Schizophrenia - Diagnosis & Classification

Question 1

Positive symptoms

Answer 1

Additional experiences of the disorder beyond ordinary existence

Question 2

Hallucinations

Answer 2

Sensory experiences that don’t truly exist (visual, auditory, gustatory, tactile, olfactory)

Question 3

Delusions

Answer 3

Irrational beliefs that can cause unusual behaviour

Question 4

Disorganised speech/thought

Answer 4

Struggle to coherently speak or think

Question 5

Negative symptoms

Answer 5

Loss of experiences/abilities and detract from ordinary experiences

Question 6

Speech poverty

Answer 6

Reduction in quality & amount of speech (i.e. delayed responses)

Question 7

Avolition

Answer 7

Reduced motivation or difficulty beginning goal-oriented activities

Question 8

Diminished emotional expression

Answer 8

Lack showcasing emotions, no tone or expression changes

Question 9

Rosenhan study 1: Aim & sample

Answer 9

See whether a group of sane people presenting themselves as having a disorder would be diagnosed insane (12 psychiatric hospitals across 5 states)

Question 10

Rosenhan study 1: Research method

Answer 10

8 pseudo-patients inc. Rosenhan, participant observation

Question 11

Rosenhan study 1: Procedure

Answer 11

• Phoned hospital and claimed they were hearing voices (words unlinked with schz - empty, hollow, thud)
• Acted normally once admitted and said no longer experienced symptoms
• Display exemplary beh.

Question 12

Rosenhan study 1: Results & effects of labelling

Answer 12

• All were admitted, all but 1 given schz. diagnosis
• In hospital from 7-52 days
• None were suspected by staff but 35/118 other patients suspected them
• Type 1 error due to being overcautious, interpret normal behaviours as pathological due to diagnosis

Question 13

Rosenhan study 2: Aim & sample

Answer 13

Would psychiatrists/MH workers be undercautious due to the first study (1 of the hospitals from the first study)

Question 14

Rosenhan study 2: Research method

Answer 14

Questionnaire

Question 15

Rosenhan study 2: Procedure

Answer 15

• Staff informed pseudo-patients would be being admitted in the next 3 months
• None were truly presented
• Asked to rate all admitted patents on a 10-point scaled (1/2 being high confidence of pseudo)

Question 16

Rosenhan study 2: Results

Answer 16

193 were admitted
- 41 suspected by at least 1 staff
- 23 suspected by 1 psychiatrist
- 19 suspected by 1 psychiatrist & 1 other staff
Type 2 error - undercautious

Question 17

Rosenhan: Conclusions

Answer 17

Diagnosis was seen as invalid because the sane & insane could not be distinguished from one-another
Could be reliable due to all but 1 in first study recieving same diagnosis
Lack of accuracy in diagnosis has consequences

Question 18

+ Key study findings: Osorio et al

Answer 18

Single diagnostic system is more reliable (180 participants) - inter-rater reliability of diagnosis +0.97, test-retest +0.92

Question 19

• Key study findings: Cheniaux et al

Answer 19

Independent assesment of 100 people using either diagnostic (39 w/DSM, 68 w/ICD) - loses reliability

Question 20

Key study findings: Szasz’s views on MH

Answer 20

• MH is a myth
• Causes stigmatisation
• They are only real with physiological impacts
• Behaviour is not a disease

Question 21

Co-morbidity

Answer 21

Simultaneous existence of multiple disorders alongside a primary disorder

Question 22

Symptom overlap

Answer 22

Symptoms existing for multiple disorders

Question 23

• Buckley et al (co-morbidity/symptom overlap)

Answer 23

50% also have depression, 47% substance abuse, 23% OCD - classification lacks validity

Question 24

• Symptoms of bi-polar (overlap)

Answer 24

Manic episodes (delusions)
Depressive episode (diminished emotional expression, avolition)

Question 25

- Pinto & Jones (ethnicity)

Answer 25

African-Caribbean origin -> 9x more likely to be diagnosed schizophrenic

Question 26

- Fischer & Buchanan (gender)

Answer 26

Men diagnosed more (1.4:1) [Cotton et al - underdiagnosed due to closer relationships with people leading to more support for condition]

Question 27

- Afro-Caribbean views of hallucinations

Answer 27

Interpreted different in Haiti as its considered communication with ancestors (ethnocentric/culturally biased diagnosis)