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Schizophrenia: A form of psychosis marked by dissociating one's self from reality. Characterised
by disruption of cognition and emotion, which affects a person's language, thought, perception,
affect and even sense of self
Sz's lack an insight to their condition and are not aware that they are ill.
In order for a diagnosis to be made 2 or more symptoms must be displayed for more than one
month along with reduced social functioning.
Positive symptoms are those that appear to reflect an excess or distortion of normal functions:
- Delusions - (Bizarre beliefs that are not real, but are real to the schizophrenic)
- Disorganised Thinking - (Feeling that thoughts have been inserted or withdrawn from the
- Hallucinations - (Unreal perceptions of environment)
Negative symptoms are those that appear to reflect a diminution or loss of normal functions:
- Affective Flattening - (Reduced range of emotional/facial expression
- Alogia - (Poverty of speech, reduced speech fluency and productivity = slowed/blocked
- Avolition - (Reduction in goal-directed behaviour - sit and do nothing everyday)…read more

Slide 2

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DSM: Used by the US.
- 2+ symptoms during a 1 month period.
- Social/occupational functioning: work, interpersonal relations.
- Duration: continuous for at least 6 months including, at least 1 month of symptoms.
ICD: Used by Europe.
- One of the syndromes, symptoms + signs.
- Two certain syndromes.
- Lasting at least one month.
Differences Similarities
- The way symptoms are catagorised. - Look at the same symptoms.
- DSM includes social/occupational - At least 1 months worth of displaying
functioning. symptoms.
- DSM ­ need at least two symptoms over a
longer period of time, ICD ­ only need one
with some symptoms over a shorter period
of time.
- ICD emphasises on 1st rank symptoms.…read more

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DSM ­ Culturally biased:
Created by + for Americans. Behaviour in one culture may not be regarded as a symptom in
another. Ie: hearing voices in some countries is a message and honour from god, not mental.
This can lead to incorrect diagnosis and treatment.
ICD ­ More universal, as Europe is bigger. Represents 193 countries.…read more

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Reliability = consistency over time and between individuals
· Validity = When it measures what it is supposed to measure.
· To have validity it must have high reliability.
Four types of validity:
» Content - extent to which an assessment measure covers the range of symptoms of
» Criterion - those diagnosed as schizo differ predictably from those not suffering
» Construct - testing hypothesis based on the diagnosis of schizo
» Predictive - predict the eventual outcome for patients who receive a diagnosis of
schizophrenia…read more

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INTER-RATER When 2 independent assessors give the same diagnoses. DSM
RELIABILITY does this.
TEST-RETEST Whether test used for diagnoses are consistent over time.
Comorbidity When 2 or more conditions co-occur ­ when symptoms are
bought about by more than one/other factor(s). Which is
common in Sz ­ occurs on 50% of patients (drug, alcohol abuse,
depression + bipolar)
+ve or ­ve Klosterkotter et al: +ve symptoms are more useful/valid in
symptoms. making a diagnosis than ­ve symptoms.
Prognosis Not every person will have the same symptoms + behaviors,
therefore it is hard to predict: Individual differences.…read more

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Problems with classifying schizophrenia:
· Argued that Schizophrenia is too broad a category for it to be a useful diagnosis. Two
patients could have completely different symptoms
Cultural differences in measuring sz:
· Copeland et al (1971)
· Description of a patient to 134 US and 194 British psychiatrists
· 69% of the US psychiatrists diagnosed schizophrenia
· 2% of the UK psychiatrists diagnosed schizophrenia
Ellason and Ross (1995) people with DID (dissociative identity disorder) have more first rank
symptoms than schizophrenics! ­ Hard to differentiate symptoms of schizophrenia from
symptoms of other diseases, they all intertwine (depression + bipolar)
· Varies massively.
· 20% recover to previous levels of functioning
· 10% achieve lasting improvement
· 30% some improvement with relapses.
Supports the idea of individual differences and that it is hard to apply symptoms and behaviours
and make a prediction/diagnosis.…read more

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