NCERT Solutions for Class 12 Psychology Chapter 4: Psychological Disorders

Chapter at a glance

Exercises

Answer

Depression (Major Depressive Disorder) – a period of at least two weeks with: 1. Depressed (sad, low) mood most of the day, nearly every day. 2. Loss of interest or pleasure in usual activities (anhedonia). 3. Significant change in body weight (loss or gain) and appetite. 4. Sleep disturbances – insomnia or excessive sleep. 5. Psychomotor agitation or retardation; fatigue and loss of energy. 6. Feelings of worthlessness or excessive guilt. 7. Inability to think or concentrate; indecisiveness. 8. Recurrent thoughts of death and suicide.

Mania – the opposite pole: 1. Elevated, euphoric (extremely happy) or irritable mood. 2. Inflated self-esteem or grandiosity. 3. Decreased need for sleep. 4. Being more talkative than usual; pressure of speech. 5. Flight of ideas – rapidly jumping from topic to topic; racing thoughts. 6. Distractibility. 7. Excessive activity, restlessness; involvement in risky activities (spending sprees, reckless driving, poor judgment).

People who experience mania alternating with depression suffer from bipolar and related disorders (bipolar I disorder, earlier called manic-depressive disorder). Mania alone is rare.

Depression: persistent sad mood, loss of interest/pleasure, change in weight and sleep, fatigue, worthlessness/guilt, poor concentration and suicidal thoughts. Mania: euphoric or irritable mood, grandiosity, little need for sleep, excessive talk, flight of ideas, distractibility, hyperactivity and risky behaviour (alternating with depression in bipolar disorder).

Answer

Attention-Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder of childhood, with two main features: inattention and hyperactivity-impulsivity. It is more common in boys.

1. Inattention: - Find it difficult to sustain mental effort during work or play. - Have trouble keeping their minds on any one thing or in following instructions. - Get bored with a task after a few minutes; easily distracted. - Disorganised; lose things, forget routines; do not seem to listen. - Do not finish tasks.

2. Hyperactivity: - Always on the go, constantly in motion — fidgeting, squirming, climbing, running around the room aimlessly. - Sitting still through a lesson is impossible; they talk excessively. - Parents and teachers say they have “a motor that never stops”.

3. Impulsivity: - Unable to control their immediate reactions or to think before they act. - Find it difficult to wait or take turns; blurt out answers. - Interrupt others, act without thinking of consequences; prone to accidents.

Consequences: poor school performance, difficulties with peers (may be disliked), low self-esteem; problems often continue into adolescence and adulthood.

Children with ADHD show inattention (easily distracted, can’t sustain effort or follow instructions, disorganised), hyperactivity (constantly moving, fidgeting, talking excessively) and impulsivity (act without thinking, can’t wait their turn, interrupt), leading to poor school performance and peer problems.

Answer

Substance-related and addictive disorders involve excessive and maladaptive use of a substance (alcohol, tobacco, heroin, cocaine, cannabis). Alcohol is one of the most commonly abused substances.

Consequences of alcohol addiction

1. Physical health

• Damage to the liver (cirrhosis), brain, heart and stomach; high blood pressure.
  • Malnutrition – alcohol provides calories but no nutrients; vitamin B deficiency can cause memory disorders (Korsakoff’s syndrome).
  • Weakened immunity; increased risk of cancers.
  • Foetal alcohol syndrome in children of mothers who drink during pregnancy.

2. Psychological

• Tolerance (need for more to get the same effect) and withdrawal symptoms (tremors, anxiety, hallucinations).
  • Impaired judgment, memory loss, blackouts; depression, anxiety; risk of suicide.

3. Social and family life

• Damage to family relationships; neglect of family; domestic violence.
  • Children of alcoholics may suffer emotional problems.

4. Occupational/economic

• Poor job performance, absenteeism, loss of job; financial problems.

5. Legal and safety

• Accidents (drunken driving), violence, crime, legal problems.

Thus, people who abuse alcohol drink large amounts regularly and rely on it to face difficult situations; eventually drinking interferes with their social behaviour, ability to think and work.

Alcohol addiction causes physical damage (liver cirrhosis, brain and heart damage, malnutrition, foetal alcohol syndrome), psychological problems (tolerance, withdrawal, memory loss, depression), family breakdown and violence, loss of job and money, and accidents, crime and legal trouble.

Answer

Yes. A distorted body image — seeing oneself as fat or overweight even when one is thin — can lead to feeding and eating disorders. Cultural ideals of thinness (in films, fashion, social media) and the desire to be attractive increase the risk, especially among adolescent girls and young women.

Forms of eating disorders

1. Anorexia nervosa – the person has a distorted body image and sees herself/himself as overweight; often refuses to eat, exercises compulsively and develops unusual habits such as refusing to eat in front of others; loses large amounts of weight and may even starve to death.
2. Bulimia nervosa – the person may eat excessive amounts of food (binge), then purge the body by using medicines such as laxatives or diuretics or by vomiting. The person feels disgusted and ashamed when binging and relieved of tension and negative emotions after purging.
3. Binge eating disorder – frequent episodes of out-of-control eating; the person tends to eat at a higher speed than normal and continues eating until uncomfortably full, even when not hungry — but without purging.

Yes — a distorted body image (seeing oneself as fat despite being thin) can lead to eating disorders: anorexia nervosa (refusing to eat, excessive weight loss), bulimia nervosa (binging followed by purging), and binge eating disorder (frequent out-of-control eating without purging).

Answer

Unlike physical illnesses, psychological disorders usually have no single physical test (like a blood test). They are diagnosed by classification systems that list symptoms and criteria, and by careful assessment.

1. Classification systems: - DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) of the American Psychiatric Association – evaluates the patient on the basis of clinically meaningful aspects of behaviour; lists each disorder with specific symptoms, duration and criteria that must be met. - ICD-10 (International Classification of Diseases, Chapter V on Mental and Behavioural Disorders) of the World Health Organisation – each disorder has a description of clinical features, other associated features and diagnostic guidelines.

2. Assessment procedures used by clinicians: - Clinical interview and case history – symptoms, their duration, onset, family history, personal history. - Observation of behaviour, mood, speech and thought. - Psychological tests – personality tests (MMPI), projective tests, intelligence tests, neuropsychological tests. - Medical/biological tests – brain scans, blood tests to rule out physical causes.

3. Criteria for abnormality – the four Ds: deviance (from social norms), distress (to the individual), dysfunction (interference with daily life) and danger (to self or others).

A diagnosis is given when the person’s symptoms match the criteria in DSM/ICD, last for the required duration and cause significant distress or impairment.

Psychological disorders are diagnosed by matching a person’s symptoms (from interviews, observation, case history and psychological tests, with medical tests to rule out physical causes) against standard criteria in classification systems such as DSM-5 (American Psychiatric Association) and ICD-10 (WHO), considering deviance, distress, dysfunction and danger.

Answer

Obsessive-compulsive disorder (OCD) involves obsessions and/or compulsions which the person is unable to control.

Often the two go together: an obsession produces anxiety, and the compulsion temporarily relieves it, which strengthens the cycle. The person usually recognises that the thoughts and actions are unreasonable but cannot control them. Related disorders include hoarding disorder, trichotillomania (hair-pulling) and excoriation (skin-picking).

Obsessions are persistent, unwanted thoughts, images or impulses (e.g. about germs) that cause anxiety; compulsions are repetitive behaviours (e.g. repeated hand-washing, checking) performed to reduce that anxiety. Obsessions are in thought, compulsions in action.

Answer

Not necessarily. A long-standing pattern of deviant behaviour may be considered abnormal only if it also meets other criteria of abnormality.

Why deviance alone is not enough

1. Deviance is relative – social norms differ across cultures and change over time. Behaviour seen as deviant in one culture may be normal in another (e.g. hearing voices may be accepted as a religious experience in some communities).
2. Positive deviance – creative geniuses, artists, saints and reformers deviate from norms in a positive way; their behaviour is unusual but not abnormal.
3. Non-conformity (unusual dress or lifestyle) is not a disorder by itself.

When it is considered abnormal – the four Ds: - Deviance – different, unusual, extreme or bizarre behaviour; - Distress – it causes suffering to the person; - Dysfunction – it interferes with the person’s ability to carry out daily activities (work, relationships); - Danger – it is dangerous to the person or others.

Long-standing, inflexible and maladaptive patterns of deviant behaviour that cause distress or impairment are considered abnormal — e.g. conduct disorder in children (aggression, destruction of property, deceitfulness, violation of rules) or personality disorders like antisocial personality in adults. Abnormal behaviour is generally maladaptive, i.e. it interferes with optimal functioning and growth.

Not by itself — deviance is relative to culture and time, and some deviance (creativity, reform) is positive. A long-standing deviant pattern is considered abnormal only when it is also distressing, dysfunctional/maladaptive or dangerous (the four Ds), as in conduct disorder or antisocial personality.

Answer

Frequently changing topics while speaking is derailment or loosening of associations — a form of formal thought disorder (disorganised thinking and speech). It is a positive symptom of schizophrenia (positive symptoms are excesses or bizarre additions to normal behaviour).

Symptoms of schizophrenia fall into three groups:

1. Positive symptoms – “pathological excesses”: - Delusions – false beliefs held firmly on inadequate grounds, not affected by rational argument: persecution (being plotted against), reference (attaching special personal meaning to others’ actions or objects), grandeur (believing oneself to be specially empowered), control (feelings, thoughts and actions are controlled by others). - Disorganised thinking and speech – loosening of associations/derailment, neologisms (inventing new words), perseveration (persistent repetition of words or thoughts). - Hallucinations – perceptions in the absence of external stimuli; auditory (most common — hearing voices), tactile, somatic, visual, gustatory, olfactory. - Inappropriate affect – emotions unsuited to the situation (e.g. laughing at sad news).

2. Negative symptoms – “pathological deficits”: - Alogia – poverty of speech; reduced speech and speech content. - Blunted and flat affect – showing less anger, sadness, joy; some show no emotions at all. - Avolition – apathy and inability to start or complete a course of action. - Social withdrawal – lack of social skills, withdrawal from others.

3. Psychomotor symptoms: - Move less spontaneously, make odd grimaces and gestures. - Catatonia – catatonic stupor (motionless and silent for long periods), catatonic rigidity (maintaining a rigid, upright posture for hours), catatonic posturing (assuming awkward, bizarre positions for long periods).

Changing topics frequently (derailment/loosening of associations) is a positive symptom. Other symptoms: positive — delusions, hallucinations, disorganised thinking (neologisms, perseveration), inappropriate affect; negative — alogia, flat affect, avolition, social withdrawal; psychomotor — odd gestures and catatonia (stupor, rigidity, posturing).

Answer

Dissociation can be viewed as a severance of the connections between ideas and emotions. It 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.

Forms of dissociative disorders

1. Dissociative amnesia – 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, usually associated with a highly stressful event.
2. Dissociative fugue (a feature of amnesia) – the person, along with memory loss, unexpectedly travels away from home and work, assumes a new identity and cannot recall the previous one. After recovery, s/he may not remember what happened during the fugue.
3. Dissociative identity disorder (earlier called multiple personality) – the most dramatic form; the person assumes alternate personalities that may or may not be aware of each other. Often associated with traumatic experiences in childhood.
4. Depersonalisation/derealisation disorder – a dreamlike state in which the person has a sense of being separated both from self and from reality. In depersonalisation, the person feels that her/his self is strange or unreal (e.g. watching oneself from outside); in derealisation, the external world seems unreal.

Dissociation is the severance of connections between ideas and emotions — feelings of unreality, estrangement or a shift of identity that blot out painful experiences. Forms: dissociative amnesia (selective memory loss, with or without fugue), dissociative identity disorder (alternate personalities), and depersonalisation/derealisation disorder (feeling detached from self or reality).

Answer

Phobias are irrational fears related to specific objects, people or situations. They often develop gradually or begin with a generalised anxiety disorder. Types: - Specific phobias – the most common type; irrational fears of specific objects or situations, e.g. fear of animals (snakes, cockroaches), heights, closed spaces. - Social anxiety disorder (social phobia) – intense fear and anxiety in social situations (e.g. speaking in public). - Agoraphobia – fear of entering unfamiliar situations; many avoid leaving home.

Yes, a fear of snakes can result from faulty learning. According to the behavioural model, abnormal behaviours are learned through conditioning:

1. Classical conditioning – a neutral stimulus (snake) becomes associated with a frightening experience. E.g. as a child, the person may have seen a snake at the same moment someone screamed or got bitten, or was frightened by a sudden fall. The snake (CS) paired with intense fear (UCR) becomes a conditioned stimulus that evokes fear (CR). The fear then generalises to all snakes, pictures of snakes, or even rope-like objects.
2. Operant conditioning – the person avoids snakes and places where snakes may be found; avoidance reduces anxiety, which is negatively reinforcing. Because the person never faces snakes, the fear is never extinguished and is maintained.
3. Observational learning (modelling) – the child may have watched a parent or sibling react with extreme fear to snakes, or seen frightening films and stories, and imitated the fear.
4. Cognitive factors – irrational beliefs (“all snakes are deadly”) and catastrophic thinking strengthen the fear.

There may also be a biological preparedness to fear snakes (evolutionarily dangerous), which makes such phobias easier to learn.

Treatment: systematic desensitisation (Wolpe) and modelling help unlearn the fear.

Phobias are irrational fears of specific objects, people or situations. A fear of snakes can be learned: through classical conditioning (snake paired with a frightening event, then generalised), maintained by operant conditioning (avoidance reduces anxiety and is reinforced), and through observational learning (imitating others’ fear), aided by irrational beliefs and biological preparedness.

Answer

Anxiety is a diffuse, vague, very unpleasant feeling of fear and apprehension, with symptoms like rapid heart rate, shortness of breath, diarrhoea, loss of appetite, fainting, dizziness, sweating, sleeplessness, frequent urination and tremors. Everyone feels some anxiety (e.g. before an exam) — this is normal and even helpful.

When it becomes a disorder: anxiety becomes a disorder when it is 1. excessive – out of proportion to the actual situation; 2. persistent – lasts for a long time (usually 6 months or more) or recurs; 3. uncontrollable – the person cannot control the worry; 4. interferes with daily functioning – work, studies, relationships; 5. occurs without a real threat or in harmless situations.

Types of anxiety disorders

1. Generalised anxiety disorder (GAD) – prolonged, vague, unexplained and intense fears not attached to any particular object; worry and apprehensive feelings about the future, hypervigilance (constantly scanning the environment for dangers), motor tension (inability to relax, restlessness, visible shakiness, muscle tension).
2. Panic disorder – recurrent anxiety (panic) attacks in which the person experiences intense terror; the attack comes suddenly whenever certain thoughts or situations arise; symptoms include shortness of breath, dizziness, trembling, palpitations, choking, nausea, chest pain, fear of going crazy, losing control or dying.
3. Phobias – irrational fears: specific phobias (animals, heights, enclosed spaces), social anxiety disorder (fear of social situations), agoraphobia (fear of unfamiliar situations, leaving home).
4. Separation anxiety disorder – (in children) fear and anxiety about separation from attachment figures, to a degree inappropriate for their age; the child may refuse to go to school, or have tantrums.

Related disorders are obsessive-compulsive disorder and post-traumatic stress disorder (now classified separately in DSM-5).

Anxiety becomes a disorder when it is excessive, persistent, uncontrollable, occurs without real threat and interferes with daily functioning. Types: generalised anxiety disorder, panic disorder, phobias (specific, social anxiety, agoraphobia) and separation anxiety disorder.

Question Project 1

Keep a small diary and jot down your emotional experiences over 3–4 days, noting when you felt happy or unhappy, joy, sadness, anger, irritation and other emotions, and the situations which elicited them.

Answer

Guidance

1. Diary format: Date | Time | Situation | Emotion | Intensity (1–5) | Duration | What I did.
2. Record at fixed points (waking up, school, with friends, returning home, bedtime) and whenever a strong emotion occurs.
3. Analysis after 3–4 days:
   • Which emotions were most frequent? When were the highs and lows?
   • Which situations/people triggered positive and negative moods?
   • How quickly did moods change and return to normal?
4. Interpretation: normal mood swings are brief, linked to situations and do not disrupt functioning — unlike mood disorders (depression, mania), which are prolonged and interfere with life.
5. Learning: understanding one’s own mood patterns helps in managing emotions (e.g. avoiding triggers, using relaxation).

Maintain a structured mood diary for 3–4 days, recording situations, emotions and intensity; analyse patterns and triggers, and note that normal mood fluctuations are brief and situational, unlike prolonged mood disorders.

Question Project 2

Studies have shown that current standards of physical attractiveness have contributed to eating disorders. Rate at least 10 people around you as Large, Average and Thin. Then look at the pictures of models and film stars in a magazine, and describe the magazine’s message about the normal or acceptable body. Does this view match what you see as normal body types in the general population?

Answer

Guidance

1. Rating: rate 10 people (family, friends, acquaintances — privately, without hurting anyone) as Large/Average/Thin; tabulate the numbers.
2. Magazine analysis: count pictures of models/stars as Large/Average/Thin; note the messages in ads and articles (diet, slimming products, “perfect figure”, fair skin, muscular male body).
3. Comparison: usually most people in the general population fall in the “average” category, whereas media images show mostly very thin women and very muscular men — an unrealistic and narrow ideal.
4. Discussion: such images can create a distorted body image and dissatisfaction, especially in adolescents, contributing to anorexia, bulimia and binge eating; promote healthy body image and acceptance of diverse body types.

Compare ratings of real people (mostly average) with media images (mostly very thin/muscular); the media’s narrow ideal does not match normal body types and can create a distorted body image that contributes to eating disorders.

Question Project 3

Make a list of movies, TV shows, or plays you have seen where a particular psychological disorder has been highlighted. Match the symptoms shown to the ones you have read. Prepare a report.

Answer

Sample list (Indian films)

Report: for each film, describe the character, list the symptoms shown, compare with textbook symptoms (DSM-5), and judge whether the portrayal is accurate, exaggerated or stigmatising; conclude on the role of media in creating awareness and reducing stigma.

List films (e.g. Taare Zameen Par — dyslexia, My Name is Khan — autism, 15 Park Avenue — schizophrenia, Bhool Bhulaiyaa — dissociative identity), compare the symptoms shown with textbook symptoms, and evaluate accuracy and stigma.

Topic checklist

• ☒ Concept and diagnosis of abnormality (Q 5, 7)
• ☒ Anxiety, OCD, phobias (Q 6, 10, 11)
• ☒ Dissociative, mood and schizophrenia (Q 1, 8, 9)
• ☒ Neurodevelopmental, eating and substance disorders (Q 2, 3, 4)
• ☒ Projects (P 1–3)

Total questions answered: 14 of 14