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Schizophrenia - Coggle Diagram
Schizophrenia
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- 'a psychotic disorder marked by severely impaired thinking, emotions, and behaviours. Schizophrenic patients are typically unable to filter sensory stimuli and many have enhanced perceptions of sounds, colours, and other features of their environment'
- Sufferers may experiences either or both positive and negative symptoms
- Different subtypes of Sz
Positive Sz seen as having symptoms of prominent delusions, hallucinations and positive formal thought disorders
Mixed Sz prominent symptoms either both negative and positive or neither is prominent
Subtypes currently only recognised in ICD-10, previous editions of DSM also made these distinctions
- Positive symptoms enhance the typical experience of sufferers, and occur in addition to their normal experiences
- Hallucinations: characterised by distorted view/perception of real stimuli or perceptions of stimuli which have no basis in reality
Auditory hallucinations may involve hallucinating the voices of loved ones or the deceased and are though to be caused by an excess of dopamine receptors in Broca's area (a neural correlate)
- Delusions: a set of beliefs with no basis in reality at all e.g. may be paranoid they're being stalked by the Royal family
Different types of delusions - persecutory, delusions of grandeur, delusional jealousy, erotonomania, somatic delusional disorders
- Negative symptoms take away the typical experience of sufferers, represents a 'loss' of experience
- Speech poverty: occurs when there's an abnormally low level of frequency and quality of speech.
Common type is 'derailment' thought to be caused by dysfunctions in central control (Frith et al, 1992) - sufferer cannot surpress automatic associations that come with each new word or idea
- Avolition: subjective reduction in interests, desires, goals and a behavioural reduction of self-initiated and purposeful acts, including motivational deficits - inability to cope with normal pressures and motivations associated with everyday living and day-to-day tasks
- Two types of classification systems for mental disorders; Diagnostic and Statistical Manual (DSM-V) and the International Classification of Disease (ICD-10)
- Different requirements for diagnosis of Sz
Both require persistent symptoms for at least a month
DSM-V - more specific diagnostic criteria; requires at least 2 or more of delusions, hallucinations, disorganised speech, catatonic behaviour
ICD-10 - broader approach of diagnosis; 'the clinical picture is dominated by relatively stable, often paranoid delusions, usually accompanied by hallucinations'
- Main differences is in terms of what organisations produce them (the WHO or the American Psychiatric Association), the number of symptoms and specificity of symptoms required as well as recognition of different subtypes of Sz
Weaknesses:
- Significant co-morbidity (high frequency of diagnosis of two disorders together) between Sz and other mental disorders e.g. OCD, PTSD - Buckley et al (2009)
Researchers - 29% of their Sz patients suffered PTSD, 50% suffered depression
Particularly in case of depression suggests Sz is so frequently diagnosed with other psychiatric disorders, these two disorders may be the same, more accurate and valid methods of diagnosis would combine the two
Issue validity of Sz diagnosis and attempting to differentiate symptoms from that of other disorders
- May be gender bias in diagnosis of Sz - Longenecker et al (2010) - not find explanation for sudden increase number male Sz diagnosis made after 80s
Cotton et al (2009) - because no differences in gender susceptibility for men and women in terms of Sz, gender bias must be to blame
Dispositional traits of most women e.g. high interpersonal functioning and being able to work even when suffering, such traits may mask symptoms of Sz or distort their severity so not serious enough to call of disgnosis
Current diagnosis system not account for biases or differences in functioning between men and women, increase likelihood of inaccurate disgnosis
- Cultural bias - Escobar et al (2012)
African Americans more likely to be diagnosed with Sz compared to Western culture patients, due to increased openness about admitting to certain symptoms which appear normal in respective cultures
Phenomenon hearing voices may be desirable sign spirituality and connectedness with ancestors, may be encourages - both classifications systems view as characteristic of Sz, combined with potential distrust of African Americans white psychiatrics may have, increase likeliness false diagnosis, lack validity
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