Clinical Psychology

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What are three problems with reliability of diagnosis?
Differences between diagnostic procedures that can damage the reliability of diagnosing disorders such as schizophrenia, Unreliable symptoms and Differences between patients such as gender or ethnicity.
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Who found evidence for differences between diagnostic procedures
Farmer et al
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What did Farmer et al find?
Found that standardised interview techniques, such as the present state examination increased reliability of diagnosing schizophrenia because it focuses on the frequency and severity of the patients symptoms
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Who found evidence for concerns with unreliable symptoms?
Mojtabi and Micholson
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What did Mojtabi and Micholson find?
Found that 50 senior American clinicians asked to differentiate between bizarre and non-bizarre delusions produced an inter-rater reliability correlation of 0.40
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Name examples of unreliable symptoms
Bizarre and non-bizarre delusions, insomnia.
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What did Mojtabi and Micholson conclude?
That even diagnostic manuals such as DSM lack reliability and are unreliable when distinguishing between those who suffer from schizophrenia and those that do not.
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Who found evidence for differences between patients?
Blake
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What did Blake find?
Found that clinicians are 6 times more likely to diagnose a patient with schizophrenia if they are described as being African-American in their case summary.
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What are four problems with validity and diagnosis?
Co-morbidity, absence of pathognomic symptoms, poor descriptive validity and diagnostic labels holding predictive validity.
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What is co-morbidity?
When the patient suffers from 2 or more mental health conditions that co-exist.
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Who found evidence of co-morbidity?
Buckley et al
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What did Buckley et al find?
Identified co-morbid conditions with schizophrenia. For example, 50% of those that suffered from schizophrenia also suffered from depression and 47% suffered from substance abuse.
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What are pathognomic symptoms?
Pathognomic symptoms are symptoms that are exclusive to certain conditions.
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What is descriptive validity?
Descriptive validity is whether a diagnostic label accurately describes a patients current state and is able to differentiate between patients with different conditions.
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Who found evidence of poor descriptive validity?
Rosenhan.
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What did Rosenhan find?
Rosenhan found that environment has a major impact on the process of diagnosis and that once labelled, patients may find it very difficult to escape the labels that have been applied to them.
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Who found evidence of diagnostic labels holding predictive validity?
Bleuer
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What did Bleuer find?
Bleuer's longitudinal study of 2000 patients diagnosed with schizophrenia revealed problems with the prognosis and predictive validity of schizophrenia.
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What is the predictive validity of schizophrenia?
Bleuer found that the predictive validity was that 40% recover from positive symptoms, 40% continue to suffer and 20% show a full recovery.
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What are four problems with culture and diagnosis?
Cultural interpretations of symptoms effect diagnosis, Negative cultural attitudes to mental health issues, Race discrimination in diagnosis and Ways that cultures express abnormality.
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Who found evidence for cultural interpretations of symptoms?
Malgady
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What did Malgady find?
Malgady found that in traditional Costa Rican culture, hearing voices is see as spirit talking which is a desirable trait whereas in the North America, hearing voices is often seen as a core symptom of schizophrenia.
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Who found evidence of Negative cultural attitudes to mental health?
Kim and Berrios.
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What did Kim and Berrios find?
Kim and Berrios identified that in some Asian languages, the direct translation of schizophrenia is "a disease of the disorganised mind".
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What are the implications of Kim and Berrios translation of Schizophrenia?
In Japan for instance, having a disorganised mind is an undesirable trait and so stigmatising that clinicians are often reluctant to diagnose patients with schizophrenia. As a result, only 20% of patients receive a formal diagnosis and help.
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Who found evidence of race discrimination in diagnosis?
Stowell-Smith and Mckeoun.
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What did Stowell-Smith and Mckeoun find?
Stowell-Smith and Mckeoun performed a discourse analysis on psychiatric reports of 18 black and white male psychopaths from a maximum security prison.
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How did Clinicians differ in their descriptions of black and white psychopaths?
Found that the focus of reports written about white psychopaths were on experiences of trauma and their emotional state whereas reports written on black psychopaths emphasised the danger they posed. This had knock-on effects on black treatment.
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What ways do cultures express abnormality differently?
Culturally bound syndromes such as Running Amok
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What is Running Amok?
In Southern Asian Cultures, Running Amok is a culturally bound syndrome in which someone becomes brooding and then commits large acts of violence against groups.
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Farmer et al

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