Symptoms of schizophrenia | AQA A-Level Psychology Revision

For 7182 specification, first teach in September 2025

AQA A-Level Psychology | Free Revision Notes

Estimated study time: 55 minutes

Schizophrenia is associated with changes in perception, thought, communication and motivation. These Symptoms of schizophrenia A-Level Psychology revision notes focus on the four symptoms named by AQA: hallucinations, delusions, speech poverty and avolition.

Hallucinations and delusions are positive symptoms, involving experiences added to ordinary functioning. Speech poverty and avolition are negative symptoms, involving a reduction or loss of usual functioning. Understanding these symptoms provides the foundation for studying co-morbidity, symptom overlap and diagnostic bias and the biological and psychological explanations of schizophrenia. The current specification explicitly requires all four symptoms and the distinction between positive and negative symptoms.

Learning Objectives 🎯

By the end of this revision page, you should be able to:

• Define hallucinations and delusions.

• Recognise hallucinations and delusions in unfamiliar scenarios.

• Define speech poverty and avolition.

• Recognise speech poverty and avolition in unfamiliar scenarios.

• Distinguish positive from negative symptoms.

• Explain why the terms positive and negative do not mean good and bad.

Revision Notes 📚

Symptoms of schizophrenia A-Level Psychology revision overview

The AQA specification identifies four symptoms of schizophrenia:

Positive symptoms	Negative symptoms
Hallucinations	Speech poverty
Delusions	Avolition

The words positive and negative describe the direction of change in functioning.

• A positive symptom involves something being added to ordinary experience.

• A negative symptom involves something being reduced, lost or absent from ordinary functioning.

AQA’s June 2024 mark scheme describes positive symptoms as behaviours or experiences added over and above typical functioning, whereas negative symptoms involve the loss or absence of usual functioning.

Important terminology

A symptom is a characteristic or experience associated with a condition.

A symptom is not automatically:

• A complete diagnosis.

• An explanation for the condition.

• Evidence of one particular cause.

• Present in every person with the diagnosis.

People diagnosed with schizophrenia may experience different combinations of symptoms.

A person may show:

• Mainly positive symptoms.

• Mainly negative symptoms.

• Both positive and negative symptoms.

• Changes in symptoms over time.

📌 Respectful language: Use “a person with schizophrenia” rather than describing someone as “a schizophrenic”. A diagnosis is not the person’s entire identity.

Positive symptoms

What is a positive symptom?

A positive symptom is an additional experience or behaviour that is not normally present.

Positive does not mean:

• Helpful.

• Pleasant.

• Desirable.

• A sign of improvement.

The term means that something has been added to ordinary psychological functioning.

The two positive symptoms required by AQA are:

1. Hallucinations.

2. Delusions.

Addition or distortion

Positive symptoms may involve an addition to or distortion of:

• Perception.

• Thought.

• Interpretation of events.

• Beliefs about oneself or other people.

For example:

• Hearing a voice when no external speaker is present adds an unusual perceptual experience.

• Believing that strangers are secretly monitoring one’s thoughts adds an unusual interpretation or belief.

Hallucinations

What is a hallucination?

A hallucination is a sensory experience that occurs without a corresponding external stimulus.

The experience may involve:

• Hearing.

• Seeing.

• Touch.

• Smell.

• Taste.

The person experiences a perception even though there is no external object or event producing it in the usual way.

For example:

A person hears a voice speaking to them, but nobody nearby has spoken and there is no external recording.

The voice is a perceptual experience for the person. It may feel vivid and real.

Hallucinations are experienced as perceptions

A hallucination is not simply:

• Thinking about a sound.

• Remembering someone’s voice.

• Imagining a picture deliberately.

• Pretending to see something.

• Telling a lie.

The person experiences the hallucination as though it is occurring through their senses.

Auditory hallucinations

An auditory hallucination involves hearing a sound without an external sound source.

Examples include hearing:

• One or more voices.

• Whispering.

• Music.

• Footsteps.

• Knocking.

• Other sounds.

Voices may appear to:

• Speak directly to the person.

• Discuss the person.

• Comment on their actions.

• Give instructions.

• Criticise or threaten them.

For example:

Tariq hears a voice repeatedly telling him that he must stay inside, although no one else can hear it.

This is an auditory hallucination because a sound is experienced without a corresponding external source.

Visual hallucinations

A visual hallucination involves seeing something that is not present in the external environment.

A person might report seeing:

• A figure.

• An animal.

• A shape.

• A flash of light.

• An object or person that others cannot see.

For example:

Amara sees a man standing beside her door, but nobody is physically present.

This is a visual hallucination.

Tactile hallucinations

A tactile hallucination involves a sensation of touch or movement without a corresponding physical stimulus.

A person might feel:

• Someone touching them.

• Something moving across the skin.

• Pressure on part of the body.

• An unexplained bodily sensation.

For example:

Sam feels insects crawling over his arms even though nothing is touching his skin.

This is a tactile hallucination.

Other sensory forms

Hallucinations may also involve smell or taste.

For example, a person may experience:

• A strong smell that has no identifiable external source.

• A taste despite not eating or drinking anything.

For an AQA answer, a clear auditory, visual or tactile example is usually easiest to explain.

Hallucinations may influence behaviour

A hallucination can affect how the person behaves.

For example:

A person hears a voice warning them not to open the door.

They may:

• Lock the door.

• Avoid visitors.

• Become frightened.

• Speak back to the voice.

• Change their plans.

The behaviour makes sense when understood from the person’s perceptual experience.

Applying hallucinations

Consider this scenario:

Leila regularly turns towards an empty part of the room and replies to a voice that nobody else can hear.

A complete application would state:

• Leila appears to be experiencing an auditory hallucination.

• She perceives a voice in the absence of an external speaker.

• The voice is an additional sensory experience.

• Hallucinations are therefore classified as a positive symptom.

Hallucination or ordinary experience?

Not every unusual sensory experience indicates schizophrenia.

For example, hearing a real sound incorrectly is not necessarily a hallucination.

Suppose someone hears a coat moving in the wind and believes for a moment that it is a person.

There is an external stimulus, the moving coat.

The person has misinterpreted something that is actually present.

A hallucination occurs where the sensory experience lacks a corresponding external stimulus.

Delusions

What is a delusion?

A delusion is a strongly held belief that is not supported by available evidence and remains fixed despite convincing contradictory information.

The belief may involve:

• Threat.

• Importance.

• Power.

• Control.

• Messages or meanings.

• Other people’s intentions.

The person does not usually hold the belief as a joke or deliberate deception.

They accept it as true.

Delusions concern beliefs, not perceptions

A delusion is a belief.

A hallucination is a sensory experience.

For example:

• “I can hear a voice saying that I am being followed” describes a hallucination.

• “Government agents are following me” describes a delusion.

The symptoms can occur together, but they are not identical.

Delusions of persecution

A delusion of persecution involves believing that another person, organisation or group intends to harm, threaten or target the individual.

Examples include believing that:

• Neighbours are planning an attack.

• Care workers intend to cause harm.

• Strangers are secretly following the person.

• An organisation is monitoring them.

• Food has deliberately been poisoned.

For example:

Dani believes that hospital staff are secretly trying to harm him, despite evidence that they are providing medical care.

This is a delusion of persecution.

Delusions of grandeur

A delusion of grandeur involves an exaggerated belief about one’s power, status, ability or importance.

A person might believe that they:

• Possess extraordinary powers.

• Are an exceptionally important historical figure.

• Have a unique global mission.

• Can control major events.

• Possess abilities that no other person has.

For example:

Eleni believes that she has been chosen to control the world’s weather.

This is a delusion of grandeur because it is an unsupported belief involving exceptional power.

Delusions of control

A delusion of control involves believing that thoughts, feelings or actions are being controlled by an outside force.

The person may believe that:

• Someone is inserting thoughts into their mind.

• Their movements are controlled by technology.

• Another person can remove thoughts.

• An external power is directing their actions.

For example:

Noah believes that a device in a nearby building is placing thoughts in his mind.

This is a delusion involving external control.

Delusions of reference

A person may believe that ordinary events contain a special personal message.

For example:

• A television presenter is communicating directly with them.

• A newspaper headline contains a hidden instruction for them.

• Strangers’ gestures are coded messages about them.

• A song has been written specifically to warn them.

For example:

Priya believes that every time a television presenter adjusts their glasses, it is a secret message intended only for her.

This is a delusional interpretation of an ordinary event.

The person believes the delusion

A delusion should not be confused with:

• Pretending.

• Fantasy used knowingly.

• Storytelling.

• An ordinary mistake corrected by evidence.

• A culturally shared belief.

The individual genuinely accepts the delusional belief as true.

Delusions may influence emotions and behaviour

A belief affects how a situation is interpreted.

For example:

A person believes that their care workers are trying to break into their home.

They may:

• Feel frightened.

• Lock doors and windows.

• Refuse help.

• Avoid appointments.

• Constantly check the house.

The behaviour may appear unusual to other people, but it is consistent with the person’s belief.

Applying delusions

George refuses to use his phone because he believes that a secret organisation is reading his thoughts through it, despite repeated evidence that this is not happening.

A developed answer would state:

• George appears to have a delusion.

• He has a fixed belief that an organisation can read his thoughts.

• The belief is unsupported and persists despite contradictory evidence.

• Delusions are an addition to ordinary thought and are therefore positive symptoms.

Hallucinations and delusions compared

Hallucination	Delusion
A sensory experience	A belief
Occurs without a corresponding external stimulus	Is not supported by available evidence
Affects perception	Affects thought or interpretation
Example: hearing a voice	Example: believing one is being monitored
Positive symptom	Positive symptom

A useful question

Ask:

Is the scenario describing what the person perceives, or what the person believes?

• Perception without an external stimulus suggests a hallucination.

• A fixed unsupported belief suggests a delusion.

Symptoms may occur together

Consider:

Mei hears a voice saying that strangers are spying on her. She consequently believes that everyone on her street works for a secret organisation.

• Hearing the voice is a hallucination.

• Believing that every neighbour is a spy is a delusion.

The hallucination may contribute to the belief, but the two symptoms should be identified separately.

Negative symptoms

What is a negative symptom?

A negative symptom involves a reduction, loss or absence of usual psychological functioning.

Negative does not mean:

• Immoral.

• Harmful by definition.

• Worse than a positive symptom.

• A pessimistic thought.

The term means that an ordinary function has been reduced or removed.

The two negative symptoms required by AQA are:

1. Speech poverty.

2. Avolition.

Reduction in functioning

Negative symptoms may affect:

• Speech.

• Motivation.

• Goal-directed behaviour.

• Everyday activity.

They may appear less dramatic than hallucinations or delusions, but they can have a substantial effect on daily life.

Speech poverty

What is speech poverty?

Speech poverty is a reduction in the amount and quality of speech.

It may involve:

• Very brief answers.

• Reduced spontaneous speech.

• Long delays before responding.

• Few details.

• Limited information in responses.

• Difficulty maintaining a conversation.

The symptom represents a reduction in normal verbal output.

Reduction in amount

A person may speak much less than expected.

For example:

Interviewer: “What did you do yesterday?”Person: “Nothing.”

The response is extremely brief and provides little information.

Reduction in quality or content

Speech poverty can also involve reduced meaningful content.

A person may:

• Provide little explanation.

• Struggle to develop an answer.

• Communicate fewer ideas.

• Require repeated prompting.

For example:

Interviewer: “How have you been feeling since your appointment?”Person: “Fine.”Interviewer: “Can you explain a little more?”Person: “No.”

The conversation contains very limited verbal information.

Speech poverty is not simply quietness

A person may be naturally quiet, shy or tired without experiencing speech poverty.

Speech poverty involves a noticeable reduction in usual verbal functioning.

It is not diagnosed simply because someone:

• Speaks softly.

• Prefers listening.

• Gives one brief answer.

• Feels anxious in one conversation.

• Does not wish to speak to a particular person.

Application questions usually provide a broader pattern of reduced speech.

Speech poverty is not the same as confused speech

Speech poverty concerns a reduction in speech.

Confused or jumbled speech involves speech being produced but lacking organisation or coherence.

For example:

• Saying almost nothing demonstrates reduced verbal output.

• Moving rapidly between unrelated ideas demonstrates a different type of language difficulty.

For this lesson, the required negative symptom is speech poverty.

Applying speech poverty

Before becoming unwell, Malik enjoyed long conversations. He now gives one-word answers, rarely starts a conversation and provides almost no detail even when encouraged.

A developed answer would state:

• Malik demonstrates speech poverty.

• His amount and quality of speech have been reduced.

• He gives extremely brief responses and does not initiate conversation.

• Speech poverty is a negative symptom because normal verbal functioning has been lost.

Avolition

What is avolition?

Avolition is a reduction in the ability or motivation to begin and continue goal-directed activities.

Goal-directed activities are behaviours carried out to achieve an outcome.

Examples include:

• Preparing food.

• Washing.

• Getting dressed.

• Completing work.

• Attending appointments.

• Studying.

• Maintaining the home.

• Socialising.

• Taking part in hobbies.

A person experiencing avolition may struggle to:

• Start an activity.

• Organise the required steps.

• Persist once the activity has begun.

• Complete ordinary tasks.

Starting an activity

A person may intend to carry out a task but fail to begin it.

For example:

Amina says that she wants to clean her room but remains sitting for several hours without starting.

Maintaining an activity

The person may begin but quickly stop.

For example:

Luca starts preparing a meal but abandons the task after taking out one ingredient.

Goal-directed behaviour

The key feature is reduced purposeful activity.

For example:

• Picking up a toothbrush but not brushing one’s teeth.

• Opening a textbook but not beginning the work.

• Planning to attend an appointment but making no preparations.

• Starting to dress but leaving the task unfinished.

Avolition is not laziness

Calling avolition “laziness” is inaccurate and stigmatising.

Avolition is a psychological symptom involving reduced motivation and goal-directed behaviour.

The person may:

• Want their situation to improve.

• Understand that a task is important.

• Feel frustrated by their inactivity.

• Be unable to initiate or sustain the action.

It is not simply a voluntary decision to avoid effort.

Avolition is not the same as physical inability

A person may have the physical ability to complete a task but struggle to begin or sustain it.

For example:

Sofia can physically prepare food but lacks the motivation to organise and complete the process.

The difficulty concerns goal-directed motivation, not necessarily strength or movement.

Applying avolition

Ethan previously attended college regularly and played football twice a week. He now spends most days inactive, does not begin his assignments and stops preparing meals before they are finished.

A developed answer would state:

• Ethan demonstrates avolition.

• There is a reduction in initiating and maintaining goal-directed behaviour.

• His study, food preparation and leisure activities have declined.

• Avolition is a negative symptom because normal motivated activity has been reduced.

Speech poverty and avolition compared

Speech poverty	Avolition
Reduction in speech	Reduction in goal-directed behaviour
Affects verbal output	Affects motivation and activity
May involve one-word answers	May involve failure to begin tasks
May involve limited content	May involve failure to persist
Negative symptom	Negative symptom

Identifying the correct negative symptom

Ask:

• Is the main reduction in communication? This suggests speech poverty.

• Is the main reduction in initiating and continuing activities? This suggests avolition.

The symptoms may occur together.

For example:

A person rarely speaks and no longer starts ordinary daily tasks.

This scenario contains evidence of both speech poverty and avolition.

Positive and negative symptoms compared

Positive symptoms	Negative symptoms
Add experiences or behaviours	Reduce or remove ordinary functioning
Involve something appearing	Involve something becoming limited or absent
Hallucinations	Speech poverty
Delusions	Avolition
May affect perception or belief	May affect communication or motivation
Do not mean “good”	Do not mean “bad”

A complete exam distinction

A strong distinction contains three elements:

1. Positive symptoms are additions to or distortions of usual functioning.

2. Negative symptoms are reductions or losses of usual functioning.

3. One accurately classified example of each is provided.

For example:

“Hallucinations are a positive symptom because an additional sensory experience occurs without an external stimulus. Speech poverty is a negative symptom because the person shows a reduction in the amount or content of ordinary speech.”

Why “added and taken away” may be too brief

Writing only:

“Positive symptoms are added and negative symptoms are taken away.”

shows the basic idea but lacks precision.

A clearer answer explains what is added or reduced:

• Experiences, perceptions or beliefs are added.

• Ordinary speech, motivation or goal-directed activity is reduced.

The June 2024 examiner report noted that some students lost a mark because their distinction contained little more than the words “added” and “taken away”.

Applying all four symptoms

Consider the following scenario:

Yasmin hears a voice telling her that her neighbours are observing her. She believes that the neighbours have placed hidden cameras throughout her home. During appointments, Yasmin gives only one-word answers. She has also stopped preparing meals and no longer begins tasks around the house.

Hallucination

Yasmin hears a voice without an identified external speaker.

This is an auditory hallucination and a positive symptom.

Delusion

She believes that hidden cameras have been placed in her home.

This is an unsupported fixed belief involving persecution or surveillance and is a positive symptom.

Speech poverty

She gives only one-word answers.

This represents reduced verbal output and is a negative symptom.

Avolition

She no longer prepares meals or begins household tasks.

This represents reduced goal-directed activity and is a negative symptom.

Worked scenario: distinguishing perception from belief

Owen says, “I can hear the television presenter speaking directly to me even when the television is switched off. The presenter has selected me to become the next leader of the country.”

Two symptoms are present:

• Hearing the presenter while the television is off is an auditory hallucination.

• Believing that he has been specially selected as national leader is a delusion of grandeur.

A common mistake would be to label the entire scenario as a hallucination.

Always separate the sensory experience from the belief.

Worked scenario: distinguishing speech from motivation

During an interview, Alina gives very short replies and does not offer any information unless repeatedly prompted. At home, however, she continues to cook, attend work and complete daily tasks.

This provides evidence of:

• Speech poverty, because her verbal output is reduced.

It does not provide clear evidence of:

• Avolition, because she continues to initiate and complete goal-directed activities.

Worked scenario: identifying avolition carefully

Ben has not attended the gym for one week because he has injured his ankle. He continues studying, socialising and completing household tasks.

This does not provide clear evidence of avolition.

Ben’s reduced gym attendance has:

• A physical explanation.

• A short duration.

• No broader pattern of lost motivation.

Do not diagnose a symptom from one isolated behaviour.

A four-step application strategy

Step 1: Identify the type of change

Is the person experiencing:

• An additional perception?

• An unsupported fixed belief?

• Reduced speech?

• Reduced goal-directed activity?

Step 2: Name the symptom

Use the exact term:

• Hallucination.

• Delusion.

• Speech poverty.

• Avolition.

Step 3: Quote or paraphrase the scenario

Identify the specific evidence.

For example:

“Hearing a voice that nobody else can hear…”

Step 4: Explain the classification

State why the symptom is positive or negative.

For example:

“…is a hallucination and therefore a positive symptom because an additional sensory experience is present.”

Application sentence structure

Use:

scenario detail → symptom → definition → positive or negative classification

For example:

“Ravi’s belief that strangers are controlling his thoughts is a delusion because it is a fixed belief unsupported by evidence. It is a positive symptom because an unusual belief has been added to ordinary functioning.”

Symptoms and later explanations

This lesson describes what the symptoms are.

Later lessons examine why they might occur.

Biological links

• genetic vulnerability

• dopamine activity and neural correlates 

Psychological links

• family communication and stress 

• dysfunctional thought processing 

Treatment links

• dopamine-blocking medication

• newer forms of drug therapy

• challenging interpretations and beliefs 

Do not turn a question asking you to describe symptoms into an essay about their cause or treatment.

Important cautions when describing symptoms

One symptom does not establish a diagnosis

A person may experience reduced motivation or an unusual perception for many reasons.

A diagnosis requires a wider professional assessment.

In an examination application question, identify the symptom supported by the scenario rather than claiming that you have diagnosed the person.

Use:

“This behaviour is consistent with avolition.”

rather than:

“This proves the person has schizophrenia.”

Symptoms can overlap with other conditions

Some symptoms may also occur in other mental health conditions.

This creates difficulties involving co-morbidity and symptom overlap.

For this lesson, focus on describing the symptoms accurately.

Symptoms vary between people

Not every person with schizophrenia experiences:

• Hallucinations.

• Delusions.

• Speech poverty.

• Avolition.

The diagnosis does not produce one identical presentation in every person.

Symptoms can affect one another

For example:

• A frightening hallucination may reduce social activity.

• A delusion may cause a person to avoid carers.

• Avolition may reduce opportunities for conversation.

• Speech poverty may make assessment more difficult.

However, one symptom should not be confused with another.

Overall summary

The four AQA symptoms can be remembered using the following structure:

Positive symptoms: added experiences

• Hallucinations: sensory experiences without corresponding external stimuli.

• Delusions: fixed beliefs that are unsupported by available evidence.

Negative symptoms: reduced functioning

• Speech poverty: reduced amount or quality of speech.

• Avolition: reduced initiation and persistence in goal-directed activity.

The key distinction is:

Positive symptoms add or distort experience.Negative symptoms reduce or remove ordinary functioning.

Hints from the Examiner Reports 💡

Examiner hint: Clearly state which symptom is positive and which is negative. AQA’s June 2024 mark scheme required a specific example of each type with an explicit classification.

Examiner hint: Explain the difference fully. Do not write only:

“Positive is added; negative is taken away.”

State that:

• Positive symptoms add unusual experiences, perceptions or beliefs.

• Negative symptoms involve a reduction or absence of ordinary functioning.

The 2024 examiner report noted that brevity caused some students to lose a mark even when they understood the basic distinction.

Examiner hint: Popular correct examples in 2024 were hallucinations as a positive symptom and avolition as a negative symptom. Other named specification symptoms are equally creditworthy when accurately described.

Examiner hint: Use the scenario rather than repeating a memorised definition. For example:

“Hearing a voice when nobody is speaking is an auditory hallucination.”

Examiner hint: Keep hallucinations and delusions separate:

• Hallucination: perception.

• Delusion: belief.

Examiner hint: Speech poverty means reduced speech. Do not confuse it with rapid, confused or jumbled speech.

Examiner hint: Avolition needs an activity-based explanation. State that the person struggles to initiate or persist in purposeful tasks.

Examiner hint: Avoid stigmatising language. Delusions are sincerely held beliefs, hallucinations are experienced as real, and avolition is not simply laziness.

Examiner hint: When the command word is “outline” or “describe”, do not spend valuable time evaluating explanations or treatments.

Common Mistakes ⚠️

Mistake: Saying positive symptoms are beneficial

Why this is incorrect:

Positive refers to an addition to ordinary functioning, not a desirable outcome.

How to improve:

Use “additional experience or behaviour”.

Mistake: Saying negative symptoms are unpleasant symptoms

Why this is incorrect:

Negative refers to a reduction or loss of ordinary functioning.

How to improve:

Identify what has been reduced, such as speech or motivation.

Mistake: Defining a hallucination as a false belief

Why this is incorrect:

A hallucination is a sensory experience.

How to improve:

Use an example involving hearing, seeing or feeling something without an external stimulus.

Mistake: Defining a delusion as seeing something unreal

Why this is incorrect:

A delusion is a belief.

How to improve:

Describe a fixed unsupported belief involving persecution, control or grandeur.

Mistake: Saying a person is pretending to hallucinate

Why this is incorrect:

A hallucination is experienced as a genuine perception.

How to improve:

Explain that the sensory experience feels real to the person.

Mistake: Treating a delusion as a lie

Why this is incorrect:

A lie involves knowingly stating something untrue. A delusion is genuinely believed.

How to improve:

State that the person accepts the belief as true.

Mistake: Giving only the topic of a delusion

Why this is incomplete:

Writing “paranoia” does not describe the belief.

How to improve:

Explain what the person believes, such as that others intend to harm them.

Mistake: Defining speech poverty as speaking quietly

Why this is incorrect:

Volume is not the central feature.

How to improve:

Refer to reduced amount, content or spontaneity of speech.

Mistake: Confusing speech poverty with confused speech

Why this is incorrect:

Speech poverty involves less speech. Confused speech may involve substantial but disorganised speech.

How to improve:

Look for brief answers, limited content and reduced verbal initiation.

Mistake: Defining avolition as laziness

Why this is inaccurate and stigmatising:

Avolition is a psychological reduction in goal-directed motivation.

How to improve:

Describe difficulty initiating and sustaining activities.

Mistake: Identifying avolition from one missed activity

Why this is insufficient:

A single event may have an ordinary explanation.

How to improve:

Look for a broader reduction in purposeful activity.

Mistake: Using “positive” and “negative” to describe severity

Why this is incorrect:

One type is not automatically more or less severe.

How to improve:

Use the addition-versus-reduction distinction.

Mistake: Claiming every person with schizophrenia experiences all four symptoms

Why this is incorrect:

Symptoms and their severity vary.

How to improve:

Use language such as “may experience”.

Mistake: Diagnosing a person from one sentence

Why this is inappropriate:

One symptom does not establish a clinical diagnosis.

How to improve:

State that the behaviour is “consistent with” a particular symptom.

Exam-Style Questions ✍️

Questions

1. What is meant by a hallucination?[2 marks]

2. What is meant by a delusion?[2 marks]

3. Explain one difference between hallucinations and delusions.[4 marks]

4. Describe speech poverty and avolition.[4 marks]

5. Using an example of each, explain the difference between positive and negative symptoms of schizophrenia.[4 marks]

6. Ruby says that she hears a voice warning her not to leave her home. She also believes that her neighbours have formed a secret group to harm her.

Identify and explain the two symptoms shown by Ruby.[4 marks]

7. During appointments, Imran gives one-word answers and rarely begins a conversation. At home, he no longer starts preparing food, cleaning or completing college work.

Explain Imran’s symptoms.[6 marks]

8. Classify each description as a hallucination, delusion, speech poverty or avolition.

a) Feeling someone touching one’s arm when nobody is nearby.b) Believing that television programmes contain secret personal instructions.c) Giving extremely brief answers with almost no detail.d) Failing to begin or complete ordinary purposeful activities.[4 marks]

9. A student writes: “Positive symptoms are good and negative symptoms are bad.”

Explain why the student’s statement is incorrect.[4 marks]

10. Outline the positive and negative symptoms of schizophrenia named in the AQA specification.[8 marks]

Answers and Mark Scheme

Question 1

Award up to two marks:

• A hallucination is a sensory or perceptual experience.

• It occurs without a corresponding external stimulus.

Credit a relevant example if it clarifies the definition.

Question 2

Award up to two marks:

• A delusion is a fixed or strongly held belief that is unsupported by available evidence.

• It may continue despite convincing contradictory information.

Do not credit a purely perceptual description.

Question 3

Award up to four marks:

• Hallucinations are sensory experiences.

• They occur without a corresponding external stimulus.

• Delusions are fixed beliefs that are not supported by evidence.

• For example, hearing a voice is a hallucination, whereas believing that an organisation is controlling one’s thoughts is a delusion.

Higher marks require an explicit comparison.

Question 4

Award up to two marks for each symptom.

Speech poverty:

• A reduction in the amount or quality of speech.

• May involve brief answers, little spontaneous speech or limited content.

Avolition:

• A reduction in the motivation or ability to initiate and persist in goal-directed behaviour.

• May involve failing to begin or complete ordinary tasks.

Question 5

Award up to four marks:

• Positive symptoms involve experiences or behaviours added to or beyond ordinary functioning.

• Hallucinations or delusions are suitable positive examples.

• Negative symptoms involve a reduction, loss or absence of usual functioning.

• Speech poverty or avolition are suitable negative examples.

A complete answer must identify and classify a specific symptom from each category.

Question 6

Award up to four marks:

• Hearing the voice is an auditory hallucination.

• The voice is experienced without a corresponding external speaker.

• Believing that the neighbours have formed a group to harm her is a delusion of persecution.

• It is a fixed unsupported belief involving threat.

• Both are positive symptoms because unusual experiences or beliefs have been added to ordinary functioning.

Question 7

Award up to six marks:

• Imran’s one-word answers demonstrate speech poverty.

• His amount or quality of verbal output is reduced.

• Rarely starting a conversation provides further evidence of reduced speech.

• His failure to start food preparation, cleaning and work demonstrates avolition.

• These are goal-directed activities that he no longer initiates.

• Both are negative symptoms because ordinary speech and motivated behaviour have been reduced.

Question 8

Award one mark for each correct classification:

a) Hallucination.b) Delusion.c) Speech poverty.d) Avolition.

Question 9

Award up to four marks:

• Positive and negative do not describe whether a symptom is good or bad.

• Positive symptoms involve an addition to ordinary experience or functioning.

• Hallucinations and delusions are positive symptoms.

• Negative symptoms involve a reduction or loss of ordinary functioning.

• Speech poverty and avolition are negative symptoms.

Question 10

A strong response should include:

Positive symptoms

Hallucinations

• Sensory experiences without a corresponding external stimulus.

• May involve hearing, seeing or touch.

• Auditory example, such as hearing voices.

• Classified as positive because an unusual perception is added.

Delusions

• Fixed beliefs not supported by evidence.

• May involve persecution, grandeur or control.

• The person genuinely accepts the belief.

• Classified as positive because an unusual belief is added.

Negative symptoms

Speech poverty

• Reduced amount or quality of speech.

• May involve brief answers, little spontaneous speech or limited content.

• Classified as negative because ordinary verbal functioning is reduced.

Avolition

• Reduced initiation and persistence in goal-directed activities.

• May affect work, self-care, food preparation or social activity.

• Classified as negative because ordinary motivation and purposeful behaviour are reduced.

Higher-level answers will describe all four symptoms accurately, use examples appropriately and explain the addition-versus-reduction distinction clearly.