IGNOU BPCC-113 Solved Question Paper PDF Download

IGNOU BPCC-113 Previous Year Solved Question Paper in Hindi

IGNOU BPCC-113 Previous Year Solved Question Paper in English

Q1. Elucidate the types of schizophrenia. Discuss the biological and psychosocial causal factors in schizophrenia. 4+6

Ans. Schizophrenia is a severe mental disorder that affects how a person thinks, feels, and behaves.

Types of Schizophrenia: Historically, DSM-IV listed several subtypes of schizophrenia, but DSM-5 has moved away from these, favouring a spectrum approach focused on symptom dimensions. The former subtypes were:

• Paranoid Schizophrenia: Characterised by prominent delusions of persecution or grandeur and auditory hallucinations. Cognitive skills and affect remain relatively intact.
• Disorganized Schizophrenia: Marked by disorganized speech, disorganized behaviour, and flat or inappropriate affect.
• Catatonic Schizophrenia: Dominated by motor abnormalities, such as immobility (catatonic stupor), excessive motor activity, or bizarre postures.
• Undifferentiated Schizophrenia: Diagnosed when a person’s symptoms do not clearly fit into any of the other subtypes.

Causal Factors: Both biological and psychosocial factors play crucial roles in the development of schizophrenia. Biological Factors:

• Genetics: Family, twin, and adoption studies show a strong genetic component. The risk of schizophrenia increases significantly if a first-degree relative has the disorder.
• Brain Chemistry (Neurochemistry): The dopamine hypothesis suggests that an excess of the neurotransmitter dopamine in certain brain regions may be linked to the positive symptoms of schizophrenia.
• Brain Abnormalities: Some individuals with schizophrenia have enlarged brain ventricles, reduced activity in the frontal lobes (hypofrontality), and abnormalities in the temporal lobe.

Psychosocial Factors:

• Family Dynamics: Living in a family with ‘High Expressed Emotion’ (EE)—characterised by high levels of criticism, hostility, and emotional over-involvement—can increase the risk of relapse in individuals with schizophrenia.
• Urban Living: Being born or raised in an urban environment has been linked to a higher risk of developing schizophrenia.
• Stressful Life Events: Trauma, abuse, or significant life stressors, particularly during childhood, can act as triggers in vulnerable individuals.
• Drug Use: The use of cannabis during adolescence is associated with an increased risk of developing schizophrenia, especially in genetically predisposed individuals.

Q2. Discuss bipolar mood disorders. Elucidate the biological causal factors of this disorder. 4+6

Ans. Bipolar mood disorders are serious mental health conditions characterized by extreme shifts in mood, energy, and activity levels. These shifts range from episodes of mania or hypomania to episodes of depression.

Types of Bipolar Disorders:

• Bipolar I Disorder: Defined by the presence of at least one full manic episode. The individual may also experience major depressive episodes, though this is not required for diagnosis. Manic episodes are severe and may require hospitalization.
• Bipolar II Disorder: Defined by the presence of at least one hypomanic episode and at least one major depressive episode. Hypomania is a less severe form of mania and does not cause major impairment in functioning.
• Cyclothymic Disorder: Involves numerous periods with hypomanic symptoms and periods with depressive symptoms that do not meet the criteria for a full episode, lasting for at least two years.

Biological Causal Factors: Biological factors play a significant role in the development of bipolar disorders.

• Genetics: This is one of the most influential factors. The risk of developing bipolar disorder is about 10 times higher for an individual who has a first-degree relative (parent, sibling) with the disorder.
• Neurochemical Factors: An imbalance of neurotransmitters in the brain is considered a primary cause. Irregularities in the levels of chemicals like norepinephrine, serotonin, and dopamine are linked to the symptoms of mania and depression.
• Hormonal Factors: Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which controls the body’s stress response, may play a role. Levels of stress hormones like cortisol are often abnormal.
• Brain Structure and Function: Neuroimaging studies have revealed that individuals with bipolar disorder may have reduced gray matter volume in certain brain regions, such as the prefrontal cortex and hippocampus.

Q3. Define Cluster A personality disorder. Explain DSM-5 criteria for schizoid personality disorder. 4+6

Ans. Definition of Cluster A Personality Disorder: Cluster A personality disorders are known as the “odd or eccentric” cluster. The defining characteristic of disorders in this group is social awkwardness and social withdrawal. Individuals with these disorders often appear peculiar or detached. According to the DSM-5, this cluster includes three personality disorders:

1. Paranoid Personality Disorder: Characterized by a pervasive distrust and suspiciousness of others.
2. Schizoid Personality Disorder: Characterized by a pattern of detachment from social relationships and a restricted range of emotional expression.
3. Schizotypal Personality Disorder: Characterized by acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior.

DSM-5 Criteria for Schizoid Personality Disorder: According to the DSM-5, Schizoid Personality Disorder is diagnosed based on a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings. This pattern begins by early adulthood and is present in a variety of contexts. The diagnosis requires the presence of four or more of the following:

• Neither desires nor enjoys close relationships, including being part of a family.
• Almost always chooses solitary activities.
• Has little, if any, interest in having sexual experiences with another person.
• Takes pleasure in few, if any, activities.
• Lacks close friends or confidants other than first-degree relatives.
• Appears indifferent to the praise or criticism of others.
• Shows emotional coldness, detachment, or flattened affectivity.

This behaviour must not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder and is not attributable to the physiological effects of another medical condition.

Q4. Discuss in detail about drug use and dependence disorder. 10

Ans. Drug use and dependence disorder, known in the DSM-5 as Substance Use Disorder (SUD) , is a complex condition in which there is a problematic pattern of using a substance (e.g., alcohol, opioids, cannabis) that leads to clinically significant impairment or distress. The disorder can range from mild to severe.

The DSM-5 combined the previous categories of substance abuse and substance dependence into a single continuum. The diagnosis of SUD is based on 11 criteria, which are grouped into four main categories:

1. Impaired Control:
   • Using the substance in larger amounts or over a longer period than was intended.
   • A persistent desire or unsuccessful efforts to cut down or control substance use.
   • Spending a great deal of time in activities necessary to obtain, use, or recover from the substance’s effects.
   • Craving, or a strong desire or urge to use the substance.
2. Social Impairment:
   • Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home.
   • Continued substance use despite having persistent social or interpersonal problems caused or exacerbated by the effects of the substance.
   • Giving up important social, occupational, or recreational activities because of substance use.
3. Risky Use:
   • Recurrent substance use in situations in which it is physically hazardous (e.g., driving while impaired).
   • Continuing substance use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
4. Pharmacological Criteria:
   • Tolerance: A need for markedly increased amounts of the substance to achieve the desired effect, or a diminished effect with continued use of the same amount.
   • Withdrawal: The characteristic withdrawal syndrome for the substance, or taking the substance (or a similar one) to relieve or avoid withdrawal symptoms.

The severity of the disorder is based on the number of criteria met within the past 12 months: 2-3 criteria (mild), 4-5 criteria (moderate), and 6 or more criteria (severe). It is recognized as a chronic brain disease that requires treatment and ongoing management.

Q5. Discuss the DSM-5 criteria of gender dysphoria in adolescents and adults. 10

Ans. Gender Dysphoria refers to the psychological distress that results from an incongruence between one’s sex assigned at birth and one’s internal gender identity. The DSM-5 emphasizes that the diagnosis is based on the distress, not the gender incongruence itself.

DSM-5 Criteria for Adolescents and Adults: For a diagnosis, the individual must experience a marked incongruence between their experienced/expressed gender and their assigned gender, lasting for at least six months. This is manifested by at least two of the following criteria:

1. A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (e.g., genitals, breasts, voice).
2. A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender.
3. A strong desire for the primary and/or secondary sex characteristics of the other gender.
4. A strong desire to be of the other gender.
5. A strong desire to be treated as the other gender.
6. A strong conviction that one has the typical feelings and reactions of the other gender.

In addition, the condition must be associated with

clinically significant distress

or impairment in social, occupational, or other important areas of functioning.

It is crucial to note that the DSM-5 does not classify gender non-conformity as a mental disorder. A diagnosis of Gender Dysphoria is made only when the gender incongruence causes the individual profound and persistent distress. The purpose of the diagnosis is to help individuals access care, such as hormone therapy, surgery, and counselling, to alleviate their distress and live in a way that is congruent with their gender identity. This approach respects the identity while addressing the associated distress.

Q6. Explain the components of psychodynamic psychotherapy and elucidate the distinctive features of the same. 10

Ans. Psychodynamic psychotherapy is a form of talk therapy derived from the psychoanalytic theories of Sigmund Freud. Its core aim is to help individuals gain insight into the unconscious conflicts and emotions that influence their current behaviour and relationships.

Components of Psychodynamic Psychotherapy:

• Focus on Affect and Expression of Emotion: The therapist encourages the client to recognize and articulate their feelings, especially those that are distressing or contradictory.
• Exploration of Attempts to Avoid Distressing Thoughts and Feelings: The therapy identifies defense mechanisms, which are tactics used to avoid painful experiences.
• Identification of Recurring Themes and Patterns: The therapist helps the client recognize recurring patterns in their thoughts, feelings, life experiences, and relationships.
• Discussion of Past Experience (Developmental Focus): This therapy holds that childhood experiences and relationships shape adult life. Exploring the past is therefore key to understanding the present.
• Focus on Interpersonal Relations: The therapy examines the client’s current patterns of interpersonal relationships and how they relate to past experiences.
• Focus on the Therapy Relationship: The relationship between the client and therapist (involving transference and countertransference ) is itself a key tool, helping to illuminate the client’s relationship patterns.
• Exploration of Fantasy Life: Dreams, fantasies, and daydreams are used to understand unconscious desires and conflicts.

Distinctive Features:

1. Emphasis on the Unconscious: It is founded on the belief that much of our behaviour is driven by unconscious processes.
2. Insight-Oriented: The goal is not just symptom relief but also to enhance self-awareness and self-understanding.
3. Centrality of the Therapeutic Relationship: The exploration of transference is a unique and central part of the therapeutic process.
4. Exploratory Nature: It is often less structured than other therapies, like CBT, allowing the client to freely explore thoughts and feelings as they arise.

Q7. Define behavioural modification. Explain the procedures involved in behavioural modification. 3+7

Ans. Definition of Behavioural Modification (3 marks): Behavioural modification is a psychotherapeutic intervention that focuses on changing undesirable or maladaptive behaviours and promoting desirable ones by applying principles of learning, particularly operant and classical conditioning. Its main emphasis is on observable behaviour rather than on a person’s internal thoughts or feelings. The goal is to replace problematic behaviours with more adaptive ones.

Procedures Involved in Behavioural Modification (7 marks): Behavioural modification involves several established procedures and techniques:

• Positive Reinforcement: Increasing the frequency of a desired behaviour by presenting a rewarding or motivating stimulus after the behaviour occurs. For example, praising a child or giving them a sticker for completing their homework. Token economies are based on this principle.
• Negative Reinforcement: Strengthening a behaviour by removing an aversive or undesirable stimulus. For example, taking an aspirin to get rid of a headache (the behaviour of taking aspirin is reinforced because it removes the pain).
• Punishment: Weakening an undesirable behaviour by presenting an aversive consequence following it. The goal is to decrease the likelihood of that behaviour in the future.
• Extinction: Weakening a behaviour by no longer providing the reinforcement that was maintaining it. For instance, if a child tantrums for attention, ignoring the tantrum can eventually lead to its extinction.
• Systematic Desensitization: Used to treat phobias. It involves pairing relaxation techniques with a hierarchy of anxiety-provoking stimuli, gradually reducing the anxiety response.
• Modeling: Learning new behaviours by observing and imitating others. The therapist or group members can demonstrate adaptive behaviours.
• Flooding: Exposing the client to the feared object or situation for a prolonged period without the possibility of escape, until the anxiety subsides.

Q8. Write short notes on the following in about 50 words each: 5+5 (a) Historical perspectives in treatment of mental disorders (b) Phases of Psychotherapy

Ans. (a) Historical perspectives in treatment of mental disorders The history of treating mental disorders has moved from superstition to science. In antiquity, mental illness was attributed to evil spirits, leading to cruel treatments like trepanation (drilling holes in the skull). Asylums were established in the Middle Ages. In the 18th century, Pinel and Tuke began the “moral treatment” movement. Freud’s psychoanalysis, behaviorism, and later the cognitive revolutions in the 20th century laid the groundwork for modern psychotherapy and pharmacological treatments.

(b) Phases of Psychotherapy Psychotherapy typically progresses through three main phases.

1. Initial Phase: This involves building a trusting relationship (rapport) between the therapist and client, conducting an assessment, and establishing the goals of therapy.
2. Middle/Working Phase: This is the longest phase, where therapeutic techniques are applied, issues are explored, insight is gained, and new skills are practiced.
3. Termination Phase: This involves reviewing progress, planning for the future, and ending the therapeutic relationship. The aim is also to prevent relapse.