AQA Psychology A A2 Level - Schizophrenia - Issues with Diagnosis and Classification
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Discuss Issues surrounding the classification and diagnosis of Schizophrenia.
- The problem of reliability is well documented. Cooper found that psychiatrists in New York were two times more likely to diagnose the patient filmed as schizophrenic than those from London. This raises concerns on whether psychiatrists using the same classification system would consistently give the same diagnosis of schizophrenia, thus reliability of the system is being questioned as despite having used the same system for diagnosis, the concordance rates are still lower than what they should be if the system was reliable.
- -Due to research such as that of Cooper's, modern classification systems now have more operationalised definitions of schizophrenia symptoms and as a result the reliability of the systems have increased - which is supported by new research which have shown higher concordance rates between different psychiatrists using the same system.
- -However even if definitions become more operationalised, the psychiatrists still use their own judgement on what is meant by the definitions as the there is no objective way of measuring delusions or hallucinations as it is in the mind of the patient.
- -This inconsistency may therefore remain despite further improvements of definitions, we can therefore question whether it's right to use an inconsistent method of diagnosis as it will lead to some being misdiagnosed and therefore the system will do nothing but mislabel people and not lead to correct treatment.
Discuss Issues surrounding the classification and diagnosis of Schizophrenia.(Labeling)
- Labeling is a big issue of the diagnosis of schizophrenic. Labeling someone as schizophrenic will affect how the person is treated. Rosenhan's study used people who did not have schizophrenia but were admitted into hospitals as they faked symptoms, and after being admitted they acted normally; taking notes and initiating contact. Despite acting normally, the workers still dismissed their actions as abnormal. This illustrates how labeling can change how people treat you.
- -Labelling has many ethical issues. People's lives will be affected. Those who are labeled schizophrenic are more likely to face discrimination than those that are not, these schizophrenic will therefore be less likely to get a job and may face social isolation. Social skills are are important factor in improving symptoms, being labeled may therefore aggravate their condition and worsen symptoms meaning the classification and diagnosis of schizophrenia may do more harm than good.
- -However labeling schizophrenics will allow correct treatment to be administered to the schizophrenics and as a result we will be able to help the sufferers as we know what is wrong with them. The classification of schizophrenic is therefore necessary in order for us to know how to help them.
- -Overall it may therefore be more unethical if we just left schizophrenics as they are. The classification systems such as DSM and ICD is therefore necessary.
Discuss Issues surrounding the classification and diagnosis of Schizophrenia. (Cultural Differences)
- Cultural Differences is used to criticise the classification system as well as the diagnosis of schizophrenia. The systems cannot be applied equally to everyone as some have different cultural backgrounds, those from less privileged background are more likely to be labelled schizophrenic, this may be due to most psychiatrist being from upper class, white background they are unable to understand understand the circumstances of those from other background e.g. those from poorer countries may truly be on the run from people but instead labeled paranoid.
- -Seeing as Cultural differences cannot be taken accounted for by the DSM, ICD and psychiatrists, those from lower socioeconomic backgrounds are more likely to be labelled schizophrenic as they are more likely to be dismissed without having their personal experience considered.
- -The classification and diagnosis is therefore invalid in certain respects as it is not able to do the task it was designed for, identifying who is truly schizophrenic. Those who exhibit behaviour which can be interpreted as persecutory beliefs may have actually been in a position where they have been stalked or targeted; they have a reason to exhibit those behaviours.
- -Therefore the classifications and process of diagnosis may need to be rethought of in order to correctly diagnose patients.
Discuss Issues surrounding the classification and diagnosis of Schizophrenia. (Validity)
- Validity is an issue. The Classification systems have been known to be unable to effectively differentiate schizophrenia symptoms from that of others. Flat effect for example may be mistaken for depression, the person will therefore receive incorrect treatment as they are diagnosed incorrectly, so whether or not the systems are able to effectively do what they are supposed is why it's validity is being questioned.
- -There are ethical issues regarding validity. Should someone be incorrectly diagnosed, they will be given the wrong treatment which could aggravate their condition and therefore worsen their symptoms, which would do more harm than could. Therefore is it ethical to keep such a system? A system that does not do what it is designed for and may only worsen a condition without allowing psychiatrists to offer appropriate treatment due to incorrect diagnosis.
- -However a classification system does allow us to a certain extent help people, should they experience hallucination they will be afraid and seek help, a classification system will assure them as we will be able to identify their condition and therefore offer them various treatments, even if some people are misdiagnosed it is still more ethical to attempt to offer help despite the risk of aggravating symptoms.
- -Therefore despite it's lack of validity the DSM and ICD should be kept as it is the most reliable and valid way of diagnosing patients we have.
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