Diagnosis & classification

define classification of mental disorders

The process of organising symptoms into categories based on which symptoms frequently cluster together

define schizophrenia

A severe mental disorder where contact with reality & insight are impaired, an example of psychosis

Schizophrenia is a….

serious mental disorder

The symptoms of schizophrenia…

severely interfere with everyday tasks

What is the ‘split’ in schizophrenia

The split that occurs is between thought and reality

what are the two major systems for the classification of mental disorders?

International Classification of Disease (ICD) & the Diagnostic and Statistical Manual (DSM)

The ICD recognises…whereas the DSM does not

various subtypes of schizophrenia

Under ICD, diagnosis requires…

2 or more positive symptoms to be present for at least 1-month. Only one symptom is required if the delusions are bizarre, or if the hallucinators consist of a voice commenting on the individual's behaviour

Under the DSM diagnosis requires…

the presence of 2 or more symptoms (delusions, hallucinations, disorganised speech, grossly disorganised/catatonic behaviour & negative symptoms) present for a significant portion of time during a 1-month period, at least 1 of the symptoms must be delusions, hallucinations or disorganised speech

What are the types of symptoms of schizophrenia?

positive & negative

define positive symptoms

Atypical symptoms experienced in addition to normal experiences

define hallucinations

A positive symptom of schizophrenia. Are sensory experiences that have either no basis in reality or are distorted perceptions of things that are there

define delusions

A positive symptom of schizophrenia. A falsely held firm belief, even when there is evidence suggesting otherwise

Positive symptoms of schizophrenia are…

additional experiences beyond those of ordinary existence

Hallucinations are…

unusual sensory experience. Some hallucinations are related to events in the environment whilst others bear no relationship to what senses are picking up in the environment

Delusions are also known as…

paranoia

Delusions make people…

behave in a way that makes sense to them, but is bizarre to others

what are the positive symptoms of schizophrenia

Hallucinations, delusions and thought disturbance

define negative symptom

Atypical experiences that represent the loss of a usual experience

define speech poverty

A negative symptom of schizophrenia involving reduced frequency & quality of speech

define avolition

A negative symptom of schizophrenia which involved loss of motivation resulting in lowered activity levels

Negative symptoms of schizophrenia involve…

the loss of usual abilities & experiences

how is speech poverty a symptom of schizophrenia

schizophrenia is characterised by changes in patterns of speech. Speech poverty places an emphasis on reduction in the amount & quality of speech in schizophrenics, which is sometimes accompanied by a delay in a person’s verbal responses during conversation or speech disorganisation where speech becomes incoherent or changes topic mid-sentence

A person experiencing avolition…

may finding it difficult to keep up with a goal-directed activity such as poor hygiene, lack of persistence in work and lack of energy

what are the negative symptoms of schizophrenia

speech poverty, avolition, lack of expressed emotion

what is the argument that the diagnosis of schizophrenia is often low in validity

validity is an important aspect of ensuring the scientific nature of psychology, it refers to accuracy, in terms of diagnosing schizophrenia & how correct the diagnosis is to a person. One way to assess validity is criterion validity; one researcher had two psychiatrists independently assess the same 100 clients using now outdated ICD and DSM criteria. The researcher found that 68 were diagnosed under ICD but only 39 under DSM

what is the argument that there is high reliability in diagnosis of schizophrenia when using modern classification system

reliability is an important aspect of ensuring the scientific nature of psychology. Reliability refers to consistency. One way of checking reliability is through inter-rater reliability, in terms of a psychiatric diagnosis inter-rater reliability is demonstrated when different clinicians reach the same diagnosis for the same person. Prior to DSM-5, reliability for schizophrenia was low, but this has now improved. One researcher reported high reliability for the diagnosis in schizophrenia in 180 individuals using the DSM-5 reaching an inter-rater reliability of +0.97; results are considered acceptably reliable when the correlation coefficient is +0.8 and above

explain the argument schizophrenia diagnosis has co-morbidity  and high symptom

if conditions occur together frequently, this calls into question the validity of their diagnosis and classification as instead of being two separate conditions, they might be a single condition for example, schizophrenia is often diagnosed with other conditions, for example, depression and substance abuse. Furthermore, it has high symptom overlap with other disorders such as bipolar disorder. As both schizophrenia and bipolar disorder include the same positive symptoms (such as delusions) and negative symptoms (such as avolition) suggesting that rather than being two separate disorders, they are variations of a single condition

explain the argument bias in the diagnostic process

diagnosis of schizophrenia is distorted by both gender and culture bias. For example, men are more likely to be diagnosed with schizophrenia. Furthermore, as symptoms (such as hearing voices) have different meanings in different cultures this can lead to discrimination by a culturally biased diagnostic system. For example, in Haiti some people believe that voices are actually communication from ancestors, meaning that whilst in the UK this would constitute as a serious symptom, in Haiti this would not be so