sz Flashcards
schizophrenia is defined as
” a psychotic disorder marked by severely impaired thinking,emotions, and behaviours. schizophrenic patients are typically unable to filter sensory stimuli and may have enhanced perceptions of sounds , colours and other features of their environment “
sufferes may experience either
negative or positive symptoms or both
positive symptoms enhance the
typical experience of sufferers and occur in addition to their normal experiences ie hallucinations and delusions
negative symptoms take away from the
typical experience of sufferers and so represents a loss of experiences ie speech poverty and avoloition
hallucinations
a positive symptom of sz which is characterised by a distorted view/perception of real stimuli or perceptions of stimuli which have no basis in reality
auditory hallucinations
may involve hallucinating the voices of loved ones or deceased and are of example through to be caused by an excess of dopamine receptors in brocas area (a neural correlate)
delusions
A positive symptom of schizophrenia and are a set of beliefs with no basis in reality at all ie the sufferer may be paranoid that they are being stalked by the Royal Family.
Different types of delusions include
persecutory, delusions of grandeur, delusional jealousy, erotonomania and somatic delusional disorders.
speech poverty
A negative symptom of schizophrenia which occurs when there is an abnormally low level of the frequency and quality of speech.
A common type of speech poverty is ‘derailment’, which is thought to be caused by dysfunctions in central control (Frith et al, 1992) and so
the sufferer cannot suppress the automatic associations that come with each new word or idea.
avolition
A subjective reduction in interests, desires and goals and a behavioural reduction of self-initiated and purposeful acts, including motivational deficits”. Therefore, avolition means the inability to cope with the normal pressures and motivations associated with everyday living and day- to-day tasks.
there are two types of classification systems for mental disorders
the diagnostic and statistical manual (DSM-V) and the International classification of disease (ICD-10)
these two systems have diffrent requirements for the diagnosis of sz , both require persistence for at least 1 month , the DSM-5 has more
specific diagnostic criteria and so requires at least 2 or more of delusions , hallucinations , disorganised speech and catatonic behaviour , whereas the ICD-10 takes a broader approach to diagnosis , simply stating that “ the clinical picot is dominated by relatively stable , often paranoid delusions , usually accomppoined by hallucinations “
therefore the main differences between the DSM and the ICD is in terms of what organisations produce them
the WHO or the American Psychatriac Association
The number of symptoms
Specificity of symptoms required for diagnosis
Recognition of different subtypes of sz
there are different subtypes of sz , for example positive sz is seen as having the symptoms of prominent delusions , hallucinations and positive formal thought disorders , on the other hand in mixed sz
the prominent symptoms are either both negative and positive or neither is prominent
subtypes are currently recognised in the ICD-10 only whereas
previous editions of the DSM also made these distinctions
- there is significant co-morbidity
between sz and other mental health disorders such as OCD and post traumatic stress disorder as suggested by Buckley et al . These researchers found that 29% of their sz patients suffered from PTSD , whilst 50% suffered depression . Particularly in the case of depression this shows that if
sz is so frequently diagnosed with other psychiatric disorders than these two disorders may actually be the same , and so a more accurate and valid method of diagnosis would be to combine these two. Therefore these are issues of validity in the diagnosis of sz and attempting to differentiate its symptoms from that of other disorders.
- there may be gender bias in the diagnosis of sz
as suggested by Longenecker et al who could not find an explanation for the sudden increase in the number of male sz diagnoses made after 1980s , cotton et al suggests that because there are no differences in genetic susceptibility for men and women in terms of sz , thus gender bias must to be to blame. dispositional traits of most women , such as
high interpersonal functioning and being able to work even when suffering , means that such traits may mask the symptoms of sz or distort their severity so that they are not serious enough to call for a diagnosis. this means that the current system of the diagnosis of sz does not account for these biases or differences in functioning between men and women , increasing the likelihood of inaccurate diagnoses.
- a second type of bias which may reduce the validity of the diagnosis of sz is the problem of cultural bias
as suggested by Escobar et al , for example African Americans are far more likely to be diagnosed with sz compared to patients belonging to western cultures , due to their increased openness about admitting to certain sz symptoms which may appear normal in their respective cultures . for example the phenomenon of hearing voices may be considered
a desirable sign of increased spirituality and connectedness with ancestors and so may even be encouraged . however both classification systems would view this as a hallmark characteristic of sz and combined with the potential distrust in African Americans that white psychiatrists may have , could increase the likelihood of false diagnoses
