Schizophrenia AO3

• Reliability


  Consistency in diagnosis
• Inter-rater reliability


  Different diagnosing clinicians reach the same diagnosis for the same individual
• Test-retest reliability


  The same individual is diagnosed the same way on two occasions
• Excellent reliability for the diagnosis of schizophrenia in 180 individuals, using DSM, five pairs of interviewers, achieved reliability of .97 and test-retest reliability of .92
• Validity


  The extent to which a diagnosis accurately represents the condition it is intended to measure
• Cheniaux found that 68 were diagnosed with schizophrenia under the ICD-10 and 39 under DSM-5, showing that schizophrenia is over-diagnosed or under-diagnosed, so criterion validity is low
• Comorbidity


  When conditions occur together frequently
• Comorbidity with other conditions questions the validity of the schizophrenia diagnosis and classification, as it may not exist as a distinct condition
• Gender bias in diagnosis


  Men have been diagnosed with schizophrenia more commonly than women since the 1980s, with a ratio of 1.4:1
• Women with schizophrenia often function better than men, suggesting they are under-diagnosed due to close relationships and support, which is a gender bias
• Cultural bias in diagnosis

  Differences in the interpretation of symptoms, such as hearing voices, based on cultural beliefs
• British people of African Caribbean origin are up to 9 times more likely to receive a schizophrenia diagnosis than white British people, despite people living in African Caribbean countries not having higher rates, suggesting cultural bias in the diagnostic system
• Symptoms of schizophrenia overlap significantly with other conditions, such as bipolar disorder, suggesting schizophrenia may not exist as a distinct condition and is hard to diagnose
• Genetic and neural factors


  • Contribute to the vulnerability to schizophrenia
• Genetic counselling


  Provides risk estimates for potential parents with a relative who has schizophrenia, but does not accurately reflect the probability of an individual child developing the condition due to the role of environmental factors
• Amphetamines, which increase dopamine, worsen symptoms in individuals with schizophrenia and induce symptoms in those without it, suggesting dopamine is implicated in the symptoms of schizophrenia
• Elevated levels of glutamate have been consistently found in several brain regions of individuals with schizophrenia, indicating that other neurotransmitters, such as glutamate, may play an equally significant role
• Family dysfunction


  Includes insecure attachment and exposure to childhood trauma, particularly abuse
• Adults with schizophrenia are disproportionately likely to have insecure attachment, and 69% of women and 59% of men with schizophrenia have a history of physical and/or sexual abuse
• Specific family-based theories like the schizophrenogenic mother and double bind lack rigorous evidence, despite the broader link between childhood trauma and schizophrenia vulnerability
• Cognitive explanations


  Focus on dysfunctional thought processing in schizophrenia
• People with schizophrenia take over twice as long on average to name the font colors in the Stroop task, indicating impaired cognitive processes
• Cognitive theories only account for the proximal origins of symptoms, without adequately addressing the distal causes like genetic factors and family dysfunction
• Antipsychotics


  Drugs used to manage the symptoms of schizophrenia
• Substantial evidence supports the effectiveness of both typical and atypical antipsychotics in managing schizophrenia symptoms
• Serious side effects of antipsychotics, such as tardive dyskinesia and neuroleptic malignant syndrome, can deter individuals from continuing treatment
• The mechanism by which antipsychotics work is not fully understood, as the original dopamine hypothesis is now known to be incomplete
• Token economies


  Systems that use tangible rewards to reinforce desired behaviors in individuals with mental health issues, including schizophrenia
• Studies have shown that token economies can reduce negative symptoms and unwanted behaviors in individuals with chronic mental health issues, including schizophrenia
• Token economies raise ethical concerns due to the significant power they give professionals to control patients' behavior, potentially infringing on personal freedoms and quality of life
• Alternative approaches, such as art therapy, may be more pleasant and ethical alternatives to token economies for managing schizophrenia
• Interactionist approach


  Considers both genetic vulnerability and environmental triggers in the development of schizophrenia
• A study found that high levels of criticism, hostility, and low levels of empathy from adoptive parents were strongly associated with the development of schizophrenia, but only in the group with high genetic risk
• The original diathesis-stress model was oversimplified, as both diathesis and stress are affected by multiple biological and psychological factors
• Combining drug treatment and psychological therapy, such as CBT, has been shown to lead to superior treatment outcomes for schizophrenia compared to medication alone, supporting the practical value of the interactionist approach
• However, the success of combined therapies does not automatically mean that interactionist explanations are correct, as this would be a logical fallacy known as the treatment-causation fallacy