BPCC-133 Solved Assignment 2024

PART A Assignment 1

Answer the following questions in about 500 words each. Each question carries 20 marks.

  1. Explain the types of schizophrenia. Discuss the causal factors of schizophrenia.


Types of Schizophrenia

Schizophrenia is a complex mental disorder characterized by disruptions in thought processes, perceptions, emotions, and behavior. There are several subtypes of schizophrenia, each with its own distinct features:

  1. Paranoid Schizophrenia: Individuals with paranoid schizophrenia often experience delusions and auditory hallucinations, but their cognitive functions and affect may remain relatively intact. They may have a strong sense of paranoia and may believe that others are plotting against them.

  2. Disorganized Schizophrenia: This subtype is characterized by disorganized speech and behavior, as well as flat or inappropriate emotions. People with disorganized schizophrenia may have difficulty in daily functioning and may exhibit unusual behaviors.

  3. Catatonic Schizophrenia: Catatonic schizophrenia is characterized by disturbances in movement. Individuals with this subtype may exhibit either excessive motor activity (catatonic excitement) or decreased motor activity (catatonic stupor). They may also display peculiar postures or repetitive movements.

  4. Undifferentiated Schizophrenia: This subtype is used when the symptoms of schizophrenia do not clearly fit into any of the other subtypes. Individuals with undifferentiated schizophrenia may exhibit a mix of symptoms from various subtypes.

  5. Residual Schizophrenia: Residual schizophrenia is characterized by a past history of at least one episode of schizophrenia, but the individual currently does not display prominent positive symptoms (such as hallucinations or delusions). However, negative symptoms (such as social withdrawal or lack of motivation) may still be present.

Causal Factors of Schizophrenia

The exact cause of schizophrenia is not fully understood, but it is believed to be the result of a complex interaction between genetic, environmental, and neurobiological factors:

  1. Genetic Factors: Schizophrenia tends to run in families, suggesting a genetic component. However, no single gene is responsible for the disorder. Instead, multiple genes are thought to contribute to an increased risk of developing schizophrenia.

  2. Neurobiological Factors: Imbalances in certain neurotransmitters, such as dopamine, serotonin, and glutamate, may play a role in the development of schizophrenia. Structural and functional abnormalities in the brain, particularly in the frontal and temporal lobes, have also been observed in individuals with schizophrenia.

  3. Environmental Factors: Prenatal and perinatal factors, such as maternal malnutrition, viral infections, and obstetric complications, have been associated with an increased risk of schizophrenia. Other environmental factors, such as early childhood adversity, substance abuse, and urban upbringing, may also contribute to the development of the disorder.

  4. Psychological and Social Factors: Stressful life events, such as trauma, loss, or abuse, may trigger or exacerbate symptoms of schizophrenia in vulnerable individuals. Social factors, such as social isolation, poor social support, and urban living, have also been linked to an increased risk of schizophrenia.

In conclusion, schizophrenia is a complex disorder with multiple subtypes and a range of causal factors. A better understanding of these factors is essential for the development of more effective treatments and interventions for individuals with schizophrenia.

  1. Elucidate the role of Sympathetic Adrenomedullary System and Hypothalamo-Pituitary Adrenocortical Axis in stress and stress related responses. Explain the clinical features of posttraumatic stress disorder.


1. Sympathetic Adrenomedullary System (SAM) in Stress Response

The Sympathetic Adrenomedullary System (SAM) is part of the autonomic nervous system (ANS) and plays a crucial role in the body's acute stress response. When an individual encounters a stressful situation, the SAM is activated to prepare the body for a fight-or-flight response. The key players in SAM are the sympathetic nerves and the adrenal medulla.

Activation of SAM:

  • Stimulus: Stressful event perceived by the brain.
  • Sympathetic Nervous System (SNS) Activation: The hypothalamus activates the SNS, leading to the release of neurotransmitters like norepinephrine.
  • Adrenal Medulla Activation: SNS stimulation triggers the release of epinephrine (adrenaline) and norepinephrine into the bloodstream from the adrenal medulla.

Physiological Effects:

  • Increased Heart Rate and Blood Pressure: Epinephrine and norepinephrine increase cardiac output and constrict blood vessels, increasing blood pressure.
  • Dilation of Bronchioles: Enhanced airflow to supply oxygen to muscles.
  • Release of Glucose: Epinephrine stimulates glycogenolysis and gluconeogenesis, increasing blood glucose levels for energy.

2. Hypothalamo-Pituitary Adrenocortical (HPA) Axis in Stress Response

The Hypothalamo-Pituitary Adrenocortical (HPA) Axis is another critical system involved in the stress response, particularly in chronic stress situations. It involves the hypothalamus, pituitary gland, and adrenal cortex.

Activation of HPA Axis:

  • Stimulus: Prolonged stress signals received by the hypothalamus.
  • Release of Corticotropin-Releasing Hormone (CRH): The hypothalamus secretes CRH, which stimulates the pituitary gland.
  • Release of Adrenocorticotropic Hormone (ACTH): CRH triggers the pituitary gland to release ACTH into the bloodstream.
  • Release of Cortisol: ACTH stimulates the adrenal cortex to release cortisol, the primary stress hormone.

Physiological Effects:

  • Anti-Inflammatory Response: Cortisol suppresses the immune system to conserve energy for stress response.
  • Glucose Regulation: Cortisol increases blood glucose levels by promoting gluconeogenesis.
  • Suppression of Non-Essential Functions: Cortisol inhibits functions like digestion and reproductive processes to prioritize survival-related functions.

3. Clinical Features of Posttraumatic Stress Disorder (PTSD)

Posttraumatic Stress Disorder (PTSD) is a psychiatric disorder that can develop after exposure to a traumatic event. It is characterized by a range of symptoms that can significantly impact a person's daily life.

Symptoms of PTSD:

  • Re-experiencing Symptoms: Flashbacks, nightmares, or intrusive thoughts about the traumatic event.
  • Avoidance Symptoms: Avoidance of places, people, or activities that remind the individual of the trauma.
  • Negative Changes in Mood and Cognition: Persistent negative beliefs, emotional numbness, and difficulty remembering the traumatic event.
  • Arousal and Reactivity Symptoms: Irritability, aggression, hypervigilance, exaggerated startle response, and difficulty concentrating.

Diagnosis and Treatment:

  • Diagnosis: Criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are used, including the presence of symptoms for at least one month.
  • Treatment: Psychotherapy, such as cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR), along with medications like selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).


In summary, the Sympathetic Adrenomedullary System (SAM) and the Hypothalamo-Pituitary Adrenocortical (HPA) Axis play crucial roles in the body's response to stress. While SAM is involved in acute stress responses, the HPA Axis is more active in chronic stress situations. Posttraumatic Stress Disorder (PTSD) is a severe condition that can develop after exposure to a traumatic event, characterized by re-experiencing, avoidance, negative mood changes, and arousal symptoms. Treatment often involves a combination of psychotherapy and medications to alleviate symptoms and improve quality of life.

Assignment 2

Answer the following questions in about 100 words each. Each question carries 5 marks.

  1. Childhood Depression


Childhood Depression: Understanding and Addressing Early Signs

Childhood depression, also known as pediatric depression, is a serious mental health condition that affects how a child feels, thinks, and behaves. While it is normal for children to experience occasional feelings of sadness or unhappiness, persistent and severe symptoms may indicate depression.

Signs and Symptoms:

  • Persistent feelings of sadness, hopelessness, or irritability
  • Loss of interest in activities once enjoyed
  • Changes in appetite or weight
  • Difficulty sleeping or sleeping too much
  • Fatigue or lack of energy
  • Feelings of worthlessness or guilt
  • Difficulty concentrating or making decisions
  • Thoughts of death or suicide

Causes and Risk Factors: Childhood depression can be caused by a combination of genetic, biological, environmental, and psychological factors. Family history of depression, traumatic life events, chronic illnesses, and certain medications can increase the risk. Additionally, children with other mental health disorders, such as anxiety or behavioral disorders, may be more susceptible.

Impact and Consequences: Untreated childhood depression can have long-lasting effects on a child's emotional, social, and academic development. It may lead to problems at school, difficulty forming relationships, and increased risk of substance abuse or suicide in adolescence and adulthood.

Treatment and Support: Early detection and intervention are crucial in managing childhood depression. Treatment options may include psychotherapy, such as cognitive-behavioral therapy (CBT) or play therapy, and in some cases, medication. Family support, a healthy lifestyle, and a supportive school environment can also play a significant role in recovery.

Conclusion: Childhood depression is a serious condition that requires prompt attention and support. By recognizing the signs and symptoms early, providing a nurturing and supportive environment, and seeking professional help when needed, we can help children navigate through this challenging time and lead fulfilling lives.

  1. Difference between oppositional defiant disorder and conduct disorder


Oppositional Defiant Disorder (ODD) vs. Conduct Disorder (CD)

Oppositional Defiant Disorder (ODD):

  • ODD is characterized by a pattern of angry/irritable mood, argumentative/defiant behavior, and vindictiveness lasting at least six months.
  • Children with ODD often lose their temper, argue with adults, defy rules, deliberately annoy others, and blame others for their mistakes.
  • ODD behaviors are typically less severe than those seen in conduct disorder.
  • ODD is more common in younger children and is often a precursor to conduct disorder.

Conduct Disorder (CD):

  • CD is a more severe condition characterized by persistent patterns of behavior that violate the rights of others or major societal norms/rules.
  • Symptoms include aggression towards people and animals, destruction of property, deceitfulness or theft, and serious violations of rules.
  • CD often involves more serious antisocial behaviors and can lead to significant impairment in social, academic, or occupational functioning.
  • CD is more common in adolescents and is associated with a higher risk of developing antisocial personality disorder in adulthood.

Distinguishing Features:

  • While both disorders involve oppositional and defiant behaviors, the key difference lies in the severity and nature of these behaviors.
  • ODD is more about disobedience and defiance, while CD involves more aggressive and antisocial behaviors.
  • The prognosis for ODD is generally more positive than for CD, as early intervention and treatment can prevent the progression to more severe antisocial behaviors.

  • Histrionic Personality Disorder


Histrionic Personality Disorder (HPD) is a mental health condition characterized by a pattern of excessive attention-seeking behavior and extreme emotionality. Individuals with HPD often crave novelty, excitement, and approval from others, and may go to great lengths to attract attention. They may exhibit dramatic and exaggerated expressions of emotion, engage in seductive or provocative behavior, and have a tendency to be easily influenced by others.

People with HPD may struggle with forming and maintaining relationships due to their tendency to be perceived as shallow or insincere. They may also have difficulty in situations that require them to delay gratification or tolerate boredom.

Treatment for HPD typically involves psychotherapy, such as cognitive behavioral therapy (CBT), which can help individuals learn healthier ways of thinking and behaving. Medication may be prescribed to address co-occurring symptoms, such as depression or anxiety, but it is not a primary treatment for HPD itself. With appropriate treatment and support, individuals with HPD can learn to manage their symptoms and improve their overall quality of life.

  1. Gambling Disorder


Gambling Disorder is a behavioral addiction characterized by persistent and recurrent problematic gambling behavior. Individuals with this disorder experience a strong urge to gamble, leading to significant distress or impairment in their personal, social, or occupational lives.

People with Gambling Disorder may exhibit the following behaviors:

  • Preoccupation with gambling, such as constantly thinking about past gambling experiences or planning future gambling ventures.
  • Need to gamble with increasing amounts of money to achieve the desired excitement.
  • Restlessness or irritability when attempting to cut down or stop gambling.
  • Using gambling as a way to escape from problems or relieve feelings of helplessness or guilt.
  • Chasing losses, or attempting to win back lost money by continuing to gamble.

Treatment for Gambling Disorder typically involves psychotherapy, such as cognitive-behavioral therapy (CBT), which aims to modify gambling-related thoughts and behaviors. Support groups and medication may also be beneficial in managing symptoms and preventing relapse. Early intervention is crucial in addressing Gambling Disorder and improving overall quality of life.

  1. Sexual Dysfunctions


Sexual dysfunctions refer to a range of difficulties that occur during any stage of the sexual response cycle, preventing an individual or couple from experiencing satisfaction from sexual activity. These dysfunctions can be classified into different categories, including disorders of desire, arousal, orgasm, and pain.

Types of Sexual Dysfunctions:

  • Hypoactive Sexual Desire Disorder (HSDD): Characterized by a lack or absence of sexual fantasies and desire for sexual activity.
  • Erectile Dysfunction (ED): The inability to achieve or maintain an erection sufficient for satisfactory sexual performance.
  • Premature Ejaculation (PE): Ejaculation that occurs sooner than desired, often within one minute of penetration.
  • Female Orgasmic Disorder: Difficulty achieving orgasm despite adequate sexual stimulation.
  • Genito-Pelvic Pain/Penetration Disorder: Persistent or recurrent difficulties with vaginal penetration, pain during intercourse, or fear/anxiety about pain.

Treatment: Treatment for sexual dysfunctions depends on the specific disorder and may include psychotherapy, medication, lifestyle changes, and addressing underlying medical conditions. Couples therapy can also be beneficial in improving communication and intimacy. Seeking professional help is crucial for effectively managing sexual dysfunctions and improving overall sexual health and well-being.

  1. Characteristics of people with Generalized Anxiety Disorder


Generalized Anxiety Disorder (GAD) is a common mental health condition characterized by persistent and excessive worry about various aspects of life, such as work, health, family, or finances. Individuals with GAD often find it challenging to control their worry, which can interfere with daily activities and relationships.

Characteristics of People with GAD:

  1. Excessive Worry: Constant and exaggerated worry about everyday events or activities, even when there is little or no reason to worry.
  2. Physical Symptoms: Along with psychological symptoms, individuals with GAD may experience physical symptoms such as muscle tension, fatigue, restlessness, irritability, and difficulty sleeping.
  3. Overthinking and Catastrophizing: Tendency to overthink situations and anticipate the worst-case scenarios, leading to heightened anxiety.
  4. Difficulty Relaxing: Finding it hard to relax or unwind, even in relaxing situations.
  5. Perfectionism: Setting high standards for themselves and feeling anxious when they are not met.
  6. Avoidance: Avoiding situations or activities that may trigger anxiety, which can lead to social or occupational impairment.
  7. Physical Health Concerns: Excessive worry about health or physical symptoms, despite reassurance from medical professionals.

Treatment: Treatment for GAD typically includes psychotherapy, medication, or a combination of both. Cognitive-behavioral therapy (CBT) is particularly effective in helping individuals manage their anxiety by changing negative thought patterns and behaviors. Medications such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) may also be prescribed to help manage symptoms.

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