Psychological Disorders Class 12 NCERT Solutions

Concept used. Depression and mania are the two opposite poles of mood. In a major depressive disorder, mood is lowered, with loss of interest or pleasure in most activities. In mania, mood is abnormally raised, with a burst of energy and activity. Bipolar I disorder shows both poles in turn. So the symptoms of one are almost a mirror image of the other.

Symptoms of depression. A person going through major depression usually shows:

1. Core mood. A depressed, sad mood and loss of interest or pleasure in almost all activities (this pair is the heart of the disorder).
2. Body. Change in body weight (eating much more or much less) and constant sleep problems (sleeping too little or too much).
3. Energy and movement. Tiredness and loss of energy, with either agitation (restlessness) or greatly slowed-down behaviour.
4. Thinking. Inability to think or concentrate clearly.
5. Self-view and danger. Excessive guilt or feelings of worthlessness, and repeated thoughts of death and suicide.

Symptoms of mania. Mania is the high pole and looks almost opposite to depression. A person in a manic episode:

• feels euphoric, that is, abnormally cheerful or "high",
• becomes extremely active and full of energy,
• is excessively talkative,
• is easily distracted and jumps from one plan to another.

Manic episodes rarely come alone. They usually alternate with depression, which is why this pattern was once called manic-depressive disorder and is now called bipolar disorder.

Depression: low mood, loss of interest, weight and sleep change, fatigue, poor concentration, guilt, suicidal thoughts. Mania: euphoria, over-activity, over-talkativeness, distractibility.

Concept used. Hyperactivity is a main feature of Attention-Deficit/Hyperactivity Disorder (ADHD), a neurodevelopmental disorder that shows up in early childhood, usually before or just after the child starts school. ADHD has two main features: inattention and hyperactivity-impulsivity. A hyperactive child is restless in body, impulsive in action, and unable to keep attention on one thing.

Inattention. Children who are inattentive find it hard to keep mental effort going during work or play. Common complaints from parents and teachers are that the child:

• does not listen and cannot concentrate,
• does not follow instructions,
• is disorganised, easily distracted and forgetful,
• does not finish assignments,
• loses interest quickly in any boring activity.

Hyperactivity and impulsivity. The hyperactive-impulsive side shows in the body and in self-control:

• the child is in constant motion and cannot sit still through a lesson,
• they fidget, squirm, climb and run around the room aimlessly,
• they are described as "driven by a motor", always on the go, and talk incessantly,
• being impulsive, they cannot control immediate reactions or think before acting,
• they find it hard to wait, take turns or delay gratification,
• minor mishaps like knocking things over are common, and more serious accidents and injuries can also happen.

A hyperactive child (ADHD) shows inattention (poor concentration, distractibility, unfinished work) and hyperactivity-impulsivity (constant movement, fidgeting, "driven by a motor", inability to wait or think before acting).

Concept used. Alcohol addiction is a substance-related and addictive disorder. People who abuse alcohol drink large amounts regularly and lean on it to cope with difficult situations. Over time the body and mind get used to it, which leads to two key changes:

1. Tolerance: the body adjusts, so the person needs to drink greater and greater amounts to feel the same effect.
2. Withdrawal: when the person stops drinking, the body reacts with unpleasant withdrawal responses.

Consequences for the individual. Drinking starts to interfere with the person's social behaviour and with their ability to think and work. Excessive drinking can seriously damage physical health. Ethyl alcohol acts on the central nervous system, where it slows down brain functioning, impairs judgment, blurs vision and disturbs memory and motor control.

Consequences for the family and society. Alcoholism does not stop at the drinker:

• it destroys millions of families, social relationships and careers,
• intoxicated drivers cause many road accidents,
• it has serious effects on the children of people with this disorder. These children have higher rates of psychological problems, especially anxiety, depression, phobias and substance-related disorders.

Alcohol addiction leads to tolerance and withdrawal, damages the person's health, judgment and work, and harms society through wrecked families, road accidents and a higher rate of psychological problems in the drinker's children.

Concept used. A distorted body image means a person sees their own body very differently from how it really is, usually seeing themselves as overweight when they are not. Feeding and eating disorders are conditions in which eating behaviour becomes seriously disturbed. Yes, a distorted body image can lead to an eating disorder. It is the central feature of anorexia nervosa, where the wrong self-image drives the person to starve themselves.

The three forms of eating disorder. NCERT classifies eating disorders into three types.

1. Anorexia nervosa: the person has a distorted body image and sees themselves as overweight. They often refuse to eat, exercise compulsively, and develop unusual habits such as refusing to eat in front of others. They may lose large amounts of weight and can even starve themselves to death.
2. Bulimia nervosa: the person eats excessive amounts of food (a binge) and then purges the body of it, by using laxatives, diuretics, or by vomiting. They often feel disgusted and ashamed when bingeing, and feel relieved of tension and negative emotions after purging.
3. Binge eating: there are frequent episodes of out-of-control eating. The person eats faster than normal and keeps eating until uncomfortably full. Large amounts of food may be eaten even when the person is not hungry. (Note: there is no purging here, unlike in bulimia.)

Yes. A distorted body image is the core of anorexia nervosa. Eating disorders are classified as anorexia nervosa (refusal to eat, starvation), bulimia nervosa (binge then purge), and binge eating (out-of-control eating without purging).

Concept used. A physician diagnoses a physical illness by examining visible bodily symptoms and lab tests. Psychological disorders cannot always be seen on the body, so they are diagnosed by matching a person's pattern of thoughts, feelings and behaviour against an agreed classification system. A classification is a list of disorders grouped into classes on the basis of shared characteristics. It lets psychologists, psychiatrists and social workers communicate with one another and understand the causes and course of a disorder.

The two main classification systems. Diagnosis rests on two official manuals.

1. The DSM (Diagnostic and Statistical Manual of Mental Disorders), published by the American Psychiatric Association (APA). The current version is DSM-5. It lays out discrete clinical criteria that indicate the presence or absence of each disorder.
2. The ICD (International Classification of Diseases), prepared by the World Health Organisation (WHO) and used officially in India. The latest revision is ICD-11. For each disorder it gives a description of the main clinical features (symptoms) and diagnostic guidelines.

How the diagnosis is actually made. The clinician collects the person's symptoms, then checks whether they match the listed criteria for a particular disorder. The behaviour is also judged against the four Ds: is it deviant, distressing, dysfunctional and dangerous? The same behaviour can be normal in one situation and abnormal in another, so context matters. For example, talking to yourself is normal if you are praying.

Psychological disorders are diagnosed by matching the person's thoughts, feelings and behaviour against the clinical criteria of a classification system: DSM-5 (APA) and ICD-11 (WHO), and by judging the behaviour on the four Ds.

Concept used. Both obsessions and compulsions are features of obsessive-compulsive disorder (OCD), in which a person cannot control their preoccupation with certain ideas, or cannot stop themselves from repeating certain acts, to the point that normal life is disturbed. The difference is that an obsession is about thought, while a compulsion is about action.

Obsessions (the thought side). Obsessive behaviour is the inability to stop thinking about a particular idea or topic. The person:

• keeps having the same thought or image again and again,
• finds these thoughts unpleasant and shameful,
• cannot push them out of the mind even though they want to.

Compulsions (the action side). Compulsive behaviour is the need to perform certain behaviours over and over again. The person:

• feels driven to repeat an act or series of acts,
• often does it in a fixed, ritual way,
• commonly deals with counting, ordering, checking, touching and washing.

In short, the obsession is the unwanted thought that creates anxiety, and the compulsion is the repeated action the person carries out to reduce that anxiety. For example, an obsessive fear of germs (thought) may lead to compulsive hand-washing (action).

An obsession is a repeated, unwanted and distressing thought; a compulsion is a repeated, irresistible action (counting, checking, washing). The thought causes anxiety; the action tries to relieve it.

Concept used. The word "abnormal" literally means "away from the normal", so it implies a deviation from clearly defined norms. But deviance by itself is not enough to call behaviour abnormal. NCERT gives two basic views, and judging real abnormality needs the four Ds: deviance, distress, dysfunction and danger. So a long-standing deviant pattern can be considered abnormal, but only when it also meets these other tests.

View 1: abnormal as deviation from social norms. Every society has norms, which are stated or unstated rules for proper conduct. Behaviours, thoughts and emotions that break these norms are called abnormal. But this view has a serious problem:

1. Norms keep shifting. Norms grow from a society's culture, history and values, and these change over time.
2. Same act, different verdict. So the same behaviour can be "abnormal" in one culture or era and accepted in another.
3. A hidden wrong assumption. It assumes that whatever society accepts is normal, and that normality is just conformity.

View 2: abnormal as maladaptive. Many psychologists say the better test is not whether society accepts the behaviour, but whether it fosters the well-being of the person and the group. By this view, even conforming behaviour can be abnormal if it is maladaptive, that is, if it interferes with the person's healthy functioning and growth.

Bringing it together. A long-standing deviant pattern is considered abnormal when it is also distressing, dysfunctional and possibly dangerous, not just different. Deviance alone is not abnormality. A behaviour that breaks a norm but is harmless and adaptive (for example, an artist's unusual lifestyle) need not be a disorder.

Yes, but only when the deviant pattern is also distressing, dysfunctional and dangerous (the four Ds) and is maladaptive, that is, it harms the person's well-being and growth. Deviance from norms alone is not abnormality.

Concept used. Schizophrenia is a group of psychotic disorders in which personal, social and occupational functioning break down because of disturbed thought, strange perceptions, unusual emotions and motor abnormalities. Its symptoms fall into three groups: positive symptoms (pathological excesses or "bizarre additions"), negative symptoms (pathological deficits), and psychomotor symptoms.

Answering the given case. Changing topics frequently while speaking is a positive symptom. It is a formal thought disorder called loosening of associations (or derailment), where the person shifts rapidly from one topic to another so the normal structure of thinking becomes muddled and illogical. It is an excess or disorder added to behaviour, so it belongs to the positive group, not the negative one.

Other positive symptoms. These are bizarre additions to behaviour:

1. Delusions: false beliefs firmly held on inadequate grounds, not changed by reason. Types include delusions of persecution (most common), reference, grandeur and control.
2. Other disorganised thinking and speech: inventing new words (neologisms) and repeating the same thoughts (perseveration).
3. Hallucinations: perceptions without any external stimulus. Auditory hallucinations (hearing voices) are most common; there are also visual, tactile, somatic, gustatory and olfactory types.
4. Inappropriate affect: emotions that do not suit the situation.

Negative symptoms. These are pathological deficits:

• alogia or poverty of speech (reduced speech and content),
• blunted affect (less emotion than normal) and flat affect (no emotion at all),
• loss of volition or avolition (apathy, inability to start or finish actions),
• social withdrawal.

Psychomotor symptoms. The person moves less, or makes odd grimaces and gestures. In extreme form this is catatonia: catatonic stupor (motionless and silent), catatonic rigidity (a rigid upright posture for hours), and catatonic posturing (awkward, bizarre positions).

Frequently changing topics is a positive symptom (loosening of associations). Other symptoms: positive (delusions, hallucinations, disorganised speech, inappropriate affect), negative (poverty of speech, flat or blunted affect, avolition, social withdrawal), and psychomotor (catatonia).

Concept used. Dissociation can be viewed as a severance, that is, a cutting off, of the connections between ideas and emotions. It involves feelings of unreality, estrangement, depersonalisation, and sometimes a loss or shift of identity. The defining feature of dissociative disorders is sudden, temporary alterations of consciousness that blot out painful experiences.

Forms of dissociative disorders. NCERT lists the following forms.

1. Dissociative amnesia: extensive but selective memory loss with no known organic cause (such as a head injury). Some people cannot recall anything about their past; others lose only specific events, people or places, while other memories stay intact.
2. Dissociative fugue: a part of dissociative amnesia. Its essential feature is an unexpected travel away from home and workplace, the assumption of a new identity, and an inability to recall the previous identity. The fugue usually ends when the person suddenly "wakes up" with no memory of what happened. It is often linked to overwhelming stress.
3. Dissociative identity disorder (multiple personality): the most dramatic form. The person assumes two or more separate and contrasting personalities (alternate personalities) that may or may not be aware of each other. It is often linked to traumatic experiences, such as abuse, in childhood.
4. Depersonalisation/Derealisation disorder: a dreamlike state in which the person feels separated both from the self and from reality. In depersonalisation the person's self-perception changes and their sense of reality is temporarily lost or altered.

Dissociation is a severance of the link between ideas and emotions, with feelings of unreality and loss of identity. Its forms are dissociative amnesia (and fugue), dissociative identity disorder, and depersonalisation/derealisation disorder.

Concept used. Phobias are irrational fears related to specific objects, people or situations. People with phobias know the fear is out of proportion, but cannot control it. Phobias often develop gradually or begin with a generalised anxiety disorder, and they fall into three main types: specific phobias, social phobias (social anxiety disorder), and agoraphobia. A fear of snakes is a specific phobia, the most common type, which includes intense fear of a certain kind of animal.

Can it come from faulty learning? Yes. The behavioural model states that both normal and abnormal behaviours are learned, and that psychological disorders result from learning maladaptive ways of behaving. What has been learned can also be unlearned. Learning happens through:

1. classical conditioning: two events that repeatedly occur close together in time become linked,
2. operant conditioning: a behaviour is shaped by the reward that follows it,
3. social learning: learning by imitating others' behaviour.

How the snake phobia could develop. The fear can grow through these learning routes.

• By classical conditioning: if a person once had a frightening encounter with a snake (a painful or scary event paired with the sight of a snake), the snake alone later triggers fear, because the two were linked in time.
• By social learning: a child who repeatedly sees a parent scream and run away from snakes may imitate that reaction and learn to fear snakes too, even without a direct bad experience.
• By operant conditioning: every time the person avoids a snake, the anxiety drops, and that relief acts as a reward. The avoidance is reinforced, so the phobia is maintained.

Phobias are irrational fears of specific objects, people or situations (specific, social, agoraphobia). A snake phobia is a specific phobia and can result from faulty learning: classical conditioning (a scary pairing), social learning (imitating a fearful model), and operant conditioning (avoidance rewarded by relief).

Concept used. Anxiety is usually defined as a diffuse, vague, very unpleasant feeling of fear and apprehension. A certain amount of anxiety is normal and even useful, for example, before an exam or a performance it motivates us to do well. The key is to know when this normal feeling crosses over into a disorder.

When anxiety becomes a disorder. Anxiety becomes a disorder when the levels of anxiety are high, distressing, and interfere with effective functioning. At that stage it is no longer the helpful "butterflies in the stomach" feeling but an anxiety disorder, the most common category of psychological disorders. The anxious person also shows physical signs such as rapid heart rate, shortness of breath, sweating, dizziness, sleeplessness and tremors.

Types of anxiety disorders. NCERT discusses these main types.

1. Generalised anxiety disorder (GAD): prolonged, vague, unexplained and intense fears that are not attached to any particular object. It is marked by worry, hypervigilance (constantly scanning the environment for danger) and motor tension (restless, unable to relax, shaky).
2. Panic disorder: recurrent anxiety attacks of intense terror. A panic attack is an abrupt surge of anxiety, with shortness of breath, dizziness, trembling, palpitations, choking, nausea, chest pain, and a fear of going crazy, losing control or dying.
3. Phobias: irrational fears of specific objects, people or situations. They are of three kinds: specific phobias, social phobias (social anxiety disorder), and agoraphobia (fear of entering unfamiliar situations or leaving home).
4. Separation anxiety disorder (SAD): being fearful and anxious about separation from attachment figures to a degree that is not appropriate for the person's age. Children may refuse to be alone, cling to parents, throw tantrums, or make suicidal gestures to avoid separation.

Anxiety becomes a disorder when it grows high, distressing and interferes with effective functioning. Its types are generalised anxiety disorder, panic disorder, phobias (specific, social, agoraphobia), and separation anxiety disorder.