Summary
Summary Schizophrenia lesson notes
- Module
- Schizophrenia
- Institution
- AQA
A* NOTES!!!!! Notes summarised from textbook. detailed A01 and clear and concise A03 following PEA structure to gain full marks.
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*In biological explanations, do not learn neural correlates of schizophrenia.,Schizophrenia
Schizophrenia A psychosis characterised by a profound disruption of cognitive and
emotion.
- Affects 1% of the world’s population.
- Symptoms can interfere with everyday tasks and sufferers often end
up homeless or hospitalised.
- Peak onset being 25-30 years however there is a gender distinction.
Classification Classification: organising symptoms into categories based on which
vs diagnosis symptoms cluster together in sufferers. Ex, categorising the symptoms of
schizophrenia. (DSM & ICU)
Diagnosis: deciding whether someone has a particular mental illness
using the classifications.
Classification:
Positive symptoms – an excess/ distortion of normal functioning.
1. Hallucinations: distortions/ exaggerations of perception in any of the senses, mostly
auditory hallucinations.
- Auditory – hearing imaginary voices.
- Visual – seeing non-existent lights, objects or faces.
- Olfactory – smelling imaginary things.
- Tactile – feeling something that isn’t actually there.
2. Delusions: irrational beliefs caused by distortions of reasoning or misinterpretations of
perceptions.
- Paranoia – feeling like the government is watching.
- Delusions of grandeur – inflated beliefs about the person’s power/ importance.
- Delusions of reference – when events in the environment appear to be directly
related to them.
3. Disorganised speech: the result of abnormal through processes, slipping from one
topic to the next mid-sentence or speaking in gibberish, word salad.
4. Very disorganised/ catatonic behaviour such as motor rigidness, purposeless
excitement, including the inability to initiate a task or complete it once started, can
lead to bad personal hygiene.
Classification:
Negative symptoms – a loss of normal functioning, AKA ‘deficit syndrome’.
1. Speech poverty: the lessening of speech fluency and productivity (slowing or blocked
thoughts). They may produce fewer words due to the spontaneous need to produce
them.
2. Avolition: apathy – the difficulty/ inability to initiate and persist in goal-directed
behaviour, often mistaken for apparent disinterest, ex. Sitting at home all day and
doing nothing.
3. Affective flattening: a reduction in the range and intensity of emotional expression;
facial expression, voice tone, eye contact, body contact.
4. Anhedonia: a loss of interest or enjoyment in all or almost all activities, or a lack of
reactivity to normally pleasurable stimuli. Physical anhedonia is restricted movement.
Social anhedonia is the disinterest in social contact.
, Diagnosing schizophrenia –
USA – DSM – must have one positive and one negative symptom.
UK – ICD – don’t need both symptoms to be diagnosed.
Diagnosis:
1. Reliability – refers to the consistency of a classification system (DSM) or a
measuring instrument.
- Inter-rater reliability is measured by a statistic called kappa score.
- 1=perfect inter-rater agreement, 0 = no agreement.
- 0.7 is considered good.
- In the DSM, Regier et al. 2013 found that the diagnosis of schizophrenia had a kappa
score of 0.46.
Culture: the rules, morals, childrearing practices that bind a group of people together and
predict their behaviour.
Copeland 1971 gave 134 US and 194 British psychiatrists a description of a patient.
- 69% of US doctors diagnosed the patient with schizophrenia.
- 2% of the British said the same.
Luharmann et al 2015 interviewed 60 schizophrenics, 20 each in Ghana, India and US.
Each was asked about the voices they heard.
- Africans and Indians reported positive experiences.
- Americans reported negative experiences.
Suggests that hearing voices isn’t a certain symptom of diagnosis for schizophrenia.
Evaluation:
There is little evidence that DSM is used with high reliability.
- Whaley 2001 found inter-rater reliability correlations in diagnosis of schizophrenia
as low as 0.11. the psychiatric diagnoses lacks objective measures, therefore inter-
rater reliability is challenged.
For a diagnosis of schizophrenia in the UK, only one of the characteristics is required, which
leads to problems with reliability of diagnosis.
- Mojtabi and Nicholson, 1995 – asked 50 senior psychiatrists in the US to
differentiate between ‘bizarre’ and ‘non-bizarre” delusions, they produced inter-rater
reliability correlations of only around 0.40, thus this central diagnostic requirement
lack sufficient reliability for it to be a reliable method to diagnose schizophrenia.
Barnes 2004 has established cultural and racial differences in the diagnoses of
schizophrenia. The ethic culture hypothesis predicts that ethnic minority groups experience
less distress associated with mental disorders because of the protective characteristics and
social structure that exist in these cultures.
- Brekke and Barrio 1997 studied 184 individuals diagnosed with schizophrenia or
on the spectrum. This sample was drawn from 2 non-white minority groups, African
Americans and Latinos, and a majority groups, white Americans, consistent with the
predictions of the ethnic culture hypothesis, they found that non-minority group
members were consistently more symptomatic than members of the 2 ethnic
minorities.
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