Schizophrenia
Diagnosis and classification
Classification- Diagnosing-
Schizophrenia doesn’t have one singular characteristic. A diagnosis system must possess validity (assess what it claims to be
The DSM-5 says one positive symptom must be assessing) and reliability (consistent diagnoses)
present. The ICD-10 says two or more negative
symptoms must be present. Issues in diagnosis:
Positive symptoms: - Co-morbidity: two illnesses together confuse diagnoses
- Symptom overlap: two or more conditions share symptoms so validity
- Hallucinations (unusual sensory experiences) of diagnosis questioned
- Delusions ( irrational beliefs which are resistant
with the truth) AO3:
- Psychomotor disturbances (rocking back and
(+) Rosenhan sent 8 participants to 12 hospitals, complaining of voices
forwards, twitches etc.)
saying ‘empty/ hollow/ thud’ and once admitted to a ward, stopped
Negative symptoms: complaining of any symptoms. He found that staff diagnosed 11 patients with
schz, one with manic depression and an avg. hospital stay was 19 days.
- Avolition (difficult to keep up with goal-directed Patients more likely to detect sanity, whereas doctors did not detect sanity at
activity) all
- Speech poverty (changing patterns in speech e.g.
(-) Rosenhan low population validity
(-) symptom overlap
(-) culture bias
, Schizophrenia
Biological explanations for schizophrenia
Genetic basis Dopamine hypothesis
Inherited disorder due to faulty genes - Neurotransmitters: brains chemical messengers work differently
- Hyperdopaminergic in subcortex- high levels of dopamine
- Twin studies: concordance rate of 48% for MZ
- Hypodopaminergic in prefrontal cortex- low levels of dopamine
and 17% for DZ twins
- Family studies: 46% if both parents has
schizophrenia and 16% with one parent Neural correlates
- Adoption studies: 10.3% with schizophrenic
biological mothers, 1.1% without Size/ function of areas of brain e.g. Enlarged ventricles
Schizophrenia is aetiologically heterogeneous (multiple - Negative symptoms: avolition includes the loss of motivation which is
genes) and polygenic (a number of factors working in associated with ventral striatum
combination) - Positive symptoms: auditory hallucinations associated with superior
temporal gyrus and anterior cingulate gyrus
AO3:
(-) cause and effect can not be established
(-) doesn’t consider other explanations – reductionist
, Schizophrenia
Psychological explanations for Schizophrenia
Family dysfunction Cognitive explanation
1. Schizophrenogenic mother- mother is cold/ controlling 1. Meta representation- dysfunction in ability to reflect on thoughts
and creates a climate of tension/secrecy and allow insight into goals (rather think its someone else)
2. Double-bind theory- communication style sends mixed 2. Central control- dysfunction in ability to suppress automatic
messages and punishment by withdrawal of love responses leading to disorganised speech
3. Expressed emotions- level of emotion expressed by
patient to carers. Verbal criticism, hostility, emotional
over involvement
AO3:
(-) childhood experiences is retrospective data but schizophrenia may have distorted
childhood memories
(-) cause and effect not established
(-) doesn’t acknowledge biological factors
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