Berlin has delusions of grandeur - positive symptom of schizophrenia
sychologist names =Red
P
Statistics =Purple
Examples =Green
Important terminology/ information =Orange
,Schizophrenia
Outline the clinical characteristics of schizophrenia
utline and evaluate issues surrounding the classification and diagnosis of schizophrenia, including reliability
O
and validity (16)
utline and evaluate biological explanations for schizophrenia: genetics, the dopamine hypothesis and neural
O
correlates (16)
utline and evaluate psychological explanations for schizophrenia: family dysfunction and cognitive
O
explanations, including dysfunctional thought processing (16)
Outline and evaluate drug therapies for treating schizophrenia: typical and atypical antipsychotics (16)
Outline and evaluate psychological therapies for schizophrenia (16)
Outline and evaluate token economies used in the management of schizophrenia (16)
utline and evaluate the importance of an interactionist approach in explaining and treating schizophrenia
O
(16)
,Outline the clinical characteristics of schizophrenia
A01 - S chizophrenia is a serious mental disorder characterised by a profound disruption to cognition and emotion
- It affects about 1% of the population.
- To make a diagnosis of schizophrenia, a clinician would use the Diagnostic & Manual of Mental Disorders
(DSM-V)
- Under this,two or more (positive or negative) symptomshave to persist for at least 6 months
ositive
P - elusions- bizarre beliefs that seem real to theperson, there are two types; delusions of
D
symptoms persecution (false belief they are being followed) and delusions of grandeur (false belief they
(excess of are powerful and have special powers)
normal - Hallucinations- Unreal perceptions of the environment
functioning) - Disorganised thinking and speech- there are severaltypes:neologisms(newly created
words),word salad(unintelligible mixture of randomwords) andclang(compulsive
rhyming)
egative
N - overty of speech (Alogia)- a reduction in the amountand quality of speech
P
symptoms - Avolition- a reduction in interests and desires aswell as an inability to initiate and persist in
(loss of goal-directed behaviour (e.g. sitting in the house for hours a day)
normal - Affective flattening- a reduction in the range andintensity of emotional expression
functioning)
, Outline and evaluate issues surrounding the classification and diagnosis of schizophrenia, including reliability and validity (16)
A01 Issues with the - alidity refers to the extent to which schizophrenia represents an accurate and real
V
validity of the diagnosis that is distinct from other disorders
classification - However, there are a number of issues:
- Gender bias-when the accuracy of diagnosis is basedon the gender of an
and diagnosis of
individual(e.g. diagnostic criteria may be biasedtowards one gender)or the
SZ clinicians have stereotypical beliefs
- Symptom overlap- SZ has synonyms that are sharedwith other mental health
illnesses such as bipolar and depression
- Co-morbidity- refers to having more than one disorderthat exists alongside a
primary diagnosis. This makes it difficult during diagnosis, but also deciding
what treatments to advise
A03 S upport for - L oring & Powellselected290 male and female psychiatriststo read case studies of
gender bias patients’ behaviour
Loring and - and make a judgement on these people using standardised diagnostic criteria.
Powell
- When the patients were described as male,56% of psychiatristshad a schizophrenia
diagnosis. When patients were described as female, only 20% were given a diagnosis
of schizophrenia.
- This shows how gender bias can impact the accuracy of diagnosing schizophrenia
because it can lead to females being under-diagnosed and males being over-diagnosed.
- Consequently, this could have implications in accessing treatment. If women are
underdiagnosed, they may not receive treatment or receive treatment that is reflective
of a mental health issue that is more stereotyped to females.
E vidence for - Ellason and Rosspointed out that SZ synonyms overlapwith bipolar disorder
symptom
overlap -Ellason
and Ross
E vidence for - uckley et alfound that50% of patients with SZ alsohave a diagnosis of depression
B
comorbidity - - This could lead to someone only being provided one diagnosis, when they have two
Buckley et al separate diagnoses
- If two conditions are co-existing, this could lead to misdiagnosis because the collection
of symptoms may confuse the psychiatrists
A01 Issues with the - eliability can be measured in terms of whether two independent assessors using the
R
reliability of the same classification system give the same diagnosis (inter rater reliability)
classification - A kappa score measure inter rater reliability, a score of 1 would be perfect
and diagnosis of - In the DSM-V trials,SZ had a kappa score of 0.47(Reiger et al.)
SZ -(Reiger et - Culture bias- Culture bias may lead to problems withboth reliability and validity in
al.) diagnosis.
A03 E vidence for - opelandfound that when British and American psychiatristswere given a description
C
cultural bias in of a patient
diagnosis - - 69% of the Americans diagnosed SZ but only 2% of the British did
Copeland
- This suggests diagnosis has very low inter-rater reliability
nreliable
U - symptom of SZ is if delusions are bizarre
A
symptoms - - 50 senior psychiatrists in the US were asked to differentiate between non-bizarre and
Mojtabi and bizarre delusions
Nicholson
- Theinter-rater reliability correlation was 0.40