AQA A level Psychology- Schizophrenia

AQA A level Psychology- Schizophrenia Terms in this set (111) What is schizophrenia? Schizophrenia is a serious mental illness/psychotic disorder that affects 1% of the population. It is characterized by disorientation and disorganized patterns of thinking, as it distorts contact with reality and impairs a person's insight. Give few key points regarding schizophrenia - Schizophrenia is often diagnosed between the ages of 15 and 35 - Tends to 'affect' men more than women (men are more likely to be diagnosed with schizophrenia) - More prevalent in city dwellers - More prevalent in people of lower economic status - More likely to be diagnosed in black people (link to cultural issues) What is the validity in the diagnosis of SZ? the extent to which schizophrenia is a unique syndrome with characteristics, signs and symptoms What is the reliability in the diagnosis of SZ? level of agreement on the diagnosis by different psychiatrists across time and cultures; stability of diagnosis over time given no change in symptoms What is classification of schizophrenia? Identifying patterns of behaviour or mental symptoms that reliably occur together to form a type of disorder. What are the four purposes of classification of schizophrenia? Communication- Enables psychiatrists, doctors and psychologists to identify and talk more easily about a group of similar individuals. Diagnosis/Prediction- Prediction of how the condition develops. Investigation- Research can be organised to determine the causes of the disorder. Treatments- Allows suitable treatments to provided to help the patient. What is the diagnosis of schizophrenia, and the four different sub-types? Schizophrenia is a split between a persons thought processes and reality. Disorganised- Disorganised speech/behaviour. Catatonic- Immobility/excessive activity. Paranoid- Preoccupation with delusions or frequent auditory hallucinations. Undifferentiated- Variation between symptoms, not fitting in to one type. What are the positive symptoms of schizophrenia? Symptoms which add to your psyche. Hallucinations- Perceptions of stimuli that are not actually present (Auditory/visual). Delusions- False beliefs which are held despite obvious contrary evidence. Delusion of Grandeur- E.G. I am Napoleon. Delusion of Reference- E.G. Song lyrics directed at me. Delusion of Persecution- E.G. You're all out to get me. Delusion of Control- E.G. Being manipulated/controlled by external forces. What are negative symptoms of schizophrenia? Symptoms which take away from a normal psyche. - speech poverty and avolition on spec Speech poverty- Monosyllabic, using fewer words. Social withdrawal- Withdrawn from family/friends. Flattening of effect- Lack of expression in face/voice. Avolotion - lack of purposeful, willed behaviour Disorganised thinking- By thought insertion, somebody inserting thoughts into the mind. Avolition- Find it difficult to keep up with goal directed behaviour. e.g lack of motivation to keep hygiene etc. What is the DSM-5 criteria for classifying schizophrenia? The American manual for classifying schizophrenia. Requires persistence of 2 or more symptoms for at least 1 month including at least one positive symptom such as hallucinations, delusions, or disorganised speech, with evidence of disturbance for at least six months What is the ICD-11 criteria for classifying schizophrenia? The manual for classifying schizophrenia used in the rest of the world. emphasises negative symptoms, requiring at least two over a one-month period. What are the different techniques to diagnosing schizophrenia? Abnormality tends to be viewed in one of two ways... Categorical approach- Sees abnormality as either yes/no. Dimensional approach- Sees abnormality as stretching along a continuum. There are often four ways to observing and diagnosing somebody with schizophrenia, each possibly giving different diagnoses: Behavioural observation- Rating scales/ behaviour coding. Clinical interview Psychological tests- IQ/Personality tests. Physiological tests- Brain scanning. What is the reliability of classification of schizophrenia? Refers to whether psychologists consistently make the same diagnosis on patients with schizophrenia. Inter- rater reliability: Two or more clinicians agree to diagnose a patient with schizophrenia. Test-retest reliability- When the same clinicians reaches the same diagnosis of SZ on the individual on two separate occasions. Diagnosis of Schizophrenia: supporting evidence for DSM-5 - One strength of the diagnosis of schizophrenia is its high inter-rater reliability. - For example, Flávia Osório et al. (2019) reported excellent reliability for the diagnosis of schizophrenia in 180 individuals using the DSM-5, with an inter-rater reliability of +0.97, and test retest reliability of +0.92. - This is a strength because it suggests different clinicians reached the same diagnosis for the same individuals, and individual clinicians consistently meet the same conclusions. - Consequently, diagnosis is more likely to be applied consistently, regardless of who is making the diagnosis or when it occurs. This reduces the potential for misdiagnosis and ensures more accurate treatment plans for individuals diagnosed with schizophrenia. Diagnosis of Schizophrenia: cultural bias - a weakness of the diagnosis of schizophrenia is its low reliability when considered across cultures - For example, positive symptoms classified by the ICD-10 and DSM-5 include hallucinations, but this may not be applicable to all cultures. - Luhrman found that African and Indian patients reported the voices to be more positive and offering advice, in comparison to violent and hateful voices common in western cultures. - This may be due to the fact that positive symptoms such as hearing voices may be more acceptable in African cultures, meaning people are more open about these experiences. - This is an issue because diagnosis will not be consistent across cultures, and suggests diagnosis's may be measuring cultural discrepancies, reducing the validity of diagnosis's - as a result, classifications of schizophrenia can be criticised for being ethnocentric and may be an imposed etic Diagnosis of Schizophrenia: symptom overlap - a weakness of schizophrenia diagnosis is symptom overlap with other conditions for example, there is considerable overlap between the symptoms of schizophrenia and other mental health disorders, such as bipolar disorder - both share positive symptoms, such as delusions, and negative symptoms, such as avolition (lack of motivation) - this is a weakness as the overlap challenges the classification of schizophrenia as a distinct disorder; for example, it could suggest that schizophrenia and bipolar disorder are not separate conditions but variations of a single disorder. - as a result, clinicians may struggle to distinguish between the two, leading to potential misdiagnoses, which may lead to incorrect treatments Diagnosis of Schizophrenia: gender bias - The diagnosis of schizophrenia can be criticised for beta bias, which consequently reduces its validity. - For example, Cotton et al. (2009) found that women with schizophrenia tend to function better than men, such as being able to maintain good family relationships This higher level of functioning may cause psychologists to overlook the diagnosis in women, as their symptoms are often masked by their ability to maintain social functioning - This is a weakness as it means women are underdiagnosed or misdiagnosed, and men are more likely to receive a diagnosis despite the two genders possibly experiencing similar symptoms. - Consequently, patients may be subject to incorrect treatment plans, and women may have worse recovery prospects Diagnosis of Schizophrenia: comorbidity - A further limitation of diagnosing schizophrenia is that there is supporting research for low validity due to co-morbidity. - For example, Buckley found that around half of patients with a diagnosis of schizophrenia also have a diagnosis of depression (50%) or substance abuse (47%). PTSD also occurred in 29% of cases and OCD in 23%. - This questions validity of the classification and diagnosis of both illnesses. - If many patients are diagnosed with both conditions, psychiatrists may not be able to tell the difference between the two conditions. - Therefore, as disorders commonly occur together it questions whether schizophrenia classification should be a whole new disorder that encompasses both schizophrenia and depressive symptoms. Diagnosis of Schizophrenia: implications - A significant weakness of the misdiagnosis of schizophrenia is its potential impact on treatment, which can lead to inappropriate or ineffective interventions. - Misdiagnosis can result in individuals receiving the wrong type of treatment, which may not address their actual needs. - This is a problem because incorrect treatment not only fails to improve the individual's condition but can also cause harm, leading to a lower quality of life and increased healthcare costs. - Moreover, the label of schizophrenia may lead the individual to accept the diagnosis and conform to the expected behaviors associated with it, fulfilling the prophecy of being "mentally ill," which can worsen their overall mental health. What research shows the diagnosis of SZ to be reliable/ unreliable? Reliable- Osorio et al, excellent agreement between clinicians when they both came from diagnosing from same system. Points to a single diagnostic system. Pairs of interviewers achieved inter-rater reliabilty of +.97 and test-retest reliability of +.92. Unreliable- Cooper, SZ had a reliability of just 46% in the DSM-5 trial. Shows that almost 1/2 patients do not get diagnosed correctly. What is validity of diagnosis of schizophrenia? Refers to the extent to which a diagnosis genuinely reflects the underlying mental disorder. Aetiological validity- Does the diagnosis reflect known causes of the disorder, E.g. Family history of SZ. Concurrent validity- The extent two which different diagnostic tools agree on the same disorder. Predictive validity- The extent to which a diagnosis can predict future behaviour. What research shows the diagnosis of schizophrenia to be valid/not valid? Not valid- Cheniaux et al- Two psychologists assessed 100 clients using the DSM/ICD system. 68 were diagnosed under the ICD and 39 under the DSM. Rosenhan- Investigated whether psychiatrists could distinguish between 8 sane pseudo patients and the insane. Found that all of the pseudo patients were admitted into hospital with the diagnosis of SZ, based on only one symptom, hearing voices, empty, hollow, thud. Suggests SZ is either over/under diagnosed according to the diagnostic system used. Description of Rosenhan's sane in insane places study into the diagnosis of SZ Aim was to investigate whether psychiatrists could distinguish 8 sane pseudo patients from the insane. 8 Pseudo patients, 5 men and 3 women went to 12 different across 5 states in the US reporting they heard 3 words (Empty/hollow/thud.) All of the pseudo patients were admitted with SZ except one with manic depression. The staff didn't notice that they were normal even though other patients suspected they were sane. This study made people distrust psychiatry and the catalyst to change conditions within the mental asylum institutes. Follow up study sending more psuedopatients and had to guess, reality was all of them were real and 43 called pseudo patients.