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RELIABILITY/VALIDITY IN THE DIAGNOSIS + CLASSIFICATION OF SZ - Coggle…
RELIABILITY/VALIDITY IN THE DIAGNOSIS + CLASSIFICATION OF SZ
Schizophrenia is
diagnosed using the DSM-5 and ICD-10
If the methods used for classifying + diagnosing schizophrenia are not reliable/valid it can cause major issues with treatment being unreliable along with invalid assessment will then lead to ineffective treatment
It is used to measure the severity of a patients symptom and assess their response to treatment
LIMITED RESEARCH TO SUPPORT THE RELIABILITY OF THE DIAGNOSIS OF SCHIZOPHRENIA - CHENIAUX (2009)
Cheniaux investigated inter-rater reliability of the DSM + ICD
2 psychiatrists assess 100 patients using DSM + ICD and found poor inter-rater reliability
1 psychiatrist diagnosed 26 patients using DSM + 44 using ICD
This shows that Sz is over or under diagnosed using different systems
Further supported by Reiger (2013)
- found a DSM-5 Kappa score or 0.46 which indicates poor inter-rater reliability + highlights a weakness of diagnosis of Sz
Diagnosis of schizophrenia must be repeatable - Theres two main types of reliability that have been investigated
Test-retest reliability
- presenting participants with the same test at different points in time to see if there's a positive correlation which will demonstrate that the assessment criteria used are consistent
Inter-rater reliability
- this is the idea of whether different clinicians reach the same conclusion
MAJOR LIMITATION - BUCKLEY - FOUND THAT CO-MORBID DEPRESSION OCCURS IN 50% OF SZ PATIENTS
Maybe we are bad at telling the difference between the 2 conditions
Or maybe they are similar they might be between seen as a single condition
This confusing picture is a weakness in the classification of Sz
Co-morbidity
Refers to the extent that 2 (or more) conditions co-occur
If conditions occur together a lot of the time it calls into question the validity of their diagnosis because they might actually be a single condition
Co-morbidities are common with schizophrenics, e.g. depression + OCD
Gender bias
Powell -
found that when 290 male + female psychiatrists were provided with 2 case studies of a patient behaviours 56% were diagnosed when described as 'males'+ only 20% were diagnosed when described as 'females'
However, there was no evidence of gender bias present with female psychiatrists. This shows that the gender of the patient + psychiatrists is clearly a factor when diagnosing the disorder
Diagnosis of Sz is dependent on the gender of the patient which could be in regards to a gender biased criteria or when clinician base judgements on stereotypical beliefs
CULTURAL BIAS - COPELAND
Found that different countries + cultures have differences in diagnosis
When 200 US + UK psychiatrists were given a description of a patient, 69% US psychiatrists diagnosed the patient with Sz, However only 2% of UK psychiatrists did
This highlights the cultural bias evident in the diagnoses of Sz
Cultural bias
Individuals of African American/Caribbean origin are several times more likely than white people to be diagnosed with Sz
However, Sz rates in Africa + West Indies are not high which suggests that it can't be due to genetic vulnerability
The positive symptoms e.g. hallucinations are more acceptable in African cultures, However, when these are reported in a different culture it is seen as bizarre/irrational
Other researchers have gone as far to suggest that white psychiatrists distrust the honesty of black people during diagnosis
GENDER BIAS - LONGNECKER
1980 men are more often diagnosed than women
His explanation was that either men are genetically more vulnerable or it is a result of gender bias e.g. women function better than males with the disorder + are more likely to ork better in relationships
This highlights that the diagnosis of the disorder is potentially subject to gender bias