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Schizophrenia Explanations – Paper 3Classification of Schizophrenia
- Schizophrenia is a mental disorder characterised by abnormal
social behaviour and failure to understand what is real. Symptoms
include false beliefs, unclear thinking hearing voices reduced
social engagement and emotional expression and lack of
motivation.
- The ICD and DSM are both classification manuals which can be
used to diagnose schizophrenia. The DSM characterises
schizophrenia according to whether there is 1 positive symptom in
the patient. The ICD sees schizophrenia as a psychotic disorder
and is characterised by severe impairments.
Issues with diagnosis:
1. Inter-rater reliability refers to the measure of consistency
between individuals, evaluating the same behaviours. It occurs
when clinicians disagree to the diagnosis. However unreliable
diagnosis may occur if clinicians don’t use the same diagnostic
tools.
2. Validity refers to the realness of what is being measured,
invalid diagnosis may occur if clinicians give a diagnosis of an
illness that doesn’t fit those symptoms.
Symptoms of Schizophrenia:
- Positive symptoms = distortion of normal functioning, rare in
everyday situations e.g. hallucinations and delusions.
- Negative symptoms = less unusual, occur in everyday life and
tend to last longer e.g. decrease in motivation.
- Co-morbidity = patient has 2 or more illnesses at the same time
- Secondary impairment = caused by the effects of living with
schizophrenia e.g. depression
Evaluating the Classification and Diagnosis of Schizophrenia
Validity Issues:
- Gender bias – Loring and Powell gave 290 participants the same
case studies to make a diagnosis, when patients were described
as male or no sex was given, 56% diagnosed schizophrenia. 20%
of patients described as female were given a schizophrenia
, diagnosis. Gender bias isn’t evident in female psychiatrists
suggesting diagnosis is influenced by the psychiatrist and by the
patients gender. This is an issue as males have more negative
symptoms and are also more likely to abuse substances more than
women. Whereas women typically function better than men,
symptom tend to be masked better and good interpersonal
functioning in women may lead to under diagnosis.
- Co-morbidity = around half of the patients with schizophrenia also
have a diagnosis od depression as well as substance abuse.
- Symptom overlap = many people who have schizophrenia have
symptoms which overlap with other symptoms for example,
symptoms of depression.
Reliability Issues:
- Cultural differences in diagnosis = Luhrman et al (2015)
interviewed 60 patients with schizophrenia, 20 each from Ghana,
India and the US. They were all asked about the voices they
heard. Many of the African and Indian subjects reported positive
experience with their voice whereas not one American did. This
suggests schizophrenia lacks a consistent set of characteristics
globally.
Biological Explanations
Explanation 1: Genetic Vulnerability
- A genetic component which predisposes some individuals to the
illness more than others, whether a person develops schizophrenia
is partly due to their genes.
Gottsman (1991) Family study:
- conducted research into the heritability of schizophrenia and found
a concordance rate of 48% for schizophrenia between MZ twins.
The findings show the closer the genetic link to someone with the
illness, the higher the risk of developing it yourself. Its thought the
condition involves combined effects of several genes, increasing
the risk of developing schizophrenia – known as the ‘candidate
gene’ implicated in the production and regulation of serotonin,
dopamine and glutamate.
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