Psychopathology for IGNOU students

IGNOU MAPC material© 2016, M S Ahluwalia Psychology Learners
MPCE-011/ASST/TMA/2015-16
IGNOU Assignment

Solved Assignment - MAPC

1000 words
Section A

Discuss humanistic approach in
relation to psychopathology.
Q1.

Humanistic approach, the Self and Self-Actualisation
5
A1
The humanistic paradigm argues that human behavior is the product of free will, the view that we control, choose,
and are responsible for our actions. In many respects, this stance is a reaction against determinism, the scientific
assumption that human behavior is caused by potentially knowable factors (a position held by the other paradigms).
Humanist Approach
Jung and Adler broke sharply with Freud. Their fundamental disagreement concerned the very nature of humanity.
Freud portrayed life as a battleground where we are continually in danger of being overwhelmed by our darkest
forces. Jung and Adler, by contrast, emphasized the positive, optimistic side of human nature. Jung talked about
setting goals, looking toward the future, and realizing one’s fullest potential.
Adler believed that human nature reaches its fullest potential when we contribute to the welfare of other individuals
and to society as a whole. He believed that we all strive to reach superior levels of intellectual and moral
development. Nevertheless, both Jung and Adler retained many of the principles of psychodynamic thought. Their
general philosophies were adopted in the middle of the century by personality theorists and became known as
humanistic psychology.
The Self and its Actualisation
Self-actualizing was the watchword for this movement. The underlying assumption is that all of us could reach our
highest potential, in all areas of functioning, if only we had the freedom to grow. Inevitably, a variety of conditions
may block our actualization.
Because every person is basically good and whole, most blocks originate outside the individual. Difficult living
conditions or stressful life or interpersonal experiences may move you away from your true self.

Client-Centered Therapy
6
A1
Abraham Maslow (1908–1970) was most systematic in describing the structure of personality. He postulated a
hierarchy of needs, beginning with our most basic physical needs for food and sex and ranging upward to our needs
for self-actualization, love, and self-esteem. Social needs such as friendship fall somewhere between. Maslow
hypothesized that we cannot progress up the hierarchy until we have satisfied the needs at lower levels.
Client-Centered Therapy
Carl Rogers (1902–1987) is, from the point of view of therapy, the most influential humanist. Rogers (1961) originated
client-centered therapy, later known as person-centered therapy. In this approach, the therapist takes a passive role,
making as few interpretations as possible.
The point is to give the individual a chance to develop during the course of therapy, unfettered by threats to the self.
Humanist theorists have great faith in the ability of human relations to foster this growth. The client-therapist
relationship is marked by:
1. Unconditional positive regard, the complete and almost unqualified acceptance of most of the client’s
feelings and actions, is critical to the humanistic approach.
2. Empathy is the sympathetic understanding of the individual’s particular view of the world.
3. Genuineness: The therapist behaves as himself rather than playing role of therapist, friend or parent so
that clients will be more straightforward and honest with themselves and will access their innate tendencies toward
growth.
Like psychoanalysis, the humanistic approach has had a substantial effect on theories of interpersonal relationships.
This approach also emphasized the importance of the therapeutic relationship in a way quite different from Freud’s
approach.

Applications and Strengths
7
A1
Rather than seeing the relationship as a means to an end (transference), humanistic therapists believed that
relationships, including the therapeutic relationship, were the single most positive influence in facilitating human
growth. In fact, Rogers made substantial contributions to the scientific study of therapist- client relationships.
Application in Psychopathology
The humanistic model contributed little new information to the field of psychopathology. One reason for this is that
its proponents, had little interest in doing research that would discover or create new knowledge. Rather, they
stressed the unique, nonquantifiable experiences of the individual, emphasizing that people are more different than
alike.
As Maslow noted, the humanistic model found its greatest application among individuals without psychological
disorders. The application of person-centered therapy to more severe psychological disorders has decreased
substantially over the decades, although certain variations have arisen periodically in some areas of psychopathology.
Strengths
Strengths of this theory include the focus on both the positive nature of humankind and the free will associated with
change. Unlike Freud’s theory and the biological approach, which focus on determinism or our lack of power over
ourselves, Maslow and others see the individual as very powerful.
A second positive aspect of humanistic theory is the ease in which many of its aspects fit well with other approaches.
Many therapists have adopted a humanistic undertone in their work with clients. While they may argue humanistic
theory does not go far enough, they see the benefit of the core components in helping people change.
Finally, most have seen the benefits of humanism carried over into different professions. Whether you take a health
class, or you study economics or business or you are in other professions the basics of humanistic thought strike an
undertone in all of what is considered human.

Criticism and Summary
8
A1
Criticism
The biggest criticism of humanistic thought appears to center around it’s lack of concrete treatment approaches
aimed at specific issues. With the basic concept behind the theory being free will, it is difficult to both develop a
treatment technique and study the effectiveness of this technique.
Secondly, humanistic theory falls short in it’s ability to help those with more severe personality or mental health
pathology. While it may show positive benefits for a minor issue, using the approach of Roger’s to treat
schizophrenia would seem ludicrous.
Finally, humanistic theory makes some generalizations about human nature that are not widely accepted as
complete. Are people basically good or are their some individuals who are not capable of this? Can we adequately
argue that everyone follows the same levels as Maslow explained, or are these levels, and even what they stand for,
be determined by the individual? These questions plague humanistic thought and the difficulty in researching the
theory does not provide any freedom.
* * *
Humanistic approach is a branch of Psychology that emphasizes the human tendencies towards growth and
fulfillment, autonomy, choice, responsibility and ultimate values such as love, truth and justice. A view point
emphasizing human existence and the situation in the world, in giving life meaning through the free choice of mature
values and commitment goals.
The concept of Self-actualisation and client centered therapy are some of the key contributions of the approach. It is
even useful in situations where individuals do not have psychological disorders. However, it has been criticized for a
lack of scientific testability of some of the postulations.
Sources:
https://prezi.com/cwl7cpza3iod/copy-of-psychopathology-humanistic-existential-model/#
Abnormal Psychology: An Integrative Approach 7e by V. Mark Durand and David H. Barlow (free preview)
Abnormal Psychology 7e_Thomas F. Oltmanns and Robert E. Emery

Explain bipolar disorders.
Q2.
9

Bipolar disorders – Diagnosis and Causes
10
A2
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood,
energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They
can result in damaged relationships, poor job or school performance, and even suicide.
Diagnosis
Doctors diagnose bipolar disorder using guidelines from the Diagnostic and Statistical Manual of Mental Disorders
(DSM). To be diagnosed with bipolar disorder, the symptoms must be a major change from your normal mood or
behavior. There are four basic types of bipolar disorder:
1. Bipolar I Disorder—defined by manic or mixed episodes that last at least seven days, or by manic symptoms that
are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically
lasting at least 2 weeks.
2. Bipolar II Disorder—defined by a pattern of depressive episodes and hypomanic episodes, but no full-blown manic
or mixed episodes.
3. Bipolar Disorder Not Otherwise Specified (BP-NOS)—diagnosed when symptoms of the illness exist but do not
meet diagnostic criteria for either bipolar I or II. However, the symptoms are clearly out of the person's normal range
of behavior.
4. Cyclothymic Disorder, or Cyclothymia—a mild form of bipolar disorder. People with cyclothymia have episodes of
hypomania as well as mild depression for at least 2 years. However, the symptoms do not meet the diagnostic
requirements for any other type of bipolar disorder.

Causes and Signs and Symptoms
11
A2
Causes
Scientists are studying the possible causes of bipolar disorder. Most scientists agree that there is no single cause.
Rather, many factors likely act together to produce the illness or increase risk.
1.Genetics: Bipolar disorder tends to run in families. Some research has suggested that people with certain genes are
more likely to develop bipolar disorder than others. Children with a parent or sibling who has bipolar disorder are
much more likely to develop the illness, compared with children who do not have a family history of bipolar disorder.
However, most children with a family history of bipolar disorder will not develop the illness.
2. Brain structure and functioning: Some imaging studies show how the brains of people with bipolar disorder may
differ from the brains of healthy people or people with other mental disorders. Example: the brain's prefrontal cortex
in adults with bipolar disorder tends to be smaller and function less well compared to adults who don't have bipolar
disorder.
3. Psychological Factors: There is fairly consistent evidence from prospective studies that recent life events and
interpersonal relationships contribute to the likelihood of onsets and recurrences of bipolar mood episodes, as they
do for onsets and recurrences of unipolar depression (Alloy et al. 2005).
Signs & Symptoms
People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called
"mood episodes." Each mood episode represents a drastic change from a person’s usual mood and behavior. An
overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a
depressive episode. Sometimes, a mood episode includes symptoms of both mania and depression. This is called a
mixed state.
Bipolar disorder usually lasts a lifetime. Episodes of mania and depression typically come back over time. Between
episodes, many people with bipolar disorder are free of symptoms, but some people may have lingering symptoms.

Signs and Symptoms and Prevalence
12
A2
Prevalence
Bipolar disorder often develops in a person's late teens or early adult years. At least half of all cases start before age
Some people have their first symptoms during childhood, while others may develop symptoms late in life.
Symptoms of mania or a manic episode Symptoms of depression or a depressive episode
Mood Changes
• A long period of feeling "high," or an overly happy or
outgoing mood
• Extreme irritability
Mood Changes
• An overly long period of feeling sad or hopeless
• Loss of interest in activities once enjoyed, including
sex.
Behavioral Changes
• Talking very fast, jumping from one idea to another,
having racing thoughts
• Being easily distracted
• Increasing activities, such as taking on new projects
• Being overly restless
• Sleeping little or not being tired
• Having an unrealistic belief in one's abilities
• Behaving impulsively and engaging in pleasurable,
high-risk behaviors
Behavioral Changes
• Feeling tired or "slowed down"
• Having problems concentrating, remembering, and
making decisions
• Being restless or irritable
• Changing eating, sleeping, or other habits
• Thinking of death or suicide, or attempting suicide.

Treatment
13
A2
Bipolar disorder cannot be cured, but it can be treated effectively over the long-term. The various methods are:
1. Medications: The types of medications generally used to treat bipolar disorder include mood stabilizers, atypical
antipsychotics, and antidepressants.
1. Mood stabilizers like Lithium (also known as Eskalith or Lithobid), Anticonvulsants like Valproic acid or
divalproex sodium (Depakote), Lamotrigine (Lamictal), gabapentin (Neurontin), topiramate (Topamax), and
oxcarbazepine (Trileptal).
2. Atypical antipsychotics like Olanzapine (Zyprexa), Aripiprazole (Abilify), Quetiapine (Seroquel), risperidone
(Risperdal) and ziprasidone (Geodon)
3. Antidepressants like Fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), and bupropion (Wellbutrin).
2. Psychotherapy: In combination with medication, psychotherapy can be an effective treatment for bipolar
disorder. Includes:
1. Cognitive behavioral therapy (CBT), which helps people with bipolar disorder learn to change harmful or
negative thought patterns and behaviors.
2. Family-focused therapy, which involves family members. It helps enhance family coping strategies, such as
recognizing new episodes early and helping their loved one. Improves communication among family
members, as well as problem-solving.
3. Interpersonal and social rhythm therapy, which helps people with bipolar disorder improve their
relationships with others and manage their daily routines.
4. Psychoeducation, which teaches people with bipolar disorder about the illness and its treatment.
Psychoeducation can help you recognize signs of an impending mood swing so you can seek treatment
early, before a full-blown episode occurs.
3. Other treatments:
4. Electroconvulsive Therapy (ECT) /Shock therapy: ECT can provide relief for people with severe bipolar disorder
who have not been able to recover with other treatments.
5. Sleep Medications: People with bipolar disorder who have trouble sleeping may be prescribed sedatives or other
sleep medications.

Summary and Sources
14
A2
Bipolar disorder, also known as bipolar affective disorder or manic depression, is a mental disorder characterized by
periods of depression and periods of elevated mood. During mania an individual feels or acts abnormally happy,
energetic, or irritable. During depression there’s less energy, too much sleep, and a negative outlook on life.
Bipolar disorder can happen due to genetic causes, biological factors and psychological factors. It can be treated using
medications including mood stabilizers, atypical antipsychotics and antidepressants, psychotherapy including CPT,
psychoeducation etc., and, ECT.
* * *
Sources:
https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
https://en.wikipedia.org/wiki/Bipolar_disorder

Describe the diagnostic features,
causes and treatment of Schizoid
personality disorder.
Q3.
15

SPD - Diagnostic Features
16
A3
Schizoid personality disorder (SPD) is a personality disorder characterized by a lack of interest in social relationships, a
tendency towards a solitary lifestyle, secretiveness, emotional coldness, and apathy. Affected individuals may
simultaneously demonstrate a rich, elaborate and exclusively internal fantasy world. They may demonstrate
significant creativity, particularly in the areas of fiction writing[citation needed] and visual arts.
Diagnostic Features
A. The essential feature of schizoid personality disorder is a pervasive pattern of detachment from social
relationships and a restricted range of expression of emotions in interpersonal settings. This pattern begins by
early adulthood and is present in a variety of contexts.
1. Individuals appear to lack a desire for intimacy, seem indifferent to opportunities to develop close relationships,
and do not seem to derive much satisfaction from being part of a family or other social group (Criterion Al).
2. They prefer spending time by themselves, rather than being with other people. They often appear to be socially
isolated or "loners" and almost always choose solitary activities or hobbies that do not include interaction with
others (Criterion A2).
3. They prefer mechanical or abstract tasks, such as computer or mathematical games. They may have very little
interest in having sexual experiences with another person (Criterion A3).
4. They take pleasure in few, if any, activities (Criterion A4). There is usually a reduced experience of pleasure from
sensory, bodily, or interpersonal experiences, such as walking on a beach at sunset or having sex.
5. These individuals have no close friends or confidants, except possibly a first-degree relative (Criterion A5).
6. Individuals with schizoid personality disorder often seem indifferent to the approval or criticism of others and do
not appear to be bothered by what others may think of them (Criterion A6).
7. They usually display a "bland" exterior without visible emotional reactivity and rarely reciprocate gestures or
facial expressions, such as smiles or nods (Criterion A7). They claim that they rarely experience strong emotions
such as anger and joy. They often display a constricted affect and appear cold and aloof.

SPD - Diagnostic Features
17
A3
B. Schizoid personality disorder should not be diagnosed if the pattern of behavior occurs exclusively during the
course of schizophrenia, a bipolar or depressive disorder with psychotic features, another psychotic disorder, or
autism spectrum disorder, or if it is attributable to the physiological effects of a neurological (e.g., temporal lobe
epilepsy) or another medical condition (Criterion B).
Culture-Related Diagnostic issues
Individuals from a variety of cultural backgrounds sometimes exhibit defensive behaviors and interpersonal styles
that may be erroneously labeled as "schizoid." Immigrants from other countries or migrants from rural areas are
sometimes mistakenly perceived as cold, hostile, or indifferent.
Gender-Related Diagnostic issues
Schizoid personality disorder is diagnosed slightly more often in males and may cause more impairment in them.
Differential Diagnosis
•Other mental disorders with psychotic symptoms: distinguished from delusional disorder, schizophrenia, and a
bipolar or depressive disorder with psychotic features because these disorders are all characterized by a period of
persistent psychotic symptoms (e.g., delusions and hallucinations).
• Autism spectrum disorder: differentiated by more severely impaired social interaction and stereotyped behaviors
and interests
• Personality change due to another medical condition: distinguished when the traits that emerge are attributable to
the effects of another medical condition on the central nervous system.
• Substance use disorders: must be distinguished from symptoms that may develop in association with persistent
substance use.
• Other personality disorders and personality traits: If an individual has personality features that meet criteria for one
or more personality disorders in addition to schizoid personality disorder, all can be diagnosed - schizotypal
personality disorder, avoidant personality disorder and obsessive-compulsive personality disorder.

SPD - Causes and Treatment
18
A3
Causes
Extensive research on the genetic, neurobiological, and psychosocial contributions to schizoid personality disorder
remains to be conducted (Phillips, Yen, & Gunderson, 2003). But combination of genetic and environmental factors is
a possible cause.
•Childhood shyness is reported as a precursor to later adult schizoid personality disorder. It may be that this
personality trait is inherited and serves as an important determinant in the development of this disorder.
•Abuse and neglect in childhood are also reported among individuals with this disorder (Johnson, Bromley, &
McGeoch, 2005). A parent who was cold and unresponsive to emotional needs.
•Family environment of the affected persons - typically emotionally reserved, have a high degree of formality and
have a communication style that is aloof and impersonal.
•Parents of children with autism are more likely to have schizoid personality disorder (Constantino et al., 2009). It is
possible that a biological dysfunction found in both autism and schizoid personality disorder combines with early
learning or early problems with interpersonal relationships to produce the social deficits that define schizoid
personality disorder (Hopwood & Thomas, 2012).
•Bio-psychological model states that no single factor is responsible but the complex and likely intertwined nature of
all three factors – biological and genetic factors, social factors and psychological factors.
Treatment
It is rare for a person with this disorder to request treatment except in response to a crisis such as extreme
depression or losing a job (Kelly et al., 2007).
Therapists often begin treatment by pointing out the value in social relationships. The person with the disorder may
even need to be taught the emotions felt by others to learn empathy (Skodol & Gunderson, 2008).

SPD - Treatment, Summary and Sources
19
A3
Because their social skills were never established or have atrophied through lack of use, people with schizoid
personality disorder often receive social skills training. The therapist takes the part of a friend or significant other in a
technique known as role-playing and helps the patient practice establishing and maintaining social relationships
(Skodol & Gunderson, 2008). This type of social skills training is helped by identifying a social network—a person or
people who will be supportive (Bender, 2005).
Short-tem therapy approach helps individual resolve the immediate crisis or problem. Long term psychotherapy is
typically avoided. Cognitive Behavioral Therapy, Group Therapy, Family Therapy and Marital Therapy can be used.
* * *
Schizoid personality disorder is an uncommon condition in which people avoid social activities and consistently shy
away from interaction with others. Person shows a pervasive pattern of detachment from social relationships and a
restricted range of expression of emotions in interpersonal settings.
The exact causes of schizoid personality disorder are unknown, although a combination of genetic and environmental
factors — particularly in early childhood — are thought to increase the risk of developing the disorder. The treatment
options include medications, psychotherapy and other therapies.
Sources:
Diagnostic and Statistical Manual of Mental Disorders - DSM 5 by American Psychiatric Association (free preview)
https://en.wikipedia.org/wiki/Schizoid_personality_disorder

400 words
Section B
20

Childhood depression
Q4.
21

22
A4
The fact that a child feels sad, lonely, or irritable does not mean he or she has childhood depression. Childhood
depression is persistent sadness. When it occurs, the child feels alone, hopeless, helpless, and worthless. When this
type of sadness is unending, it disrupts every part of the child's life. It interferes with the child's daily activities,
schoolwork, and peer relationships. It can also affect the life of each family member.
Causes
It could be caused by any combination of factors that relate to physical health, life events, family history,
environment, genetic vulnerability, and biochemical disturbance.
Signs and Symptoms
The symptoms of childhood depression may vary. It depends on the child and his or her particular mood disorder.
Common ones include:
• Changes in appetite -- either increased appetite or decreased
• Changes in sleep -- sleeplessness or excessive sleep
• Continuous feelings of sadness or hopelessness
• Difficulty concentrating
• Fatigue and low energy
• Feelings of worthlessness or guilt
• Impaired thinking or concentration
• Increased sensitivity to rejection
• Irritability or anger
• Physical complaints (such as stomachaches or headaches) that do not respond to treatment
• Reduced ability to function during events and activities at home or with friends, in school or during
• extracurricular activities, or when involved with hobbies or other interests
• Social withdrawal

23
A4
• Thoughts of death or suicide
• Vocal outbursts or crying
Not all children have all of the symptoms of childhood depression. In fact, kids have different symptoms of childhood
depression at different times and in different settings.
Prevalence
Studies show that, at any point in time, 10% to 15% of children and adolescents have some symptoms of depression.
A child has an increased chance of childhood depression if he or she has a family history of depression, particularly a
parent who had depression at an early age. Once a child experiences major depression, he or she is at risk of
developing another depression within the next five years.
Treatment
Psychotherapy first and antidepressant medicine as an additional option if symptoms are severe or if there is no
significant improvement with psychotherapy alone.
However, antidepressant medications may increase the risk of suicidal thinking and behavior in children and
adolescents with depression and other psychiatric disorders.
Long-Term Outlook
Studies have found that first-time episodes of childhood depression occur at younger ages than previously thought.
And, as in adults, depression may reoccur later in life.
Depression often occurs at the same time as other physical illnesses. Because studies have shown that depression
may precede more serious mental illness later in life, diagnosis, early treatment, and close monitoring are crucial.

Summary and Sources
24
A4
Childhood depression is a state where a child has a persistent feeling of sadness and helplessness. The symptoms
become disruptive and interfere with the normal life of the child. Childhood depression can be assessed, diagnosed,
and effectively treated with medications and/or psychotherapy. Left untreated, childhood depression is a serious
depressive disorder that can lead to suicide.
* * *
Source:
http://www.webmd.com/depression/childhood-depression

Parenting styles
Q5.
25

Parenting Styles
26
A5
A parenting style is a psychological construct representing standard strategies that parents use in their child rearing.
The quality of parenting is far more essential than the quantity of time spent with the child. Parenting styles are the
representation of how parents respond and demand to their children.
Some potential causes of these differences include culture, personality, family size, parental background,
socioeconomic status, educational level, and religion.
During the early 1960s, psychologist Diana Baumrind conducted a study on more than 100 preschool-age children
(Baumrind, 1967). Using naturalistic observation, parental interviews and other research methods, she identified four
important dimensions of parenting: Disciplinary strategies, Warmth and nurturance, Communication styles and
Expectations of maturity and control.
Based on these dimensions, Baumrind suggested that the majority of parents display one of three different parenting
styles. Maccoby and Martin suggested the addition of a fourth parenting style (1983).
The Four Parenting Styles
1. Authoritarian Parenting: According to Baumrind, these parents "are obedience- and status-oriented, and expect
their orders to be obeyed without explanation" (1991). Failure to follow such rules usually results in punishment.
Authoritarian parents fail to explain the reasoning behind these rules.
2. Authoritative Parenting: Baumrind suggests that these parents "monitor and impart clear standards for their
children’s conduct. They are assertive, but not intrusive and restrictive. Their disciplinary methods are
supportive, rather than punitive. They want their children to be assertive as well as socially responsible, and self-
regulated as well as cooperative" (1991).

Parenting Styles, Summary and Sources
27
A5
3. Permissive Indulgent Parenting: According to Baumrind, permissive parents "are more responsive than they are
demanding. They are nontraditional and lenient, do not require mature behavior, allow considerable self-
regulation, and avoid confrontation" (1991). They often take on the status of a friend more than that of a parent.
4. Permissive uninvolved Parenting: It is characterized by few demands, low responsiveness and little
communication. While these parents fulfill the child's basic needs, they are generally detached from their child's
life. In extreme cases, these parents may even reject or neglect the needs of their children.
Impact of Parenting Styles
• Authoritarian: lead to children who are obedient and proficient, but rank lower in happiness, social competence
and self-esteem.
• Authoritative: results in children who are happy, capable and successful (Maccoby, 1992).
• Permissive: results in children who rank low in happiness and self-regulation. These children are more likely to
experience problems with authority and tend to perform poorly in school.
• Uninvolved: rank lowest across all life domains. These children tend to lack self-control, have low self-esteem and
are less competent than their peers.
* * *
A parenting style is a psychological construct representing standard strategies that parents use in their child rearing.
They are associated with different child outcomes. However, other important factors including culture, children's
perceptions of parental treatment, and social influences also play an important role in children's behavior. "There is
no universally "best" style of parenting," writes author Douglas Bernstein.
Sources:
http://psychology.about.com/od/developmentalpsychology/a/parenting-style.htm
https://en.wikipedia.org/wiki/Parenting_styles

Depersonalisation disorder
Q6.
28

Depersonalization Disorder
29
A6
Depersonalization disorder is one of a group of conditions called dissociative disorders. Dissociative disorders are
mental illnesses that involve disruptions or breakdowns of memory, consciousness, awareness, identity, and/or
perception. When one or more of these functions is disrupted, symptoms can result.
Diagnostic Criteria
A. The presence of persistent or recurrent experiences of depersonalization, derealization, or both:
1. Depersonalization: Experiences of unreality, detachment, or being an outside observer with respect to one’s
thoughts, feelings, sensations, body, or actions (e.g., perceptual alterations, distorted sense of time, unreal or
absent self, emotional and/or physical numbing).
2. Derealization: Experiences of unreality or detachment with respect to surroundings (e.g., individuals or objects
are experienced as unreal, dreamlike, foggy, lifeless, or visually distorted).
B. During the depersonalization or derealization experiences, reality testing remains intact.
C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of
functioning.
D. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, medication) or
another medical condition (e.g., seizures).
E. The disturbance is not better explained by another mental disorder, such as schizophrenia, panic disorder, major
depressive disorder, acute stress disorder, posttraumatic stress disorder, or another dissociative disorder.

Depersonalization Disorder
30
A6
Prevalence
In general, approximately one-half of all adults have experienced at least one lifetime episode of
depersonalization/derealization. Lifetime prevalence in U.S. and non-U.S. countries is approximately 2% (range of
0.8% to 2.8%). The gender ratio for the disorder is 1:1.
Development and Course
The mean age at onset of depersonalization/derealization disorder is 16 years, although the disorder can start in early
or middle childhood; a minority cannot recall ever not having had the symptoms. Onset can range from extremely
sudden to gradual. Duration of depersonalization/derealization disorder episodes can vary greatly, from brief (hours
or days) to prolonged (weeks, months, or years).
The course of the disorder is often persistent. About one-third of cases involve discrete episodes; another third,
continuous symptoms from the start; and still another third, an initially episodic course that eventually becomes
continuous.
Risk and Prognostic Factors
Temperamental: harm-avoidant temperament, immature defenses, and both disconnection and overconnection
schemata.
Environmental: clear association with childhood interpersonal traumas in particular, emotional abuse and emotional
neglect.
Differential Diagnosis
•Illness anxiety disorder
•Major depressive disorder
•Obsessive-compulsive disorder
•Other dissociative disorders

Depersonalization Disorder, Summary and Sources
31
A6
•Anxiety disorders
•Psychotic disorders
•Substance/medication-induced disorders
•Mental disorders due to another medical condition
Comorbidity
Lifetime comorbidities are high for unipolar depressive disorder and for any anxiety disorder, with a significant
proportion of the sample having both disorders. The three most commonly co-occurring personality disorders were
avoidant, borderline, and obsessive-compulsive.
* * *
Depersonalisation disorder involves the presence of persistent or recurrent experiences of unreality, detachment, or
being an outside observer with respect to one’s thoughts, feelings, sensations, body, or actions or with the
surroundings. It usually starts in mid-teenage years. Every other adult faces the disorder at some point in time,
however the lifetime prevalence is in 2% of the population.
Sources:
http://www.webmd.com/mental-health/depersonalization-disorder-mental-health

Body Dysmorphic disorder
Q7.
32

Body Dysmorphic disorder
33
A7
Body dysmorphic disorder (BDD), also known as body dysmorphia or dysmorphic syndrome, but originally termed
dysmorphophobia, is a mental disorder characterized by an obsessive preoccupation that some aspect of one's own
appearance is severely flawed and warrants exceptional measures to hide or fix it. The DSM-5 categorizes BDD in the
obsessive–compulsive spectrum, and distinguishes it from anorexia nervosa.
Diagnostic Criteria:
•Criterion A: Individuals with body dysmorphic disorder (formerly dysmorphophobia) are preoccupied with one or
more perceived defects or flaws in their physical appearance, which they believe look ugly, unattractive, abnormal, or
deformed. The perceived flaws are not observable or appear only slight to other individuals.
Preoccupations can focus on one or many body areas. Any body area can be the focus of concern. Some individuals
are concerned about perceived asymmetry of body areas.
The preoccupations are intrusive, unwanted, time-consuming (occurring, on average, 3-8 hours per day), and usually
difficult to resist or control.
•Criterion B: Excessive repetitive behaviors or mental acts (e.g., comparing) are performed in response to the
preoccupation. The individual feels driven to perform these behaviors, which are not pleasurable and may increase
anxiety and dysphoria. They are typically time-consuming and difficult to resist or control.
Common behaviors are comparing one's appearance with that of other individuals; repeatedly checking perceived
defects in mirrors or other reflecting surfaces or examining them directly; excessively grooming; camouflaging;
seeking reassurance about how the perceived flaws look; touching disliked areas to check them; excessively
exercising or weight lifting; and seeking cosmetic procedures.
•Criterion C: The preoccupation must cause clinically significant distress or impairment in social, occupational, or
other important areas of functioning; usually both are present. Body dysmorphic disorder must be differentiated
from an eating disorder.

Body Dysmorphic disorder, Summary and Sources
34
A7
Insight regarding body dysmorphic disorder beliefs can range from good to absent/delusional. On average, insight is
poor; one third or more of individuals currently have delusional body dysmorphic disorder beliefs.
• Criterion D: The appearance preoccupation is not better explained by concerns with body fat or weight in an
individual whose symptoms meet diagnostic criteria for an eating disorder.
Development and Course
The mean age at disorder onset is 16-17 years, the median age at onset is 15 years, and the most common age at
onset is 12-13 years.
The disorder appears to usually be chronic, although improvement is likely when evidence-based treatment is
received. Individuals with disorder onset before age 18 years are more likely to attempt suicide, have more
comorbidity, and have gradual (rather than acute) disorder onset than those with adult-onset body dysmorphic
disorder.
* * *
Individuals with body dysmorphic disorder (formerly dysmorphophobia) are preoccupied with one or more perceived
defects or flaws in their physical appearance, which they believe look ugly, unattractive, abnormal, or deformed.
Excessive repetitive behaviors or mental acts (e.g., comparing) are performed in response to the preoccupation. It
causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Sources:
https://en.wikipedia.org/wiki/Body_dysmorphic_disorder

Types of delusional disorder
Q8.
35

Types of Delusional Disorder
36
A8
Delusional disorder refers to a condition associated with one or more non-bizarre delusions of thinking - such as
expressing beliefs that occur in real life such as being poisoned, being stalked, being loved or deceived, or having an
illness, provided no other symptoms of schizophrenia are exhibited. As per DSM V, the various types of delusional
disorders are:
1. Erotomanic type: In this type, the central theme of the delusion is that another person is in love with the
individual. The person about whom this conviction is held is usually of higher status (e.g., a famous individual or a
superior at work) but can be a complete stranger. Efforts to contact the object of the delusion are common.
2. Grandiose type: In this type, the central theme of the delusion is the conviction of having some great talent or
insight or of having made some important discovery. Less commonly, the individual may have the delusion of
having a special relationship with a prominent individual or of being a prominent person (in which case the actual
individual may be regarded as an impostor). Grandiose delusions may have a religious content.
3. Jealous type: In this type, the central theme of the delusion is that of an unfaithful partner. This belief is arrived at
without due cause and is based on incorrect inferences supported by small bits of "evidence" (e.g., disarrayed
clothing). The individual with the delusion usually confronts the spouse or lover and attempts to intervene in the
imagined infidelity.
4. Persecutory type: In this type, the central theme of the delusion involves the individual's belief of being conspired
against, cheated, spied on, followed, poisoned, maliciously maligned, harassed, or obstructed in the pursuit of
long-term goals. Small slights may be exaggerated and become the focus of a delusional system. The affected
individual may engage in repeated attempts to obtain satisfaction by legal or legislative action. Individuals with
persecutory delusions are often resentful and angry and may resort to violence against those they believe are
hurting them.

Types of Delusional Disorder, Summary and Sources
37
A8
5. Somatic type: In this type, the central theme of the delusion involves bodily functions or sensations. Somatic
delusions can occur in several forms. Most common is the belief that the individual emits a foul odor; that there is
an infestation of insects on or in the skin; that there is an internal parasite; that certain parts of the body are
misshapen or ugly; or that parts of the body are not functioning.
6. Mixed type: This subtype applies when no one delusional theme predominates.
7. Unspecified type: This subtype applies when the dominant delusional belief cannot be clearly determined or is
not described in the specific types (e.g., referential delusions without a prominent persecutory or grandiose
component).
* * *
The main feature of delusional disorders is the presence of delusions, which are unshakable beliefs in something
untrue. They are of 7 types: erotomanic type, grandiose type, jealous type, persecutory type, somatic type, mixed
type and unspecified type.
Sources:
https://www.psychologytoday.com/conditions/delusional-disorder
www.webmd.com/schizophrenia/guide/delusional-disorder

50 words
Section C
38

Asperger syndrome
39
A9
It is named after Austrian pediatrician Hans Asperger who, in 1944, studied and described children who lacked
nonverbal communication skills, demonstrated limited empathy with their peers, and were physically clumsy.
Essential features:
1. severe and sustained impairment in social interaction (Criterion A)
2. development of restricted, repetitive patterns of behavior, interests, and activities (Criterion B)
3. The disturbance must cause clinically significant impairment in social, occupational, or other important areas of
functioning (Criterion C).
4. There are no clinically significant delays or deviance in language acquisition (e.g., single non-echoed words are
used communicatively by age 2 years, and spontaneous communicative phrases are used by age 3 years)
(Criterion D), although more subtle aspects of social communication (e.g., ty pical give-and-take in conversation)
may be affected.
5. In addition, during the first 3 years of life, there are no clinically significant delays in cognitive development as
manifested by expressing normal curiosity about the environment or in the acquisition of age-appropriate
learning s kills and adaptive behaviors (other than in social interaction) (Criterion E).
The diagnosis of Asperger's was replaced by a diagnosis of autism spectrum disorder on a severity scale, in (DSM-5).
* * *
Sources:
https://en.wikipedia.org/wiki/Asperger_syndrome
Diagnostic and Statistical Manual of Mental Disorders - DSM IV TR by American Psychiatric Association

Axis IV of DSM-IV TR
40
A10
Axis IV is for reporting psychosocial and environmental problems that may affect the diagnosis, treatment, and
prognosis of mental disorders (Axes I and II).
A psychosocial or environmental problem may be a negative life event, an environmental difficulty or deficiency, a
familial or other interpersonal stress, an inadequacy of social support or personal resources, or other problem
relating to the context in which a person's difficulties have developed.
In addition to playing a role in the initiation or exacerbation of a mental disorder, psychosocial problems may also
develop as a consequence of a person's psychopathology or may constitute problems that should be considered in
the overall management plan.
The problems are grouped together in the following categories:
• Problems with primary support group
• Problems related to the social environment
• Educational problems
• Occupational problems
• Housing problems
• Economic problems
• Problems with access to health care services
• Problems related to interaction with the legal sys tem/crime
• Other psychosocial and environmental problems
* * *
Sources:
Diagnostic and Statistical Manual of Mental Disorders - DSM IV TR by American Psychiatric Association

Behaviour modification
41
A11
Behavior modification is the traditional term for the use
of empirically demonstrated behavior change
techniques to increase or decrease the frequency of
behaviors. The purpose behind behavior modification is
not to understand why or how a particular behavior
started. Instead, it only focuses on changing the behavior,
and there are various different methods used to
accomplish it. This includes:
•Positive reinforcement
•Negative reinforcement
•Punishment
•Flooding
•Systematic desensitization
•Relaxation Therapy
•Aversion therapy
•Biofeedback
•Habit reversal
•Modeling
•Shaping
•Extinction
•Token economy
•Cognitive Behavior Therapy
It is used to treat many disorders such as attention deficit
disorder, phobic disorders, obsessive compulsive
disorders, generalized anxiety disorder, panic disorders,
habit disorders, autism, sexual deviations/dysfunctions,
social skills deficits or oppositional defiant disorder.
Furthermore, the fundamentals of behavior modification
can be used to increase desired behaviors in any
individual, regardless of functional level.
Behavior modification is now known as Applied behavior
analysis (ABA) which is more analytical than it used to be.
* * *
Sources:
http://www.livestrong.com/article/105661-behavior-
modification/
http://study.com/academy/lesson/what-is-behavior-
modification-definition-techniques-examples.html
https://en.wikipedia.org/wiki/Behavior_modification

Amnesia
42
A12
Amnesia (from Greek ἀμνησία from ἀ- meaning "without" and μνήμη memory), also known as amnesic syndrome, is
a deficit in memory. The memory can be either wholly or partially lost. And it may be due to organic brain disorders
like dementia or psychiatric conditions like dissociation.
Dissociative amnesia is characterized by an inability to recall autobiographical information. This amnesia may be
localized (i.e., an event or period of time), selective (i.e., a specific aspect of an event), or generalized (i.e., identity
and life history). It is an inability to recall autobiographical information that is inconsistent with normal forgetting. It
may or may not involve purposeful travel or bewildered wandering (i.e., fugue).
Although some individuals with amnesia promptly notice that they have "lost time" or that they have a gap in their
memory, most individuals with dissociative disorders are initially unaware of their amnesias. For them, awareness of
amnesia occurs only when personal identity is lost or when circumstances make these individuals aware that
autobiographical information is missing (e.g., when they discover evidence of events they cannot recall or when
others tell them or ask them about events they cannot recall).
* * *
Sources:
https://en.wikipedia.org/wiki/Amnesia

Substance abuse
43
A13
Substance-Abuse is a maladaptive pattern of substance use leading to clinically significant impairment or distress, as
manifested by one (or more) of the following, occurring within a 12-month period:
1. recurrent substance use resulting in a failure to fulfil major role obligations at work, school, or home
2. recurrent substance use in situations in which it is physically hazardous
3. recurrent substance-related legal problems
4. continued substance use despite having persistent or recurrent social or interpersonal problems caused or
exacerbated by the effects of the substance
DSM-5 defines substance abuse in terms of how significantly it interferes with the user’s life. If substances disrupt
your education, job, or relationships with others, and put you in physically dangerous situations (for example, while
driving) you would be considered a drug abuser.
Some evidence suggests that drug use can predict later job outcomes. In one study, researchers found that repeated
hard drug use (using one or more of the following: amphetamines, barbiturates, crack, cocaine, PCP, LSD, other
psychedelics, crystal meth, inhalants, heroin, or other narcotics) predicted poor job outcomes after college (Arria et
al., 2013).
* * *
Sources:

Psychoeducation
44
A14
Psychoeducation refers to the education offered to individuals with a mental health condition and their families to
help empower them and deal with their condition in an optimal way. It helps individuals with schizophrenia, clinical
depression, anxiety disorders, psychotic illnesses, eating disorders, and personality disorders.
The goal of Psychoeducation is to ensure that the patient and family members understand the illness. By doing this,
the patient's own capabilities, resources and coping skills are strengthened and used to contribute to their own
health and wellbeing on a long-term basis. It also destigmatizes psychological disturbances and thus diminish barriers
to treatment.
Patients and family members, who are more well-informed about the disease, feel less helpless. Patients who receive
psychoeducation are less likely to relapse or be readmitted to the hospital. They function better overall and are more
satisfied with the treatment they receive.
Important elements in psychoeducation are:
•Information about the disorder
•Emotional discharge
•Support of a medication or psychotherapeutic treatment, as cooperation is promoted between the mental health
professional and patient
•Assistance to self-help
* * *
Sources:
Abnormal Psychology 15e by James N Butcher, Susan Mineka and Jill M. Hooley
https://en.wikipedia.org/wiki/Psychoeducation

Postpartum psychosis
45
A15
Postpartum psychosis (or puerperal psychosis) is a term that covers a group of mental illnesses with the sudden onset of
psychotic symptoms following childbirth.
These psychoses are endogenous, heritable illnesses with acute onset, benign episodic course and response to mood-
normalizing and mood-stabilizing treatments. The onset is abrupt, and symptoms rapidly reach a climax of severity.
Some women have typical manic symptoms, such as euphoria, overactivity, decreased sleep requirement,
loquaciousness, flight of ideas, increased sociability, disinhibition, irritability, violence and delusions, which are usually
grandiose or religious in content; on the whole these symptoms are more severe than in mania occurring at other times,
with highly disorganized speech and extreme excitement. Others have severe depression with delusions, auditory
hallucinations, mutism, stupor or transient swings into hypomania.
Often, out of fear of stigma or misunderstanding, women hide their condition. Two steps that can be taken to mitigate
this risk are:
1. The taking of a thorough, detailed history prior to giving birth by a competent professional, and
2. Education of medical care professionals, expectant women and their families.
* * *
Sources:
https://en.wikipedia.org/wiki/Postpartum_psychosis

Hallucinations
46
A16
A hallucination is a sensory experience that seems real to the person having it, but occurs in the absence of any
external perceptual stimulus. The word comes from the Latin verb hallucinere or allucinere, meaning to “wander in
mind” or “idle talk” (Aleman & Larøi, 2008).
Hallucinations can occur in any sensory modality (auditory, visual, olfactory, tactile, or gustatory). However, auditory
hallucinations (e.g., hearing voices) are by far the most common. Hallucinations can even be induced in healthy
people if they are under a lot of stress and drink a lot of caffeine.
Hallucinations often have relevance for the patient at some affective, conceptual, or behavioral level. Patients can
become emotionally involved in their hallucinations, often incorporating them into their delusions. In some cases,
patients may even act on their hallucinations and do what the voices tell them to do. People who consider
themselves to be socially inferior tend to perceive the voices they hear as being more powerful than they are and to
behave accordingly (Paulik, 2011).
* * *
Sources:

Reformatory Paranoia
47
A17
The chief feature of paranoia is a permanent delusion, and delusion can be of many kinds. Hence, kinds of paranoia
have been distinguished on the basis of kinds of delusions. Reformatory paranoia is a type of paranoia in which the
individual has a delusion that he is a great reformer/curator. He believes that everyone around is suffering from a
dangerous disease or lack of understanding. As their reformer, his goal is to free the others from this disease or lack
of understanding.
The disorder may result in the patient having inter-personal issues and other such issues as exist in Paranoia. He may
show the symptoms typical of paranoia patients such as self-referential thinking, thought broadcasting, magical
thinking, thought withdrawal, thought insertion, ideas of reference etc.
* * *
Sources:
http://www.healthguidance.org/entry/15511/1/The-Causes-of-Paranoia.html
Abnormal Psychology by Rachana Sharma (free preview)

Narcissistic Personality Disorder
48
A18
Individuals with narcissistic personality disorder show an exaggerated sense of self-importance, a preoccupation with
being admired, and a lack of empathy for the feelings of others (Pincus & Lukowitsky, 2010; Ronningstam, 2005,
2009). Numerous studies support the notion of two subtypes of narcissism: grandiose and vulnerable narcissism (Cain
et al., 2008, Ronningstam, 2005).
Diagnostic criteria as per DSM V:
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by
early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
1. has a grandiose sense of self-importance
2. is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
3. believes that he or she is “special” and unique and can only be understood by, or should associate with, other
special or high-status people (or institutions)
4. requires excessive admiration
5. has a sense of entitlement
6. is interpersonally exploitative
7. lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
8. is often envious of others or believes that others are envious of him or her
9. shows arrogant, haughty behaviors or attitudes
* * *
Sources:

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