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Psychological Disorders

NCERT Class 12 · Psychology Based on NCERT Class 12 Psychology textbook · Free CBSE study kit

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Chapter Notes

Overview
This chapter introduces the concept of abnormality and psychological disorders, exploring the criteria (four Ds), historical perspectives, and classification systems (DSM-5 and ICD-10). It delves into the biological, psychological, and socio-cultural factors underlying abnormal behaviour, with a special focus on the diathesis-stress model. The major psychological disorders covered include anxiety disorders, obsessive-compulsive and related disorders, trauma- and stressor-related disorders, somatic symptom and related disorders, dissociative disorders, depressive disorders, bipolar and related disorders, schizophrenia spectrum and other psychotic disorders, neurodevelopmental disorders, disruptive/impulse-control/conduct disorders, feeding and eating disorders, and substance-related and addictive disorders. The one big idea a student must walk away with is that psychological disorders are not a sign of weakness or shame but are medical conditions influenced by a complex interplay of biological, psychological, and social factors, and they can be understood, classified, and treated.
Key Concepts (45)
Four Ds
The common features of most definitions of abnormality: deviance (different, extreme, unusual), distress (unpleasant and upsetting), dysfunction (interfering with daily activities), and danger (to self or others).
e.g. A person who refuses to leave home because of intense fear of open spaces shows deviance (unusual behaviour), distress (anxiety), dysfunction (cannot work or socialize), and potential danger (if forced to go out).
Abnormal Psychology
The area within psychology focused on maladaptive behaviour – its causes, consequences, and treatment.
e.g. A psychologist studying why a student develops extreme exam anxiety and how to treat it is working in abnormal psychology.
Maladaptive Behaviour
Behaviour that interferes with optimal functioning and growth, often indicating a failure in adaptation to life challenges.
e.g. A student who remains silent in class even when having doubts, because of fear, is showing maladaptive behaviour as it hinders learning.
Deviation from Social Norms
A view that abnormal behaviour is a label given to behaviour that deviates from a society's stated or unstated rules for proper conduct.
e.g. In a culture that values cooperation, aggressive assertiveness may be labelled abnormal, whereas in a competitive culture it may be accepted.
Biological/Organic Approach
The belief that abnormal behaviour is caused by the body and brain not working properly, including faulty genes, endocrine imbalances, or neurotransmitter problems.
e.g. Depression linked to low activity of serotonin is an example of the biological approach.
Psychological Approach
The view that psychological problems are caused by inadequacies in the way an individual thinks, feels, or perceives the world.
e.g. A person who holds irrational beliefs like 'I must be perfect to be loved' may develop anxiety disorders.
Bio-psycho-social Approach
An interactional approach stating that biological, psychological, and social factors all play important roles in influencing the expression and outcome of psychological disorders.
e.g. Schizophrenia may involve genetic predisposition (biological), stressful life events (psychological), and poor family support (social).
DSM-5
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, published by the American Psychiatric Association, presenting discrete clinical criteria for the presence or absence of disorders.
e.g. A psychiatrist uses DSM-5 criteria to diagnose a patient with Major Depressive Disorder based on specific symptoms like depressed mood and loss of interest.
ICD-10
The tenth revision of the International Classification of Diseases, prepared by the WHO, officially used in India for classifying behavioural and mental disorders.
e.g. A hospital in India uses ICD-10 codes to record a patient's diagnosis of schizophrenia.
Diathesis-Stress Model
A model stating that psychological disorders develop when a diathesis (biological predisposition) is set off by a stressful situation; it has three components: diathesis, vulnerability, and pathogenic stressors.
e.g. A person with a family history of depression (diathesis) who experiences a major loss (stressor) may develop a depressive disorder.
Anxiety
A diffuse, vague, very unpleasant feeling of fear and apprehension, accompanied by symptoms like rapid heart rate, shortness of breath, sweating, and sleeplessness.
e.g. Feeling intense fear and palpitations before a board exam is normal anxiety, but if it prevents studying, it may indicate an anxiety disorder.
Generalised Anxiety Disorder
Prolonged, vague, unexplained, and intense fears not attached to any particular object, with symptoms including hypervigilance, motor tension, and restlessness.
e.g. A person who constantly worries about health, finances, and family without any specific trigger, and cannot relax, may have this disorder.
Panic Disorder
Recurrent anxiety attacks (panic attacks) characterized by intense terror, with symptoms like shortness of breath, dizziness, trembling, palpitations, and fear of dying or losing control.
e.g. A person suddenly experiences a racing heart, choking sensation, and fear of dying while driving, leading to avoidance of driving.
Specific Phobia
Irrational fears related to specific objects, people, or situations, such as fear of animals, enclosed spaces, or heights.
e.g. A person who refuses to enter a room if they see a lizard, even though the lizard is harmless, has a specific phobia.
Social Anxiety Disorder (Social Phobia)
Intense and incapacitating fear and embarrassment when dealing with others, leading to avoidance of social situations.
e.g. A student who cannot speak a word of a well-rehearsed speech in front of an audience due to extreme fear of embarrassment.
Agoraphobia
Fear of entering unfamiliar situations, often leading to fear of leaving home and severely limiting normal life activities.
e.g. A person who stays indoors for months because they are afraid of open spaces, crowds, or public transport.
Separation Anxiety Disorder (SAD)
Fearful and anxious about separation from attachment figures to a developmentally inappropriate extent, with symptoms like clinging, tantrums, and refusal to go to school.
e.g. A child who screams and throws tantrums every morning when the mother drops them at school, and shadows the parent at home.
Obsessive-Compulsive Disorder (OCD)
A disorder where the person is unable to control preoccupation with specific ideas (obsessions) or repeatedly carry out particular acts (compulsions), affecting normal activities.
e.g. A person who washes hands repeatedly after touching anything, or feels compelled to step only on certain floor patterns while walking.
Obsessive Behaviour
The inability to stop thinking about a particular idea or topic, often unpleasant and shameful to the person.
e.g. Constantly thinking that one's hands are contaminated with germs, even after washing them thoroughly.
Compulsive Behaviour
The need to perform certain behaviours over and over again, such as counting, ordering, checking, touching, and washing.
e.g. Checking the door lock ten times before leaving the house, even though the person knows it is locked.
Post-Traumatic Stress Disorder (PTSD)
A disorder experienced by people who have been caught in natural disasters, bomb blasts, serious accidents, or war, with symptoms including recurrent dreams, flashbacks, impaired concentration, and emotional numbing.
e.g. A survivor of a tsunami who has recurrent nightmares of the wave and avoids beaches or water bodies.
Somatic Symptom Disorder
A condition where a person has persistent body-related symptoms (which may or may not be related to a serious medical condition), is overly preoccupied with them, and experiences significant distress and disturbance in daily life.
e.g. A person who constantly complains of severe headaches and visits many doctors, but medical tests show no physical cause.
Illness Anxiety Disorder
Persistent preoccupation about developing a serious illness, with constant worry and anxiety about one's health, even when medical tests are negative.
e.g. A person who, after hearing about a friend's cancer, becomes convinced they have cancer and repeatedly seeks medical reassurance.
Conversion Disorder
A condition where the person suffers from loss or impairment of motor or sensory function (e.g., paralysis, blindness, deafness) that has no physical cause but may be a response to stress.
e.g. A person who suddenly becomes unable to walk after a traumatic event, but medical examinations show no nerve or muscle damage.
Dissociative Amnesia
Extensive but selective memory loss that has no known organic cause, often related to a stressful or traumatic event.
e.g. A person who cannot remember anything about their past after a car accident, but has no head injury.
Dissociative Fugue
A part of dissociative amnesia characterized by unexpected travel away from home, assumption of a new identity, and inability to recall the previous identity, often associated with overwhelming stress.
e.g. A person who leaves their job and family, moves to a new city, starts a new life with a different name, and later 'wakes up' with no memory of the fugue.
Dissociative Identity Disorder (Multiple Personality)
The most dramatic dissociative disorder where the person assumes alternate personalities that may or may not be aware of each other, often associated with traumatic childhood experiences.
e.g. A person who sometimes behaves as a shy child and at other times as an aggressive adult, with no memory of the other personality's actions.
Depersonalisation/Derealisation Disorder
A dreamlike state where the person has a sense of being separated both from self (depersonalisation) and from reality (derealisation), with temporary loss or change of reality.
e.g. A person feels like they are watching themselves from outside their body, or that the world around them is unreal or foggy.
Major Depressive Disorder
A period of depressed mood and/or loss of interest or pleasure in most activities, together with symptoms like change in body weight, sleep problems, tiredness, inability to think clearly, agitation, slowed behaviour, and thoughts of death or suicide.
e.g. A person who feels sad, worthless, and tired for weeks, loses interest in hobbies, sleeps too much or too little, and has thoughts of ending their life.
Bipolar I Disorder
A disorder involving both mania and depression, which are alternately present and sometimes interrupted by periods of normal mood; earlier called manic-depressive disorder.
e.g. A person who experiences a week of extreme energy, little sleep, grand plans (mania), followed by weeks of deep depression and hopelessness.
Schizophrenia
A group of psychotic disorders in which personal, social, and occupational functioning deteriorate due to disturbed thought processes, strange perceptions, unusual emotional states, and motor abnormalities.
e.g. A person who believes they are being controlled by aliens (delusion), hears voices commenting on their actions (hallucination), and shows no emotion (flat affect).
Delusion
A false belief that is firmly held on inadequate grounds, not affected by rational argument, and has no basis in reality.
e.g. A person with schizophrenia who believes the police are conspiring to trap them in a spy scandal, despite no evidence.
Hallucination
Perceptions that occur in the absence of external stimuli; can be auditory, visual, tactile, somatic, gustatory, or olfactory.
e.g. A person with schizophrenia hearing voices that speak directly to them or talk about them in the third person.
Positive Symptoms of Schizophrenia
Pathological excesses or bizarre additions to behaviour, including delusions, disorganised thinking and speech, heightened perception, hallucinations, and inappropriate affect.
e.g. A person with schizophrenia who invents new words (neologisms) and shifts rapidly between unrelated topics (loosening of associations).
Negative Symptoms of Schizophrenia
Pathological deficits including poverty of speech (alogia), blunted or flat affect, loss of volition (avolition), and social withdrawal.
e.g. A person with schizophrenia who speaks very little, shows no emotion, and has no motivation to start or complete any task.
Catatonia
Extreme psychomotor symptoms in schizophrenia, including catatonic stupor (motionless and silent for long periods), catatonic rigidity (maintaining a rigid upright posture), and catatonic posturing (assuming awkward, bizarre positions).
e.g. A person with schizophrenia who stands in a rigid, awkward position for hours without moving or speaking.
Attention-Deficit/Hyperactivity Disorder (ADHD)
A neurodevelopmental disorder with two main features: inattention (difficulty sustaining mental effort, easily distracted) and hyperactivity-impulsivity (constant motion, inability to wait or think before acting).
e.g. A child who cannot sit still in class, fidgets constantly, interrupts others, and loses interest in tasks quickly.
Autism Spectrum Disorder
A neurodevelopmental disorder characterized by widespread impairments in social interaction and communication skills, and stereotyped patterns of behaviours, interests, and activities; about 70% have intellectual disabilities.
e.g. A child who avoids eye contact, does not respond to their name, lines up toys repeatedly, and has difficulty understanding others' emotions.
Intellectual Disability
Below average intellectual functioning (IQ of approximately 70 or below) with deficits in adaptive behaviour (communication, self-care, social skills, etc.) manifested before age 18.
e.g. A 15-year-old who has an IQ of 65 and struggles with basic reading, self-care, and social interactions compared to peers.
Specific Learning Disorder
Difficulty in perceiving or processing information efficiently and accurately, manifesting during early school years as problems in basic skills in reading, writing, and/or mathematics, with performance below average for age.
e.g. A child who has difficulty reading words accurately and fluently despite normal intelligence and adequate instruction.
Oppositional Defiant Disorder (ODD)
A disruptive disorder where children display age-inappropriate stubbornness, irritability, defiance, disobedience, and hostile behaviour, often justifying their behaviour as a reaction to circumstances.
e.g. A child who frequently argues with adults, refuses to comply with rules, and deliberately annoys others, but blames others for their behaviour.
Conduct Disorder
Age-inappropriate actions and attitudes that violate family expectations, societal norms, and the personal or property rights of others, including aggressive actions, property damage, deceitfulness, and serious rule violations.
e.g. A teenager who bullies other children, steals, sets fires, and runs away from home repeatedly.
Anorexia Nervosa
An eating disorder where the individual has a distorted body image, sees themselves as overweight, refuses to eat, exercises compulsively, and may lose large amounts of weight or starve to death.
e.g. A teenage girl who weighs significantly less than normal but insists she is fat, refuses meals, and exercises for hours daily.
Bulimia Nervosa
An eating disorder where the individual eats excessive amounts of food (binge) and then purges by using laxatives, diuretics, or vomiting, often feeling disgusted and ashamed.
e.g. A person who secretly eats a large quantity of food in a short time and then forces themselves to vomit to avoid weight gain.
Binge Eating Disorder
Frequent episodes of out-of-control eating, eating at a higher speed than normal, eating until uncomfortably full, and eating large amounts when not hungry.
e.g. A person who eats an entire pizza and a tub of ice cream in one sitting, feeling out of control and distressed afterward.
How It Works
Classification of Psychological Disorders
  1. Step 1: Disorders are grouped into categories based on shared characteristics such as symptoms, course, and outcome.
  2. Step 2: The DSM-5 (APA) and ICD-10 (WHO) provide official manuals with clinical criteria for each disorder.
  3. Step 3: Each disorder has a description of main clinical features, associated features, and diagnostic guidelines.
  4. Step 4: Classification enables communication among professionals and helps in understanding causes and treatment.
💡 DSM-5 is American, ICD-10 is international and officially used in India. Students often confuse which is used where.
Diathesis-Stress Model
  1. Step 1: A person inherits a biological predisposition (diathesis) for a disorder, such as a genetic vulnerability to depression.
  2. Step 2: This diathesis creates a vulnerability, meaning the person is 'at risk' or predisposed to develop the disorder.
  3. Step 3: The person is exposed to pathogenic stressors (e.g., trauma, loss, chronic stress).
  4. Step 4: If the stressor is severe enough, the predisposition may evolve into an actual disorder.
💡 Both diathesis AND stress are necessary; neither alone is sufficient. Students often think one or the other is enough.
Development of Phobias
  1. Step 1: A person may have a generalised anxiety disorder or a gradual onset of fear.
  2. Step 2: The fear becomes attached to a specific object, person, or situation (e.g., a dog, social interaction, open spaces).
  3. Step 3: The fear is irrational and leads to avoidance behaviour.
  4. Step 4: Avoidance reinforces the fear, as the person never learns that the situation is safe.
💡 Phobias often develop gradually, not suddenly. The avoidance behaviour is key to maintaining the phobia.
Formation of Delusions in Schizophrenia
  1. Step 1: The person develops false beliefs that are firmly held despite inadequate grounds and contrary evidence.
  2. Step 2: Common types include delusions of persecution (being plotted against), reference (special personal meaning), grandeur (being specially empowered), and control (being controlled by others).
  3. Step 3: These delusions are not affected by rational argument and have no basis in reality.
  4. Step 4: They contribute to the person's disturbed thought processes and impaired functioning.
💡 Delusions are FALSE beliefs, not hallucinations (which are false perceptions). Students often mix these two.
Suicide Prevention (WHO Measures)
  1. Step 1: Limit access to the means of suicide (e.g., pesticides, firearms).
  2. Step 2: Ensure responsible reporting of suicide by media.
  3. Step 3: Implement alcohol-related policies to reduce alcohol use disorders.
  4. Step 4: Early identification, treatment, and care of people at risk.
  5. Step 5: Train health workers in assessing and managing suicide risk.
  6. Step 6: Provide care for people who attempted suicide and offer community support.
💡 Suicide is preventable. The strongest risk factor is a previous suicidal attempt. Stigma prevents people from seeking help.
Exam Traps — Don't Make These Mistakes
⚠ Confusing Delusions with Hallucinations
✗ A person with schizophrenia hears voices (hallucination) and believes they are being followed (delusion) — students often call both 'hallucinations' or both 'delusions'.
→ Delusions are false beliefs (cognitive), while hallucinations are false perceptions (sensory). They are distinct positive symptoms of schizophrenia.
✓ Delusions are false beliefs firmly held despite evidence; hallucinations are perceptions without external stimuli, e.g., auditory hallucinations (hearing voices).
⚠ Mixing Up Somatic Symptom Disorder and Illness Anxiety Disorder
✗ Both disorders involve worrying about health, so students often write they are the same.
→ In somatic symptom disorder, the concern is expressed through physical complaints (e.g., pain). In illness anxiety disorder, the main concern is anxiety about developing a serious illness, not the physical symptoms themselves.
✓ Somatic symptom disorder: persistent physical symptoms with excessive preoccupation. Illness anxiety disorder: persistent worry about having or developing a serious illness, with minimal or no physical symptoms.
⚠ Confusing Negative and Positive Symptoms of Schizophrenia
✗ Students often list hallucinations and delusions as negative symptoms, or flat affect as a positive symptom.
→ Positive symptoms are 'excesses' or 'additions' (hallucinations, delusions, disorganised speech). Negative symptoms are 'deficits' (flat affect, alogia, avolition, social withdrawal).
✓ Positive symptoms: delusions, hallucinations, disorganised thinking, inappropriate affect. Negative symptoms: alogia (poverty of speech), blunted/flat affect, avolition (loss of volition), social withdrawal.
⚠ Thinking All Anxiety is an Anxiety Disorder
✗ Students often write that any nervousness before an exam or a presentation is an anxiety disorder.
→ Normal anxiety is expected and motivates performance. An anxiety disorder involves high levels of anxiety that are distressing and interfere with effective functioning.
✓ Normal anxiety is time-limited and adaptive. An anxiety disorder is diagnosed when anxiety is excessive, persistent, and impairs daily life, e.g., panic attacks, phobias, generalised anxiety.
⚠ Confusing Bipolar I and Bipolar II
✗ Students often write that both involve mania and depression without specifying the severity of mania.
→ Bipolar I involves full manic episodes (severe, impairing functioning). Bipolar II involves hypomanic episodes (less severe) and major depressive episodes.
✓ Bipolar I disorder: at least one manic episode (often alternating with depression). Bipolar II disorder: hypomanic episodes (milder than mania) and major depressive episodes.
⚠ Assuming All Memory Loss is Dissociative Amnesia
✗ Students write that any forgetfulness or memory loss after an accident is dissociative amnesia.
→ Dissociative amnesia has no known organic cause (e.g., head injury). Memory loss due to brain damage, concussion, or medical conditions is not dissociative amnesia.
✓ Dissociative amnesia is extensive, selective memory loss without organic cause, often related to trauma. Organic amnesia (e.g., from head injury) is not dissociative.
Compare & Contrast
Classification system and publisher
DSM-5
ICD-10
DSM-5 is published by the American Psychiatric Association (APA) and is primarily used in the USA. ICD-10 is published by the World Health Organisation (WHO) and is officially used in India and many other countries.
Expression of health concern
Somatic Symptom Disorder
Illness Anxiety Disorder
In somatic symptom disorder, the concern is expressed through physical complaints (e.g., pain, fatigue) with excessive preoccupation. In illness anxiety disorder, the main concern is anxiety about developing a serious illness, with minimal or no physical symptoms.
Eating and purging behaviour
Anorexia Nervosa
Bulimia Nervosa
In anorexia nervosa, the person refuses to eat, exercises compulsively, and loses significant weight. In bulimia nervosa, the person binges on large amounts of food and then purges (vomiting, laxatives) to avoid weight gain.
Severity of manic episodes
Bipolar I Disorder
Bipolar II Disorder
Bipolar I involves full manic episodes (severe, impairing functioning, often requiring hospitalisation). Bipolar II involves hypomanic episodes (less severe, not impairing functioning significantly) and major depressive episodes.
Exam Focus
Marks pattern: 2-3 MCQs (1 mark each), 1-2 Short Answer questions (2-3 marks), 1 Long Answer question (4-5 marks). Total approximately 10-12 marks.
Most asked: Four Ds of abnormality · Diathesis-stress model · Types of anxiety disorders (especially phobias, panic disorder, GAD) · Positive and negative symptoms of schizophrenia · Major depressive disorder and bipolar disorder · OCD (obsessions and compulsions) · Dissociative identity disorder · Neurodevelopmental disorders (ADHD, autism spectrum disorder) · Eating disorders (anorexia nervosa, bulimia nervosa) · Substance-related disorders and suicide prevention
Don't skip: Explain the diathesis-stress model with an example.; Differentiate between positive and negative symptoms of schizophrenia.; Describe the types of anxiety disorders and their symptoms.; Compare and contrast anorexia nervosa and bulimia nervosa.; Explain the factors underlying abnormal behaviour (biological, psychological, socio-cultural).
One-Line Revision (read aloud before the exam)
  1. The four Ds of abnormality are deviance, distress, dysfunction, and danger.
  2. Abnormal behaviour can be viewed as deviation from social norms or as maladaptive behaviour.
  3. The biological approach links psychological disorders to neurotransmitters like GABA (anxiety), dopamine (schizophrenia), and serotonin (depression).
  4. The diathesis-stress model states that a biological predisposition (diathesis) combined with stress leads to a disorder.
  5. DSM-5 is the American classification manual; ICD-10 is the WHO manual used in India.
  6. Generalised anxiety disorder involves prolonged, vague fears with hypervigilance and motor tension.
  7. Panic disorder involves recurrent, unpredictable panic attacks with intense terror and physical symptoms.
  8. Specific phobias are irrational fears of specific objects or situations; social phobia is fear of social situations; agoraphobia is fear of open/unfamiliar places.
  9. OCD involves obsessions (unwanted thoughts) and compulsions (repetitive behaviours) like washing or checking.
  10. PTSD occurs after trauma and includes flashbacks, nightmares, and emotional numbing.
  11. Somatic symptom disorder involves physical complaints without medical cause; illness anxiety disorder involves worry about having a serious illness.
  12. Dissociative amnesia is memory loss without organic cause; dissociative identity disorder involves multiple personalities.
  13. Major depressive disorder includes depressed mood, loss of interest, sleep/appetite changes, and suicidal thoughts.
  14. Bipolar I disorder involves mania and depression; bipolar II involves hypomania and depression.
  15. Schizophrenia positive symptoms: delusions, hallucinations, disorganised speech, inappropriate affect.
  16. Schizophrenia negative symptoms: alogia, flat affect, avolition, social withdrawal.
  17. Catatonia includes stupor, rigidity, and posturing in schizophrenia.
  18. ADHD features inattention and hyperactivity-impulsivity.
  19. Autism spectrum disorder involves impaired social interaction, communication, and repetitive behaviours.
  20. Anorexia nervosa involves refusal to eat and distorted body image; bulimia nervosa involves bingeing and purging.
  21. Suicide is preventable; key measures include limiting access to means, responsible media reporting, and early identification of at-risk individuals.

MCQs — 10 Questions with Answers

Q1. According to the Four Ds framework, which of the following BEST defines a psychological disorder?

  • A. Any behaviour that differs from the majority of people in society
  • B. Behaviour that is deviant, distressing, dysfunctional, and possibly dangerous ✓
  • C. Any behaviour that makes the person unhappy or uncomfortable
  • D. Behaviour that violates social norms regardless of the person's well-being

Answer: B — The Four Ds framework specifically requires deviance, distress, dysfunction, and danger together; A focuses only on deviance, C lacks dysfunction criterion, and D ignores harm assessment.

Q2. Which approach to defining abnormality emphasises that conforming behaviour can be abnormal if it interferes with optimal functioning and growth?

  • A. Social norms approach
  • B. Maladaptive behaviour approach ✓
  • C. Statistical deviation approach
  • D. Cultural relativism approach

Answer: B — The maladaptive approach prioritises harm to well-being over cultural conformity, meaning even socially acceptable silence that blocks learning becomes abnormal if it prevents growth.

Q3. A student worries excessively about exams, health, and career for 8 months. The worry occurs more days than not and is accompanied by restlessness and difficulty concentrating. Which disorder does this BEST fit?

  • A. Specific Phobia
  • B. Panic Disorder
  • C. Generalised Anxiety Disorder ✓
  • D. Social Anxiety Disorder

Answer: C — GAD requires 6+ months of excessive worry across multiple domains (exams, health, career) with physical symptoms; the 8-month duration and multiple worry topics confirm GAD over single-focused phobia.

Q4. A person experiences a sudden 45-minute episode of intense fear, heart palpitations, sweating, and dizziness without an obvious trigger. This happens repeatedly over three months, and now avoids situations where panic might occur. This pattern BEST matches which disorder?

  • A. Specific Phobia
  • B. Panic Disorder ✓
  • C. Post-Traumatic Stress Disorder
  • D. Generalised Anxiety Disorder

Answer: B — Panic Disorder is defined by recurrent unexpected panic attacks (sudden intense fear + physical symptoms) plus anticipatory anxiety and avoidance; specific phobia requires a clear external object/situation trigger.

Q5. Which of the following is NOT a diagnostic criterion for Major Depressive Disorder?

  • A. Anhedonia (loss of interest or pleasure in activities)
  • B. Symptoms lasting at least two consecutive weeks
  • C. Hallucinations or delusions unrelated to mood ✓
  • D. Significant impairment in social or occupational functioning

Answer: C — Hallucinations/delusions belong to schizophrenia spectrum, not MDD; A, B, and D are core diagnostic criteria for MDD requiring 5+ symptoms including anhedonia or depressed mood for 2+ weeks with functional impairment.

Q6. A person experiences a one-week period of abnormally elevated mood, increased goal-directed activity, and risky behaviour, followed by a three-month period of depressed mood, anhedonia, and fatigue. Which disorder does this pattern BEST indicate?

  • A. Major Depressive Disorder
  • B. Bipolar I Disorder ✓
  • C. Bipolar II Disorder
  • D. Cyclothymic Disorder

Answer: B — Bipolar I requires at least one full manic episode (elevated mood + risky behaviour lasting 1+ week) plus depressive episodes; Bipolar II has hypomania (shorter, milder) not full mania, ruling out C.

Q7. A teenager hears voices telling them to harm themselves, believes they are being followed by a secret organisation, and speaks in a disorganised, hard-to-follow manner. These symptoms began 6 weeks ago. Which of the following BEST describes these symptoms?

  • A. Negative symptoms of schizophrenia
  • B. Positive symptoms of schizophrenia ✓
  • C. Mood symptoms of Bipolar I Disorder
  • D. Symptoms of Major Depressive Disorder with psychotic features

Answer: B — Hallucinations (hearing voices), delusions (belief of being followed), and disorganised speech are positive symptoms that add abnormal experiences; negative symptoms involve loss of function (flat affect, alogia, avolition).

Q8. A child shows persistent difficulty maintaining attention in multiple settings, leaves tasks incomplete, loses necessary items frequently, and fidgets constantly. The parents and teachers both report these behaviours began at age 5. Which disorder is MOST likely?

  • A. Autism Spectrum Disorder
  • B. Oppositional Defiant Disorder
  • C. Attention-Deficit/Hyperactivity Disorder ✓
  • D. Specific Learning Disorder

Answer: C — ADHD requires inattention symptoms (incomplete tasks, loses items, difficulty sustaining attention) AND/OR hyperactivity-impulsivity (fidgeting) across 2+ settings before age 12; autism focuses on social communication and repetitive patterns.

Q9. Which statement about Obsessive-Compulsive Disorder is correct? (A) Obsessions are always followed by compulsions that the person finds pleasurable. (B) Compulsions are repetitive behaviours performed to reduce anxiety caused by obsessions. (C) OCD is simply a personality trait of being perfectionistic. (D) Obsessions are voluntary thoughts that the person enjoys thinking about.

  • A. Only A is correct
  • B. Only B is correct ✓
  • C. Both A and B are correct
  • D. A, B, and C are correct

Answer: B — B is the correct definition: compulsions reduce obsession-related anxiety; A is wrong (compulsions cause discomfort not pleasure), C confuses OCD with perfectionism, and D is wrong (obsessions are intrusive/unwanted, not chosen).

Q10. Assertion: In schizophrenia, negative symptoms like flat affect and alogia indicate a loss of normal emotional and motivational functioning. Reason: Negative symptoms are called 'negative' because they subtract from normal functioning rather than adding abnormal experiences.

  • A. Both Assertion and Reason are true; Reason correctly explains the Assertion ✓
  • B. Both Assertion and Reason are true; Reason does NOT correctly explain the Assertion
  • C. Assertion is true; Reason is false
  • D. Assertion is false; Reason is true

Answer: A — Both statements are accurate: negative symptoms (flat affect = reduced emotional expression; alogia = poverty of speech) do represent loss of normal functioning, and they are termed 'negative' precisely because they subtract or diminish normal capacities rather than add bizarre experiences.

Flashcards

What does the Four Ds framework mean for defining abnormality?

Deviance (differs from social norms), Distress (causes suffering), Dysfunction (interferes with daily functioning), and Danger (harm to self or others) are four criteria that together define a psychological disorder.

How does the maladaptive behaviour approach differ from the social norms approach to abnormality?

Maladaptive approach focuses on whether behaviour interferes with well-being and growth regardless of social acceptance, while social norms approach labels behaviour abnormal only if it violates cultural expectations—making cultural differences the key distinction.

What is the diagnostic duration criterion for Major Depressive Disorder?

A person must have five or more depressive symptoms (including depressed mood or anhedonia) that persist for at least two consecutive weeks to meet the diagnosis of Major Depressive Disorder.

Distinguish between obsessions and compulsions in Obsessive-Compulsive Disorder.

Obsessions are intrusive, unwanted thoughts or images that cause anxiety, while compulsions are repetitive behaviours or mental acts performed to reduce the anxiety caused by obsessions.

What is the key difference between Bipolar I and Bipolar II Disorder?

Bipolar I includes at least one full manic episode (extreme mood elevation and high-risk behaviour), whereas Bipolar II includes hypomanic episodes (less severe elevation) plus depressive episodes but no full mania.

Name three positive symptoms of schizophrenia.

Hallucinations (sensory experiences without external stimuli), delusions (fixed false beliefs), and disorganised speech or catatonic behaviour are positive symptoms that add abnormal experiences to perception and thought.

What do negative symptoms of schizophrenia reflect?

Negative symptoms like alogia (poverty of speech), avolition (lack of motivation), flat affect, and anhedonia reflect a loss or reduction of normal emotional and motivational functioning.

What are the two core features of Autism Spectrum Disorder?

Persistent deficits in social communication (nonverbal cues, peer relationships) and restricted, repetitive patterns of behaviour, interests, or activities that appear from early childhood.

What diagnostic criteria must be met for Generalised Anxiety Disorder?

Excessive worry about multiple life domains that occurs more days than not for at least six months, accompanied by three or more physical or cognitive symptoms such as restlessness or concentration difficulty.

How does substance dependence differ from substance tolerance?

Tolerance is a need for increasing amounts of a drug to achieve the same effect, while dependence is a compulsive need to use the substance despite harmful consequences, involving both physical and psychological addiction.

Important Board Questions

Define psychological abnormality using the Four Ds framework and give one example from daily life. [2 marks]

State each D clearly (Deviance, Distress, Dysfunction, Danger) in one line, then illustrate with a realistic example like excessive hand-washing (OCD) or extreme social withdrawal that interferes with studying.

Explain the difference between the social norms approach and the maladaptive behaviour approach to defining abnormality. Why might the maladaptive approach be more useful in psychology? [3 marks]

Social norms = behaviour abnormal if it violates cultural expectations (varies by culture); Maladaptive = behaviour abnormal if it harms well-being & growth (consistent across cultures). Utility: cultural bias avoided, focus on actual harm to person makes treatment possible.

Describe the diagnostic criteria for Major Depressive Disorder and distinguish it from Bipolar I Disorder. Include the required duration of symptoms and the key difference in mood episodes for each diagnosis. [6 marks]

MDD: 5+ symptoms (including depressed mood OR anhedonia + sleep/appetite/guilt/fatigue/concentration changes/suicidal thoughts) for 2+ weeks, depressive episodes only. Bipolar I: at least one manic episode (elevated mood, risky behaviour, decreased sleep need, lasting 1+ week) PLUS depressive episodes, mood alternates. Duration and presence of manic (vs depressive-only) episodes differentiate them.

Assertion-Reason Questions for Psychological Disorders

Q1. Assertion (A):

Abnormal behaviour is best defined by deviation from social norms in all societies.

Reason (R):

Social norms are universal and unchanging across cultures and historical periods.

Answer: D — A is false but R is true — Both the assertion and reason are false. The textbook criticises the social norms approach and emphasises that norms are culturally specific and change over time. The chapter advocates for the maladaptive approach as a more robust criterion, not social deviation alone. The reason is explicitly contradicted by the text: 'A society's values may change over time.'

Q2. Assertion (A):

The maladaptive approach views abnormal behaviour as behaviour that interferes with optimal functioning and growth.

Reason (R):

This approach includes the concept of actualisation of potential from Maslow's hierarchy of needs.

Answer: A — Both A and R are true, and R is the correct explanation of A — Both the assertion and reason are true, and the reason correctly explains the assertion. The textbook explicitly states the maladaptive approach focuses on behaviour that 'interferes with optimal functioning and growth' and specifically references 'actualisation of potential' from Maslow's theory as the theoretical foundation. The reason directly supports why the assertion is true.

Q3. Assertion (A):

Psychological disorders should not carry social stigma because they represent a failure in adaptation similar to other illnesses.

Reason (R):

All psychological disorders have purely biological causes that can be treated with medication.

Answer: C — A is true but R is false — The assertion is true—the textbook advocates destigmatisation by comparing mental illness to physical illness. However, the reason is false because psychological disorders have multiple causes (biological, psychological, sociocultural), not purely biological ones, and not all are treatable with medication alone. The assertion's validity doesn't depend on the reason given; the reason oversimplifies the aetiology of mental illness.

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Case-Based Questions (CBQ) for Psychological Disorders

Case Study:

Arjun, a 22-year-old college student in Bangalore, recently started avoiding his classes and socialising with friends. He reports persistent worry about his health, grades, and future career, though his academic performance remains above average and his health tests are normal. He feels restless, fatigued, and has difficulty concentrating. Arjun states, 'I know my worries don't make sense, but I can't stop them. I'm so afraid something will go wrong.' His family describes him as previously confident but increasingly withdrawn over the past 6 months. He experiences sleep disturbances and muscle tension. Despite reassurance from parents and doctors, his anxiety persists.

Q1. According to the Four Ds framework, which criterion is MOST clearly demonstrated by Arjun's symptoms?

  • A. Deviance—his worry is unusual and irrational
  • B. Distress—his anxiety is causing him emotional upset and affecting daily functioning ✓
  • C. Danger—his symptoms pose a physical risk to himself or others
  • D. Dysfunction—his excessive worry about hypothetical future events is maladaptive

Answer: B

Q2. Arjun's insight that his worries 'don't make sense' but his inability to stop them suggests which type of abnormal symptom?

  • A. Deviation from social norms due to cultural differences
  • B. Maladaptive behaviour that interferes with concentration, sleep, and social engagement ✓
  • C. Culturally sanctioned stress response typical of competitive college environments
  • D. Normal anxiety that all students experience and will naturally resolve

Answer: B

Q3. Which aspect of the maladaptive approach is exemplified by Arjun's case?

  • A. His behaviour deviates from Indian social expectations of stoicism
  • B. His symptoms indicate a failure to conform to family values and expectations
  • C. His worry is more intense than his peers', making it statistically abnormal
  • D. His anxiety interferes with growth, actualisation of potential, and well-being despite external success ✓

Answer: D

Q4. If Arjun's anxiety were culturally validated as a form of spiritual sensitivity in his family tradition and caused him no distress (he viewed it as normal), would the Four Ds framework still classify this as a psychological disorder?

  • A. Possibly not, because without distress, dysfunction, deviance, or danger, it would not meet all Four Ds criteria ✓
  • B. Yes, because intrusive thoughts are always signs of disorder
  • C. No, because cultural acceptance always indicates normality
  • D. Yes, because anxiety symptoms require treatment regardless of cultural context

Answer: A

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Previous Year Questions (PYQ) for Psychological Disorders

Real CBSE board exam questions from past papers — free to attempt.

CBSE 2026 · Set Psychology · 1 mark

_________ is characterised by widespread impairments in social interactions and communication skills, and stereotyped patterns of behaviours, interests and activities.

  • Dyslexia
  • Autism Spectrum Disorder
  • Specific Learning Disorder
  • Attention Deficit Hyperactivity Disorder

CBSE 2026 · Set Psychology · 2 marks

Somatic symptom disorder and illness anxiety disorder are concerned with medical illness, yet they are different. Explain using relevant example.

CBSE 2026 · Set Psychology · 3 marks

Rohan, a 10-year-old diagnosed with intellectual deficiency as per AAMD guidelines, is supported with a special education plan. Based on his diagnosis, identify two common features he might display in his daily functioning.

CBSE 2026 · Set Psychology · 6 marks

Ravi has been showing signs of extreme social withdrawal and erratic mood swings. As a psychology student, how would you apply different approaches/models/factors to understand and explain any abnormal behaviour?

CBSE 2026 · Set Psychology · 1 mark

Shreya's parents brought her to the school counsellor after noticing: • Noticeable weight loss over the past eight months. • Skipping meals and avoiding dinners. • Constant complaints of feeling "too fat" despite appearing underweight. • Loss of energy, irritability and frequent mood swings. Shreya herself insisted that "everything is fine," expressing frustration about being forced to discuss her eating habits.

What is Shreya suffering from?

CBSE 2026 · Set Psychology · 2 marks

Shreya's parents brought her to the school counsellor after noticing: • Noticeable weight loss over the past eight months. • Skipping meals and avoiding dinners. • Constant complaints of feeling "too fat" despite appearing underweight. • Loss of energy, irritability and frequent mood swings. Shreya herself insisted that "everything is fine," expressing frustration about being forced to discuss her eating habits.

Identify and explain the various other forms of this disorder.

CBSE 2025 · Set 63_psychology · 1 mark

Which of the following statements best describes how societal norms influence the perception of abnormal behaviour?

  • Societal norms are universally consistent and do not change over time.
  • Behaviours, thoughts and emotions that align with societal norms are always considered abnormal.
  • Societal norms are derived from society's culture, including its history, values and institutions and these norms can change over time.
  • Aggressive behaviour is universally accepted as normal behaviour across all cultures.

CBSE 2025 · Set 63_psychology · 4 marks

Meera has an intense irrational fear of spiders and experiences sudden episodes of intense terror with breathlessness and dizziness. Identify the two types of anxiety disorders she might be suffering from and suggest one coping strategy for each.

CBSE 2025 · Set 63_psychology · 1 mark

At any one time, a diverse set of individual, family, community and structural factors may combine to protect or undermine mental health. Although most people are resilient, people who are exposed to adverse circumstances – including poverty, violence, disability and inequality – are at higher risk of developing a mental health condition. Protective and risk factors include individual, psychological and biological factors, such as emotional skills as well as genetics. Many of the risks and protective factors are influenced through changes in brain structure and/or function. People with mental disorders also require social support, including support in developing and maintaining personal, family and social relationships. People with mental disorders may also need support for educational programmes, employment, housing and participation in other meaningful activities.

According to the above paragraph, what type of people are more likely to have a psychological disorder?

CBSE 2025 · Set 63_psychology · 2 marks

At any one time, a diverse set of individual, family, community and structural factors may combine to protect or undermine mental health. Although most people are resilient, people who are exposed to adverse circumstances – including poverty, violence, disability and inequality – are at higher risk of developing a mental health condition. Protective and risk factors include individual, psychological and biological factors, such as emotional skills as well as genetics. Many of the risks and protective factors are influenced through changes in brain structure and/or function. People with mental disorders also require social support, including support in developing and maintaining personal, family and social relationships. People with mental disorders may also need support for educational programmes, employment, housing and participation in other meaningful activities.

State two steps which are helpful in addressing the concerns of mentally-ill people.

CBSE 2023 · Set 63_Psychology · 1 mark

Which of the following statements is/are true about the diathesis-stress model?

  • Only (i) is true.
  • (i) and (iii) are true.
  • Only (iii) is true.
  • (ii) and (iv) are true.

CBSE 2023 · Set 63_Psychology · 1 mark

Some people are unable to prevent themselves from specific ideas or from repeatedly carrying out a set of actions that disrupts their daily functioning. These people are showing symptoms of ____________.

  • Manic depressive disorder
  • Panic disorder
  • Somatic symptom disorder
  • Obsessive-compulsive disorder

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