Sample question (and answer) on schizophrenia
(a) Outline clinical characteristics of schizophrenia.
(5 marks)
Examiner notes
The term ‘clinical characteristics’ does not have one specific meaning, so could be a brief outline of the
different forms of schizophrenia and their characteristics, although it is most likely to mean the ‘symptoms’
of schizophrenia. As this question is only worth five marks, you would not be expected to cover all the
possible symptoms of schizophrenia, so perhaps it is best to illustrate the concept of positive symptoms with
a couple of examples and the same with negative symptoms. Remember this is only worth five marks, so
probably 150 words would suffice.
5 – 4 marks
Outline is accurate and coherent
3 – 2 marks
Outline is limited, generally accurate and reasonably coherent
1 mark
Outline is weak and muddled or very limited
0 mark
No creditworthy material
There are two main types of clinical characteristic in schizophrenia. These are the positive and
negative symptoms. Positive clinical characteristics are symptoms like hearing voices or seeing
hallucinations. A person who sees things that aren’t there, or hears things that aren’t there is
experiencing hallucinations. Another important positive symptom is experiencing delusions, like a
delusion of grandeur, e.g. a person imagining that they are famous. Negative symptoms include
things like not being able to experience pleasure or responding to questions using a meaningless
phrase.
(b) Explain issues associated with the classification and/or diagnosis of schizophrenia. (10 marks)
Examiner notes
Questions that use the term ‘explain’ can be hard to decipher as sometimes explain can be AO1 and AO2
and sometimes (as here), it is AO2 only. It is examination board advice to simply ignore the injunction and
answer the question, and this is perhaps one of the rare occasions where that advice is helpful. Identifying
the issues (remember to cover at least two) would be considered the product of analysis (and therefore
AO2), and further elaboration of those issues would push the mark up into the higher mark bands.
Reliability and validity are the usual issues although there are others such as labelling and stigmatising,
overlap with other disorders and so on. Note that this question is about schizophrenia and should be
restricted to this disorder.
AO2/AO3 mark allocation
10-9 marks Effective
Explanation demonstrates sound analysis and understanding. The answer is well focused and shows
coherent elaboration and/or a clear line of argument. Ideas are well structured and expressed clearly
and fluently. Consistently effective use of psychological terminology. Appropriate use of grammar,
punctuation and spelling.
8-6 marks Reasonable
Explanation demonstrates reasonable analysis and understanding. The answer is generally focused
and shows reasonable elaboration and/or a line of argument is evident. Most ideas appropriately
structured and expressed clearly. Appropriate use of psychological terminology. Minor errors of
grammar, punctuation and spelling only occasionally compromise meaning.
5-3 marks Basic
Explanation demonstrates basic, superficial understanding. The answer is sometimes focused and
shows some evidence of elaboration. Expression of ideas lacks clarity. Limited use of psychological
terminology. Errors of grammar, punctuation and spelling are intrusive.
2-1 marks Rudimentary
Explanation is rudimentary demonstrating very limited understanding. The answer is weak, muddled
and incomplete. Material is not used effectively and may be mainly irrelevant. Deficiency in
expression of ideas results in confusion and ambiguity. The answer lacks structure, often merely a
series of unconnected assertions. Errors of grammar, punctuation and spelling are frequent and
intrusive.
0 marks No creditworthy material is presented
There are several issues that could affect the diagnosis and classification of schizophrenia. The first of
these is reliability. Reliability means that if a classification system is used by different people, then they
should produce the same outcome. If they do produce the same outcome (i.e. a diagnosis of
schizophrenia), then they have inter-rater reliability. Early versions of the DSM were less reliable than
later versions such as DSM-IV, therefore are considered to be of more use to psychiatrists.
The second issue is validity, whether classifying someone as schizophrenic means that the symptoms
that they experience are the same and that they respond to treatment in the same way. If different
patients respond to treatment in the same way (e.g. through drug treatments) then diagnosis has
predictive validity. However, evidence suggests this is not the case, as drug treatments are not
successful with all patients, and some people never recover from schizophrenia, whereas others
recover more or less completely.
A third issue is the ethics of diagnosis. Some psychologists believe that by diagnosing someone with
schizophrenia they are being stigmatised, which will change their life for the worse because of the
way other people will react towards them. However, others disagree, claiming that by diagnosing
someone with schizophrenia it makes their condition less frightening for them.
(c) Outline and evaluate one biological therapy used in the treatment of schizophrenia. (4 marks
+ 6 marks)
Examiner notes
This question indicates the number of marks available for AO1 (4) and for AO2 (6). As is always the case, this
should dictate how much you write for each in response. Note also that the therapy must be biological and
that you should only write about one. The most likely therapy would be drug therapy and this might be
restricted to conventional antipsychotics or may also include a brief outline (most probably their mode of
action) of atypical antipsychotics. Evaluation might include a consideration of their effectiveness, ethical
issues in the use of drug treatments and so on.
AO1 mark allocation
4 marks
Outline is reasonably thorough, accurate and coherent
3-2 marks
Outline is limited, generally accurate and reasonably coherent
1 mark
Outline is weak and muddled or very limited
0 marks
No creditworthy material
AO2/AO3 mark allocation
6 marks Effective
Commentary demonstrates sound analysis and understanding. Application of knowledge is effective
and shows coherent elaboration. Ideas are well structured and expressed clearly and fluently.
Consistently effective use of psychological terminology. Appropriate use of grammar, punctuation
and spelling.
5-4 marks Reasonable
Commentary demonstrates reasonable analysis and understanding. Application of knowledge is
reasonably effective and shows some elaboration. Most ideas appropriately structured and
expressed clearly. Appropriate use of psychological terminology. Minor errors of grammar,
punctuation and spelling only occasionally compromise meaning.
3-2 marks Basic
Commentary demonstrates basic, superficial understanding. Application of knowledge is basic.
Expression of ideas lacks clarity. Limited use of psychological terminology. Errors of grammar,
punctuation and spelling are intrusive.
1 mark Rudimentary
Commentary is rudimentary demonstrating very limited understanding. Application of knowledge is
weak, muddled and may be mainly irrelevant. Deficiency in expression of ideas results in confusion
and ambiguity. The answer lacks structure, often merely a series of unconnected assertions. Errors
of grammar, punctuation and spelling are frequent and intrusive.
0 marks No creditworthy material is presented.
A common biological therapy used in the treatment of schizophrenia is anti-psychotic drugs. These
work by blocking the action of dopamine. Schizophrenia is thought to be caused by too much
dopamine activity in the brain, which leads to the positive symptoms such as delusions and
hallucinations. Anti-psychotic drugs block the receptors that receive dopamine, so that the symptoms
are reduced. Drug treatments of schizophrenia are widely used because they are effective in reducing
the positive symptoms. However, they are not effective in the treatment of negative symptoms, where
psychological treatments are more likely to be used. Drug treatments are also more likely to have side
effects. For example, they can become addictive if taken continuously. Drug treatments also tend to
have side effects, which are often disturbing enough to stop the patient taking the drug. Drug
treatments may not offer a complete cure, and may only have a positive effect on the symptoms of
schizophrenia so long as the patient is taking the drugs. As soon as they stop taking the drug, the
symptoms (and thus the schizophrenia) reappears. Finally, there are ethical issues in the use of drugs
for the treatment of schizophrenia. The use of anti-psychotics has been likened to a chemical
straitjacket, and they also take away the personal responsibility of the schizophrenic for their own
recovery.