AQA A Level Psychology: Schizophrenia Latest 2023 Graded A+

AQA A Level Psychology: Schizophrenia Latest 2023 Graded A+ What is Schizophrenia? ○ Severe mental disorder characterised by profound disruption of cognition and emotion, affects language, perception, thought, affect and sense of self ○ Thoughts & emotions impaired so contact is lost w/external reality ○ Consists of positive (excess or distortion of normal func) and negative (lack of func, weakens ability to cope in everyday activities) symptoms How is SZ diagnosed? ○ DSM - V (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) used in US while Europe ICD (International Classification of Diseases) is more commonly used (11th version) ◘ Person must have experienced at least 2 symptoms (hallucinations, delusions, organised speech, catatonic behavi, neg symp) or only 1 if symp. is bizarre/persistent hallucinations which affects social functioning & is persistent for 6 mnths w/at least 1 mnth of active symptoms ○ Positive Symptoms: ◘ Hallucinations; bizarre, unreal perceptions of enviro can be auditory, visual, olfactory (smell) or tactile (feeling) ◘ Delusions; bizarre beliefs that seem real to person, can be paranoid in nature (e.g. feeling of being spied on/followed), may involve inflated beliefs (delusions of grandeur), delusions of reference (events directly related to them e.g. 'personal' msgs over TV/radio) ◘ Disorganised speech; abnormal thought process, unable to organise own thoughts and shows up in speech, slip from one topic to another (Derailment), sometimes incoherent (word salad) ◘ Grossly disorganised or catatonic behaviour; inability/motivation to initiate task/complete, rigid postures, aimless motor activity ○ Negative Symptoms: ◘ Speech poverty (alogia); lessening of speech fluency and productivity, reflect slow/blocked thoughts, fewer words in given time ◘ Avolition; reduction of interests/desires, inability to initiate/persist in goal-directed behave, reduction in self-initiated involvement in activities available to patient ◘ Affective flattening; reduction in range/intensity of emotional expression, fewer body/facial movements, deficit in prosody (intonation, tempo, loudness and pausing) ◘ Anhedonia; loss of interest/pleasure in all activities/lack of reactivity to normally pleasurable stimuli, physical (food, bodily contact etc), social (interpersonal situations) How reliable is SZ diagnosis? ○ Consistency of measurements, diagnostic reliability requires diagnosis to be repeatable (clinicians reach same conclusion at 2 diff points in time or diff clinicians), inter-rater reliability of 0.7 or above good (DSM-V had kappa score of only .46) Copeland did study consisting of 134 US and 194 British psychiatrists, all given patient description 69% of US diagnosed SZ, only 2% of Brit Luhrmann; 60 diagnosed adults, 20 from Ghana, India and US, only US voices were negative, violent and hateful, rest found voices to be 'playful' (indicates cult diff) Lil evid that DSM has high reliability, Whale found inter-rate reliability as low as 0.11 Rosenhan's 'sane in insane places' study shows that those labelled w/SZ, tho displaying no symptoms, were stuck w/label 50 senior psychiatrists asked to differentiate between bizarre and non-bizarre delusions, produced inter-reliability correlations of 0.4 Brekke and Barrio found evid for cult differences, 184 indiv diagnosed from min groups and maj group, ethnic min tend to experience less distress associated w/mental disorders How valid is SZ diagnosis? ○ Extent diagnosis represents reality and clear distinction from other disorders, to what extent does the classification system measures what is says it measure? ○ Gender Bias: ◘ Accuracy of diagnosis is dependent on gender ◘ Gender-biased diagnostic criteria, clinicians base judgements on stereotypes ◘ Some DSM criteria biased towards pathologising one gender ◘ Broverman argues that US defintions equated mentally healthy adult behaviour with mentally healthy male behavi ○ Symptom Overlap: ◘ Symptoms appear in other disorders e.g. depression and bipolar disorder ◘ Ellason and Ross found ppl with dissociative identity disorder have more SZ symptoms than actual schizophrenics ◘ Most people can receive at least one other diagnosis ○ Co-morbidity: ◘ Extent that 2+ cond co-occur ◘ Psychiatric co-morbidities common among SZ e.g. substance abuse, anxiety and depression ◘ Buckley; co-morbid depression occurs in 50% of ptnts, 47% substance abuse ◘ Swetz's meta-analysis found 12% of patients with SZ fulfilled diagnostic criteria of OCD and 25% had obsessive-compulsive symptoms / Loring and Powell; 290 male and female psychiatrists read 2 case vignettes of ptnt behavi, asked to offer judgement, when pnt male/no info about gender 56% diagnose, when female only 20%, tho this division was not as evident among female psychiatrists US study, 6 mill hosp records, 45% co-morbidity, also in non-psych diagnosis, diagnosed with SZ also diagnosed w/hypothyrodisism, asthma, hypertension and type 2 diabetes Prognosis varied 20% recover prev levl of func, 10% sign and lasting improve, 30% some improve ses (Diagnosis has lil pred validity) Outline the Genetic Hypothesis in explaining SZ ○ Gottesman 1991, look to determine whether there is genetic link in onset of SZ as it is more common among biological relatives of person with SZ ○ Closer degree of relatedness, greater concordance