Advanced psychology Flashcards

1
Q

While measuring attitudes to abortion, the subjects are given a set
of statements carefully chosen by a panel of judges beforehand. Each
statement carries a pre-assigned value. The subjects are asked to indicate
whether they agree or not with each statement. Which of the following
methods is being used in this study?
A. Likert Scale
B. Osgood’s Semantic Differential Scale
C. Thurstone Scale
D. Sociogram
E. Scalogram

A

C. Various methods are used to measure the attitudes of a subject on a specifi c issue. The
method described in Question 1 is an example of the Thurstone scale. When constructing a
Thurstone scale, hundreds of statements are initially produced pertaining to a particular topic, for
example abortion. These statements are presented to a sample of people (similar to a panel of
judges) who are asked to score the statements on an 11-point scale. A set number of statements,
for example 10 on each extreme (positive and negative attitude), are chosen based on the
consistency of scores given by the judges. Each of these statements will carry a value that is the
average of 100 judgements on the 11-point scale. These 20 statements are clubbed together to
produce an attitude scale, which is administered to the subject. The subject will then indicate
what statements he agrees with. It is not often used because the method is too tedious. The
11 points (used to rate each statement) are assumed to be intervals and averages are used to
obtain the value scores. This is not entirely accurate as the 11-point scale is in fact ordinal. In the
Likert scale, graded ‘strongly agree’ to ‘strongly disagree’ measures are employed. It is statistically
reliable (ordinal data) and easy to construct. It is usually constructed as a fi ve- to seven-point
scale.

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2
Q

A boring task is administered to two groups of people. One group is
paid £20 and the other is paid £1 for undertaking the task. Which of
the following results is possible after completion of the task?
A. Only the £1 group will appreciate the usefulness of the task.
B. Only the £20 group will appreciate the usefulness of the task.
C. Both groups will equally appreciate the task.
D. Both groups will equally detest the task.
E. The outcome will depend on the length of the task

A

A. Contrary to popular belief, the group that is paid more will not appreciate the boring
task. As they obtained a good incentive, they will not develop a dissonance. They may lie about
its usefulness but in fact they will not change their belief about the boring nature of the task. In
contrast, the lowly paid group will experience a cognitive dissonance between the two facts—
‘This task is boring’ and ‘I am doing this task without much incentive’. Hence they will change their
initial attitude towards the task and, in fact, will start liking the task. This is called the one-dollar/
20-dollar experiment and explains processes that substantiate counter-attitudinal behaviours.

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3
Q

Measured attitudes often differ from observed behaviours. Which of the
following could improve the correlation between a measured attitude
and actual behaviour?
A. Repeated measurement of attitudes
B. Measuring attitude in a general context without hypothetical constraints
C. Measuring the single most predictive attitude for a given behaviour
D. Measuring attitudes with specifi ed target, context, and time elements
E. Postal survey of attitudes

A

D. In the fi eld of attitude research, the relative lack of correlation between expressed
attitude and actual behaviour is an important hurdle. Attitudes can be elicited with specifi c
assessment of:
1. The target of one’s attitude
2. The actual action expected when faced with the target
3. The specifi ed context in which such action is expected
4. The time when this action is expected.
With such specifi c assessment, the correlation between measured attitude and behaviour
improves considerably. Single instances of behaviours are not reliable indicators of attitudes.
Repeated observations of behaviours (not measurement of attitudes, as stated in Choice A)
may improve the validity. The notion that a specifi c behaviour is infl uenced by one predominant
attitude is too simple and reductionist. Various attitudes interact to produce behaviour. There is
no evidence to suggest that a postal survey of attitudes has better validity than other methods.

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4
Q

A politician is trying to persuade his working-class audience to vote in
favour of his space science policy. Which of the following will produce a
successful persuasion?
A. Being highly credible with respect to the policy
B. Appearing strikingly different from the audience
C. Providing an overview of both good and bad aspects of his policy
D. Inducing a high degree of fear regarding the consequences of non-acceptance
E. Introducing the topic by emphasizing that the policy has been made by a panel
unknown to the politician

A

A. The success of persuasive communication depends on many variables. These variables
can be grouped as those that depend on the source (communicator—the politician in this case),
the message itself, the audience, and the medium of communication. A communicator who is
perceived to be reliable, likeable, attractive, and an expert are positive features that will result in
effective persuasion. When the audience perceive a degree of similarity with the communicator,
the effectiveness of persuasion increases. Inducing moderate but not a high degree of fear can
help effective persuasion. When a message is presented to a well-educated and highly informed
audience who will hear both sides of a story before making a judgement, explaining both pros
and cons (two-sided messages) is more useful than just highlighting the advantages of a policy
(one-sided messages). Providing disclaimers, for example highlighting one’s distance from the
advocated message, is often counterproductive.

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5
Q

Which of the following statements is incorrect with respect to the role
of fear in changing one’s attitudes?
A. Absence of fear can inhibit attitude change
B. Extreme fear can inhibit attitude change
C. In the presence of precise instructions, fear facilitates attitude change
D. Feeling of vulnerability decreases attitude change
E. Fear and attitude change are related by an inverted U shaped curve

A

D. The relationship between fear and persuasion is an inverted U shape—too little or
too much fear will reduce the effectiveness of persuasion. This is similar to the Yerkes–Dodson
law which correlates arousal with performance of an activity. When one is too aroused,
performance is inhibited. At the same time, when someone is not aroused at all, performance is
again inhibited. Optimum arousal seems to be necessary for peak performances. This is clearly
evident in performing sexual activity. When a subject is made to feel vulnerable, this increases
one’s concerns and, as a result, increases one’s attention to a message. For example in order
to persuade adolescents to practice safer sex, the high prevalence of HIV is highlighted before
advising safe sexual practices.

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6
Q

An autistic child is successively reinforced for behaviours ranging
from making eye contact, attending to therapist’s speech, and imitating
speech sounds until sentences are uttered in normal social contexts.
This technique is called
A. Shaping
B. Chaining
C. Flooding
D. Aversion therapy
E. Token economy

A

A. Shaping refers to an operant conditioning technique that has been used in autistic
children. It consists of successive reinforcement of behaviours that approximate to the fi nal
desired behaviour. It is different from chaining in that chaining involves eliciting a complex
behaviour by reinforcing the comparatively simpler components of the behavioural chain.
Flooding is a behavioural technique used in exposure therapy. In this technique, sudden exposure
to highly threatening stimulus (from a hierarchical list of various anxiety provoking situations)
is attempted. It is often unacceptable to many patients and is not popular. Aversion therapy
is not used in present-day behavioural treatment. It refers to a conditioning technique where
negative reinforcement is used to bring about a desired behaviour or to stop an unwanted
behaviour. It is not very effective as any positive outcome tends to be temporary. Token economy
is a contingency technique where immediately available secondary reinforcers (e.g. coupons,
vouchers, tokens) are used to reward a desirable behaviour. Later, primary reinforcers can
be obtained in exchange for secondary reinforcers. A wide variety of behaviours can be thus
reinforced even in large group settings

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7
Q

A smoker is made aware of numerous health problems that could
occur due to smoking. If the smoker attempts to reduce the dissonance
between his smoking behaviour and health beliefs, which of the following
is least likely to happen?
A. Change in smoking behaviour
B. Removing the dissonant health belief
C. Minimizing the importance of one’s health
D. Adding a new belief, for example ‘fi lter cigarettes are safe’
E. Denying the strength of evidence for smoking-related harm

A

A. This is an example of cognitive dissonance or, more precisely, attitude behaviour
discrepancy. Cognitive dissonance is defi ned as a psychological tension that arises when
inconsistent cognitions are held simultaneously. A similar tension can also occur when there is
a discrepancy between one’s attitude and behaviour. When one is faced with such dissonance,
a change in behaviour happens very rarely. Changing one’s behaviour requires more motivation,
effort, and sustained energy. Instead one of the following three happens more often:
1. Removal or denial of the dissonant cognition (‘There is no evidence that smoking is harmful’)
2. Trivializing the dissonant cognition (‘I do not smoke that much’ or ‘Pleasure is more important
than health’)
3. Adding a new consonant cognition to counter balance the dissonance (‘Smoking helps to
reduce my tension’ or ‘Not everyone who smokes will die early’).

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8
Q
Inducing cognitive dissonance is an important therapeutic approach in
which of the following treatments?
A. Systematic desensitization
B. Token therapy
C. Interpersonal therapy
D. Motivation enhancement therapy
E. Brief psychodynamic therapy
A

D. The concept of cognitive dissonance is therapeutically employed in motivation
enhancement therapy. When treating harmful users of alcohol, the evidence for harm caused by
alcohol is highlighted along with refl ecting on one’s continuous drinking behaviour. This induces a
cognitive dissonance which will drive towards an action.

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9
Q

Which of the following terms describes an evaluative rather than
a descriptive stand one holds about oneself?
A. Self-image
B. Bodily self
C. Self-esteem
D. Self-consciousness
E. Ideal self

A

C. Self-esteem refers to an evaluative stand one holds about oneself. In self-psychology an
array of terms are used, somewhat confusing the concepts.
Self-consciousness: awareness of distinct self compared to other objects in the
environment. Only humans are thought to possess full self-consciousness.
Self-image: this refers to an answer one might give for the question ‘who are you?’ It includes
one’s description of social roles (social self), personality traits, and physical characters
(bodily self). We do not feel odd swallowing our own saliva as it is a part of our self-image.
Imagine being asked to swallow someone else’s saliva!
Self-esteem: this refers to a personal judgement of worthiness expressed in the attitudes one
holds towards oneself.
Ideal-self: this represents ‘what we would like ourselves to be’. One’s self-esteem depends on the
discrepancy between one’s ideal self and self-image.

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10
Q
Behavioural couples therapy is a treatment approach used in which
of the following conditions?
A. Alcohol use disorder
B. Premature ejaculation
C. Sex offender therapy
D. Delusional jealousy
E. Dependent personality disorder
A

A. Behavioural couples therapy is a specifi c intervention for alcoholism. It is derived from a
general behavioural conceptualization of substance abuse, which assumes that family interactions
reinforce alcohol-seeking behaviour. It has strong empirical and randomized controlled trial-based
evidence for its effectiveness. It encourages family members to reward abstinence. Soon after the
substance user seeks help, the patient and their partner are seen together in therapy for 15 to 20
out-patient couple sessions over 5 to 6 months. The therapist arranges a daily ‘sobriety contract’
in which the patient states his or her intent not to drink or use drugs that day (traditionally, one
day at a time), and the spouse expresses support for the patient’s efforts to stay abstinent. Stop–
start or squeeze–pause techniques (Masters and Johnson) are used for premature ejaculation.
Sex offender treatment programmes in the UK largely use Cognitive Behavioural Therapy
(CBT)-based treatment approaches.

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11
Q

Which of the following factors plays a role in the development
of self-concept?
A. Reaction of others towards oneself
B. Social comparison one makes with others
C. Social roles one plays in everyday life
D. Identifi cation with a social group
E. All of the above

A

E. All of the given factors in the question play equally important roles in developing one’s
self-concept. Parents react differently to their children according to their birth order. The eldest
born is given more responsibility. This leads to a higher self-esteem in most fi rst-born children.
In a social environment, individuals make constant comparisons with other persons surrounding
them in different domains. One’s self-concept depends very much on the outcome of such
comparisons. As one grows older, one takes up a variety of social roles. The role we play in
society is crucial in the development of self-concept. Individuals often identify themselves as a
part of a group for example ‘I am a football fan’. This social identity plays an important role in
self-development.

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12
Q

In a prosperous country with good tolerance, a famine strikes all
of a sudden. This is followed by a surge of intolerance between two
racial tribes wherein the minorities are discriminated against. Which
of the following theories can explain this prejudice?
A. Relative deprivation theory
B. Group membership theory
C. Social identity theory
D. Authoritarian personality theory
E. Cognitive dissonance theory

A

A. Various theories have been put forward to explain prejudice and discrimination.
According to relative deprivation theory, when sudden discrepancies develop between the needs
of a society and resources possessed by the society, acute relative deprivation results. This in
turn leads to aggressive and discriminatory behaviour against a specifi c target, even though the
targeted group was in no way responsible for the deprivation. Group membership theory states
that mere perception of the existence of another group is suffi cient to trigger discriminatory
behaviour. Prejudice is common in individuals who suffer excessive disciplinary upbringing and
later develop authoritarian personality. However, this authoritarian personality theory fails to
explain sudden surges in social prejudice. According to social identity theory an individual strives
to achieve a positive self-esteem by improving his social identity. Positive preference to one’s
own group (in group) can improve this image. Prejudice and discrimination can develop from this
biased attitude. Cognitive dissonance theory is not a theory of prejudice.

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13
Q

The term ‘nomothetic’ in personality theories refers to which of
the following concepts?
A. Personality is unique for each individual
B. Individuals have overlapping personality traits
C. Ambiguity can induce personality variables to come to the surface
D. Personality is infl uenced by pathological processes
E. Personality is not measurable but can only be described

A

B. Personality theories can be broadly divided into nomothetic theories and idiographic
theories. Nomothetic theories take the view that there are common underlying traits in people’s
personality; we only differ in the degree (and intensity) to which we have these various traits.
Cattell and Eysenck are important proponents of this approach. Idiographic theories take the
view that every individual is unique and we cannot place people into boxes of similar shape and
size. Psychoanalytic theories of personality and humanistic theories are examples of idiographic
approach. According to idiographic theories, personality is better described than measured.
Personality is thought to be pathoplastic, as it modifi es psychiatric disease expression and itself
becomes modifi ed by the infl uence of a disease process. Ambiguous stimuli elicit responses that
are coloured by one’s personality and style of thinking. Projective tests, such as Rorschach’s ink
blot test, utilize this property

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14
Q

Which of the following distinctions between prejudice and discrimination
holds true?
A. Prejudice is a behaviour while discrimination is an attitude
B. Discrimination and prejudice are both attitudes
C. Prejudice is an attitude while discrimination is a behaviour
D. Discrimination has both cognitive and behavioural components
E. Prejudice can only be negative while discrimination could be positive or negative

A

C. Prejudice is best viewed as an attitude whose components include a cognitive part
(stereotypes), affective part (hostility and hatred), and behavioural part. The behaviour related
to prejudice can vary from mild to a severe extreme. Allport described (i) antilocution,
(ii) avoidance of contact, (iii) discrimination, (iv) physical attack, and (v) extermination, as the
behaviours associated with prejudice. One can have positive, neutral, or negative prejudice too.
Of note is the term racism, which refers to an economical and political ideology while racial
prejudice refers to individual attitudes

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15
Q
Which of the following is the average age by which the concept of theory
of mind becomes established in children?
A. 2 to 2 1/2 years
B. 1 to 1 1/2 years
C. 3 1/2 to 4 years
D. 6 to 7 years
E. 8 to 9 years
A

C. Theory of mind develops around the age of 3 1/2 to 4 years old in most humans. Initially
this is confi ned to the rudimentary concept of private thinking—understanding that one’s
thoughts are not visible to others. This is followed by understanding the existence of similar
mental processes in other individuals—termed theory of mind. False belief task or Sally Anne
task is used to test the theory of mind.

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16
Q
Which of the following is often the fi rst social category learnt by a
developing child?
A. Concept of individualism
B. Gender concept
C. Race concept
D. Religion concept
E. Age concept
A

E. Age is often the fi rst social category learnt by a child. It is thought to be developed
even before a child develops full language abilities. Even the concept of numbers comes later.
Exemplifying this, it is noted that age-related mistakes, such as calling an adult a baby, almost
never occur in children. Gender identity develops around 3 years of age

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17
Q
The average age by which most humans develop self-recognition is
A. 1 to 3 months
B. 16 to 18 months
C. 18 to 20 months
D. 12 to 14 months
E. 4 to 6 months
A

C. Self-recognition could be demonstrated in a growing infant by using a mirror. When a
red dot is unknowingly placed on the face of a child, the child starts touching its face to explore
the dot when a mirror is shown. This ‘touching the dot’ phenomenon does not occur less than
15 months of age; 5 to 25% of infants touch the dot by 18 months, while nearly 75% touch the
dot by age 20 months. It is thus concluded that self-recognition rapidly develops between 18 and
20 months. Object permanence is thought to be a prerequisite to develop self-recognition so it is
not possible before 9 months of age.

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18
Q
‘Touching the dot’ is a popular psychological experiment to demonstrate
which of the following concepts?
A. Self-esteem
B. Gestalt theory of perception
C. Self-recognition
D. Visual perception
E. Depth perception
A

C. Gallup conducted the famous ‘touching the dot’ experiments to demonstrate selfrecognition.
It is noted that only higher primates and humans older than 20 months successfully
demonstrate ‘touching the dot’. Mirror recognition by primates may be a refl ection of behavioural
recognition, that is ‘the one in the mirror is the same as me’ rather than self-recognition, that is
‘the one in the mirror is me’.

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19
Q
After her failure in an examination in spite of hard work, a candidate
starts regarding the failure as a stepping stone to success. Which of
the following explains such an attitude?
A. Effort justifi cation dissonance
B. Denial mechanism
C. Passive–aggressive personality
D. Narcissistic personality
E. Learned helplessness
A

A. When we spend much effort in attaining a goal but do not attain the goal eventually, we
are faced with a dissonance. The two facts ‘I worked really hard’ and ‘I failed my exam’ cannot
coexist logically. Hence one starts perceiving that the result is not so bad and some may even
consider that the result was indeed good for one’s spiritual progress! This ‘suffering-leadsto-
liking’ effect is also called effort justifi cation dissonance. There is no narcissism or passive
aggression in such behaviour. This is not a denial as the subject still accepts the failure but
interprets it differently

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20
Q
Which of the following methods of measuring attitudes uses bipolar
adjectives?
A. Likert scale
B. Osgood’s Semantic Differential scale
C. Thurstone Scale
D. Sociogram
E. Scalogram
A

B. Osgood’s Semantic Differential Scale is used to measure verbally expressed attitudes. It
allows different attitudes about a particular topic to be measured on the same scale. It includes
various factors constituting an attitude; for example while expressing one’s attitudes regarding
a politician one can rate him using an evaluative component (good ↔ bad), activity component
(active ↔ inactive), and potency component (powerful ↔ weak), etc. Between the extremes of
these bipolar adjectives a seven-point scale is placed and the subject is asked to indicate a score
for each factor. Osgood’s semantic differential assumes that every concept can be represented
in a hypothetical semantic space with two extremes. Sociometry is a method of measuring
interpersonal attitudes and it involves constructing a sociogram—for example a representation
of ‘who likes whom’ in a family. Guttman’s scalogram consists of various statements arranged
in a hierarchy. Choosing a statement invariably implies that all statements that come below the
chosen statement are accepted. Scalogram is also utilized in measurement of attitudes

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21
Q

While undergoing couples therapy, each partner agrees a way of rewarding
the other when the desired behaviour is carried out. This is called
A. Sculpting
B. Role reversal
C. Socratic questioning
D. Guided discovery
E. Reciprocity negotiation

A

E. Reciprocity negotiation, role reversal, and sculpting are terms associated with couples
therapy. In reciprocity negotiation, mutual rewarding of desirable behaviours through expression
of affection or approval is carried out. This is often a primary component in couples therapy.
In role reversal, mutual exchange of viewpoints takes place in a role-play setting. This helps in
understanding each other’s differing points of view of an issue. This technique is also used in
psychodrama and group therapy. Sculpting refers to silent enactment of positions that express an
aspect of relationship without verbal exchanges. Socratic questioning and guided discovery are
terms associated with cognitive therapy.

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22
Q
The id impulses are counterbalanced by defence mechanisms mediated by
ego. When id retaliates against the moral imposed by superego, which of the
following results?
A. Repressions
B. Obsessions
C. Suppression
D. Repetition compulsion
E. Dissociation
A

D. In simple terms, repetition compulsion refers to a person’s tendency to repeat past
traumatic behaviours. In psychoanalysis, ego defences are considered to rein over id impulses.
When this defence is superseded, confl ict arises leading to anxiety and various defences invoked
in response. The ego mediates between timely release of id impulses and morals imposed by
the superego. At times, the direct control of superego is thwarted and id impulses repetitively
present, that is repetition compulsion which is a form of acting out

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23
Q
A 45-year-old depressed man becomes clingy and tearful when his wife
visits him. He adapts a fetal posture and sleeps on her lap. Which of the
following is being exhibited?
A. Repression
B. Sadism
C. Retardation
D. Regression
E. Degeneration
A

D. Regression refers to moving back on one’s developmental behaviours at times of crisis, as
exemplifi ed in the question. Repression is the shifting of conscious confl icts to the unconscious,
leading to reduced anxiety. Sadism is purposeful infl icting of pain on oneself.

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24
Q

According to psychoanalytic theories of anxiety which of the following
anxieties is the most primitive in development?
A. Disintegration anxiety
B. Superego anxiety
C. Castration anxiety
D. Separation anxiety
E. Stranger anxiety

A

A. Disintegration anxiety precedes other types of anxiety discussed in the question.
According to Klein, soon after birth and thereafter the child experiences an intense fear of
fragmentation, called disintegration anxiety by later theorists. This is sequentially followed by
persecutory fear (against the mother) and, later, separation anxiety. Castration anxiety is seen
in the oedipal stage. Superego anxiety is the anxiety arising out of choices one has to make
between instinctual drives and social morals. This is a mature type of anxiety that develops late in
a child.

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25
Q

Which of the following applies to Jungian modifi cation of psychoanalysis?
A. Active imagination is encouraged
B. Thanatos or death instinct forms the dominant concept
C. Uninterrupted, lifelong psychotherapy is encouraged
D. Jungian therapy is based on object relations theory
E. Play therapy is encouraged

A
  1. A. Jung was widely expected to succeed Freud as the leader of psychoanalysis, but Jung
    distanced himself from Freud on the account of Freud’s ideas on infantile sexuality. Jung founded
    analytical psychology and expanded on ‘unconscious’ to include ‘collective unconscious’. Jungian
    psychotherapy is a classical psychoanalytic therapy in the broad sense but Jung introduced
    active imagination or fantasy as a mode of therapy. He emphasized having holidays from analysis
    to refl ect and think. He encouraged art therapy too. He stressed the concept of indiv
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26
Q

A psychiatric trainee is reprimanded for using social network websites
with explicit sexual content while at work. He explains that such breaks
are very important while doing a stressful job and preventing web access
at work will only make him less effi cient at work. Which of the following
defence mechanisms is he using?
A. Intellectualization
B. Reaction formation
C. Projection
D. Rationalization
E. Sublimation

A

D. This example refers to rationalization. A rationalizing individual offers rational
explanations in an attempt to justify unacceptable attitudes or beliefs or actions.
Intellectualization is closely allied to rationalization, but it is very important to note that in
rationalization, the motives are usually primal and instinctually determined, for example sex,
aggression, greed, etc. Intellectualization is an immature defence. It refers to excessively using
intellectual processes to avoid experiencing painful emotions (not necessarily libidinal). An
intellectualizing individual places undue emphasis on inanimate objects or parts to avoid dealing
with emotion-provoking, ‘living’ elements. He may have more focus on outside reality to avoid
inner feelings; in the process he may pay more attention to irrelevant details.

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27
Q

The term cathexis in psychoanalysis refers to which of the following?
A. The junction between two neurones
B. Re-enactment of childhood confl icts during a therapy session
C. Narrating negative experiences in life without inhibition
D. The instinctual energy stored in neurones
E. A defence mechanism thought to act during sleep

A

D. Cathexis refers to the supposed libidinal energy stored in neurones and kept under
control by the monitoring action of ego. Release of cathexis presents as impulses and defence
mechanisms serve to alter the expression. Libidinal energy may be constructive sexual energy or
destructive aggression. The junction between two neurones is called a synapse. Re-enactment of
childhood confl icts during a therapy session refers to transference. Dream work includes various
processes and revisions and not defence mechanisms as such.

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28
Q

A patient attending psychotherapy sessions for pervasive anxiety
and depression shows reduced interest in the therapy gradually,
after the fi rst eight sessions. When questioned she replies that she
continues to attend only to achieve the satisfaction of ‘being looked-after’.
Which of the following processes explains the above?
A. Counter transference
B. Transference neurosis
C. Transference regression
D. Aggression turned outwards
E. Narcissistic transference

A

B. Transference neurosis involves the re-creation of the patient’s confl icts enacted
within the psychoanalysis session. This enactment mirrors aspects of the infantile neurosis.
The transference neurosis usually develops in the middle phase of analysis, when the patient,
after initial engagement, stops displaying consistent motivation but engages in therapy to attain
emotional satisfaction of re-enacting her infantile confl ict. Emergence of the transference neurosis
is usually a slow and gradual process but when a patient has a propensity for transference
regression (e.g. emotionally unstable or histrionic) this can occur quiet early in the therapy

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29
Q

Which of the following themes is central to Kleinian psychoanalysis?
A. Relationship between past and present life
B. Relationship between libidinal desires and routine events
C. Relationship between internal and external world
D. Relationship between collective and individual unconscious
E. Relationship between ideal and real self

A

C. Self–object relationship is the central theme in object relations theory propounded
by Melanie Klein. The relationship between the internal and external world as represented
by objects is studied in detail by object relation therapists. The relationship between past and
present is emphasized more in a Freudian style of psychoanalysis.

30
Q

Which of the following is true according to the social identity theory?
A. Individuals often choose between social identity and personal identity
B. Each individual has a single specifi c social identity
C. In-group attitudes help preserve social identity
D. Social identity cannot infl uence self-esteem directly
E. Discriminatory behaviour is not related to one’s social identity

A

C. Preference towards one’s own group with positive in-group attributional bias helps in
preserving one’s social identity. According to social identity theory (SIT), an individual strives
to achieve a positive self-esteem through personal and also social identity. So both exist
concurrently. One can have several social identities according to the community in which one
lives. Social identity has direct infl uence on one’s self-esteem. By improving one’s social identity,
one can improve self-esteem. Unfortunately, while developing a strong social identity, in addition
to pro in-group bias, one develops anti out-group bias that results in discrimination.

31
Q

In a therapy group for patients with emotional instability, a 34-year-old
lady realizes how her interactions differ signifi cantly in the group
compared to her past relationships. Which of the following processes
is described in this scenario?
A. Positive group identifi cation
B. Group cohesion
C. Corrective emotional experience
D. Mirroring
E. Catharsis

A

cC. Corrective emotional experience was seen by Alexander as the central part of change
secondary to psychotherapy. Processes that take place in a therapy setting give the patient an
opportunity to refl ect on their past experiences and make necessary behavioural or cognitive
and emotional changes to reduce one’s diffi culties. Positive identifi cation refers to an unconscious
group mechanism in which a person incorporates the characteristics and the qualities of the
group. Catharsis refers to the process by which mere expression of ideas and confl icts is
accompanied by an emotional response which produces a sense of relief. Group cohesion refers
to the sense that the group is working together towards a common goal.

32
Q

Which of the following factors is not considered infl uential in achieving
personal growth and change while undergoing a group therapy?
A. Instillation of hope
B. Imparting information
C. Imitative behaviour
D. Stable administration
E. Socialization in the group

A

D. Yalom cited 11 ‘curative’ factors responsible for change in groups. Stability of
administration is not one of them. The curative factors include instillation of hope, universality,
imparting information (feedback), altruism, corrective recapitulation, socialization techniques,
imitative behaviour, interpersonal learning, group cohesiveness, catharsis, and existential factors.
Of these, cohesiveness and learning from feedback are valued positively, though other factors
may also be important

33
Q

In therapeutic dramatization (psychodrama) the term protagonist
refers to which of the following?
A. The person most loved by the patient
B. The therapist
C. A fellow patient who aids in treatment
D. The patient
E. The person most hated by the patient

A

D. The term protagonist in therapeutic dramatization (psychodrama) refers to the patient.
Auxiliary ego refers to an accomplice who acts as a signifi cant person in patient’s life. The
director is the therapist who conducts the role playing.

34
Q

According to Freud’s structural model of mind, which of the following
is correctly arranged in order of development?
A. Ego, id, superego
B. Id, ego, superego
C. Superego, ego, id
D. Superego, id, ego
E. Id, superego, ego

A

B. According to Freud, id is the most primitive structure to develop. A baby is more or less
born with the pleasure principle id. Soon after birth the child develops a concept of internal self
versus external world, coinciding with the development of ego. Superego is largely a by-product
of introjected parental values and social discipline. This develops only when a child is able to
identify with its same-sex parent. This takes place following successful resolution of the oedipal
complex. Interestingly, Freud considered the superego of girls to be weaker than boys as oedipal
complex develops in a different trajectory for girls. A girl believes she has been castrated by her
mother during development. She develops ‘penis envy’ and loves her father but, realizing she
cannot have a penis, she replaces the envy with a wish for a baby. This leads to identifi cation with
her mother—but as prominent confl ict-related anxiety is not involved, superego that develops at
resolution of the Electra complex is weaker compared to boys.

35
Q

Which of the following psychosexual phases and developmental fears
is correctly matched?
A. Oral phase: fear of annihilation
B. Anal phase: fear of loss of loved object
C. Genital phase: castration anxiety
D. Latent phase: feelings of guilt
E. Oedipal phase: fear of annihilation

A

D. According to psychodynamic theory, different phases of development are associated with
different levels of anxiety. As soon as a child is born, he/she experiences what Klein described
as disintegration anxiety, followed by persecutory (destructive) anxiety against the mother with
resultant separation anxiety (related to depressive position). Here the fear is one of losing the
loved object, that is the mother. In the oedipal phase, the most daunting fear is castration anxiety.
When maturing out of the oedipal stage and entering the latent or genital stage, the child learns
the experience of guilt secondary to development of superego. Hence development of superego
needs resolution of oedipal confl ict.

36
Q

A therapist encourages her patient to continue avoiding the phobic
object, in order to create an insight about the problems associated
with such behaviour. Which of the following techniques is she using?
A. Triangulation
B. Negative transference
C. Paradoxical injunction
D. Reframing
E. Covert sensitization

A

C. The technique of paradoxical injunction developed from work of Gregory Bateson. Here,
a therapist suggests that the patient intentionally engages in the unwanted behaviour, as described
in the question. Though this seems to be counterintuitive, the therapy can create new insights
for some patients. It is sometimes used in family therapy. Triangulation is one of the processes
concerning family dynamics wherein the child is roped into confl icts between the mother and
father and a triad is sustained. Reframing is also called positive connotation. It refers to redefi ning
and relabelling all negatively expressed feelings and behaviours as positive. It is used in family
therapy. Covert sensitization refers to a behavioural method of reducing the frequency of
unwanted behaviour by associating it with the imagination (covert) of unpleasant consequences

37
Q
Which of the following groups has a high level of leadership activity
with highly specifi c therapy goals?
A. Psychodrama
B. Interpersonal therapy
C. Problem-solving therapy
D. Problem-drinkers groups
E. Systems-centred groups
A

D. Group therapies can be classifi ed according to the objectives of the group and how the
group is led or managed (leadership). Highly specifi c, target-oriented groups include structured
groups for drug use or alcohol use, activity groups such as occupational therapy groups, etc.
These groups have a high level of leader input. Psychodrama, music therapy, and systems-centred
groups are some less-specifi c therapies but are highly directed by the leader or therapist.
Problem-solving therapy and psychoeducational groups are highly specifi c but have a low level of
therapist activity. Support groups, art therapy, interpersonal therapy, and groups such as Tavistockmodel
analytic groups have a low level of leader activity and have low specifi city with respect to
treatment goals.

38
Q

Which of the following disorders and defence mechanisms is
correctly paired?
A. Anankastic personality: projective identifi cation
B. Schizoid personality: splitting
C. Conversion disorder: suppression
D. OCD: undoing
E. Anorexia: anticipation

A

D. Various defence mechanisms are used by patients and so-called normal populations
at different times. People can have a style or pattern of predominant defence mechanisms.
Traditionally, the psychodynamic school has proposed certain defences to be associated
with certain diseases: obsessive compulsive disorder (OCD) with isolation of affect, undoing,
and reaction formation; anorexia with denial, displacement, and rationalization; hysteria with
conversion and repression; somatoform disorders with somatization; fugue with dissociation;
schizoid personality with fantasy; borderline personality with splitting, projective identifi cation,
and introjection.

39
Q
Which of the following is not a major principle of a therapeutic community?
A. Communalism
B. Democratization
C. Permissiveness
D. Instillation of hope
E. Reality confrontation
A

D. The four major principles on which a therapeutic community is based are exemplifi ed
by the Henderson hospital model. According to this model, the major components (with a
mnemonic CPD-R) are:
1. Communalism—staff are not separated from inmates by uniforms or behaviours; mutual
helping and learning occurs
2. Permissiveness—tolerating each other and realizing unpredictable behaviour can happen
within the community
3. Democratization—shared decision making and joint running of the unit
4. Reality confrontation—self-deception or distortions from reality are dealt with honestly and
openly by all members without formalities.
Instillation of hope is necessary for any supportive psychotherapy but has not been described as
one of the four major principles behind therapeutic communities.

40
Q

Which of the following can reduce prejudice against a minority group?
A. Negotiating under conditions imposed by the minorities
B. Improving social contact between members of equal status
C. Increasing personal friendships between opposite group members
D. Careful prevention of self-experience of prejudice by the members of dominant group
E. Setting up competitive targets between the two groups

A

B. Social psychologists have put forward various explanations to answer the question ‘how
to reduce prejudice?’ Allport developed the ‘contact hypothesis’ to explain that when people
of equal social status stay in close contact and pursue a common goal, the differences between
them can disappear. It is well established that ‘autistic hostility’ between members of two groups
exists due to lack of suffi cient knowledge about the members of the opposite group. This
ignorance leads to reinforcement of negative stereotypes, for example ‘We are hard working;
they are lazy’. This is also known as a ‘mirror-image phenomenon’. The assumption that everyone
in the opposite group is the same, called ‘illusion of out-group homogeneity’, also reduces with
improved social contact, but it is important to note that this does not relate to a necessary
increase in personal friendships between opposite group members. Imposing strongly one-sided
conditions for negotiations will reduce perceived equality status, leading to maintenance of
prejudice. Self-experience of prejudice by the members of one group can reduce the prejudiced
behaviour exhibited by these members towards others. This was demonstrated by Elliott in the
blue eyes/brown eyes experiment. When groups are set common goals to pursue, cooperation
instead of competition ensues. This aids in reducing prejudice

41
Q

Which of the following concepts refers to the ability of an analyst to
deal with repeated primitive transferences which evolve during
psychotherapy without retaliation or abandonment of the patient?
A. Containing
B. Holding
C. Probing
D. Withstanding
E. Working through

A

B. The description in Question 41 refers to ‘holding’. Holding was proposed by Winnicot.
While administering psychotherapy, the affective and cognitive dispositions of a therapist play
an important part. The cognitive capacity of the therapist to maintain objectivity and focus on
selected facts during a discourse is called ‘containing’ (proposed by Bion). The affective disposition
of the therapist, which helps in restraining oneself from retaliating to negative transferences,
is called ‘holding’. Working through refers to the process by which the therapist repeatedly
elaborates the identifi ed confl ict throughout the therapy in order to enable the patient to
recognize and deal with it effectively.

42
Q
Which of the following stages of change is most suitable to start
acamprosate?
A. Precontemplation
B. Contemplation
C. Maintenance
D. Action
E. Relapse
A

D. Patients must be abstinent at the time of initiation of acamprosate. In precontemplation
phase the patient will simply refuse an intervention. While contemplating treatment the patient
will be still drinking actively. When he acts to stop drinking he will need withdrawal support. This
is the best time to start acamprosate so that he can have reduced craving, which will aid him
to stay in maintenance mode and reduce the likelihood of relapses. An occasional single relapse
need not result in discontinuation of acamprosate. Starting when the patient had already relapsed
will not be an ideal strategy

43
Q

When asked to recall the attachment experience in childhood,
a subject gives an unelaborated account, minimizing problems
faced as a child. Which of the following attachment style has this
subject most likely had as a child?
A. Secure autonomous pattern
B. Insecure avoidant pattern
C. Insecure disorganized pattern
D. Insecure ambivalent pattern
E. Multiple attachment pattern

A

B. This question tests one’s knowledge about Main’s Adult Attachment Interview. This is
a 15-item, semistructured, psychodynamic interview of adults exploring one’s experience as a
child. The attachment style one had as a child correlates with the type of responses given when
answering this interview. Those who had secure attachment provide spontaneous and coherent
answers with an ability to talk freely about negative experiences in childhood. Those who had
an avoidant (insecure) pattern often minimize their experiences, do not elaborate on them, and
do not use colourful metaphors during the discourse. Those who had insecure but ambivalent
(enmeshed) attachment use multiple emotionally laden responses and ramble excessively.
Broken continuity and interrupted logical fl ow of thoughts is seen in those who had insecure,
disorganized attachment pattern. Multiple attachments are common and their presence can be
detected without the need for a discourse analysis.

44
Q
Defi cits, disputes, and role transitions are identifi ed in which of
the following psychotherapies?
A. Dialectic behavioural therapy
B. Rational emotive therapy
C. Interpersonal therapy
D. Brief dynamic therapy
E. Motivational enhancement therapy
A

C. Interpersonal psychotherapy (IPT) was proposed by Klerman and Weissman. The theory
behind IPT is the observation that the development and maintenance of depression occur in a
social and interpersonal context. The outcomes of most psychiatric illnesses are infl uenced by
the interpersonal relationships between the patient and signifi cant others. The therapy takes
place in three phases: identifi cation of problems, targeted action, and consolidating gains. Major
interpersonal problems can be classifi ed as grief, role defi cits, role disputes, and role transitions.
Grief refers to loss of a relationship. Role dispute arises due to confl icts between the related
individuals. Role transition refers to life changes, for example change in job, etc. Defi cit refers to
social impoverishment and inadequate relationships.

45
Q
Which of the following therapies uses the terms ‘snags’, ‘dilemmas’,
and ‘role repertoires’?
A. Dialectic behavioural therapy
B. Rational emotive therapy
C. Interpersonal therapy
D. Cognitive analytical therapy
E. Motivational enhancement therapy
A

D. These terms are used in cognitive analytical therapy (CAT), founded by Ryle. CAT
views behaviour in terms of a procedural sequence model. When a goal-directed activity is
carried out, a sequence of mental components is involved. An important function is making and
testing hypotheses for successful social interactions. Some times, in what are termed neurotic
repetitions, these sequences fail and effective hypothesis testing does not take place. These are:
1. Traps: where negative assumptions lead to blunting of the hypothetical approach
2. Dilemmas: false dichotomies are identifi ed in decision making wherein the tested hypothesis
can have either of just two outcomes
3. Snags (or subtle negative aspect of goals): in spite of having a good hypothesis this does not
get tested as it is perceived to be forbidden or dangerous

46
Q
Which of the following treatments was specifi cally developed to
reduce intentional self-harm behaviour?
A. Dialectic behavioural therapy
B. Rational emotive therapy
C. Interpersonal therapy
D. Cognitive analytical therapy
E. Motivational enhancement therapy
A

A. Dialectical behaviour therapy (DBT) was specifi cally designed by Linehan to address
repeated self-harm behaviour, especially in patients with emotional instability. The core
components of DBT are:
1. Affect regulation
2. Distress tolerance
3. Social skills training
4. Enhancing interpersonal effectiveness.
Ellis developed rational emotive therapy, which is predominantly cognitive-theory based.

47
Q

Your pet dog barks at your new friend who visits you at home. When
you hug your friend during every subsequent visit, the dog gradually
stops barking. Which of the following best explains this phenomenon?
A. Reciprocal determinism
B. Reciprocal inhibition
C. Applied relaxation
D. Biofeedback
E. Vicarious learning

A

B. This is called reciprocal inhibition. Wolpe introduced this term to explain how
contradictory and incompatible responses cannot be conditioned to coexist simultaneously; as a
result one response will be suppressed. In this example, suppression of stranger anxiety response
(barking) follows the evocation of faithfulness and friendliness in the presence of the dog’s
primary food-giver. The physiologically antagonistic response of friendliness serves to extinguish
barking through reciprocal inhibition. Reciprocal determinism and vicarious learning refer to
social learning or modelling theory. There was no applied relaxation or biofeedback provided to
the dog in question.

48
Q

A teacher notices that one of her pupils is sleeping during her lecture
while the rest are actively listening. She concludes that her lecture is
boring and worthless. Which of the following cognitive distortions
best suits the above description?
A. Arbitrary inference
B. Catastrophic interpretation
C. Overgeneralization
D. Selective abstraction
E. Dichotomous thinking

A

D. This question tests one’s knowledge of Beck’s cognitive distortions. Cognitive distortions
are dysfunctional patterns of thinking that serve to produce and maintain depression or
anxiety. A useful mnemonic to remember cognitive distortions is MOSPAD—minimization or
magnifi cation, overgeneralization, selective abstraction, personalization, arbitrary inference, and
dichotomous thinking. In this scenario, the teacher can see one sleepy student amidst many
active participants, yet the teacher chooses to select the negative aspect of the truth—selective
abstraction. In arbitrary inference one comes to conclusion without seeing both sides of a coin.
In minimization, one downplays one’s successful achievements. Magnifi cation reefers to overrating
one’s negative aspects. In dichotomous thinking, a subject splits events around him to ‘black or
white’, that is either good or bad with no grey area in between. Catastrophic interpretation is
seen in panic attacks where minor events are misinterpreted in catastrophic proportions.

49
Q

Production of repetitive phonemes seen in a growing child is called
babbling. Which of the following is true with respect to babbling?
A. Deaf–mute children do not babble.
B. Babbling is seen around 6 weeks of age.
C. The age of attaining the ability to babble depends on the mother tongue.
D. Babbling takes place irrespective of the presence of adults in the vicinity.
E. Babbling stops when the fi rst word is learnt.

A

D. Babbling refers to the repetitive production of consonants around the age of 6 months.
It is seen at the same developmental age irrespective of one’s culture and mother tongue. It is
largely an innate developmental milestone. Even deaf and mute children babble, but around 9 to
12 months this reduces and stops. Normally, babbling continues well into 18 months of age and
does not stop with the production of the fi rst words. Babbling is practiced alone by a child even
in the absence of any adults; this means that communication is not the only intention in babbling.

50
Q
In Cattell’s personality theory, the 16 measured personality factors
(16PF) can be termed
A. Surface traits
B. Secondary traits
C. Source traits
D. Central traits
E. Cardinal traits
A

C. Source traits refer to those traits that act as basic building blocks of personality, as
measured by Cattell’s 16PF. Surface traits are easily observable traits that are correlated strongly
with one another but are not important for making one’s personality. Allport derived various
trait labels from around 18 000 adjectives used in English. According to him, there are three main
variants of traits—cardinal traits are the infl uential, core traits while central traits refer to the fi ve
to 10 less general traits an individual possesses. Least important of all are secondary traits, which
are least general and consistent and are only noticed by close friends.

51
Q

While making a moral judgement on a narrated story, a girl expresses
that there is no wrong in doing things which will get her candies.
Which phase of moral development is she in?
A. Universal ethical orientation
B. Social contract orientation
C. Conventional morality
D. Obedience orientation
E. Reward orientation

A

E. Kohlberg’s stages of moral development include three major levels (which are not
necessarily progressive phases during development), each containing two parts. In the stage of
preconventional morality the child is initially punishment avoidant, that is anything that avoids
punishment is a right thing to do. Later, reward orientation develops—anything that results in
‘candies’, as in this question, is morally right. In conventional morality, the child believes that the
majority is always right and what pleases others must be morally right. Later, the child learns
that doing one’s duty and maintaining order defi nes moral values. The third level is one of
postconventional mortality. Here, one thinks that an individual’s life comes above all man-made
laws and, if necessary, laws should be changed by mutual agreement in a democratic country.
Some people develop a higher, stage 6 morality, called universal ethical orientation. Here,
universal moral principles are upheld more than an individual’s sense of personal right or wrong.

52
Q

During psychotherapy, a patient starts becoming unwell after a prolonged
period of good recovery, in spite of having many more sessions to come in
the future. Which of the following can explain the above?
A. Negative therapeutic reaction
B. Termination reaction
C. Negative transference reaction
D. Uncovering repressed memories
E. Resistance to change

A

A. Freud observed that some patients became unwell when they started recovering from
their diffi culties during psychotherapy. He attributed this phenomenon to the guilt surrounding
the change. This is usually noted in the middle phase of treatment. This must be differentiated from
negative transference where aggressive or paranoid projective transference takes place, sometimes
hindering the therapy progression. Termination reaction refers to the resistance offered by some
patients while terminating therapy. The above example cannot be resistance to change as initial
improvement could not have occurred as described if there was resistance to change.

53
Q
Which of the following is not a cognitive variable crucial for
social learning?
A. Attention
B. Imitative reproduction
C. Memory retention
D. Motivation
E. Problem solving
A

E. Albert Bandura proposed the social learning theory based on modelling (vicarious
learning). Cognitive variables are crucial in mediating social learning. These variables are:
1. Attention
2. Visual image or semantic code recorded in memory
3. Memory permanence using rehearsal and organization (retention)
4. Copying or imitation of behaviour
5. Motivation to perform the learnt act.
It is important to note that social learning differentiated learning from performance.
Reinforcement is generally not needed for learning but for performance. Problem solving is not a
cognitive variable mediating vicarious learning.

54
Q

Which of the following best describes supportive psychotherapy?
A. It is a goal-directed psychotherapy
B. Its primary aim is to help patients strengthen their ego defences
C. It is generally a brief and time-limited therapy
D. Its primary aim is to provide generic social skills training
E. Explicit reassurance must not be given when sought by the patient

A

B. Supportive psychotherapy refers to a common component in many therapeutic
operations. It refers to a supportive, explicitly reassuring approach to allay anxiety and help
patients in crises. Positive instillation of hope, strengthening existing ego defence mechanisms, and
environmental manipulation for supporting one’s coping strategies are important components
of supportive psychotherapy. It is generally provided unlimited in a predictable ‘as and when
necessary’ manner. It is not specifi cally goal-oriented and hence social skills training cannot be
considered as supportive psychotherapy.

55
Q
Which of the following cognitive distortions is characteristically
seen in patients with panic attacks?
A. Catastrophic thinking
B. Minimization
C. Dichotomous thinking
D. Rationalization
E. Overgeneralization
A

A. Catastrophic thinking is a common cognitive distortion seen in patients with panic
attacks. Minor physiological aberrations, such as missed heart beats or palpitations are common
events. A catastrophic thinker interprets these minor aberrations in catastrophic proportion,
making him think he is going to have a heart attack or he is going to die. When a similar
experience occurs with faintness or dizziness, this is interpreted as ‘going crazy’. Secondary to
such catastrophic thinking, autonomic arousal and resultant panic sets in.

56
Q

In Milgram’s obedience experiments, which of the following decreased
the tendency of the subject to administer shock to a victim?
A. Prominent authority of experimenter
B. Proximity of victim to the subject
C. Proximity of the experimenter to the subject
D. Administration of shock using a proxy or helper
E. Removing responsibility from the subject

A

B. Milgram conducted controversial experiments to explore why many conscientious
individuals in Nazi Germany obeyed Hitler. In his paradigm, subjects were asked to administer a
(sham) electric shock to a victim under some false pretence by pressing a dial. The victim can cry
in agony to the awe and shock of many subjects. It was noted that most subjects would obey an
authoritative experimenter and administer shocks, especially if they are not in close proximity
to the victim or if the authority is keeping a close watch on the subjects. Peer rebellion against
the orders of experimenter reduced obedience while proxy administration increased obedience.
When the subjects were given more responsibility regarding the pain infl icted on the victim, the
obedience (administering shocks) decreased

57
Q
Discussing a controversial decision in a group strengthens average
individual inclinations to vote against the risky decision. What is the
name given to the above process?
A. Obedience
B. Conformity
C. Groupthink
D. Group polarization
E. Risky shift
A

D. Group polarization refers to the phenomenon described in Question 57. There are
various processes that infl uence individuals when making decisions as a part of a group. The
group can make more risky decisions than those that an individual him/herself can. This is called
risky shift. A group discussion process can strengthen average individual inclinations and polarize
the group in the direction where most individuals were heading already. This is called group
polarization. While making extreme decisions, the desire to agree with other members of a group
can override rational judgment applicable in individual decision making. This is called groupthink.
Conformity is a process whereby no explicit requirement is made to do a certain task, but
peer infl uence and need for acceptance pushes one to carry out the task. Obedience refers to
conditions where the individual is explicitly asked to do a task and this instruction comes from an
authority.

58
Q

Which of the following statements with respect to language
development is incorrect?
A. The earliest learnt words are context bound
B. ‘Holophrases’ are one-word substitutes for a whole sentence
C. Vocabulary of word-production exceeds word-comprehension by 18 months of age
D. Propositions are learnt later than verbs
E. Telegraphic speech is seen after 18 months of age

A

C. At 18 months of age, the number of words understood by the child will usually exceed
the number of words that the child can produce. Initially, a child uses words in a contextual fashion,
for example the word duck is used only when a toy duck is pushed face down on the fl oor. Later
the words get decontextualized and used more generously. At one point during development,
the child uses ‘holophrases’ which are single words substituting the function of a full sentence.
Verbal use of language is learnt earlier than propositions such as ‘to’, ‘as’, etc. Telegraphic speech
consists of using two or more connected words without functional elements such as conjunctions
or propositions for example ‘Papa go bye’. This occurs around 18 months of age.

59
Q

In a behavioural therapy session for repetitive hair pulling, the patient
is asked to wear gloves when he fi nds himself in a stressful situation
that can promote hair pulling. This technique could be termed
A. Self-monitoring
B. Stimulus control
C. Chaining
D. Negative practice
E. Exposure and response prevention

A

B. The technique described here is called stimulus control. This is often utilized in relapse
prevention for drug users and also in compulsive behaviours such as hair pulling or skin picking.
It is not usually employed as a stand-alone therapy but is provided in combination with other
behavioural and cognitive techniques to control compulsive symptoms. Self-monitoring refers
to keeping a logbook or diary of problem behaviour in order to refl ect and work through
the problem. Chaining is a behavioural technique where successive reinforcement of simple
behaviours leads to learning of a complex behaviour. Negative practice is a behavioural technique
used in tics and Tourette’s syndrome. Exposure and response prevention is used to reduce
compulsions in OCD where exposure to an anxiety-provoking situation is deliberately coupled
with not responding in a problematic fashion, that is compulsive behaviours

60
Q

Repeated eye movement during a conscious recollection is used as
a psychotherapeutic technique in which of the following disorders?
A. Panic disorder
B. Agoraphobia
C. Compulsive skin picking
D. PTSD
E. Depression

A

D. The treatment described here is EMDR—eye movement desensitization and
reprocessing. This technique was serendipitously discovered by Shapiro. When repeated eye
movements in a relaxed state are induced by the therapist, conscious recollection of traumatic
material can be successfully combined with positive thoughts. This has been advocated and
practised for post-traumatic stress disorder (PTSD). The three components are:
1. Imagined exposure
2. Cognitive reappraisal replacing negative thoughts with positive ones
3. Saccadic eye movements induced by the therapist.
The role of the latter is not clearly established and it does not compare well against simple
exposure therapy.

61
Q

Which of the following is true regarding the Parental Bonding Instrument?
A. It is an observer-rated scale to be administered by trained child psychologists
B. It is prone to recall bias
C. It is used to elicit attachment style from breast feeding mothers
D. It is used to interview school-aged children on the quality of bonding
E. The questions are semistructured

A

B. The Parental Bonding Instrument (PBI) is a self-report measure to be completed by
those who are at least 16 years of age. The subjects are asked to score their parents on 25
attitudinal and behavioural items (each with a four-point Likert scale), as remembered during the
fi rst 16 years of the respondent’s development. Hence it is prone to a high degree of recall bias.
Potential sources of error include ‘amnesia’ of early childhood memories, pressure to appear
‘conventional’, or ‘social’, bias due to personality factors, trait characteristics, mood, and other
psychopathology. The construct validity is also questionable

62
Q
The fi ve-areas approach to CBT includes focusing on all of the following
domains of a patient’s experience except
A. Behaviours
B. Physical symptoms
C. Relationships
D. Thinking
E. Traumatic past
A

E. The fi ve-areas approach for assessment in CBT was proposed by Williams; it is a jargonfree
and easily accessible model of CBT for use in busy clinical settings. It allows the patient and
therapist to understand the patient’s symptoms in a deeper manner by exploring:
1. Situation, relationships, resources, and practical problems
2. Symptoms such as physical feelings
3. Behaviours and activity level
4. Thinking
5. Feelings, mood, and emotions

63
Q

While administering CBT, all of the following are appropriate therapeutic
processes that can be employed by a therapist except
A. Encouraging reduction in working hours to reduce stress
B. Exploring the patient’s illness model
C. Setting goals and targets initially
D. Setting tasks to be completed as homework
E. Using the patient’s own descriptive terms

A

A. Active discouragement of work may be counter-therapeutic in most conditions. CBT
does not adopt such prescriptive approach to problem solving. Exploring the patient’s beliefs
about his/her illness is an important part of assessment during CBT. Similarly, clear goal-setting
can be therapeutic and has a role in motivating the patient. Homework tasks may include
putting into practice what the patient learns during treatment sessions. Using the patient’s own
language can be helpful in enhancing therapeutic alliance and avoid misinterpretations during the
therapeutic process.

64
Q

Which of the following is true with respect to psychoanalytic theory
of depression?
A. Awareness of a painful thought is important for the origin of depression
B. Anger can present as depression
C. The concept of ‘object’ always refers to a parent
D. The main source of depression is dream content
E. Depression cannot be treated after early adulthood

A

B. Classic psychoanalytic theory of depression compares depression with mourning. High
dependence and ambivalence in relationships may predispose to depression after object loss.
The object referred to in psychotherapy need not necessarily be one’s parent; it can be any other
person or even an inanimate but personally important object. Identifi cation is an unconscious
mechanism wherein the self tries to become the same as the lost object in some respect. In
depression, identifi cation occurs on the basis of sympathy, guilt, or longing to keep a relationship
with the lost object. In addition, it is thought that an excessively harsh or envious superego can
infl uence severity, chronicity, and refractoriness of depression. Such superego turns aggression
and anxiety against the self.

65
Q
Which one among the following processes seen in group therapy
is not associated with Wilfred Bion?
A. Basic assumptions
B. Amplifi cation
C. Fight–fl ight
D. Pairing
E. Dependency
A

B. The ‘basic assumptions’ put forward by Bion are processes that need to be tackled
effectively for group work to proceed. Bion postulated that when people meet in a group ‘basic
assumptions’ become prominent. The basic assumptions include dependency (being passive and
expecting the group leader to provide answers), pairing (coupling of idealized group members
could lead to the birth of some creative answer to their problems), and fi ght–fl ight (the group’s
response to perceived threats to its existence from outside) reactions. Various techniques
employed in group therapy include ‘mirroring’ (non-judgmental refl ection of one’s experience),
‘amplifi cation’ (increase in emotional resonance by sharing), and ‘catharsis’ (supported ventilation
of emotions). Within a group, processes such as scape-goating (e.g. blaming one member for lack
of progress) or idealization of the therapist could occur. Similarly, unhealthy denigration could
happen among team members. These are thought to be counter-therapeutic to the progress of
the treatment.

66
Q

Richard is a student in sociology at the University. He favours behaviour
such as reading, meditating, creative writing, and composing music,
compared to his fl at mate, Martin, who prefers to spend most of his time
with his circle of friends. According to Jung’s type trait theory of personality,
Richard would best be described as an
A. Ambivert
B. Ectomorph
C. Endomorph
D. Extrovert
E. Introvert

A

A. Jung introduced the terms extraversion and introversion. He believed that people had
different attitudes towards life in general. According to Jung, an extravert is primarily interested
in the world of external objects, as depicted by Martin, who wants to be in the company of his
friends. An introvert is mostly interested in what goes on within his own mind. Jung thought that
both attitudes were necessary for a full comprehension of reality. Indeed, a number of people
are what Jung referred to as ambiverts, but people are usually one-sided and tended to one or
other extreme. The other concepts introduced by Jung include the concept of the collective
unconscious, archetypes, animus, anima, and the shadow. Constitutional psychology is a theory,
developed in the 1940s, by American psychologist William Herbert Sheldon. He associated body
types with temperament. He divided people into three types: ectomorphs (ectoderm–skinny),
mesomorphs (mesoderm–muscle), and endomorphs (gut–fatty). As such, Sheldon thought these
body types correspond to certain temperaments that fi t quite closely to popular stereotypes
of the modern day. For the ease of recall—‘the skinny nerd’ (ectomorph), ‘the jolly fat man’
(endomorph), ‘the slow-witted tough guy’ (mesomorph). Most scientists consider this theory to
be outdated.

67
Q

Jim is an 80-year-old man who leads a retired life with his wife Sarah. He
had been a postman till he retired at the age of 60. He raised two children
who are successful engineers and have families of their own. Looking
back at his life, he gets a sense of fulfi lment and feels that he can face
approaching death with a sense of acceptance. According to Erikson,
what trait does he have?
A. Generativity
B. Identity
C. Integrity
D. Isolation
E. Self-actualization

A

C. According to Erikson, older people may look back on their lives with a sense of panic
and a feeling that time is running out and chances are used up. This can lead to anxiety disorders.
A decline in physical function can contribute to various psychosomatic illness, hypochondriasis,
and depression. People who are facing death may fi nd it intolerable not to have been generative
or had signifi cant attachments in life. Integrity, according to Erikson, is characterized by an
acceptance of life. Without this acceptance people feel a sense of despair, leading to severe
depression and suicide in some cases. Generativity is the stage prior to the stage of integrity,
between 40 and 65, failure of which leads to stagnation. Intimacy stage is seen between 20 and
40 years, where signifi cant relationships are acquired. A failure of this stage leads to isolation.
Identity versus role confusion is seen in the teen years, leading up to 20, during which the
individual develops a sense of self.

68
Q

Non-directiveness, unconditional positive regard, active listening, and
empathy are features of a psychotherapeutic technique originated by
Carl Rogers. Which of the following therapies do these terms represent?
A. Behaviour therapy
B. Client centred therapy
C. Family therapy
D. Psychoanalytic psychotherapy
E. Rational emotive therapy

A

B. Carl Rogers believed that people are born with a capacity to direct themselves towards
a level of completeness called self-actualization. Rogers viewed personality as a dynamic
phenomenon, which involves communications, relationships, and self-concepts and which changes
regularly. He developed a treatment programme called client-centred psychotherapy. Here
the therapist helps the client to achieve their self-actualization by producing an atmosphere
conducive to it. The therapist holds the clients with unconditional positive regard, accepting
him/her for what he/she is. He encouraged active listening, empathy, and non-directiveness, all
principles which have been adopted by mainstream psychiatry. Other therapeutic practices
include attention to the present, focus on clients’ feelings, emphasis on process, trust in the
potential and self-responsibility of clients, and a philosophy grounded in a positive attitude
toward them, rather than a preconceived structure of treatment

69
Q
The ABCD system of emotional self-control is a feature of which of
the following therapies?
A. Client-centred therapy
B. Cognitive therapy
C. Family therapy
D. Psychoanalytic psychotherapy
E. Rational emotive behaviour therapy
A

E. Rational emotive behaviour therapy was fi rst developed by Albert Ellis, an American
psychologist, in the 1950s. It can be considered one of the fi rst forms of cognitive behaviour
therapy. The therapy is based on the concept of how people’s view of various events can affect
the consequences. Typically, a situation (antecedent or A), triggers certain beliefs (B) about
A. These beliefs, which are usually dysfunctional, lead to certain behavioural and emotional
consequences (C), which are again dysfunctional
A (antecedent) → B (Beliefs) → Consequences (C)
The therapy is directed towards identifying these faulty beliefs and disputing (D) these beliefs.
These steps are not very dissimilar from cognitive behaviour therapy, developed by Aaron Beck a
decade later.

70
Q

Behavioural activation can be used as a method of treating depression.
In behavioural activation, one’s day is structured with certain activities
consistent with the intended positive outcome. Which of the following is
the major component of activity scheduling?
A. Keeping notes and diaries to prompt the patient
B. Listing only pleasurable activities on the schedule
C. Negative reinforcement of avoidance behaviour
D. Postponing an activity until the development of full motivation
E. Scheduling activities that have been avoided

A

E. Behavioural activation is a treatment for depression developed by Martell. It is now
delivered largely as a part of other behavioural and cognitive psychotherapies for depression.
Behavioural activation involves the development of activity scheduling; the main focus of activity
scheduling is the use of avoided activities as a guide for daily scheduling and functional analysis of
cognitive processes that involve avoidance.