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Flashcards

Schziophrenia

Oliver Philpott Psychology A level English 23 cards

Cards in this deck (23)

  1. 1Classification of SZ.Not a single defining characteristic, more a cluster of symptoms.
    2 major systems for classification or mental disorders, WHO's International Classification of Diseases edition 10 (ICD10)
    & the American Psychiatric Associations Diagnosis and Statistical Manual edition 5 (DSM-5)
  2. 2DSM-5In order to be diagnosed with SZ, a patient must exhibit at least 2 of the following: Delusions, Hallucinations, Disorganised Speach, Disorganised or catatonic behaviour or Negative Symptoms.
    Delusions, Hallucinations or disorganised speech MUST be present, with at least 1 month of active symptoms, with social or occupational deterioration problems.
  3. 3ICD-10Symptoms should be present for most of the time during a psychotic episode last for at least 1 month. At least 1 of the symptoms listed: Thought echo, Delusions of control, Hallucinatory voices, Persistent delusions.
    OR at least 2 of the following: Persistent hallucinations, Neologisms (Breaks in trains of thought), Catatonic behaviour, Negative symptoms.
  4. 4Positive Symptoms.Atypical symptoms experience in addition to normal experiences.
    Hallucinations: unusual sensory experiences, E.g. voices heard, seeing things that aren't there.
    Delusions: AKA paranoia, delusions are irrationa beliefs. Common delusions involve being an important hitsorical, political or religious figures. or, being persuctute by the Govenrment.
  5. 5Negative Symptoms.Atypical experiences that represent the loss of a usual experience such as clear thinking.
    Avolition: a lack of motivation, identified by poor hygiene, lack of persistence in work/school, lack of energy.
    Speech Poverty: A reduction in the amount and quality of speech. Sometimes accompanied by a delay in the sufferer's verbal responses.
  6. 6Reliability in diagnosis and classification.Reliability means consistency of symptoms measurement-inter rater reliability means the extent to which different assessors agree on their assessments.
  7. 7Elie Cheniaux et al on the reliability of diagnosis.2 psychiatrists independently diagnosed 100 patients using the ICD & DSM. Psych1: ICD 44, DSM 26. Psych 2: ICD 24, DSM 24.
    Inter rater reliability was poor, meaning reliability in diagnosing SZ is poor.
  8. 8Soderberg et al & Nilsson et al on the reliability of diagnosis.Soderberg et al reported a concordance rate of 81% using DSM. DSM is regarded as the more reliable classification as its more specific.
    Nilsson et al found only a 60% concordance rate using the ICD classification system, implying DSM is stronger.
    Diagnosis for SZ is stronger than other disorders e.g. SZ 81% concordance vs. anxiety 63% concordance.
  9. 9The validity of classification and diagnosis of SZ.Validity is the extent to which we are measuring what we are intending to measure; in the case of SZ it concerns the accuracy of the diagnosis. Looking at the results of Cheniaux et al study we see that SZ is much more likely to be diagnosed in ICD than DSM, meaning it is either overdiagnosed in ICD or underdiagnosed in DSM
  10. 10Mason et al. on the validity of diagnosis and classification of SZ.Found that more modern classification systems had high predictive validity (if diagnosis leads to successful treatment then the diagnosis is valid), especially if only symptoms that lasted 6 months were considered. This suggests that predictive diagnosis has improved over time, as classification systems have been updated.
  11. 11Confounding evidence to predictive validity strengths.Predictive validity of diagnosis can be argued to be low beacuse there is too much variety in the outcomes of SZ. E.g. Birchwood and Jackson argue that 20% of SZ recover and never have another episode while 10% are so affected they commit suicide. These differences in symptoms and outcomes make it very difficult to establish the validity of the diagnosis system.
  12. 12Symptom overlap.In diagnosing SZ symptoms of the disorder are often found with other disorders which make it difficult to identify the disorder.
    Symptom overlap is common with bipolar disorder (BP) as neg symptoms as well as pos symptoms can occur in both. Under ICD a patient may be diagnosed with SZ but under the DSM BP. This suggests that these disorders may be one.
  13. 13Co-morbitdity.Co-morbidity is when 2 conditions occur at the same time. SZ is commonly diagnosed with depression (50%) substance abuse (47%), PTSD (29%) and OCD (23%). This can pose a problem as it could be that the clinician is just nt god at telling the difference or mayy that severe depression looks like SZ (Visa Versa).
  14. 14Cultural bias in diagnosis.The tendency to over-diagnose members of other cultures as suffering SZ.
    In Britain, those of Afro-Caribbean descent are much more likely to be diagnosed with SZ and confined to secure hospitals.
  15. 15Cochrane on cultural bias.Reported that the incidence of SZ in the West Indies and Britain to be similar (~1%) however those of Afro-Caribbean descent are 7X more likely to be diagnosed with SZ. It could be that there is cultural bias or Afro-Caribbean people in the UK experience more stress from poverty and racism.
  16. 16Whaley on cultural bias.Believes the main reason for the incidence of SZ among black Americans (2.1%) being greater than white Americans (1.4%) is due to ethnic differences in symptom expression which are overlooked or misinterpreted. This suggests a lack of validity in diagnosing SZ cross-culturally.
  17. 17Gender bias in SZ diagnosis.The accepted belief was that males and females were equally vulnerable to the disorder. However, some argue that clinicians (the majority of whom are male) have misapplied diagnosis criteria to women.
  18. 18Lewin at al & Castle et al on gender bias in the diagnosis of SZ.Lewin found that if clearer diagnosis criteria were applied, the no. of female sufferers was much lower. This was supporter by Castle who foudn that using more restrictive diagnostic criteria that the male incidence of the disorder was twice that of males.
  19. 19Gender Bias in SZ.Males tend to suffer more neg symptoms while women are able to continue working and have good relations. This means sometimes women are not diagnosed even though they have the disorder. Also, the disorder manifests at 18-25 in males and 25-35 in females, this is often over looked.
  20. 20Biological explanations for SZ: GeneticsSZ is transmitted by genes passed on to individuals from their families. It is difficult to decipher genetic explanations as family members tend to have similar environments.
  21. 21Gottesman and Kety & Ingraham the Genetic explanation.conducted a large-scale family study and found a strong relationship between the degree of genetic similarity and shared risk of SZ, MZ twins (48%). Kety and Ingraham found prevalence rates of SZ were 10x higher among genetic than adoptive relatives. This suggests genetics play a greater role than environment.
  22. 22Specific genetic explanation.Believed that several genes involved which increase an individual's risk to developing SZ. It is thought to be polygenic as it requires a no. of factors, and aetiologically heterogeneous as different combinations of factors lead to SZ.
  23. 23Evaluation of the genetic explanation.

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A level Psychology (paper 3) Flashcards on Schziophrenia, created by Oliver Philpott on 12/03/2017.
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Oliver Philpott
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