L2 Issues Associated with Classification and Diagnosis of SZ

Question 1

What is Reliability in the context of diagnosing SZ?

Answer 1

• Refers to the consistency of the measuring instrument (the ICD and DSM) in diagnosing SZ
• An example is Inter-Rater Reliability, where two more diagnosticians agree and diagnose SZ

Question 2

What is Validity in the context of diagnosing SZ?

Answer 2

• The extent to which we are measuring what we intend to, whether the ICD and DSM is assessing what it claims to be (SZ)
• If they are both valid we can be sure that those who are diagnosed with SZ actually have SZ

Question 3

What is the Key Study of Cheniaux et al?

Answer 3

• 2 Psychiatrists independently diagnosed 100 patients with the DSM or ICD
• Inter-rater reliability was poor
• One psychiatrist diagnosed 26 (DSM) and 44 (ICD) and the other 13 (DSM) and 24 (ICD)
• Showing poor reliability and validity of diagnosing SZ

Question 4

What is Co-morbidity as an issue?

Answer 4

• A concern of validity
• When two or more mental disorders occur together, meaning they are diagnosed together or co-exist in the individual at the same
• Poses a challenge for classification and diagnosis of SZ as it is hard to distinguish between both disorders, e.g one may suffer SZ and depression at the same time

Question 5

Negative of Co-morbidity?

Answer 5

Too much overlap
- There is too much overlap between schizophrenia, mood disorders and OCD, clinicians need to be sure they have SZ and not something else
- Sometimes may classify a patient as having both SZ and Depression to not have to make a judgement between the two, making diagnosis invalid

Question 6

What is Symptom Overlap as an issue?

Answer 6

• A concern of validity
• Positive and Negative symptoms of SZ can be found in other disorders, e.g depression and bipolar
• Shared symptoms could lead to an unreliable/incorrect diagnosis because the person may show a symptom, e.g delusions which could be diagnosed as SZ but actually be another condition, e.g bipolar disorder

Question 7

Positive of Symptom Overlap?

Answer 7

Use of Brain Scan/EEG’s
- Examining the brain in great detail and check the grey matter in the brain, grey matter is where intelligence is held
- SZ patients tend to suffer from deterioration of the grey matter, this can be checked by brain scan to ensure the correct diagnosis has been made

Question 8

Negative of Symptom Overlap?

Answer 8

• Found evidence of SZ being misdiagnosed as another illness cause of symptom overlap, causing years of delay
• SZ patients do not receive the necessary treatment they need and this can increase the suicide rate and deterioration
• Important that patients get a valid diagnosis in the first place

Question 9

What is Gender Bias as an issue?

Answer 9

• Accuracy of SZ diagnosis can be dependant on the gender of the patient which leads to gender bias occurring
• Male sufferers seem to be show more negative symptoms than women, and suffer more from substance abuse
• Males also have an earlier onset age compared to women, leading to them potentially wrongly being diagnosed

Question 10

Positive of Gender Bias?

Answer 10

• Found female sex hormone estradiol can reduce their vulnerability to SZ
• When paired with anti-psychotic drugs it can be a protective factor present in females, lowering their chances of developing SZ
• Clinicians must take this into account during diagnosis to ensure a valid diagnosis

Question 11

Negative of Gender Bias?

Answer 11

Females develop SZ later
- Validity is in question as females develop SZ 4-10 years later than males
- Males and females are vulnerable to different types of SZ and this must be taken into account when classifying and diagnosing the illness

Question 12

What is Culture Bias as an issue?

Answer 12

When someones culture has an influence on their diagnosis of SZ

Question 13

Key study for culture bias (AO1)?

Answer 13

Davidson and Neale (1994)
- Showed in Asian cultures people are rewarded/praised if they do not show they are suffering from emotional or psychological issues - making them less likely to seek help for SZ
- In Arabic Cultures people are encouraged to show emotions, making it more likely for them to seek help for SZ
- Therefore there is a cultural bias when examining the number of people that suffer from SZ

Question 14

Positive of culture bias?

Answer 14

• Cultural Relativism has support
  
  • Afro-Caribbean people have little immunity to flu and those children born to mothers who had the flu in their second trimester have an 88% increased chance of SZ
  • May be a cultural vulnerability for Afro-Caribbeans in developing SZ, more so than white population

Question 15

Negative of culture bias?

Answer 15

• Cultural Relativism
  
  • Psychologist may not understand the patients symptoms correctly due to not understanding their cultural background, may lead to misdiagnosis of SZ
  • People from an African background may be wrongly diagnosed as they claim to hear voices of God (due to religion)