Question 112 marks
Question
(a) Outline two characteristics of schizophrenia. [2] (b) Describe token economy (Paul and Lentz, 1977) as a treatment for schizophrenia and delusional disorder. [4] (c) Discuss the ethics of using token economies as a treatment for schizophrenia and delusional disorder. [6]
Mark scheme
1(a) Outline two characteristics of schizophrenia. 2 Award 1 mark for each characteristic For example: Positive symptoms – delusions, hallucinations, disorganised speech. Negative symptoms – flattened affect, avolition, poverty of speech, and social withdrawal. Other appropriate responses should also be credited. 1(b) Describe token economy (Paul and Lentz, 1977) as a treatment for schizophrenia and delusional disorder. 4 Award 1–2 marks for a basic answer with some understanding of the topic area. Award 3–4 marks for a detailed answer with clear understanding of the topic area. For example: Based around operant conditioning (1). Patients with schizophrenia (usually in institutional care) are rewarded with tokens for instances of desirable behaviours (1) such as making beds, taking medication, self-care, engaging socially, and attending therapy sessions (1). The tokens can be exchanged for luxury items such as cigarettes, TV use, sweets, or clothing (1). In some instances, tokens can be removed for behaviours considered undesirable like angry outbursts (1). Other appropriate responses should also be credited. 1(c) Discuss the ethics of using token economies as a treatment for schizophrenia and delusional disorder. 6 Likely ethical issues will be: • Use of vulnerable patients who may not be capable of giving informed consent; • Inability to withdraw from the scheme without loss of privileges; • Psychological harm as patient may feel that they are being judged adversely for merely suffering with an abnormality over which they have little control; • Briefing as patients can be made fully aware of why they are engaging in the program and how it will help them; • No deception is being used; Mark according to the levels of response criteria below: Level 3 (5–6 marks) • Candidates will show a clear understanding of the question and will discuss at least 2 appropriate ethical issues (positive or negative); • Candidates will provide a good explanation with clear detail; Level 2 (3–4 marks) • Candidates will show an understanding of the question and will explain appropriate ethical issues (at least 2) in less detail; • Candidates will provide a good explanation; Level 1 (1–2 marks) • Candidates will show a basic understanding of the question and will attempt to explain ethical issues. There could be a brief explanation of one ethical issue; • Candidates will provide a limited explanation; Level 0 (0 marks) No response worthy of credit. Other appropriate responses should also be credited.