Schizophrenia: Classifications

Question 1

What are positive symptoms?

Answer 1

Atypical symptoms experienced in addition to normal experiences e.g. hallucinations, delusions.

Question 2

What are negative symptoms?

Answer 2

Atypical experiences that represent the loss of a usual experience e.g. loss of clear thinking, loss of motivation.

Question 3

Explain the diagnosis and classification of SZ:

Answer 3

• DSM-5 or ICD-10 is used. They are slightly different in their diagnosis of SZ.
• The DSM-5 requires one positive symptom to be shown for SZ diagnosis, whereas the ICD-10 requires two negative symptoms for SZ diagnosis.
• Previous editions of the DSM-5 and ICD-10 recognsied subgroups of schizophrena e.g. paranoid SZ involved mainly powerful hallucinations and delusions.
• These subtypes have been dropped becuase they tended to be inconsistent e.g. someone with a diagnosis of paranoid SZ would not neecessarily show the same symptoms a few years later.

Question 4

What are the 2 main positive symptoms of SZ? Explain what the two actually are:

Answer 4

Hallucinations:
- Unusual sensory experiences that can be related or unrelated to the environment the individual is in e.g. voices can be heard talking to or commenting on a person.
- Hallucinations can be experienced in any sense e.g. they may see distorted facial features or people/animals that are not actually there.

Delusions:
- Also known as paranoia, they are irrational beliefs that can take a range of forms.
- Common delusions include being an important historical or political figure, such as Jesus.
- Delusions commonly involve being persecuted e.g,. by the government or aliens.
- Delusions may make a person believe that they are under external control. they can make a person behave in ways that make sense to them but seem bizarre to others.

Question 5

What are the 2 main negative symptoms of SZ? Explain what they actually are:

Answer 5

Speech poverty:
- There is an emphasis on reduction in the amount of speech and the quality of it.
- Sometimes accompanied by a delay in a persons verbal responses during convesation.
- Emphasis is placed on speech disorganisation in which speech becomes incoherent or the topic changes mid-sentence.

Avolition:
- Also known as apathy, finding it difficult to begin or keep up with goal-directed activities.
- SZ individuals often experience a lack of motivation to carry out daily activities.
- 3 signs of avolition were identified: poor hygiene and grooming, lack of persistence in work, and lack of energy.

Question 6

What are the 4 evaluation points for the diagnosis and classification of SZ?

Answer 6

1) Good reliability (S)
2) Co-morbidity (L)
3) Gender bias (L)
4) Culture bias (L)

Question 7

Explain good reliability (S) as an evaluation point for the diagnosis and classification of SZ:

Answer 7

• A strength is that it has good reliability
• A psychological diagnosis is said to be reliable when different diagnosing clinicians reach the same diagnosis for the same individuals (inter-rater reliability) AND when the same diagnosing clinicians reach the same diagnosis twice for the same individual (test-retest reliability).
• Priopr to the DSM-5 the reliability for SZ diagnosis was low but has now improved. Osorio et al reports excellent reliability for diagnosis of SZ in 180 individuals using the DSM-5. Pairs of interviewers had a reliability of around +o.95
• Suggests that wr can reasonably sure that the diagnosis of SZ is consistently applied.

Question 8

Explain co-morbidity (L) as an evaluation point for the diagnosis and classification of SZ:

Answer 8

• A limitation is that there is a risk of co-morbidity when diagnosising SZ.
• If conditions occur together a lot of the time then this questions the validity of their diagnosis as they may actually be a single condition.
• SZ is commonly diagnosed with other conditions- e.g. half of those diagnosed with SZ also had a diagnosis of depression or substance abuse.
• This is a problem for classification because it means SZ may not exist as a distinct condition, which is a problem for diagnosis as at least some people diagnosed with SZ may have unusual cases of conditions such as depression.

Question 9

Explain gender bias (L) as an evaluation point for the diagnosis and classification of SZ:

Answer 9

• A limitation in the diagnosis of SZ is the existence of gender bias.
• Since the 1980s men have been diagnosed with SZ more than women (1.4:1).
• One possible explanation for this is that women are less vulnerable than men, perhaps due to genetic factors.
• It seems more likely that women are under-diagnosed because they have closer relationships and hence get support. This leads to women with SZ often function better than men.
• This under-diagnosis is a gender bias and means women may not therefore be recieving treatment and services that may benefit them.

Question 10

Explain culture bias (L) as an evaluation point for the diagnosis and classification of SZ:

Answer 10

• A limitation is the existence of culture bias.
• Some symptoms of SZ, particularly hearing voices, have different meanings in different cultures.
• E.g. some people in Haiti believe the voices are communications from ancestors . British people of African-Caribbean origin are up to x9 as likely to receive a diagnosis of SZ compared to white British people, although people living in African-Caribbean countries are not; ruling out a genetic vulnerability.
• The most likely explanation for this is culture bias in diagnosis of clients by psychiatrists from a different cultural background. This leads to an over-interpretation of symptoms in black British people.
• Suggests that British African- Caribbean people may be discriminated against by a culturally bias diagnosistic system.