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1. [Year]Schizophrenia Homework Boooklet Contains all past papers, possible exam questions and essay sentence starters [Type the company name] [Type the company address]…
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  • 1. [Year]Schizophrenia Homework Boooklet Contains all past papers, possible exam questions and essay sentence starters [Type the company name] [Type the company address] [Type the phone number] [Type the fax number]
  • 2. January 2011 1. Outline clinical characteristics of schizophrenia. (5 marks) 2. Outline one psychological explanation of schizophrenia. (4 marks) 3. Evaluate psychological explanations of schizophrenia. (16 marks)AO1 = 5 marksCandidates are likely to describe symptoms included in the ICD or DSM manuals eg:thought control, delusions, hallucinatory voices, other persistent hallucinations,incoherent/irrelevant speech, catatonic behaviour, negative symptoms (such as lackof drive/motivation, flat affect, inappropriate emotional response and suddenmood swings). Clinical characteristics of schizophrenia could also legitimatelyinclude factors such as the prevalence, course and outcome of the disorder.However, causal explanations and evaluative commentary, forexample, on the difficulty of diagnosis, are not creditworthy. Similarly, theidentification of different types of schizophrenia is not creditworthy unless thecharacteristics of these different types are described.4 marks Candidates are required to provide an outline of one psychologicalexplanation of schizophrenia. Where candidates provide more than oneexplanation, examiners should credit the best account. Descriptions of biologicalexplanations are not creditworthy. Sociocultural explanations are included in thespecification as examples of psychological explanations and are perfectlyacceptable here. Answers are most likely to focus on one ofthe following explanations:• psychodynamic ( including family systems theory)• cognitive• behaviouralCandidates could also legitimately outline the role of expressed emotion inschizophrenia or refer to the social drift hypothesis. However, in both cases, theyare more relevant to explaining the maintenance of schizophrenia rather than itsorigins so candidates might find it difficult to access full marks here. An outline ofthe diathesis-stress explanation is acceptable provided the candidates emphasisethe psychological aspect. Evaluation of explanations receives no credit.AO2/AO3 = 16 marksCandidates are required to provide an evaluation of psychological explanations ofschizophrenia. The question refers to explanations in the plural since it could bedifficult for candidates to provide sufficient evaluative material on a singlepsychological explanation for full marks. However, given that evaluative points areoften relevant to more than one explanation, no partial performance criteria applyfor this question.Candidates can legitimately refer to biological explanations but answers will onlygain credit where the material is clearly used to offer commentary on the worth ofpsychological explanations. Detailed descriptions of biological explanations cannotgain credit. Similarly, detailed descriptions of psychological explanations cannotgain credit – the focus in this part of the question is on evaluation. The evaluationcan be both positive and negative:One criticism of psychodynamic theory, for example, is that it places responsibilityon mothers. The behavioural explanation is criticised, for example, because it ishard to accept 2
  • 3. that the bizarre and complex patterns of behaviour seen in people withschizophrenia can beacquired through simple learning processes; the cognitive explanation can becriticised for being descriptive rather than explanatory. More general evaluationsthat apply to most psychological explanations include the following none of themcan adequately account for the indisputable fact that schizophrenia runs in familiesand that the increased risk is directly associated with the degree of relatedness.There is a lack of strong empirical evidence to support the psychologicalexplanations and there is also a problem of disentangling cause and effect (eg doesfaulty thinking cause schizophrenia or vice versa?). It is also legitimate to refer totherapies ie that treatments arising from psychodynamic and behaviouralexplanations appear to have little therapeutic effect in schizophrenia.Another general point concerns the diversity of symptoms found in peoplediagnosed either with schizophrenia or a sub-type of schizophrenia – it may be thecase, for example, that some explanations can account for certain symptoms betterthan others. Candidates might also use the diathesis-stress model as a way ofreconciling biological and psychological explanations. 3
  • 4. Jan 2011‘There is considerable evidence that schizophrenia is caused by biologicalfactors. These can be genetic, neuroanatomical, biochemical, viral or acombination of such factors.’Discuss biological explanations of schizophrenia.As indicated in the quotation, there are various biological explanations ofschizophrenia. Candidates can access full marks by covering two in depth or morethan two in slightly less detail. Partial performance criteria apply where candidatesoffer only one biological explanation. It is difficult for candidates to offer detaileddescriptions of the genetic explanation so, in this case, description of studies whichhave provided evidence for heritability can be regarded as elaboration of theexplanation and, therefore, awarded AO1 credit. However, descriptions ofnumerous studies which make the same point do not meet the criteria for the highmark bands. The most likely biochemical explanation focuses on the dopaminehypothesis. Neuroanatomical explanations tend to focus on damaged brainstructures (abnormalities in the frontal and pre-frontal cortex, enlarged ventriclesetc). Other acceptable explanations include viral influences, birth complications,season of birth, maternal stress in pregnancy and links tosubstance abuse. Candidates may present neuropsychological models (Frith), this isacceptable provided that the focus is on biological elements of the model.Evolutionary explanations are acceptable. AO2/AO3 = 16 marksCandidates are required to provide an evaluation of biological explanations ofschizophrenia. The question refers to explanations in the plural. However, giventhat evaluative points are often relevant to more than one explanation, no partialperformance criteria apply for AO2/AO3.Candidates can legitimately refer to psychological explanations but answers willonly gain credit where the material is clearly used to offer commentary on theworth of biological explanations. Similarly, any discussion of therapies is onlycreditworthy if it is directly relevant to an assessment of the underlyingexplanation. Evaluation will depend on the particular explanation eg in the case ofgenetics, candidates could discuss the quality of supporting evidence and theproblems of drawing appropriate conclusions. For example, the data from someadoption studies have been re-analysed (eg Wahlberg et al, 2000 re-analysed datafrom tienari et al, 2000) to show rather less support for genetic factors than theoriginal researchers claimed. There is also a problem in longitudinal adoptionstudies that diagnostic criteria for schizophrenia have changed significantly overtime. Candidates might also consider the current situation in the search for thelocation of specific genes. Until these have been reliably identified, it is difficult tounderstand the precise mechanism of genetic transmission.Evaluation that consists solely of brief statements eg twins share the sameenvironment there is no 100% concordance with no elaboration or clear relevanceto schizophrenia only meets the criteria for basic. This is one explanation whichreally can be described as reductionist. However, candidates need to elaboratebeyond this is reductionist to show effective AO2/AO2 skills.Evaluation of other biological explanations might also focus on the quality ofsupporting evidence (eg contradictory results from different studies, issues ofcause and effect, animal studies). One general point that can be applied to mostbiological explanations concerns the diversity of symptoms found in people eitherdiagnosed with schizophrenia or a sub-type of schizophrenia . 4
  • 5. DISCUSS issues surrounding the classification and diagnosis ofschizophrenia. Jan 2010There are many issues surrounding the classification and diagnosis of mentaldisorders in general, most of which are related in some way to the idea of reliabilityand validity. It is acceptable to describe overarching issues as long as they haverelevance to schizophrenia. However, there are some issues, which are particularlyrelevant to schizophrenia eg the range of sub-types of schizophrenia and thedifficulty of distinguishing between them. For AO1 credit,candidates need to identify some of these issues. For example:• The reliability of the major classification systems ICD and DSM• The availability of other diagnostic criteria for schizophrenia eg Schneider criteria• The lack of homogeneity in schizophrenic symptoms• The problems of labelling• The problem of co-morbidity• The problem of distinguishing schizophrenia from, for example, mood or personality disorders• The lack of objective tests for schizophrenia• The difficulty of being able to predict outcome or response to treatment• Cultural differences in symptom presentation• The question of whether schizophrenia is a mental disorder at allCandidates who simply offer lists of signs and symptoms of schizophrenia or whodescribe classification systems are not really addressing the issues surroundingdiagnosis and classification. Such material is rudimentary.Examiners should be mindful of a depth/breadth trade-off here – candidates candescribe a few issues in detail or more issues in less detail..AO2/3 = 16 marks Discussion of issues surrounding the classification anddiagnosis of schizophrenia including methodological evaluation of the evidence.Candidates achieve AO2/3 credit by evaluating and offering commentary on theissues they have identified for example considering the consequences arising fromthe issue. They could discuss the advantages and disadvantages of usingclassification systems to diagnose schizophrenia. For example, diagnosis might leadto labelling which causes long-term problems for the person with schizophrenia interms of getting/keeping employment or establishing relationships. On the otherhand, careful diagnosis can lead to effective treatment programmes which would,otherwise, not be offered.. 5
  • 6. Jun 2010Therapies can be time-consuming and, in some cases, uncomfortable for theclient. It is, therefore, very important to offer the most appropriate and effectivetype of treatment.’Outline and evaluate two or more therapies used in the treatment ofschizophrenia.(9 marks + 16 marks)AO1 = 9 marks Outline of two or more appropriate therapies. Discussion oftherapies and methodological evaluation of evidence. Candidates are likely toevaluate therapies in terms of the issues raised in the quotation, but the wordingallows discussion of a wider range. Evaluation must be relevant to therapies suitedto schizophrenia. Material on other therapies will only be creditworthy if it isexplicitly used to offer relevant commentary.Issues of appropriateness could include:• the nature of the disorder means that some therapies are more appropriate than others• factors affecting the choice of treatment, eg financial constraints, availability of appropriate therapist, accuracy of original diagnosis• ethical issues, eg possible harmful side-effects, issues of informed consent, dehumanising effects of some treatments.Issues of effectiveness could include:• problems of measuring effectiveness, eg when to measure, how to measure, what criteria to choose.• Wide range of symptoms – treatments might be effective for some but not others• Placebo effects.There is an expectation that at least two therapies will be offered for AO1 credit.However, some evaluation points are likely to cover more than one type of therapyand so partial performance criteria will not apply to AO2/3.Credit could be for evaluation of research in terms of methodological issues,reliability, validity and the extent to which generalisations can be made, egtreatment outcome research often has problems of operational definition andissues concerning the allocation of participants to treatment groups. Other materialrelevant to How Science Works might include analysis and interpretation of data,accurate communication of ideas; applications and implications of scientificfindings in relation to the chosen therapy. 6
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