Article Critique: Research Study-Assessment Testing of Psychosis in Schizophrenic Patients
The article “Diagnostic Validity of the Eppendorf Schizophrenia Inventory (ESI): A Self-Report Screen for Ultrahigh Risk and Acute Psychosis,” by Maurice A. J. Niessen, Peter M. A. J. Dingemans, Reinaud van de Fliert, Hiske E. Becker, Dorien H. Nieman, and Don Linszen-will be used for this critique. The Eppendorf Schizophrenia Inventory or ESI, was utilized in this study as a new tool to screen for psychotic symptoms in the Schizophrenic patient, (Niessen, et. al, 2010). It was discovered that the Eppendorf Schizophrenia Inventory (ESI), was able to differentiate the symptoms of inpatient and outpatient schizophrenic patients (Niessen, et. al., 2010). What the authors ultimately wanted to determine was if the ESI could anticipate the different predictors of psychosis in different patients.
Schizophrenia has long been known as a psychotic disorder, having five different categories. The symptoms of Schizophrenia can include negative symptoms, hallucinations, disorganized speech and thought patterns. Also abnormal or disorganized motor behavior, and delusions. Many patients experience psychotic episodes, while some never experience psychosis. The objective of this study was to try and determine why
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not every patient will exhibit psychosis. Schizophrenia is diagnosed using tests and criteria’s, after assessing all of an individual’s symptoms. The authors who completed this study, examined the ESI, and discovered the test could be a valid predictor of psychosis; in some instances, (Niessen, et. al., 2010). The ESI was developed as an evaluation of a patient’s own cognitive, and self-conceptualization of personal symptoms. The inventory is basically a questionnaire the patient completes about themselves. This test is administered prior to psychotic episodes to rate the behaviors preceding psychosis. The test was created by using the exact wording of diagnosed Schizophrenic patients, to create the evaluation. The ESI was deemed a satisfactory tool to use in evaluation of Schizophrenic patients. If the test is administered at the correct time, and other subsequent testing is administered as a follow-up (Niessen, et. al., 2010). Methods. The methodology used for this study was taken from three different samples. The first sample in the study was taken from referrals, known as high-risk. This sample consisted of 275 patients. Those patients in the first sample were suspected to be entering psychotic phase and help-seeking. The second sample were all impatient and were definitely in psychosis, consisted of 73 patients. The third sample were 30 outpatients and were not in an active psychotic state. The three samples were picked from a hospital setting, an inpatient and an outpatient clinic. The tests were administered in the subject’s homes, and in the hospital or clinical settings (Niessen, et. al., 2010). The ESI administered to these patients was a questionnaire similar to a Likert scale test.
It consisted of forty questions. It tested impairments of speech and attention span; interpretation of mood and events; questioned whether the individuals were being manipulated and controlled by “others”; and if the individuals were experiencing any issues of perception of self. Five questions were added by the researchers to evaluate their individual flaws pertaining to Frankness. The purpose of the frankness scale was to act as a control. An example question asks the patient if they take offense when something does not turn out the way that they wanted it to happen (Niessen, et. al.,
2010). The researchers utilized a survey type test of the research subjects. As was mentioned earlier, this was in the form of a Likert scale test. Which asks participants to answer a statement ranging from zero to five. An example would be zero as not at all likely, and five being extremely likely. Instructions were included in the test to explain to the participants how to complete the test. If the subjects answered zero to all the questions, they were excluded from the study. The researchers determined a zero answer to all of the questions showed the subjects were not willing to be completely truthful about their thoughts, feelings, and behaviors (Niessen, et. al., 2010). Results. The results of the study seem to prove that there is no real way to accurately predict whether a Schizophrenic patient will develop psychosis. Using different assessments can help in the treatment plans for individual patients. With the creation of the ESI, the researchers were able to fine tune an assessment model that was more accurate in some instances. However, the test results were all over the place. Considering that each case is very different from the next. If, for instance, there were substance abuse present, the accuracy of the assessment could be considered invalid (Niessen, et. al., 2010). One fact that came out of the study was that the ESI should be used as a precursor to other testing models. When used as a preliminary assessment, the ESI can be used as a sort of screening tool as it were, of developing psychosis. Once the ESI has been completed, the researchers suggested that other more advanced testing can then be administered. The consensus was that this test should be used as a rule when a patient is admitted to hospital. The researchers seem to prove their hypothesis, that in fact, the ESI is a valid tool in detecting and predicting psychosis in Schizophrenic patients (Niessen, et. al., 2010). Discussion. This subject was chosen due to an interest in understanding Schizophrenia. And what new research and testing is available. The author has a half-sister Sharee, who was diagnosed with this mental illness a year and a half ago. For many years, the author’s family struggled to find help for Sharee, and the experience can be compared to a rollercoaster ride, that continuously went off the rails. Because of years of misdiagnosis and a failure to correctly treat Sharee’s symptoms, her life spiraled out of control. The methodology of this study was fairly easy to understand. Other standard testing has been unable to consistently predict the onset of psychosis. With further study and creation of accurate tests, the diagnosis and treatment of Schizophrenia will be much easier. With proper assessment of subjects while transitioning, this test could save patients a lot of suffering. This mental illness is one that is very hard to predict and treat. And the creation of new and better models will serve future patients well. The researchers should continue to study this approach and improve on the accuracy of detection. Future researchers will hopefully continue to look for new and better ways to improve on the current data available.
According to the DSM-IV, schizophrenia is classified under the section of “Schizophrenia and other psychotic disorders”. Schizophrenia is one of the most serious major chronic brain disorders in the field of mental health; it is a neurological disorder that affects the cognitive functions of the human brain. People living with this incapacitating illness can experience multiple symptoms that will cause extreme strain in their own and their families and friends life. The individual can lose reality, unable to work, have delusions and hallucinations, may have disorganized speech and thought processes, will withdraw from people and activities, they may become suspicious and paranoid, may behave inappropriately in every day social situations. They may neglect personal hygiene and dress improperly, use excessive make-up; every day life is becoming chaotic for everyone involved.
Since it was designed as a self-report tool that assesses a broad scope of clinical conditions, its reliability and validity can be considered as strong. In its 478 items, the MMPI-A covers the 10 original scales of MPPI, six validity scales, PSY-5 scales, and 15 content component scales. Then there are also three social introversion sub-scales, the 31 Harris Lingoes sub-scales and six supplementary scales. More importantly, studies of the MMPI-A have shown high test and retest consistency through which reliability and validity can be guaranteed (Gass & Odland, 2012). With the exception of the MF scale that is part of the four factor model, the remaining three which are General Maladjustment, Social Introversion and Over-Control, relevantly address the behavioral problems exhibited by Jane. Hence, it is imperative that the racial disparity of the MF scale be considered from a cultural perspective because studies have shown that there is a tendency of non-Whites scoring higher than other races (Gass & Odland, 2014). Ideally, the variations in cultural values must be considered when applying the test on Whites and non-Whites since the differences reflect socio-economic factors rather than racial
The Multidimensional Personality Questionnaire is a tool often used by professionals to assess a patient’s personality subtypes on a rating scale of 20 to 80. Under the higher order temperament factor Positive Emotionality (PEM) there are four trait scales. For the trait scale Well Being, John Wayne Gacy would score a 70. He was an upstanding member of his community, liked by his neighbors and coworkers, and would even attend children’s birthday parties and hospitals dressed as Pogo the Clown (Hickey, 2016). He had a cheerful disposition when facing the public, however, he only receives a 70 because he would, in fact, be subject to violent mood swings. For the trait scale Social Potency, Gacy receives a score of 80. He
According to (Barlow, 2001), Schizophrenia is a psychological or mental disorder that makes the patient recognize real things and to have abnormal social behavior. Schizophrenia is characterized by symptoms such as confused thinking, hallucinations, false beliefs, demotivation, reduced social interaction and emotional expressions (Linkov, 2008). Diagnosis of this disorder is done through observation of patient’s behavior, and previously reported experiences (Mothersill, 2007). In this paper, therefore, my primary goal is to discuss Schizophrenia and how this condition is diagnosed and treated.
Facts: Ahmad Edwards who had been diagnosed with schizophrenia tried to steal shoes at a department store in Indiana in July 1999. After being discovered, the man took his gun and fired at a security officer. Besides, Edwards accidentally injured a bystander. An FBI agent apprehended Edwards. Before Edwards was arrested, the agent shot him in his thigh, because the man had refused to drop the gun. The man was accused in attempted murder, theft, and criminal recklessness. Afterwards, his mental state became the subject of 3 competency hearings and 2 requests of self-representation. After his competency had been questioned during the first three hearings, Edwards appealed to the appellate court in the State of Indiana as he believed that his
According to Gamble and Brennan (2000), the effectiveness of medication for schizophrenia to relieve patients from psychotic symptoms is limited. Although patients have adequate medication, some received little or no benefit from it and almost half of them still experience psychotic symptoms. They are also more likely to suffer relapse (Gamble and Brennan, 2000). Furthermore, Valmaggia, et al. (2005) found that 50% of patients who fully adhere to anti-psychotic medication regimes still have ongoing positi...
Schizophrenia is a severe and debilitating mental disorder that affects approximately 1% of the population worldwide (Mamani, Gurak, & Suro, 2014). Schizophrenia is characterized by positive symptoms, including hallucinations, delusions and disorganized thinking and speech, as well as negative symptoms, including flat affect, apathy, lack of motivation or drive and social isolation. Schizophrenia is also associated with cognitive, social, and functional deficits and abnormalities in mood, such as anxiety and depression (Larson, Walker, & Compton, 2010). Due to the chronic and impairing nature of schizophrenia, recent research has focused on identifying and treating individuals in the prodromal phase of illness, also referred to as the at-risk mental state or ARMS (Tiffin & Welsh, 2013). The prodrome or ARMS refers to the period of time beginning with declines in areas including cognition and social, emotional and perceptual functioning, and ending with the onset of a schizophrenia spectrum disorder (White, Anjum, & Schulz, 2006). Identification and treatment of the prodromal period is of utmost importance, as research has shown that a longer duration of untreated psychosis (DUP) is associated with poorer prognosis for patients (Kaur & Cadenhead, 2010; Larson et al., 2010).
This assessment was designed to interpret the mind of an adolescent utilizing and integrating his theory into the assessment. Based on the different general outlines of personality, the levels of personality, and the domains of personality, the assessment was designed to predict of help develop a hypothesis of what is troubling an adolescent mentally. There are four different assessments within the MACI broken by age and by gender. There is one assessment for males 13-15, one for females 13-15, one for males 16-19, and one for females 16-19. “The MACI has 31 scales divided into three clinical domains (clinical sydromes, expressed concerns, and personality styles) and a fourth domain consisting of three modifying indices (desirability, disclosure, and debasement) plus a basic validity check.” (Pinto & Grilo, p. 1508, 2004) The MACI was intended to work with the DSM-IV diagnoses for predicting likelihood of a clinical symptom in an adolescent. In the Mental Measurements Yearbook, Sandoval points out there are 31 scales in the MACI and the self- report system allows the personality and predisposition of the adolescent to be rated by the expert on themselves. It is intended to measure common adolescent issues, such as: mood disorders, major depressive disorder, dysthymia, alcohol and substance use, ADHD, etc. The participants in the assessment take a 160 question, true or false format assessment, which
Schizophrenia is a disorder that affects about 1 in 100 people at different stages in their lives and is very difficult to diagnose. It has many symptoms that typically begin to appear around age 18-30 (2). Signs of Schizophrenia can be misread and sometimes overlooked due to the amount of other disorders that share many of the symptoms. Autism is one example. Symptoms can be classified into "negative" and "positive." Negative symptoms could be seen as those that are absent but should be present. Examples of negative symptoms include lack of motivation or apathy, blunted feelings, depression, and social withdrawal (1). Positive symptoms are those that should be present but are absent. Some examples of positive symptoms are hallucinations, delusions, thought disorder, and an altered sense of self (1). It is thought that hallucinations are the...
[1]Schizophrenia is a chronic and severe brain disorder, though most people may call it an illness. With this disorder the person is more likely to experience “Imaginary friends”,[2] Hearing voices that are not there, and being very paranoid. The people who have schizophrenia are often withdrawn and can be agitated easily. [3]The main thought to the symptoms are known to be paranoia, although the symptoms can vary depending on the person and what type of schizophrenia that he or she may have. [6][7]There are five types of schizophrenia, which include, paranoid, disorganized, catatonic, undifferentiated, and residual schizophrenia.
National Library of Medicine, National Institute of Health. Schizophrenia. 31 Jan 2013. Web. 15 May 2014
Some people have many different views and ideas about schizophrenia and what really is considered schizophrenia. “Eugen Bleuler had four primary symptoms were abnormal associations, autistic behavior and thinking, abnormal affect, and ambivalence. As well as the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association in its second edition was heavily influenced by Bleulers criteria to make the diagnosis of schizophrenia. Bleuler thought that between thought processes and thought, emotion, and behavior to be the hallmark of illnesses and the most obvious and striking manifestation of schizophrenia were only ‘accessory symptoms’ and saw symptoms of schizophrenia in a continuum with normal behavior” (Kaplan and Sadock, page 1432). The definition of schizophrenia is not just one disorder; other disorders branch out of the vague and interesting schizophrenia as in paranoid, catatonia, hebephrenia, disorganized, undifferentiated, residual, and many more.
Schizophrenia can be described by a wide-ranging spectrum of emotional and cognitive dysfunctions. These can include hallucinations, delusions, disorganized speech and behavior, as well as inappropriate emotions. Consequently, this disease can affect people from all walks of life. Since schizophrenia is such a complex disorder it can ultimately affect a person’s entire existence and their struggle to function daily. With a chronic disease like this, most people have a difficult time functioning in society. This can make it hard for someone who is schizophrenic to relate to others as well as maintain significant relationships. Life expectancy for those who suffer this illness tend to be shorter than average. This is due to the higher rate of accident and suicide. The symptoms of schizophrenia can be broken down into different categories: positive, negative and disorganized. Positive symptoms include hallucinations and delusions. These tend to be the more obvious signs of psychosis. On the other hand negative symptoms indicate deficits or absence of normal behavior which can affect sp...
Information regarding the study was handed out to participant along with, pocket sized notebooks, and instructions for how to utilize the notebooks for diary entries. Before the study started the participants were to attend and hour long training session where they had to identify behavior that misled their partner. They were also given examples to of deception and the categories of deception so they knew exactly what to report in their diary entries. The participants job was to record in their notebooks every time deception was used with their partner for a period of seven days. They were to record what for of deception was used whether it be, exaggerations, half truths, lies or secrets, which answered the first question in the study. In order to answer the second question of the study participants had to answer what there reasoning behind using deception
Morasco, B. J., Gfeller, J. D., & Elder, K. A. (2007). The Utility of the NEO–PI–R Validity Scales to Detect Response Distortion: A Comparison With the MMPI–2. Journal of Personality Assessment, 88(3), 227-281. doi:10.1080/00223890701293924