Schizophrenia - diagnosis, classification, symptoms Integrate into c&d essay / ao1 / ao2
AO1
Schizophrenia Symptoms
- A psychotic disorder, a person suffering from
psychosis, + & - symptoms (would detail) Positive symptoms
- Psychotic episode: losing contact with reality - Additional experiences, beyond those of ordinary existence
Prevalence Hallucinations:
- Affects 1% of the population (serious mental disorder) - Unusual sensory experiences
- More common in males, city-dwellers & lower - No basis in reality or distorted perceptions of real things.
socio-economic groups. - Experienced in relation to any sense
Diagnosis - Auditory - hearing voices
- To diagnose the disorder then it must be classified. - Visual - seeing people who aren’t there
- Classification: Identify symptoms that go together, Delusions:
linking to a disorder / what categories exist - Beliefs that have no basis in reality
- Diagnosis: Identify symptoms, use classification - Schizophrenics behave in ways which make sense to them,
systems to identify the disorder / which disorder? but are bizarre to others.
- (OCD, depression, schizophrenia) - EG: being followed /being a victim of a conspiracy
- Classification = catalogue - Paranoid delusions
- Diagnosis = decision
Negative symptoms:
2 main classification systems & their differences - Loss of usual abilities & experiences
DSM-5 (Diagnostic statistical manual Speech poverty
- Used in England & European countries - A reduction in the amount/quality of speech
- 1 positive symptom must be present - Delay in verbal responses.
ICD-11 (International classification of disorders) Avolition:
- Used in America - A severe loss of motivation to carry out everyday tasks
- 2 or more negative symptoms must be present - EG: work / personal care / hobbies
- Emphasis on both negative & positive symptoms - Low activity levels
- Unwillingness to carry out goal-directed behaviours.
, 1 - Reliability & validity in the diagnosis and/or classification of SZ
AO1 AO3
16m structure: Ao3 - Reliability
- AO1 Reliability Diagnosis of sczpnia has good reliability Diagnosis + classification
- AO3 x 2 - Osorio → objective
- AO1 Validity - Osorio et al (2019) reported excellent reliability for SZ
- AO3 x2 diagnosis
- Using the DSM- ppts & 2 independent interviewers
Classification / manuals & symptoms - E: Inter-rater agreement of +.97 / Test-retest reliability of +.92
- ICD - 11: American / 2 or more (-) symptoms - Excellent agreement between clinicians using different
- EG: avolition & speech poverty procedures (both derived from the DSM-5 system)
- DSM - 5: British & European / 1 or more (+) symptoms - T: The diagnosis of schizophrenia is consistently applied.
- EG: hallucinations &delusions
Gender bias Diagnosis
AO1 - Reliability (Consistency) - F & B- females / boys
- Issue of reliability in relation to the classification & diagnosis - Fischer & Buchanan (2017) found men are diagnosed with
of SZ SZ more often than women in a ratio of 1.4 : 1
- Consistency of diagnosis - E: Women have better social support, masking symptoms.
- Reliable diagnosis: Consistent between clinicians - T: Women may go underdiagnosed, meaning they miss out
(inter-rater) / AND between occasions (test-retest) on helpful treatment.
- Objective judgments about symptom presence and severity
- Inter-rater reliability: consistency of diagnoses made by Culture bias Diagnosis
different clinicians / method of assessment - Symptoms like hearing voices is the norm in some cultures -
- Test-retest reliability: consistency between repeats, same in some Afro-Carribean societies, people claim to ‘hear
person, same psychologist voices’ from their ancestors
- Seen as a privilege & a voice of guidance.
- E: Studies suggest that Afro-Carribean men are up to 10x
more likely than white British men to receive a diagnosis.
- UK psychiatrists may overinterpret symptoms, different
clinicians with different expectations of symptoms
- Differing diagnoses → low inter-rater reliability
- T: People in the UK (Afro-Carribean men) may be
discriminated against
- In a culturally-biased diagnostic symptom.
AO1 - Validity (Accurate) Ao3 - Validity
- Issue of validity in relation to the classification & diagnosis of Co-morbidity with other conditions Diagnosis
SZ - E: Buckley et al (2009) concluded SZ is comorbid with
- Extent the diagnosis is accurate & legitimate depression (50% of cases) / substance abuse (47%) / OCD
- Distinct from other disorders. (23%)
- Criterion validity: assesses whether different procedures - High comorbidity (occurence of 2 illnesses/conditions
used to access SZ arrive at the same diagnosis. together)
- Suggests SZ is NOT a single condition, it is commonly
Cheniaux et al (2009) diagnosed with other conditions
- 2 psychiatrists independently assess 100 clients - T: SZ may not exist as a distinct condition
- ICD-11 = 68 diagnosed with SZ - Mental health is a complex area which increases ambiguity in
- DSM-5 = 39 diagnosed with SZ diagnosing SZ
- Low criterion validity = leads to the under/over- diagnosis of Symptom overlap Classification + Diagnosis
SZ - Both sczpnia & bipolar disorder involve delusions and
- ICD-11 is more likely to overdiagnose due to the commonality avolition.
of negative symptoms - Symptom overlap between symptoms of SZ & many other
- EG: avolition (severe loss of motivation) conditions
- Experienced by all people during certain periods - E: They may be the same condition - a classification issue -
as SZ is hard to distinguish from bipolar.
- T: It lacks a unique symptom profile
- If it does exist, it is hard to diagnose
- Differing outcomes using the DSM vs ICD.
AO1
Schizophrenia Symptoms
- A psychotic disorder, a person suffering from
psychosis, + & - symptoms (would detail) Positive symptoms
- Psychotic episode: losing contact with reality - Additional experiences, beyond those of ordinary existence
Prevalence Hallucinations:
- Affects 1% of the population (serious mental disorder) - Unusual sensory experiences
- More common in males, city-dwellers & lower - No basis in reality or distorted perceptions of real things.
socio-economic groups. - Experienced in relation to any sense
Diagnosis - Auditory - hearing voices
- To diagnose the disorder then it must be classified. - Visual - seeing people who aren’t there
- Classification: Identify symptoms that go together, Delusions:
linking to a disorder / what categories exist - Beliefs that have no basis in reality
- Diagnosis: Identify symptoms, use classification - Schizophrenics behave in ways which make sense to them,
systems to identify the disorder / which disorder? but are bizarre to others.
- (OCD, depression, schizophrenia) - EG: being followed /being a victim of a conspiracy
- Classification = catalogue - Paranoid delusions
- Diagnosis = decision
Negative symptoms:
2 main classification systems & their differences - Loss of usual abilities & experiences
DSM-5 (Diagnostic statistical manual Speech poverty
- Used in England & European countries - A reduction in the amount/quality of speech
- 1 positive symptom must be present - Delay in verbal responses.
ICD-11 (International classification of disorders) Avolition:
- Used in America - A severe loss of motivation to carry out everyday tasks
- 2 or more negative symptoms must be present - EG: work / personal care / hobbies
- Emphasis on both negative & positive symptoms - Low activity levels
- Unwillingness to carry out goal-directed behaviours.
, 1 - Reliability & validity in the diagnosis and/or classification of SZ
AO1 AO3
16m structure: Ao3 - Reliability
- AO1 Reliability Diagnosis of sczpnia has good reliability Diagnosis + classification
- AO3 x 2 - Osorio → objective
- AO1 Validity - Osorio et al (2019) reported excellent reliability for SZ
- AO3 x2 diagnosis
- Using the DSM- ppts & 2 independent interviewers
Classification / manuals & symptoms - E: Inter-rater agreement of +.97 / Test-retest reliability of +.92
- ICD - 11: American / 2 or more (-) symptoms - Excellent agreement between clinicians using different
- EG: avolition & speech poverty procedures (both derived from the DSM-5 system)
- DSM - 5: British & European / 1 or more (+) symptoms - T: The diagnosis of schizophrenia is consistently applied.
- EG: hallucinations &delusions
Gender bias Diagnosis
AO1 - Reliability (Consistency) - F & B- females / boys
- Issue of reliability in relation to the classification & diagnosis - Fischer & Buchanan (2017) found men are diagnosed with
of SZ SZ more often than women in a ratio of 1.4 : 1
- Consistency of diagnosis - E: Women have better social support, masking symptoms.
- Reliable diagnosis: Consistent between clinicians - T: Women may go underdiagnosed, meaning they miss out
(inter-rater) / AND between occasions (test-retest) on helpful treatment.
- Objective judgments about symptom presence and severity
- Inter-rater reliability: consistency of diagnoses made by Culture bias Diagnosis
different clinicians / method of assessment - Symptoms like hearing voices is the norm in some cultures -
- Test-retest reliability: consistency between repeats, same in some Afro-Carribean societies, people claim to ‘hear
person, same psychologist voices’ from their ancestors
- Seen as a privilege & a voice of guidance.
- E: Studies suggest that Afro-Carribean men are up to 10x
more likely than white British men to receive a diagnosis.
- UK psychiatrists may overinterpret symptoms, different
clinicians with different expectations of symptoms
- Differing diagnoses → low inter-rater reliability
- T: People in the UK (Afro-Carribean men) may be
discriminated against
- In a culturally-biased diagnostic symptom.
AO1 - Validity (Accurate) Ao3 - Validity
- Issue of validity in relation to the classification & diagnosis of Co-morbidity with other conditions Diagnosis
SZ - E: Buckley et al (2009) concluded SZ is comorbid with
- Extent the diagnosis is accurate & legitimate depression (50% of cases) / substance abuse (47%) / OCD
- Distinct from other disorders. (23%)
- Criterion validity: assesses whether different procedures - High comorbidity (occurence of 2 illnesses/conditions
used to access SZ arrive at the same diagnosis. together)
- Suggests SZ is NOT a single condition, it is commonly
Cheniaux et al (2009) diagnosed with other conditions
- 2 psychiatrists independently assess 100 clients - T: SZ may not exist as a distinct condition
- ICD-11 = 68 diagnosed with SZ - Mental health is a complex area which increases ambiguity in
- DSM-5 = 39 diagnosed with SZ diagnosing SZ
- Low criterion validity = leads to the under/over- diagnosis of Symptom overlap Classification + Diagnosis
SZ - Both sczpnia & bipolar disorder involve delusions and
- ICD-11 is more likely to overdiagnose due to the commonality avolition.
of negative symptoms - Symptom overlap between symptoms of SZ & many other
- EG: avolition (severe loss of motivation) conditions
- Experienced by all people during certain periods - E: They may be the same condition - a classification issue -
as SZ is hard to distinguish from bipolar.
- T: It lacks a unique symptom profile
- If it does exist, it is hard to diagnose
- Differing outcomes using the DSM vs ICD.
