AQA A-level Psychology (7182): Paper 3 – Schizophrenia – Practice Questions

These are original questions written for Marlbridge, for revision and practice on this content. They are not reproduced past-paper questions, and they do not replicate the exam’s exact structure, question count or mark tariffs – examination boards hold copyright in their own papers. Use these alongside the official past papers from your board or school.

This set practises Schizophrenia for AQA A-level Psychology (7182), from the AQA AS and A-level Psychology (7181, 7182) specification, Version 1.4 (1 September 2025), for teaching from September 2025. It covers every point in section 4.3.5, plus the research methods and maths skills that section 4.3 says are assessed in Paper 3. The specification places Schizophrenia in Option 2, assessed in Section C of Paper 3: Issues and Options in Psychology. All people, places and data in the questions are fictional.

Revise first with the Schizophrenia study guide and the Schizophrenia revision notes. The 7182 course hub and the 7182 checklist show the rest of the course.

Questions

1. Explain the difference between a positive symptom and a negative symptom of schizophrenia. [2]

2. Read the description below.

Daniyal (fictional), aged 26. Daniyal has told his sister that a television presenter sends him secret instructions through the evening news, which he must decode each night. Over six months he has stopped going to work, no longer cooks or washes his clothes and spends most days in his room. When his sister asks how he is, he usually says “fine” and nothing more, often after a long pause. His doctor notes that he reports very low mood and has been drinking heavily.

(a) Identify one positive symptom and one negative symptom shown by Daniyal. Use evidence from the description for each. [4] (b) Explain how co-morbidity and symptom overlap could make diagnosis difficult in Daniyal’s case. [4]

3. Outline the dopamine hypothesis as an explanation of schizophrenia. [4]

4. A research team studied twin pairs on the fictional Northmere Twin Register. In each pair, at least one twin had a diagnosis of schizophrenia.

Twin type	Number of pairs	Pairs where both twins had a diagnosis
Monozygotic (identical)	60	27
Dizygotic (non-identical)	80	12

(a) Calculate the concordance rate, as a percentage, for each twin type. Show your working. [2] (b) Explain what these data suggest about the genetic explanation of schizophrenia, and give one reason why they do not show that genes alone cause it. [4]

5. Distinguish between typical and atypical antipsychotics. [4]

6. Outline expressed emotion as a family dysfunction explanation of schizophrenia. [3]

7. At the fictional Ashcombe Clinic, 120 people with schizophrenia were randomly allocated to two groups. One group of 60 received family therapy alongside medication. The other group of 60 received medication only. After 12 months, 15 people in the family therapy group and 27 people in the medication-only group had relapsed.

(a) Calculate the percentage of each group that relapsed. [2] (b) Name a suitable statistical test for these data and give two reasons for your choice. [3] (c) The calculated value of chi-squared was 5.27. The critical value for df = 1 at p ≤ 0.05 (two-tailed) is 3.84. State whether the result is significant and explain why. [2] (d) Explain why the clinicians who judged relapse should not have known which group each person was in. [2]

8. Read the description below.

Ruth (fictional), aged 34. Ruth hears a voice she believes belongs to her former manager. It criticises her when she is alone in the evening. She is convinced he has hidden a microphone in her flat and rarely goes out.

Explain how a therapist might use cognitive behaviour therapy with Ruth. [4]

9. Explain how dysfunctional thought processing could account for symptoms of schizophrenia. [4]

10. Evaluate drug therapy as a treatment for schizophrenia. Refer to both typical and atypical antipsychotics. [8]

11. Discuss culture bias and gender bias in the diagnosis of schizophrenia. [8]

12. Discuss the importance of an interactionist approach in explaining and treating schizophrenia. Refer to the diathesis-stress model in your answer. [16]

Answers

Extended responses (questions 10-12) are marked in the real exam with levels of response, not point by point. The points below show the kind of content that earns credit.

1. A positive symptom is an experience added to normal functioning, such as hallucinations [1]. A negative symptom is a loss or reduction of normal functioning, such as avolition [1]. [2] Examiner insight: “Positive” does not mean desirable; an answer that implies it gains nothing for that half.

2. (a) Positive: a delusion [1]. He believes a presenter sends him secret instructions through the news, with no evidence for it [1]. Negative: avolition [1]. He has stopped going to work and no longer cooks or washes his clothes [1]. Speech poverty (“fine” after a long pause) is also creditworthy as the negative symptom. [4] (b) Co-morbidity: his low mood and heavy drinking may be depression and a substance use disorder occurring alongside schizophrenia [1]. The clinician must decide whether these are separate conditions, which affects which treatments are offered [1]. Symptom overlap: withdrawal, low motivation and short replies are also features of depression [1], so one clinician might diagnose schizophrenia and another depression, which lowers the accuracy of diagnosis [1]. [4] Examiner insight: each mark in (b) needs a detail from Daniyal’s case; a textbook definition of co-morbidity alone earns very little.

3. The original hypothesis proposed hyperdopaminergia, excess dopamine activity in subcortical areas [1], linked to positive symptoms such as hallucinations [1]. The revised hypothesis added hypodopaminergia in the prefrontal cortex [1], linked to negative symptoms such as avolition [1]. [4] Examiner insight: name the brain area for each version; “too much dopamine” with no location is too vague for full marks.

4. (a) Monozygotic: 27 / 60 x 100 = 45% [1]. Dizygotic: 12 / 80 x 100 = 15% [1]. [2] (b) Monozygotic concordance (45%) is three times dizygotic concordance (15%) [1]. Monozygotic twins share all their genes and dizygotic twins share about half, so higher concordance with greater genetic similarity suggests a genetic influence [1]. However, 55% of monozygotic pairs were not concordant despite identical genes, so other factors must be involved [1]. Also, twins raised together share an environment, and identical twins may be treated more alike, which could raise their concordance [1]. [4] Examiner insight: use the actual figures from the table; “MZ is higher” with no numbers misses the application mark.

5. Typical antipsychotics are older drugs, such as chlorpromazine [1], that work mainly by blocking dopamine D2 receptors [1]. Atypical antipsychotics, such as clozapine, came into wide use later and act on dopamine and on other systems such as serotonin [1]. Typical drugs are more often linked to movement side effects, while some atypicals are linked to weight gain or, for clozapine, a fall in white blood cells [1]. [4] Examiner insight: “distinguish” needs a clear contrast, so set each feature of one type against the same feature of the other.

6. Expressed emotion is the level of criticism and hostility shown by family members towards the person [1], together with emotional over-involvement, such as intrusive concern [1]. High expressed emotion acts as a source of stress and is linked to a higher risk of relapse [1]. [3] Examiner insight: say that EE mainly predicts relapse; presenting it as the original cause is a common error.

7. (a) Family therapy group: 15 / 60 x 100 = 25% [1]. Medication-only group: 27 / 60 x 100 = 45% [1]. [2] (b) Chi-squared [1]. The data are nominal, because each person either relapsed or did not [1]. The design is independent groups and the researchers are testing for a difference between them [1]. [3] (c) The result is significant [1], because for chi-squared the calculated value (5.27) must be equal to or greater than the critical value (3.84), and it is [1]. [2] (d) Judging relapse involves interpretation, so clinicians who knew the groups might be biased towards finding fewer relapses after family therapy [1]. Masking them removes this investigator effect and raises the internal validity of the conclusion [1]. [2] Examiner insight: in (b), each reason must link to these data (relapsed or not, two separate groups), not just recite the rules for the test.

8. The therapist would first explore when the voice occurs, such as when Ruth is alone in the evening, to help her make sense of it [1]. They would use reality testing on the microphone belief, for example by asking what evidence she would expect to find if it were true [1]. They might help her consider an alternative explanation, such as the voice being her own inner speech or memories of past criticism [1]. They would build coping strategies, such as planned activities in the evening, aiming to reduce her distress rather than remove every symptom [1]. [4] Examiner insight: name Ruth’s voice, her microphone belief and her evenings alone; generic CBT steps for depression score poorly here.

9. Frith described metarepresentation as the ability to recognise your own thoughts as your own [1]. If it fails, a person may experience their own inner speech as an external voice, giving hallucinations [1]. Central control is the ability to suppress automatic responses while carrying out a deliberate action [1]. If it fails, unrelated word associations may break into speech, giving derailed, disorganised speech [1]. [4] Examiner insight: link each faulty process to a named symptom; describing the processes alone earns half the marks at most.

10. Typical antipsychotics block D2 receptors, reducing dopamine activity and positive symptoms [1]. Atypicals act on dopamine and other systems, and clozapine is used when other drugs have not worked [1]. Leucht et al. (2013) found every one of 15 antipsychotics did better than placebo [1], with clozapine ranked most effective for overall symptoms [1]. Typical drugs are linked to movement problems such as tardive dyskinesia [1]. Some atypicals are linked to weight gain, and clozapine needs regular blood tests [1]. Drugs act quickly and can reduce symptoms enough for a person to take part in therapy, which supports their appropriateness [1]. However, they reduce symptoms rather than cure the condition, and unpleasant side effects may lead some people to stop taking them [1]. [8] Examiner insight: for AO3, judge both effectiveness and appropriateness, as section 4.3 asks; listing side effects alone is only half the evaluation.

11. Culture bias is when diagnosis is distorted by the clinician’s cultural norms [1]. Luhrmann et al. (2015) found voice-hearers in the USA more often described violent voices, while those in India and Ghana more often described familiar or positive ones [1]. This suggests criteria based on one culture’s experience may not fit others [1]. The AESOP study (Fearon et al., 2006) found higher rates of diagnosis among Black Caribbean and Black African groups in England [1]. Some argue this reflects diagnostic bias; others argue it reflects real effects of social adversity and stress [1]. Gender bias is when diagnosis is distorted by the person’s gender [1]. Men have often been diagnosed more than women, and one argument is that women’s better social functioning may hide their symptoms [1]. Bias matters because a wrong diagnosis leads to unsuitable treatment, although some group differences may be genuine [1]. [8] Examiner insight: present the competing interpretations of group differences fairly; asserting a single cause without evidence loses AO3 credit.

12. An interactionist approach explains schizophrenia through biological, psychological and social factors acting together [1]. The diathesis-stress model says disorder develops when a vulnerability meets a trigger [1]. Meehl (1962) proposed the diathesis was a single gene [1], but research now points to many genes, such as the 108 locations found by Ripke et al. (2014), and possibly early trauma [1]. Stressors include stressful life events, a high-EE home and heavy cannabis use [1]. In treatment, it means combining drugs with CBT and family therapy [1]. Tienari et al. (2004) found genetic risk mattered mainly in dysfunctional adoptive families, directly supporting the model [1]. It explains why identical twin concordance is well below 100% [1]. It also explains relapse, as high EE can act as a stressor after onset [1]. Pharoah et al. (2010) found family intervention may reduce relapse compared with standard care [1]. Drugs may reduce symptoms enough for a person to engage with CBT, so combining them is practical [1]. NICE guidance in England recommends offering CBT and family intervention, reflecting this approach [1]. However, the model is hard to test, because it does not say exactly how diathesis and stress combine [1]. Combined treatment also makes it hard to know which element is working [1]. It avoids biological and environmental reductionism, taking an interactionist position in the nature-nurture debate [1]. Overall, it fits the evidence best but makes less precise predictions than single-cause models [1]. [16] Examiner insight: the question says “explaining and treating”, so an answer that ignores treatment cannot reach the top level.

Where marks are usually lost

• Calling positive symptoms “good” or negative symptoms “bad”.
• In scenario questions, defining terms without quoting the scenario’s details.
• Giving concordance figures from the table with no interpretation of what they do and do not show.
• Saying antipsychotics “cure” schizophrenia.
• Choosing a statistical test without linking the reasons to the data’s level of measurement and design.
• Forgetting that for chi-squared the calculated value must be equal to or greater than the critical value.
• Treating expressed emotion as proof of cause rather than a predictor of relapse.
• Writing about CBT for depression rather than CBT for voices and delusions.
• Ignoring the treatment half of an interactionist question.

Next steps

• Recheck weak areas in the Schizophrenia study guide and the revision notes.
• Compare how CBT and drugs are used for other disorders with the Paper 1 Introductory practice.
• Practise the debates that strengthen AO3 with the Issues and debates practice.
• Find your gaps across the course with our diagnostics.
• Want a tutor to mark your essays? Book a free trial class.

Official syllabus

AQA AS and A-level Psychology (7181, 7182) specification, Version 1.4 (1 September 2025), for teaching from September 2025. Schizophrenia is section 4.3.5; the Paper 3 structure appears in the specification at a glance.