1. Issues in Diagnosis and Classification
Schizophrenia
Issues in Diagnosis and Classification

2. 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.

3. Diagnosis Why am I playing this?
Choose a song to fit the topic and explain why.

4. Common Misconceptions
What do you know?

5. 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

6. 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

7. 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

8. Diagnosing Schizophrenia
Gerald
Give an example of your own or from the video of each of these

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

10. Why does it matter if clinicians get the diagnosis wrong?

11. 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.

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

13. 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

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

15. 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

16. 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

17. Reliability guidance notes
Test retest
Inter rater reliability
Kappa Score

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

19. 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?

20. 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

21. 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?

22. 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?

23. Essay Plan

24. 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

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