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- not necessarily curing schizophrenia.","mcqOptions":[{"text":"curing","correct":true,"explanation":"Modification aims to reduce the impact of schizophrenia, but current treatments do not reliably remove the disorder permanently or guarantee that symptoms will never return."},{"text":"diagnosing","correct":false,"explanation":"Diagnosing identifies schizophrenia rather than modifying its symptoms or effects. The missing term is “curing”, because successful symptom reduction does not necessarily eliminate the disorder permanently."},{"text":"causing","correct":false,"explanation":"Causing schizophrenia is the opposite of treatment and is not the ultimate standard against which modification is judged. The correct term is “curing”, meaning permanently eliminating the disorder."},{"text":"worsening","correct":false,"explanation":"Worsening schizophrenia is not a treatment goal and would increase symptoms or impairment. The correct term is “curing”, which is not required for treatment to produce meaningful improvement."}]},{"id":"86199253-39b0-4cc2-a168-11c2d7815a13","cardType":"basic","points":1,"front":"Which symptom type includes hallucinations and delusions?","back":"Positive symptoms - experiences added to normal functioning.","mcqOptions":[{"text":"Positive symptoms - experiences added to normal functioning.","correct":true,"explanation":"Hallucinations and delusions are positive symptoms because they add experiences or beliefs that are not normally present, rather than reducing an existing ability or behaviour."},{"text":"Negative symptoms - experiences removed from normal functioning.","correct":false,"explanation":"Negative symptoms involve losses such as avolition and speech poverty, not added experiences. Hallucinations and delusions are positive symptoms because they add abnormal perceptions and beliefs."},{"text":"Cognitive symptoms - difficulties affecting mental processing.","correct":false,"explanation":"Cognitive symptoms concern difficulties with processes such as attention, memory and executive functioning. Hallucinations and delusions are positive symptoms because they add experiences to normal functioning."},{"text":"Affective symptoms - disturbances in mood and emotion.","correct":false,"explanation":"Affective symptoms concern mood and emotional experience rather than false perceptions or beliefs. Hallucinations and delusions are positive symptoms because they add experiences to normal functioning."}]},{"id":"8ac6a798-a271-46aa-b865-1fc9102447d7","cardType":"basic","points":1,"front":"Which symptom type includes avolition and speech poverty?","back":"Negative symptoms - reductions in normal functioning.","mcqOptions":[{"text":"Negative symptoms - reductions in normal functioning.","correct":true,"explanation":"Avolition and speech poverty are negative symptoms because they represent reductions in motivation and verbal output that would ordinarily form part of normal functioning."},{"text":"Positive symptoms - additions to normal functioning.","correct":false,"explanation":"Positive symptoms add abnormal experiences such as hallucinations and delusions. Avolition and speech poverty are negative symptoms because they involve reduced motivation and verbal expression."},{"text":"Cognitive symptoms - disruptions to mental processing.","correct":false,"explanation":"Cognitive symptoms involve impaired attention, memory or executive functioning rather than specifically reduced motivation and speech. Avolition and speech poverty are classified as negative symptoms."},{"text":"Affective symptoms - disturbances in emotional functioning.","correct":false,"explanation":"Affective symptoms primarily involve disturbances of mood or emotional state. Avolition and speech poverty are negative symptoms because normal motivation and verbal output are diminished."}]},{"id":"3ea22709-9429-4115-8462-c5d17eca39e2","cardType":"cloze","points":null,"front":"Antipsychotic drugs mainly modify schizophrenia by changing activity in [ ] systems in the brain.","back":"Antipsychotic drugs mainly modify schizophrenia by changing activity in dopamine systems in the brain.","mcqOptions":[{"text":"dopamine","correct":true,"explanation":"Antipsychotics primarily alter dopamine neurotransmission, especially by reducing activation at D2 receptors. This helps control positive symptoms associated with excessive dopamine activity in particular pathways."},{"text":"acetylcholine","correct":false,"explanation":"Acetylcholine is important for functions including memory and muscle activation, but it is not the main target of antipsychotic treatment. The required neurotransmitter is dopamine."},{"text":"GABA","correct":false,"explanation":"GABA is the brain’s principal inhibitory neurotransmitter, but antipsychotics do not mainly work by changing GABA systems. Their primary therapeutic mechanism involves dopamine activity."},{"text":"endorphin","correct":false,"explanation":"Endorphins contribute to pain relief and reward, but they are not the principal neurotransmitter target of antipsychotics. These drugs mainly modify activity in dopamine systems."}]},{"id":"528211e5-c0a9-414e-9ded-99b87b988652","cardType":"basic","points":1,"front":"How do typical antipsychotics act at dopamine receptors?","back":"They block D2 receptors as dopamine antagonists.","mcqOptions":[{"text":"They block D2 receptors as dopamine antagonists.","correct":true,"explanation":"Typical antipsychotics are dopamine antagonists that occupy and block D2 receptors. This reduces dopamine signalling, particularly the excessive mesolimbic activity associated with positive symptoms."},{"text":"They stimulate D2 receptors as dopamine agonists.","correct":false,"explanation":"Stimulating D2 receptors would increase dopamine signalling and could intensify positive symptoms rather than treat them. Typical antipsychotics act as antagonists by blocking D2 receptors."},{"text":"They block serotonin receptors as serotonin antagonists.","correct":false,"explanation":"Although some antipsychotics affect serotonin receptors, typical antipsychotics are defined mainly by strong dopamine D2 antagonism. They reduce dopamine signalling by blocking D2 receptors."},{"text":"They inhibit dopamine synthesis as enzyme antagonists.","correct":false,"explanation":"Typical antipsychotics do not primarily prevent dopamine from being produced. They act at receptor sites, blocking D2 receptors so dopamine cannot activate them normally."}]},{"id":"afd60f39-fd7d-4ebb-974b-e315621d74d5","cardType":"basic","points":2,"front":"How does D2 receptor blockade reduce positive symptoms?","back":"Reduced dopamine overstimulation lowers hallucination and delusion intensity.","mcqOptions":[{"text":"Reduced dopamine overstimulation lowers hallucination and delusion intensity.","correct":true,"explanation":"Blocking D2 receptors decreases excessive dopamine signalling in the mesolimbic pathway. This can reduce the strength or frequency of added experiences such as hallucinations and delusions."},{"text":"Increased dopamine overstimulation lowers hallucination and delusion intensity.","correct":false,"explanation":"Increasing dopamine overstimulation is associated with stronger positive symptoms, not symptom reduction. D2 blockade works by reducing excessive dopamine activity, thereby lowering hallucination and delusion intensity."},{"text":"Increased serotonin overstimulation lowers hallucination and delusion intensity.","correct":false,"explanation":"Positive symptom reduction is primarily linked to lower dopamine activity, not greater serotonin overstimulation. D2 receptor blockade reduces excessive dopamine signalling associated with hallucinations and delusions."},{"text":"Reduced dopamine understimulation lowers hallucination and delusion intensity.","correct":false,"explanation":"Further reducing already low dopamine activity would be more relevant to worsening negative symptoms. Positive symptoms improve when D2 blockade reduces dopamine overstimulation in mesolimbic pathways."}]},{"id":"0ef3c966-702f-4e23-a2e6-8159cdbd8a48","cardType":"cloze","points":null,"front":"Typical antipsychotics are also called [ ] antipsychotics.","back":"Typical antipsychotics are also called first-generation antipsychotics.","mcqOptions":[{"text":"first-generation","correct":true,"explanation":"Typical antipsychotics were the earlier class introduced for schizophrenia, so they are termed first-generation antipsychotics. They generally produce strong dopamine D2 receptor blockade."},{"text":"second-generation","correct":false,"explanation":"Second-generation refers to atypical antipsychotics, which were developed after typical drugs and often have broader receptor effects. Typical antipsychotics are called first-generation antipsychotics."},{"text":"atypical","correct":false,"explanation":"Atypical describes the later class of antipsychotics, not the typical drugs. Typical antipsychotics are known as first-generation because they were the earlier treatment class."},{"text":"new-generation","correct":false,"explanation":"New-generation would imply a later treatment class and is not the alternative name for typical antipsychotics. Typical drugs are classified as first-generation antipsychotics."}]},{"id":"9e292a01-ae99-4820-8324-c8133e67e784","cardType":"basic","points":2,"front":"Why can dopamine blockade cause extrapyramidal side effects?","back":"Blocking dopamine in movement pathways causes stiffness, tremors or restlessness.","mcqOptions":[{"text":"Blocking dopamine in movement pathways causes stiffness, tremors or restlessness.","correct":true,"explanation":"Dopamine helps regulate movement in the nigrostriatal pathway. Blocking D2 receptors there can disrupt motor control, producing extrapyramidal effects such as stiffness, tremors and restlessness."},{"text":"Blocking dopamine in reward pathways causes stiffness, tremors or restlessness.","correct":false,"explanation":"Dopamine blockade in reward-related mesolimbic pathways mainly contributes to reducing positive symptoms. Extrapyramidal effects arise when dopamine is blocked in movement pathways such as the nigrostriatal pathway."},{"text":"Blocking dopamine in emotional pathways causes stiffness, tremors or restlessness.","correct":false,"explanation":"Dopamine blockade in emotional pathways is not the direct cause of extrapyramidal motor effects. These effects result from disrupted dopamine signalling in movement pathways, particularly the nigrostriatal pathway."},{"text":"Blocking dopamine in cognitive pathways causes stiffness, tremors or restlessness.","correct":false,"explanation":"Dopamine changes in cognitive pathways may contribute to cognitive or negative symptoms rather than extrapyramidal movement effects. Stiffness and tremors result from blockade in movement pathways."}]},{"id":"70db9d7f-f13b-4214-814b-695fbf4dae2b","cardType":"cloze","points":null,"front":"Long-term antipsychotic use may lead to [ ], involving involuntary movements and sometimes being [ ].","back":"Long-term antipsychotic use may lead to tardive dyskinesia, involving involuntary movements and sometimes being irreversible.","mcqOptions":[{"text":"Long-term antipsychotic use may lead to tardive dyskinesia, involving involuntary movements and sometimes being irreversible.","correct":true,"explanation":"Tardive dyskinesia is a potential consequence of prolonged antipsychotic use, especially with typical antipsychotics. Its involuntary facial and bodily movements can persist even after medication is withdrawn."},{"text":"Long-term antipsychotic use may lead to tardive dyskinesia, involving involuntary movements and sometimes being reversible.","correct":false,"explanation":"Some drug-induced movement problems disappear after treatment changes, but tardive dyskinesia may be irreversible. This persistence makes it a particularly serious risk of long-term antipsychotic use."},{"text":"Long-term antipsychotic use may lead to acute dystonia, involving involuntary movements and sometimes being irreversible.","correct":false,"explanation":"Acute dystonia usually develops shortly after starting or increasing antipsychotic medication and is generally treatable. The potentially irreversible long-term movement disorder is tardive dyskinesia."},{"text":"Long-term antipsychotic use may lead to agranulocytosis, involving involuntary movements and sometimes being irreversible.","correct":false,"explanation":"Agranulocytosis is a dangerous reduction in white blood cells, particularly associated with clozapine, rather than a movement disorder. The long-term involuntary movements described are tardive dyskinesia."}]},{"id":"6e49c6b9-b592-4a2e-8194-b40750405ccd","cardType":"basic","points":1,"front":"When is clozapine often used?","back":"For treatment-resistant schizophrenia.","mcqOptions":[{"text":"For treatment-resistant schizophrenia.","correct":true,"explanation":"Clozapine is generally offered when schizophrenia has not responded adequately to other antipsychotics. Its potentially serious side effects mean it is not normally the first medication prescribed."},{"text":"For first-episode schizophrenia.","correct":false,"explanation":"First-episode schizophrenia is usually treated initially with an antipsychotic carrying fewer monitoring requirements. Clozapine is generally reserved for treatment-resistant schizophrenia because of its serious potential side effects."},{"text":"For mild anxiety without psychosis.","correct":false,"explanation":"Clozapine is an antipsychotic rather than a standard treatment for mild anxiety. It is commonly reserved for treatment-resistant schizophrenia after other antipsychotics have proved ineffective."},{"text":"For short-term insomnia in schizophrenia.","correct":false,"explanation":"Although clozapine can cause sedation, it is not prescribed primarily as a short-term sleep treatment. Its main use is managing treatment-resistant schizophrenia."}]},{"id":"db2103cf-a369-4961-b5d1-00276cc274c9","cardType":"basic","points":2,"front":"Why do clozapine patients need regular blood monitoring?","back":"Risk of agranulocytosis - dangerous white blood cell reduction.","mcqOptions":[{"text":"Risk of agranulocytosis - dangerous white blood cell reduction.","correct":true,"explanation":"Clozapine can cause agranulocytosis, severely reducing the white blood cells needed to fight infection. Regular blood tests allow this dangerous adverse effect to be detected promptly."},{"text":"Risk of hyperglycaemia - dangerous white blood cell reduction.","correct":false,"explanation":"Hyperglycaemia means abnormally high blood glucose, not a reduction in white blood cells. Clozapine blood monitoring primarily guards against agranulocytosis, which can impair resistance to infection."},{"text":"Risk of thrombocytosis - dangerous white blood cell reduction.","correct":false,"explanation":"Thrombocytosis involves an abnormally high platelet count rather than reduced white blood cells. Clozapine patients require monitoring because agranulocytosis can dangerously weaken immune defence."},{"text":"Risk of tardive dyskinesia - dangerous white blood cell reduction.","correct":false,"explanation":"Tardive dyskinesia is a movement disorder involving involuntary movements, not a reduction in white blood cells. Clozapine blood tests specifically monitor for agranulocytosis."}]},{"id":"6296a2cb-566b-4c9f-8a3c-ba71f4618504","cardType":"basic","points":1,"front":"What did Thornley et al. (2003) find about chlorpromazine?","back":"It was more effective than placebo for symptoms and relapse.","mcqOptions":[{"text":"It was more effective than placebo for symptoms and relapse.","correct":true,"explanation":"Thornley et al. found that chlorpromazine performed better than placebo in reducing symptoms and lowering relapse rates, supporting the effectiveness of antipsychotic drug treatment."},{"text":"It was no more effective than placebo for symptoms and relapse.","correct":false,"explanation":"This reverses the study’s conclusion. Thornley et al. found that chlorpromazine was more effective than placebo at reducing symptoms and preventing relapse."},{"text":"It was less effective than placebo for symptoms and relapse.","correct":false,"explanation":"Placebo did not outperform chlorpromazine in the review. Thornley et al. reported that chlorpromazine was more effective than placebo for both symptoms and relapse."},{"text":"It was effective only for negative symptoms, not relapse.","correct":false,"explanation":"The findings were not restricted to negative symptoms, and relapse was also examined. Chlorpromazine was more effective than placebo for reducing symptoms and relapse."}]},{"id":"0f355ea8-b59f-47f3-941d-f36d4946ed7e","cardType":"basic","points":2,"front":"Why are antipsychotics useful in acute psychosis?","back":"Fast symptom reduction can help engagement with further support.","mcqOptions":[{"text":"Fast symptom reduction can help engagement with further support.","correct":true,"explanation":"Antipsychotics can reduce severe acute symptoms relatively quickly, making communication and participation easier. This can enable the person to engage with psychological therapies and other support."},{"text":"Permanent symptom elimination means no further support is required.","correct":false,"explanation":"Antipsychotics do not permanently eliminate schizophrenia or remove the need for wider support. Their rapid reduction of acute symptoms can instead help patients engage with further treatment."},{"text":"Gradual symptom reduction prevents any immediate risk to the patient.","correct":false,"explanation":"The key benefit during acute psychosis is relatively fast symptom reduction, not gradual change. Medication may reduce immediate risk, but it cannot guarantee that all risk is prevented."},{"text":"Fast symptom reduction removes the need for psychological treatment.","correct":false,"explanation":"Rapid symptom reduction can make psychological treatment easier to access, but it does not make such treatment unnecessary. Antipsychotics are often combined with psychological and social support."}]},{"id":"f1a25a1c-a956-4bdf-8c5f-6ed79785dd99","cardType":"basic","points":2,"front":"How can antipsychotic side effects increase relapse risk?","back":"Severe side effects may reduce adherence, so medication is stopped.","mcqOptions":[{"text":"Severe side effects may reduce adherence, so medication is stopped.","correct":true,"explanation":"Distressing side effects can make patients unwilling to continue taking antipsychotics as prescribed. Stopping medication can allow symptoms to return, thereby increasing the risk of relapse."},{"text":"Severe side effects may increase adherence, so medication is continued.","correct":false,"explanation":"This reverses the usual relationship: unpleasant side effects commonly reduce willingness to take medication. Reduced adherence and stopping treatment can then increase the likelihood of relapse."},{"text":"Severe side effects may reduce insight, so medication becomes ineffective.","correct":false,"explanation":"Side effects raise relapse risk mainly by discouraging adherence, not by directly removing insight or making the drug ineffective. Patients may stop taking medication because its adverse effects are intolerable."},{"text":"Severe side effects may reduce drug tolerance, so relapse becomes biologically inevitable.","correct":false,"explanation":"Relapse is not an inevitable biological consequence of reduced drug tolerance. The important mechanism is behavioural: severe side effects can reduce adherence, leading patients to stop medication."}]},{"id":"9ad7a18c-1e9f-45a2-b00f-4d1dc4068ef8","cardType":"cloze","points":null,"front":"A purely biological treatment may be criticised as [ ] because schizophrenia is treated too narrowly.","back":"A purely biological treatment may be criticised as reductionist because schizophrenia is treated too narrowly.","mcqOptions":[{"text":"reductionist","correct":true,"explanation":"A purely biological treatment is reductionist because it explains and treats schizophrenia mainly through biological mechanisms, potentially neglecting relevant psychological and social influences."},{"text":"holistic","correct":false,"explanation":"A holistic treatment would consider biological, psychological and social influences together. Treating schizophrenia only through biology is instead criticised as reductionist because its focus is too narrow."},{"text":"interactionist","correct":false,"explanation":"An interactionist approach examines how biological and environmental factors combine, rather than treating schizophrenia through biology alone. A narrowly biological treatment is described as reductionist."},{"text":"idiographic","correct":false,"explanation":"Idiographic approaches focus closely on the unique individual rather than necessarily reducing behaviour to biology. The criticism of treating schizophrenia too narrowly is reductionism."}]},{"id":"9599037b-9e2a-4ed2-a074-1e9ec48149f7","cardType":"cloze","points":null,"front":"CBTp helps people examine [ ] of experiences and develop [ ].","back":"CBTp helps people examine interpretations of experiences and develop coping strategies.","mcqOptions":[{"text":"CBTp helps people examine interpretations of experiences and develop coping strategies.","correct":true,"explanation":"CBTp helps patients question how they interpret unusual experiences and identify less distressing explanations. It also develops practical coping strategies for managing symptoms and improving everyday functioning."},{"text":"CBTp helps people examine interpretations of experiences and develop medication schedules.","correct":false,"explanation":"CBTp does explore interpretations, but developing medication schedules is a medical management task rather than its central psychological aim. The therapy helps patients develop coping strategies."},{"text":"CBTp helps people examine neurochemical origins of experiences and develop coping strategies.","correct":false,"explanation":"Investigating neurochemical origins belongs to a biological approach rather than the main work of CBTp. CBTp examines patients’ interpretations of experiences and develops coping strategies."},{"text":"CBTp helps people examine neurochemical origins of experiences and develop medication schedules.","correct":false,"explanation":"This describes biological explanation and medication management rather than cognitive behavioural therapy. CBTp focuses on examining interpretations of experiences and developing practical coping strategies."}]},{"id":"1b7825a3-0717-4558-a84f-b88805f9b950","cardType":"basic","points":2,"front":"In CBTp, what does a formulation link together?","back":"Thoughts, feelings, symptoms and behaviours maintaining distress.","mcqOptions":[{"text":"Thoughts, feelings, symptoms and behaviours maintaining distress.","correct":true,"explanation":"A formulation in CBTp links these experiences and behaviours into an explanation of what maintains the person’s distress, helping the therapist target relevant patterns."},{"text":"Genes, neurotransmitters, symptoms and diagnoses causing schizophrenia.","correct":false,"explanation":"This reflects a biological explanation rather than a CBTp formulation. CBTp links thoughts, feelings, symptoms and behaviours that maintain distress, rather than identifying genetic or neurotransmitter causes."},{"text":"Triggers, medication, hallucinations and intelligence predicting recovery.","correct":false,"explanation":"Medication and intelligence are not the core components linked in a CBTp formulation. The correct formulation connects thoughts, feelings, symptoms and behaviours maintaining distress."},{"text":"Beliefs, brain structure, symptoms and personality producing psychosis.","correct":false,"explanation":"This mixes cognitive and biological factors and focuses on producing psychosis. CBTp formulations instead connect thoughts, feelings, symptoms and behaviours that maintain distress."}]},{"id":"273fce9f-ef01-4875-9e64-954dfea15684","cardType":"cloze","points":null,"front":"In CBTp, [ ] examines beliefs against evidence; [ ] test predictions safely.","back":"In CBTp, reality testing examines beliefs against evidence; behavioural experiments test predictions safely.","mcqOptions":[{"text":"In CBTp, reality testing examines beliefs against evidence; behavioural experiments test predictions safely.","correct":true,"explanation":"Reality testing compares beliefs with available evidence, while behavioural experiments allow predictions to be tested safely in practice, helping evaluate unhelpful interpretations."},{"text":"In CBTp, cognitive restructuring examines beliefs against evidence; exposure exercises test predictions safely.","correct":false,"explanation":"Cognitive restructuring is related to challenging thoughts, but the specific technique examining beliefs against evidence here is reality testing, and predictions are tested through behavioural experiments."},{"text":"In CBTp, reality testing examines beliefs against evidence; thought diaries test predictions safely.","correct":false,"explanation":"Thought diaries record experiences and identify patterns, but they do not directly test predictions. The second technique is behavioural experiments, which safely test what a belief predicts."},{"text":"In CBTp, behavioural experiments examine beliefs against evidence; reality testing test predictions safely.","correct":false,"explanation":"The two techniques have been reversed. Reality testing examines beliefs against evidence, whereas behavioural experiments are used to test predictions safely."}]},{"id":"f031979c-5faf-40c7-8600-22741ab39861","cardType":"basic","points":2,"front":"How can CBT reduce distress without eliminating voices?","back":"It makes voices feel less threatening and controlling.","mcqOptions":[{"text":"It makes voices feel less threatening and controlling.","correct":true,"explanation":"CBTp can change how a person interprets and responds to voices, reducing their perceived threat and control even when the voices themselves continue."},{"text":"It makes voices feel more frequent and intrusive.","correct":false,"explanation":"Increasing perceived frequency and intrusiveness would usually increase distress, not reduce it. CBTp aims to make voices feel less threatening and controlling without necessarily removing them."},{"text":"It makes voices feel completely absent and eliminated.","correct":false,"explanation":"CBTp does not have to eliminate hallucinations to reduce distress. Its benefit can come from making voices feel less threatening and controlling."},{"text":"It makes voices feel externally caused and unavoidable.","correct":false,"explanation":"Viewing voices as unavoidable and externally caused may strengthen their perceived power. CBTp reduces distress by making voices feel less threatening and controlling."}]},{"id":"5a853f16-b7a7-4f7a-a042-bd0c7bd567a4","cardType":"basic","points":1,"front":"What did Sensky et al. (2000) find about CBT versus befriending?","back":"CBT maintained improvement better at follow-up.","mcqOptions":[{"text":"CBT maintained improvement better at follow-up.","correct":true,"explanation":"Sensky et al. found that CBT produced better maintenance of improvement at follow-up than befriending, suggesting benefits persisted beyond the immediate treatment period."},{"text":"Befriending maintained improvement better at follow-up.","correct":false,"explanation":"This reverses the study’s finding. Sensky et al. reported that CBT maintained improvement better than befriending at follow-up."},{"text":"CBT produced improvement only during treatment.","correct":false,"explanation":"The study did not find that CBT benefits disappeared after treatment. CBT maintained improvement better at follow-up than befriending."},{"text":"Neither treatment maintained improvement at follow-up.","correct":false,"explanation":"This incorrectly suggests that both approaches lost their benefits. Sensky et al. found better maintenance of improvement for CBT than for befriending."}]},{"id":"833cfd77-b008-4e27-a1d0-f3b3ac61f875","cardType":"basic","points":1,"front":"What did Jauhar et al. (2014) argue about CBT effects?","back":"With stronger controls, effects on core symptoms were smaller.","mcqOptions":[{"text":"With stronger controls, effects on core symptoms were smaller.","correct":true,"explanation":"Jauhar et al. argued that better-controlled studies produced smaller CBT effects on core symptoms, raising doubts about the strength of the apparent treatment benefit."},{"text":"With stronger controls, effects on core symptoms were larger.","correct":false,"explanation":"This is the opposite of Jauhar et al.’s conclusion. They argued that CBT effects on core symptoms were smaller when stronger controls were used."},{"text":"With stronger controls, effects on core symptoms were unchanged.","correct":false,"explanation":"Jauhar et al. did not conclude that stronger controls left the effects unchanged. Their argument was that effects on core symptoms became smaller."},{"text":"With stronger controls, effects on core symptoms were eliminated.","correct":false,"explanation":"The review did not claim that all effects disappeared completely. It argued that stronger controls reduced the apparent effects on core symptoms, making them smaller."}]},{"id":"9a734f8b-f9b8-4886-bd18-ca3d1afbcda0","cardType":"basic","points":1,"front":"Why may CBT be difficult during acute psychosis?","back":"Severe distress or suspicion can block engagement.","mcqOptions":[{"text":"Severe distress or suspicion can block engagement.","correct":true,"explanation":"During acute psychosis, severe distress, suspiciousness or mistrust may make it difficult for a person to attend, communicate openly or engage with CBTp."},{"text":"Severe distress or suspicion can guarantee engagement.","correct":false,"explanation":"Acute distress and suspicion generally make collaboration more difficult rather than guaranteeing it. They can block engagement with CBTp during acute psychosis."},{"text":"Severe distress or suspicion can improve concentration.","correct":false,"explanation":"Acute psychosis commonly disrupts concentration and trust, rather than improving them. Severe distress or suspicion can block engagement with CBTp."},{"text":"Severe distress or suspicion can remove the need for rapport.","correct":false,"explanation":"Trust and rapport remain important when someone is distressed or suspicious. These difficulties can block engagement, so they do not remove the need for rapport."}]},{"id":"c7780870-73f2-4158-af46-344a3ae53048","cardType":"basic","points":1,"front":"What combined approach does NICE generally recommend?","back":"Antipsychotic medication alongside CBTp and family intervention.","mcqOptions":[{"text":"Antipsychotic medication alongside CBTp and family intervention.","correct":true,"explanation":"NICE generally recommends a combined approach: antipsychotic medication alongside psychological therapy such as CBTp and support or intervention involving the family."},{"text":"Antipsychotic medication alongside befriending and sleep restriction.","correct":false,"explanation":"Befriending may be used as a comparison condition, but sleep restriction is not the general NICE combination for schizophrenia. The recommended approach includes CBTp and family intervention."},{"text":"Antipsychotic medication alongside psychoanalysis and token economies.","correct":false,"explanation":"These are not the combined approach generally recommended by NICE for schizophrenia. NICE recommends antipsychotic medication alongside CBTp and family intervention."},{"text":"Antipsychotic medication alongside family intervention only.","correct":false,"explanation":"Family intervention is recommended, but this option omits CBTp from the combined approach. NICE generally recommends antipsychotic medication alongside both CBTp and family intervention."}]},{"id":"0eaa0486-60d7-450c-8237-e2329cf25381","cardType":"basic","points":1,"front":"In treatment research, what makes a study an RCT?","back":"Participants are randomly allocated to treatment conditions.","mcqOptions":[{"text":"Participants are randomly allocated to treatment conditions.","correct":true,"explanation":"Random allocation gives each participant a comparable chance of entering each condition, reducing allocation bias and helping researchers make stronger causal conclusions about treatment effects."},{"text":"Participants are self-selected into treatment conditions.","correct":false,"explanation":"Self-selection can create systematic differences between groups, such as motivation or symptom severity. An RCT requires participants to be randomly allocated to treatment conditions."},{"text":"Participants are matched by preference to treatment conditions.","correct":false,"explanation":"Matching by preference is not random allocation and can introduce group differences linked to expectations or motivation. In an RCT, participants are randomly allocated to conditions."},{"text":"Participants are allocated by the clinician to treatment conditions.","correct":false,"explanation":"Clinician allocation may be influenced by judgement about suitability or prognosis, creating allocation bias. An RCT instead randomly allocates participants to treatment conditions."}]},{"id":"868174cc-95c9-4444-8de9-fede1f194d61","cardType":"basic","points":1,"front":"Which test fits the same patients measured before and after CBT using ordinal scores?","back":"Wilcoxon signed-ranks.","mcqOptions":[{"text":"Wilcoxon signed-ranks.","correct":true,"explanation":"The Wilcoxon signed-ranks test compares two related sets of ordinal data, such as the same patients’ scores before and after CBT."},{"text":"Paired-samples t-test.","correct":false,"explanation":"A paired-samples t-test compares related measurements but requires interval or ratio data with suitable assumptions. For ordinal scores, the correct test is the Wilcoxon signed-ranks test."},{"text":"Mann-Whitney U.","correct":false,"explanation":"The Mann-Whitney U test compares scores from two independent groups, not the same patients measured twice. Related ordinal scores before and after CBT require the Wilcoxon signed-ranks test."},{"text":"Spearman’s rho.","correct":false,"explanation":"Spearman’s rho measures the correlation between two ranked variables rather than testing a before-and-after difference. The appropriate test for related ordinal scores is the Wilcoxon signed-ranks test."}]},{"id":"9d27fd55-cb05-43c6-8300-6c8a298a8b34","cardType":"cloze","points":null,"front":"A directional hypothesis uses a [ ] test; a non-directional hypothesis uses a [ ] test.","back":"A directional hypothesis uses a one-tailed test; a non-directional hypothesis uses a two-tailed test.","mcqOptions":[{"text":"A directional hypothesis uses a one-tailed test; a non-directional hypothesis uses a two-tailed test.","correct":true,"explanation":"A directional hypothesis predicts the direction of an effect, so significance is tested in one tail. A non-directional hypothesis predicts an effect without its direction, requiring two tails."},{"text":"A directional hypothesis uses a two-tailed test; a non-directional hypothesis uses a one-tailed test.","correct":false,"explanation":"This reverses the relationship: two-tailed tests suit non-directional predictions, whereas one-tailed tests suit directional predictions because the expected direction is specified."},{"text":"A directional hypothesis uses a one-tailed test; a non-directional hypothesis uses a one-tailed test.","correct":false,"explanation":"Although a directional hypothesis uses a one-tailed test, a non-directional hypothesis cannot specify one direction. It requires a two-tailed test so effects in either direction can be detected."},{"text":"A directional hypothesis uses a two-tailed test; a non-directional hypothesis uses a two-tailed test.","correct":false,"explanation":"A two-tailed test is correct for a non-directional hypothesis, but a directional hypothesis predicts where the effect will occur. Therefore, it should use a one-tailed test."}]}]}],"examCountdown":{"examDate":"2027-05-18","paperLabel":"Component 1"},"heading":"Schizophrenia: methods of modifying the behaviour","title":"Schizophrenia: methods of modifying the behaviour Flashcards","topbar":{"backHref":"/a-level/psychology/eduqas/flashcards"},"topicSidebar":"$L39"}]}],"topicId":"715369ab-fb1b-5494-a822-6852349754de","walled":"$L3a"}],"$L3b","$L3c"]