Post RN BSN Psychology Course – Units IX to XII Solved Answers
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| Solved model answers for Units IX-XII of the Post RN BSN psychology course syllabus (Course No. 706). Use as a revision guide and verify with your course notes. |
Unit IX: Abnormal Psychology: Normal and Abnormal Behaviour, Classification
Course syllabus · Model exam answers
B.Sc NURSING (POST-RN), FIRST YEAR, SEMESTER-I
SOCIAL SCIENCES (PSYCHOLOGY) – COURSE NO. 706
UNIT IX: ABNORMAL PSYCHOLOGY: NORMAL AND ABNORMAL BEHAVIOUR, CLASSIFICATION
Syllabus topics: Definitions of normal and abnormal behaviour; classification of mental disorders.
Q-1. Define abnormal psychology. How is abnormal behaviour defined?
Abnormal psychology is the scientific study of unusual patterns of behaviour, emotion and thought that may be understood as mental disorders, including their causes, classification, treatment and prevention.
There is no single definition of abnormality. Several criteria are used together:
| Criterion | Meaning | Limitation |
|---|---|---|
| Statistical infrequency | Behaviour that is very rare compared with the average (e.g. very low or very high mood or IQ) | Rare behaviour is not always a problem (genius); some common problems (depression) are not rare |
| Deviation from social norms | Behaviour that violates cultural or social rules | Norms differ between cultures and change over time |
| Maladaptive behaviour / impaired functioning | Behaviour that interferes with work, study, relationships or self-care | Some harmful behaviour is socially accepted |
| Personal distress | The person suffers emotionally | Some disorders (mania, some personality disorders) cause little distress to the person |
| Danger to self or others | Risk of harm | Not all disorders involve risk |
A useful summary is the four Ds: deviance, distress, dysfunction and danger. Clinicians consider all criteria, the person’s culture and the context.
Q-2. Differentiate between normal and abnormal behaviour. What are the characteristics of a mentally healthy person?
| Point | Normal behaviour | Abnormal behaviour |
|---|---|---|
| Adjustment | Adapts to stress and change | Poor adaptation or persistent maladjustment |
| Emotions | Appropriate, proportionate and flexible | Excessive, flat, inappropriate or unstable |
| Thinking | Realistic and organized | Delusions, disorganized or distorted thinking |
| Functioning | Maintains work, relationships and self-care | Marked impairment |
| Insight | Understands own condition | Often limited insight (in severe disorders) |
The World Health Organization describes mental health as a state of well-being in which a person realizes their abilities, can cope with the normal stresses of life, can work productively and can contribute to their community. It is more than the absence of disease.
Characteristics of a mentally healthy person
- Realistic perception of self and others and acceptance of oneself.
- Ability to cope with stress and disappointment.
- Emotional balance and self-control.
- Capacity to form and keep satisfying relationships.
- Independence combined with responsibility.
- Productive work or study.
- Flexible thinking and the ability to learn from experience.
- A sense of purpose and values.
Note: the line between normal and abnormal is a continuum, not a sharp border.
Q-3. Discuss the causes of abnormal behaviour (biopsychosocial and diathesis–stress models).
Most mental disorders have multiple causes.
Biological factors
- Genetic inheritance (family history).
- Brain structure and neurotransmitter imbalance.
- Hormonal and endocrine disorders.
- Prenatal and birth complications, infections, head injury.
- Substance use, chronic illness and medication effects.
Psychological factors
- Early childhood trauma, neglect and abuse.
- Learned maladaptive behaviour and thinking patterns.
- Poor coping skills, low self-esteem and personality traits.
- Loss, grief and severe stress.
Social and cultural factors
- Poverty, unemployment and social isolation.
- Family conflict, domestic violence and poor support.
- War, migration, disasters and discrimination.
- Stigma and lack of mental health services.
Diathesis–stress model: a person may have an inherited or acquired vulnerability (diathesis); the disorder appears when it meets sufficient life stress. The biopsychosocial model combines all three groups of factors.
Conclusion: Understanding the multiple causes helps nurses avoid blame and plan holistic care.
Q-4. Describe the classification of mental disorders. Explain DSM-5 and ICD.
Classification groups mental disorders according to shared symptoms so that professionals can diagnose, communicate, treat and research them in a common language.
| System | Published by | Notes |
|---|---|---|
| DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition; DSM-5-TR is the text revision) | American Psychiatric Association | Uses diagnostic criteria for each disorder; the older multiaxial system was dropped in DSM-5 |
| ICD (International Classification of Diseases), mental, behavioural and neurodevelopmental disorders chapter | World Health Organization | International standard used for health statistics; ICD-11 is the current version |
Major categories in DSM-5 (examples)
- Neurodevelopmental disorders (intellectual disability, autism spectrum, ADHD).
- Schizophrenia spectrum and other psychotic disorders.
- Bipolar and related disorders.
- Depressive disorders.
- Anxiety disorders.
- Obsessive–compulsive and related disorders.
- Trauma- and stressor-related disorders (PTSD).
- Dissociative disorders.
- Somatic symptom and related disorders.
- Feeding and eating disorders.
- Sleep–wake disorders.
- Disruptive, impulse-control and conduct disorders.
- Substance-related and addictive disorders.
- Neurocognitive disorders (delirium, dementia).
- Personality disorders.
Individual disorders are diagnosed by qualified clinicians using the current criteria. Exact labels and criteria change between editions.
Q-5. Write the advantages and limitations of classifying mental disorders.
| Advantages | Limitations |
|---|---|
| Common language for professionals | Risk of labelling and stigma |
| Guides diagnosis and treatment planning | Categories may oversimplify symptoms that lie on a continuum |
| Allows research and statistics | People often fit more than one diagnosis (comorbidity) |
| Helps with prognosis and service planning | Cultural differences may be overlooked |
| Supports insurance, records and legal needs | Diagnosis can be unreliable when done without training |
Nursing relevance: nurses use diagnoses in care planning but treat the person, not the label, and use respectful language.
Q-6. Differentiate between neurosis and psychosis (traditional terms).
| Point | Neurosis (neurotic disorders) | Psychosis (psychotic disorders) |
|---|---|---|
| Contact with reality | Retained | Lost or severely disturbed |
| Insight | Usually present | Usually absent or poor |
| Main symptoms | Anxiety, fears, obsessions, mild to moderate depression | Delusions, hallucinations, disorganized speech and behaviour |
| Personality | Relatively intact | May be severely disorganized |
| Examples | Anxiety disorders, phobias, OCD | Schizophrenia, severe mania or depression with psychosis |
| Treatment | Often outpatient psychotherapy and medication | Often medication, sometimes admission |
Note: DSM and ICD no longer use these terms as diagnoses, but they are still used in teaching and examinations.
Q-7. Describe the role of the nurse in caring for people with mental disorders, including reducing stigma.
- Build trust with a calm, respectful and non-judgemental attitude.
- Assess mental state, risk (suicide, violence, self-neglect) and physical health.
- Use therapeutic communication: active listening, open questions, silence, empathy.
- Ensure safety and a low-stimulation environment.
- Give medicines as prescribed, observe effects and side effects.
- Provide psychoeducation to patient and family.
- Involve family and promote community reintegration.
- Protect rights and confidentiality; follow mental health law and ethics.
- Challenge myths: mental illness is not a weakness, is not caused by laziness or “weak faith”, and is treatable.
- Refer to psychiatrists, psychologists, social workers and community services.
Conclusion: Mental health nursing combines clinical care, compassion and advocacy.
Unit X: Abnormal Psychology: Anxiety, Mood, Schizophrenia and Personality Disorders
Course syllabus · Model exam answers
B.Sc NURSING (POST-RN), FIRST YEAR, SEMESTER-I
SOCIAL SCIENCES (PSYCHOLOGY) – COURSE NO. 706
UNIT X: ABNORMAL PSYCHOLOGY: ANXIETY, MOOD, SCHIZOPHRENIA AND PERSONALITY DISORDERS
Syllabus topics: Anxiety, mood, schizophrenia and personality disorders, with perspectives on each.
Q-1. Define anxiety. Describe the types of anxiety disorders.
Anxiety is an unpleasant feeling of worry, fear or tension about a possible future threat, with bodily symptoms. It becomes a disorder when it is excessive, persistent, out of proportion and impairs functioning.
Symptoms
- Physical: palpitations, sweating, trembling, breathlessness, chest tightness, nausea, dizziness, muscle tension, headache, sleep disturbance.
- Psychological: worry, fear, restlessness, poor concentration, irritability.
- Behavioural: avoidance, reassurance-seeking.
| Disorder | Key features |
|---|---|
| Generalized anxiety disorder (GAD) | Excessive worry about many things, on most days for at least six months, with restlessness, fatigue, poor concentration, muscle tension, irritability or sleep problems |
| Panic disorder | Sudden episodes of intense fear peaking within minutes (palpitations, chest pain, breathlessness, fear of dying or losing control), then persistent worry about further attacks |
| Specific phobia | Marked fear of a particular object or situation (heights, injections, animals), leading to avoidance |
| Social anxiety disorder | Fear of being judged or embarrassed in social or performance situations |
| Agoraphobia | Fear of places where escape or help may be difficult (crowds, public transport) |
| Separation anxiety disorder | Excessive fear of separation from attachment figures (common in children) |
Related disorders (separate groups in DSM-5): obsessive–compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).
Q-2. Explain the perspectives (causes) of anxiety disorders.
| Perspective | Explanation |
|---|---|
| Biological | Genetic vulnerability; overactive amygdala; low GABA and altered serotonin and noradrenaline activity; overactive sympathetic nervous system |
| Psychodynamic | Anxiety arises from unconscious conflict between id impulses and the superego; defence mechanisms fail |
| Behavioural | Fear is learned by classical conditioning (e.g. dog bite leads to fear of dogs) and maintained by avoidance (negative reinforcement); also learned by observation |
| Cognitive | Catastrophic thinking and overestimating danger; misinterpreting body sensations (e.g. palpitations mean a heart attack) |
| Sociocultural | Stressful life events, trauma, family environment, social pressure and poverty |
Q-3. Write short notes on OCD and PTSD.
Obsessive–compulsive disorder (OCD)
- Obsessions: recurrent, unwanted thoughts, images or urges (contamination, doubt, order).
- Compulsions: repetitive behaviours or mental acts (washing, checking, counting) done to reduce anxiety.
- Time-consuming (more than one hour a day) or causes distress and impairment.
- Treatment: exposure and response prevention (ERP, a form of CBT), antidepressant medicines such as SSRIs, support.
Post-traumatic stress disorder (PTSD)
- Follows exposure to actual or threatened death, serious injury or sexual violence.
- Symptom groups: intrusion (flashbacks, nightmares), avoidance, negative changes in thinking and mood, and arousal (hypervigilance, startle, poor sleep).
- Lasts more than one month and impairs functioning.
- Treatment: trauma-focused psychotherapy (trauma-focused CBT, EMDR), support and sometimes medicines.
Nursing care: provide safety, listen without forcing details, teach grounding and breathing techniques, and refer for specialist care.
Q-4. Describe nursing management of a patient with anxiety.
- Stay with the anxious person and use a calm, quiet manner.
- Assess the level of anxiety (mild, moderate, severe, panic) and any risk.
- Use short, simple sentences; give clear information; avoid arguing.
- Reduce stimulation: quiet, non-threatening environment.
- Teach slow diaphragmatic breathing, progressive muscle relaxation and grounding.
- Encourage the person to express feelings; identify triggers.
- Promote sleep, exercise, regular meals and limit caffeine.
- Give prescribed medicines and observe effects.
- Teach coping skills and refer for CBT when appropriate.
- Educate family.
Q-5. Define mood disorders. Describe depressive disorders.
Mood (affective) disorders are disorders in which a disturbance of mood (persistent sadness or elevated mood) is the main problem, with changes in thinking, energy, sleep and behaviour.
Major depressive disorder (MDD)
At least five of these symptoms present during the same two weeks, including depressed mood or loss of interest or pleasure, and causing impairment:
- Depressed mood most of the day.
- Marked loss of interest or pleasure (anhedonia).
- Significant change in weight or appetite.
- Insomnia or hypersomnia.
- Psychomotor agitation or slowing.
- Fatigue or loss of energy.
- Feelings of worthlessness or excessive guilt.
- Poor concentration or indecisiveness.
- Recurrent thoughts of death or suicide.
Other depressive disorders
- Persistent depressive disorder (dysthymia): depressed mood most days for at least two years in adults.
- Postpartum (perinatal) depression: depression during pregnancy or after childbirth.
- Seasonal pattern: episodes recur at a particular season.
- Depression with psychotic features: delusions or hallucinations with severe depression.
Q-6. Describe bipolar disorder.
Bipolar disorder involves episodes of abnormally elevated mood (mania or hypomania) and usually episodes of depression.
| Feature | Mania | Depression |
|---|---|---|
| Mood | Elevated, expansive or irritable | Sad, empty, hopeless |
| Energy and sleep | High energy; little need for sleep | Fatigue; sleep disturbed |
| Thinking and speech | Racing thoughts, pressured speech, flight of ideas, grandiosity | Slowed thinking, guilt, worthlessness |
| Behaviour | Overactivity, risk-taking, overspending, poor judgement | Withdrawal, reduced activity |
| Insight | Often poor | Variable |
| Type | Summary |
|---|---|
| Bipolar I | At least one manic episode lasting at least one week (or needing hospital care) |
| Bipolar II | At least one hypomanic episode (at least four days, milder than mania) and one major depressive episode |
| Cyclothymic disorder | Many mild mood swings for at least two years, not meeting full criteria |
Treatment: mood stabilizers (such as lithium and some anticonvulsants), antipsychotics, psychoeducation, regular routines and sleep, and psychotherapy. Nursing: safety, reduce stimulation in mania, monitor medication and blood levels where required, and prevent relapse.
Q-7. Explain the perspectives (causes) of mood disorders.
| Perspective | Explanation |
|---|---|
| Biological | Genes; low serotonin, noradrenaline and dopamine activity (monoamine hypothesis); overactive stress hormone system (cortisol); structural brain changes; medical illness and some drugs |
| Psychodynamic | Depression follows real or symbolic loss with anger turned inward against the self (Freud) |
| Behavioural | Too little positive reinforcement; loss of rewards and activity |
| Cognitive | Aaron Beck: negative cognitive triad (negative views of self, the world and the future) and thinking errors; Seligman: learned helplessness, feeling no control over events |
| Sociocultural | Stressful life events, poverty, loss, abuse, isolation, lack of social support; higher reported rates in women, linked to social and biological factors |
Q-8. Discuss suicide: risk factors, warning signs and nursing management.
Suicide is the act of intentionally ending one’s own life. It is a major preventable cause of death, often linked with depression, substance use and other mental disorders.
Risk factors
- Previous attempt; family history of suicide.
- Depression, bipolar disorder, schizophrenia, substance use, personality disorder.
- Hopelessness, severe stress, loss, humiliation or chronic painful illness.
- Social isolation, unemployment, financial problems.
- Access to lethal means.
Warning signs
- Talking about wanting to die or being a burden.
- Hopelessness, severe mood change, withdrawal.
- Giving away possessions or saying goodbye.
- Sudden calm after prolonged depression.
- Increased alcohol or drug use.
Nursing management
- Take every statement seriously and ask directly and kindly about suicidal thoughts, plan and intent; this does not put the idea in a person’s mind.
- Do not leave a person at immediate risk alone; arrange close observation and a safe environment.
- Remove hazards and means where possible.
- Arrange urgent assessment by a doctor or mental health team.
- Build a safety plan and identify supports.
- Treat the underlying disorder and follow hospital policy; document carefully.
- Support family and staff after an event.
If you or someone you know is at immediate risk, contact local emergency services or a mental health professional straight away.
Q-9. Define schizophrenia. Describe its symptoms and types.
Schizophrenia is a severe, long-lasting psychotic disorder that affects thinking, perception, emotion, behaviour and social functioning. About 1 in 100 people are affected during their lifetime. It usually begins in late adolescence or early adulthood.
| Symptom group | Examples |
|---|---|
| Positive (added experiences) | Hallucinations (usually hearing voices), delusions (persecutory, grandiose, reference), disorganized speech, disorganized or catatonic behaviour |
| Negative (reduced functions) | Blunted or flat affect, alogia (poverty of speech), avolition (lack of motivation), anhedonia, asociality, self-neglect |
| Cognitive | Poor attention, memory and executive function (planning) |
Diagnosis (summary): two or more of delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behaviour and negative symptoms (at least one of the first three) for a significant part of one month, with signs of disturbance lasting at least six months, and impaired functioning.
Traditional types (subtypes, removed from DSM-5 but still taught)
- Paranoid: prominent delusions of persecution and hallucinations, relatively preserved thinking.
- Disorganized (hebephrenic): disorganized speech and behaviour, inappropriate affect.
- Catatonic: stupor, rigidity, mutism, posturing or excitement.
- Undifferentiated: mixed symptoms.
- Residual: mainly negative symptoms after an acute episode.
Phases: prodromal (early warning changes), active (psychotic symptoms) and residual.
Q-10. Explain the perspectives (causes) of schizophrenia.
| Perspective | Explanation |
|---|---|
| Biological (genetic) | Strong hereditary component: the risk is much higher in relatives, and higher in identical than fraternal twins, but not 100%, so genes alone do not explain it |
| Neurochemical | Dopamine hypothesis: overactivity of dopamine pathways is linked to positive symptoms; glutamate and other neurotransmitters are also involved |
| Brain structure | Enlarged ventricles and reduced grey matter in some people; neurodevelopmental problems |
| Prenatal and environmental | Maternal infection or malnutrition in pregnancy, birth complications, cannabis use, urban living, migration, childhood trauma |
| Psychological | Stress and family emotional climate (high expressed emotion) can trigger relapse; the older “double-bind” theory is not supported as a cause |
| Diathesis–stress | Biological vulnerability plus environmental stress leads to onset |
Q-11. Describe the management and nursing care of a patient with schizophrenia.
Treatment
- Antipsychotic medicines (first- and second-generation), including long-acting injections for adherence.
- Psychosocial treatment: psychoeducation, cognitive behavioural therapy for psychosis, family therapy, social-skills training and supported employment.
- Rehabilitation and community care to prevent relapse.
- ECT in selected cases (e.g. catatonia, treatment resistance).
Nursing care
- Build trust; be consistent, honest and non-confrontational.
- Do not argue with or confirm delusions; acknowledge the feelings and present reality gently.
- Respond to hallucinations: ask about content (especially commands to harm), ensure safety.
- Maintain a low-stimulation, structured environment and routine.
- Promote self-care, nutrition, hygiene and sleep.
- Observe for medication side effects (e.g. sedation, stiffness, tremor, weight gain, metabolic changes) and encourage adherence.
- Monitor for relapse signs and suicide risk.
- Educate and support the family; reduce stigma; plan discharge and follow-up.
Q-12. Define personality disorder. Describe the clusters.
A personality disorder is an enduring pattern of inner experience and behaviour that deviates markedly from cultural expectations, is inflexible and pervasive, begins in adolescence or early adulthood, is stable over time and leads to distress or impairment.
| Cluster | Disorders | Main features |
|---|---|---|
| A: odd or eccentric | Paranoid, schizoid, schizotypal | Suspiciousness; detachment and restricted emotion; eccentric beliefs and odd behaviour |
| B: dramatic, emotional, erratic | Antisocial, borderline, histrionic, narcissistic | Disregard for others’ rights; unstable moods, relationships and self-image with impulsivity; attention seeking; grandiosity and lack of empathy |
| C: anxious or fearful | Avoidant, dependent, obsessive–compulsive personality | Fear of criticism and social inhibition; need to be taken care of; perfectionism and rigid control |
Personality disorders can be diagnosed only after adolescence and by trained professionals.
Q-13. Explain the perspectives and management of personality disorders.
| Perspective | Explanation |
|---|---|
| Biological | Genetic influences on temperament (impulsivity, emotional reactivity); brain differences |
| Psychodynamic | Disturbed early relationships and parenting; weak ego development and primitive defences |
| Behavioural / learning | Maladaptive behaviour learned through reinforcement and modelling |
| Cognitive | Rigid core beliefs and distorted thinking about self and others |
| Sociocultural | Childhood abuse or neglect, unstable families, social deprivation |
Management
- Long-term psychotherapy is the main treatment: dialectical behaviour therapy (DBT) for borderline personality disorder, cognitive therapy, schema therapy and mentalization-based therapy.
- Medicines may be used for specific symptoms (mood, anxiety, psychosis) but do not cure the disorder.
- Nursing: set clear, consistent limits; use calm and non-judgemental communication; avoid taking behaviour personally; assess self-harm and suicide risk; work as a team to avoid splitting.
Unit XI: Psychological Therapies
Course syllabus · Model exam answers
B.Sc NURSING (POST-RN), FIRST YEAR, SEMESTER-I
SOCIAL SCIENCES (PSYCHOLOGY) – COURSE NO. 706
UNIT XI: PSYCHOLOGICAL THERAPIES
Syllabus topics: Psychological therapies; their effectiveness; the influence of culture and gender.
Q-1. Define psychotherapy. Classify the types of therapy.
Psychotherapy (“talking therapy”) is the treatment of mental and emotional problems by psychological methods, using a planned relationship between a trained therapist and a client, to relieve distress and change thoughts, feelings and behaviour.
| Group | Examples |
|---|---|
| Psychodynamic | Psychoanalysis, brief psychodynamic therapy |
| Behavioural | Systematic desensitization, exposure, token economy, modelling, aversion therapy |
| Cognitive and cognitive–behavioural | Beck’s cognitive therapy, CBT, Ellis’s rational emotive behaviour therapy |
| Humanistic | Client-centred (Rogers), Gestalt, existential therapy |
| Group, family and couples therapy | Support groups, family therapy, marital therapy |
| Biological (somatic) therapies | Medication, electroconvulsive therapy (ECT), brain stimulation |
| Other | Play therapy, art and music therapy, relaxation and mindfulness, interpersonal therapy |
Many therapists use an eclectic approach, combining methods to suit the client.
Q-2. Describe psychoanalytic (psychodynamic) therapy.
Developed by Sigmund Freud. It assumes that mental problems come from unconscious conflicts, usually from childhood. The aim is to bring unconscious material into awareness (insight).
Techniques
- Free association: the client says whatever comes to mind.
- Dream analysis: interpreting manifest and latent content.
- Interpretation: the therapist explains meanings of thoughts and behaviour.
- Resistance: blocking of painful material, which the therapist works with.
- Transference: the client redirects feelings about important people onto the therapist.
- Catharsis: relief from expressing repressed emotions.
Limitations: long (months or years), costly and less suitable for severe psychosis or for people who need quick symptom relief. Modern brief psychodynamic therapies are shorter.
Q-3. Describe behaviour therapy and its techniques.
Behaviour therapy is based on learning theory (classical and operant conditioning and social learning). It treats the problem behaviour itself by changing learning.
| Technique | Description | Example |
|---|---|---|
| Systematic desensitization (Joseph Wolpe) | Relaxation is paired with gradual exposure to a fear hierarchy | Gradually approaching an injection phobia |
| Exposure and response prevention | Facing the feared stimulus while not performing the compulsion | OCD handwashing |
| Flooding | Prolonged intense exposure to the feared stimulus (with consent and support) | Severe phobia |
| Aversion therapy | Pairing unwanted behaviour with an unpleasant stimulus | Alcohol dependence (limited use today) |
| Token economy | Earning tokens for desired behaviour, exchanged for rewards | Ward programmes |
| Modelling | Learning by watching others | Child observes calm patient during dressing |
| Relaxation and biofeedback | Reducing physical tension | Anxiety, pain |
| Social-skills and assertiveness training | Practice of communication skills | Shyness, schizophrenia rehabilitation |
Q-4. Explain cognitive therapy and cognitive behavioural therapy (CBT).
Cognitive therapy (Aaron Beck) assumes that emotional problems come from distorted thinking. CBT combines cognitive and behavioural methods. Rational emotive behaviour therapy (Albert Ellis) uses the A–B–C model: Activating event → Belief → Consequence (emotion), and disputes irrational beliefs.
Common thinking errors
- All-or-nothing thinking.
- Catastrophizing.
- Overgeneralization.
- Mind reading.
- Emotional reasoning.
- Personalization.
Steps of CBT
- Assess the problem and set goals.
- Teach the link among thoughts, feelings and behaviour.
- Identify automatic negative thoughts (thought diary).
- Challenge and test them with evidence.
- Replace with balanced thoughts.
- Behavioural experiments and activity scheduling; homework.
- Relapse prevention.
Uses: depression, anxiety disorders, OCD, PTSD, eating disorders, insomnia and psychosis. CBT is short-term (often 8–20 sessions) and has strong research support.
Q-5. Describe humanistic (client-centred) therapy.
Carl Rogers’s client-centred therapy is non-directive: the client leads and the therapist provides conditions for growth.
- Unconditional positive regard: accepting the client without judgement.
- Empathy: accurately understanding the client’s feelings.
- Congruence (genuineness): the therapist is honest and real.
- Active listening and reflection of feelings.
The aim is self-acceptance and self-actualization. These skills form the basis of therapeutic communication in nursing. Gestalt therapy (Fritz Perls) focuses on awareness of the present moment and unfinished business. Existential therapy focuses on meaning, freedom and responsibility.
Q-6. Write short notes on group, family and couples therapy.
Group therapy
Several clients with similar problems meet with a therapist. Benefits: sharing, support, learning from others, reduced isolation, cost-effective. Examples: support groups, psychoeducation groups, groups for addiction.
Family therapy
Treats the family as a system; problems are seen as patterns of interaction rather than one person’s fault. It improves communication and reduces conflict and high expressed emotion (useful in schizophrenia, eating disorders and child problems).
Couples (marital) therapy
Improves communication, problem solving and intimacy for partners.
Self-help and community support
Peer support groups and community programmes help recovery and reduce relapse.
Q-7. Describe biological therapies: medication and electroconvulsive therapy (ECT).
| Group of medicines | Used for | Examples of effects to observe |
|---|---|---|
| Antipsychotics | Schizophrenia, mania, severe agitation | Sedation, extrapyramidal symptoms (tremor, stiffness), weight gain, metabolic changes |
| Antidepressants (SSRIs and others) | Depression, anxiety, OCD | Nausea, sleep or sexual side effects; takes weeks to work; monitor for suicidal thoughts early in treatment |
| Mood stabilizers (lithium, others) | Bipolar disorder | Blood-level monitoring (lithium), tremor, thirst, kidney and thyroid effects |
| Anxiolytics and hypnotics (benzodiazepines) | Short-term anxiety and insomnia | Drowsiness, dependence, withdrawal; avoid abrupt stopping |
| Stimulants and others | ADHD | Appetite, sleep and heart-rate effects |
Electroconvulsive therapy (ECT)
- What: a controlled electrical stimulus gives a brief seizure under general anaesthesia with a muscle relaxant.
- Indications: severe depression (especially with psychosis, suicidality or refusal of food), catatonia, severe mania or treatment-resistant illness.
- Side effects: temporary confusion, headache, short-term memory loss.
- Nursing care: informed consent; fasting and routine pre-anaesthetic care; monitoring and reorientation afterwards; reassure the patient.
Other brain-stimulation treatments include repetitive transcranial magnetic stimulation (rTMS).
Q-8. Discuss the effectiveness of psychological therapies.
- Early debate: Hans Eysenck (1952) claimed psychotherapy was no better than no treatment, which led to more research.
- Meta-analysis: Smith and Glass (1977) combined hundreds of studies and found that the average treated person does better than most untreated people. Later research confirms this for many conditions.
- Specific evidence: CBT is effective for depression, anxiety disorders, OCD and PTSD; exposure methods for phobias; DBT for borderline personality disorder; family interventions for schizophrenia.
- Common factors: a strong therapeutic alliance, empathy, hope, and client motivation influence outcomes across therapies.
- Combination: for moderate to severe depression and psychosis, medication together with psychotherapy often works better than either alone.
- Factors affecting effectiveness: severity and type of problem, early treatment, client readiness, therapist skill, treatment length and adherence, and social support.
- Limitations: not everyone improves; relapse occurs; access is limited in many places; therapies must be evidence-based and ethical.
Q-9. Discuss the influence of culture on psychological therapy.
- Beliefs about illness: some communities explain mental illness by spiritual, social or physical causes. People may first approach religious or traditional healers or family, and later health services.
- Stigma: fear of shame for the family can delay treatment.
- Language and communication: use interpreters when needed; understand idioms of distress (e.g. bodily complaints).
- Family and community: in collectivist cultures, decisions often involve the family; therapy may need family participation.
- Values: respect for authority, modesty, privacy and religion shape what clients will discuss.
- Therapist bias: using Western norms for all may lead to misdiagnosis.
- Cultural competence: learn about the client’s background, ask respectfully, adapt methods, and work with community and faith leaders where appropriate.
Q-10. Discuss the influence of gender on psychological therapy.
- Women are diagnosed with depression and anxiety more often; men are more often diagnosed with substance use and antisocial behaviour. Social roles, stress, hormonal factors, reporting and help-seeking all play a part.
- Men may be less likely to seek help because of ideas about masculinity; they may be under-diagnosed and have higher suicide completion rates in many countries.
- Women may face violence, abuse, discrimination, and pregnancy- and birth-related mental health conditions; women-friendly, safe and confidential services improve access.
- Therapist gender may matter to clients, especially in culturally conservative settings or after abuse.
- Avoid gender stereotypes in diagnosis and treatment; provide gender-sensitive care.
- Include perinatal mental health and domestic-violence screening in care.
Q-11. Describe the role of the nurse in psychological therapies and mental health care.
- Therapeutic communication and the therapeutic nurse–patient relationship.
- Milieu therapy: planning a safe, structured and supportive ward environment.
- Administering medicines, observing effects and teaching about them.
- Assisting with ECT and other treatments.
- Leading or co-leading psychoeducation and relaxation groups.
- Crisis intervention and risk assessment.
- Teaching coping skills; encouraging adherence and follow-up.
- Supporting families and linking with community services.
- Documenting and maintaining confidentiality and patients’ rights.
Unit XII: Social Psychology
Course syllabus · Model exam answers
B.Sc NURSING (POST-RN), FIRST YEAR, SEMESTER-I
SOCIAL SCIENCES (PSYCHOLOGY) – COURSE NO. 706
UNIT XII: SOCIAL PSYCHOLOGY
Syllabus topics: Beliefs, attitudes and stereotyping; social influence; conformity, compliance and obedience.
Q-1. Define social psychology. Describe its scope.
Social psychology is the scientific study of how people’s thoughts, feelings and behaviour are influenced by the real or imagined presence of other people.
Scope (topics)
- Social perception and attribution.
- Beliefs and attitudes; attitude change and persuasion.
- Stereotypes, prejudice and discrimination.
- Social influence: conformity, compliance and obedience.
- Group behaviour: social facilitation, social loafing, groupthink, leadership.
- Helping behaviour and aggression.
- Interpersonal attraction and relationships.
Nursing relevance: explains patient and family behaviour, teamwork, communication, prejudice in healthcare and the effect of the group on behaviour.
Q-2. Explain social perception and attribution.
Social perception is how we form impressions of others. Attribution is explaining the causes of behaviour.
| Type of attribution | Meaning | Example |
|---|---|---|
| Internal (dispositional) | Cause lies in the person (character, effort) | “He is late because he is lazy.” |
| External (situational) | Cause lies in the situation | “He is late because of traffic.” |
- Fundamental attribution error: overestimating personal causes and underestimating situations when judging others.
- Self-serving bias: taking credit for success and blaming the situation for failure.
- First impressions and the halo effect: one positive trait colours the overall judgement.
Nursing relevance: avoid assuming a patient who misses appointments is “non-compliant” or careless without exploring situational causes (cost, transport, fear).
Q-3. Define attitude and belief. Describe the components, formation and functions of attitudes.
Belief: an idea that a person holds to be true (“vaccines protect children”). Attitude: a lasting positive or negative evaluation of a person, object, idea or event, which influences behaviour.
| Component (ABC model) | Meaning | Example: attitude to hand hygiene |
|---|---|---|
| Affective | Feelings | I feel it is important |
| Behavioural | Intention or action | I wash my hands before every patient |
| Cognitive | Beliefs and thoughts | Washing reduces infection |
Formation
- Direct experience.
- Learning: classical conditioning (association), operant conditioning (reward) and observation (modelling).
- Family, peers, school, culture, religion and media.
Functions (Katz)
- Knowledge function: organizes information.
- Utilitarian function: helps gain rewards and avoid punishment.
- Ego-defensive function: protects self-esteem.
- Value-expressive function: expresses personal values.
Measurement
Likert scales, semantic differential, questionnaires, interviews and observation.
Attitude and behaviour: attitudes predict behaviour better when they are strong, specific, based on direct experience and when social pressures are small.
Q-4. Explain how attitudes change. Describe persuasion and cognitive dissonance.
Persuasion
- Source: credible, expert, trustworthy and likeable communicators persuade better.
- Message: clear, logical, emotional appeals (fear appeals work if a solution is offered), two-sided arguments for informed audiences.
- Audience: age, intelligence, self-esteem and existing attitude.
- Channel: face-to-face contact is usually stronger than mass media.
Cognitive dissonance (Leon Festinger)
Discomfort that arises when beliefs and behaviour conflict (e.g. a smoker knows smoking is harmful). People reduce it by changing the behaviour, changing the belief, or adding justifications.
Use in health education: credible nurse, clear message, relevant examples, involvement of the person and family, and small achievable steps (as in smoking cessation or immunization campaigns).
Q-5. Define stereotype, prejudice and discrimination. Discuss their causes and how to reduce them.
| Term | Meaning | Example |
|---|---|---|
| Stereotype | A fixed, oversimplified belief about a group (cognitive) | “All men are poor caregivers.” |
| Prejudice | A negative attitude or feeling towards a group (affective) | Disliking people of a certain group |
| Discrimination | Unfair behaviour towards members of a group (behavioural) | Refusing care or a job because of group membership |
Causes
- Social learning from family, peers and media.
- Social categorization and in-group favouritism (social identity theory, Tajfel).
- Competition for resources (realistic conflict theory, Sherif).
- Scapegoating: blaming a group for problems.
- Cognitive shortcuts and illusory correlations.
- Lack of contact and information.
Reducing prejudice
- Equal-status, cooperative contact between groups (contact hypothesis, Allport).
- Shared goals that need cooperation (Sherif’s Robbers Cave study).
- Education and awareness of bias.
- Laws and policies against discrimination.
- Positive role models and diverse teams.
Nursing relevance: stigma towards mental illness, HIV, disability, gender, religion, ethnicity or poverty harms care. Nurses must provide equal, respectful and non-discriminatory care and challenge bias.
Q-6. What is social influence? Describe its main forms.
Social influence is the change in a person’s thoughts, feelings or behaviour because of other people.
| Form | Source of pressure | Example |
|---|---|---|
| Conformity | Group norms (unspoken pressure) | Following the dress or habits of the ward team |
| Compliance | A direct request from someone with no authority | Agreeing to a colleague’s request |
| Obedience | An order from an authority figure | Following a doctor’s order |
Q-7. Explain conformity. Describe the Asch experiment and the factors that affect conformity.
Conformity is changing one’s behaviour or opinion to match that of a group because of real or imagined group pressure.
Asch experiment (1951)
Solomon Asch asked participants to judge which of three lines matched a standard line. Participants were in a group of confederates who unanimously gave a wrong answer on critical trials. About three-quarters of participants conformed at least once and, on average, about one-third of the answers conformed to the group’s incorrect view, although the correct answer was obvious.
Factors increasing conformity
- Larger unanimous majority (effect levels off at about 3–5 people).
- Group unanimity: a single dissenter greatly reduces conformity.
- Difficult or ambiguous task.
- Low self-esteem and high need for approval.
- Group attractiveness, cohesiveness and status.
- Collectivist culture.
- Public (rather than private) response.
Types
- Normative influence: conforming to be accepted.
- Informational influence: conforming because the group seems to know better.
Nursing relevance: new nurses may copy unsafe shortcuts of the team. Safe practice requires speaking up even when the group disagrees.
Q-8. Describe compliance and the techniques used to gain it.
Compliance is going along with a request made by another person, although the person need not do so.
| Technique | How it works | Example |
|---|---|---|
| Foot-in-the-door (Freedman and Fraser, 1966) | Agreement to a small request makes agreement to a bigger later request more likely | Ask a patient to try a short walk, then a longer walk |
| Door-in-the-face (Cialdini) | After refusing a large request, people accept a smaller one | Ask for a big commitment, then a smaller one |
| Low-ball | Commitment is made, then hidden costs are added | Agreeing and then learning of added conditions |
| That’s-not-all | A bonus is offered before the person responds | Adding free items to a deal |
| Reciprocity | People feel they must repay favours | A free sample leads to a purchase |
In healthcare, compliance/adherence also means following medical advice. Adherence improves with clear explanations, shared decision-making, simple regimens and trust. Nurses must obtain informed consent and not use manipulative techniques.
Q-9. Explain obedience. Describe Milgram’s experiment and the factors that affect obedience.
Obedience is following direct commands from an authority figure.
Milgram’s experiment (1963)
Stanley Milgram told participants (“teachers”) to give increasing electric shocks to a “learner” (an actor who received no real shocks) for wrong answers. In the basic study, about 65% went to the maximum 450 volts, although many showed distress. The study showed that ordinary people may obey authority even when it conflicts with conscience.
Factors increasing obedience
- Authority figure present, with perceived legitimacy and uniform or status.
- Prestigious setting (university).
- Physical distance from the victim.
- Gradual escalation of demands.
- Lack of role models who disobey.
- Diffusion of responsibility (“I am only following orders”).
Ethical issues
Deception, severe distress to participants and difficulty withdrawing; led to stricter research ethics (informed consent, debriefing, right to withdraw).
Nursing relevance
- Nurses must follow lawful and safe instructions but are personally accountable for their actions.
- An unsafe or unclear order must be questioned, clarified and escalated (use chain of command and incident reports).
- Create a culture where staff can speak up (reduces errors).
“Following orders” is not a defence for unethical acts.
Q-10. Differentiate between conformity, compliance and obedience.
| Point | Conformity | Compliance | Obedience |
|---|---|---|---|
| Pressure | From the group (implicit) | From a request (explicit) | From an authority figure (command) |
| Source status | Equal | Equal or no authority | Higher authority |
| Behaviour change | Match group norms | Respond to request | Follow orders |
| Experiment | Asch | Freedman and Fraser; Cialdini | Milgram |
| Example | Adopting ward habits | Agreeing to a colleague’s favour | Carrying out a senior’s instruction |
Q-11. Write short notes on group behaviour: social facilitation, social loafing, groupthink and the bystander effect.
| Concept | Meaning | Example / note |
|---|---|---|
| Social facilitation (Zajonc) | The presence of others improves performance on easy or well-learned tasks but worsens it on difficult tasks | A student performs a familiar skill well in front of others but struggles with a new one |
| Social loafing | People put in less effort in a group than alone | Group assignments; reduced by clear individual roles |
| Groupthink (Janis) | A cohesive group suppresses disagreement to maintain harmony and makes poor decisions | Ward team ignores warning signs; prevent by encouraging dissent and outside opinion |
| Bystander effect (Darley and Latané) | The more people present, the less likely anyone is to help, due to diffusion of responsibility | An emergency in a crowded place; train staff to act and call for help |
| Group polarization | Group discussion makes views more extreme | Teams making riskier decisions |
Prosocial behaviour: helping others is increased by empathy, modelling, a clear need and personal responsibility. Nursing is a prosocial profession built on empathy and altruism.
Q-12. Describe the importance of social psychology for nurses.
- Understanding how attitudes and beliefs affect health behaviour and adherence.
- Designing persuasive and culturally sensitive health education.
- Reducing stigma, stereotypes and discrimination in care.
- Working effectively in teams; avoiding groupthink and unsafe conformity.
- Speaking up and questioning unsafe orders.
- Improving communication and leadership.
- Understanding family and community influences on patients.
- Promoting helping behaviour and a caring organizational culture.
Course references (as listed in the syllabus): Atkinson, R.L., Atkinson, R.C., Smith, E.E., Bem, D.J., & Nolen-Hoeksema, S. (1996). Hilgard’s Introduction to Psychology (12th ed.). Harcourt Brace. Feldman, R.S. (1993). Understanding Psychology (3rd ed.). McGraw-Hill.
Source syllabus: Post RN BSN Nursing Psychology Course (original post dated April 12, 2019).
Series: Part 4 of 4 – Units IX–XII. Part 1: Units I–III. Part 2: Units IV–VI. Part 3: Units VII (mental ability), VII (emotions) and VIII.
Independent educational resource: POST RN BSN Nursing Resources is not affiliated with, endorsed by or an official publication of LUMHS or PNMC. Model answers are study aids; verify against your course notes and textbooks.
POST RN BSN Nursing Resources
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