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In a depressive disorder the person experiences sadness and guilt for a long period of time.

The fear that is experienced unnecessarily in a non threatening situation is called a phobia.

An intense, persistent irrational fear of something that produces conscious avoidance of the feared subject, activity or situation is called a phobia. 

• Phobias can vary in degree and how much they interfere with healthy adaptation to the environment. Some otherwise normal and well-adjusted persons also have phobias. 

Phobias are mainly of three types : 

1. Specific phobias are those directed towards specific objects and situations and can be varied, e.g., acrophobia (fear of heights), pyrophobia (fear of fire), and hydrophobia (fear of water). 

2. Social phobia is a fear of social situations, and people with this phobia may avoid a wide range of situations in which they fear they will be exposed to, scrutinized and possibly humiliated by other people. 

3. Agoraphobia: is the term used when people developed a fear of entering unfamiliar situations. Social learning theories work on the principle that our experience be it positive or negative such as phobia of lizards/cockroaches are the result of learning process which start early in life. Small children can play with snakes; they are not aware of the danger involved. For them it is just another play object, as they grow up the fear of these things are instilled by their parents and society which is reinforced and accounts for reactions like phobia. A psychoanalytical account for the same could involve attribution to some unconscious > or/and repressed experiences. For example, suppose in your childhood you watched a group of roudy boys brutally torturing a cockroach/snake, which eventually died, although you going about the incidence after some days, but it might remain in back of your mind forever, which might explain your phobia to cockroaches which might remind you of the incidence and disturbs you emotionally.

A phobia is a persistent, irrational fear of a situation or object. Phobias are of three types viz. Social phobia (fear of social situations); specific phobias (fear of particular situations) and agoraphobia (fear of being alone in public places from which there is no easy escape). Some phobias are:

1. Claustrophobia (fear of enclose spaces) 

2. Acrophobia (fear of heights) 

3. Homophobia (fear of blood) 

4. Zoophobia (fear of animals) 

5. Arachnophobia (fear of spiders) 

6. Pyrophobia (fear of fire) 

7. Trypanophobia (fear of needles and injections) 

8. Xenophobia (fear of foreigners or strangers)

According to DSM-5, there are five criteria (indicators) for psychological disorders.

1. Clinically significant syndrome – In psychological disorders, there should be a cluster of symptoms together i.e., a syndrome. 

2. Distress and Impairment – There should be distress, i.e., psychological pain due to negative feelings and stress, as well as impairment, i.e., inability to perform appropriate roles in personal and social situations. 

3. Dysfunction – If the symptoms lead to developmental or psychological dysfunctions, it signifies mental disorders. 

4. Responses to stressors that are normally accepted responses e.g., sadness experienced at the loss of a loved one or culturally sanctioned responses are not considered as signs of mental disorders. 

5. Behaviour which is only deviant but does not produce any disability/ distress/ dysfunction does not become a sign of mental disorder.

Anxiety disorders are characterised by feelings of worry and restlessness that tend to interfere with daily activities. Besides generalized anxiety disorder and phobia which are explained in the chapter, anxiety disorders includes Panic disorder, ObsessiveCompulsive disorder (OCD) and Social Anxiety disorders include disorders in which anxiety is the main symptom or is experienced. When an attempt is made to modify maladjustment.

Karan – Quadrant 2, Pramila – Quadrant 3, 

Lalita – Quadrant 4, Santosh – Quadrant 3.

All the stated examples show at least one of the five criteria for abnormality. 

1. Hemant seems superstitious and lacks confidence. He appears moderately healthy. 

2. Seema exhibits personal distress and signs of sleep disorders. 

3. Rakesh exhibits clear symptoms of abnormal behaviour and seems extremely unhealthy mentally.

4. Reena seems to have anxiety disorder and may need professional help.

Correct option is (a) DSM-5

Answer is (c) syndrome

The term ‘Schizophrenia’ is derived from Greek words Schizein (to split) and phren (mind). Thus, the literal meaning of the word ‘schizophrenia’ is split mind. The term ‘schizophrenia’ was coined in 1911 by a Swiss psychologist, Paul Eugene Bleuler. Schizophrenia is a psychotic disorder. According to DSM-5 the two types of symptoms for schizophrenia are- 

(a) Positive symptoms are an excess addition to normal thoughts or behaviour of the period. Such symptoms are-

1. hallucinations – mainly auditory and visual hallucination 

2. delusions – mainly of grandeur, reference and persecution 

3. disorganized thought and speech 

4. bizarre body movements and disorganized behaviour 

5. incongruent affect.

(b) Negative symptoms are deficits of normal emotional responses or of thought processes. They lead to low level of functioning and may not improve much even with treatment. This includes

1. emotional blunting – diminished emotional expression 

2. anhedonia – inability to experience deep positive emotions 

3. alogia – diminished speed 

4. asociality – lack of desire to form relationships 

5. avolition – lack of motivation 6. apathy.

Sometimes, a schizophrenic exhibits positive as well as negative symptoms.

True

Feeling of hopelessness is one of the symptoms seen in depressive disorders is True

Red flags for the following disorders. 

(1) Phobias

• Displaying extreme nervousness or distress when in the presence of the source of the phobia 
• Avoidance behaviour 
• Refusal to face certain situations

• Irritability, moodiness and agitation. 
• Inability to concentrate 
• Unexplained aches and pains 
• Disruptions in sleep habits 
• Changes in appetite and eating habits 
• Suicidal thoughts.

• Change in thought processes, and concentration 
• Change in sleep patterns 
• Change is social interaction 
• Uncharacteristic moodiness

(4) PTSD

• Persistent negative thoughts 
• Trouble in concentration 
• Irritability and aggression 
• Engaging in reckless behaviour 
• Changes in sleep and appetite
• Loss of interest in friends/ family / favourite activities.

Answer is (b) 2

i. False

ii. True

iii. True

iv. True

v. True

vi. False

vii. False

Answer is (a) withdrawal

Delusions is a false belief that is strongly held by an individual in spite of the presence of contrary evidence, Delusions are a symptom of mental disorders. Commonly noticed delusions are delusion of grandeur, delusions of persecution, delusion of influence or control, delusion of reference, etc.

Suggestible stage of PTSD refers to a person who may seek guidance from others and may either accept these suggestions unquestioningly or may get extra sensitive.

The person is said to be diagnosed with PTSD when the symptoms of Acute Stress Disorder (ASD) continue for more than one month with the same intensity.

Psychotherapy refers to the systematic attempt by a mental health professional to assist a person to overcome some psychological disorders.

Addictive disorders refer to the physical and psychological inability to stop consuming some substance or indulging in some activity although it is harmful.

If the symptoms of Acute Stress Disorder (ASD) continue for more than one month with the same intensity, the person is diagnosed with PTSD. A person who has suffered trauma goes through three stages viz

1. Shock stage – the individual is in shock, i.e., extremely disturbed. 

2. Suggestible stage – he/she may seek guidance from others and may either accept these suggestions unquestioningly or may get extra sensitive. 

3. Recovery stage – the person shows signs of recovery.

However, some persons still show signs of mental illness i.e., PTSD. 

The symptoms of PTSD include 

1. nightmares, flashbacks, severe anxiety 

2. hyper vigilance and avoidance of situations that bring back the trauma 

3. irritability, social isolation 4. survivour’s guilt

Achenbach has identified two factors in behavioural disorders:

• Externalizing Factors

• Internalizing Factors

These disorders must manifest before the age of 18. On the basis of these two factors he classified children’s disorders in two categories:

• The externalizing disorders or undercontrolled emotions: Behaviours that are disruptive and often aggressive and aversive to others in the child’s environment.

• The Internalizing disorders or over-controlled emotions: Those conditions where the child experiences depression, anxiety, and discomfort that may not be evident to others.

1. Externalizing Disorders:

(a) Attention-deficit Hyperactivity Disorder (ADHD).

(b) Oppositional Defiant Disorder (ODD).

(c) Conduct Disorder.

(а) Attention-deficit Hyperactivity Disorder (ADHD):

The two main features of ADHD are:

(i) Inattention (ii) Hyperactivity-impulsivity

 Inattention:

• Children who are inattentive find it difficult to sustain mental effort during work or play.

• They have a hard time keeping their minds on any one thing or in following instructions.

Common complaints are that

• The child does not listen, cannot concentrate, does not follow instructions, is disorganized, easily distracted forgetful, does not finish assignments, and is quick to lose interest in boring activities.

• Children who are impulsive, unable to control their immediate reactions or to think before they act.

• They find it difficult to wait or take turns, have difficulty resisting immediate temptations or delaying gratification.

•  Minor mishaps such as knocking things are common whereas more serious accidents and injuries can also occur.

•Hyperactivity also takes many forms. Children with ADHD are in constant notion. Sitting still for some time through a lesson is impossible for them.The child may fidget, squirm, climb and run around the room aimlessly.

• Parents and teachers describe them as ‘driven by a motor’, always on the go, and talk a lot.

• Boys are four times more prone for this diagnosis than girls.

(b) Children with Oppositional Defiant Disorder (ODD):

• Age-inappropriate amounts of stubbornness,

• Irritable, • Defiant, disobedient, and

• Behave in a hostile manner.

Unlike ADHD, the rates of ODD in boys and girls are not very different.

(c) Conduct Disorder and Antisocial Behaviour refer to age-inappropriate actions and attitudes that violate family expectation, societal norms, and the personal or property rights of other.

The behaviours typical of conduct disorder include:

• Aggressive actions that cause or threaten harm to people or animals,

• Non-aggressive conduct that causes property damage,

• Major dishonesty,

• Theft and

• Serious rule violations.

Children show many different types of aggressive behaviour, as—1

• Verbal aggression (i.e., name-calling, swearing),

• Physical aggression (i.e., hitting, fighting),

• Hostile aggression (i.e., directed at inflicting injury to others),

• Proactive aggression (i.e., dominating and bullying others without provocation).

2. Internalizing disorders

(a) Separation Anxiety Disorder (SAD) (b) Depression

(a) Separation anxiety disorder is an internalizing disorder unique to children. Its most prominent symptom is—

• Excessive anxiety or even panic experienced by children at being separated from their parents.

• Have difficulty being in a room by themselves, going to school alone, are fearful of entering new situations, and cling to and shadow their parents’ every move.

• To avoid separation, children with SAD may fuss, scream, throw severe tantrums, or make suicidal gestures.

(b) Depression:

• An infant may show sadness by being passive and unresponsive; a preschooler may appear withdrawn and inhibited; a school-age child may be argumentative and combative; and a teenager may express feelings of guilt and hopelessness.

Disorders relating to maladaptive behaviours resulting from regular and consistent use of the substance involved are called substance abuse disorders.

These disorders include problems associated with using and abusing such drugs as alcohol, cocaine and which alter the way people think, feel and behave.There are two sub-groups of

substance-use disorders:

(a) Substance Dependence refers to intense craving for the substance to which the person is addicted.

The person shows tolerance, withdrawal symptoms and compulsive drug taking. Tolerance means that the person has to use more and more of a substance to get the same effect.

Withdrawal refers to physical symptoms that occur when a person stops or cuts down on the use of a psychoactive substance, i.e., a substance that has the ability to change an individual’s consciousness, mood and thinking processes.

(b) Substance Abuse refers to recurrent and significant adverse consequences related to the use of substances. 

People, who regularly consume drugs, damage their family and social relationships, perform poorly at work, and create physical hazards. Substance abuse disorders are a joint result of physiological dependence and psychological dependence. Physiological dependence refers to withdrawal symptoms, i.e., the excessive dependence of the body on drugs. Psychological dependence, on the other hand, refers to the strong craving for a drug because of its pleasurable effects. 

The three most common forms of substance abuse:

• Alcohol abuse and dependence • Heroin abuse and dependence

• Cocaine abuse and dependence

Alcohol Abuse and Dependence:

• People, who abuse alcohol, drink large amounts regularly and rely on it to help them face difficult situations.

• Eventually, the drinking interferes with their social behaviour and ability to think and work.

• For many people the pattern of alcohol abuse extends to dependence. That is . their bodies build up a tolerance for alcohol and they need to drink even greater amounts to feel its effects.

• They also experience withdrawal responses when they stop drinking. Alcoholism destroys millions of families and careers.

• Intoxicated drivers are responsible for many road accidents.

• It also has serious effects in the children of persons with this disorder.

• These children have higher rates of psychological problems. Particularly anxiety.

• Depression phobias afid substance-related disorders.

• Excessive drinking can seriously damage physical health. Some of the ill effects of alcohol can be been on health and psychological functioning.

Heroin Abuse and Dependence:

• Heroin intake significantly interferes with social and occupational functioning.

• Most abusers further develop a dependence on heroin, revolving their lives around the substance, building up a tolerance for it, and experiencing a withdrawal reaction when they stop taking it.

• The most direct danger of heroin abuse is an overdose, which slows down the respiratory centres in the brain, almost paralyzing breathing, arid in many cases causing death.

• Regular use of cocaine may lead to a pattern of abuse in which the person may be intoxicated throughout the day and function poorly in social relationships and at work.

• It may also cause problem in short-term memory and attention.

• Dependence may develop, so that cocaine dominates the person’s life, more of the drug is needed to get the desired effects and stopping it results in feeling of depression, fatigue, sleep problems, irritability and anxiety.

• Cocaine poses serious dangerous effects on psychological functioning and physical well-being.

• Sometimes anxiety and tension are associated with obsessions—persistent unwanted thoughts, impulses or ideas or compulsions—seemingly irrational behaviours repeatedly carried out in a fixed, repetitive way. 

• People with obsessive-compulsive disorders find their obsessions or compulsions distressing and debilitating but feel unable to stop them, 

• The compulsive actions are usually carried on to alleviate the anxiety caused by obsessions. A person provoked with anxious thoughts may try to block them out by compulsively counting steps while walking. Another person obsessed with the idea that he is guilty or dirty, may wash his hands every few minutes, sometimes till the bleed.

 • The symptoms of OCD include a contamination – an obsession of contamination followed by washing or compulsive avoidance of the object. Shame and disgust and the feeling of being easily contaminated are common. Patients usually believe that the contamination is spread from object to object or person to person by the slightest contact. 

(a) Pathological Doubt—Obsession of doubt followed by the compulsion of checking. Patients have an obsessional self-doubt and are always feeling guilty about having forgotten something. The checking may involve multiple trips back – to the house to check the stove. 

(b) Intrusive Thoughts—repetitive thoughts of a sexual or aggressive act that is reprehensible to the patient. This is usually not followed by compulsions. . 

(c) Symmetry—he need for symmetry and precision, which can lead to a compulsion of slowness. Patients can literally take an hour to shave their faces or eat a meal. 

(d) Other symptom patterns may include religions obsessions and compulsive hoardings as well as trichotillomania (compulsive half pulling) and nail-biting.