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Summary Classification and Diagnosis of Schizophrenia

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Breakdown of key AO1 & AO3 points to build an essay. A good plan - got me through A levels / Revision. Textbox Style.

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Classification and diagnosis of schizophrenia
AO1 BRIEF: 3 marks
AO3: 1-3 marks
Schizophrenia is a severe mental illness characterised by
Inter-rater reliability is the extent to which different assessors come to
profound Aicore
disruption of cognition and emotion, and occurs in the same conclusion on a particular patient. This is measured by a ‘kappa
about 1% of the population. Positive symptoms of score’, where a score of 0.7 or above indicates good inter-rater reliability.
schizophrenia are additional experiences to normally In the classification of schizophrenia, there is a lack of evidence that the
functioning people, such as hallucinations and delusions. DSM is always being used with high reliability. For example, Whaley
found that inter-rater reliability correlations in the diagnosis of
Hallucinations include hearing voices and delusions are
schizophrenia were as low as 0.11. Rosenhan’s study also demonstrates
irrational beliefs, such as the feeling of being an important issues with the reliability of diagnosing disorders like schizophrenia, as he
historical figure. Negative symptoms of schizophrenia are found that hospitals saw of patients as fake, when they all
those that typical people can do, but a schizophrenic cannot. genuinely had schizophrenia. This means that there are problems with
For example, avolition is reduced motivation to begin / the consistency of classifying schizophrenia, and therefore the diagnosis
maintain goal directed activities in order to achieve a result of the illness lacks reliability.

and speech poverty is a lack of verbal fluency and production.
AO3: 4-6 marks

Culture bias is the tendency for people to make a judgment based on
their particular cultural standards. This is a major limitation of the
AO1 EXPLAIN: 6 marks reliability of classifying schizophrenia, as it reflects people’s personal
views. Hallucinations like hearing voices appear to be influenced by the
The classification of schizophrenia is the process of organising cultural environment. For example, Africa and India reported positive
symptoms into categories. This involves using either the experiences (like receiving advice) with their voices, whereas Americans
International Classification of Diseases (ICD) or the Diagnostic experienced violent and hurtful voices. This suggests that schizophrenia
and Statistical Manual for mental disorders (DSM). When lacks consistent features. To add to this, a study was carried where 69%
using the DSM, positive symptoms like delusions and of Americans diagnosed a particular patient with schizophrenia,
compared to only 2% of British. This again shows culture bias in the
hallucinations must be present for diagnosis whereas the ICD
reliability of diagnosing schizophrenia, which could consequently lead to
requires 2 or more negative symptoms. As well as this, the misdiagnosis and the giving out of wrong treatments, wasting both
DSM groups mental disorders in terms of their common money and time.
features. However, the most recent version of the ICD (most
commonly used) divides symptoms into positive and negative. AO3: 7-8 marks
The diagnosis of schizophrenia is the identification of an
Co-morbidity is an issue for the validity of the diagnosis of mental illness,
illness depending on which category of the classification
referring to the extent that two or more conditions can occur at the same
system the symptoms fall into.
time. For example, anxiety and depression are common in schizophrenics.
Weber calculated hospital comorbidity rates finding that 45% of
schizophrenics had other psychiatric disorders, therefore lowering the
standard of care received. Symptom overlap occurs when two or more
conditions share symptoms, as Ellason and Ross pointed out that those
with dissociative identity disorder have more schizophrenic symptoms
than those with schizophrenia itself. This therefore decreases the validity
of the diagnosis of schizophrenia as it may mean that a patient is wrongly
told that they have a particular disorder. This could have further
consequences like the distribution of wrong medication.
Notes:

Hallucinations: unusual sensory experiences of stimuli that AO3: 9-10 marks
have nothing to do with reality / distorted perceptions of
Gender bias is when the accuracy of diagnosis is dependent on the
environmental events, e.g. hearing voices of critism / seeing gender of an individual. This can vary due to diagnostic criteria or the
distorted facial expressions judgements made by clinicians – e.g. stereotypical beliefs about gender.
Broverman found that clinicians in America equated mentally healthy
Delusions: irrational beliefs that have no relationship with adult behaviour with mentally healthy male behaviour, suggesting that
reality, e.g. the feeling of being an important historical figure there is a tendency for women to be seen as less mentally healthy. This
means that in America women are more likely to be diagnosed with
Catatonic behaviour: the lack of motivation to start / schizophrenia compared to men, as there is an automatic judgement
complete a task, leading to difficulties in daily life and that women are less mentally healthy simply due to their gender.
Consequently, this decreases the validity of the diagnosis of
decreased interest in personal hygiene
schizophrenia and also significantly reduces the consistency and
reliability of the classification system for schizophrenia cross culturally,
Anhedonia: loss of interest in usually pleasurable activities –
due to different cultural views on gender.
an inability to experience pleasure


Word count: AO1: 212, AO3: 513, TOTAL: 725


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