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Classification and Diagnosis of Schizophrenia- Essay Plan
1. Describe in some detail the clinical characteristics of schizophrenia- delusions, hallucinations,
disorganised speech, grossly disorganised or catatonic behaviour and negative symptoms.
Not able to function adequately in one area of their life, happens for at least six months and
not just down to organic causes (drugs). Not a split personality or multiple personalities,
don't always display the symptoms. Positive symptoms show an excess or distortion of
normal functions, negative symptoms show a loss of normal functions.
2. Positive Symptoms: Delusions- bizarre beliefs that seem real to the person, can be paranoid,
as well as inflated beliefs about their power and importance, Experiences of control- under
control of an alien force that has invaded their mind, Hallucinations- bizarre, unreal
perceptions of the environment, usually auditory (hearing voices) but can be linked to other
senses also, Disordered thinking- thoughts are being broadcast so others can hear them.
Negative Symptoms: Affective Flattening- reduction in the range and intensity of emotional
expression, Alogia- speech is not fluent caused by slow or blocked thoughts, Avolition- not
able to carry out goal directed behaviour.
3. Define Reliability- Reliability is the extent to which psychiatrists can agree on the same
diagnoses when assessing patients. There are a few issues of reliability linked with the
classification and diagnosis of schizophrenia.
4. Critical Point 1: It is difficult diagnosing patients by using the DSM classification. This is
because some people could be perfectly sane but display a couple of the symptoms of
schizophrenia. For instance Rosenhan carried out an experiment where normal sane people
were admitted to a psychiatric hospitals claiming they heard unfamiliar voices in their heads
saying words "empty", "hollow" and "thud". All the participants were diagnosed as
schizophrenic and admitted to the wards, during their stay none of the staff recognised that
they were actually sane. Another study to support this statement is research done by
Abelson. He got participants to watch a video of a man being interviewed, half of them were
told he was being interviewed for a job the other half were told he was a patient for a
psychiatric hospital. The group who were told he was a job applicant gave a positive opinion
of him, whereas the other group gave the opposite. Therefore this shows that the situation
you are in can affect how you are diagnosed.
5. Critical Point 2: There is also an element of culture bias. In some cultures it is seen as normal
to speak in tongues such as the Caribbean this is to do with their religious beliefs. However,
if they were in the UK they are likely to be diagnosed as schizophrenic. As a result of this, it is
difficult to say that the DSM classification can be applied universally.
6. Define Validity- Validity is linked with reliability but is not the same thing. It is whether what
you're measuring is actually applicable to the disorder in question. In this case whether the
symptoms of schizophrenia are really a true representation of what schizophrenia is.
7. Critical Point 1: There is debate about what schizophrenia actually is. Schneider in 1959
recorded the psychotic symptoms that he thought distinguished schizophrenia from other
psychotic disorders. He believed that by doing this it would make diagnosing schizophrenia
easier, however some of the "schizophrenic symptoms" were found in other disorders. Also
Ellason and Ross stated that dissociative identity disorder (DID) have more "schizophrenic"
symptoms than people diagnosed with schizophrenia. Consequently, this backs up the claims
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Critical Point 2: Another key point is about the issue of gender bias. Kaplan claimed that
diagnostic systems are male centred, for all of the DSM editions the authors have been
predominately male. It was also found that the male members of the DSM committee
pathologised stereotypic feminine traits instead of stereotypic masculine traits. Therefore
this supports the masculine biased assumptions about what behaviours are considered
normal and healthy, and is a key example of alpha bias.