AQA A-level Psychology · 4.3.5

Schizophrenia

50 exam-style questions with answers for 4.3.5 Schizophrenia in AQA A-level Psychology (spec 7182). Practise with flashcards, a topic quiz, a random quiz across the course, 5 crosswords, or read every question and answer below. Not official AQA material.

All 50 questions and answers

Question 1 · Spec 4.3.5 · Classification
What is schizophrenia? [2 marks]
Answer:
A severe mental disorder in which contact with reality and insight are impaired (1); it affects about 1% of the population and is a form of psychosis (1).
Question 2 · Spec 4.3.5 · Classification
Outline how schizophrenia is classified in the DSM-5 and the ICD-10. [2 marks]
Answer:
DSM-5 requires at least one positive symptom, e.g. delusions or hallucinations (1); ICD-10 (and ICD-11) require two or more negative symptoms, or one positive symptom, so it is easier to be diagnosed using ICD (1).
Question 3 · Spec 4.3.5 · Positive symptoms
What are positive symptoms of schizophrenia? Give two examples. [3 marks]
Answer:
Atypical symptoms experienced in addition to normal experiences (1); hallucinations: unusual sensory experiences, e.g. hearing voices (1); delusions: irrational beliefs, e.g. believing you are an important person such as Jesus, or that you are being persecuted (1).
Question 4 · Spec 4.3.5 · Negative symptoms
What are negative symptoms of schizophrenia? Give two examples. [3 marks]
Answer:
A loss of usual abilities and experiences (1); speech poverty: reduced frequency and quality of speech (1); avolition: severe loss of motivation to carry out everyday activities, e.g. poor hygiene and lack of persistence at work (1).
Question 5 · Spec 4.3.5 · Positive symptoms
Classify each symptom as positive or negative: (a) hearing voices; (b) avolition; (c) believing you are being followed by the government. [3 marks]
Answer:
(a) positive (1); (b) negative (1); (c) positive (1).
Question 6 · Spec 4.3.5 · Reliability
Explain what is meant by reliability in the diagnosis of schizophrenia. [2 marks]
Answer:
Reliability is the consistency of diagnosis (1); inter-rater reliability means different clinicians should reach the same diagnosis for the same patient (1).
Question 7 · Spec 4.3.5 · Reliability
Explain one issue with the reliability of diagnosis of schizophrenia. [2 marks]
Answer:
Cheniaux et al. (2009) had two psychiatrists diagnose 100 patients using DSM and ICD (1); one diagnosed 26 with schizophrenia using DSM and 44 using ICD, the other 13 and 24, showing poor inter-rater reliability (1).
Question 8 · Spec 4.3.5 · Validity
Explain what is meant by validity in the diagnosis of schizophrenia. [2 marks]
Answer:
Validity is the extent to which we are diagnosing a real disorder that is distinct from others (1); criterion validity: whether different classification systems arrive at the same diagnosis (1).
Question 9 · Spec 4.3.5 · Validity
Explain one issue with the validity of diagnosis of schizophrenia. [2 marks]
Answer:
Cheniaux et al. found schizophrenia was much more likely to be diagnosed using ICD than DSM (1); so schizophrenia is either over-diagnosed in ICD or under-diagnosed in DSM, showing poor criterion validity (1).
Question 10 · Spec 4.3.5 · Co-morbidity
Explain how co-morbidity is a problem for the diagnosis of schizophrenia. [3 marks]
Answer:
Co-morbidity is when two or more conditions occur together (1); Buckley et al. (2009) found about half of schizophrenia patients also had depression and 47% had substance abuse (1); this suggests schizophrenia may not be a single disorder, which challenges validity (1).
Question 11 · Spec 4.3.5 · Symptom overlap
Explain how symptom overlap is a problem for the diagnosis of schizophrenia. [2 marks]
Answer:
Many symptoms of schizophrenia, e.g. hallucinations and avolition, also occur in other disorders such as bipolar disorder (1); this makes it hard to distinguish schizophrenia from other conditions, reducing validity (1).
Question 12 · Spec 4.3.5 · Gender bias
Explain how gender bias may affect the diagnosis of schizophrenia. [2 marks]
Answer:
Men are diagnosed more than women, possibly because women function better, e.g. having better relationships (1); Cotton et al. (2009) suggested this may lead to under-diagnosis in women, as they may hide symptoms (1).
Question 13 · Spec 4.3.5 · Culture bias
Explain how culture bias may affect the diagnosis of schizophrenia. [2 marks]
Answer:
African-Americans and Afro-Caribbeans are much more likely to be diagnosed than white people (1); positive symptoms such as hearing voices may be more acceptable in some cultures, so they may be misinterpreted by white psychiatrists (1).
Question 14 · Spec 4.3.5 · Genetics
Outline the genetic explanation for schizophrenia. [3 marks]
Answer:
Schizophrenia runs in families: Gottesman (1991) found the risk increases with genetic similarity, e.g. 48% for MZ twins, 17% for DZ twins and 9% for siblings (1); it is polygenic, involving many candidate genes, e.g. those related to dopamine (1); it is also aetiologically heterogeneous: different combinations of genes can cause it (1).
Question 15 · Spec 4.3.5 · Genetics
Explain one strength of the genetic explanation for schizophrenia. [2 marks]
Answer:
Tienari et al. (2004) found adopted children whose biological mothers had schizophrenia were more likely to develop it (1); this shows a genetic influence separate from the environment (1).
Question 16 · Spec 4.3.5 · Genetics
Explain one limitation of the genetic explanation for schizophrenia. [2 marks]
Answer:
MZ twins have only 48% concordance, so genes cannot be the only cause (1); environmental factors, e.g. family dysfunction or cannabis use, must also be involved (1).
Question 17 · Spec 4.3.5 · Neural correlates
Outline the original dopamine hypothesis. [3 marks]
Answer:
Schizophrenia is linked to high levels of dopamine (hyperdopaminergia) in the subcortex (1); e.g. excess dopamine receptors in Broca's area may explain speech poverty and auditory hallucinations (1); drugs that increase dopamine, e.g. amphetamines, can cause schizophrenia-like symptoms (1).
Question 18 · Spec 4.3.5 · Neural correlates
Outline the revised dopamine hypothesis. [2 marks]
Answer:
Davis et al. (1991) proposed low levels of dopamine (hypodopaminergia) in the prefrontal cortex (1); this may explain negative symptoms, while high levels in the subcortex explain positive symptoms (1).
Question 19 · Spec 4.3.5 · Neural correlates
Outline one other neural correlate of schizophrenia. [2 marks]
Answer:
Juckel et al. (2006) found reduced activity in the ventral striatum, which is involved in anticipation of reward (1); this is correlated with negative symptoms such as avolition (1).
Question 20 · Spec 4.3.5 · Neural correlates
Explain one strength of the dopamine hypothesis. [2 marks]
Answer:
Antipsychotic drugs that reduce dopamine activity reduce symptoms of schizophrenia (1); and amphetamines that increase dopamine can produce schizophrenia-like symptoms, supporting a link (1).
Question 21 · Spec 4.3.5 · Neural correlates
Explain one limitation of the dopamine hypothesis. [2 marks]
Answer:
Glutamate may also be involved, as several candidate genes are linked to glutamate (1); and correlations between dopamine and schizophrenia do not show cause, as dopamine levels could be an effect of the disorder (1).
Question 22 · Spec 4.3.5 · Family dysfunction
Outline the schizophrenogenic mother explanation. [2 marks]
Answer:
Fromm-Reichmann (1948) proposed some mothers are cold, rejecting and controlling (1); this creates a family climate of tension and secrecy, which leads to distrust and paranoid delusions (1).
Question 23 · Spec 4.3.5 · Family dysfunction
Outline the double-bind theory. [3 marks]
Answer:
Bateson et al. (1956) proposed the child receives contradictory messages from parents (1); e.g. being told they are loved while being shown no affection (1); the child fears doing the wrong thing and this prevents them developing an internally coherent construction of reality, leading to disorganised thinking (1).
Question 24 · Spec 4.3.5 · Family dysfunction
What is expressed emotion? [2 marks]
Answer:
The level of negative emotion expressed towards the patient by carers (1); e.g. verbal criticism, hostility and emotional over-involvement, which is a source of stress that may trigger relapse (1).
Question 25 · Spec 4.3.5 · Family dysfunction
Explain one limitation of family dysfunction as an explanation for schizophrenia. [2 marks]
Answer:
Evidence for the schizophrenogenic mother and double-bind theories is weak, relying on clinical observation (1); and they blame parents, which may cause distress for families of patients (1).
Question 26 · Spec 4.3.5 · Cognitive explanations
Outline Frith et al.'s (1992) cognitive explanation for schizophrenia. [3 marks]
Answer:
Schizophrenia is linked to dysfunctional thought processing (1); metarepresentation dysfunction: the inability to reflect on thoughts and recognise them as one's own, leading to hearing voices and thought insertion (1); central control dysfunction: the inability to suppress automatic responses, leading to speech poverty and derailment (1).
Question 27 · Spec 4.3.5 · Cognitive explanations
Explain one strength of the cognitive explanation for schizophrenia. [2 marks]
Answer:
Stirling et al. (2006) found patients took twice as long to complete the Stroop test as a control group (1); this supports the idea of central control dysfunction (1).
Question 28 · Spec 4.3.5 · Cognitive explanations
Explain one limitation of the cognitive explanation for schizophrenia. [2 marks]
Answer:
It explains the symptoms but not the origins of dysfunctional thought processing (1); so it is a proximal explanation, and biological factors may cause the cognitive problems (1).
Question 29 · Spec 4.3.5 · Drug therapy
Outline typical antipsychotics as a treatment for schizophrenia. [3 marks]
Answer:
Typical antipsychotics, e.g. chlorpromazine, have been used since the 1950s (1); they are dopamine antagonists that block dopamine receptors in the synapse, reducing dopamine action (1); this reduces positive symptoms such as hallucinations (1).
Question 30 · Spec 4.3.5 · Drug therapy
Outline atypical antipsychotics as a treatment for schizophrenia. [3 marks]
Answer:
Atypical antipsychotics, e.g. clozapine and risperidone, were developed from the 1970s (1); clozapine binds to dopamine, serotonin and glutamate receptors, improving mood and reducing depression (1); they aim to improve effectiveness and reduce side effects, and can treat negative symptoms (1).
Question 31 · Spec 4.3.5 · Drug therapy
Explain one strength of antipsychotic drugs. [2 marks]
Answer:
Thornley et al. (2003) reviewed studies and found chlorpromazine was associated with better functioning and reduced symptoms compared with a placebo (1); and relapse rates were lower, showing drugs are effective (1).
Question 32 · Spec 4.3.5 · Drug therapy
Explain one limitation of antipsychotic drugs. [2 marks]
Answer:
They have serious side effects, e.g. typical antipsychotics can cause tardive dyskinesia (involuntary facial movements) and neuroleptic malignant syndrome (1); and they may act as a 'chemical cosh', calming patients rather than treating the disorder (1).
Question 33 · Spec 4.3.5 · CBT
Outline CBT as a treatment for schizophrenia. [3 marks]
Answer:
Patients have around 5–20 sessions, individually or in groups (1); patients learn to identify irrational thoughts and understand the origins of symptoms, e.g. that voices are their own thoughts (1); this helps them challenge delusions and reduce anxiety, although it does not cure the condition (1).
Question 34 · Spec 4.3.5 · CBT
Explain one strength of CBT for schizophrenia. [2 marks]
Answer:
Jauhar et al. (2014) reviewed 34 studies and found CBT had a significant but small effect on positive and negative symptoms (1); and NICE recommends CBT for schizophrenia (1).
Question 35 · Spec 4.3.5 · Family therapy
Outline family therapy as a treatment for schizophrenia. [3 marks]
Answer:
Treatment with the family of the patient, aiming to improve communication and interaction (1); it aims to reduce expressed emotion and the stress that could trigger relapse (1); Burbach (2018) set out a model including forming a therapeutic alliance, reducing anger and guilt, and improving the family's ability to anticipate and solve problems (1).
Question 36 · Spec 4.3.5 · Family therapy
Explain one strength of family therapy. [2 marks]
Answer:
McFarlane (2016) found family therapy was one of the most effective treatments, with relapse rates reduced by 50–60% (1); it also benefits the whole family, e.g. by reducing stress for carers (1).
Question 37 · Spec 4.3.5 · Token economies
Outline token economies in the management of schizophrenia. [3 marks]
Answer:
Tokens are given immediately for desirable behaviour, e.g. personal hygiene (1); tokens are secondary reinforcers that can be exchanged for primary reinforcers, e.g. sweets or privileges (1); this aims to manage negative symptoms such as avolition by reinforcing desired behaviour (1).
Question 38 · Spec 4.3.5 · Token economies
Explain one limitation of token economies. [2 marks]
Answer:
Behaviour may not transfer outside the hospital, as the tokens are no longer available (1); and there are ethical issues, as patients who are severely ill may be unable to earn tokens and be deprived of privileges (1).
Question 39 · Spec 4.3.5 · Token economies
Explain the difference between treating and managing schizophrenia. [2 marks]
Answer:
Treatment aims to reduce the symptoms or cure the disorder, e.g. drug therapy (1); management aims to make the condition more bearable and help the patient live with it, e.g. token economies (1).
Question 40 · Spec 4.3.5 · Diathesis-stress
Outline the diathesis-stress model of schizophrenia. [3 marks]
Answer:
Both a vulnerability (diathesis) and a trigger (stressor) are needed for schizophrenia to develop (1); Meehl (1962) argued the diathesis was a single 'schizogene', but modern views see it as polygenic or caused by early trauma (1); stressors can include psychological trauma or cannabis use (1).
Question 41 · Spec 4.3.5 · Diathesis-stress
Outline one study supporting the diathesis-stress model. [2 marks]
Answer:
Tienari et al. (2004) studied adopted children of mothers with schizophrenia (1); a high genetic risk combined with a high level of family criticism was linked to greater risk of schizophrenia (1).
Question 42 · Spec 4.3.5 · Interactionist approach
Explain the importance of an interactionist approach in treating schizophrenia. [2 marks]
Answer:
Combining biological and psychological treatments, e.g. antipsychotics and CBT, is more effective than either alone (1); Tarrier et al. (2004) found patients on medication plus CBT had lower symptom levels than those on medication only (1).
Question 43 · Spec 4.3.5 · Interactionist approach
Explain one limitation of the interactionist approach. [2 marks]
Answer:
It is hard to identify the precise role of each factor or how they interact (1); and the original diathesis-stress model is oversimplified, as there are many genes and stressors involved (1).
Question 44 · Spec 4.3.5 · Drug therapy
Explain why the effectiveness of antipsychotics may have been exaggerated. [2 marks]
Answer:
Healy (2012) suggested some successful trials were published several times, exaggerating the evidence (1); and the calming effect of drugs may make patients easier to manage rather than actually treating symptoms (1).
Question 45 · Spec 4.3.5 · Classification
Explain why the diagnosis of schizophrenia may lead to labelling. [2 marks]
Answer:
A diagnosis may cause the person to be seen and treated differently by others (1); and they may come to see themselves as 'a schizophrenic', which may affect recovery (1).
Question 46 · Spec 4.3.5 · Positive symptoms
Explain the difference between a hallucination and a delusion. [2 marks]
Answer:
A hallucination is a sensory experience that is not based on reality, e.g. seeing or hearing things (1); a delusion is a false belief that has no basis in reality, e.g. paranoid or grandiose beliefs (1).
Question 47 · Spec 4.3.5 · Negative symptoms
What is meant by alogia? [2 marks]
Answer:
Alogia is another term for speech poverty (1); it includes reduced amount or quality of speech, and speech blocking (1).
Question 48 · Spec 4.3.5 · Genetics
Explain why family studies cannot fully demonstrate a genetic basis for schizophrenia. [2 marks]
Answer:
Family members share the same environment as well as genes (1); so the higher risk in relatives may be due to environmental factors, e.g. family dysfunction (1).
Question 49 · Spec 4.3.5 · Neural correlates
Explain why neural correlates do not prove that brain differences cause schizophrenia. [2 marks]
Answer:
A correlation shows a relationship but not cause and effect (1); brain differences could be a result of the disorder, or of medication, rather than the cause (1).
Question 50 · Spec 4.3.5 · Treatments
A patient with schizophrenia relapses after returning home to a critical family. Which treatment would be most suitable? Explain why. [2 marks]
Answer:
Family therapy (1); because it reduces expressed emotion, which is a source of stress that can trigger relapse (1).

← 4.3.4 Cognition and development 4.3.6 Eating behaviour →

Schizophrenia

All 50 questions and answers

More AQA A-level Psychology topics

Cookies on Knowledge Noodles

Cookie settings