Schizophrenia (Paper 3)

What is psychosis?

A severe mental disorder where thoughts and emotions are so impaired contact is lost with external reality

How much of the population does schizophrenia affect?

1% of the population

At what ages is schizophrenia most commonly diagnosed at?

15-35

Who is affected more, men or women?

Men and women are affected equally

Who is **most** likely to be affected?

Working Class young men who live in **urban** areas

What are the two most common symptoms of schizphrenia?

Delusions and Hallucinations

What is a **delusion**?

False beliefs that are firmly held despite being completely illogical, or for which there is no evidence

What is a **delusion of persecution**?

The belief that others want to harm, threaten or manipulate you

What is a **delusion of grandeur**?

This is the idea that you are an important individual, even god-like and have extraordinary powers

What is a **delusion of control**?

Individuals may believe that they are under the control of an alien force that has invaded their mind and/or body.

What is a **Hallucination**?

Disturbances in perception (rather than disturbances in thought). They are false perceptions that have no basis in reality. Many schizophrenics report hearing voices that instruct them to do something that could be harmful to themselves and others.

What is **Speech Poverty?**

Lessening of speech fluency and productivity

What is **Avolition?**

The reduction of, or inability to initiate or persist in goal directed behaviour (i.e completing tasks)

What iis **Catatonic Behaviour?**

When someone is awake but does not seem to respond to other people and their environment

What is meant by **positive symptoms of schizophrenia?**

Reflecting an @@excess or distortion@@ of ‘normal’ functions

What is meant by **negative symptoms of schizophrenia?**

@@Loss@@ of ‘normal’ functioning

Give **3** examples of positive symptoms of schizophrenia

* Delsusions
* Hallucinations
* Disorganised Speech/ behaviour

Give **3** examples of negative symptoms of schizophrenia

* Avolition
* Speech Poverty
* Catatonic Behaviour

What is meant by **reliability** (in context to schizophrenia)?

The **consistency** of a measuring tool i.e the DSM or other tests used in diagnosis - @@a test@@ @@must be valid to be reliable@@

What is **test-retest** reliability?

Doctors must be able to reach the same conclusions about a patient at **two different points in time**

What is **inter-rater** reliability?

Doctors must reach the same conclusion about a patient’s diagnosis when assessed independently.

Outline **Cheniaux et al. (2009)** study into reliability

* Two psychiatrists independently diagnosed 100 patients using the DSM and the ICD
* Doctor 1 diagnosed @@**26** patients with schizophrenia according to the DSM and **44** accoring to the ICD@@
* Doctor 2 diagnosed @@**13** according to the DSM and **24** according to the ICD.@@

What does **Cheniaux et al. (2009)’s** study suggests about reliability in schizophrenia diagnoses?

This suggests that the **inter-rater** reliability of classification systems are unreliable. Firstly using the same classification system (DSM), Doctor 1 diagnosed twice the number of pts and between the ICD and DSM, more pts are classed according to the ICD.

What are the **cultural differences** in diagnoses of schizophrenia?

* *Copeland* found that 69% of US psychiatrist diagnosed a pt description compared to just 2% of Bristiish psychiatrists
* *Luhrmann* found that there was a difference in hearing voices across cultures. In Ghana and India, the voices where seen as @@‘playful’,@@ possibly due to the high spirituality in these cultures. In the US however, the voices were @@violent and agressive@@

What is meant by **validity,** in terms of schizophrenia?

The extent to which a diagnosis is accurate and meaningful - the DSM must measure schizophrenia accuartely.

What does **Cheniaux et al. (2009)’s** study suggests about validity of schizophrenia diagnoses?

It **undermines the validity** of the current classification systems to diagnose schizophrenia due to the fact that results vary so much, that neither can possible be accurate

What is **gender bias,** in terms of schizophrenia?

**When the diagnosis is dependent on the gender of an individual.** This may be due to gender-biased diagnostic criteria or clinicians basing diagnoses on stereotypes about gender

What is **symptom overlap** in terms of schizophrenia?

Many of the symptoms of schizophrenia are **also found in other disorders** such as depression and bipolar disorder.

What is **Co-Morbidity** in terms of schizophrenia?

**The extent to which two or more conditions co-occur.** Schizophrenia often occurs alongside substance abuse, anxiety and depression.

Outline **Rosenhan (1973)’s** study ‘**Sane in Insane Places’** about?

* He went to US psychiatric hospitals, getting 8 ordinary people to claim they could hear voices - **7 of the 8 were admitted**
* In the second experiment, he called the psychiatric hospital warning them some fake patients would be coming in. In fact, there were non but around **10% were suspected as fakes**

What does **Rosenhan (1973)’s** study ‘**Sane in Insane Places’** show, in terms of the validity and reliability of schizophrenia diagnoses?

This shos there is low validity in schizophrenia diagnoses, as the criteria is easily manipulated to be a measure of certain ‘symptoms’

↳ @@A test must be valid for it to be reliable@@

Evaluate **Rosenhan (1973)’s** study ‘**Sane in Insane Places’**

%%Strengths%%

↳ High Value Study

↳ Representative sample

==Weaknesses==

↳ Low Temporal Validity

↳ Unethical: Hospital staff not informed

Explain what is meant by **Heredity** in relation to schizophrenia?

Genetics as an explanation for schizophrenia

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