psychopathology

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  • Created by: rianna
  • Created on: 06-12-12 10:43
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  • Issues surrounding the classification & diagnosis surrounding the disorder
    • How useful is it to diagnose and individual with schizophrenia
      • Major benefit is the individual is in a position to receive treatment
      • However diagnosis has tendency to become a label
        • Also subject to discrimination may loose friends, affects everyday life eg getting a job, and there is side effects linked to the medicine
    • The reliability of a diagnosis
      • Refers to consistency of diagnosis if clinician can make same diagnosis known as test retest reliability if two clinicians get same diagnosis known as inter rater reliability
      • Beck reported 54% concordance rate between practitioners  diagnosing 153 patients
      • The attitudes and characteristics of clinicians can affect reliability of diagnosis
        • evidence suggests US psychiatrists more likely to diagnose schizophrenia than UK, Copelands study 64% US diagnosed but only 2% UK diagnosed
      • The use of different classification systems and diagnostic criteria can affect reliability of diagnosis
        • Several classification systems, so clinicians come to different conclusions,
        • Farmer et al found standardised interview technique known as present state technique increases reliability because focuses on frequency and severity of symptoms
      • The personal interpretations of clinicians can affect diagnosis
        • one clinician could interpret a certain action in one way while another entirely differently
        • Motjabi & Nicholson asked 50 psychiatrists to differentiate  between bizarre and non-bizarre delusions, concordance rate was 40%, show clearly element of subjectivity
    • The validity of diagnosis
      • concerns how accurate and correct the diagnosis the diagnosis is
      • Rosenhans study- sent 8 normal people to 12 different mental hospitals claiming they had been hearing voices, all were admitted and 7 were diagnosed with schizophrenia, after admission claimed they couldn't hear voices stay ranged from 7-52. Eventually discharged schizophrenia in remission
        • Shows poor validity as diagnosis is not correct
      • The issue of co-morbidity can affect diagnosis
        • This is where the symptoms of more than one disorder co-exist at same time eg schizophrenia and depression
          • Buckley identified comorbid conditions alongside schizophrenia 50% also had depression 47% also suffered from substance abuse, therefore should receive dual diagnosis to receive appropriate treatment
      • Symptoms of schizophrenia overlap with symptoms of other disorders
        • Difficult to tell certain conditions apart can lead to incorrect diagnosis
        • This could lead to inappropriate treatment DSM has tried to overcome this by proposing mixed disorder categories, however validity of these disorders has been questioned
      • If diagnosis does not lead to a successful treatment this indicates a problem with predictive validity
        • Should be able to predict outcome for a patient and response to treatment eg medication
        • Crowe found that not all schizophrenics respond to medication, while some with bipolar do benefit. Led to believe term schizophrenia should be abandoned and each symptom should be treated differently
  • The validity of diagnosis
    • concerns how accurate and correct the diagnosis the diagnosis is
    • Rosenhans study- sent 8 normal people to 12 different mental hospitals claiming they had been hearing voices, all were admitted and 7 were diagnosed with schizophrenia, after admission claimed they couldn't hear voices stay ranged from 7-52. Eventually discharged schizophrenia in remission
      • Shows poor validity as diagnosis is not correct
    • The issue of co-morbidity can affect diagnosis
      • This is where the symptoms of more than one disorder co-exist at same time eg schizophrenia and depression
        • Buckley identified comorbid conditions alongside schizophrenia 50% also had depression 47% also suffered from substance abuse, therefore should receive dual diagnosis to receive appropriate treatment
    • Symptoms of schizophrenia overlap with symptoms of other disorders
      • Difficult to tell certain conditions apart can lead to incorrect diagnosis
      • This could lead to inappropriate treatment DSM has tried to overcome this by proposing mixed disorder categories, however validity of these disorders has been questioned
    • If diagnosis does not lead to a successful treatment this indicates a problem with predictive validity
      • Should be able to predict outcome for a patient and response to treatment eg medication
      • Crowe found that not all schizophrenics respond to medication, while some with bipolar do benefit. Led to believe term schizophrenia should be abandoned and each symptom should be treated differently

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