Diagnosis of Schizophrenia (AQA A Level Psychology): Flashcards
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What do the terms 'positive' and 'negative' symptoms of schizophrenia refer to?
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What do the terms 'positive' and 'negative' symptoms of schizophrenia refer to?
What is added to or taken away from normal functioning, not how helpful or harmful the symptoms are.
Define hallucinations.
Hallucinations are unusual sensory experiences which can occur in relation to any sense.
Give two forms that hallucinations can take.
Voices talking to or commenting on the person, often criticising them, and seeing distortions in the environment, e.g. in facial expressions.
Define delusions.
Delusions are misguided or irrational beliefs, such as believing one is Jesus, paranoia that the CIA is spying on you, or believing one has magic powers or is possessed.
True or False?
Believing parts of your body are under external control is a delusion of control.
True.
Delusions of control are one form of delusion, alongside paranoia and unfounded beliefs about one's abilities or body.
Positive symptoms may cause alarm and distress as they are manifestations of the illness.
Positive symptoms may cause alarm and distress as they are active manifestations of the illness.
Are people with schizophrenia more often victims or perpetrators of violence?
Victims. The vast majority of people with schizophrenia are not aggressive.
True or False?
Hallucinations and delusions are negative symptoms of schizophrenia.
False.
They are positive symptoms, as they add to normal functioning. Negative symptoms include speech poverty and avolition.
Define speech poverty (alogia).
Speech poverty is a reduction in the amount and quality of speech, e.g. delayed responses in conversation, limited vocabulary and vagueness.
True or False?
Speech disorganisation is classified in DSM-5 as a negative symptom.
False.
Speech disorganisation (incoherent speech or abruptly changing topic) is classified as a positive symptom. Speech poverty remains a negative symptom.
Define avolition.
Avolition, sometimes called apathy, is finding it difficult to begin or keep up with goal-directed activity, involving sharply reduced motivation.
What three signs of avolition did Andreasen (1982) identify?
Neglect of personal hygiene, neglect of work or education, and neglect of activities usually found pleasurable.
Why are negative symptoms less immediately noticeable than positive symptoms?
They are not active manifestations of the illness but a withdrawal from life.
Negative symptoms overlap considerably with the symptoms of , which can complicate diagnosis.
Negative symptoms overlap considerably with the symptoms of depression, which can complicate diagnosis.
Why is categorising schizophrenia into positive and negative symptoms reductionist?
It simplifies a complex disorder into narrow classifications, overlooking psychological, cognitive and social factors, and may limit treatment to biological approaches.
How might classifying symptoms such as delusions lead to culture bias?
Symptoms may be interpreted differently across cultures. What is a delusion in one culture may be a spiritual belief in another, leading to misdiagnosis or overdiagnosis in non-Western populations.
Define co-morbidity.
Co-morbidity is when one patient is diagnosed with two or more mental illnesses, e.g. schizophrenia and depression, which may share a common genetic basis.
Define symptom overlap.
Symptom overlap is when two or more illnesses share some of the same symptoms, e.g. avolition overlaps with the lethargy and lack of motivation seen in depression.
Why does symptom overlap make diagnosis difficult?
It is hard to distinguish between disorders, e.g. schizophrenia and bipolar disorder both involve delusions and avolition, so the same person could receive different diagnoses from different clinicians.
disorder is a diagnostic category for people showing a combination of mood disorder symptoms and psychotic symptoms.
Schizoaffective disorder is a diagnostic category for people showing a combination of mood disorder symptoms and psychotic symptoms.
True or False?
Researchers agree that schizoaffective disorder is distinct from schizophrenia.
False.
There is ongoing debate over whether it is genuinely distinct from schizophrenia and bipolar disorder or simply represents the overlap between them.
What did Newson et al. (2021) find in their meta-analysis?
Across 107,349 adults, there was significant symptom overlap across DSM-5 disorder categories, whose criteria do not sufficiently distinguish schizophrenia from co-morbid disorders.
Give one strength and one limitation of Newson et al. (2021).
Strength: the use of secondary data makes the research swift and cost-effective. Limitation: it lacks explanatory power, giving no insight into why overlap occurs.
Buckley et al. (2009) found that % of people with schizophrenia also have depression.
Buckley et al. (2009) found that 50% of people with schizophrenia also have depression.
Name two co-morbidities of schizophrenia identified by Buckley et al. (2009).
Any two of substance abuse disorder (47%), PTSD (29%), OCD (23%) and panic disorder (15%).
Why is 50% co-morbidity with depression a problem for diagnosing schizophrenia?
Either clinicians are poor at distinguishing the two conditions, or very severe depression closely resembles schizophrenia, in which case they may be better understood as related conditions.
What practical application did van Dee et al. (2023) give co-morbidity research?
Co-occurring symptoms such as depression reduce the probability of remission, and the most impactful co-morbidities differ between individuals, so treatment can be tailored.
How has recognising co-morbidity driven integrated care?
Mental health, physical health and substance-abuse services are coordinated rather than separate. This matters because medications can interact, e.g. some antipsychotics increase the risk of diabetes.
Why does symptom overlap mean early intervention opportunities are missed?
Initial symptoms of schizophrenia are non-specific (low mood, social withdrawal) and resemble depression, which delays diagnosis when early treatment predicts better outcomes.
True or False?
Substance use and extreme sleep deprivation can produce psychotic-like experiences.
True.
Apparent symptoms may have non-psychotic origins, so misattribution could lead to someone receiving antipsychotics for a condition they do not have.
Define gender bias in diagnosis.
Gender bias in diagnosis is any instance of a person being diagnosed according to their gender rather than their symptoms.
How might alpha bias occur in the diagnosis of schizophrenia?
A woman presenting with symptoms is not diagnosed because the clinician views her as a 'hysterical female' rather than taking her symptoms seriously.
How might beta bias occur in the diagnosis of schizophrenia?
Clinicians use male models of health to diagnose women and ignore that risk factors differ between males and females, taking a 'one size fits all' approach.
Define culture bias in diagnosis.
Culture bias in diagnosis is when a clinician does not take a patient's culture into account when making a diagnosis.
How does ukuthwasa illustrate culture bias in diagnosis?
It has some symptom overlap with schizophrenia, so a British clinician is likely to diagnose schizophrenia, whereas in Africa the symptoms are often seen as spiritual empowerment.
What did Escobar (2012) point out about psychiatrists diagnosing Black patients?
Overwhelmingly white psychiatrists may over-interpret symptoms and distrust the honesty of Black patients during diagnosis.
Hearing voices may be more acceptable in some cultures because of beliefs about communication with .
Hearing voices may be more acceptable in some cultures because of beliefs about communication with ancestors.
What did Hambrecht et al. (1993) find?
Males and females are equally at risk of developing schizophrenia, but it is underdiagnosed in women.
How does Cotton et al. (2009) explain the underdiagnosis of schizophrenia in women?
Women with schizophrenia typically function better than men, so symptoms may be masked or cases may seem too mild to warrant a diagnosis.
Schwartz et al. (2019) found African Americans are times more likely to be diagnosed with schizophrenia.
Schwartz et al. (2019) found African Americans are 2.4 times more likely to be diagnosed with schizophrenia.
Give one limitation of Schwartz et al. (2019).
The use of rating scales means the fine detail of symptoms is lost when a standardised measure is applied.
True or False?
Diagnosing schizophrenia is a socially sensitive issue.
True.
It carries stigma and negative stereotypes, and misdiagnosis can incorrectly label individuals, affecting employment, relationships and self-esteem.
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