Issues in Diagnosis and Classification Schizophrenia Issues in Diagnosis and Classification

1 2 3 4 Specification Classification of schizophrenia. Positive symptoms of schizophrenia, including hallucinations and delusions. 3 Negative symptoms of schizophrenia, including speech poverty and avolition. 4 Reliability and validity in diagnosis and classification of schizophrenia, including reference to co-morbidity, culture, gender bias and symptom overlap.

Diagnosis Why am I playing this? https://www.youtube.com/watch?v=Y9mRl9tW3kE Choose a song to fit the topic and explain why.

Common Misconceptions What do you know? https://youtu.be/J-JVBO7nLv0

THE MYTHS MYTH: Schizophrenia is rare. Schizophrenia is quite common-1 in 100 people worldwide. MYTH: Schizophrenia is a multiple or split personality. People with schizophrenia do not have more than one personality. MYTH: Schizophrenia is caused by street drugs. FACT: Some street drugs can cause similar symptoms, young people early symptoms may use drugs to mask their symptoms. Street drugs can make the illness worse. MYTH: People with a mental illness never recover. All who can be treated and most helped. Some completely recover. MYTH: People with schizophrenia are violent and dangerous. Most individuals are not. They are more likely to harm themselves. Suicide rates are high – over 10%. THE MYTHS

Hallucinations Delusions Here are the main positive symptoms experienced: Hallucinations Delusions Experiencing sensations that aren't caused by anything or anybody around them All the senses; auditory, visual, touch, taste and smell The most common hallucination experienced is hearing voices or other sounds The voices vary in each individual case - for example they can be male or female, loud or quiet, abusive or annoying, give instructions and even speak in a foreign language Hallucinations are very real to those experiencing them even though no-one else around them can hear the voices or experience the sensations An unshakable belief, that his held with complete conviction, in something that is very unlikely, strange or obviously untrue A person with schizophrenia may develop delusions as a way to explain the hallucinations they are experiencing Paranoid delusions are common and sufferers believe that something, or someone, is deliberately trying to mislead, manipulate, hurt or, in some cases, even kill them Delusions of grandeur, which is where an individual believes that they have some imaginary power or authority, such as thinking that they are on a mission from God or that they are a secret agent

Speech Poverty/Alogia The negative symptoms of schizophrenia can be present for several years before diagnosis. These symptoms often appear gradually and slowly get worse. The main negative symptoms include: Social withdrawal Difficulty starting a conversation or finding it hard to speak to people Feeling uncomfortable with other people or feel that they have nothing to say and will often give short one word answers Speech Poverty/Alogia Difficulty in planning and setting goals No interest in socialising or hobbies A person does not want to do anything and will sit in the house for hours or even days Avolition

Diagnosing Schizophrenia Gerald http://www.youtube.com/watch?v=gGnl8dqEoPQ Give an example of your own or from the video of each of these

Exam question I will mark during the group task and feedback at the end.

Why does it matter if clinicians get the diagnosis wrong?

Discuss issues associated with the classification and / or diagnosis of schizophrenia. (Total 16 marks) AO1 Description of issues concerned with classification and diagnosis, Related in some way to reliability and validity. E.g. co-morbidity, culture and gender bias. Other issues can receive credit if they are made relevant to schizophrenia. AO3 Discussion of issues identified when classifying/diagnosing. Evaluate and offer commentary on issues identified. Example consider consequences arising from the issue. Discussion of problems associated with classification. E.g. might lead to labelling and stigmatisation causing long-term problems of getting / keeping employment and leading to a self-fulfilling prophecy.

Overview Reliability Cultural Differences Validity Gender Bias Symptom Overlap Co-Morbidity

How to answer this question AO1 Define the relevant term; reliability or validity in this context Define the meaning if the relevant issue; the key four Use examples where possible to show understanding AO3 Discuss why this is an issue Elaborate with potential further issues that it could lead to counter-arguments to this being an issue Supporting evidence

Issues with the reliability and validity of a diagnosis and classification of Schizophrenia Culture Bias Validity Gender Bias Symptom Overlap Co-morbidity AO3

Stage 1: Research your section Pair 1: Reliability Pair 2: Validity Pair 3: Culture Bias Pair 4: Gender Bias Pair 5: Symptom Overlap Pair 6: Co-morbidity

Stage 2: Speed Dating 1- reliability 6- co-morbidity 2- Validity 1- Relibility 3- Culture Bias 4- Gender Bias 5- Symptom Overlap 4- Gender bias 6- Co-Morbidity Stage 2: Speed Dating

Reliability guidance notes Test retest Inter rater reliability Kappa Score

Validity guidance notes The importance of Mutual exclusivity The meaning of Accuracy Descriptive validity Predictive validity

Culture Bias guidance notes AO1 What does it mean? Example found by Luhrman et al (15). AO3 Whaley’s findings What are the effects of inconsistent diagnosis?

Gender Bias guidance notes AO1 What does it mean? Example explaining why women can on the whole be likely to be perceived as less healthy. Consider also the dominance of males in science field. AO3 Research Support What are the effects of gender bias? How could it be overcome? Gender Bias guidance notes

Symptom Overlap Guidance Notes AO1 What does it mean? Examples of specific symptoms that could overlap with other disorders. AO3 What are the consequences? Consider how it shows low predictive validity How could it be improved?

Co-morbidity Guidance Notes AO1 What does it mean? Examples of other disorders which are co-morbid with Schizophrenia AO3 What are the consequences of co-morbidity?

Essay Plan

Reliability in this context Culture Bias Define it in context: Example: How it is an issue with elaboration: Validity in this context Gender Bias Co-Morbidity Symptom Overlap

Exam question feedback I will mark during the group task and feedback at the end.