People with symptoms of schizophrenia are often diagnosed through an interview with their doctor. Freeman (2008) says virtual reality (VR) is useful for symptom assessment and the treatment of psychotic disorders. Freeman also says this technology has many other applications.

Mark scheme

Marking points from the official mark scheme (Oct/Nov 2018). The mark or mark type is shown in brackets.

1. (a) Misinterpretation of other peoples' behaviour is a key feature of persecutory ideation. The occurrence and intensity of hallucinations is affected by the social context.
2. (a) Negative symptoms such as anhedonia, asociality, and blunted affect reflect difficulties in social interactions.
3. (a) Withdrawal and avoidance of other people is frequent in schizophrenia, leading to isolation and rumination.
4. (a) The use of virtual reality (VR) – interactive immersive computer environments – allows one of the key variables in understanding psychosis, social environments, to be controlled.
5. (b) Perhaps the most striking application of VR to psychiatric problems has been for the treatment of height phobia. For example, Emmelkamp et al. 33 patients with acrophobia to 3 sessions of exposure to heights in vivo or in VR. Both forms of exposure were equally efficacious. Even though the patients knew the VR heights were not real, anxious responses were still triggered. The patients' responses to real or VR environments were equivalent.
6. (b) Researchers have also shown that virtual heights can be presented equally effectively with a Head-Mounted Display or a Cave Automatic Virtual Environment 7 system in which images are projected into a room and the user wears stereoscopic shutter glasses.
7. (b) VR has also been applied to the treatment of other anxiety conditions such as post-traumatic stress disorder (PTSD) and flying phobia.
8. (c) Symptom assessment is usually carried out with the practitioner/doctor and patient sitting in a (bare) clinic room talking, with retrospective recall of the past week or month. In contrast, VR can provide a standardised assessment of actual symptom occurrence.
9. (c) To date, VR has only been used for the experimental investigation of persecutory ideation. Clinical assessment is used regularly for every disorder.
10. (c) Questionnaire assessments of paranoia cannot rule out paranoid thoughts that are grounded in reality. Even interview methods often cannot establish the truth of the claims underlying a suspicious thought. However, if a neutral social situation is presented using VR, any paranoid thoughts that occur are known to be unfounded.
11. (d) Strengths: controls the environment allowing a range of situations and settings to be investigated.
12. (d) Strengths: ensures patients with psychosis are not making up situations and symptoms.
13. (d) Strengths: treatment can be conducted in a safe environment for both patient (and public).
14. (d) Strengths: has many uses. Freeman lists 7 uses: symptom assessment, identification of symptom markers, establishment of predictive factors, tests of putative causal factors, investigation of the differential prediction of symptoms, determination of toxic elements in the environment, and development of treatment.
15. (d) Weaknesses: may have side effects such as simulator sickness – dizziness, nausea, headache and eyestrain.
16. (d) Weaknesses: VR cannot establish truth of claims underlying suspicious thought (but neither can any method).
17. (d) Weaknesses: VR is only as good as the programmers ability to write an appropriate programme.
18. (d) Weaknesses: a programme may only apply generally and not be tailor-made for the needs of specific individuals.
19. (d) Conclusion: any appropriate conclusion drawn from the discussion that has been presented. A conclusion is a 'decision reached by reasoning' and so a summary of points already made scores 0 marks.