Class 12 Psychology Chapter 4 Psychological Disorders NCERT Solutions

Q. Identify the symptoms associated with depression and mania.

Answer: Major Depressive Disorder involves a period of depressed mood and/or loss of interest or pleasure in most activities, along with symptoms such as change in body weight, constant sleep problems, tiredness, inability to think clearly, agitation, greatly slowed behaviour, excessive guilt or feelings of worthlessness, and thoughts of death and suicide. In Bipolar I Disorder, manic episodes usually alternate with these depressive episodes; the chapter does not list mania’s own symptoms separately; it says Bipolar I involves both mania and depression, which are alternately present and sometimes interrupted by periods of normal mood.

Q. Describe the characteristics of children with hyperactivity.

Answer: Hyperactivity-impulsivity is one of the two main features of ADHD, along with inattention. Children with ADHD are in constant motion: sitting still through a lesson is impossible for them, and a child may fidget, squirm, climb, or run around the room aimlessly. Parents and teachers describe them as “driven by a motor,” always on the go, and talking incessantly. Children who are also impulsive cannot control their immediate reactions or think before they act; they find it difficult to wait or take turns, have difficulty resisting immediate temptations or delaying gratification, and minor mishaps such as knocking things over are common, though more serious accidents can also occur.

Q. What are the consequences of alcohol substance addiction?

Answer: People who abuse alcohol drink large amounts regularly and rely on it to face difficult situations. Drinking eventually interferes with their social behaviour and ability to think and work; the body builds a tolerance so more alcohol is needed for the same effect, and withdrawal responses appear when they stop drinking. Alcoholism destroys millions of families, social relationships and careers; intoxicated drivers are responsible for many road accidents. It also seriously affects the children of people with this disorder, who show higher rates of psychological problems, particularly anxiety, depression, phobias and substance-related disorders. Excessive drinking can seriously damage physical health. Box 4.2 adds its effects on psychological functioning: judgment and inhibition are depressed first, then speech and memory falter, and motor difficulties (unsteady walking, blurred vision, trouble hearing) increase.

Q. Can a distorted body image lead to eating disorders? Classify the various forms of it.

Answer: Yes. In anorexia nervosa, the individual has a distorted body image that leads them to see themself as overweight, often refusing to eat, exercising compulsively, and developing unusual habits such as refusing to eat in front of others; the person may lose large amounts of weight and even starve themself to death. The chapter classifies feeding and eating disorders into three forms: anorexia nervosa (as above); bulimia nervosa, where the individual eats excessive amounts of food and then purges their body of it using laxatives, diuretics, or by vomiting, often feeling disgusted and ashamed when bingeing and relieved of tension after purging; and binge eating, frequent episodes of out-of-control eating at a higher speed than normal, continuing until the person feels uncomfortably full, sometimes even without feeling hungry.

Q. “Physicians make diagnosis looking at a person’s physical symptoms.” How are psychological disorders diagnosed?

Answer: Psychological disorders are diagnosed using official classification systems that describe the clinical features and symptoms of each disorder. The American Psychiatric Association’s DSM-5 presents discrete clinical criteria that indicate the presence or absence of a disorder. The World Health Organisation’s ICD-10 Classification of Behavioural and Mental Disorders, officially used in India and elsewhere, provides a description of each disorder’s main clinical features or symptoms, along with other associated features and diagnostic guidelines. A diagnosis is reached by matching the person’s symptoms against these criteria.

Q. Distinguish between obsessions and compulsions.

Answer: Obsessive behaviour is the inability to stop thinking about a particular idea or topic; the person often finds these thoughts unpleasant and shameful. Compulsive behaviour is the need to perform certain behaviours over and over again; many compulsions deal with counting, ordering, checking, touching and washing. Both are features of Obsessive-Compulsive and Related Disorders, along with conditions like hoarding disorder, trichotillomania (hair-pulling disorder) and excoriation (skin-picking) disorder.

Q. Can a long-standing pattern of deviant behaviour be considered abnormal? Elaborate.

Answer: This depends on which view of abnormality is applied. Under the “deviation from social norms” view, a long-standing pattern that departs markedly from a society’s accepted conduct would be labelled abnormal simply because it is deviant, since this view defines abnormality as behaviour that breaks a society’s stated or unstated rules for proper conduct. Under the “maladaptive behaviour” view, however, the same long-standing pattern is abnormal only if it actually interferes with the individual’s or the group’s well-being, growth and functioning, regardless of whether society approves of it or not; this view also holds that even a conforming, socially accepted pattern can be abnormal if it is maladaptive. So the answer is yes, a long-standing deviant pattern can be considered abnormal, but the two views justify this conclusion on different grounds: social disapproval on one hand, and interference with well-being and functioning on the other.

Q. While speaking in public the patient changes topics frequently, is this a positive or a negative symptom of schizophrenia? Describe the other symptoms of schizophrenia.

Answer: Frequently changing topics while speaking is a positive symptom of schizophrenia; it is an example of a formal thought disorder called “loosening of associations” or “derailment,” which the chapter groups under positive symptoms (pathological excesses). Schizophrenia’s symptoms fall into three categories. Positive symptoms include delusions (persecution, reference, grandeur and control), disorganised thinking and speech (loosening of associations, neologisms, perseveration), hallucinations (most commonly auditory, but also tactile, somatic, visual, gustatory and olfactory), and inappropriate affect. Negative symptoms are pathological deficits: alogia (poverty of speech), blunted or flat affect, and avolition (apathy and inability to start or complete tasks), along with social withdrawal. Psychomotor symptoms include odd grimaces and gestures, and can reach the extreme form of catatonia: catatonic stupor, catatonic rigidity, or catatonic posturing.

Q. What do you understand by the term ‘dissociation’? Discuss its various forms.

Answer: Dissociation can be viewed as the severance of the connections between ideas and emotions. It involves feelings of unreality, estrangement, depersonalisation, and sometimes a loss or shift of identity; a sudden, temporary alteration of consciousness that blots out painful experiences is a defining characteristic of dissociative disorders. Its forms are: Dissociative Amnesia, extensive but selective memory loss with no known organic cause, of which dissociative fugue is a part (unexpected travel away from home and workplace, assumption of a new identity, and inability to recall the previous identity, usually ending when the person “wakes up” with no memory of the fugue); Dissociative Identity Disorder, often called multiple personality, the most dramatic dissociative disorder, often associated with traumatic experiences in childhood, where the person assumes alternate personalities that may or may not be aware of each other; and Depersonalisation/Derealisation Disorder, a dreamlike state in which the person feels separated from both self and reality, with a temporary change or loss of the sense of reality.

Q. What are phobias? If someone had an intense fear of snakes, could this simple phobia be a result of faulty learning? Analyse how this phobia could have developed.

Answer: Phobias are irrational fears related to specific objects, people, or situations, which often develop gradually or begin with a generalised anxiety disorder. They are grouped into three main types: specific phobias (fear of a particular animal or an enclosed space, the most common type), social anxiety disorder or social phobia (intense, incapacitating fear and embarrassment dealing with others), and agoraphobia (fear of entering unfamiliar situations, often limiting the person to their home). Yes, an intense fear of snakes could well be the result of faulty learning: the behavioural model states that both normal and abnormal behaviours are learned, through classical conditioning (a frightening event repeatedly occurring close in time to snakes), operant conditioning (behaviour is followed by a reward; for example, avoiding snakes is rewarded by relief from fear), or social learning (observing a parent or another person’s fearful reaction to a snake). This model also holds that what has been learned can be unlearned.

Q. Anxiety has been called the “butterflies in the stomach feeling”. At what stage does anxiety become a disorder? Discuss its types.

Answer: Anxiety, a diffuse, vague, unpleasant feeling of fear and apprehension, is normal and even useful in small amounts, for instance before an exam, where it motivates good performance. It becomes an anxiety disorder when it reaches a high level that is distressing and interferes with effective functioning; anxiety disorders are, in fact, the most common category of psychological disorders. Its types include: Generalised Anxiety Disorder, prolonged, vague, unexplained and intense fears not attached to any particular object, marked by hypervigilance and motor tension; Panic Disorder, recurrent, unpredictable anxiety attacks of intense terror with physical symptoms such as breathlessness, dizziness, trembling and palpitations; Phobias, of three kinds (specific phobia, social anxiety disorder, and agoraphobia); and Separation Anxiety Disorder, extreme distress on separation, or the expectation of separation, from home or an attachment figure, beyond what is developmentally appropriate.

Q. Talk to three people: one of your friends, a friend of your parents, and your neighbour. Ask them if they have seen someone who is mentally ill or who has mental problems. Try to understand why they find this behaviour abnormal, what are the signs and symptoms shown by this person, what caused this behaviour and can this person be helped. Share the information you elicited in class and see if there are some common features, which make us label others as ‘abnormal’.

Answer (guidance): This is a field activity, so the answers will be your own. When you compare them in class, sort what people said under the chapter’s ‘four Ds’: deviance (different, extreme, unusual behaviour), distress (upsetting to the person and to others), dysfunction (interfering with daily activities) and danger (to the person or to others). Check also which of the two views each person was using: behaviour that breaks society’s norms, or behaviour that is maladaptive and harms well-being. The chapter warns that people’s ideas about psychological disorders are often vague and coloured by superstition, ignorance and fear, and that the stigma attached to mental illness makes people hesitant to consult a doctor or psychologist. Its own conclusion is that a psychological disorder which indicates a failure in adaptation should be viewed as any other illness.

Q. Certain behaviours like eating sand would be considered abnormal. But not if it was done after being stranded on a beach in a plane crash. Listed below are ‘abnormal’ behaviours followed by situations where the behaviours might be considered normal. (i) talking to yourself: you are praying. (ii) standing in the middle of the street waving your arms wildly: you are a traffic policeman. Think about it and list similar examples.

Answer: The point of the activity is that the same behaviour can be normal or abnormal depending on the situation. Similar examples: (i) shouting and screaming at the top of your voice: you are cheering your team in a stadium; (ii) crying loudly in public: you are at the funeral of someone close; (iii) refusing to eat for a whole day: you are keeping a religious fast; (iv) painting your face in bright colours and dancing in the street: you are taking part in a festival procession; (v) talking loudly to people who are not there: you are an actor rehearsing a role. In each case the context gives the behaviour a purpose, so it is not deviant, distressing or dysfunctional.

Q. Recall how you felt before your Class X Board examination. How did you feel when the examinations were drawing near (one month before the examinations; one week before the examinations; on the day of the examination, and when you were entering the examination hall)? Also try to recollect what you felt when you were awaiting your results. Write down your experiences in terms of bodily symptoms (e.g. ‘butterflies in the stomach’, clammy hands, excessive perspiration, etc.) as well as mental experiences (e.g. tension, worry, pressure, etc.). Compare your symptoms with those of your classmates and classify them as Mild, Moderate, or Severe.

Answer (guidance): Your list will be personal. Bodily symptoms students usually note are the ones the chapter gives for anxiety: rapid heart rate, shortness of breath, loss of appetite, dizziness, sweating, sleeplessness, frequent urination and tremors. Mental experiences are worry, tension and apprehension about the future. Note whether your anxiety rose as the examination came nearer and how it changed afterwards. The lesson the chapter draws is that such anxiety is normal and expected, and even motivates us to do our task well; only high levels of anxiety that are distressing and interfere with effective functioning indicate an anxiety disorder.

Q. You may have got some bad news in the family (for example, death of a close relative) or watched your favourite character dying in a film or got less marks than you hoped for or lost your pet. This may have made you sad and depressed and hopeless about the future. Try and recall such incidents in your life. List the situations that led to this reaction. Compare your list and reactions with those of others in class.

Answer (guidance): Situations students usually list are the death of a relative or pet, lower marks than expected, a break-up of a friendship and failing to reach a goal. The chapter explains that in day-to-day life we use the word depression for such normal feelings after a significant loss. Major depressive disorder is different: it is a period of depressed mood and/or loss of interest or pleasure in most activities, together with other symptoms such as change in body weight, constant sleep problems, tiredness, inability to think clearly, agitation, greatly slowed behaviour, excessive guilt or worthlessness, and thoughts of death and suicide. The chapter also lists warning signs of a student in distress that should be taken seriously: lack of interest in common activities, declining grades, decreasing effort, misbehaviour in the classroom, mysterious or repeated absence, and smoking, drinking or drug misuse.

Q. Can you list some characters in films you have seen or books you have read who suffered from any of the disorders we have studied here like depression or schizophrenia showing some of these delusions? Can you identify which kind of delusion each of these is? 1. A person who believes that s/he is going to be the next President of India. 2. One who believes that the intelligence agencies/police are conspiring to trap her/him in a spy scandal. 3. One who believes that s/he is the incarnation of God and can make things happen. 4. One who believes that the tsunami occurred to prevent her/him from enjoying her/his holidays. 5. One who believes that her/his actions are controlled by the satellite through a chip implanted in her/his brain by some extraterrestrial beings.

Answer: The first part depends on the films and books you know. The five beliefs are:

• 1. Delusion of grandeur: the person believes she/he is a specially empowered person.
• 2. Delusion of persecution: the person believes she/he is being plotted against, spied on or deliberately victimised.
• 3. Delusion of grandeur: believing oneself to be the incarnation of God, able to make things happen.
• 4. Delusion of reference: special and personal meaning is attached to an event (the tsunami) that has nothing to do with the person.
• 5. Delusion of control: the person believes her/his actions are controlled by others (here, a satellite and a chip).