Assignment Code: MPC-053/ASST/TMA/July 2022-January 2023

Course Code: MPC-053

Assignment Name: Mental Health in Special Areas

Year: 2022-2023

Verification Status: Verified by Professor

SECTION – A

Answer the following questions in about 1000 words each. 3x15 = 45 marks

1. Explain the concept of marriage. Discuss issues in marital relationship affecting mental health.

Ans) One of the most significant occasions in a person's life is marriage. It has an impact on a person's bodily health, emotional and psychological well-being, and social standing. It not only helps the individual reach a greater degree of psychological development, but also satisfies the basic biological urge for sexual fulfilment in a way that is acceptable to society.

The four ashramas described in the Hindu Dharma Shastras begin with marriage, or Grihastha ashrama. Real family life begins when a person marries. Marriage, in the context of Indian society, involves not just two people, but also two families and two cultures. Beyond the immediate pair, marriage has effects on the families involved, the neighbourhood, and society as a whole. The current, previous, and next generations are all impacted.

A man and woman's physical relationship is socially sanctioned by marriage. It creates the groundwork for creating a family. Marriage is primarily the acceptance of two people's interpersonal ties, which are typically intimate and sexual. Marriage imposes obligations on the couple in terms of law, society, libido, emotion, finances, spirituality, and religion. It is a complicated social organisation that requires clear and thorough understanding in order to take advantage of the cosy, loving, and safe feeling it provides rather than feel entrapped by it.

Issues in Marital Relationship affecting Mental Health

Marriage can be a blissful union. However, if they do not deliberately focus on preserving, developing, and sustaining their relationship, a lot of problems may arise in this relationship between the two people. These have an adverse effect on the couple's mental health and degrade the marriage.

Interpersonal Relationship: Creating a couple bond is a critical interpersonal job in a marriage. This is essential for a successful marriage. It is crucial for the couple to understand each other's expectations and to communicate clearly in light of the shifting conventional values and socio-cultural shifts. Low communication regarding expectations makes a spouse resentful that they are not being considerate and understanding. Disagreements and misunderstandings can be eliminated with clear communication. In the context of Indian marriage, communication not only occurs between the partners but also between the wife and the husband's family, which has an effect on the couple's mental health.

Secondary Status of Women: Women's status in the family and society has historically been viewed as secondary. History demonstrates that married women have extremely minimal rights in the majority of nations. They were seen as the husband's property because he was the one in charge. Women could not be legal representatives, inherit property, or own property. The spouses' lives are impacted by their unequal treatment, which also stops the marriage from developing into a happy union. However, there have been incremental modifications to the law governing marriage, as well as changes in public opinion and societal mores. The standing of women has been changed, and attention has been paid to their rights and uniqueness. Even though attitudes toward women's place in society have gradually changed, most women still experience marital inequities that have a severe impact on their mental health.

Sexual Relationship: A significant portion of the total satisfaction in a marriage comes from sexual fulfilment. Couples frequently fail to recognise that such fulfilment must be earned and necessitates a significant amount of tolerance, patience, effort, and understanding. They need to make adjustments based on a realistic assessment of their partner's and their own sexual preferences and prowess. Every couple should also be familiar with certain fundamental facts concerning the sexual elements of marriage. Couples may also experience issues in their sexual connection if they are unable to express their desires and sentiments to one another openly due to fear, shyness, ridicule, etc. So, either they stick with the status quo, or they start having extramarital affairs. The mental health of the partners is impacted by the lack of trust and understanding in the sexual interaction.

Duties and Responsibilities: The roles of men and women are established in the conventional patriarchal society. But as chances for education, training, and career have grown, modern women have become more independent and self-assured. They must also perform their traditional jobs at the same time. When there is a lack of communication between the partners, marriages may find it difficult to modify. Marriage adjustments come in two flavours, such as "for adjustment" and "we adjustment." The former refers to a family's adjustment, whilst the latter refers to a couple's adjustment to one another. In "for adjustment," the couple invests time, resources, and effort into raising the family, while in "we adjustment," they make an attempt to understand one another.

Finance, Work and Retirement: The couples' financial and professional responsibilities may cause conflict and stress as they progress in their relationship. In the modern world of ever-increasing needs and demands, disagreements about money can cause significant friction between partners. Additionally, raising children has an impact on their mental health, particularly when there is no support system in place, as is the case with the nuclear family system that prevails in modern society. Retirement and health concerns as they age have an impact on their marital connection.

Separation and Divorce: The marriage scenario has been drastically changed by the rising acceptance of divorce. Marriage is no longer viewed as a lifelong commitment. Without giving it much thought, those who get married and divorced have damaged the institution of marriage, diminished its worth, and jeopardised the family system. In the event of separation and divorce, sociocultural factors place more strain and stress on the woman. It makes mental disease more likely. Men turn to drink and drug misuse while women are more likely to experience depression.

As a result, the married couple's relationship faces a number of problems. However, it should be recognised that marital fights can be used as stepping stones for personal development. They can, in fact, become a source of support and help one live a fuller, more fulfilling life. Couples must resist rigidity, refrain from taking one another for granted, and truly invest in their union by devoting time, effort, and energy.

2. Discuss the factors affecting mental health in women.

Ans) Adversely affect women in the following ways:

Mental Disorders

A meta-analysis of 13 epidemiological studies conducted in various parts of India found that 64.8 out of every 1000 females had a mental condition. Women are more likely than men to experience common mental disorders such depression, anxiety disorders, and psychological anguish. These results hold true across a variety of investigations conducted in various settings and nations. One of the most conclusive results in mental epidemiology is the gender difference in depression. Women outnumbered males in lifetime prevalence rates of major depression, according to a comprehensive evaluation of nearly all general population studies conducted to date in the United States, Puerto Rico, Canada, France, Iceland, Taiwan, Korea, Germany, and Hong Kong. Clinical, community, and cross-racial samples have all shown this disparity.

Additionally, depression in women may be more enduring, and relapse is significantly predicted by gender. According to data from a World Bank study, while depressive disorders only accounted for 12.6% of the neuropsychiatric disorders that caused disability in men in developing countries, they accounted for nearly 30% of it in women. In underprivileged populations, the gender pay gap frequently becomes much more prominent. Women are far more likely to be diagnosed with obsessive compulsive disorder, somatization disorder, and panic disorder in addition to having greater rates of depression and anxiety. Contrarily, men are more likely to be diagnosed with alcoholism/dependence and antisocial personality disorder. Additionally, compared to men, women have post-traumatic stress disorder at much higher rates.

Domestic Violence

Alarmingly high rates of violence against women are prevalent. According to the findings of a WHO multi-country study on women's health and domestic violence, between 25 and 50 percent of women reported experiencing physical abuse from a current or former partner. Women are much more likely than men to experience intimate partner violence. All three of the characteristics—humiliation, imposed inferior ranking and subordination, and barred escape or entrapment—that social research on depression in women has found to be present in domestic violence—tend to be repeated and grow in severity over time.

Women who experience violence have lower coping skills and self-esteem. Additionally, it makes them more susceptible to psychological problems and poor mental health. High rates of depression and co-morbid psychopathology, such as posttraumatic stress disorder, dissociative disorders, phobias, substance use, and suicidality, are linked to violence—physical, sexual, and psychological—including phobias. Even when other potentially significant factors have been statistically controlled in data analysis, the degree and length of exposure to violence are highly predictive of the severity of mental health consequences. This has been discovered in studies on the effects of domestic violence and child sexual abuse on mental health.

Sexual Violence

Female mental health is significantly impacted by sexual violence and harassment. Women are more likely than men to be sexually and physically abused, and they also have higher rates of comorbid anxiety, despair, and sickness (Brunette & Drake, 1998). Women's minds are greatly impacted by rape, forced prostitution, sexual abuse, sexual remarks and advances, etc. The objectification of women, which encourages numerous crimes against women, is a reflection of women's subordinate status and how society views women.

Women endure a wider variety of pressures in life due to the nature of their role, position, and status in society, which puts their physical and mental health at higher risk. They are more prone to mental health and psychological issues because to attitude differences in gender norms and expectations. Violence against women—both physical and psychological—has a negative effect on the victims and has detrimental effects on their mental health. It is a denial of women's fundamental human rights. When there are any socioeconomic, political, or cultural changes, it is the women who end up being the victims and who suffer the most. Rape is a common occurrence worldwide, and it is magnified in nations experiencing social unrest and political unrest. The victims of sexual violence in times of war and conflict are the girls and women.

Despite being important first responders to rape victims, many health professionals lack the necessary expertise to address the psychological needs of these women and offer them psychological counselling. The entire system, including the police, attorneys, and judges, must be considerate of the mental health of women who have experienced sexual violence.

Sexual assault trauma can have an adverse impact on mental health, including symptoms like anxiety, guilt, dread, avoidance, sexual dysfunction, food disorders, restless nights, and more.

Major depression, generalised anxiety disorder, post-traumatic stress disorder, obsessive compulsive disorders, suicidal ideation, and alcohol and drug use problems are among the severe mental health repercussions. In some nations, women must battle with cultural ideas that link a woman's value to her virginity in addition to the emotional and psychological effects of the rape act. Instead of offering help to sexual abuse victims, society forces them to wed the rapist in order to escape the shame of personal and familial dishonour. Due of the shame, many women turn to prostitution or commit suicide, and others are murdered by family members.

Substance Abuse

The use of substances by women is a topic covered in a recent WHO report. Although there are regional variations, rates of female substance misuse—in particular, abuse of alcohol, tranquillizers, and analgesics—are rising globally. Despite rising rates, there are few programmes available to help women. Most nations have a long history of viewing substance misuse as a man's issue and as being incompatible with a woman's character and place in society. Due to this, there is a lot of shame associated with women who take drugs. Women are hesitant to use these services, not just due to the stigma attached but also because they are expensive. Even where services are available, they have been designed to meet the requirements of male substance abusers.

Women might get assistance from support and self-help organisations to deal with the issue. To satisfy the demands of such women's mental health, family members, counsellors, friends, and medical professionals can offer the care and support that they so desperately need. Counsellors, families, close friends, important peers, and treatment or educational professionals are all available sources of support for substance addicts. With abusers, group therapy is a successful intervention technique. It aids addicts in their recovery process. The abusers' sharing of their experiences teaches them how to empower one another. Abuser self-help groups are more successful because they boost confidence and provide solutions to difficulties. With abusers, group therapy is a successful intervention technique. It aids addicts in their recovery process.

3. Explain the impact of mental health problems at workplace. What are the risk factors that contribute to mental health problems at the workplace.

Ans) It's important to recognise and effectively manage the effects of mental health issues on employment and productivity. Long-term advantages for the employees, employer, and organisation come from safeguarding and promoting healthy mental health at work. Therefore, it is important that we comprehend this and make deliberate, proactive attempts to address workplace mental health difficulties. The workplace has the potential to improve someone's mental health, to exacerbate an existing problem, or to cause the emergence of a mental health issue. As a result, mental health issues directly affect employers and enterprises through more absenteeism, decreased output, greater expenses, and lower profits. They also have indirect effects on employers due to things like staff morale decline. Let's look more closely at a few of these elements.

Increased Absenteeism

35 to 45 percent of workplace absences in many industrialised nations are brought on by mental health issues. In the United Kingdom, for instance, mental health issues account for between 5 and 6 million lost working days yearly, making them the second most significant reason for absences from work. According to a study conducted in the US, mental illnesses cost employers on average 6 working days each month for every 100 employees.

Decreased Productivity

Mental health issues can significantly lower productivity even when an employee is present at work. For instance, in the US, there were 31 "cutback" days per 100 workers each month on average due to a mental illness. This amounts to 20 million working days each year during which workers are not at their highest levels of productivity due to mental health issues. In a prominent financial services company in the USA, the average number of working days missed due to short-term disability for each employee with depression was 44, as opposed to 42 for heart disease, 39 for lower back pain, and 21 for asthma.

Increased Costs

Each depressed employee in the US costs their companies over $3,000 in lost productivity. Instead of therapy, absenteeism and lost productivity account for the majority of costs for companies. According to the Association of Canadian Insurance Companies, mental health issues account for 30 to 50 percent of disability payments, and they are the main reason for extended absences from work. According to the experience of many businesses, it is quite likely that an employee's absence will extend longer than a year if it has lasted for three months due to mental health issues.

Indirect Costs

It is difficult to measure the many indirect costs of mental illnesses at work, including decreased productivity, low morale, high employee turnover, early retirement, and workplace grievances and lawsuits.

Employees and their Families

Mental health issues can affect an individual's quality of life and have serious economic and societal repercussions. Employees with mental health issues may experience financial hardship due to missed work days and high healthcare bills. Many employees lack insurance to cover the cost of illness or missed work, especially those in low-paying jobs or tiny firms. They are unable to afford the leave of absence needed for recuperation or have access to medical care for their mental health issue.

Stigma

People who have mental health issues frequently face stigma and discrimination. Without effective treatment, the financial and personal strain of having a mental health issue can create a harmful vicious cycle that may exacerbate the issue. Mental health issues also have an influence on families. They can have financial hardships as a result of their decreased income, rising health care expenditures, the stress of adjusting to their changed behaviour, disruption of their daily routine, and fewer opportunities for social interaction.

The Community

The expense of therapy, particularly hospitalisation, is included in the cost of mental health issues to the larger population. Other costs to the community are those associated with lost output, fatalities, the results of untreated illnesses, social marginalisation, and violations of human rights. Workplace mental health issues negatively impact the country's economy.

Risk Factors for Mental Health Problems

Individual Risk Factors:

Biological Factors: Biological variables, such as genetic makeup and disruptions in neuronal connectivity, are linked to mental health issues.

Psychological Factors: The emergence of mental health issues is related to personal psychological characteristics. For instance, children who experience prolonged separation from their primary caregiver or lack of loving are more likely to experience mental or behavioural disorders as youngsters or as adults.

Social Factors: The emergence of mental health issues is influenced by social variables such as urbanisation, poverty, and technological advancements. Poverty is greatly exacerbated by the costs of treating mental health issues and the lost productivity they cause, and it is also exacerbated by conditions that are related to poverty, such as inadequate housing and malnutrition. Both the perception of stressors and the effect of stress on mental health outcomes are significantly influenced by social support from co-workers and superiors as well as cooperative problem-solving.

Organizational Risk Factors:

The following categories of job design and working environment have been identified as significant risk factors for mental health:

1. Work load and pace: Instead of production requirements, the important issue in this situation is the extent of the worker's control over the rate of work. Fast-paced assembly work may be particularly harmful to one's mental well-being.

2. Work schedule :Night work and alternating shifts have been linked to an increased risk of mental health issues.

3. Role stressors: Role conflict and ambiguity, both prevalent in many workplaces, have a detrimental effect on mental health..

4. Career security factors: Mental health is negatively impacted by feelings of insecurity related to problems like employment future or obsolescence, professional advancement, and promotion of early retirement.

5. Interpersonal relations: Unpleasant psychological reactions are substantially more likely when co-workers have poor or unsupportive relationships.

6. Home-work interface: The effects for a person's mental health of tensions between home and work. The risk of having a mental health issue might be increased by factors including competing demands at work and at home, a lack of support at work for personal responsibilities, or insufficient support at home for work commitments.

SECTION – B

Answer the following questions in about 400 words each. 5 x 5 = 25 marks

4. Explain the cognitive disorders in the older population.

Ans) A impairment in cognitive functioning is the primary aspect of cognitive disorders. These illnesses cause problems with thinking, memory, attention, and perception. The majority of mental illnesses have an impact on cognitive processes, including memory processing, perception, and problem solving. These cognitive conditions include forgetfulness, delirium, and dementia.

Memory, judgement, and other cognitive abilities are impaired in dementia syndrome, a significant diagnosis among the elderly. Dementia affects 2 to 5 percent of people over 65 in the general population and is said to double every five years. 50 to 60 percent of dementia patients have Alzheimer's disease, while 15 to 30 percent have the vascular subtype. One to five percent of dementia cases are due to other prevalent factors, such as head trauma, alcohol consumption, and mobility disorders.

Dementia frequently has memory loss as a key component. The patient has trouble remembering what they have already learnt as well as picking up new knowledge. Along with aphasia (language difficulty), apraxia (inability to perform motor tasks despite having intact motor functions), agnosia (inability to recognise or identify objects despite having intact sensory functions), and executive functioning issues, patients with dementia may also experience other symptoms (planning, organizing, sequencing, abstracting). Significantly less social or occupational functioning than before is caused by these cognitive deficiencies.

Delirium is another cognitive illness that is defined by alterations in cognitive functioning and a temporary state of confusion. Patients who are older than 60, have dementia, cerebrovascular accidents, burns, infections, and alcohol withdrawal are more likely to experience delirium. Initial treatment for delirium patients is maintaining critical parameters through medical care. Through the history, physical examination, and laboratory tests, the cause of delirium is determined. After determining the cause of the confused state, a specific therapy or intervention is begun.

Clinicians additionally take care of and control overstimulating and excessive environmental factors that are in the patient's immediate area. Patient should be maintained in a calm, well-lit room with basic furnishings. Regular reminders of time, place, and person should be given to the patient by family members and medical staff. Restrictions ought to be avoided. Low dose antipsychotics (Haloperidol or Risperidone, either oral or injectable) may be used for agitated behaviour.

Delirium is further divided into the following groups based on aetiology:

1. Delirium brought on by a general medical problem, such as an infection or tumour.

2. Delirium brought on by alcohol or narcotics, such as cannabis.

3. Delirium brought on by several factors.

4. Delirium brought on by other factors, such as sleep deprivation.

The symptoms of amnestic condition include memory loss and forgetfulness. Amnestic condition is further divided into three subcategories based on the aetiology:

1. Disorders of amnesia brought on by medical conditions like hypoxia.

2. Diseases of amnesia brought on by toxins or drugs like benzodiazepines or cannabis.

3. Unknown cause.

5. Describe the management of sexual dysfunction.

Ans) Before 1970, individual psychotherapies were the most often used intervention for sexual dysfunction. Early developmental tensions were emphasised as the primary cause of sexual dysfunction in the traditional psychodynamic theories. Therefore, resolving these conflicts would result in the ego accepting its sexual urges and the issue being solved. For a successful outcome, sex therapy should preferably involve both the patient and the partner. It should be emphasised in therapy that it is useless to blame oneself or one's partner, that sex is a voluntary act between two people, and that it is not something a man does to a woman or a woman to a man. The partnership benefits from improved social communication, which can take the shape of extremely intimate interpersonal interactions.

Behavioural techniques

Behavioural therapists view sexual dysfunction as a maladaptive behaviour. The client is systematically desensitised by engaging in a hierarchy of sexual activities that cause anxiety. Techniques for sensitization and desensitisation are the main components of the therapy. Most of the deficiencies seen in clinical practise can be accounted for by the general principles.

The following are the main rules to be followed:

1. Educating the couple/client: The couple is counselled to discuss their concerns in a non-judgmental manner, to encourage their partners to see, hear, and comprehend each other's perspective, and to teach verbal and nonverbal communication skills, both generally and during sexual activity in particular.

2. Setting the framework for the therapy: Set clear expectations for the therapy, remove myths and sensationalised representations of sex therapy, and let the couple acknowledge and take ownership of much of their treatment

3. Proscribe sex: It is advised to refrain from sexual engagement unless you are specifically instructed to do so in order to reduce performance stress and anxiety.

4. Sensate focus exercises: These are regimented exercises with roughly 3-5 sessions scheduled in between visits. Help the couple understand that having and receiving pleasure can be delightful without being considered foreplay or a precursor to sexual intercourse, and that sexual activity is not only restricted to sexual intercourse.

5. Systematic Sensitization and Desensitization: ‘One of the most popular and effective procedures under this topic is the Start-Stop Sensitization technique, which is utilised for premature ejaculation.

Integrated Sex Therapy

1. When sex therapy is more appropriately referred to as "Integrated Sex Therapy," it is typically combined with other treatment modalities. Supportive, psychodynamic, insight-oriented, and notably behaviour therapy are all included in the sex therapy programme and improve outcomes.

2. The attachment aspect of sexuality is given more attention in "syndyastic sexual therapy." This strengthens the couple's connection and intimacy while also enhancing sexual performance. This distinguishes syndyastic sexual therapy from other forms of therapy by putting the satisfaction of psychosocial basic needs at the centre of therapy.

   
   

Pharmacological Management

1. Several medications have been developed recently to treat impotence and early ejaculation. These medications enhance erections and blood flow to the penis. Among them are vardenafil, tadalafil, and sildenafil. Regardless of the cause of erectile dysfunction, these medications work.

6. Explain functional behavioural assessment.

Ans) To determine the fundamental causes of behaviour, functional behavioural evaluation is performed. It aids in identifying particular causes of the child's problematic behaviour. Definition of the problematic behaviour, or its explicit description, is the first step in the process. It involves characterising the behaviour in a form that makes it straightforward to monitor, document, and communicate about it.

Making an acceptable intervention choice is made easier by the issue behaviour’s concrete explanation. The child's behaviour is meticulously and methodically watched in a range of settings, including the classroom, the playground, during assemblies, during lunch, at home, etc., and the distinct aspects of the behaviour are meticulously recorded. Finding the functions of the problem behaviour comes after defining the problem behaviour. Functional behavioural assessment is carried out for this.

Steps in Functional Behavioural Assessment

Direct Assessment: This uses the A-B-C method. It speaks about the antecedents (what occurred before the behaviour), the behaviour (how the behaviour was described at the time), and the consequences (what happened after the behaviour).

Controlling A and changing C change B. This is accomplished by determining both the circumstances that precede and initiate the behaviour as well as the reinforcing effects that keep it going. The target behaviour’s causes and effects may be overt, visible conditions or secret mental occurrences that the person whose behaviour has to be changed has reported.

The behaviour’s frequency, persistence, and seriousness are all noted as well. The teachers and the parents can individually keep a "symptoms diary" for this.

Direct Evaluation Parents, teachers, peers, and any other relevant individuals in the child's life are surveyed using a structured interview technique to learn more about their child's behaviour. The child could also be interviewed to learn more about his or her viewpoint and perception. The information emphasises:

1. What time does the behaviour happen?

2. Who is in the room when the behaviour happens.

3. When it doesn't happen.

4. What comes before the behaviour, i.e., the character of the conversation or the events that took place before the behaviour

5. What took place following the behaviour.

6. What appropriate behaviour could take the place of this problematic behaviour.

Data Analysis: The data are then collected and examined. This enables us to ascertain the purpose the behaviour is fulfilling for the child, such as whether it aids in gaining attention, receiving a reward, avoiding responsibility, avoiding doing homework, etc.

Tentative Hypothesis: On the basis of the foregoing, potential solutions or hypotheses are formulated and tested. The hypothesis makes predictions about the situations in which the issue behaviour is most and least likely to occur as well as the outcomes that support the behaviour once the relevance or functions of the behaviour are known. The hypothesis is put to the test by altering the environment. If the hypothesis is confirmed, a behaviour intervention strategy will be developed. If the hypothesis is not supported by the data, a new hypothesis must be developed, and the data reanalysed.

Behaviour Intervention Plan: A plan of intervention is developed to reduce or alter the maladaptive issue behaviour. By adjusting the behaviour’s antecedents and/or consequences, it focuses on teaching more suitable behaviour that fulfils the same purpose as the disruptive problem behaviour.

7. Explain the interventions for behaviour addictions.

Ans) Psychoeducation, psychotherapy interventions, motivational enhancement, cognitive therapy, behaviour therapy, and family-focused therapy are all examples of interventions.

Psychoeducation

The person needs to be informed on the nature of the issue, including information about sustaining elements and unfavourable effects that may result from it. Pamphlets with self-help information can also be distributed.

Psychotherapeutic intervention

Two strategies are used in psychotherapeutic intervention: complete abstinence or moderate use. Even for people who are internet addicts, it is impractical to pursue the entire abstinence paradigm given the internet's many benefits and useful applications in daily life. The overarching tenet should be "moderate and controlled use." In the abstinence approach, the person utilises other online applications sparingly while forgoing one specific application. For those who have tried and failed to cut back on their use of a particular application, this model of abstinence is advised. Information regarding the initiating and maintaining elements is gathered before the intervention even begins.

Motivational enhancement therapy

It is necessary to increase the subjects' motivation because they are frequently not very motivated for treatment. A methodical intervention strategy for inducing change in internet addicts is motivational enhancement treatment (MET). It is based on motivational psychology principles and intended to bring about quick, inwardly driven transformation. Instead of trying to train and mentor the client through recovery step by step, this therapy style uses motivating techniques to mobilise the client's own resources for change. Exercises for motivational balance support motivational interviewing.

Cognitive behaviour Therapy

According to the theory behind cognitive behaviour therapy, addiction develops whenever a person thinks that they lack social and familial support, leading to the development of what are known as maladaptive cognitions and behaviours regarding themselves and the outside world. It consists of two parts: skill development and functional analysis. The structured evaluation on the internet addiction test is part of the functional analysis, along with the triggers/reasons for use that cause a subject's maladaptive behaviours and the immediate positive effects that maintained the maladaptive behaviours. Training in skills includes coping style development and dealing with a variety of stimuli. Adolescents have individual therapy sessions where the emphasis is on fostering treatment engagement and boosting motivation.

Family Oriented therapies

Interventions centred on the family have also been effective. Parents or the spouse can be treated along with other family members. The goal is to improve awareness of the harmful effects of excessive internet use and other behaviours, to build coping mechanisms, to promote prosocial peer behaviour, and to improve parenting techniques.

Implications

A thorough psychiatric examination is required due to the co-morbidity of the disorder with other psychiatric illnesses, including depression, anxiety disorders, and occasionally even severe mental illnesses. Only after that should specialised therapy for behavioural addictions be begun. Given that onset frequently occurs during puberty, parents must keep an eye on their children. In order to address the emergence of these addictions in the Indian setting and the accompanying burden linked with it, it is necessary to comprehend the prevalence/pattern/longitudinal work.

8. Discuss the psychological approaches to treatment of alcoholism.

Ans) The following treatments have the strongest empirical backing:

Brief Intervention

The purpose of a brief intervention is to be carried out by medical experts who are not trained in addiction therapy. The acronym FRAMES stands for feedback, responsibility, guidance, menu of tactics, empathy, and self-efficacy. Six components were proposed to highlight the essential components of brief intervention. It is often limited to four sessions or less, with each session lasting anything between a few minutes and an hour. With adult and adolescent patients who are not alcohol addicted, it is most frequently utilised, and its objective may be moderate drinking as opposed to abstinence.

Brief Strategic Family Therapy

Many people with substance abuse disorders attribute their patterns and dynamics for using drugs to interactions with both their present and birth families. In addition, interactions between family members and the substance user can either exacerbate the situation or significantly help to solve it. When a client shows indications that his substance addiction is significantly influenced by family members' actions or interactions with them, family therapy is especially appropriate.

Cognitive Behavioural Interventions

The foundation of CBT techniques, which were modified from Marlatt and Gordon's Relapse Prevention treatment for problem drinking, is the idea that learning processes contribute to the formation of unhelpful behavioural patterns. People acquire the ability to recognise and address undesirable behaviours. CBT aims to assist patients in recognising, avoiding, and coping. In other words, recognise the circumstances in which individuals are most prone to use alcohol, avoid these circumstances when appropriate, and cope more skilfully with a variety of issues and problematic behaviours related to alcohol misuse.

Community Reinforcement Approach

A job club, marital therapy, social skills/relapse prevention instruction, and disulfiram are all components of the individual counselling strategy known as CRA, which was first created for alcoholism (Antabuse). The main objective is to raise abstinence.

Patients must significantly alter their lifestyles in order to attain and maintain abstinence, notably in the following four areas:

1. Family relationships.

2. Recreational activiti.es.

3. Social networks

4. Vocation.

Contingency Management

In contingency management, a client is routinely provided with a tangible commodity or service in exchange for a specific behaviour, which could include abstinence from or moderate consumption of alcohol.

Motivational Interviewing/ Enhancement

The goal of motivational enhancement therapy (MET) is to help clients develop their own drive for change as well as a personal decision and change strategy. Despite being planned and directed, the method is essentially client cantered. When it comes to alcohol misuse, MET aims to change the destructive usage of the drug. No absolute aim is imposed through MET because each client establishes his or her own objectives, however counsellors may suggest particular objectives like total abstinence. It's also possible to look into a wider variety of life objectives.

SECTION – C

Answer the following questions in about 50 words each. 10 x 3 = 30 marks

9. Asperger’s disorder

Ans) A developmental disorder affecting ability to effectively socialise and communicate. Asperger's syndrome is a condition on the autism spectrum, with generally higher functioning. People with this condition may be socially awkward and have an all-absorbing interest in specific topics. Communication training and behavioural therapy can help people with the syndrome learn to socialise more successfully.

10. Aversion therapy

Ans) Aversion therapy is a form of psychological treatment in which the patient is exposed to a stimulus while simultaneously being subjected to some form of discomfort. This conditioning is intended to cause the patient to associate the stimulus with unpleasant sensations with the intention of quelling the targeted (sometimes compulsive) behaviour.

11. Play therapy

Ans) Play therapy refers to a range of methods of capitalising on children's natural urge to explore and harnessing it to meet and respond to the developmental and later also their mental health needs. It is also used for forensic or psychological assessment purposes where the individual is too young or too traumatised to give a verbal account of adverse, abusive or potentially criminal circumstances in their life.

12. Self-report

Ans) Self-report or self-observation is another indirect method of assessment of individual

behaviour. This method is used to assess behaviour which are not possible to be observed

by an assessor. The client is asked to record his/her own behaviour in an objective and

quantifiable manner. In spite of its drawbacks, it is a unique method of obtaining

information regarding private behaviour of the client.

13. Spina bifida

Ans) A birth defect in which a developing baby's spinal cord fails to develop properly. It occurs when a developing baby's spinal cord fails to develop or close properly while in the womb. Symptoms can sometimes be seen on the skin above the spinal defect. They include an abnormal tuft of hair, a birthmark or protruding spinal cord tissue. When treatment is necessary, it's carried out through surgery to close the defect. Other treatments focus on managing complications.

14. Mnemonic method

Ans) With this approach, students must compose a lengthy text and analyse their ongoing writing. This technique is intended to improve recall for the details and order of creating expository prose, like writing a storey. Simple mnemonic techniques are given to them in order to control the writing process. For instance, the acronym "WWWH" may stand for "Who," "Where," "When," and "How." These kinds of tactics can be demonstrated, discussed in groups, and practised to be taught and developed. Similar checklists can be created by teachers to help students recall the steps for a particular composition writing assignment.

15. Diagnosis of specific learning disability

Ans) In addition to having at least average intellect, a person must also have access to sufficient learning opportunities in order to receive a diagnosis of a specific learning disability. Any sensory abnormality that can limit learning in the youngster should be absent. These prerequisites must be met in order to identify children with learning disabilities.

16. Genetic counselling

Ans) Genetic counselling is to raise awareness of the genetic component of mental impairment, especially among young individuals and couples. Psychologists, educators, and doctors who talk about the hereditary component of mental retardation must be involved. The genetic counsellor clarifies how desirable the offspring will be to their parents, siblings, and occasionally even more distant relatives. The main concern of the counsellor is frequently the possibility of having further children who are mentally retarded.

17. 12-step facilitation therapy

Ans) Alcohol, stimulants, and opiate addiction and abuse are all treated through 12-step facilitation therapy. The goal of 12-step facilitation therapy is to enhance the possibility that a substance abuser would join and actively participate in 12-step self-help groups, which will help to encourage abstinence. It contains acceptance, surrender, and active participation as its three main tenets.

18. Multisystemic therapy

Ans) MST is an intense, family-focused and community-based treatment program for juveniles with serious criminal offenses who are possibly abusing substances. It is also a therapy strategy to teach their families how to foster their success in recovery. The goals of MST are to lower rates of criminal behaviour in juvenile offenders.