MPCE 011 Solved Guess Paper Psychopathology for IGNOU MAPC (Master of Arts Psychology)

Sample 1. Explain the bio-psychosocial causes of psychopathology

Developmental Pathogenesis: Risk Factors

The risk factor model is a paradigm that facilitates the understanding of developmental deviations.

Risk factors are divided into three large categories. They can be applied at any stage of development.

1. Individual level. Both physical and emotional points matter here. Examples are atypical genetic polymorphisms, deficits in perception and high levels of generalised anxiety.
2. Family level. A parent with a serious mental illness is the classic example. Family dynamics also count. A scapegoated child in a home that allows child maltreatment is at very high risk.
3. Community level. Discrimination based on ethnic or racial status and social disadvantage fall here. These rarely occur alone, so their exact effect is hard to measure.

Biological Causes

The biological viewpoint believes that cognitive, emotional and behavioural symptoms of psychological disorders come from disorders of the nervous system and endocrine system, or that they are inherited.

1. Genetic vulnerabilities. Genotype, the genes we are born with, is fixed at birth. Phenotype, the traits we can actually see, is the product of genes and environment. Only a predisposition, also called a diathesis, is inherited, not the disorder itself.
2. The neuro-endocrine system. The HPA axis is the most important one. Under stress the hypothalamus, pituitary and adrenal cortex release cortisol. Chronic stress on this axis is linked to schizophrenia, depression and post traumatic stress disorder.
3. Physical handicaps. The most common birth difficulty linked with later mental disorders is low birth weight. It is most often a factor in premature births.
4. Early physical deprivation. Lack of food, sleep and stimulation harms mental growth. Severe malnutrition blocks brain growth and lowers intelligence.

Psychosocial Causes

1. Parental deprivation and separation. Children who miss normal parenting in infancy show maladaptive personality growth.
2. Childhood traumas. Psychic trauma means any bad experience that leaves a psychological wound. Later stress reopens that wound.
3. Parental psychopathology. Parents with schizophrenia, depression, antisocial personality disorder or alcoholism have children at higher risk.
4. Parenting styles. The authoritative style gives the best outcome. Authoritarian, permissive-indulgent and neglectful-uninvolved styles all raise risk.
5. Inadequate communication. Parents who are too busy to listen fail to give support, mainly during a crisis.
6. Disrupted family relationships. Marital discord, divorce and separation can have traumatic effects on children.

Socio-Cultural Causes

1. The socio-cultural environment. We receive a socio-cultural inheritance just like a genetic one. Conflicting or unclear social roles damage healthy personality growth.
2. Pathogenic societal influences. The lower the socio-economic class, the higher the incidence of abnormal behaviour.
3. Disorder engendering social roles. Soldiers asked to kill may later develop serious feelings of guilt.
4. Social change and uncertainty. Rapid change creates despair and helplessness, which are well established conditions for abnormal reactions.

Conclusion. No single viewpoint fully explains abnormal behaviour. Biological, psychosocial and socio-cultural causes work together, so an integrative evaluation of all of them is essential.

Sample 2. Describe the clinical features and etiology of post-traumatic stress disorder and discuss its treatment

Post-Traumatic Stress Disorder: Symptoms and Clinical Features

Post-Traumatic Stress Disorder (PTSD) is a psychiatric condition developed as an aftermath of severe trauma often involving violence and demolition.

DSM IV-TR requires a history of exposure to severe trauma, meaning experiencing or witnessing events involving actual or threatened death, serious injury or threat to the integrity of self and others. The reactions are mainly fear, helplessness and terror.

Three Groups of Symptoms

1. Intrusive memory, at least one. Repeated and intrusive recollection of the event, distressing dreams, and intense distress when any cue resembles the trauma, for example a tyre bursting after a terrorist attack.
2. Avoidance and numbing, at least three. The victim avoids thoughts, feelings and activities linked to the trauma, feels detachment and a restricted range of emotions, and may sense a foreshortened future.
3. Excessive arousal, at least two. Difficulty sleeping, irritability, outbursts of anger, poor concentration and an exaggerated startle response.

Symptoms must last at least one month. Less than three months is acute, more than that is chronic. When the victim feels she did not play her role properly, it is known as survivor's guilt.

Aetiology: Biological Factors

Temperamental factors build a vulnerable personality, and twin studies show these run in families. Trauma activates the noradrenergic system and raises norepinephrine, causing exaggerated startle responses and heightened arousal.

Aetiology: Psychological Factors

1. Vulnerable personality and life events. Being female, early separation from parents, family history of psychiatric disorder and pre-existing anxiety or mood disorders.
2. Psychoanalytical approach. People suppress or repress the painful memories. PTSD is the ego's struggle to fit the experience into the existing personality.
3. Learning theory approach. PTSD results from classical conditioning, an avoidance response, like a railway accident victim who can never board a train again.
4. Cognitive approach. The coping style is emotion focussed rather than problem focussed, and personal responsibility for failures brings survivor guilt.
5. Existential approach. Trauma disturbs the meaning of life and develops nihilism about anything good.

Socio-Cultural Factors

In combat stress, strong group morale keeps symptoms less severe and a supportive environment helps. In cases of rape, society often blames the victim.

Treatment

1. Medicines. Antidepressants and tranquillisers help, and SSRIs have been particularly successful.
2. Short term crisis therapy. The therapist stays proactively engaged with the person.
3. Trauma-focused cognitive-behavioural therapy. The most widely used technique. The victim is slowly exposed to avoided thoughts and situations, and erroneous thoughts are replaced with reality oriented ones.
4. EMDR. Eye Movement Desensitisation and Reprocessing, developed by Francine Shapiro in 1987, uses eye movements, hand taps or sounds, that is, rhythmic left-right stimulation.
5. Existential approach and family therapy. Viktor Frankl's logotherapy builds a broader framework of meaning, and family therapy helps the whole family absorb the trauma.

Conclusion. PTSD is diagnosed from three symptom groups after severe trauma. For all approaches, the key is gradual exposure to the memories along with coping skills.

Sample 3. Discuss the causes of major depression and describe the subtypes of it

Major Depressive disorder, commonly called major depression, unipolar depression, or clinical depression, is where a person has one or more major depressive episode.

The most common time of onset is between 20 and 30 years, with a later peak between 30 and 40.

Subtypes (Specifiers) of Major Depression

1. Atypical Depression. Mood reactivity, weight gain or increased appetite, excessive sleep, leaden paralysis and hypersensitivity to rejection.
2. Melancholic Depression. Loss of pleasure in most activities, worsening in the morning hours, early morning waking, psychomotor retardation and excessive guilt.
3. Catatonic Depression. A rare, severe form with motor disturbance. The person is mute and almost stuporose.
4. Psychotic Major Depression. A major depressive episode with psychotic symptoms such as delusions or hallucinations.
5. Postpartum Depression. Intense depression after giving birth, with an incidence rate of 10 to 15 per cent.
6. Seasonal Affective Disorder. Also known as winter depression. Episodes come in autumn or winter and resolve in spring.

Causes of Major Depression

The Diathesis Model says depression results when a pre-existing vulnerability is activated by stressful life events, and twin studies show a moderate genetic contribution. Beck (1967) found that depressed people have a distinctly negative view of themselves and the world, and named three concepts: a triad of negative thoughts about oneself, one's world and one's future, depressive schemas, and distorted information processing. Seligman compared it to learned helplessness.

Treatment

A combination of an antidepressant plus a psychological treatment is better than either alone. Cognitive Behavioural Therapy changes harmful thought patterns, and Interpersonal Psychotherapy resolves problems in existing relationships.

Conclusion. Major depression has five subtype specifiers plus postpartum and seasonal patterns, and its causes are biological, psychological and social together.

Sample 4. Define paranoia and describe the symptoms and types of paranoia

Paranoia disorder consists of pervasive, long-standing suspiciousness and generalised mistrust of others.

According to Kraepelin, the cause of delusion here is internal and no hallucination is involved. He used the term pure paranoia where a delusion was present without any fall in intellectual ability.

Characteristic Features

The central characteristic is a high degree of mistrustfulness and suspicion. Even friendly gestures are read as manipulative or malevolent. Such people have no intimate friends, and marriages are marked by pathological jealousy.

Symptoms of Paranoia

The main symptom is permanent delusion. There is delusion in schizophrenia also, but there it is not permanent or organised. In paranoia the patient is sentimental, suspicious, irritable, introverted, depressed, obstinate, jealous, selfish, unsocial and bitter.

Kinds of Paranoia

1. Persecutory paranoia. The most prevalent type. The patient believes all those around him are enemies who want to harm him.
2. Religious paranoia. A permanent delusion of a religious nature, for example believing he is the messenger of God.
3. Reformatory paranoia. The patient considers himself a great reformer and sees everyone around him as suffering from a dangerous disease.
4. Erotic paranoia. The patient believes some member of the opposite sex from an illustrious family wants to marry him.
5. Litigious paranoia. The patient files meaningless cases against other people and feels they are linked together to bother him.
6. Hypochondriacal paranoia. The patient believes he is suffering from all kinds of ridiculous diseases and blames others for his suffering.

Conclusion. Paranoia is marked by permanent, organised delusion without hallucination. Its six kinds differ only in the theme of the delusion.

Sample 5. Write a short note on schizoid personality disorder

Schizoid Personality Disorder is characterised by a long-standing pattern of detachment from social relationships.

1. Origin of the term. Bleuler (1924) used the term for a tendency to turn attention toward one's inner life and away from the external world.
2. Diagnostic criteria. DSM-IV-TR requires four or more: neither desires nor enjoys close relationships, chooses solitary activities, little interest in sex, takes pleasure in few activities, lacks close friends, indifferent to praise or criticism, shows emotional coldness.
3. In ordinary terms. Such a person is the typical loner, and their lives may seem directionless.
4. Prevalence and treatment. It is rare, less than 1 per cent of the population. Treatment is short-term and solution-focused.