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27 Cards in this Set
- Front
- Back
- 3rd side (hint)
What is schizophrenia?
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- Mental disorder - 1% of world's population suffer - commonly around the age of 15-35. - Affects sufferer's thought processes, physical functions & perceptions of reality. - Symptoms can vary in type & severity. - Some sufferers only encounter symptoms sporadically, while others suffer more persistently. |
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Define 'positive symptoms' & give 3 examples.
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Symptoms in addition to normal functioning. - Hallucinations - Delusions - Catatonic Behaviour
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Outline Hallucinations: Positive Symptom |
Unusual perceptions of the environment stimuli unique to the individual, which no one else can perceive. - Usually auditory but other times visual, olfactory (disgusting smells) or tactile (feeling something or someone touching you).
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Outline Delusions: Positive Symptom
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Irrational beliefs that seem real but are not true in reality. - Paranoid delusions: individual believes they are being persecuted or spied on. - Delusions of grandeur: exaggerated belief's about one's own abilities or importance (e.g superpowers or fame). |
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Outline Catatonic Behaviour: Positive symptom
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Abnormal motor activity, where a person can experience a loss of motor skills or extreme hyperactive motor activity (rigid or frenzied).
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Define 'negative symptoms' and give examples.
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A reduction in normal functioning. - Avolition - Speech Poverty - Affective Flattening - Disorganised Thinking - Anhedonia - Social/Occupational Dysfunction |
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Outline Avolition: negative symptom
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A reduction in, or inability to initiate or engage in goal-directed behaviours and a reduction in self-motivation.
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Outline Speech Poverty: negative symptom
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- Reduction in the amount or quality of what is spoken. - Reduction in verbal fluency - Delay in verbal responses
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Outline Affective Flattening: negative symptom
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A reduction in the range of their emotional expressions, for example: tone of voice, facial expressions & eye contact.
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Outline Anhedonia: negative symptom
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A general loss of interest or pleasure in everyday life & activities.
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What does reliability refer to in the context of schizophrenia?
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The consistency of symptom measurement.
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What 2 ways can the reliability of schizophrenia be assessed?
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1. Test-retest reliablitiy: Same clinician makes the same diagnosis on separate occasions from the same info provided. 2. Inter-rater reliability: Different clinicians make identical diagnosis, independently, on same patient.
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Limitation of Reliability in Schizophrenia Diagnosis: Evidence for low inter-rater reliability |
- Cheniaux et al investigated inter-rater reliability between clinicians. - 2 psychiatrists independently diagnosed 100 patients using DSM & ICD. - Found poor inter-rater reliability: using DSM one diagnosed 26 patients & other 13; using ICD one diagnosed 44 & other 13. - Poor consistency undermines the reliability of diagnosis. |
- Who investigated the inter-rater reliability between clinicians? - How many patients & using which 2 'manuals'? - Results found using DSM & ICD?
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Culture Bias - Effect on Reliability |
- Tendency to over-diagnosis members of ethnic minorities. - E.G Afro-Caribbeans several times more likely than white people to be diagnosed. - People who create diagnostic tools (DSM) are from predominately white backgrounds w/ different set of norms & values to ethnic group. - Culture bias may affect inter-rater-reliability of diagnosis & classification b/c individual reporting same symptoms to clinicians from different cultural backgrounds may not receive same diagnosis. - E.G hearing voices has -ve connotations in 1 culture but may be viewed as a +ve experience in another. - Not considered abnormal & therefore wouldn't lead to diagnosis of condition
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- What does cultural bias lead to a tendency to do? - E.G Afro-Caribbeans... - What about people who created the DSM? - Effect on inter-rater reliability and why? - Use the example of hearing voices...
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Limitation of Reliability in Schizophrenia Diagnosis: Evidence for Cultural Bias
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- Luhrmann et al investigated 60 adults (20 each from Ghana, India & US) w/ schizophrenia. - Used interviews to ask pps about voices they heard. - Ghanaian & Indians reported +ve experiences whereas not one American did. - Implies if Ghanaian & Indian patient reported hearing voices may be viewed as -ve experience by US clinician but not by one from their own culture. - Leads to low inter-rater reliability of diagnosis between clinicians of different cultures. |
- Who studied 60 patients? - What symptom were the suffering from? - How did the Ghanaians and Indians report the experience vs American? - What does this imply about US clinician? - Low inter-rater reliability between who? |
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Limitation of Reliability in Schizophrenia Diagnosis: Labelling is a -ve consequence of cultural bias
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- Individuals who display characteristics considered abnormal by a particular culture but not their own may be labelled as 'schizophrenic'. - May not understand why they have been given this label & makes them feel ostracised from society. - May struggle to cope w/ being different, may lead to social withdrawal, avolition & disorganised thinking (symptoms of schizophrenia). - Being labelled as a 'schizophrenic' a self-fulfilling prophecy has resulted in the person succumbing to the label. |
- What may individuals who display characteristics be considered as & then labelled? - What may this make them feel? - Struggling to cope w/ being different may lead to... - Self-fulfilling prophecy |
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What is validity in terms of schizophrenia?
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The accuracy of a diagnosis. - Schizophrenia should be a disorder separated from other disorders. - This is done by using classifications systems = DSM & ICD. |
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In what 2 ways can the validity of diagnosis be assessed?
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1. Concurrent Validity: ectent to which different classification systems identify symptoms of schizophrenia according to their criteria & arrive @ same diagnosis. If both agree diagnosis has concurrent validity. 2. Predictive Validity: Extent to which diagnosis leads to a successful treatment (reduces symptoms). If treatment outcome is successful shows diagnosis has predictive validity. |
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What is Co-morbidity & the effect of the validity of diagnosis?
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- Co-morbidity = 2 or more disorders occurring @ the same time. - Schizophrenia is co-morbid w/ disorders like: substance abuse, depression & OCD. - Affects the validity of classification & diagnosis b/c leads to uncertainty about whether different disorder should be considered independently. |
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Limitation of Co-morbidity: Evidence highlighting the issue of co-morbidity in diagnosis |
- Buckley et al estimated 50% of schizophrenics had co-morbid depression, 47% substance abuse & 23% OCD. - Highlights problem of trying to distinguish separate disorders. - High levels of co-morbidity suggest schizophrenia consists of distinct sub-types. - E.G. schizophrenia w/ obsessive- compulsive symptoms may be a sub-type which should be considered distinct from schizophrenia w/ substance abuse. |
- Which researcher? - %s of co-morbidity w/ depression, substance abuse and OCD. - What problem does this highlight? - What does the high levels of co-morbidity suggest & example. |
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Limitation of Co-morbidity: Schizophrenics w/ co-morbid conditions are excluded from research. |
- May be b/c a clinician may diagnose a patient w/ one of common co-morbid disorders (e.g. bipolar) and not recognise they also have schizophrenia so therefore won't be eligible. - Means any research findings from such research may not represent sufferers of schizophrenia w/ prominent co-morbid disorder & has low internal & population validity. |
- Why might patients not be included in research for schizophrenia. - What happens to the findings of these studies? - low what types of validity? |
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Outline symptom overlap and its effect on validity of diagnosis.
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- Occurs b/c symptoms of schizophrenia are also found w/ other disorders. - Affects the validity of diagnosis b/c it makes it difficult for clinicians to decide which disorder patient is suffering from. - Symptom overlap w/ schizophrenia & bipolar, where depressed mood & hallucination are both common symptoms. |
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Limitation of Symptom overlap w/ schizophrenia: evidence highlighting the issue of symptom overlap in diagnosis
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- Ophoff et al assessed genetic material from 50,000 patients. - Found 3/7 gene locations on the genome were associated w/ both schizophrenia & bipolar. - The common genetic basis provides possible reason for shared symptoms between disorders. - Implication is that schizophrenia w/ manic symptoms may be classified as a sub-type of schizophrenia rather than considering schizophrenia & bipolar as distinct disorders. |
- Which researcher assessed the genetic material of 50,000 patients. - What was found? - What does this prove a possible reason for? - Implication is that schizophrenia w/ manic symptoms may be classified as a... |
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Limitation of Symptom overlap w/ schizophrenia: Misdiagnosis due to symptom overlap
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- Misdiagnosis b/c when symptoms overlaps (hallucinations) they can be identified by clinician, may provide a diagnosis of 1 of the 2 possible disorder (bipolar) but other disorder (schizophrenia). - Can lead to a course of treatment for misdiagnosed disorder which may be ineffective or in some cases exacerbate it. - One way to deal w/ issue: examine the grey matter of the brain, as schizophrenics can experience a decrease of grey matter, while bipolar sufferers do not. - Shows how empirical evidence can support a more subjective approach to provide a more valid diagnosis. |
- How does misdiagnosis occur? - What type of treatment does this lead to? - How do you deal w/ this issue (grey matter...)? - What does this show about empirical evidence? |
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Outline how gender bias affects the validity of diagnosis.
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- Schizophrenia is statistically more prevalent in males than females. - May be b/c of gender bias in the way clinicians interpret symptoms which causes an inaccuracy in diagnosis rather than difference between sexes. - Female patients typically function better than males. - When suffering from the symptom avolition, females may seek support while males are less likely. - High interpersonal functioning may explain why some women haven't been diagnosed w/ schizophrenia when men w/ similar symptoms have been. - Affects the validity of diagnosis as clinicians may under-diagnose schizophrenia in women b/c symptoms seem too mild to warrant diagnosis or are masked. |
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Limitation of Gender Bias in schizophrenia diagnosis: evidence that females ability to function can lead to under-diagnosis |
- Kulkarni et al - Found female sex hormone estradiol was effective in treating schizophrenia in women when added to antipsychotic therapy. - Suggests female biology naturally helps women function better & feel less inclined to seek clinical consultation. - Males on other hand, who lack estradiol are less able to function & visit clinician. - Biological differences between the sexes may lead to the under diagnosis of females. |
- Estradiol w/ antipsychotic therapy. - Female biology naturally helps... - What about men? |
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Limitation of Gender Bias in schizophrenia diagnosis: Evidence that females are under-diagnosed |
- Loring & Powell - Randomly selected 290 psychiatrists & asked them to read info about 2 patients & diagnose them according to standard diagnostic criteria. - When patients not assigned a gender 56% compared to when described as females=20%. - Shows gender bias when interpreting symptoms. |
- How many randomly selected 290 psychiatrists?- What the psychiatrists asked to do?- Not assigned a gender, what were the %s. |