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161 original questions across 22 selected topic areas. No account or payment required to practise.
Cambridge International AS & A Level Psychology (9990), examination year 2027: AI-assisted conceptual alignment to official sources, not teacher or exam-board certification. Syllabus mapping and remaining coverage.
13 questions in this topic
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Subtopics in this topic (13)
Schizophrenia: symptom descriptions are not diagnoses
Freeman: neutral worlds and persecutory interpretation
Schizophrenia: comparing intervention claims
Mood: episodes versus score labels
Oruc: an overall null and subgroup trends
Mood interventions: mechanism and effectiveness
Gambling: harm, classification and measurement
Impulse explanations: consequence versus feeling-state
Grant: predictors are not prescriptions
Anxiety: broad worry and specific triggers
Chapman and DeLapp: one case, several components
OCD: intrusive thoughts and invisible compulsions
Lovell: delivery format and non-inferiority
13 of 13 questions shown
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Question 1The NHS distinguishes positive symptoms, such as hallucinations or delusions, from negative symptoms such as reduced interest and expression. A fictional note calls these 'good' and 'bad' symptoms and identifies schizophrenia from social withdrawal alone. (a) Correct the terminology. (b) Explain the limits of the single-observation inference. (c) Compare what a case history and a standardised symptom measure could contribute. Do not diagnose a real or fictional individual.
Primary reading: https://www.nhs.uk/mental-health/conditions/schizophrenia/symptoms/
Resource and boundary: NHS public clinical summary: positive and negative symptoms, not a complete ICD-11 diagnostic specification.
Coverage boundary: Complete ICD-11 criteria and an authentic schizophrenia case account remain outstanding; a fictional note is not substituted for a required clinical case study.4 indicative marks
The NHS distinguishes positive symptoms, such as hallucinations or delusions, from negative symptoms such as reduced interest and expression. A fictional note calls these 'good' and 'bad' symptoms and identifies schizophrenia from social withdrawal alone. (a) Correct the terminology. (b) Explain the limits of the single-observation inference. (c) Compare what a case history and a standardised symptom measure could contribute. Do not diagnose a real or fictional individual.
Primary reading: https://www.nhs.uk/mental-health/conditions/schizophrenia/symptoms/
Resource and boundary: NHS public clinical summary: positive and negative symptoms, not a complete ICD-11 diagnostic specification.
Coverage boundary: Complete ICD-11 criteria and an authentic schizophrenia case account remain outstanding; a fictional note is not substituted for a required clinical case study.
Cambridge 2027: Partial conceptual match
Schizophrenia: symptom descriptions are not diagnoses: selected aspects are explicitly practised, not whole section or whole study coverage. Complete ICD-11 criteria and an authentic schizophrenia case account remain outstanding; a fictional note is not substituted for a required clinical case study. Independent teacher approval pending.
Positive refers to experiences or changes such as hallucinations and delusions, not desirable outcomes. Negative refers to reductions in aspects such as interest, social engagement or expression, not moral badness. The terms describe different aspects of presentation rather than two kinds of person.
Withdrawal can have many explanations, including circumstances and other difficulties. An isolated observation does not establish the course, impairment or alternative explanations needed for qualified assessment. The NHS summary introduces symptom distinctions; it is not a complete ICD-11 checklist.
A detailed case history can reveal change over time, personal meanings and context, but one case cannot represent all presentations. A standardised measure can support consistent comparisons, yet numerical agreement does not guarantee validity and a total can conceal different symptom patterns. Combining relevant information can improve understanding without authorising learners to label anyone. No symptom simulation or diagnostic procedure is proposed.
Self-marking points
View marking points
Explain positive/negative as descriptive categories, not value judgements.
Distinguish altered perception/belief from reduced usual functioning.
Reject social withdrawal alone as sufficient diagnostic evidence.
Compare contextual case history and standardised measurement with limits.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 2Freeman et al. (2003) placed 24 nonclinical participants in a neutral virtual environment containing virtual people. Positive interpretations were common; some participants reported reference or persecution ideas, associated with higher anxiety and interpersonal sensitivity. (a) Explain the purpose of a standard neutral environment. (b) Distinguish a persecutory interpretation from evidence of actual hostile intent. (c) Evaluate whether this pilot diagnoses schizophrenia or establishes anxiety as its cause.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/12972853/
Resource and boundary: Primary article abstract: nonclinical pilot, neutral virtual characters, reported interpretations and anxiety association; not the full methods.
Primary reading: https://www.nhs.uk/mental-health/conditions/schizophrenia/symptoms/
Resource and boundary: NHS public clinical summary: positive and negative symptoms, not a complete ICD-11 diagnostic specification.
Coverage boundary: Full Freeman procedure, instruments, recruitment and detailed findings still require a fuller source; complete ICD-11 criteria and a schizophrenia case study remain outstanding.4 indicative marks
Freeman et al. (2003) placed 24 nonclinical participants in a neutral virtual environment containing virtual people. Positive interpretations were common; some participants reported reference or persecution ideas, associated with higher anxiety and interpersonal sensitivity. (a) Explain the purpose of a standard neutral environment. (b) Distinguish a persecutory interpretation from evidence of actual hostile intent. (c) Evaluate whether this pilot diagnoses schizophrenia or establishes anxiety as its cause.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/12972853/
Resource and boundary: Primary article abstract: nonclinical pilot, neutral virtual characters, reported interpretations and anxiety association; not the full methods.
Primary reading: https://www.nhs.uk/mental-health/conditions/schizophrenia/symptoms/
Resource and boundary: NHS public clinical summary: positive and negative symptoms, not a complete ICD-11 diagnostic specification.
Coverage boundary: Full Freeman procedure, instruments, recruitment and detailed findings still require a fuller source; complete ICD-11 criteria and a schizophrenia case study remain outstanding.
Cambridge 2027: Partial conceptual match
Freeman: neutral worlds and persecutory interpretation: selected aspects are explicitly practised, not whole section or whole study coverage. Full Freeman procedure, instruments, recruitment and detailed findings still require a fuller source; complete ICD-11 criteria and a schizophrenia case study remain outstanding. Independent teacher approval pending.
Holding the virtual scene relatively constant helps compare interpretations without actual strangers behaving differently towards each participant. Neutral design does not guarantee that every participant experiences the scene as neutral.
Persecution concerns intended harm; reference concerns events being personally significant. A reported threatening interpretation is evidence about the participant's experience, not evidence that a virtual character actually intended harm.
Anxiety and interpersonal sensitivity covaried with persecutory thoughts. Prior vulnerability, interpretation affecting anxiety, and other variables remain alternatives. The pilot does not randomly manipulate anxiety or establish schizophrenia in any participant. Its value is methodological feasibility, not a diagnostic test.
Self-marking points
View marking points
Link standardisation to comparable external social cues.
Distinguish a reported interpretation from programmed hostile behaviour.
Identify the nonclinical sample as a clinical-generalisation limit.
Reject diagnosis and causal direction from this association.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 3An educational poster says: 'Newer antipsychotics have no adverse effects; talking therapy and medicine are interchangeable; ECT is routine for schizophrenia.' (a) Correct each claim using the cited NHS/NICE summaries. (b) Explain why a change in symptoms is not necessarily a change in everyday functioning. (c) Give a balanced evaluation of comparing interventions. Do not recommend care for an individual.
Primary reading: https://www.nhs.uk/mental-health/conditions/schizophrenia/treatment/
Resource and boundary: NHS public clinical summary: individually tailored care, typical/atypical antipsychotics, talking therapies and adverse effects; not personal prescribing advice.
Primary reading: https://www.nice.org.uk/Guidance/CG178/chapter/recommendations
Resource and boundary: NICE clinical guideline recommendation 1.5.7.4: ECT is not recommended for general management of schizophrenia; narrowly qualified catatonia context.
Coverage boundary: Sensky study-specific CBT evidence, fuller pharmacology and the historical ECT evidence are not supplied.4 indicative marks
An educational poster says: 'Newer antipsychotics have no adverse effects; talking therapy and medicine are interchangeable; ECT is routine for schizophrenia.' (a) Correct each claim using the cited NHS/NICE summaries. (b) Explain why a change in symptoms is not necessarily a change in everyday functioning. (c) Give a balanced evaluation of comparing interventions. Do not recommend care for an individual.
Primary reading: https://www.nhs.uk/mental-health/conditions/schizophrenia/treatment/
Resource and boundary: NHS public clinical summary: individually tailored care, typical/atypical antipsychotics, talking therapies and adverse effects; not personal prescribing advice.
Primary reading: https://www.nice.org.uk/Guidance/CG178/chapter/recommendations
Resource and boundary: NICE clinical guideline recommendation 1.5.7.4: ECT is not recommended for general management of schizophrenia; narrowly qualified catatonia context.
Coverage boundary: Sensky study-specific CBT evidence, fuller pharmacology and the historical ECT evidence are not supplied.
Cambridge 2027: Partial conceptual match
Schizophrenia: comparing intervention claims: selected aspects are explicitly practised, not whole section or whole study coverage. Sensky study-specific CBT evidence, fuller pharmacology and the historical ECT evidence are not supplied. Independent teacher approval pending.
Typical and atypical are generations of antipsychotic medication, not unsafe versus harmless categories. NHS guidance describes benefits alongside adverse effects and monitoring. CBT addresses interpretations and coping, so combined care need not imply that either approach is redundant.
NICE does not recommend ECT for general management of schizophrenia; its statement identifies a restricted severe-catatonia context. An examination syllabus listing an intervention is not a current universal recommendation.
A fair evaluation considers symptom distress, participation in daily life, adverse effects, acceptability and sustained outcomes. Differences in baseline severity and additional support can confound comparisons. Public guidance describes care principles, not a randomised estimate proving one option always best. Clinical decisions belong to qualified teams, not this exercise.
Self-marking points
View marking points
Recognise adverse effects with both typical and atypical medicines.
Describe talking therapy and medicine as potentially complementary.
Distinguish the syllabus listing of ECT from NICE's restricted context.
Compare symptoms, functioning, harms and follow-up rather than a single outcome.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 4A fictional revision note equates one low questionnaire score with 'no disorder' and one sad day with 'bipolar disorder'. (a) Explain why episode history matters when comparing depressive and bipolar presentations. (b) Explain what a depression inventory score can contribute and cannot settle. (c) Evaluate language/cultural interpretation and the need for multiple information sources. Do not diagnose the fictional person.
Primary reading: https://www.who.int/news-room/fact-sheets/detail/mental-disorders
Resource and boundary: WHO ICD-11-oriented public fact sheet: depression, bipolar and anxiety descriptions and distress/impairment; not complete diagnostic criteria.
Primary reading: https://www.nhs.uk/mental-health/conditions/bipolar-disorder/
Resource and boundary: NHS public clinical summary: manic/hypomanic and depressive episodes, intervening stability and specialist assessment.
Coverage boundary: Complete ICD-11 mood criteria and Beck Depression Inventory structure, validation and interpretation need specialist review; no instrument is reproduced.4 indicative marks
A fictional revision note equates one low questionnaire score with 'no disorder' and one sad day with 'bipolar disorder'. (a) Explain why episode history matters when comparing depressive and bipolar presentations. (b) Explain what a depression inventory score can contribute and cannot settle. (c) Evaluate language/cultural interpretation and the need for multiple information sources. Do not diagnose the fictional person.
Primary reading: https://www.who.int/news-room/fact-sheets/detail/mental-disorders
Resource and boundary: WHO ICD-11-oriented public fact sheet: depression, bipolar and anxiety descriptions and distress/impairment; not complete diagnostic criteria.
Primary reading: https://www.nhs.uk/mental-health/conditions/bipolar-disorder/
Resource and boundary: NHS public clinical summary: manic/hypomanic and depressive episodes, intervening stability and specialist assessment.
Coverage boundary: Complete ICD-11 mood criteria and Beck Depression Inventory structure, validation and interpretation need specialist review; no instrument is reproduced.
Cambridge 2027: Partial conceptual match
Mood: episodes versus score labels: selected aspects are explicitly practised, not whole section or whole study coverage. Complete ICD-11 mood criteria and Beck Depression Inventory structure, validation and interpretation need specialist review; no instrument is reproduced. Independent teacher approval pending.
The WHO description concerns persistent mood/interest changes and associated symptoms, not an isolated disappointment. The NHS bipolar summary describes episodes of elevated or irritable mood and changed energy as well as depression, with possible intervening stability. Sadness alone does not establish bipolar disorder.
An inventory can standardise reported symptom severity and track change, but a total loses detail about course, context and impairment. It cannot by itself determine a diagnosis or exclude every condition. No Beck items, cut-offs or norms are supplied here.
Wording and cultural expectations can affect how people report experiences. Consistent administration aids reliability but does not guarantee comparable meaning across languages. Qualified assessment integrates history and other relevant evidence; this is a conceptual comparison, not a diagnostic checklist.
Self-marking points
View marking points
Distinguish depressive episodes from ordinary short mood changes.
Recognise manic/hypomanic history as relevant to bipolar assessment.
Separate quantitative symptom measurement from a clinical diagnosis.
Explain cultural/language validity and contextual assessment.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 5Oruc et al. (1997) compared DNA polymorphisms in serotonin receptor 2c and transporter genes in 42 bipolar I patients and 40 controls. The abstract reports no significant associations in the total patient sample, with female subgroup trends. (a) Identify the actual population and comparison. (b) Evaluate 'these genes cause unipolar depression in all women'. (c) Explain why the overall null does not rule out every genetic contribution.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/9342201/
Resource and boundary: Primary article abstract: bipolar I case-control DNA analysis, overall null associations and female subgroup trends; not a complete study account.
Coverage boundary: Primary abstract only; full recruitment, laboratory procedure and complex result tables are not independently verified here. The official reference-list summary is secondary guidance, not a substitute for checking disputed scientific claims.4 indicative marks
Oruc et al. (1997) compared DNA polymorphisms in serotonin receptor 2c and transporter genes in 42 bipolar I patients and 40 controls. The abstract reports no significant associations in the total patient sample, with female subgroup trends. (a) Identify the actual population and comparison. (b) Evaluate 'these genes cause unipolar depression in all women'. (c) Explain why the overall null does not rule out every genetic contribution.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/9342201/
Resource and boundary: Primary article abstract: bipolar I case-control DNA analysis, overall null associations and female subgroup trends; not a complete study account.
Coverage boundary: Primary abstract only; full recruitment, laboratory procedure and complex result tables are not independently verified here. The official reference-list summary is secondary guidance, not a substitute for checking disputed scientific claims.
Cambridge 2027: Partial conceptual match
Oruc: an overall null and subgroup trends: selected aspects are explicitly practised, not whole section or whole study coverage. Primary abstract only; full recruitment, laboratory procedure and complex result tables are not independently verified here. The official reference-list summary is secondary guidance, not a substitute for checking disputed scientific claims. Independent teacher approval pending.
The case group had bipolar I disorder. Its placement under depressive explanations in the syllabus does not change the population actually studied. Controls offer a comparison of variant distributions, not a randomised allocation to illness.
The overall analysis did not establish an association. Female subgroup trends warrant investigation, not a universal sex-specific causal rule. Subgroup exploration and the small sample make independent replication important; no statistical calculation is required here.
A null finding for these measured variants in this sample is not a test of every gene, interaction or environmental contribution. Equally, biological plausibility does not turn a null into positive evidence. The defensible conclusion is bounded uncertainty, not genetic destiny or proof that genes never matter.
Self-marking points
View marking points
Identify bipolar I rather than relabelling patients as unipolar.
Distinguish measured genotype association from manipulated causation.
Keep subgroup trends tentative and limited to the studied variants.
Explain limited sensitivity and scope of the overall null.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 6A fictional essay claims that an antidepressant helping someone proves a single chemical deficiency caused their depression, and that cognitive restructuring means simply insisting on positive thoughts. (a) Evaluate both claims. (b) Contrast a biochemical account of intervention with the purpose of cognitive therapy. (c) Explain two requirements for a fair effectiveness comparison without giving treatment advice.
Primary reading: https://www.nhs.uk/mental-health/conditions/depression-in-adults/treatment/
Resource and boundary: NHS public clinical summary: CBT and other treatment approaches; not a comparative efficacy trial or a full REBT account.
Coverage boundary: Tricyclic/MAOI/SSRI mechanisms, Ellis REBT and Beck-specific evidence require further source-led tasks; this is not complete mood-intervention coverage.4 indicative marks
A fictional essay claims that an antidepressant helping someone proves a single chemical deficiency caused their depression, and that cognitive restructuring means simply insisting on positive thoughts. (a) Evaluate both claims. (b) Contrast a biochemical account of intervention with the purpose of cognitive therapy. (c) Explain two requirements for a fair effectiveness comparison without giving treatment advice.
Primary reading: https://www.nhs.uk/mental-health/conditions/depression-in-adults/treatment/
Resource and boundary: NHS public clinical summary: CBT and other treatment approaches; not a comparative efficacy trial or a full REBT account.
Coverage boundary: Tricyclic/MAOI/SSRI mechanisms, Ellis REBT and Beck-specific evidence require further source-led tasks; this is not complete mood-intervention coverage.
Cambridge 2027: Partial conceptual match
Mood interventions: mechanism and effectiveness: selected aspects are explicitly practised, not whole section or whole study coverage. Tricyclic/MAOI/SSRI mechanisms, Ellis REBT and Beck-specific evidence require further source-led tasks; this is not complete mood-intervention coverage. Independent teacher approval pending.
An intervention may alter a pathway without proving that a deficit in that pathway originally caused every case. Improvement can also involve expectations, concurrent support and time. A treatment mechanism and a complete aetiology are different claims.
Cognitive therapy examines links between interpretations, feelings and behaviour and evaluates unhelpful thinking. It does not imply blame or that distress is unreal. Biological and psychological accounts can describe interacting levels rather than exclusive alternatives.
Compare groups with documented initial severity and co-interventions, and examine functioning, reported symptoms, acceptability, adverse effects and follow-up. A mean improvement can conceal non-response. The NHS summary supports broad conceptual distinctions, not a head-to-head effect size or a prescription. No medicine selection, dosing or withdrawal is proposed.
Self-marking points
View marking points
Reject reverse inference from treatment response to a unique cause.
Explain examining unhelpful interpretations rather than compulsory positivity.
Separate proposed mechanism from evidence of sustained benefit.
Address comparable groups, multiple outcomes and harms.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 7The WHO describes impaired gambling control, increasing priority and persistence despite harm. (a) Explain why money spent alone cannot establish disorder. (b) Explain why the syllabus heading 'impulse control' must not be mistaken for a complete current ICD-11 taxonomy. (c) Evaluate using a symptom questionnaire instead of contextual assessment, without applying a diagnosis or supplying test items.
Primary reading: https://www.who.int/news-room/fact-sheets/detail/gambling
Resource and boundary: WHO public fact sheet: ICD-11 gambling control, priority and persistence despite harm; gambling is classified with addictive behaviours, not a complete impulse-disorder taxonomy.
Coverage boundary: Kleptomania and pyromania ICD-11 criteria, K-SAS validation and complete gambling diagnostic requirements remain held; this task supports only bounded classification/measurement aspects.4 indicative marks
The WHO describes impaired gambling control, increasing priority and persistence despite harm. (a) Explain why money spent alone cannot establish disorder. (b) Explain why the syllabus heading 'impulse control' must not be mistaken for a complete current ICD-11 taxonomy. (c) Evaluate using a symptom questionnaire instead of contextual assessment, without applying a diagnosis or supplying test items.
Primary reading: https://www.who.int/news-room/fact-sheets/detail/gambling
Resource and boundary: WHO public fact sheet: ICD-11 gambling control, priority and persistence despite harm; gambling is classified with addictive behaviours, not a complete impulse-disorder taxonomy.
Coverage boundary: Kleptomania and pyromania ICD-11 criteria, K-SAS validation and complete gambling diagnostic requirements remain held; this task supports only bounded classification/measurement aspects.
Cambridge 2027: Partial conceptual match
Gambling: harm, classification and measurement: selected aspects are explicitly practised, not whole section or whole study coverage. Kleptomania and pyromania ICD-11 criteria, K-SAS validation and complete gambling diagnostic requirements remain held; this task supports only bounded classification/measurement aspects. Independent teacher approval pending.
The same spending can have different consequences and context. The WHO description focuses on behavioural control, displaced activities and continued behaviour despite consequences; harm can also occur below diagnostic thresholds.
Cambridge groups several conditions together for teaching. WHO classifies gambling disorder alongside addictive behaviours. Neither a syllabus heading nor a single questionnaire score settles classification or individual diagnosis.
Questionnaires can organise reports and track change, but depend on comprehension and willingness to disclose. A score may not explain the circumstances of harm or the activities displaced by gambling. Construct and population validity must be established rather than assumed from numerical scoring. No real respondent or behaviour is being assessed here.
Self-marking points
View marking points
Relate interpretation to control, priority and harm, not expenditure alone.
Distinguish a quantitative symptom measure from diagnosis.
Explain how comprehension or willingness to disclose can limit a questionnaire's account of context.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 8Miller's feeling-state theory proposes that intense positive feelings become linked to an activity and motivate its repetition. (a) Contrast this with positive reinforcement. (b) Explain why a case illustration cannot establish that the linkage caused all impulse-control disorders. (c) Evaluate what a dopamine-only account would omit. No gambling, spending or other risky behaviour is to be performed.
Primary reading: https://journals.sagepub.com/doi/10.1177/1534765610365912
Resource and boundary: Primary article abstract: feeling-state hypothesis linking intense positive feelings and behaviour, illustrated by a case; not experimental proof.
Primary reading: https://www.who.int/news-room/fact-sheets/detail/gambling
Resource and boundary: WHO public fact sheet: ICD-11 gambling control, priority and persistence despite harm; gambling is classified with addictive behaviours, not a complete impulse-disorder taxonomy.
Coverage boundary: Detailed dopamine evidence and experimental tests of feeling-state theory remain outstanding. Miller is not treated as a proven universal explanation or a treatment recommendation.4 indicative marks
Miller's feeling-state theory proposes that intense positive feelings become linked to an activity and motivate its repetition. (a) Contrast this with positive reinforcement. (b) Explain why a case illustration cannot establish that the linkage caused all impulse-control disorders. (c) Evaluate what a dopamine-only account would omit. No gambling, spending or other risky behaviour is to be performed.
Primary reading: https://journals.sagepub.com/doi/10.1177/1534765610365912
Resource and boundary: Primary article abstract: feeling-state hypothesis linking intense positive feelings and behaviour, illustrated by a case; not experimental proof.
Primary reading: https://www.who.int/news-room/fact-sheets/detail/gambling
Resource and boundary: WHO public fact sheet: ICD-11 gambling control, priority and persistence despite harm; gambling is classified with addictive behaviours, not a complete impulse-disorder taxonomy.
Coverage boundary: Detailed dopamine evidence and experimental tests of feeling-state theory remain outstanding. Miller is not treated as a proven universal explanation or a treatment recommendation.
Cambridge 2027: Partial conceptual match
Impulse explanations: consequence versus feeling-state: selected aspects are explicitly practised, not whole section or whole study coverage. Detailed dopamine evidence and experimental tests of feeling-state theory remain outstanding. Miller is not treated as a proven universal explanation or a treatment recommendation. Independent teacher approval pending.
Positive reinforcement concerns an added rewarding consequence that increases later responding. Feeling-state theory adds a proposed link between remembered positive experience and the activity. The same repetition could fit both descriptions without distinguishing the mechanisms.
Miller's abstract presents a theoretical account and a case illustration, not a randomly controlled test of every alternative. Retrospective explanations can be influenced by memory and therapist interpretation; a convincing narrative is not unique causal identification.
A dopamine account addresses reward-related biology but cannot alone explain access, advertising, social context or the meaning of an activity. Conversely, a psychological account should not deny biological contributions. Useful evaluation asks what would discriminate predictions rather than declaring one level sufficient for everyone.
Self-marking points
View marking points
Define reinforcement through a consequence increasing subsequent behaviour.
Describe feeling-state linkage as a cognitive-affective hypothesis.
Explain causal and generalisation limitations of a case illustration.
Identify environmental and interpretive factors omitted by reductionism.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 9Grant et al. (2008) examined predictors across two placebo-controlled opiate-antagonist trials for pathological gambling. The discussion links family history of alcoholism with response and notes only acute 16- or 18-week follow-up and exclusions affecting generalisation. (a) Distinguish a treatment comparison from an association with a pre-existing predictor. (b) Evaluate a claim of permanent benefit for everyone. (c) Explain why these findings do not establish a genetic mechanism or personal medicine choice.
Primary reading: https://pmc.ncbi.nlm.nih.gov/articles/PMC3683409
Resource and boundary: Primary author manuscript: discussion on predictors across two placebo-controlled trials, acute follow-up and exclusion-related generalisation limits; detailed methods not supplied here.
Coverage boundary: Detailed trial samples, allocation protocols and quantitative outcome tables not verified for this task; full key-study account plus covert sensitisation/Glover and imaginal-desensitisation evidence remain outstanding.4 indicative marks
Grant et al. (2008) examined predictors across two placebo-controlled opiate-antagonist trials for pathological gambling. The discussion links family history of alcoholism with response and notes only acute 16- or 18-week follow-up and exclusions affecting generalisation. (a) Distinguish a treatment comparison from an association with a pre-existing predictor. (b) Evaluate a claim of permanent benefit for everyone. (c) Explain why these findings do not establish a genetic mechanism or personal medicine choice.
Primary reading: https://pmc.ncbi.nlm.nih.gov/articles/PMC3683409
Resource and boundary: Primary author manuscript: discussion on predictors across two placebo-controlled trials, acute follow-up and exclusion-related generalisation limits; detailed methods not supplied here.
Coverage boundary: Detailed trial samples, allocation protocols and quantitative outcome tables not verified for this task; full key-study account plus covert sensitisation/Glover and imaginal-desensitisation evidence remain outstanding.
Cambridge 2027: Partial conceptual match
Grant: predictors are not prescriptions: selected aspects are explicitly practised, not whole section or whole study coverage. Detailed trial samples, allocation protocols and quantitative outcome tables not verified for this task; full key-study account plus covert sensitisation/Glover and imaginal-desensitisation evidence remain outstanding. Independent teacher approval pending.
Placebo-controlled trials can support treatment comparisons, but family history was not experimentally assigned. A predictor associated with improvement does not show that family history itself caused that response.
The discussion identifies short follow-up and exclusion of some comorbid conditions. Thus permanent effectiveness and transfer to every person with gambling problems exceed the evidence. Improvement on a study outcome is also not identical to resolution of all financial or social harm.
Family history combines possible biological and shared-environment influences. Genetic or neural mediation requires direct investigation, not deduction from the predictor alone. These historical findings concern research interpretation; no drug, dose or treatment decision is offered. Psychological approaches still need separate evidence, not dismissal because a medicine study exists.
Self-marking points
View marking points
Separate assigned treatment from unassigned family history.
Bound findings by acute follow-up and selected treatment seekers.
Identify genetic mediation as a hypothesis needing direct evidence.
Reject universal benefit and personal prescribing inference.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 10Compare generalised worry with object/situation-linked phobic fear. (a) Explain why nervousness before one appointment does not establish either disorder. (b) Discuss how self-report and behavioural information might differ. (c) Evaluate equating a GAD-7 score with a complete assessment of blood-injection-injury phobia. Do not assess classmates or expose anyone to feared material.
Primary reading: https://www.who.int/news-room/fact-sheets/detail/mental-disorders
Resource and boundary: WHO ICD-11-oriented public fact sheet: depression, bipolar and anxiety descriptions and distress/impairment; not complete diagnostic criteria.
Primary reading: https://www.nhs.uk/mental-health/conditions/phobias/
Resource and boundary: NHS public clinical summary: object/situation-linked fear and impairment; no diagnostic algorithm or exposure exercise supplied.
Coverage boundary: Complete ICD-11 GAD, agoraphobia and BII requirements, GAD-7/BIPI evidence and Mas study details remain to be developed.4 indicative marks
Compare generalised worry with object/situation-linked phobic fear. (a) Explain why nervousness before one appointment does not establish either disorder. (b) Discuss how self-report and behavioural information might differ. (c) Evaluate equating a GAD-7 score with a complete assessment of blood-injection-injury phobia. Do not assess classmates or expose anyone to feared material.
Primary reading: https://www.who.int/news-room/fact-sheets/detail/mental-disorders
Resource and boundary: WHO ICD-11-oriented public fact sheet: depression, bipolar and anxiety descriptions and distress/impairment; not complete diagnostic criteria.
Primary reading: https://www.nhs.uk/mental-health/conditions/phobias/
Resource and boundary: NHS public clinical summary: object/situation-linked fear and impairment; no diagnostic algorithm or exposure exercise supplied.
Coverage boundary: Complete ICD-11 GAD, agoraphobia and BII requirements, GAD-7/BIPI evidence and Mas study details remain to be developed.
Cambridge 2027: Partial conceptual match
Anxiety: broad worry and specific triggers: selected aspects are explicitly practised, not whole section or whole study coverage. Complete ICD-11 GAD, agoraphobia and BII requirements, GAD-7/BIPI evidence and Mas study details remain to be developed. Independent teacher approval pending.
WHO describes anxiety disorders in terms of excessive fear/worry and significant distress or impaired functioning; the NHS phobia summary highlights particular objects or situations. Everyday nervousness is not sufficient to identify a condition.
A person may report substantial distress without obvious avoidance, while circumstances may prevent approach for reasons unrelated to fear. Combining information helps but does not turn classroom observation into professional assessment.
GAD-7 and the Blood Injection Phobia Inventory target different aspects; a general worry score does not establish a specific phobia. Standardisation and reliability do not guarantee validity for another construct or group. No items, score cut-offs, diagnostic instructions or clinical exposure tasks are provided.
Self-marking points
View marking points
Distinguish broad excessive worry from specific trigger-linked fear.
Require context, persistence and impairment rather than one event.
Recognise different information in subjective reports and behaviour.
Reject automatic transfer between GAD-7 and BIPI constructs.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 11Chapman and DeLapp's adult BII case combined cognitive-behavioural components and applied muscle tension across nine sessions. At 12-month follow-up the reported BAI score had changed from 41 to 7. (a) Explain the value of converging symptom and real-life follow-up evidence. (b) Evaluate attributing the change solely to one component. (c) Discuss idiographic usefulness and limits. Analyse the report only; do not reproduce clinical techniques.
Primary reading: https://www.drkevinchapman.com/wp-content/uploads/2017/01/ChapmanDeLapp_BII-Phobia-preprint.pdf
Resource and boundary: Author-hosted OnlineFirst published article, Version of Record dated 30 October 2013: assessment, course of treatment, follow-up and limitations, sections 5, 7, 10 and 12; historical case, not a treatment manual for learners.
Coverage boundary: Selected assessment/follow-up aspects only; full key-study chronology, all measures and competing intervention evidence still need teacher-led study.4 indicative marks
Chapman and DeLapp's adult BII case combined cognitive-behavioural components and applied muscle tension across nine sessions. At 12-month follow-up the reported BAI score had changed from 41 to 7. (a) Explain the value of converging symptom and real-life follow-up evidence. (b) Evaluate attributing the change solely to one component. (c) Discuss idiographic usefulness and limits. Analyse the report only; do not reproduce clinical techniques.
Primary reading: https://www.drkevinchapman.com/wp-content/uploads/2017/01/ChapmanDeLapp_BII-Phobia-preprint.pdf
Resource and boundary: Author-hosted OnlineFirst published article, Version of Record dated 30 October 2013: assessment, course of treatment, follow-up and limitations, sections 5, 7, 10 and 12; historical case, not a treatment manual for learners.
Coverage boundary: Selected assessment/follow-up aspects only; full key-study chronology, all measures and competing intervention evidence still need teacher-led study.
Cambridge 2027: Partial conceptual match
Chapman and DeLapp: one case, several components: selected aspects are explicitly practised, not whole section or whole study coverage. Selected assessment/follow-up aspects only; full key-study chronology, all measures and competing intervention evidence still need teacher-led study. Independent teacher approval pending.
A later symptom report and reported ability to engage with medical care address different aspects of improvement. Follow-up gives more information about maintenance than immediate post-session ratings, though self-report and contact with the therapist can influence the evidence.
Several components changed together. Without a dismantling comparison, the case cannot identify applied tension, cognitive work or another component as uniquely responsible. Expectancy, concurrent influences and time cannot be fully excluded.
The detailed history is useful for understanding a person's presentation and barriers, but not an estimate of typical population response. The paper itself calls for controlled comparisons. Historical BAI values are supplied for interpretation, not screening norms or a diagnosis. Nothing here instructs learners to induce fainting, seek injections or perform exposure or muscle-tension procedures.
Self-marking points
View marking points
Identify repeated within-case assessment and follow-up as strengths.
Distinguish questionnaire change from real-life functioning.
Explain the absence of a component-isolating control comparison.
Limit generalisation from one adult clinical case.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 12A fictional textbook says 'OCD means enjoying tidiness, and every compulsion is visible'. (a) Correct both statements using the NHS summary. (b) Explain why temporary relief could maintain a compulsion. (c) Evaluate relying on an observer's checklist rather than the person's account. Do not identify or label a real person.
Primary reading: https://www.nhs.uk/mental-health/conditions/obsessive-compulsive-disorder-ocd/symptoms/
Resource and boundary: NHS public clinical summary: obsessions, overt/mental compulsions and temporary relief; not a licensed assessment instrument.
Coverage boundary: Complete ICD-11 requirements, the specified clinical case and measurement evidence remain outstanding; no licensed instrument is reproduced.4 indicative marks
A fictional textbook says 'OCD means enjoying tidiness, and every compulsion is visible'. (a) Correct both statements using the NHS summary. (b) Explain why temporary relief could maintain a compulsion. (c) Evaluate relying on an observer's checklist rather than the person's account. Do not identify or label a real person.
Primary reading: https://www.nhs.uk/mental-health/conditions/obsessive-compulsive-disorder-ocd/symptoms/
Resource and boundary: NHS public clinical summary: obsessions, overt/mental compulsions and temporary relief; not a licensed assessment instrument.
Coverage boundary: Complete ICD-11 requirements, the specified clinical case and measurement evidence remain outstanding; no licensed instrument is reproduced.
Cambridge 2027: Partial conceptual match
OCD: intrusive thoughts and invisible compulsions: selected aspects are explicitly practised, not whole section or whole study coverage. Complete ICD-11 requirements, the specified clinical case and measurement evidence remain outstanding; no licensed instrument is reproduced. Independent teacher approval pending.
Obsessions are unwanted recurrent thoughts, images or urges; compulsions can be behaviours or mental acts. Liking an orderly desk does not establish the distress or impairment associated with a clinical presentation.
If relief follows a compulsion and makes it more likely, removal of an aversive state can function as negative reinforcement. This explains possible maintenance, not why the initial obsession arose or what treatment is appropriate.
An observer can record visible actions consistently but miss mental rituals and meanings. Self-report adds internal experience, though recall and disclosure affect it. Triangulation is more informative than equating visibility with severity. No clinical scale, individual diagnosis or symptom-induction exercise is supplied.
Self-marking points
View marking points
Distinguish distressing intrusive obsessions from a preference for tidiness.
Recognise repetitive mental as well as overt compulsions.
Explain relief-based negative reinforcement as maintenance, not proof of origin.
Discuss observation's limited access to internal experience.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 13Lovell et al. randomised 72 patients to telephone or face-to-face delivery of CBT involving exposure and response prevention. The abstract reports high satisfaction in both conditions and a six-month Yale Brown difference of -0.55. (a) Identify what was compared and what was not. (b) Explain why a small observed difference alone cannot establish identical effectiveness. (c) Evaluate access and generalisation, without proposing treatment for anyone.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/16935946/
Resource and boundary: Primary article abstract: randomised non-inferiority comparison, 72 patients, delivery formats, measures and six-month outcome; full protocol and margin not established by this abstract.
Primary reading: https://www.nhs.uk/mental-health/conditions/obsessive-compulsive-disorder-ocd/treatment/
Resource and boundary: NHS public clinical summary: clinician-supported CBT with ERP and medicines; not instructions to perform ERP or change medication.
Coverage boundary: Full trial protocol, non-inferiority margin, attrition, delivery schedule and outcome analyses need inspection before a complete key-study summary; biochemical OCD evidence also remains incomplete.4 indicative marks
Lovell et al. randomised 72 patients to telephone or face-to-face delivery of CBT involving exposure and response prevention. The abstract reports high satisfaction in both conditions and a six-month Yale Brown difference of -0.55. (a) Identify what was compared and what was not. (b) Explain why a small observed difference alone cannot establish identical effectiveness. (c) Evaluate access and generalisation, without proposing treatment for anyone.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/16935946/
Resource and boundary: Primary article abstract: randomised non-inferiority comparison, 72 patients, delivery formats, measures and six-month outcome; full protocol and margin not established by this abstract.
Primary reading: https://www.nhs.uk/mental-health/conditions/obsessive-compulsive-disorder-ocd/treatment/
Resource and boundary: NHS public clinical summary: clinician-supported CBT with ERP and medicines; not instructions to perform ERP or change medication.
Coverage boundary: Full trial protocol, non-inferiority margin, attrition, delivery schedule and outcome analyses need inspection before a complete key-study summary; biochemical OCD evidence also remains incomplete.
Cambridge 2027: Partial conceptual match
Lovell: delivery format and non-inferiority: selected aspects are explicitly practised, not whole section or whole study coverage. Full trial protocol, non-inferiority margin, attrition, delivery schedule and outcome analyses need inspection before a complete key-study summary; biochemical OCD evidence also remains incomplete. Independent teacher approval pending.
Both arms received the same broad therapeutic approach, delivered differently. This comparison cannot isolate the effect of CBT against no treatment. Random allocation improves comparability of arms, not population representativeness.
Non-inferiority asks whether a possible disadvantage is acceptably bounded relative to a specified margin. A small point difference is not enough without uncertainty and protocol details. Those details are not established from the supplied abstract; learners need not calculate statistical tests.
Remote delivery may reduce travel barriers but can introduce privacy, communication and accessibility barriers. High satisfaction is not a substitute for symptom or functional outcomes, and six months is not lifelong follow-up. This is historical study interpretation, not instructions for ERP or medicine use; full clinical care requires qualified assessment.
Self-marking points
View marking points
Identify delivery format rather than CBT versus no therapy as the comparison.
Explain random allocation without claiming representative sampling.
Distinguish a non-inferiority question from proof of exact equality.
Evaluate access and limits beyond the studied services and follow-up.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
