Odisha State Board CHSE Odisha Class 12 Psychology Solutions Unit 4 Long Answer Questions Part-2.
CHSE Odisha 12th Class Psychology Unit 4 Long Answer Questions Part-2
Long Questions With Answers
Write the classification of biological disorders.
In order to understand psychological disorders, we need to begin by classifying them. A classification of such disorders consists of a list of categories of specific psychological disorders grouped into various classes on the basis of some shared characteristics. Classifications are useful because they enable users like psychologists, psychiatrists and social workers to communicate with each other about the disorder and help in understanding the causes of psychological disorders and the processes involved in their development and maintenance.
The American Psychiatric Association (APA) has published an official manual describing and classifying various kinds of psychological disorders. The current version of it, the Diagnostic and Statistical Manual of Mental Disorders, IV Edition (DSM-IV), evaluates the patient on five axes or dimensions rather than just one broad aspect of ‘mental disorder’. These dimensions relate to biological, psychological, social and other aspects.
The classification scheme officially used in India and elsewhere is the tenth revision of the International Classification of Diseases (ICD-10), which is known as the ICD-10 Classification of Behavioural and Mental Disorders. It was prepared by the World Health Organisation (WHO). For each disorder, a description of the main clinical features or symptoms and of other associated features including diagnostic guidelines is provided in this scheme.
What are the approaches to understanding abnormal behaviour?
In order to understand something as complex as abnormal behaviour, psychologists use different approaches. Each approach in use today emphasises a different aspect of human behaviour and explains and treats abnormality in line with that aspect. These approaches also emphasise the role of different factors such as biological, psychological and interpersonal and socio-cultUral factors.
We will examine some of the approaches which are currently being used to explain abnormal behaviour. Biological factors influence all aspects of our behaviour. A wide range of biological factors such as faulty genes, endocrine imbalances, malnutrition, injuries and other conditions may interfere with the normal development and functioning of the human body. These factors may be potential causes of abnormal behaviour. We have already come across the biological model.
According to this model, abnormal behaviour has a biochemical or physiological basis. Biological researchers have found that psychological disorders are often related to problems in the transmission of messages from one neuron to another. You have studied in Class XI, that a tiny space called a synapse separates one neuron from the next and the message must move across that space.
When an electrical impulse reaches a neuron’s ending, the nerve ending is stimulated to release a chemical, called a neurotransmitter. Studies indicate that abnormal activity by certain neurotransmitters can lead to specific psychological disorders. Anxiety disorders have been linked to low activity of the neurotransmitter gamma-aminobutyric acid (GABA) schizophrenia to the excess activity of dopamine, and depression to low activity of serotonin.
Genetic factors have been linked to mood disorders, schizophrenia, mental retardation and other psychological disorders. Researchers have not, however, been able to identify the specific genes that are the culprits. It appears that in most cases, no single gene is responsible for a particular behaviour or a psychological disorder. In fact, many genes combine to help bring about our various behaviours and emotional reactions, both functional and dysfunctional.
Although there is sound evidence to believe that genetic/ biochemical factors are involved in mental disorders as diverse as schizophrenia, depression, anxiety, etc. and biology alone cannot account for most mental disorders. There are several psychological models which provide a psychological explanation of mental disorders. These models maintain that psychological and interpersonal factors have a significant role to play in abnormal behaviour.
These factors include maternal deprivation (separation from the mother, or lack of warmth and stimulation during early years of life), faulty parent-child relationships (rejection, overprotection, over permissiveness, faulty discipline, etc.), maladaptive family structures (inadequate or disturbed family) and severe stress. The psychological models include the psychodynamic, behavioural, cognitive and humanistic-existential models.
The psychodynamic model is the oldest and most famous of the modern psychological models. You have already read about this model in Chapter 2 on Self and Personality. Psychodynamic theorists believe that behaviour, whether normal or abnormal, is determined by psychological forces within the person of which s/he is not consciously aware. These internal forces are considered dynamic, i.e. they interact with one another and their interaction gives shape to behaviour, thoughts and emotions.
Abnormal symptoms are viewed as the result of conflicts between these forces. This model was first formulated by Freud who believed that three central forces shape personality — instinctual needs, drives and impulses (id), rational thinking (ego), and moral standards (superego). Freud stated that abnormal behaviour is a symbolic expression of unconscious mental conflicts that can be generally traced to early childhood or infancy.
Another model that emphasises the role of psychological factors is the behavioural model. This model states that both normal and abnormal behaviours are learned and psychological disorders are the result of learning maladaptive ways of behaving. The model concentrates on behaviours that are learned through conditioning and propose that what has been learned can be unlearned.
Learning can take place by classical conditioning (temporal association in which two events repeatedly occur close together in time), operant conditioning (behaviour is followed by a reward), and social learning (learning by imitating others’ behaviour). These three types of conditioning account for behaviour, whether adaptive or maladaptive. Psychological factors are also emphasised by the cognitive model. This model states that abnormal functioning can result from cognitive problems.
People may hold assumptions and attitudes about themselves that are irrational and inaccurate. People may also repeatedly think in illogical ways and makeover generalisations, that is, – they may draw broad, negative conclusions on the basis of a single insignificant event. Another psychological model is the humanistic-existential model which focuses on broader aspects of human existence.
Humanists believe that human beings are born with a natural tendency to be friendly, cooperative and constructive, and are driven to self-actualise, i.e. to fulfil this potential for goodness and growth. Existentialists believe that from birth we have total freedom to give meaning to our existence or to avoid that responsibility. Those who shirk from this responsibility would live empty, inauthentic and dysfunctional lives.
In addition to the biological and psychosocial factors, socio-cultural factors such as war and violence, group prejudice and discrimination, economic and employment problems and rapid social change, put stress on most of us and cafes also lead to psychological problems in some individuals. According to the sociocultural model, abnormal behaviour is best understood in light of the social and cultural forces that influence an individual.
As behaviour is shaped by societal forces, factors such as family structure and communication, social networks, societal conditions and societal labels and roles become more important. It has been found that certain family systems are likely to produce abnormal functioning in individual members. Some families have an enmeshed structure in which the members are over involved in each other’s activities, thoughts and feelings.
Children from this kind of family may have difficulty in becoming independent in life. The broader social networks in which people operate include their social and professional relationships. Studies have shown that people who are isolated and lack social support, i.e. strong and fulfilling interpersonal relationships in their lives are likely to become more depressed and remain depressed longer than those who have good friendships.
Socio-cultural theorists also believe that abnormal functioning is influenced by the societal labels and roles assigned to troubled people. When people break the norms of their society, they are called deviant and ‘mentally ill’. Such labels tend to stick so that the person may be viewed as ‘crazy’ and encouraged to act sick. The person gradually learns to accept and play the sick role, and functions in a disturbed manner.
In addition to these models, one of the most widely accepted explanations of abnormal behaviour has been provided by the diathesis-stress model. This model states that psychological disorders develop when a diathesis (biological predisposition to the disorder) is set off a stressful situation. This model has three components. The first is the diathesis or the presence of some biological aberration which may be inherited.
The second component is that the diathesis may carry a vulnerability to developing a psychological disorder. This means that the person is ‘at risk’ or ‘predisposed’ to develop the disorder. The third component is the presence of pathogenic stressors, i.e. factors/stressors that may lead to psychopathology. If such “at risk” persons are exposed to these stressors, their predisposition may actually evolve into a disorder. This model has been applied to several disorders including anxiety, depression, and schizophrenia.
What are the major psychological disorders?
One day while driving home, Deb felt his heart beating rapidly, he started sweating profusely and even felt short of breath. He was so scared that he stopped the car and stepped out. In the next few months, these attacks increased and now he was hesitant to drive for fear of being caught in traffic during an attack. Deb started feeling that he had gone crazy and would die. Soon he remained indoors and refused to move out of the house.
We experience anxiety when we are waiting to take an examination or visit a dentist, or even give a solo performance. This is normal and expected and even motivates us to do our tasks well. On the other hand, high levels of anxiety that are distressing and interfere with effective functioning indicate the presence of an anxiety disorder— the most common category of psychological disorders. Everyone has worries and fears.
The term anxiety is usually defined as a diffuse, vague, very unpleasant feeling of fear and apprehension. The anxious individual also shows combinations of the following symptoms: rapid heart rate, shortness of breath, diarrhoea, loss of appetite, fainting, dizziness, sweating, sleeplessness, frequent urination and tremors. There are many types of anxiety disorders (see Table 4.2).
They include generalised anxiety disorder, which consists of prolonged, vague, unexplained and intense fears that are not attached to any particular object. The symptoms include worry and apprehensive feelings about the future; hypervigilance, which involves constantly scanning the environment for dangers. It is marked by motor tension, as a result of which the person is unable to relax, is restless and visibly shaky and tense.
Another type of anxiety disorder is panic disorder, which consists of recurrent anxiety attacks in which the person experiences intense terror. A panic attack denotes an abrupt surge of intense anxiety rising to a peak when thoughts of particular stimuli are present. Such thoughts occur in an unpredictable manner. The clinical features include shortness of breath, dizziness, trembling, palpitations, choking, nausea, chest pain or discomfort, fear of going crazy, losing control or dying.
You might have met of heard of someone who was afraid to travel in a lift or climb to the tenth floor of a building or refused to enter a room if s/he saw a lizard. You may have also felt it yourself or seen a friend unable to speak a word of a well-memorised and rehearsed speech before an audience. These kinds of fears are termed as phobias. People who have phobias have irrational fears related to specific objects, people, or situations. Phobias often develop gradually or begin with a generalised anxiety disorder. Phobias can be grouped into three main types, i.e. specific phobias, social phobias and agoraphobia.
Specific phobias are the most commonly occurring type of phobia. This group includes irrational fears such as intense fear of a certain type of animal, or of being in an enclosed space. Intense and incapacitating fear and embarrassment when dealing with others characterises social phobias.
Agoraphobia is the term used when people develop a fear of entering unfamiliar situations. Many agoraphobics are afraid of leaving their homes. So their ability to carry out normal life activities is severely limited. Have you ever noticed someone washing their hands every time they touch something, or washing even things like coins, or stepping only within the patterns on the floor or road while walking.
People affected by the obsessive-compulsive disorder are unable to control their preoccupation with specific ideas or are unable to prevent themselves from repeatedly carrying out a particular act or series of acts that affect their ability to carry out normal activities.
Obsessive behaviour is the inability to stop thinking about a particular idea or topic. The person involved/often finds these thoughts to be 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. Very often people who have been caught in a natural disaster (such as a tsunami) or have been victims of bomb blasts by terrorists, or been in a serious accident or in a war-related situation, experience posttraumatic stress disorder (PTSD). PTSD symptoms vary widely but may include recurrent dreams, flashbacks, impaired concentration and emotional numbing.
These are conditions in which there are physical symptoms in the absence of physical disease. In somatoform disorders, the individual has psychological difficulties and complains of physical symptoms, for which there is no biological cause. Somatoform disorders include pain disorders, somatisation disorders, conversion disorders, and hypochondriasis.
Pain disorders involve reports of extreme and incapacitating pain, either without any identifiable biological symptoms or greatly in excess of what might be expected to accompany biological symptoms. How people interpret pain influences their overall adjustment. Some pain sufferers can learn to use active coping, i.e. remaining active and ignoring the pain. Others engage in passive coping, which leads to reduced activity and social withdrawal.
Patients with somatisation disorders have multiple recurrent or chronic bodily complaints. These complaints are likely to be presented in a dramatic and exaggerated way. Common complaints are headaches, fatigue, heart palpitations, fainting spells, vomiting, and allergies. Patients with this disorder believe that they are sick, provide long and detailed histories of their illness and take large quantities of medicine.
The symptoms of conversion disorders are the reported loss of part or all of some basic body functions. Paralysis, blindness, deafness and difficulty in walking are generally among the symptoms reported. These symptoms often occur after a stressful experience and may be quite sudden.
Hypochondriasis is diagnosed if a person has a persistent belief that s/he has a serious illness, despite medical reassurance, lack of physical findings, and failure to develop the disease. Hypochondriacs have an obsessive preoccupation and concern with the condition of their bodily organs, and they continually worry about, their health.
Write the major anxiety disorders.
Generalised Anxiety Disorder:
prolonged, vague, unexplained and intense fears that have no object, accompanied by hypervigilance and motor tension.
frequent anxiety attacks characterised by feelings of intense terror arid dread; unpredictable ‘panic attacks’ along with physiological symptoms like breathlessness, palpitations, trembling, dizziness, and a sense of losing control or even dying.
irrational fears related to specific objects, interactions with others, and unfamiliar situations.
Obsessive-compulsive Disorder :
being preoccupied with certain thoughts that are viewed by the person to be embarrassing or shameful, and being unable to check the impulse to repeatedly carry out certain acts like checking, washing, counting, etc.
Post-traumatic Stress Disorder (PTSD) :
recurrent dreams, flashbacks, impaired concentration and emotional numbing followed by a traumatic or stressful event like a natural disaster, serious accident, etc.
What is dissociative disorders?
Dissociative Disorders: Dissociation can be viewed as a severance of the connections between ideas and emotions. Dissociation involves feelings of unreality, estrangement, depersonalisation, and sometimes a loss or shift of identity. Sudden temporary alterations of consciousness that blot out painful experiences are a defining characteristic of dissociative disorders.
Four conditions are included in this group: dissociative amnesia, dissociative fugue, dissociative identity disorder, and depersonalisation. Salient features of somatoform and dissociative disorders are given.
Salient Features of Somatoform and Dissociative Disorders
The person is unable to recall important, personal information often related to a stressful and traumatic report. The extent of forgetting is beyond normal.
The person suffers from a rare disorder that combines amnesia with travelling away from a stressful environment.
Dissociative identity (multiple personalities) :
The person exhibits two or more separate and contrasting personalities associated with a history of physical abuse.
A person interprets insignificant symptoms as signs of a serious illness despite repeated medical evaluations that point to no pathology disease.
A person exhibits vague and recurring physical/bodily symptoms such as pain, acidity, etc., without any organic cause.
The person suffers from a loss or impairment of motor or sensory function (e.g., paralysis, blindness, etc.) that has no physical cause but may be a response to stress and psychological problems.
Dissociative amnesia is characterised by extensive but selective memory loss that has no known organic cause (e.g., head injury). Some people cannot remember anything about their past. Others can no longer recall specific events, people, places, Or objects, while their memory for other events remains intact. This disorder is often associated with overwhelming stress.
Dissociative fugue has, as its essential feature, an unexpected travel away from home and the workplace, the assumption of a new identity, and the inability to recall the previous identity. The fugue usually ends when the person suddenly ‘wakes up’ with no memory of the events that occurred during the fugue.
Dissociative identity disorder:
Dissociative identity disorder often referred to as multiple personalities, is the most dramatic of the dissociative disorders. It is often associated with traumatic experiences in childhood. In this disorder, the person assumes alternate personalities that may or may not be aware of each other.
Depersonalisation involves a dreamlike state in which the person has a sense of being separated both from self and from reality. In depersonalisation, there is a change of self-perception, and the person’s sense of reality is temporarily lost or changed.
What is mood disorders?
Mood disorders are characterised by disturbances in mood or prolonged emotional state. The most common mood disorder is depression, which covers a variety of negative moods and behavioural changes. Depression can refer to a symptom Oi a disorder. In day-to-day life, we often use the term depression to refer to normal feelings after a significant loss, such as the break-up of a relationship, or the failure to attain a significant goal. The main types of mood disorders include depressive, manic dead bipolar disorders.
Major depressive disorder:
Major depressive disorder is defined as a period of depressed mood and/or loss of interest or pleasure in most activities, together with other symptoms which may include a change in body weight, constant sleep problems, tiredness, inability to think clearly, agitation, greatly slowed behaviour and thoughts of death and suicide. Other symptoms include excessive guilt or feelings of worthlessness.
Factors Predisposing towards Depression :
Genetic makeup or heredity is an important risk factor for major depression and bipolar disorders. Age is also a risk factor. For instance, women are particularly at risk during young adulthood, while for men the risk is highest in early middle age. Similarly, gender also plays a great role in this differential risk addition. For example, women in comparison to men are more likely to report a depressive disorder.
Other risk factors are experiencing negative life events and a lack of social support. Another less common mood disorder is mania. People suffering from mania become euphoric (‘high’), extremely active, excessively talkative, and easily distractible. Manic episodes rarely appear by themselves; they usually alternate with depression. Such a mood disorder, in which both mania and depression are alternately present, is sometimes interrupted by periods of normal mood.
This is known as a bipolar mood disorder. Bipolar mood disorders were earlier referred to as manic-depressive disorders. Among the mood disorders, the lifetime risk of a suicide attempt is highest in case of bipolar mood disorders. Several risk factors in addition to the mental health status of a person predict the likelihood of suicide. These include age, gender, ethnicity, or race and recent occurrence of serious life events. Teenagers and young adults are as much at high risk for suicide, as those who are over 70 years.
Gender is also an influencing factor, i.e. men have a higher rate of contemplated suicide than women. Other factors that affect suicide rates are cultural attitudes toward suicide. In Japan, for instance, suicide is the culturally appropriate way to deal with feelings of shame and disgrace. Negative expectations, hopelessness, setting unrealistically high standards and being over-critical in self-evaluation are important themes for those who have suicidal, preoccupations.
Suicide can be prevented by being alert to some of the symptoms which include :
- changes in eating and sleeping habits
- withdrawal from friends, family and regular activities
- violent actions, rebellious behaviour, running away
- drug and alcohol abuse.
- marked personality change
- persistent boredom
- difficulty in concentration.
- complaints about physical symptoms, and
- loss of interest in pleasurable activities.
However, seeking timely help from a professional counsellor/psychologist can help to prevent the likelihood of suicide.
What is Schizophrenic Disorders and state its symptoms?
Schizophrenia is the descriptive term for a group of psychotic disorders in which personal, social and occupational functioning deteriorate as a result of disturbed thought processes, strange perceptions, unusual emotional states, and motor abnormalities. It is a debilitating disorder. The social and psychological costs of schizophrenia are tremendous, both to patients as well as to their families and society.
Symptoms of Schizophrenia:
The symptoms of schizophrenia can be grouped into three categories, viz. positive symptoms (i.e. excesses of thought, emotion and behaviour), negative symptoms (i.e. deficits of thought, emotion, and behaviour) and psychomotor symptoms.
Positive symptoms are ‘pathological excesses’ or ‘bizarre addition?’ to a person’s behaviour. Delusions, disorganised thinking and speech, heightened perception and hallucinations, and inappropriate effects are the ones most often found in schizophrenia. Many people with schizophrenia develop delusions. A delusion is a false belief that is firmly held on inadequate grounds. It is not affected by rational argument and has no basis in reality.
Delusions of persecution:
Delusions of persecution are the most common in schizophrenia. People with this delusion believe that they are being plotted against, spied on, slandered, threatened, attacked Or deliberately victimised. People with schizophrenia may also experience delusions of reference in which they attach special and personal meaning to the actions of others or to objects and events.
Delusions of grandeur:
In delusions of grandeur, people believe themselves to be specially empowered persons and in delusions of control, they believe that their feelings, thoughts and actions are controlled by others. People with schizophrenia may not be able to think logically and may speak in peculiar ways. These formal thought disorders can make communication extremely difficult.
These include rapidly shifting from one topic to another so that the normal structure of thinking is muddled and becomes illogical (loosening of associations, derailment), inventing new words or phrases (neologisms), and persistent aid inappropriate repetition of the same thoughts (perseveration). Schizophrenics may have hallucinations, i. e. perceptions that occur in the absence of external stimuli.
Auditory hallucinations are most common in schizophrenia. Patients hear sounds or voices that speak words, phrases and sentences directly to the patient (second-person hallucination) or talk to one another referring/to the patient as s/he (third-person hallucination). Hallucinations can also involve the other senses.
These include tactile hallucinations (i.e. forms of tingling, burning), somatic hallucinations (i.e. something happening inside the body such as a snake crawling inside one’s stomach), visual hallucinations (i.e. vague perceptions of colour or distinct visions of people or objects), gustatory hallucinations (i.e. food or drink taste strange), and olfactory hallucinations (i.e. smell of poison or smoke). People with schizophrenia also show inappropriate effects, i.e’. emotions that are unsuited to the situation.
Negative symptoms are ‘pathological deficits’ and include poverty of speech, blunted and flat affect, loss of volition, and social withdrawal. People with schizophrenia show alogia or poverty of speech, i.e. a reduction in speech and speech content, felony people with schizophrenia show less anger, sadness, joy, and other feelings than most people do. Thus they have blunted effect Some show no emotions at all, a condition is known as flat affect. Also, patients with schizophrenia experience avolition or apathy and an inability to start or complete a course of action.
People with this disorder may withdraw socially and become totally focused on their own ideas and fantasies. People with schizophrenia also show psychomotor Symptoms. They move less spontaneously or make odd grimaces and gestures. These symptoms may take extreme forms known as catatonia. People in a catatonic stupor remain motionless and silent for long stretches of time. Some show catatonic rigidity, i.e. maintaining a rigid, upright posture for hours. Others exhibit catatonic posturing, i.e. assuming awkward, bizarre positions for long periods.
Write the: Sub-types of Schizophrenia.
According to DSM-IV-TR, the sub-types of schizophrenia and their characteristics are:
- Paranoid type :
Preoccupation with delusions or auditory hallucinations; no disorganised speech or behaviour or inappropriate affect.
- Disorganised type:
Disorganised speech and behaviour; inappropriate or flat affect; no catatonic symptoms.
- Catatonic type :
Extreme motor immobility; excessive motor inactivity; extreme negativism (i.e. resistance to instructions) or mutism (i.e. refusing to speak).
- Undifferentiated type :
Does not fit any of the sub-types but meets symptom criteria.
- Residua] type:
Has experienced at least one episode of schizophrenia; no positive symptoms but shows negative symptoms.
What is Behavioural and Developmental Disorders?
There are certain disorders that are specific to children and if neglected can lead to serious consequences later in life. Children have less self-understanding and they have not yet developed a stable sense of identity nor do they have an adequate frame of reference regarding reality, possibility and value. As a result, they are unable to cope with stressful events which might be reflected in behavioural and emotional problems.
On the other hand, although their inexperience and lack of self-sufficiency make them easily upset by problems that seem minor to an adult, children typically bounce back more quickly. We will now discuss several disorders of childhood like Attention-deficit Hyperactivity Disorder (ADHD), Conduct Disorder, and Separation Anxiety Disorder. These disorders, if not attended to, can lead to more serious and chronic disorders as the child moves into adulthood.
Classification of children’s disorders has followed a different path than that of adult disorders. Achenbach has identified two factors, i.e. extermination and internalisation, which include the majority of childhood behaviour problems. The externalising disorders, or under-controlled problems, include behaviours that are disruptive and often aggressive and aversive to others in the child’s environment.
Internalising disorders, or overcontrolled problems, are those conditions where the child experiences depression, anxiety, and discomfort that may not be evident to others. There are several disorders in which children display disruptive or externalising behaviours. We will now focus on three prominent disorders, viz. Attention-deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder.
The two main features of (ADHD) are inattention and hyperactivity-impulsivity. 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 disorganised, easily distracted, forgetful, does not finish assignments and is quick, to lose interest in boring activities.
Children who are impulsive seem unable to control their immediate reactions or to think before they act. They find it difficult to wait or take turns and have difficulty resisting immediate temptations or delaying gratification. Minor mishaps such as knocking things over are common whereas more serious accidents and injuries can also occur. Hyperactivity also takes many forms. Children with (ADHD) are in constant motion. Sitting still 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 talking incessantly. Boys are four times more likely to be given this diagnosis than girls. Children with Oppositional Defiant Disorder (ODD) display age-inappropriate amounts of stubbornness, are irritable, defiant, disobedient, and behave in a hostile manner. Unlike ADHD, the rates of ODD in boys and girls are not very different.
The terms Conduct Disorder and Antisocial Behaviour refer to age-inappropriate actions and attitudes that violate family expectations, societal norms, and the personal or property rights of others. 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 deceitfulness or theft, and serious rule violations.
Children show many different types of aggressive behaviour, such as verbal aggression (i.e. name-calling, swearing), physical aggression (i.e. hitting, fighting), hostile aggression (i.e. directed at inflicting injury to others) and proactive aggression (i.e. dominating and bullying others without provocation). Internalising disorders include Separation Anxiety Disorder (SAD) and Depression. Separation anxiety disorder is an internalising disorder unique to children.
Its most prominent symptom is excessive anxiety or even panic experienced by children at being separated from their parents. Children with SAD may have difficulty being in a room by themselves, going to school alone, are fearful of entering hew 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.
The ways in which children express and experience depression are related to their level of physical, emotional, and cognitive development. An infant may show sadness by being passive and unresponsive; a pre¬schooler may appear withdrawn and inhibited; a school-age child may be argumentative and combative, and a teenager may express feelings of guilt and hopelessness. Children may also have more serious disorders called Pervasive Developmental Disorders.
These disorders are characterised by severe and widespread impairments in social interaction and communication skills, and stereotyped patterns of behaviours, interests and activities. Autistic disorder or autism is one of the most common of these disorders. Children with autistic disorder have marked difficulties in social interaction and communication a restricted range of interests, and a strong desire for routine.
About 70 per cent of children with autism are also mentally retarded. Children with autism experience profound difficulties in relating to other people. They are unable to initiate social behaviour and seem unresponsive to other people’s feelings. They are unable to share experiences or emotions with others. They also show serious abnormalities in communication and language that persist over time.
Many autistic children never develop speech and those who do, have repetitive and deviant speech patterns. Children with autism often show narrow patterns of interest and repetitive behaviours such as lining up objects or stereotyped body movements such as rocking. These motor movements may be self-stimulatory such as hand flapping or self-injurious such as banging their head against the wall.
What is Substance-use Disorders?
Addictive behaviour, whether it involves excessive intake of high-calorie food resulting in extreme obesity or involving the abuse of substances such as alcohol or cocaine, is one of the most severe problems being faced by society today. 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 heroin, which alter the way people think, feel and behave. There are two sub-groups of substance-use disorders, i.e. those related to substance dependence and those related to substance abuse.
In substance dependence, there is an intense craving for the substance to which the person is addicted, and 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.
In substance abuse, there are recurrent and significant adverse consequences related to the use of substances. People who regularly ingest drugs damage their family and social relationships, perform poorly at work and create physical hazards. We will now focus on the three most common forms of substance abuse, viz. alcohol abuse and dependence, heroin abuse and dependence and cocaine abuse and dependence.
Alcohol Abuse and Dependence People who abuse alcohol drink large amounts regularly and rely on it to help 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 and stopping it results in feelings of depression, fatigue, sleep problems, irritability and anxiety. Cocaine poses serious dangers. It has dangerous effects on psychological functioning and physical well-being.
Describe the nature and scope of psychotherapy. Highlight the importance of therapeutic relationships in psychotherapy.
Nature and scope of psychotherapy: Psychotherapy is a voluntary relationship between the one seeking treatment or the client and the one who treats or the therapist. The purpose of the relationship is to help the client to solve the psychological problems faces by her or him. The relationship is conducive for building the trust of the client so that problems may be freely discussed.
Psychotherapies aim at changing maladaptive behaviours, decreasing the sense of personal distress and helping the client to adapt better to her/his environment. The inadequate marital, occupational and social adjustment also requires that major changes be made in an individual’s personal environment.
AH, psychotherapies aim at a few or all of the following goals :
- Reinforcing the client’s resolve for betterment.
- Lessening emotional pressure.
- Unfolding the potential for positive growth.
- Modifying habits,
- Changing thinking patterns.
- Increasing self-awareness.
- Improving interpersonal relations and communication.
- Facilitating decision-making.
- Becoming aware of one’s choices in life.
Relating to one’s social environment in a more creative and self-aware manner. The special relationship between the client and the therapist is known as the
therapeutic relationship or alliance.
There are two major components of a therapeutic alliance:
- The first component is the contractual nature of the relationship in which two willing individuals, the client and the therapist, enter into a partnership that aims at helping the client overcome her/his problems.
- The second component of the therapeutic alliance is the limited duration of the therapy. This alliance lasts until the client becomes able to deal with her/his problems and take control of her/his life.
This relationship has several unique properties. It is a trusting and confiding relationship. The high level of trust enables the client to unburden herself/himself to the therapist and confide her/his psychological and personal problems to the latter. The therapist encourages this by being accepting, empathic, genuine, and warm to the client.
The therapist conveys by her/his words and behaviours that she is not judging the client and will continue to show the same positive feelings towards the client even if the client is rude or confides in all the wrong things that she may have done or thought about. The therapeutic alliance also requires that the therapist must keep strict confidentiality of the experiences, events, feelings, or thoughts disclosed by the client. The therapist must not exploit the trust and confidence of the Client in any way.