Clinical Characteristics of Schizophrenia including reliability and validity.


For AQA Psychology a A-Level. (A2)
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Clinical Characteristics of Schizophrenia including reliability and validity.
  1. AO1
    1. Brief facts and figures
      1. 50 times higher risk of attempting suicide
        1. Suicide is number one cause of premature deaths among people with schizophrenia
          1. Over a lifetime, about 1% of the population will develop schizophrenia
          2. DSM-V
            1. Diagnostic and statistical manual of mental disorders 5th edition
              1. Certain groups of symptoms can be classed together as a syndrome
                1. Allows mental disorders to be diagnosed and treated
                2. Selective criteria from DSM-V
                  1. Must have two or more characteristic symptoms present for a significant portion of time
                    1. e.g. delusions, hallucinations, disorganised speech
                    2. Social/occupational dysfunction for a significant portion of time
                      1. Duration: continuos signs of disturbance for at least 6 months
                      2. Positive and negative symptoms
                        1. Positive Symptoms are those that appear to reflect an excess or distortion of normal functions
                          1. e.g. delusions, hallucinations, disrorganied speech
                          2. Negative Symptoms are those that appear to reflect a loss of normal functions
                            1. e.g. effective flattening, alogia, avolition
                        2. AO2
                          1. DSM-V
                            1. Advantage of the DSM-V is that therapies are usually specific to certain disorders so a reliable diagnosis can point to a particular type of therapy
                              1. Disadvantage of the DSM-V is misdiagnosis as if this occurs, it could lead to inappropriate treatment and sometimes, wrongful institutionalisation
                              2. Reliability
                                1. Refers to the consistency of a measuring instrument to asses and diagnosis schizophrenia
                                  1. Inter-rater reliability refers to whether two independent assessors give similar diagnoses
                                    1. Challenges- WHALEY (2001)- found inter-rater reliability correlations in the diagnosis of Schizophrenia as low as +0.11
                                      1. Supports- Jakobsen et al. (2005) took a random sample of 100 danish patients with a history of psychosis and found high sensitivity of inter rater reliability of 93%
                                        1. AO3- Cultural Bias
                                      2. Test-retest reliability refers to whether tests used to deliver these diagnoses are consistent over time
                                        1. Supports- PRESCOTT et al. (1986) analysed the test retest reliability of several measure of attention and information processing in 14 chronic schizophrenics and found performances on these measures were stable over 6 months
                                          1. AO3- Longitudinal
                                    2. Validity
                                      1. Refers to the extent that a diagnosis represents something that is real and distinct from other disorders and that the extent the DSM-V measures what it claims to measure
                                        1. Comorbidity refers to the extent that two or more conditions co-occur. Psychiatric comorbidities are common in schizophrenics including substance abuse, anxiety and symptoms of depression
                                          1. Support- BUCKLEY et al. (2009) estimate that comorbid depression occurs in 50% of patients and 47% of patients also have a lifetime diagnosis of comorbid substance abuse. This creates difficulties in the diagnosis of the disorder as well as treatment.
                                        2. ROSENHANN- being sane in insane places
                                          1. AO3- ethics
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