Taylor’s College Cambridge A-Levels Programme

9990 Psychology
A2 Level Tutorial (August 2021)

Paper 3 Essay Based Qs

1. (a) Describe characteristics and assessment of schizophrenia spectrum and psychotic

disorders. [8]
Syllabus Content
a. Definition
b. Case study
c. DSM-V positive and negative symptoms of SZ
d. Delusional disorders
e. VR symptoms assessment – FREEMAN, 2008- aim, sample, procedures, findings
and conclusions
(Barely One page)

(b) Evaluate characteristics and assessment of schizophrenia spectrum and psychotic

disorders, including a discussion of validity. [10]

Usefulness, Determinism vs Freewill, Reductionism vs holism, cultural bias, reliability,

generalization, individual vs situational, nature vs nurture, methodology (strength or
weaknesses)

RULE: CHOOSE AN APPROPRIATE ISSUE OR DEBAT, EVALUATE 3 ISSUES INCLUDING

THE NAMED ISSUE. DO NOT REPEAT INFORMATION/POINTS

Validity- DSM-V is valid measure to determine the positive and negative symptoms of
SZ; symptoms are part of the DSM-V after many review of SZ of cases around the
world. 6 months or more- diagnosed as SZ; case study is valid- the in depth
information regarding paranoid SZ symptoms were real and behavior was real. The
study of VR is not valid- low population validity- the sample was not real SZ patient,
non-clinical population

Reliability: DSM-V is reliable- symptoms listed in the manual is similar to the

symptoms of SZ patients in the western setting. The manual is develop after review
may SZ patients and assessment of symptoms. The study of freeman is reliable-
standardized procedures- replicable- the standardized use of VR- local train setting or
library setting- all participants were under the VR and wore the head gear.

Cultural Bias- all the symptoms indicated in the DSM-V is culturally biased-based on
the western symptoms assessment-based on the western population who display the
symptoms of SZ- not culturally universal- different culture or ethnic or different
countries may have different types of symptoms display by the SZ. Positive and
negative may not be universal; FREEMAN- universal- the use of VR can be applied in
many cultures and uses of VR- treatment programs- universal-can be applied to all
people around the world.
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9990 Psychology
A2 Level Tutorial (August 2021)

Case Study- highly valid- in depth, ecological validity, usefulness; not generalizable,
not reliable.

Usefulness/application- DSM-V can be useful to diagnose SZ cases; other types of

disorders- depression; case study- further reference to similar cases- psychiatrist.
DSM-V positive and negative- understand the symptoms of SZ and diagnoses. The
study of freeman- assess symptoms of SZ effectively, have treatment- hierarchal fear
test, educate SZ on their symptoms, learning to cope

Determinism-

2. (a) Describe explanations of schizophrenia and delusional disorder. [8]

(b) Evaluate explanations of schizophrenia and delusional disorder, including a

discussion of reductionism. [10]

3. (a) Describe the treatment and management of schizophrenia and delusional disorder.
[8]
a. biochemical treatment- antipsychotics and atypical antipsychotics
b. ECT
c. Token economy- Paul & Lentz
d. CBT- Sensky

(b) Evaluate the treatment and management of schizophrenia and delusional disorder,
including a discussion of determinism. [10]
Determinism vs freewill- biochemical treatment- antipsychotics and atypical antipsychotic-
the affect of the treatment is definitive and the patients cannot control the reduction of
symptoms of SZ- the medication works by reducing the dopamine in the synaptic gap,
increasing the breakdown of the dopamine. ECT is also deterministic- this treatment is
chosen when other treatments fails- the treatment is necessary because it involves
rewiring the brain- improvement can be seen within 2 to 3 weeks- patient cannot control
the changes in the brain or CNS. Token economy is more freewill- patients can choose to
participate in the therapy0 they can choose to withdraw from the programe if they do not
feel comfortable. CBT- more freewill- patients can choose to participate in the therapy or
not participate- level of engagement can differ form one client to other client.
 Taylor’s College Cambridge A-Levels Programme
9990 Psychology
A2 Level Tutorial (August 2021)

Effectiveness- biochemical treatment is effective-antipsychotic is effective in treating the

symptoms of SZ Haddad & Correll (2018) found the proportion of patients who showed a
marked to moderate degree of improvement was 75% for those who received
antipsychotic treatment and 23% for those who received placebo. ECT is proven to
effective. Grover et al (2017) – 63% of the patients with treatment resistant SZ showed
>30% reduction symptoms. Token economy is also effective – the social learning program
in the Paul & Lentz study showed significant improvement in the positive and negative
symptoms of SZ. CBT is also proven to effective even after 9 month follow up. Sensky- the
CBT group has reduction in the symptoms of SZ even after 9 months.

Appropriateness- cost and side effects.

Biochemical treatments- costly if the treatment persists for a long period od time. The cost
of certain antipsychotic can be expensive and not affordable. ECT cam be more
economically friendly as the treatment is done in a hospital and the patient may opt to go to
a public hospital and the cost will be cheaper.

Token economy can be costly if they program is conducted in a private institution. The cost
od the rewards can be included in the patients admission cost.
CBT can be costly as it depends on the no of session patients reqiore to see improvement-
the payments is made per session- the longer the session, the more expensive it will be.
CBT if done pribate setting can be expensive as well. Biochemical and ECT is more ethical
compared to token economy and CBT- biochemical treatment and ECT- patients are
completely aware of the treatment- consumption of medication is with the consent of the
aptients

Paper 4
People with symptoms of schizophrenia are often diagnosed through an
interview with their doctor. Freeman (2008) says virtual reality (VR) is useful
for symptom assessment and the treatment of psychotic disorders. Freeman
also says this technology has many other applications.

(a) Explain the symptoms of schizophrenia which are targeted by virtual reality.
[2]

Suggest two uses of VR in abnormal psychology, other than the application to SZ

(4)
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9990 Psychology
A2 Level Tutorial (August 2021)

can be used for other disorders such as depression or anxiety - knowing the
environmental factors which may trigger anxiety or depression and remove or avoid
those factors.
To identify people who are at higher risk of developing certain mental disorders such
as depression and educating these people about the disorder and about precautionary
measures

Give two differences between the use of virtual reality for symptom assessment
of schizophrenia and an interview with a doctor. (4)

VR does not involve face to face contact - the individual will have contact with the VR
headgear whereas an interview requires them to be face-to-face and speaking directly
to the doctor

an interview with a doctor could have possible issues with validity as there may be
interviewer bias as well as social desirability whereas VR may reduce the bias by
reducing the contact between the interviewer and sz - the patient are in a VR headgear
- no chances of bias.

In an interview where patients are asked questions, patients may not be in a state
where they are able to provide honest, coherent answers e.g. due to alogia or
anhedonia, cannot gather in-depth information. When using virtual reality for
symptom assessment, can gather information from observing patients so patients do
not need to be asked questions - assess real time symptoms of SZ

(d) Discuss the strengths and weaknesses of using virtual reality to treat
schizophrenia. You should include a conclusion in your answer.
[5]

2 marks- strengths link to q

2 – weaknesses link to q
1 – conclusion- DO NOT SUMMARIZE- reasonnnn outtt

Strength:

reliability- the same VR technology can be used for multiple patients in multple
experiments allowing replicability and reliability

treatment can be carry out in a safe environment for the patients (ethics)

weakness:

may going through some side effects. For example headache and dizziness (ethics)
 Taylor’s College Cambridge A-Levels Programme
9990 Psychology
A2 Level Tutorial (August 2021)

weakness- ethics- rights of withdrawal may not be clear to patient as once they are in
the VR simulation they may forget that they are in the simulation and feel unable to
escape

The study lacks ecological validity due to the use of virtual avatars which could not
completely replicate the expressions of a real human being. Therefore, the subsequent
behaviours of participants towards virtual avatars may not necessarily be the same as
compared to if they were in a real social setting. As such, it can be argued whether or
not reducing symptoms of patients towards virtual avatars can be applied to reducing
their symptoms in real life as well.

Conclusion:
in conclusion; while VR technology does suffer from some ethical issues such as rights
to withdrawal and possible psychological and physical harm-these issues are arguably
negliagle and solvable if the technology is improved therefore ultimately VR
technology is still a useful measure in assessing SZ