schizophrenia- symptoms and validity and reliability in diagnosis Flashcards

1
Q

schizophrenia definition

A

a severe mental disorder involving impaired insight and loss of contact with reality, it is a form of psychosis

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2
Q

what are the 2 major classification systems used for psychology and where are they mostly used

A

diagnostic statistical manual (DSM-5) (USA)
world health organisation - international classification of diseases (ICD-11) (europe)

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3
Q

what are the 2 types of symptoms a person with schizophrenia could experience

A

positive and negative

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4
Q

what are positive symptoms of schizophrenia (overall definition)

A

they appear to reflect an excess or distortion of normal functions

ie hightening/more off, they arent positive as in good

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5
Q

what are the 4 positive symptoms of schizophrenia

A

hallucinations
delusions
disorganised speech
grossly diorganised/catatonic behaviour

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6
Q

what are hallucinations

A

they are unreal perceptions of the environment involving any sense, things that other people dont experience.

auditory/hearing voices to eg harm themselves or others.
visual/seeing eg faces, lights
olfactory/smelling eg rotting meat
tactile/feeling eg bugs under skin

Perceiving things happen around us that aren’t real.
usually hearing many voices

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7
Q

what are delusions

A

beliefs that seem real to the person but arent
paranoid- ie persecutory eg being followed/spied on
inflated beliefs- about power/importance believing theyre famous/have special powers.
Of reference- external events appear to be related to themselves eg on TV/radio

Irrational beliefs that are firmly held onto.

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8
Q

what is disorganised speech

A

result of abnormal thought processes which has problems organising thoughts and it shows up in speech

includes:
derailment- slipping from one topic to another even mid sentence
experience “word salad”- extreme incoherence resulting in gibberish

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9
Q

what is grossly disorganised/catatonic behaviour

A

inability/lack of motivation to initiate/finish a task.

difficulties in daily life eg personal hygiene, wearing thick clothes on a hot day, acting bizarre.

catatonic behaviour is reduced reactions to immediate environment eg rigid postured, aimless motor activity

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10
Q

what are the negative symptoms of schizophrenia (4)

A

speech poverty
avolition
affective flattening
anhedonic

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11
Q

what is speech poverty

A

aka alogia

the lessening of speech fluency and productivity (reflecting slowing/blocked thoughts)

you produce fewer words in a given time on a task of verbal fluency eg name as many animals as you can in 1 min. its not about not knowing about them but problem spontaneously producing them
less complex syntax eg fewer clauses

Minimal speech.
Lack of spontaneous, unprompted speech.

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12
Q

what is avolition

A

reduction of interests, desires, inability to initiate and persist in goal directed behaviour

could cause them to just sit in the house for hours everyday.

it isnt about poor social function/disinterest but a reduction in self initiated involvement in activities that are available to the patient

A persistent lack of motivation to complete normal, everyday tasks.

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13
Q

what is affective flattening

A

a reduction in the range and intensity of emotional expression inc facial expression eg decrease in smiling and facial movement

voice tone, eye contact and body language decrease

a decrease in coverbal behaviour ie of hands, head and face movements that accompany speech

decrease in prosody ie prarlinguistic features eg inotation, tempo, loudness and pausing that give cues to listener about emotional and attitudinal content and turn taking

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14
Q

what is Anhedonia

A

a loss of interest or pleasure in all/almost all activites or lack of reactivity to normally pleasurable stimuli

may be persuasive ie all embracing
may be confined to a certain aspect of experience

physical anhedonia is the inability to experience physical pleasures eg food, bodily contact

social anhedonia is inability to experience pleasure from interpersonal situations eg interacting with other people

social anhedonia is associated with other disorders eg depression whereas physical isnt which makes it a more reliable symptom of schizophrenia

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15
Q

Deana stopped leaving her house because, outside, everybody that she walked past said horrible things to her. When she confronted them, they denied it because they didn’t actually say anything. She also didn’t want to go shopping or to see friends, because she couldn’t be bothered to do anything anymore and never had the motivation to do things like she used to.

A

avolition and hallucinations

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16
Q

To be diagnosed with schizophrenia, what do patients need to display? according to the dsm

A

At least 2 of the main symptoms for at least 6 months.

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17
Q

what does reliability mean in terms of schizophrenia diagnosis (general)

A

that multiple doctors are consistent in their diagnosis of a patient, the diagnosis is repeatable

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18
Q

what does inter-rater reliability mean for the diagnosis of schizophrenia

A

different clinicians must reach the same conclusions

measured using the kappa score (1=perf IRR) (0=no agreement) (0.7+ =good)

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19
Q

If several doctors make the same diagnosis, this makes the diagnosis more…

A

reliable

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20
Q

what does test retest mean for the diagnosis of schizophrenia

A

clinicians must be able to reach the same conclusions at two different points in time

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21
Q

when is a diagnosis valid (2 reasons)

A

The doctor doesn’t incorrectly diagnose people who don’t have a particular illness.

The criteria used to make the diagnosis allow us to correctly identify people who have a particular illness.

22
Q

Steph faked some symptoms of a common disorder, described these symptoms to the doctor and received a diagnosis. She then saw a different doctor, who gave the same diagnosis

reliable+/valid

23
Q

Azriel faked some symptoms of a common disorder, described these symptoms to the doctor and received a diagnosis. He then saw a different doctor, who gave a different diagnosis.
reliable+/valid and why

A

neither reliable or valid

As Azriel’s two doctors were not consistent, his diagnosis is not reliable.

Azriel does not have a disorder at all, so his diagnosis was not valid either

24
Q

what did beck say about the changes of the diagnosis of schizophrenia over time

A

in 1962 Beck found that diagnoses were
52% similar
In 2005, researchers found that they were 81⁢% similar.

A diagnosis of schizophrenia is becoming more reliable over time.

25
The doctors in Rosenhan’s study gave the volunteers a diagnosis of schizophrenia when they were actually mentally healthy. What do these diagnoses lack?
validity
26
rosenhans method
Rosenhan got 8 volunteers, who pretended to have schizophrenia, admitted into hospital. Rosenhan tested how long it took doctors to declare that the volunteers were healthy. Rosenhan conducted an observation study they acted normal once admitted
27
rosenhans findings
It took the doctors between 7 and 52 days to realise the diagnoses were wrong, and that the volunteers were healthy. The study showed that the diagnosis of schizophrenia can lack validity. did not lack reliability because the diagnoses were consistent
28
What type of cultural bias it is when someone assumes that other cultures behave the same as their own?
Ethnocentric bias.
29
consequences of cultural bias in diagnosing disorders (2 reasons + overall)
Doctors might be more likely to diagnose someone from another culture with a mental disorder. Two doctors with different cultural backgrounds might give the same patient a different diagnosis. overall reduces the reliability of the diagnosis
30
If a doctor incorrectly diagnoses a patient with schizophrenia, what would this diagnosis lack?
validity
31
When doctors diagnose schizophrenia, they rely on the ..... of their own culture to decide whether a patient’s behaviours match symptoms of schizophrenia. This means they are ..... likely to diagnose schizophrenia in patients who are from a different culture to the doctor’s own. So, cultural bias.... the validity and reliability of a diagnosis.
social norms more reduces
32
what study is used to support culture bias in schizophrenia diagnosis
Cochrane’s
33
In Cochrane’s study, why were Afro-Caribbean people living in Britain being overdiagnosed with schizophrenia due to cultural bias?
Doctors in Britain were judging the patients using the social norms from their own culture.
34
what did Cochrane’s study
Cochrane conducted a review comparing the number of people diagnosed with schizophrenia in the Caribbean and in Britain The overall rate of schizophrenia was similar in the Caribbean and in Britain.
35
what did Cochrane’s find
Afro-Caribbean people were 7 times more likely to be diagnosed with schizophrenia in Britain than in the Caribbean. Cochrane concluded that this was because of cultural bias by British doctors.
36
what is alpha bias
over exaggerating differences in men and womens behaviour
37
what is beta bias
ignoring real differences between men and women
38
Patients with the same symptoms might get different diagnosis depending on their gender, reducing the ..... of the dignosis
reliability
39
If the criteria used to diagnose schizophrenia over or under-exaggerate the differences between men and women, then they won’t correctly identify schizophrenia in all men and women. This reduces the ...... of the diagnosis.
validity
40
effects of alpha and beta bias
Both types of bias can lead to under or over-diagnosis of schizophrenia in women and in men. Under or over-diagnosis due to gender bias can reduce the reliability and the validity of the diagnosis.
41
what study supports for gender bias in the diagnosis of schizophrenia
loring and powell
42
Since the differences between men and women were over-exaggerated in Loring and Powell’s study, what does this mean the doctors were displaying?
alpha bias
43
The diagnoses in Loring and Powell’s study were not consistent. What does this tell us that the diagnoses lacked?
reliability
44
What method was used in Loring and Powell’s study?
They gave male and female doctors identical descriptions of a patient’s symptoms They varied the patient’s gender the doctors (290) were randomly selected
45
in loring and powells study... When the patient was described as female ... % doctors diagnosed the patient with schizophrenia.
20%
46
in loring and powells study... When the patient was described as male ... % doctors diagnosed the patient with schizophrenia.
56%
47
what does loring and powells study indicate that there is
alpha bias in the diagnosis of schizophrenia
48
Explain how cultural bias affects the reliability of a diagnosis.
Cultural bias means that doctors might be more likely to diagnose someone from another culture with a mental disorder. This means that the same patient might get a different diagnosis, depending on the cultural background of their doctor, which would therefore reduce the reliability of the diagnosis because it would not be consistent.
49
How does gender bias affect reliability of diagnosis?
Patients with the same symptoms might get different diagnoses depending on their gender.
50
How does gender bias affect validity of diagnosis?
If the criteria used to diagnose schizophrenia over or under-exaggerate the differences between men and women, then they won’t correctly identify schizophrenia in all men and women.
51