Clinical Psychology 9990
Chisala Lishomwa
Clinical Psychology – Exam Learning Guide (CIE A Level 9990)
1.1 Schizophrenia
1.1.1 Diagnostic Criteria (ICD-11)
Definition:
Schizophrenia is a severe and chronic psychotic disorder characterised by
distortions in thinking, perception, emotions, language, sense of self, and
behaviour.
ICD-11 Criteria:
The individual must experience at least one of the following core symptoms
for a significant portion of time during a one-month period:
Hallucinations: Typically auditory (hearing voices).
Delusions: Fixed, false beliefs that are resistant to reason.
Disorganised thinking: Manifested in speech (e.g., derailment,
incoherence).
These are accompanied by other symptoms such as:
Abnormal motor behaviour (e.g., agitation, catatonia).
Negative symptoms: Reduced emotional expression (affective
flattening), poverty of speech (alogia), and a loss of motivation (avolition).
Duration: Symptoms must persist for at least one month and cause
significant social or occupational dysfunction.
,Symptom Categories:
Positive symptoms: Additions to normal experience (hallucinations,
delusions, disorganised speech/behaviour).
Negative symptoms: Subtractions from normal experience (avolition,
alogia, flat affect, anhedonia).
Case Study Example – John Nash:
The mathematician John Nash, depicted in A Beautiful Mind, is a classic case
study. He experienced persecutory delusions (believing he was being pursued
by government agents), auditory hallucinations, and significant social
impairment, yet his high-level intellectual functioning remained largely
intact, illustrating the complex nature of the disorder.
Types of Delusions:
Persecutory: The belief that one is being harmed, harassed, or conspired
against (e.g., "the government implanted a chip in my brain").
Grandiose: An inflated sense of power, knowledge, or identity (e.g., "I am
the chosen prophet sent to save the world").
Referential: The belief that neutral environmental events have a special
and personal meaning (e.g., "the news presenter is sending secret messages to
me through the broadcast").
Key Study: Freeman et al. (2003) – Virtual Reality and Persecutory
Ideation
Aim: To investigate whether virtual reality (VR) could be used to safely
study persecutory ideation in a controlled environment.
Method: A non-clinical sample of 200 university students completed
psychometric scales measuring paranoia and anxiety. They then experienced
a 4-minute simulated journey on a London Underground train via a VR
headset. The virtual environment contained neutral avatars programmed to
, exhibit neutral behaviour (e.g., occasionally glancing around or reading a
paper).
Results: Approximately one-third of participants reported significant
paranoid thoughts about the neutral avatars (e.g., "they were staring at me,"
"they looked hostile"). Participants who scored higher on baseline paranoia
measures were significantly more likely to interpret the neutral scenario in a
paranoid way.
Conclusion: VR provides a valid, safe, and ethical method for studying the
formation of delusional ideas in a controlled setting. The findings suggest
that persecutory ideation exists on a continuum and can be triggered by
ambiguous social situations in vulnerable individuals.
Evaluation:
Strengths: High ecological validity (simulates a real-world environment);
highly ethical (avoids exposing participants to real-life dangers or distress).
Limitations: Low population generalisability (student sample may not
represent a clinical population); the artificial setting may not fully capture the
intensity of paranoia in real-life contexts.
Issues & Debates:
Individual vs. Situational: The study highlights how delusions may arise
from an interaction between individual cognitive biases (vulnerability) and
situational triggers (ambiguous environments).
Idiographic vs. Nomothetic: Case studies like John Nash provide deep,
idiographic insight, while group studies like Freeman et al. seek nomothetic
laws.
Use of Children: Schizophrenia is rarely studied in children due to its
typical onset in late adolescence/early adulthood.
Ethics: VR is a ethically superior method for researching distressing
phenomena compared to real-world experiments.
Possible Exam Questions:
Outline two positive symptoms of schizophrenia. (4 marks)
Chisala Lishomwa
Clinical Psychology – Exam Learning Guide (CIE A Level 9990)
1.1 Schizophrenia
1.1.1 Diagnostic Criteria (ICD-11)
Definition:
Schizophrenia is a severe and chronic psychotic disorder characterised by
distortions in thinking, perception, emotions, language, sense of self, and
behaviour.
ICD-11 Criteria:
The individual must experience at least one of the following core symptoms
for a significant portion of time during a one-month period:
Hallucinations: Typically auditory (hearing voices).
Delusions: Fixed, false beliefs that are resistant to reason.
Disorganised thinking: Manifested in speech (e.g., derailment,
incoherence).
These are accompanied by other symptoms such as:
Abnormal motor behaviour (e.g., agitation, catatonia).
Negative symptoms: Reduced emotional expression (affective
flattening), poverty of speech (alogia), and a loss of motivation (avolition).
Duration: Symptoms must persist for at least one month and cause
significant social or occupational dysfunction.
,Symptom Categories:
Positive symptoms: Additions to normal experience (hallucinations,
delusions, disorganised speech/behaviour).
Negative symptoms: Subtractions from normal experience (avolition,
alogia, flat affect, anhedonia).
Case Study Example – John Nash:
The mathematician John Nash, depicted in A Beautiful Mind, is a classic case
study. He experienced persecutory delusions (believing he was being pursued
by government agents), auditory hallucinations, and significant social
impairment, yet his high-level intellectual functioning remained largely
intact, illustrating the complex nature of the disorder.
Types of Delusions:
Persecutory: The belief that one is being harmed, harassed, or conspired
against (e.g., "the government implanted a chip in my brain").
Grandiose: An inflated sense of power, knowledge, or identity (e.g., "I am
the chosen prophet sent to save the world").
Referential: The belief that neutral environmental events have a special
and personal meaning (e.g., "the news presenter is sending secret messages to
me through the broadcast").
Key Study: Freeman et al. (2003) – Virtual Reality and Persecutory
Ideation
Aim: To investigate whether virtual reality (VR) could be used to safely
study persecutory ideation in a controlled environment.
Method: A non-clinical sample of 200 university students completed
psychometric scales measuring paranoia and anxiety. They then experienced
a 4-minute simulated journey on a London Underground train via a VR
headset. The virtual environment contained neutral avatars programmed to
, exhibit neutral behaviour (e.g., occasionally glancing around or reading a
paper).
Results: Approximately one-third of participants reported significant
paranoid thoughts about the neutral avatars (e.g., "they were staring at me,"
"they looked hostile"). Participants who scored higher on baseline paranoia
measures were significantly more likely to interpret the neutral scenario in a
paranoid way.
Conclusion: VR provides a valid, safe, and ethical method for studying the
formation of delusional ideas in a controlled setting. The findings suggest
that persecutory ideation exists on a continuum and can be triggered by
ambiguous social situations in vulnerable individuals.
Evaluation:
Strengths: High ecological validity (simulates a real-world environment);
highly ethical (avoids exposing participants to real-life dangers or distress).
Limitations: Low population generalisability (student sample may not
represent a clinical population); the artificial setting may not fully capture the
intensity of paranoia in real-life contexts.
Issues & Debates:
Individual vs. Situational: The study highlights how delusions may arise
from an interaction between individual cognitive biases (vulnerability) and
situational triggers (ambiguous environments).
Idiographic vs. Nomothetic: Case studies like John Nash provide deep,
idiographic insight, while group studies like Freeman et al. seek nomothetic
laws.
Use of Children: Schizophrenia is rarely studied in children due to its
typical onset in late adolescence/early adulthood.
Ethics: VR is a ethically superior method for researching distressing
phenomena compared to real-world experiments.
Possible Exam Questions:
Outline two positive symptoms of schizophrenia. (4 marks)
