Classification and Diagnosis of Schizophrenia- Essay Plan

1. Describe in some detail the clinical characteristics of schizophreniadelusions, hallucinations, disorganised speech, grossly disorganised or
catatonic behaviour and negative symptoms. Not able to function
adequately in one area of their life, happens for at least six months and
not just down to organic causes (drugs). Not a split personality or multiple
personalities, dont always display the symptoms. Positive symptoms show
an excess or distortion of normal functions, negative symptoms show a
loss of normal functions.
2. Positive Symptoms: Delusions- bizarre beliefs that seem real to the person,
can be paranoid, as well as inflated beliefs about their power and
importance, Experiences of control- under control of an alien force that
has invaded their mind, Hallucinations- bizarre, unreal perceptions of the
environment, usually auditory (hearing voices) but can be linked to other
senses also, Disordered thinking- thoughts are being broadcast so others
can hear them. Negative Symptoms: Affective Flattening- reduction in the
range and intensity of emotional expression, Alogia- speech is not fluent
caused by slow or blocked thoughts, Avolition- not able to carry out goal
directed behaviour.
3. Define Reliability- Reliability is the extent to which psychiatrists can agree
on the same diagnoses when assessing patients. There are a few issues of
reliability linked with the classification and diagnosis of schizophrenia.
4. Critical Point 1: It is difficult diagnosing patients by using the DSM
classification. This is because some people could be perfectly sane but
display a couple of the symptoms of schizophrenia. For instance Rosenhan
carried out an experiment where normal sane people were admitted to a
psychiatric hospitals claiming they heard unfamiliar voices in their heads
saying words empty, hollow and thud. All the participants were
diagnosed as schizophrenic and admitted to the wards, during their stay
none of the staff recognised that they were actually sane. Another study to
support this statement is research done by Abelson. He got participants to
watch a video of a man being interviewed, half of them were told he was
being interviewed for a job the other half were told he was a patient for a
psychiatric hospital. The group who were told he was a job applicant gave
a positive opinion of him, whereas the other group gave the opposite.
Therefore this shows that the situation you are in can affect how you are
diagnosed.
5. Critical Point 2: There is also an element of culture bias. In some cultures it
is seen as normal to speak in tongues such as the Caribbean this is to do
with their religious beliefs. However, if they were in the UK they are likely
to be diagnosed as schizophrenic. As a result of this, it is difficult to say
that the DSM classification can be applied universally.
6. Define Validity- Validity is linked with reliability but is not the same thing. It
is whether what youre measuring is actually applicable to the disorder in
question. In this case whether the symptoms of schizophrenia are really a
true representation of what schizophrenia is.

7. Critical Point 1: There is debate about what schizophrenia actually is.

Schneider in 1959 recorded the psychotic symptoms that he thought
distinguished schizophrenia from other psychotic disorders. He believed
that by doing this it would make diagnosing schizophrenia easier, however
some of the schizophrenic symptoms were found in other disorders. Also
Ellason and Ross stated that dissociative identity disorder (DID) have more
schizophrenic symptoms than people diagnosed with schizophrenia.
Consequently, this backs up the claims that there is a question of whether
schizophrenia can be considered a proper disorder as there are so many
different symptoms for it.
8. Critical Point 2: Another key point is about the issue of gender bias. Kaplan
claimed that diagnostic systems are male centred, for all of the DSM
editions the authors have been predominately male. It was also found that
the male members of the DSM committee pathologised stereotypic
feminine traits instead of stereotypic masculine traits. Therefore this
supports the masculine biased assumptions about what behaviours are
considered normal and healthy, and is a key example of alpha bias.

9. Critical Point 3: Finally, there is the problem in the fact that not only do
people diagnosed as schizophrenic rarely share the same symptoms, but
they do not share the same outcomes. The prognosis for patients
diagnosed with schizophrenia fluctuates, with about 20% recovering their
previous level of functioning, 10% achieving significant and lasting
improvement and only about 30% showing some improvement with
intermittent relapses. Harrison argues that what seems to influence the
outcome of having schizophrenia is more to do with gender and
psychosocial factors, for example social skills, academic achievement and
family tolerance of schizophrenic behaviour. Therefore, this raises issues
about schizophrenia once again as external factors play a role in
diagnosing whether someone is schizophrenic or not.