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Original, AI-authored English practice with worked guidance. Selected topics only; independent teacher review is pending. This is not a complete syllabus, official past-paper collection or predicted exam score. Check your own exam-board specification: these concepts are not certified against a particular board or exam year.
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
Exact English revisions checked in an AI-assisted academic review; independent teacher approval is still pending.
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Original multipart written practice. Partial support, teacher approval pending. Educational analysis, not diagnosis, treatment instructions, a complete study text or practical certification.
Subtopics in this topic (13)
Communication: confidence is not comprehension
Savage and Armstrong: satisfaction depends on context
Service use: barriers are not evidence of deception
Adherence: intentions, beliefs and resources
Yokley and Glenwick: effect size versus efficiency
Pain: real experience without a present limb
Brudvik: whose pain rating?
Pain management: condition-specific evidence
Stress: triangulation rather than a biological verdict
Bridge: mood improvement is not cancer treatment
Health messages: understanding is not behaviour change
Health promotion: rewards and reporting incentives
Shoshani and Steinmetz: pupils are not independent schools
13 of 13 questions shown
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Question 1McKinstry and Wang surveyed 475 patients in five practices using photographs of doctors' dress; preferences varied between practices. NICE recommends accessible language and checking understanding. (a) Contrast non-verbal confidence cues with verbal comprehension. (b) Evaluate using clothing preference as evidence of medical competence. (c) Propose a written-only improvement to a fictional appointment information sheet and explain how comprehension, not liking, would be assessed.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/1747264/
Resource and boundary: McKinstry and Wang primary abstract: photographic survey of dress preferences in five practices; confidence is not clinical competence.
Primary reading: https://www.nice.org.uk/guidance/CG138/chapter/recommendations
Resource and boundary: NICE recommendations 1.1.2-1.1.4 and 1.5.4-1.5.8: access needs, jargon, open questions and checking understanding; guidance, not experimental effect estimates.
Coverage boundary: McKinlay terminology evidence and fuller verbal/non-verbal study detail remain outstanding; this is partial communication support.4 indicative marks
McKinstry and Wang surveyed 475 patients in five practices using photographs of doctors' dress; preferences varied between practices. NICE recommends accessible language and checking understanding. (a) Contrast non-verbal confidence cues with verbal comprehension. (b) Evaluate using clothing preference as evidence of medical competence. (c) Propose a written-only improvement to a fictional appointment information sheet and explain how comprehension, not liking, would be assessed.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/1747264/
Resource and boundary: McKinstry and Wang primary abstract: photographic survey of dress preferences in five practices; confidence is not clinical competence.
Primary reading: https://www.nice.org.uk/guidance/CG138/chapter/recommendations
Resource and boundary: NICE recommendations 1.1.2-1.1.4 and 1.5.4-1.5.8: access needs, jargon, open questions and checking understanding; guidance, not experimental effect estimates.
Coverage boundary: McKinlay terminology evidence and fuller verbal/non-verbal study detail remain outstanding; this is partial communication support.
Cambridge 2027: Partial conceptual match
Communication: confidence is not comprehension: selected aspects are explicitly practised, not whole section or whole study coverage. McKinlay terminology evidence and fuller verbal/non-verbal study detail remain outstanding; this is partial communication support. Independent teacher approval pending.
Clothing can influence expectations, whereas a reader may still misunderstand the words used. The photographic survey measures attitudes to appearance, not the accuracy of a consultation or treatment outcome.
Variation between practices cautions against universal dress rules. Historical local preferences may not transfer to other cultures, settings or current services. Confidence can be misplaced and is not a competence test.
For a fictional appointment sheet, replace an unfamiliar administrative term with a plain phrase and ask the reader to state the listed time and location. Use a prewritten answer key rather than a satisfaction question. Such a check is a proposed task, not a validated clinical measure. NICE guidance supplies a communication principle, not an experimental effect size.
Self-marking points
View marking points
Distinguish appearance-based expectations from understood information.
Limit photographic preference findings to attitudes, not competence.
Explain contextual and temporal generalisation limits.
Propose plain wording and an independently scored comprehension check.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 2Savage and Armstrong randomly assigned directing or sharing styles during advice/treatment/prognosis in consultations with one London GP. Directing generally produced higher reported satisfaction, particularly for physical problems or prescriptions; reported response rates were 89% initially and 58% a week later. (a) Explain the actual outcome. (b) Evaluate 'sharing is always inferior'. (c) Discuss follow-up non-response and one-GP generalisation.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/2282112/
Resource and boundary: Primary article abstract: randomised directing/sharing consultation comparison, satisfaction, response rates and subgroup findings; not the full paper or its erratum.
Coverage boundary: Abstract-bound account: full procedure and published erratum need inspection; false-positive/negative diagnosis and disclosure/presentation require additional tasks.4 indicative marks
Savage and Armstrong randomly assigned directing or sharing styles during advice/treatment/prognosis in consultations with one London GP. Directing generally produced higher reported satisfaction, particularly for physical problems or prescriptions; reported response rates were 89% initially and 58% a week later. (a) Explain the actual outcome. (b) Evaluate 'sharing is always inferior'. (c) Discuss follow-up non-response and one-GP generalisation.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/2282112/
Resource and boundary: Primary article abstract: randomised directing/sharing consultation comparison, satisfaction, response rates and subgroup findings; not the full paper or its erratum.
Coverage boundary: Abstract-bound account: full procedure and published erratum need inspection; false-positive/negative diagnosis and disclosure/presentation require additional tasks.
Cambridge 2027: Partial conceptual match
Savage and Armstrong: satisfaction depends on context: selected aspects are explicitly practised, not whole section or whole study coverage. Abstract-bound account: full procedure and published erratum need inspection; false-positive/negative diagnosis and disclosure/presentation require additional tasks. Independent teacher approval pending.
The outcome was how patients rated aspects of the consultation. Style assignment helps examine its influence, but higher satisfaction does not by itself establish more accurate diagnosis or improved health.
The abstract reports that the pattern was not significant in every type of consultation. Absence of a significant subgroup difference is not proof of identical effects, and a broad preference does not mean every patient benefits from the same style.
The lower one-week response rate permits selective follow-up: dissatisfied or busy patients might respond differently, but the direction is not known here. One GP in one practice limits transfer to other practitioners and populations. A fair evaluation weighs realistic consultations against narrow practitioner coverage rather than treating either feature as decisive alone.
Self-marking points
View marking points
Identify reported satisfaction rather than diagnostic accuracy or recovery.
Respect subgroup/context limits on the overall pattern.
Explain potential selective non-response without assuming its direction.
Limit practitioner and setting generalisation.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 3A fictional adult delays a routine appointment because transport is difficult and they expect little benefit. A commentator calls this malingering. (a) Use the Health Belief Model to offer a non-blaming interpretation. (b) Contrast external practical gain with sick-role motivation in the public factitious-disorder summary. (c) Explain why neither label follows from a missed appointment or inconsistent account.
Primary reading: https://www.nice.org.uk/guidance/ph6/evidence/behaviour-change-review-4-models-369664528
Resource and boundary: NICE commissioned models review, glossary p18: Health Belief Model constructs including susceptibility, severity, benefits, barriers, self-efficacy and cues; not proof of causation.
Primary reading: https://www.nhs.uk/mental-health/conditions/munchausen-syndrome/overview/
Resource and boundary: NHS public summary: sick-role motivation distinguished from external practical gain; cannot establish deception in an individual.
Primary reading: https://www.nice.org.uk/guidance/CG138/chapter/recommendations
Resource and boundary: NICE recommendations 1.1.2-1.1.4 and 1.5.4-1.5.8: access needs, jargon, open questions and checking understanding; guidance, not experimental effect estimates.
Coverage boundary: Safer and Aleem/Ajarim study details and complete diagnostic features remain outstanding; no deception-detection method is supplied.4 indicative marks
A fictional adult delays a routine appointment because transport is difficult and they expect little benefit. A commentator calls this malingering. (a) Use the Health Belief Model to offer a non-blaming interpretation. (b) Contrast external practical gain with sick-role motivation in the public factitious-disorder summary. (c) Explain why neither label follows from a missed appointment or inconsistent account.
Primary reading: https://www.nice.org.uk/guidance/ph6/evidence/behaviour-change-review-4-models-369664528
Resource and boundary: NICE commissioned models review, glossary p18: Health Belief Model constructs including susceptibility, severity, benefits, barriers, self-efficacy and cues; not proof of causation.
Primary reading: https://www.nhs.uk/mental-health/conditions/munchausen-syndrome/overview/
Resource and boundary: NHS public summary: sick-role motivation distinguished from external practical gain; cannot establish deception in an individual.
Primary reading: https://www.nice.org.uk/guidance/CG138/chapter/recommendations
Resource and boundary: NICE recommendations 1.1.2-1.1.4 and 1.5.4-1.5.8: access needs, jargon, open questions and checking understanding; guidance, not experimental effect estimates.
Coverage boundary: Safer and Aleem/Ajarim study details and complete diagnostic features remain outstanding; no deception-detection method is supplied.
Cambridge 2027: Partial conceptual match
Service use: barriers are not evidence of deception: selected aspects are explicitly practised, not whole section or whole study coverage. Safer and Aleem/Ajarim study details and complete diagnostic features remain outstanding; no deception-detection method is supplied. Independent teacher approval pending.
Expected benefit may be low while the practical cost of travel is high. A model of perceived threat, benefits and barriers can organise questions about delay, but beliefs alone omit service availability and resources.
The NHS summary distinguishes sick-role motivation from practical external gain. These are conceptual distinctions about fabrication and motivation, not explanations automatically applicable to this vignette.
Delay can arise without deception. Inconsistency can reflect memory, language, changing symptoms or incomplete information. Neither factitious disorder nor malingering should be inferred from these observations. The exercise concerns evaluating explanations and avoiding stigma; it does not train learners to investigate real patients or advise delaying care.
Self-marking points
View marking points
Apply perceived benefits and barriers to the stated delay.
Distinguish intentional symptom fabrication from ordinary access difficulty.
Contrast external gain and sick-role motivation conceptually.
Reject individual deception labels from insufficient evidence.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 4Fictional case A forgets an agreed routine appointment despite wanting to attend; case B chooses not to attend because expected costs exceed benefits. (a) Compare intentional and unintentional non-adherence. (b) Apply Health Belief Model concepts without assuming the beliefs are medically correct. (c) Evaluate explaining both cases as a fixed personality flaw.
Primary reading: https://www.nice.org.uk/guidance/cg76/chapter/Introduction
Resource and boundary: NICE clinical guideline introduction: overlapping intentional/unintentional barriers and non-blaming, patient-centred understanding.
Primary reading: https://www.nice.org.uk/guidance/ph6/evidence/behaviour-change-review-4-models-369664528
Resource and boundary: NICE commissioned models review, glossary p18: Health Belief Model constructs including susceptibility, severity, benefits, barriers, self-efficacy and cues; not proof of causation.
Coverage boundary: Laba study-specific evidence and fuller types/consequences of treatment non-adherence need additional source-led work.4 indicative marks
Fictional case A forgets an agreed routine appointment despite wanting to attend; case B chooses not to attend because expected costs exceed benefits. (a) Compare intentional and unintentional non-adherence. (b) Apply Health Belief Model concepts without assuming the beliefs are medically correct. (c) Evaluate explaining both cases as a fixed personality flaw.
Primary reading: https://www.nice.org.uk/guidance/cg76/chapter/Introduction
Resource and boundary: NICE clinical guideline introduction: overlapping intentional/unintentional barriers and non-blaming, patient-centred understanding.
Primary reading: https://www.nice.org.uk/guidance/ph6/evidence/behaviour-change-review-4-models-369664528
Resource and boundary: NICE commissioned models review, glossary p18: Health Belief Model constructs including susceptibility, severity, benefits, barriers, self-efficacy and cues; not proof of causation.
Coverage boundary: Laba study-specific evidence and fuller types/consequences of treatment non-adherence need additional source-led work.
Cambridge 2027: Partial conceptual match
Adherence: intentions, beliefs and resources: selected aspects are explicitly practised, not whole section or whole study coverage. Laba study-specific evidence and fuller types/consequences of treatment non-adherence need additional source-led work. Independent teacher approval pending.
A illustrates an intention-action gap, whereas B illustrates a decision based on expected consequences. The categories can overlap: someone may doubt benefit and also face practical barriers. NICE explicitly frames adherence as more than a patient's isolated failing.
Perceived severity and susceptibility can affect motivation; expected benefit and transport cost can affect a decision, and a reminder can act as a cue. Explaining a choice does not endorse its medical safety or establish that the model uniquely caused it.
A personality-only account ignores access, communication, changing circumstances and agreed decision-making. A reminder may address forgetting but not cost or concerns. These are fictional appointment examples, not instructions to alter prescribed treatment, miss care or pressure someone into compliance.
Self-marking points
View marking points
Distinguish inability/forgetting from a decision not to follow advice.
Recognise that intentional and unintentional barriers can overlap.
Apply perceived benefits, barriers and a cue to action to the scenario.
Use a non-blaming individual-and-situation evaluation.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 5Yokley and Glenwick allocated families of 1,133 immunisation-deficient preschool children to six conditions: general prompt, specific prompt, specific prompt plus access, specific prompt plus monetary incentive, contact control and no-contact control. The abstract reports the largest effect with incentives but greatest cost-effectiveness for specific prompts alone. (a) Explain the value of both controls. (b) Distinguish effectiveness from efficiency. (c) Evaluate attributing the incentive condition's outcome solely to money.
Primary reading: https://pmc.ncbi.nlm.nih.gov/articles/PMC1307948/
Resource and boundary: Primary article abstract: families of 1,133 children, six conditions, attendance effects and relative cost-effectiveness; full procedural details not inferred.
Coverage boundary: Primary abstract only: exact randomisation unit, intervention delivery, attendance windows, cost calculations and full results need inspection; Chaney child-adherence and contracts/customisation evidence remain incomplete.4 indicative marks
Yokley and Glenwick allocated families of 1,133 immunisation-deficient preschool children to six conditions: general prompt, specific prompt, specific prompt plus access, specific prompt plus monetary incentive, contact control and no-contact control. The abstract reports the largest effect with incentives but greatest cost-effectiveness for specific prompts alone. (a) Explain the value of both controls. (b) Distinguish effectiveness from efficiency. (c) Evaluate attributing the incentive condition's outcome solely to money.
Primary reading: https://pmc.ncbi.nlm.nih.gov/articles/PMC1307948/
Resource and boundary: Primary article abstract: families of 1,133 children, six conditions, attendance effects and relative cost-effectiveness; full procedural details not inferred.
Coverage boundary: Primary abstract only: exact randomisation unit, intervention delivery, attendance windows, cost calculations and full results need inspection; Chaney child-adherence and contracts/customisation evidence remain incomplete.
Cambridge 2027: Partial conceptual match
Yokley and Glenwick: effect size versus efficiency: selected aspects are explicitly practised, not whole section or whole study coverage. Primary abstract only: exact randomisation unit, intervention delivery, attendance windows, cost calculations and full results need inspection; Chaney child-adherence and contracts/customisation evidence remain incomplete. Independent teacher approval pending.
The contact control helps examine whether contact itself matters, while the no-contact group provides a comparison without that contact. Conditions involving specific prompts permit more informative comparisons than contrasting the combined package only with no intervention.
The greatest attendance improvement need not produce the best return per resource used. The reported ranking therefore is not contradictory, and no numerical effect or cost has been supplied for calculation.
The incentive arm included a prompt, so its outcome is not automatically a pure money effect. Local access, historical context and participating families limit transfer. Parents' participation, possible incentive pressure and children's welfare matter. This historical analysis is not a proposal to change vaccinations or recruit families for a classroom study.
Self-marking points
View marking points
Distinguish contact from no-contact comparison purposes.
Separate attendance change from cost per benefit.
Recognise combined prompt-plus-incentive content.
Bound generalisation and ethical interpretation in child health.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 6The NHS distinguishes residual-limb pain from real pain felt in a limb that has been amputated, and discusses central feedback and mirror visual feedback. (a) Explain why 'phantom' does not mean fabricated. (b) Evaluate a simple account equating all pain with current tissue damage at the felt location. (c) Explain why improvement reported after mirror feedback would not alone prove a unique mechanism or universal cure. No pain is to be induced.
Primary reading: https://www.nhs.uk/tests-and-treatments/amputation/
Resource and boundary: NHS public summary: phantom pain is real, distinct from residual-limb pain; central feedback account and mirror visual feedback, not a controlled efficacy estimate.
Coverage boundary: Specificity versus gate-control mechanisms, acute/chronic distinctions and the specified MacLachlan case remain incomplete; the inaccessible original gate-control paper is not represented as inspected.4 indicative marks
The NHS distinguishes residual-limb pain from real pain felt in a limb that has been amputated, and discusses central feedback and mirror visual feedback. (a) Explain why 'phantom' does not mean fabricated. (b) Evaluate a simple account equating all pain with current tissue damage at the felt location. (c) Explain why improvement reported after mirror feedback would not alone prove a unique mechanism or universal cure. No pain is to be induced.
Primary reading: https://www.nhs.uk/tests-and-treatments/amputation/
Resource and boundary: NHS public summary: phantom pain is real, distinct from residual-limb pain; central feedback account and mirror visual feedback, not a controlled efficacy estimate.
Coverage boundary: Specificity versus gate-control mechanisms, acute/chronic distinctions and the specified MacLachlan case remain incomplete; the inaccessible original gate-control paper is not represented as inspected.
Cambridge 2027: Partial conceptual match
Pain: real experience without a present limb: selected aspects are explicitly practised, not whole section or whole study coverage. Specificity versus gate-control mechanisms, acute/chronic distinctions and the specified MacLachlan case remain incomplete; the inaccessible original gate-control paper is not represented as inspected. Independent teacher approval pending.
Pain can be felt as coming from an absent limb. That is a genuine experience, not evidence of pretence. Pain in the remaining limb can have different contributors, so the two descriptions should not be collapsed.
A strict one-to-one local tissue-damage account struggles with pain at an absent location. Neural processing and central representation must be considered; this does not imply that all pain is psychological or that tissue damage is irrelevant.
The NHS summary describes possible central-feedback explanations and variable responses. A change after an intervention can also reflect time, expectations or other care unless a suitable comparison addresses them. No universal effect estimate is supplied, and this exercise is not a mirror-therapy procedure or rehabilitation recommendation.
Self-marking points
View marking points
Affirm the reality of phantom pain and distinguish its location from residual-limb pain.
Identify a limitation of a simple local damage-to-pain account.
Describe central feedback as an explanatory possibility, not established exclusivity.
Separate public clinical summary from controlled causal evidence.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 7Brudvik et al. studied 243 children aged 3-15 in a Norwegian emergency outpatient setting. Age-adapted child ratings and independent parent/physician ratings produced mean scores of 5.5, 4.8 and 3.2 respectively. (a) Interpret the ordering without treating every individual as identical. (b) Explain why professional status does not make a rating an objective pain detector. (c) Evaluate cross-sectional inference and different response formats.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/27797872/
Resource and boundary: Primary article abstract: cross-sectional paediatric sample, independent ratings and mean pain scores; no causal treatment comparison.
Coverage boundary: Abstract-bounded key-study support; full recruitment, scale-conversion details and analyses remain unverified. McGill, visual analogue and UAB scale coverage requires further work; the study is not inaccurately called a uniform VAS experiment.4 indicative marks
Brudvik et al. studied 243 children aged 3-15 in a Norwegian emergency outpatient setting. Age-adapted child ratings and independent parent/physician ratings produced mean scores of 5.5, 4.8 and 3.2 respectively. (a) Interpret the ordering without treating every individual as identical. (b) Explain why professional status does not make a rating an objective pain detector. (c) Evaluate cross-sectional inference and different response formats.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/27797872/
Resource and boundary: Primary article abstract: cross-sectional paediatric sample, independent ratings and mean pain scores; no causal treatment comparison.
Coverage boundary: Abstract-bounded key-study support; full recruitment, scale-conversion details and analyses remain unverified. McGill, visual analogue and UAB scale coverage requires further work; the study is not inaccurately called a uniform VAS experiment.
Cambridge 2027: Partial conceptual match
Brudvik: whose pain rating?: selected aspects are explicitly practised, not whole section or whole study coverage. Abstract-bounded key-study support; full recruitment, scale-conversion details and analyses remain unverified. McGill, visual analogue and UAB scale coverage requires further work; the study is not inaccurately called a uniform VAS experiment. Independent teacher approval pending.
The child mean was highest, followed by parents and physicians. Means summarise groups; they do not show that every child-parent-physician trio followed that order or that one person's experience can be replaced by a group average.
Independent scoring avoids one rater simply copying another, but does not eliminate systematic underestimation. Pain is subjective, and age-adapted child formats deserve consideration when comparing numbers.
The study documents discrepancies in this setting, not an experiment proving why they occurred or which intervention would correct them. Communication, condition type and rating format could contribute. Children's self-reports are important evidence, not proof that a numeric score is a complete assessment. No clinical decision or analgesic instruction follows.
Self-marking points
View marking points
Correctly order child, parent and physician mean ratings.
Avoid inferring the same ordering for every individual.
Distinguish independent ratings from objectively verified internal pain.
Identify cross-sectional causal limits and scale comparability concerns.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 8A fictional revision poster says every syllabus-listed pain intervention is currently recommended for every type of pain. (a) Use NG193 to challenge this. (b) Compare a psychological account involving attention/interpretation with a physical intervention claim. (c) Explain why sham comparisons, functioning, harms and follow-up matter. Do not suggest an intervention for an individual.
Primary reading: https://www.nice.org.uk/guidance/ng193/chapter/recommendations
Resource and boundary: NICE NG193 recommendations 1.2.3-1.2.6: chronic primary pain in people aged 16 and over, trained-professional psychological therapy, qualified acupuncture consideration and no TENS recommendation.
Coverage boundary: Full biochemical mechanisms, evidence on attention diversion/non-pain imagery/cognitive redefinition, acupuncture and TENS beyond this guideline scope remain incomplete.4 indicative marks
A fictional revision poster says every syllabus-listed pain intervention is currently recommended for every type of pain. (a) Use NG193 to challenge this. (b) Compare a psychological account involving attention/interpretation with a physical intervention claim. (c) Explain why sham comparisons, functioning, harms and follow-up matter. Do not suggest an intervention for an individual.
Primary reading: https://www.nice.org.uk/guidance/ng193/chapter/recommendations
Resource and boundary: NICE NG193 recommendations 1.2.3-1.2.6: chronic primary pain in people aged 16 and over, trained-professional psychological therapy, qualified acupuncture consideration and no TENS recommendation.
Coverage boundary: Full biochemical mechanisms, evidence on attention diversion/non-pain imagery/cognitive redefinition, acupuncture and TENS beyond this guideline scope remain incomplete.
Cambridge 2027: Partial conceptual match
Pain management: condition-specific evidence: selected aspects are explicitly practised, not whole section or whole study coverage. Full biochemical mechanisms, evidence on attention diversion/non-pain imagery/cognitive redefinition, acupuncture and TENS beyond this guideline scope remain incomplete. Independent teacher approval pending.
NICE NG193 applies to people aged 16 and over and distinguishes assessment of chronic pain from management of chronic primary pain. Its recommendations cannot be transferred automatically to younger children or all acute, secondary or phantom pain.
For chronic primary pain in that age group it discusses trained-professional CBT/ACT and qualified consideration of acupuncture, but does not recommend offering TENS because of lack of evidence of benefit in that scope. Listing TENS in a syllabus is not a universal clinical endorsement.
Attention and interpretation can affect pain experience without making it unreal. Credible comparison conditions help separate specific effects from expectations, though masking may be difficult. A balanced judgement examines functioning, distress, adverse effects and durability, not only immediate ratings. This is evidence appraisal, with no device settings, needling, medicines or self-experimentation.
Self-marking points
View marking points
State NG193's chronic primary pain scope for people aged 16 and over.
Distinguish qualified acupuncture consideration from its TENS recommendation.
Explain attention/interpretation without dismissing pain as imaginary.
Evaluate controls and multiple outcomes rather than universal efficacy.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 9Evans and Wener's 2006 abstract describes 208 rail commuters: longer commutes were associated with larger salivary cortisol elevations relative to rest, greater perceived stress and lower task persistence. (a) Explain what each measure adds. (b) Evaluate treating cortisol as an infallible individual stress diagnosis. (c) Discuss baseline, timing and causal limits. Analyse supplied evidence only; collect no biological samples and induce no stress.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/16719613/
Resource and boundary: Evans and Wener primary abstract: 208 Manhattan rail commuters, duration associated with cortisol elevation relative to rest, perceived stress and persistence. Published 2006; syllabus cites an Evans/Wener example as 2007, so not silently equated.
Coverage boundary: Wang fMRI/heart-rate evidence, life-events and Type A questionnaires, exact Evans/Wener bibliographic alignment and full study methods remain outstanding.4 indicative marks
Evans and Wener's 2006 abstract describes 208 rail commuters: longer commutes were associated with larger salivary cortisol elevations relative to rest, greater perceived stress and lower task persistence. (a) Explain what each measure adds. (b) Evaluate treating cortisol as an infallible individual stress diagnosis. (c) Discuss baseline, timing and causal limits. Analyse supplied evidence only; collect no biological samples and induce no stress.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/16719613/
Resource and boundary: Evans and Wener primary abstract: 208 Manhattan rail commuters, duration associated with cortisol elevation relative to rest, perceived stress and persistence. Published 2006; syllabus cites an Evans/Wener example as 2007, so not silently equated.
Coverage boundary: Wang fMRI/heart-rate evidence, life-events and Type A questionnaires, exact Evans/Wener bibliographic alignment and full study methods remain outstanding.
Cambridge 2027: Partial conceptual match
Stress: triangulation rather than a biological verdict: selected aspects are explicitly practised, not whole section or whole study coverage. Wang fMRI/heart-rate evidence, life-events and Type A questionnaires, exact Evans/Wener bibliographic alignment and full study methods remain outstanding. Independent teacher approval pending.
Cortisol provides physiological information; reported stress concerns experience; task persistence concerns behaviour. Agreement can support an interpretation without proving that all three measure exactly the same construct.
A resting baseline helps contextualise elevation, but measurement timing, daily rhythm and other influences still matter. A laboratory value is not an infallible diagnosis of someone's mental state. Conversely, self-report is not worthless merely because it is subjective.
Commuting duration was associated with outcomes, not randomly assigned here. Work schedules, route conditions or other differences could contribute. The 2006 paper is cited transparently rather than silently equated with the syllabus's 2007 Evans/Wener example. No sampling or stress-induction procedure is proposed.
Self-marking points
View marking points
Distinguish biological, subjective and behavioural measures.
Explain the role of a resting comparison.
Identify timing and non-stress influences as measurement concerns.
Reject causal or diagnostic certainty from association.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 10Bridge et al.'s six-week randomised study recruited 154 women receiving radiotherapy for early breast cancer; 15 withdrew. It compared talking contact, relaxation, and relaxation plus imagery. Mood disturbance favoured intervention groups, but Leeds depression/anxiety scores did not differ between groups. (a) Explain the control's value. (b) Evaluate selecting only the favourable measure. (c) Evaluate the claim that imagery cures cancer.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/3144333/
Resource and boundary: Primary article abstract: six-week randomised trial, 154 women, 15 withdrawals, mood versus Leeds scale findings; no cancer survival endpoint.
Coverage boundary: Primary abstract only: full allocation, group denominators, instruments and analyses remain to inspect. Biofeedback and stress-inoculation phases require separate evidence; no clinical protocol supplied.4 indicative marks
Bridge et al.'s six-week randomised study recruited 154 women receiving radiotherapy for early breast cancer; 15 withdrew. It compared talking contact, relaxation, and relaxation plus imagery. Mood disturbance favoured intervention groups, but Leeds depression/anxiety scores did not differ between groups. (a) Explain the control's value. (b) Evaluate selecting only the favourable measure. (c) Evaluate the claim that imagery cures cancer.
Primary reading: https://pubmed.ncbi.nlm.nih.gov/3144333/
Resource and boundary: Primary article abstract: six-week randomised trial, 154 women, 15 withdrawals, mood versus Leeds scale findings; no cancer survival endpoint.
Coverage boundary: Primary abstract only: full allocation, group denominators, instruments and analyses remain to inspect. Biofeedback and stress-inoculation phases require separate evidence; no clinical protocol supplied.
Cambridge 2027: Partial conceptual match
Bridge: mood improvement is not cancer treatment: selected aspects are explicitly practised, not whole section or whole study coverage. Primary abstract only: full allocation, group denominators, instruments and analyses remain to inspect. Biofeedback and stress-inoculation phases require separate evidence; no clinical protocol supplied. Independent teacher approval pending.
Talking contact helps address whether attention alone contributes, although it does not make all expectations identical. Comparing relaxation with the combined arm addresses the addition of imagery more directly than comparing the combined arm only with contact.
Improvement in one outcome should be reported alongside the absence of a between-group difference on the Leeds scales. Different constructs and responsiveness are possible; selecting one measure overstates consistency.
Withdrawals may affect comparability if related to outcome, and six weeks cannot establish lasting benefit. Psychological outcomes during radiotherapy are not tumour response or survival outcomes. The study cannot justify replacing oncology care. This is an analysis of a historical trial, not relaxation instructions or medical advice.
Self-marking points
View marking points
Recognise talking contact as a comparison for researcher attention.
Distinguish mood disturbance from Leeds scale findings.
Discuss withdrawal and short follow-up as limitations.
Reject cancer cure or survival inference from psychological endpoints.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 11A fictional team claims that a message receiving high 'easy to understand' ratings must have improved health behaviour, and that stronger fear must always help. (a) Distinguish clarity, intention and observed behaviour. (b) Explain a defensible comparison between accessible information and usual wording. (c) Evaluate fear appeals ethically and methodologically without using frightening material or claiming an uninspected study result.
Primary reading: https://www.nice.org.uk/guidance/CG138/chapter/recommendations
Resource and boundary: NICE recommendations 1.1.2-1.1.4 and 1.5.4-1.5.8: access needs, jargon, open questions and checking understanding; guidance, not experimental effect estimates.
Coverage boundary: Janis/Feshbach and Lewin study-specific findings and full fear-arousal content remain held; this task is bounded information-strategy evaluation, not a substitute summary of those studies.4 indicative marks
A fictional team claims that a message receiving high 'easy to understand' ratings must have improved health behaviour, and that stronger fear must always help. (a) Distinguish clarity, intention and observed behaviour. (b) Explain a defensible comparison between accessible information and usual wording. (c) Evaluate fear appeals ethically and methodologically without using frightening material or claiming an uninspected study result.
Primary reading: https://www.nice.org.uk/guidance/CG138/chapter/recommendations
Resource and boundary: NICE recommendations 1.1.2-1.1.4 and 1.5.4-1.5.8: access needs, jargon, open questions and checking understanding; guidance, not experimental effect estimates.
Coverage boundary: Janis/Feshbach and Lewin study-specific findings and full fear-arousal content remain held; this task is bounded information-strategy evaluation, not a substitute summary of those studies.
Cambridge 2027: Partial conceptual match
Health messages: understanding is not behaviour change: selected aspects are explicitly practised, not whole section or whole study coverage. Janis/Feshbach and Lewin study-specific findings and full fear-arousal content remain held; this task is bounded information-strategy evaluation, not a substitute summary of those studies. Independent teacher approval pending.
A rating of clarity measures a judgement about a message, not necessarily understanding or subsequent action. An independently scored comprehension task and a later behavioural measure address different questions.
A fair comparison would hold factual content constant while varying wording, with comparable presentation and follow-up. NICE supports accessible communication as a principle, not a numerical estimate of improved behaviour.
Increasing fear is not an ethically neutral way to obtain attention. Distress and avoidance are plausible concerns that must be assessed, not invented findings from this exercise. Longitudinal evidence is needed to distinguish momentary reaction from sustained change. No threatening imagery, misleading risks or live health experiment is proposed.
Self-marking points
View marking points
Distinguish message comprehension, intention and behaviour.
Apply accessible wording and an equivalent-content comparison.
Recognise distress, avoidance and expectancy as concerns rather than established results here.
Require follow-up evidence before an effectiveness claim.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 12Fox et al. described trading-stamp contingencies in two open-pit mines and reductions in recorded injuries over time. Some contingencies depended on group injury records; others rewarded adopted safety suggestions. (a) Explain reinforcement in this programme. (b) Evaluate the possibility that recorded injury changes and actual safety changes differ. (c) Explain why transfer to a school healthy-eating programme needs separate evidence and safeguards.
Primary reading: https://stacks.cdc.gov/view/cdc/185350/cdc_185350_DS1.pdf
Resource and boundary: Fox et al. primary paper pp215-217: two mines, trading stamps, injury-related and safety-suggestion contingencies, longitudinal injury outcomes; historical evaluation only.
Coverage boundary: Tapper school healthy-eating evidence is not developed here, so the school leaf remains held despite a partial section placement. Full Fox numerical results and reporting checks also require further study.4 indicative marks
Fox et al. described trading-stamp contingencies in two open-pit mines and reductions in recorded injuries over time. Some contingencies depended on group injury records; others rewarded adopted safety suggestions. (a) Explain reinforcement in this programme. (b) Evaluate the possibility that recorded injury changes and actual safety changes differ. (c) Explain why transfer to a school healthy-eating programme needs separate evidence and safeguards.
Primary reading: https://stacks.cdc.gov/view/cdc/185350/cdc_185350_DS1.pdf
Resource and boundary: Fox et al. primary paper pp215-217: two mines, trading stamps, injury-related and safety-suggestion contingencies, longitudinal injury outcomes; historical evaluation only.
Coverage boundary: Tapper school healthy-eating evidence is not developed here, so the school leaf remains held despite a partial section placement. Full Fox numerical results and reporting checks also require further study.
Cambridge 2027: Partial conceptual match
Health promotion: rewards and reporting incentives: selected aspects are explicitly practised, not whole section or whole study coverage. Tapper school healthy-eating evidence is not developed here, so the school leaf remains held despite a partial section placement. Full Fox numerical results and reporting checks also require further study. Independent teacher approval pending.
Exchangeable stamps could reinforce actions or outcomes to which awards were contingent. Safety-suggestion rewards and injury-free-record contingencies do not necessarily influence the same behaviour.
Recorded reductions may reflect real improvement, but incentives linked to injury records create a reporting question. That is a possible bias, not proof that workers concealed injuries. Independent audits and confidential reporting would help distinguish explanations. Long follow-up is valuable, though staffing, equipment and other changes can also affect trends.
A school differs in authority, developmental needs and the meaning of rewards. Evidence of workplace outcomes does not prove changes in children's eating or long-term health. Food access, allergies, assent and parental permission require attention; withholding food or penalising injury reports is not proposed. This is written historical evaluation only.
Self-marking points
View marking points
Link exchangeable tokens and contingent consequences to reinforcement.
Distinguish reported injuries from the underlying occurrence of harm.
Recognise longitudinal field strengths and competing time-related changes.
Explain child consent/welfare and setting-specific limits on transfer.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
Question 13Shoshani and Steinmetz's methods describe one intervention school and a demographically matched wait-list school. Longitudinal analyses report 537 and 501 pupils. Reported distress declined in the intervention group while increasing in controls. (a) Explain why this is not individual random allocation of 1,038 pupils. (b) Evaluate school-level confounding and self-report. (c) Explain why positive psychology is not proof that optimism prevents all illness.
Primary reading: https://wholebeinginstitute.com/wp-content/uploads/On-line-paper-positive-psychology-at-school.pdf
Resource and boundary: Public primary article copy: methods 2.1 and limitations, one intervention school and matched wait-list school, longitudinal analysis numbers; reported attrition counts do not reconcile fully.
Coverage boundary: Selected methods/limitations only; numerical attrition reconciliation and full outcome-specific account need checking. Unrealistic optimism and pleasant/good/meaningful-life distinctions need fuller source-led exercises.4 indicative marks
Shoshani and Steinmetz's methods describe one intervention school and a demographically matched wait-list school. Longitudinal analyses report 537 and 501 pupils. Reported distress declined in the intervention group while increasing in controls. (a) Explain why this is not individual random allocation of 1,038 pupils. (b) Evaluate school-level confounding and self-report. (c) Explain why positive psychology is not proof that optimism prevents all illness.
Primary reading: https://wholebeinginstitute.com/wp-content/uploads/On-line-paper-positive-psychology-at-school.pdf
Resource and boundary: Public primary article copy: methods 2.1 and limitations, one intervention school and matched wait-list school, longitudinal analysis numbers; reported attrition counts do not reconcile fully.
Coverage boundary: Selected methods/limitations only; numerical attrition reconciliation and full outcome-specific account need checking. Unrealistic optimism and pleasant/good/meaningful-life distinctions need fuller source-led exercises.
Cambridge 2027: Partial conceptual match
Shoshani and Steinmetz: pupils are not independent schools: selected aspects are explicitly practised, not whole section or whole study coverage. Selected methods/limitations only; numerical attrition reconciliation and full outcome-specific account need checking. Unrealistic optimism and pleasant/good/meaningful-life distinctions need fuller source-led exercises. Independent teacher approval pending.
The paper describes random selection of the intervention school followed by selection of a similar comparison school. Pupils were not individually randomised between programmes. A large pupil count does not create many independent intervention schools.
School culture, leadership or unmeasured differences could accompany programme membership. Repeated measures and a comparison improve on a single post-test, but do not eliminate these alternatives. Self-report may reflect expectations, and a multicomponent programme cannot identify one uniquely active ingredient.
The findings concern reported mental-health and wellbeing outcomes in these schools, not immunity from illness. Positive psychology concerns strengths and wellbeing, not denying distress. The paper's starting, withdrawal and final group counts do not fully reconcile; report the analysis counts as stated without inventing an attrition explanation.
Self-marking points
View marking points
Identify school-level programme membership and matched comparison.
Distinguish pupil count from independent school replications.
Evaluate school confounding, self-report and multicomponent intervention.
Bound conclusions to the measured school mental-health outcomes.
Examiner tip
Use the cited evidence for the stated aspect only. Distinguish observed findings, proposed explanations and unsupported clinical conclusions.
