Validity In Diagnosis

Question 1

Validity in general refers to

Answer 1

Whether something measures what it intends to measure

Question 2

In the context of schizophrenia diagnosis, validity refers to

Answer 2

Whether a patient diagnosed with schizophrenia actually does have the disorder
Whether the classification itself is meaningful

Question 3

Issue with validity

Answer 3

Gender bias

Question 4

Since the 1980s, men have been diagnosed more often than women. While this may be because males are more genetically vulnerable, it could reflect…

Answer 4

Stereotyped beliefs about gender held by clinicians or indeed parents (parents tend to be less tolerant of schizophrenic sons than daughters, causing them to seek treatment earlier.)

Question 5

A negative implication of this issue is that clinicians may be under-diagnosing schizophrenia in women (failing to spot the condition)

Answer 5

This could be due to female patients having good good interpersonal functioning so their symptoms are either masked or appear too mild to warrant diagnosis

Question 6

Research evidence from Loring and Powell suggesting that schizophrenia has a gender bias

Answer 6

Gave psychiatrists patient case stories and asked them to offer their judgment regarding diagnosis using standard criteria, when the patient was described as “male” or gender not mentioned 56% gave a diagnosis compared to only 20% when described as female

Question 7

Issue with validity

Answer 7

Co-morbidity

Question 8

Patients diagnosed with schizophrenia are often diagnosed with another disorder such has depression, anxiety or OCD. This is called comorbidity

Answer 8

Such cases are complex, clinicians are required to diagnose each condition separately.

E.g patients diagnosed with to comorbid disorders would be given what is known as a dual diagnosis

Question 9

A negative implication of this is that comorbid patients are difficult to treat effectively, as it is required to address each diagnosed disorder in the treatment programme

Answer 9

Co-morbid patients may be prescribed numerous drugs this increases the risk of side effects and non compliance

Question 10

Research evidence from Buckley

Answer 10

Identified 50% of schiz patients also had depression 29% ptsd and 23% OCD

If half of schiz patients are also diagnosed with depression, suggest that they are best seen as a single condition.

Raises questions of the validity of schizophrenia as a classification because they could be diagnosing the wrong disorder

Question 11

Issue with validity

Answer 11

Symptom overlap

Question 12

Conditions that have very symptoms to schiz eg delusiojs and hallucinations can occur in BPD and major depression

Answer 12

Because schiz doesn’t have any pathognomic symptoms (exclusive to/only occur in) it can be hard for clinicians to tell it apart from other conditions

Question 13

A positive outcome of this issue. DSM built in a exclusion criteria so clinicians have to rule out certain disorders before diagnosing schiz

Answer 13

Eg symptoms should not be a result of depression, substance or medical condition. Making it more likely the diagnosis of schiz, when given is valid

Question 14

Research evidence from Ellason and Ross

And Schneider

Answer 14

Point out people with dissociative identity disorder actually have more schiz symptoms than people with schiz

Listed the symptoms he believed distinguished schiz from other disorders- first rank symptoms (because of their importance to the diagnosis). Form the basis of the current diagnosis of schiz ICD-10. Argued using these symptoms would make the diagnosis of schiz more valid

Eg delusional perception