schizophrenia- symptoms and validity and reliability in diagnosis

Question 1

schizophrenia definition

Answer 1

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

Question 2

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

Answer 2

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

Question 3

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

Answer 3

positive and negative

Question 4

what are positive symptoms of schizophrenia (overall definition)

Answer 4

they appear to reflect an excess or distortion of normal functions

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

Question 5

what are the 4 positive symptoms of schizophrenia

Answer 5

hallucinations
delusions
disorganised speech
grossly diorganised/catatonic behaviour

Question 6

what are hallucinations

Answer 6

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

Question 7

what are delusions

Answer 7

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.

Question 8

what is disorganised speech

Answer 8

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

Question 9

what is grossly disorganised/catatonic behaviour

Answer 9

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

Question 10

what are the negative symptoms of schizophrenia (4)

Answer 10

speech poverty
avolition
affective flattening
anhedonic

Question 11

what is speech poverty

Answer 11

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.

Question 12

what is avolition

Answer 12

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.

Question 13

what is affective flattening

Answer 13

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

Question 14

what is Anhedonia

Answer 14

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

Question 15

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.

Answer 15

avolition and hallucinations

Question 16

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

Answer 16

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

Question 17

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

Answer 17

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

Question 18

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

Answer 18

different clinicians must reach the same conclusions

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

Question 19

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

Answer 19

reliable

Question 20

what does test retest mean for the diagnosis of schizophrenia

Answer 20

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

Question 21

when is a diagnosis valid (2 reasons)

Answer 21

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.

Question 22

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

Answer 22

reliable

Question 23

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

Answer 23

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

Question 24

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

Answer 24

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.

Question 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?

Answer 25

validity

Question 26

rosenhans method

Answer 26

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

Question 27

rosenhans findings

Answer 27

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

Question 28

What type of cultural bias it is when someone assumes that other cultures behave the same as their own?

Answer 28

Ethnocentric bias.

Question 29

consequences of cultural bias in diagnosing disorders (2 reasons + overall)

Answer 29

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

Question 30

If a doctor incorrectly diagnoses a patient with schizophrenia, what would this diagnosis lack?

Answer 30

validity

Question 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.

Answer 31

social norms more reduces

Question 32

what study is used to support culture bias in schizophrenia diagnosis

Answer 32

Cochrane’s

Question 33

In Cochrane’s study, why were Afro-Caribbean people living in Britain being overdiagnosed with schizophrenia due to cultural bias?

Answer 33

Doctors in Britain were judging the patients using the social norms from their own culture.

Question 34

what did Cochrane’s study

Answer 34

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.

Question 35

what did Cochrane’s find

Answer 35

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.

Question 36

what is alpha bias

Answer 36

over exaggerating differences in men and womens behaviour

Question 37

what is beta bias

Answer 37

ignoring real differences between men and women

Question 38

Patients with the same symptoms might get different diagnosis depending on their gender, reducing the ..... of the dignosis

Answer 38

reliability

Question 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.

Answer 39

validity

Question 40

effects of alpha and beta bias

Answer 40

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.

Question 41

what study supports for gender bias in the diagnosis of schizophrenia

Answer 41

loring and powell

Question 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?

Answer 42

alpha bias

Question 43

The diagnoses in Loring and Powell’s study were not consistent. What does this tell us that the diagnoses lacked?

Answer 43

reliability

Question 44

What method was used in Loring and Powell’s study?

Answer 44

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

Question 45

in loring and powells study... When the patient was described as female ... % doctors diagnosed the patient with schizophrenia.

Answer 45

20%

Question 46

in loring and powells study... When the patient was described as male ... % doctors diagnosed the patient with schizophrenia.

Answer 46

56%

Question 47

what does loring and powells study indicate that there is

Answer 47

alpha bias in the diagnosis of schizophrenia

Question 48

Explain how cultural bias affects the reliability of a diagnosis.

Answer 48

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.

Question 49

How does gender bias affect reliability of diagnosis?

Answer 49

Patients with the same symptoms might get different diagnoses depending on their gender.

Question 50

How does gender bias affect validity of diagnosis?

Answer 50

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.