Test: Psychological Disorders- 2 - MCAT MCQ

Disorder refers to a state which affects an individual's mood, feeling, thinking, and behavior. It results in constant behavior patterns that affect the function of normal life and the elimination of purposeful functioning of cognition and emotions.
Key Points
Abnormal forgetting caused by mental and physical trauma is called amnesia as it is a disorder in which:

• one can't remember an event due to brain injury.
• one can't form new memories due to trauma or stress.
• one can't recall old memories due to ill-effect of alcohol.
• one can't recognize familiar faces due to traumatic events.

Hence, it could be concluded that abnormal forgetting caused by mental trauma and physical trauma is called amnesia.
Additional Information

• Fugue:- It refers to a form of amnesia in which individuals lose their memories either partially or totally.
• Deja vu:- It refers to a feeling which makes individuals feel that they have already experienced the present situation.
• Repression:- It refers to the practice of suppressing a desire or putting things into darkness.

Key Points

• When mental factors such as stress cause physical symptoms the condition is known as somatisation.
• Somatoform disorders are a severe form of somatisation where physical symptoms can cause great distress, often long-term.
• However, people with somatoform disorders are usually convinced that their symptoms have a physical cause.

For example, many people have occasional headaches caused by mental stress. But, stress and other mental health problems can cause many other.
Additional Information
Physical symptoms such as:

• Chest pains
• Tiredness
• Dizziness
• Back pain
• Feeling sick (nauseated)

Key Points
Entrepreneurial competencies are the skills and ability necessary for an entrepreneur to venture into an enterprise organize, and manage an enterprise ability and competently realize the goal for which the enterprise is established.
The following competencies are identified as facets of intelligence in the Indian tradition:

• Cognitive capacity: Sensitivity to context, understanding, discrimination, problem solving and effective communication.
• Social competence: Respect for social order, commitment to elders, the young and the needy concern about others, recognising others perspectives.
• Emotional competence: Self-regulation and self-monitoring of emotions, honesty politeness, good conduct and self-evaluation.
• Entrepreneurial competence: Commitment, persistence, patience, hard work, vigilance and goal-directed behaviours.

Eating disorder: It is a mental disorder in which there are disturbances when it comes to eating behavior, which leads to some sort of illness physically. It is categorized into three categories.

• Anorexia Nervosa: It is characterized by the perception in people find themselves overweight. The following are its characteristics and symptoms:
  • People usually eat too less and exercise too much.
  • This disorder is generally found in girls during adolescence.
  • People often check their weight, and find themselves overweight even if they are underweight.
  • Many die out of starvation, while there are cases in which it is found that some die due to suicide.
• Bulimia Nervosa: In this, people generally consume a large amount of food in a single attempt and it happens frequently. To offset this, people vomit, observe fast, and do excessive exercise.
• Binge Eating: It is similar to Bulimia Nervosa in the way that excessive eating takes place, however, there is no scope of compensation to digest the food. As a result, the person suffers from obesity or is overweight.

Hence, we conclude that the above-mentioned eating disorder in adolescence is known as Anorexia Nervosa.
Additional Information

• Developmental disorder: It refers to the severe, chronic disability of an individual that is likely to continue indefinitely. It affects the function of normal life and eliminations of purposeful functioning of cognition and emotions.
• Obsessive-Compulsive Neurosis: It is a kind of disorder in which individuals feel compelled to perform uncontrollable repetitive behaviours. In this disorder, individuals originate repeated thoughts that lead to compulsive behaviour.

A disorder could be defined as a set of problems, which result in causing significant difficulty, distress, impairment, and/or suffering in a person's daily life.
Key Points

• Anorexia-Nervosa often simply called anorexia is an eating disorder characterized by abnormally low body weight, an intense fear of gaining weight, and a distorted perception of weight.
• People with anorexia place a high value on controlling their weight and shape, using extreme efforts that tend to significantly interfere with their lives.
• To prevent weight gain or to continue losing weight, people with anorexia usually severely restrict the amount of food they eat.
• They may control calorie intake by vomiting after eating or by misusing laxatives, diet aids, diuretics, or enemas. 
• Anorexia isn't really about food. It's an extremely unhealthy and sometimes life-threatening way to try to cope with emotional problems.

Hence, it is clear that anorexia nervosa is an eating disorder.

Somatoform Disorders:
These are conditions in which there are physical symptoms in the absence of a 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. 

Important Points
Hypochondriasis

• It 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.

Key Points
Conversion disorder:

• 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.

Dissociative Disorders:

• Dissociation can be viewed as 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.

Agnosia:

• Agnosia is the general term for the inability, due to brain damage, to recognize previously familiar objects.
• At the highest level, then, it may be regarded as a deficit of the “what” system.
• Object recognition may also fail because of disruption to an earlier stage of processing.

Aphasia:

• It affects reading comprehension or speech production.
• A child speaks in short, fragmented phrases (expressive aphasia).
• Also, a child is not able to write, hence, it’s a language impairment.

Adipsia:

• Adipsia is a disease characterized by the absence of thirst even in the presence of body water depletion or salt excess.
• It is a rare condition that typically presents as hypernatremic dehydration.
• The cause is usually a hypothalamic lesion, which can be congenital or acquired.
• The term hypodipsia refers to a partial deficiency of the thirst mechanism.

Amnesia:

• Amnesia is a form of memory loss.
• Some people with amnesia have difficulty forming new memories. Others can't recall facts or past experiences.
• People with amnesia usually retain knowledge of their own identity, as well as motor skills.
• Mild memory loss is a normal part of aging.

Hence, The general term for the inability to recognize familiar objects is Agnosia.

Hallucination is a false perception that has a compulsive sense of the reality of objects although relevant and adequate stimuli for such perception are lacking. It is an abnormal phenomenon.
Types of hallucinations:

• Auditory hallucinations: 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).
• 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 color 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)

Schizophrenia 

• It involves a range of problems with thinking (cognition), behavior, and emotions. 
• Signs and symptoms may vary, but usually involve delusions, hallucinations, or disorganized speech, and reflect an impaired ability to function. Schizophrenia is a psychosis, a type of mental illness characterized by distortions in thinking, perception, emotions, language, sense of self, and behaviour.

Common experiences include:

• hallucination: hearing, seeing, or feeling things that are not there;
• delusion: fixed false beliefs or suspicions not shared by others in the person’s culture and that are firmly held even when there is evidence to the contrary;
• abnormal behaviour: disorganized behaviour such as wandering aimlessly, mumbling or laughing to self (self-talk), strange appearance, self-neglect, or appearing unkempt;
• disorganized speech: incoherent or irrelevant speech; and/or
• disturbances of emotions: marked apathy or disconnect between reported emotion and what is observed such as a facial expression or body language.

Paranoia:

• An unrealistic distrust of others or a feeling of being persecuted. Extreme degrees may be a sign of mental illness.
• Paranoia is the feeling that you're being threatened in some way, such as people watching you or acting against you, even though there's no proof that it's true.
• It happens to a lot of people at some point. Even when you know that your concerns aren't based in reality, they can be troubling if they happen too often.
• symptoms of paranoia include mistrust, hypervigilance, difficulty with forgiveness, defensive attitude in response to imagined criticism, preoccupation with hidden motives, fear of being deceived or taken advantage of, inability to relax, or are argumentative.

Myopia: 

• Nearsightedness (myopia) is a common vision condition in which you can see objects near to you clearly, but objects farther away are blurry.
• It occurs when the shape of your eye causes light rays to bend (refract) incorrectly, focusing images in front of your retina instead of on your retina.

Hysteria:

• It is mental instability, fits of rage, and anxiety; things that can actually happen when you are suffering from an illness or trauma.
• In 1980, hysteria was removed from medical texts as a disorder unto itself, but it has remained present as a symptom of the disease brought on by specific trauma, both physical and mental.
• Its symptoms include anxiety, shortness of breath, fainting, nervousness, sexual desire, insomnia, fluid retention, heaviness in the abdomen, irritability, loss of appetite for food or sex, (paradoxically) 

Key Points

• Agoraphobia is a type of anxiety disorder in which you fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed. You fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd.
• The anxiety is caused by fear that there's no easy way to escape or get help if the anxiety intensifies. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to worry about having another attack and avoid the places where it may happen again.
• People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. You may feel that you need a companion, such as a relative or friend, to go with you to public places. The fear can be so overwhelming that you may feel unable to leave your home.
• Agoraphobia treatment can be challenging because it usually means confronting your fears. But with psychotherapy and medications, you can escape the trap of agoraphobia and live a more enjoyable life.

Key Points

• Experiential intelligence is one component (experiential-creative) of the Triarchic theory of intelligence that was put forward by researcher Steinberg in 1985. 
• This theory holds that there are multiple components of intelligence that he referred to as multiple components, performance components, and knowledge-acquisition components. 
• These components are theorized to combine in various combinations to perform intellectual tasks such as perceiving problems in our long-term memory, perceiving relations between objects, and applying relations to another set of terms. 
• The experiential-creative component deals chiefly with how well a task is performed with regard to how familiar it is.
• For example, we all know that any task becomes easier with practice no matter how difficult it may have been the first time tried.

Autism Spectrum Disorder (ASD), a developmental disorder impairs the communication, self-regulation, and social interaction skills of an individual. Autism is a “spectrum condition” that affects people differently and to varying degrees.
Important Points
Characteristics of autism include:

• It is an early-onset disorder that is present from birth and can be diagnosed as early as 2 years of age in the developmental stage.
• Presence of repetitive patterns of behavior.
• Severe impairment in basic social skills.
• Problems or delay in the development of communication skills.
• Problems with non-verbal communication such as body language.
• Trouble in developing and maintaining relationships with others
• Avoiding eye contact with others.
• Under or overreaction to one or more of the five senses: sight, touch, taste, smell, or hearing.

Hence, it could be concluded that the problem in vision and hearing is not a characteristic of Autism Spectrum Disorder.

There are several psychological models that 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.

Psychodynamic model:

• 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.

Behavioural model:

• This model states that both normal and abnormal behaviors are learned and psychological disorders are the result of learning maladaptive ways of behaving.
• The model concentrates on behaviors 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.

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 make overgeneralizations, that is, they may draw broad, negative conclusions on the basis of a single insignificant event

Humanistic-existential model:

• It 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-actualize, i.e. to fulfill 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 dysfunction.

Hence, The psychological model that explains abnormal behavior in the light of learning maladaptive ways is Behavioural model.
Additional Information
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.

Autism spectrum disorder: Neurodevelopmental disorder beginning in infancy and involving a wide range of abnormalities, including deficits in language, perceptual, and motor development, defective reality testing, and social withdrawal.
Key Points
Characteristic of childhood Autism:

• A common characteristic seen in the speech of CWA is echolalia. Echolalia consists of repeating words and phrases or repeating what the other person says. 
• Children with autism spectrum disorder 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 of them never develop speech and those who do, have repetitive and deviant speech patterns.
• Such children often show narrow patterns of interests 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 (i.e Violent temper tantrums).
• Due to the nature of these difficulties in terms of verbal and non-verbal communication, individuals with autism spectrum disorder tend to experience difficulties in starting, maintaining and even understanding relationships.

Hence, Encopresis and overeating is not a characteristic of childhood Autism.

Phobia:

• A phobia is a morbid on pathological fear which the patient realizes to be absurd but nevertheless is unable to explain and overcome it.
• You might have met or 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

Additional Information
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 bipolar mood disorder.

Note: Paranoia is sub-type of schizophrenia.

Melancholia is a kind of depression with the most common symptoms of evident mental disorder, slimness, lack of enjoyment, feeling guilty, and having no appetite. In modern medicine, the word “melancholia” only refers to mental and affective symptoms of depression.
Organic disorder:

• An organic mental disorder is a previously used term to describe a dysfunction of the brain that was meant to exclude psychiatric disorders.
• It is currently known under the category of neurocognitive disorders.
• It describes reduced brain function due to illnesses that are not psychiatric in nature. 
• Sometimes the term organic mental disorder is used interchangeably with the terms organic brain syndrome (OBS), chronic organic brain syndrome, or neurocognitive disorder—this latter term is the one used more commonly now.

Functional disorder:

• Functional neurological disorder (FND) is a medical condition in which there is a problem with the functioning of the nervous system and how the brain and body sends and/or receives signals, rather than a structural disease process such as multiple sclerosis or stroke.
• FND can encompass a wide variety of neurological symptoms, such as limb weakness or seizures.
• FND is a condition at the interface between the specialties of neurology and psychiatry.
• Conventional tests such as MRI brain scans and EEGs are usually normal in patients with FND. 

Neurotic disorder:

• Neurosis refers to a class of functional mental disorder involving distress but not delusions or hallucinations, where behavior is not outside socially acceptable norms.
• It is also known as psychoneurosis or neurotic disorder.

Affective disorder:

• Affective disorders are illnesses that affect the way you think and feel.
• The symptoms may be quite severe. In most cases, they won't go away on their own.
• The most common affective disorders are depression and bipolar disorder.

​Hence, Melancholia comes under Affective disorder.