Assignment Code: MCFT-002 / TMA-2 / ASST / 2022-23

Course Code: MCFT-002

Assignment Name: Mental Health and Disorders

Year: 2022 - 2023

Verification Status: Verified by Professor

Note: - (i) Answer all the questions in both sections.

(ii) Answers to questions of Section “A” should not exceed 300 words each.

Section A - Descriptive Questions (10x6=60 marks)

Q 1. Why is assessment of mental disorders required? Give examples to explain your answer.

Ans) A thorough mental disorder evaluation is needed to understand, label, and help the client overcome their issues. The in-depth analysis is methodical and sequential, following predetermined guidelines. Assessments may require multiple sessions to complete. The setting—outpatient, inpatient, or other—may affect the assessment's scope.

Evaluation of mental disorders is necessary for a number of reasons, including the following:

1. Establishing a diagnosis: Using an assessment, you should be able to determine a working diagnosis for the client's condition as well as comprehend the nature of the problem they are experiencing. The client will be able to take action to better manage the issues that they are experiencing once this diagnosis has been provided.

2. Planning the treatment: An evaluation ought to be able to provide assistance in the process of planning the subsequent steps in the management of the problems, including what must be done right away and what must be done in the future.

3. Referral to a specialist for further management: Depending on the results of the evaluation, you should be able to deduce whether or not the customer needs your assistance or the assistance of another specialist. In that case, you will be in a position to provide them with the appropriate referral.

4. Establish rapport and make the client comfortable: An evaluation can be a useful tool for breaking the ice with a client and encouraging that client to speak freely about any issues that they are experiencing without the fear of being misunderstood. In addition, you can use an evaluation to assist you in deciding whether or not the client is a good candidate for therapy.

Examples of Mental Disorders

Depression, anxiety disorders, schizophrenia, and bipolar disorder are some examples of mental disorders that need to be evaluated. During assessment, one will typically conduct a thorough analysis of the patient's symptoms, as well as a review of their medical history and observations of their behaviour.

Q 2. How can behavioural techniques be used to help a teenager suffering from severe acne?

Discuss.

Ans) Acne vulgaris is a common disease that affects the sebaceous glands, and it can cause a variety of lesions, including scarring, to appear on the face. Acne vulgaris is frequently reported to worsen as a result of patients' high levels of stress. The presence of itching in acne is linked to recent stressful life events as well as symptoms of depression.

Scratching is a common symptom of atopic dermatitis, and anxiety has been shown to make the condition worse. Patients suffering from psoriasis who worry an excessive amount have a negative impact on the treatment outcome. Alopecia areata, which can start in either childhood or adulthood, is accompanied by anxiety symptoms. Acne has a significant negative impact on a person's ability to function socially and professionally, and there is a correlation between the severity of the acne and feelings of anxiety and low self-esteem. Patients who suffer from acne that is mild to moderate often experience significant psychological distress and concerns about their body image.

Behavioural techniques can be used to help a teenager with severe acne in the following ways:

1. Relaxation techniques: Encouraging the teenager to practice relaxation techniques, such as deep breathing or progressive muscle relaxation, to manage stress and reduce the physical symptoms of acne.

2. Cognitive restructuring: Helping the teenager reframe negative thoughts about their acne and promoting positive self-talk.

3. Goal setting: Encouraging the teenager to set achievable goals for their skin care routine and reward them for progress.

4. Social support: Encouraging the teenager to reach out to friends and family for support and participate in social activities to boost self-esteem and confidence.

5. Avoidance of skin irritants: Educating the teenager about common skin irritants and encouraging them to avoid these triggers.

6. Sleep hygiene: Promoting healthy sleep habits to reduce stress and promote skin health.

7. Exercise: Encouraging physical activity to reduce stress and promote overall well-being.

Q 3. Analyse reasons for poor compliance to treatment in individuals with schizophrenia.

Ans) Around fifty percent of outpatients and twenty percent of inpatients with schizophrenia do not take their prescribed medications as directed, making poor compliance with drug prescriptions a fairly widespread problem in the treatment of schizophrenia. It is of the utmost importance for patients who have schizophrenia to adhere to the treatment plan that has been devised for them. This is due to the fact that a relapse of the illness is more likely to occur when antipsychotic drugs are either stopped or taken on an irregular basis.

There are several reasons for poor compliance to treatment in individuals with schizophrenia, including:

1. Patients, as well as their family members or caregivers, may hold unfavourable views regarding medication.

2. Patients frequently have the misconception that they are healthy and do not require any treatment as a result.

3. Because of the patient's potentially disordered thinking, it is possible that they will forget to take their prescribed medications on a daily basis.

4. There is a possibility that the prescribing physicians did not adequately explain the treatment plan.

5. It is possible that family members will not fully comprehend the directions, leading them to inadvertently administer medication to the patient in the wrong manner (dosage and timing).

6. The medications' various adverse effects.

7. When the patient is feeling better, family members might mistakenly believe that they can stop treatment.

8. Abuse of substances like alcohol or cannabis reduces the effectiveness of treatment, which often results in patients discontinuing their prescribed medication.

9. The price of treatment as well as the expected length of treatment. The problem of patient compliance continues to be one of the most significant challenges in the treatment of schizophrenia, and any one of these reasons or a combination of them may apply to a given individual.

Q 4. How do the following theories explain neurotic disorders: Support your answer with examples. (5+5)

i) Learning theory

Ans) The learning theory says that classical and operant conditioning are to blame for neurotic disorders. Classical conditioning happens when a neutral stimulus becomes linked to an unpleasant response by being paired with it over and over again. This can cause anxiety and phobias. For example, if someone has panic attacks every time they are in a crowded place, they may start to fear being in crowded places.

Operant conditioning happens when behaviours are rewarded or punished, which makes them happen again or stops them from happening. For example, a person who washes their hands over and over again as a way to deal with anxiety may reinforce the behaviour by feeling less anxious, which can lead to obsessive-compulsive disorder.

Both classical and operant conditioning can lead to the development of bad habits that make it easier for neurotic disorders to start and stay around.

ii) Psychoanalytic theory

Ans) The psychoanalytic theory explains neurotic disorders as the result of unconscious conflicts between unconscious desires and the demands of society. According to this theory, neurotic symptoms arise as a way of resolving these internal conflicts and serving as a defence mechanism against unconscious anxieties and desires.

For example, a person with obsessive-compulsive disorder may have unconscious sexual or aggressive desires that are unacceptable to them. The compulsive behaviour serves as a way to manage anxiety and guilt associated with these unconscious desires.

Similarly, a person with social anxiety disorder may have unconscious desires for attention and affection, but also feel unworthy of these desires. Their anxiety and avoidance of social situations serve as a defence mechanism to prevent the unconscious anxieties and desires from being realized and leading to feelings of inadequacy and shame.

Overall, the psychoanalytic theory views neurotic disorders as rooted in unconscious psychological processes and conflict and seeks to uncover and resolve these unconscious conflicts through psychoanalysis.

Q 5. Discuss the principles of management of personality disorders.

Ans) The Principles of Management of some of the personality disorders are:

1. Paranoid Personality Disorder

Low-dose antipsychotics reduce near-delirium thoughts. Paranoid people distrust others, so the therapist's confrontation will be misinterpreted. Therapists should be polite and not interfere. Misreading intentions can cause overreaction to threats. Therapy helps. Decentring is hard for paranoid people. Their threats are taken seriously because they cannot distinguish fantasy from reality. Cognitive therapy can help work and social situations. Family therapy reduces mistrust and suspicion. Marriage counselling helps couples grow and manage the patient's negative traits.

2. Schizoid Personality Disorder

Low-dose antipsychotics and/or selective serotonin reuptake inhibitors can help some people (SSRIs). Cognitive therapy tries to teach specific ways of thinking, like being able to see things from someone else's point of view. Training in social skills to improve the quality of interactions with other people is important to help people get along better with each other.

3. Schizotypal Personality Disorder

Antipsychotics reduce this disorder's delusions and confusion. SSRIs help obsessive-compulsive patients. Psychotherapy should improve social skills since social incompetence is a major symptom. The patient may participate in role-playing activities to practise better behaviour. Teaching the patient to judge their thoughts by what they see rather than how they feel is crucial to treating this disorder. Thus, patients can question and change their crazy ideas

.

4. Antisocial Personality Disorder

Pharmacotherapy treats anxiety, anger, etc. These drugs may treat ADD/ADHD. Dynamic psychotherapy is not recommended for violent people. Specific issues need psychotherapy. Patients can adapt. Impulse control and anger management teach healthy habits. Group therapy and social skills training, especially in jails, improve behaviour. Family therapy should help the family stop helping the antisocial person with their unhealthy habits and make it easier for them to support each other and protect themselves from their unpredictable actions. Teens with evolving antisocial personality disorder need family therapy to ensure consistency. Rule-following reduces bad behaviour.

5. Borderline Personality Disorder

Borderline personalities believe that the world is a dangerous place, that they are helpless and that they will be abandoned by others owing to them being undesirable. Cognitive therapies aim at changing this pattern of thinking by encouraging the patient to test these maladaptive schemas against past experiences and reality. The patient is also trained to challenge the tendency to perceive everything in black and white (dichotomous thinking).

Q 6. Describe types of hearing loss.

Ans) Damage to any part of the ear can cause hearing loss. Hearing loss can occur before, during, or after birth. Family history of childhood deafness, consanguineous marriages, pregnancy illness, rubella during pregnancy, and poor mother health may be prenatal causes. Premature birth, oxygen deprivation, no birth cry, and low birth weight are probable causes. After birth, ear, nose, face, and throat deformities, infectious diseases (mumps, measles, meningitis, viral fever), ear injury, loud sound, and neglected ear discharge cause it. High-risk children should get hearing tests early.

The more sensitive your hearing is, the worse your hearing loss will be. Hearing loss can be mild, moderate, moderately severe, severe, or profound.

The types of hearing loss are as follows:

1. Conductive hearing loss: Hearing loss due to any problem in the outer ear and/or middle ear can lead to conductive hearing loss.

2. Sensory neural hearing loss: Hearing loss due to any problem in the inner ear and/or auditory nerve is termed as sensor-neural hearing loss.

3. Mixed hearing loss: Hearing loss due to any problem in the outer and / or middle ear including inner ear is termed as mixed hearing loss.

4. Central hearing loss: The hearing loss due to defects in central auditory processing is termed as central hearing loss. The child can hear the sound but has problem in understanding and interpreting the speech and language.

5. Functional hearing loss: This is hearing loss when there is no anatomical and physiological abnormality in the auditory system but the child has problem in hearing due to malingering or psychological problems.

Section B - Short Answer Type Questions (40 marks)

Q 1. Write short notes (in about 150 words each) on the following: (5x8=40 marks)

i) Biomedical perspective of stress

Ans) From a biomedical point of view, stress is a physical reaction to something that is seen as a threat or a challenge. It says that stress causes stress hormones like cortisol and adrenaline to be released. These hormones affect different body systems and can cause physical and physiological changes like a faster heart rate, higher blood pressure, and tighter muscles. Stress that lasts for a long time can also hurt the immune system and make it more likely that someone will get heart disease, anxiety, or depression. The following points show the effects of Biomedical Perspective Stress:

1. Stress activates the hypothalamic-pituitary-adrenal (HPA) axis leading to release of cortisol.

2. Chronic stress can result in cortisol dysregulation and contribute to diseases such as obesity, type 2 diabetes, and cardiovascular disease.

3. Stress can weaken the immune system and increase vulnerability to infections.

4. Chronic stress can also affect mental health, increasing the risk for depression and anxiety disorders.

5. Mind-body interventions such as mindfulness and exercise have been shown to reduce stress and improve overall health.

ii) Warning signs for dementia

Ans) Dementia is a broad term used to describe a decline in cognitive function, including memory loss and difficulties with thinking, problem-solving, and language. It affects multiple areas of the brain and can lead to changes in behaviour and mood. Dementia is most commonly seen in older adults and is caused by a variety of factors, including damage to brain cells from diseases such as Alzheimer's and Parkinson's, as well as from brain injury, stroke, and other conditions. There is no cure for dementia, but treatments and lifestyle changes can help improve quality of life for people with the condition.

Ten Warning Signs for Dementia

1) Recent memory loss affecting job,

2) Difficulty performing familiar tasks,

3) Problems with language,

4) Disorientation to time or place,

5) Poor or decreased judgment,

6) Problems with abstract thinking,

7) Misplacing things,

8) Changes in mood or behaviour,

9) Changes in personality, and

10) Loss of initiative.

iii) CBT

Ans) Cognitive-behavioural therapy (CBT) is a form of psychotherapy that aims to change negative patterns of thinking and behaviour. CBT is based on the idea that our thoughts, feelings, and behaviours are interconnected, and that negative thoughts and behaviours can lead to emotional distress. During therapy, individuals work with a therapist to identify and challenge negative thoughts and beliefs, learn coping skills and stress-management techniques, and practice positive behaviour changes. CBT has been found to be effective in treating a wide range of mental health conditions, including anxiety, depression, obsessive-compulsive disorder, post-traumatic stress disorder, and phobias.

Cognitive therapy is based on the idea that faulty ways of thinking can trigger depression. The therapist helps to understand one’s thought patterns.

1. First, any harmful, unhelpful and ‘false’ ideas or thoughts which are making one depressed are identified.

2. A more adaptive way of coping is taught. The aim is then to change ways of thinking to avoid these ideas. Also, patients are helped to have thought patterns which are more realistic and helpful.

3. Once these techniques are taught, the persons have to apply these for themselves whenever symptoms occur.

iv) Opioids

Ans) Opium, which comes from the poppy plant, is the first opioid. An opioid is any drug that works in the body the same way that opium does. Opioids are a type of drug that is used to stop or lessen pain. They work by attaching to certain pain receptors in the brain and making pain feel less intense.

There are three broad classes of opioids:

1. Naturally occurring substances, such as morphine and codeine.

2. Semi-synthetics such as heroin, oxycodone that are produced by modifying natural substances.

3. Pure synthetics like fentanyl and methadone are not made from opium, but they have the same effect on the brain as opium. When opioids are given to someone who has never taken them before, they make them feel bad. But when heroin or morphine is injected over and over again, it causes a "rush" that lasts less than a minute. It's been called a state of deep happiness. Pain relief comes from not being able to feel pain and from being in a dreamlike state where you don't react as much to your surroundings. At higher doses, there may be excitement and shaking.

v) Dependent Personality Disorder

Ans) Dependent Personality Disorder (DPD) is a mental health condition characterized by an excessive need to be taken care of and a fear of being alone or abandoned. People with DPD have difficulty making decisions, initiating projects, and expressing opinions. They may go to great lengths to please others and may feel helpless and hopeless when a relationship ends. They may also have trouble forming their own identity and may struggle with self-confidence and assertiveness.

Dependent personality disorder is when a person always wants to be close to another person and expects that person to make all of their decisions for them. The person doesn't feel like she or he has any control over her or his life, so it's hard for her or him to make decisions on his or her own. They usually cling to one relationship or another as a way to feel better. They only spend time together with people they can count on, and they tend to stay in a relationship even if it hurts them physically or emotionally. When a relationship ends, they look for another one. The person's ability to do their job is hurt because they cannot make decisions without help.

vi) Features of abnormal grief

Ans) Abnormal grief can be seen as a change in the way grief usually gets better. It can cause a lot of mental illness or distress and make someone more likely to have other physical and mental problems. Grief that is not normal lasts longer than the usual two to six months. This is a common sign of abnormal grief.

Abnormal grief, also known as complicated grief, is a severe form of grief that occurs after the loss of a loved one. It is characterized by the following features:

1. Intense and persistent yearning for the deceased

2. Difficulty accepting the reality of the loss.

3. Difficulty performing daily activities.

4. Extreme bitterness or anger about the loss

5. Numbness or detachment from others

6. Feelings of hopelessness or guilt

7. Avoidance of reminders of the loss

8. Trouble finding meaning in life without the deceased.

These symptoms last longer than typical grief and interfere with a person's ability to function and move forward. Abnormal grief can be treated with therapy, such as cognitive-behavioural therapy or grief-focused therapy, and medication for related symptoms such as depression and anxiety.

vii) ADHD

Ans) Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects attention, impulsivity, and hyperactivity. People with ADHD have difficulty paying attention, following through on tasks, and controlling impulsive behaviour. They may also be excessively active or have trouble sitting still. ADHD is usually diagnosed in childhood and can continue into adulthood. It is believed to be caused by a combination of genetic and environmental factors. Treatment for ADHD typically involves medication, such as stimulants, as well as behavioural therapy and lifestyle changes. In some cases, a combination of treatments is effective in managing symptoms.

One idea about what causes ADHD is that it is caused by small amounts of brain damage, but this idea has been questioned. Also, it's not clear that the home environment has anything to do with this syndrome. Recent research shows that kids with ADHD who get multiple treatments (like medicine and counselling for their parents) are less likely to act out as teenagers. The main goal of management would be to keep things organised and in order. Parent counselling helps them figure out what is wrong, accept their child's condition, and understand that their child's hyperactivity is not on purpose.

viii) Epilepsy

Ans) Epilepsy is a neurological disorder characterized by recurrent seizures. Seizures are episodes of abnormal electrical activity in the brain that can cause a variety of symptoms, such as convulsions, loss of consciousness, and strange sensations. The cause of epilepsy is often unknown, but it can be triggered by brain injury, infection, genetic factors, and other conditions. Treatment for epilepsy typically involves medication to control seizures, but in some cases, surgical intervention may be necessary. People with epilepsy can lead normal lives with proper management of their condition, but it is important for them to work closely with their healthcare provider to determine the best treatment plan for their individual needs.

Epileptic seizures can be classified as follows:

1. Partial seizures

2. Psychomotor epilepsy

Epilepsy can be caused due to:

1. Organic lesions as tumours in the brain

2. Head injuries

3. Fever

4. Infections as meningitis

5. Hereditary disorders as Batten’s disease.