they share common symptoms, i.e. lowered motivation/mood
Why is co-morbidity a problem?
It means schizophrenia may not exist as a distinct condition which may lead to misdiagnosis
Schizophrenia may not exist as a distinct condition, which may lead to misdiagnosis. This is a problem of
co-morbidity
How has gender bias been seen in the diagnosis of schizophrenia?
Since the 1980s men have been diagnosed with schizophrenia more often than women
What might be a reason behind men being diagnosed with schizophrenia more often than women?
Men are more genetically vulnerable to developing schizophrenia
What might be a reason behind men being diagnosed with schizophrenia more often than women?
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)
How has culture bias been seen in the diagnosis of schizophrenia?
English people of African origin are much more likely to be diagnosed with schizophrenia in the UK
What might be a reason behind the higher diagnosis rates of English people of African origin in the UK?
Some behaviours classed as positive symptoms of schizophrenia are normal in African cultures (e.g. hearing voices as part of ancestor communication)
Symptom overlap questions the…
validity and reliability of the classification and diagnosis of schizophrenia
Why does symptom overlap question the validity and reliability of the classification and diagnosis of schizophrenia?
Because an individual may be diagnosed with the wrong disorder
As a result of symptom overlap, an individual may be diagnosed with the wrong disorder. What are the consequences of this?
Individuals may not receive appropriate treatment
Which researcher concluded that 50% of patients with schizophrenia are also diagnosed with depression, and 23% of schizophrenia patients are also diagnosed with OCD?
Buckley et al. (2009)
As a result of co-morbidity, doctors may not be diagnosing schizophrenia correctly. What are the consequences of this?
Individuals may not receive appropriate treatment
Women who share similar symptoms as men may not receive the same diagnosis as their symptoms seem mild. What is the issue here?
Gender bias
What is meant by a positive symptom?
An additional experience beyond those of ordinary existence
What is meant by a negative symptom?
A loss of usual abilities and experiences
Define hallucinations (1m)
Unusual sensory experiences that have no basis in reality, they can affect any of the senses
Define delusions (2m)
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
What is meant by avolition?
Severe loss of motivation to carry out everyday tasks and difficulty to begin or keep up with goal-directed activity
Define speech poverty (2m)
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
Define diagnosis (2m)
The identification of the nature of an illness or other problem by examination of the symptoms, i.e. someone reporting hearing voices
Define classification (2m)
The action or process of classifying something: the classification of disease according to symptoms, i.e. a symptom of schizophrenia is hallucinations
What is meant by reliability in the classification of schizophrenia?
The extent to which the ICD and DSM consistently agree upon how schizophrenia should be classified
What is meant by reliability in the diagnosis of schizophrenia?
The extent to which two or more health professionals would consistently agree on the same diagnosis
What is meant by validity in the classification of schizophrenia?
The extent to which the ICD and DSM accurately identify the symptoms of schizophrenia
What is meant by validity in the diagnosis of schizophrenia?
The extent to which two or more health professionals would accurately diagnose schizophrenia, when using the classification systems
How do findings by Cheniaux (2009) show inconsistency in diagnosis?
- 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
How do findings by Cheniaux (2009) show inconsistency in classification?
- 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
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?
Inconsistency in diagnosis (poor reliability in diagnosis)
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?
Inconsistency in classification (poor reliability in classification)
How much more likely are Afro-Caribbeans living in the UK to receive a diagnosis of schizophrenia compared to white Britons?
Ten times
