RELIABILITY AND VALIDITY: COMORBIDITY, SYMPTOM OVERLAP AND CULTURE/GENDER BIAS

Question 2

ICD-10, DSM-5

Answer 2

• According to ICD-10, there are 5 main subtypes of schizophrenia disorder: Disorganised, Catatonic, Paranoid, Undifferentiated, and Residual.
• In the DSM-5 system one positive symptom must be present for diagnosis.
• Under ICD, two or more negative symptoms must be present for a diagnosis to be made only one symptom is needed if the delusions are bizarre, or if the hallucinations consist of a voice commenting on the individual’s behaviour

Question 2

Schizophrenia (SZ)

Answer 2

• is a mental disorder that causes a disconnect from reality, resulting in disruptions to cognition, emotion, language, thought, perception, and sense of self.
• Positive symptoms are additional experiences beyond those of ordinary existence, For example, hallucinations (unusual sensory experiences) and delusions (irrational beliefs).
• Negative symptoms are the loss of usual abilities/experiences.
• They include avolition (loss of interest and motivation) and speech poverty (changes in amount/quality of speech).
• While the negative symptoms are much less dramatic, they tend to last for longer than the positive symptoms

Question 3

One limitation of the classification of SZ- has low inter-rater reliability.

Answer 3

• For example, Cheniaux et al had 2 psychiatrists independently diagnose 100 people using both manuals, and found that psychiatrist 1 diagnosed almost twice as many patients than psychiatrist 2, for both manuals, and that both psychiatrists diagnosed significantly more patients using ICD than DSM.
• This shows that there are flaws with the current system of diagnosis, and can lead to inconsistent and inaccurate diagnoses.
• This is a disadvantage as being wrongly diagnosed and labelled as schizophrenic can have serious consequences in all areas of life, such as employment and relationships.
• Although classification systems for diagnosing disorders are not always reliable,they do provide practitioners with a common language permitting communication of research ideas and findings, which may ultimately lead to a better understanding of the disorder and the development of better treatments.
• Furthermore, evidence does generally suggest that reliability of diagnosis has improved as classifications systems have been updated.

Question 4

One limitation of the classification of SZ is that research to suggest it is unreliable.

Answer 4

• For example, Rosenhan’s study on being ‘Sane In Insane Places’ resulted in his pseudo- patients being admitted, diagnosed and treated, despite having nothing wrong with them, suggesting that diagnosis is influenced by expectations and situational factors.
• And, the only people who suspected the fake patients were other patients.
• This is a disadvantage as receiving an incorrect diagnosis, being labelled, and admitted to a psychiatric hospital could have a self-fulfilling prophecy effect on the patient and lead to a deterioration in their mental health.
• This could lead to people not receiving appropriate treatment, and/or wrong treatment, and therefore decreasing their quality of life

Question 5

A limitation is that norms vary across cultures- they are culturally relative.

Answer 5

• For example, in western cultures hearing voices is a sign of psychosis yet in eastern cultures, particularly African-Caribbean
  cultures, it is considered to be socially acceptable- even a positive thing as it is assumed to be communication with God.
• This results in people from african-caribbean cultures being 7 times more likely to be diagnosed with schizophrenia than westerners.
• This is a disadvantage as classifying and diagnosing schizophrenia cannot be applied cross- culturally.
• Furthermore, this creates difficulties for black people in finding jobs, and so has a negative impact on their wider life, and quality of life