Introduction to Psychiatry — MCQs

Introduction to Psychiatry Indian Medical PG Practice Questions and MCQs

Question 171: Who proposed the theory of psychosexual development?

A. Freud (Correct Answer)
B. Piaget
C. Skinner
D. Kaplan

Explanation: ***Correct: Freud*** - **Sigmund Freud** is widely recognized for originating the theory of **psychosexual development**, which posits that personality develops through a series of stages connected to erogenous zones. - His theory includes distinct stages such as the **oral**, **anal**, **phallic**, **latency**, and **genital** stages, each associated with specific conflicts and developmental tasks. *Incorrect: Piaget* - **Jean Piaget** is known for his theory of **cognitive development**, which describes how children construct their understanding of the world through stages like sensorimotor, preoperational, concrete operational, and formal operational. - His work focuses on the development of **thought processes** and reasoning, rather than psychosexual urges. *Incorrect: Skinner* - **B.F. Skinner** was a proponent of **behaviorism**, emphasizing the role of **operant conditioning** in shaping behavior through reinforcement and punishment. - His theories primarily deal with learned behaviors and environmental influences, not internal psychosexual drives. *Incorrect: Kaplan* - **Harold Kaplan** was a psychiatrist known for his contributions to the field of **sex therapy** and his work on sexual dysfunction. - While his work is related to sexuality, he did not propose the foundational theory of psychosexual development.

Question 172: A 25-year-old patient presents with persistent delusions of persecution, auditory hallucinations, and social withdrawal for the past 8 months. There is no history of substance abuse or medical illness. What is the most likely diagnosis?

A. Schizophrenia (Correct Answer)
B. Major depressive disorder with psychotic features
C. Brief psychotic disorder
D. Bipolar disorder, manic episode

Explanation: ***Schizophrenia*** - This patient presents with **psychotic symptoms** (delusions of persecution, auditory hallucinations) and **negative symptoms** (social withdrawal) lasting for **8 months**. - The duration of symptoms **exceeds 6 months**, which meets the diagnostic criteria for **schizophrenia** according to DSM-5. - The presence of **two or more characteristic symptoms** (delusions and hallucinations) along with **social/occupational dysfunction** (social withdrawal) and **no substance abuse or medical illness** confirms this diagnosis. *Major depressive disorder with psychotic features* - While psychotic features can occur in major depression, the primary symptoms would be **depressed mood** and/or **anhedonia**, which are not reported here. - The prominent **delusions of persecution** and **auditory hallucinations** without significant mood symptoms make this diagnosis unlikely. *Brief psychotic disorder* - This disorder is characterized by the sudden onset of **psychotic symptoms** lasting **less than 1 month**. - The patient's symptoms have persisted for **8 months**, far exceeding the criteria for brief psychotic disorder. *Bipolar disorder, manic episode* - A manic episode would involve a distinct period of **abnormally and persistently elevated, expansive, or irritable mood**, increased goal-directed activity or energy, and other manic symptoms. - The primary symptoms described are **psychotic** and **negative symptoms** rather than mood elevation, making this diagnosis incorrect.

Question 173: Provision of the Mental Health Act 2017, based on WHO guidelines, includes all, except:

A. Social support
B. Screening family members (Correct Answer)
C. Human rights
D. Communication regarding care and treatment

Explanation: ***Screening family members*** - The Mental Health Act 2017 focuses on the **rights, treatment, and support of individuals with mental illness**, not routine screening of their family members. - The Act does not contain provisions mandating **screening of asymptomatic family members**, though family history may be relevant for clinical assessment. - This is **not a provision** outlined in the Act based on WHO guidelines. *Human rights* - The Act is explicitly grounded in the **protection and promotion of human rights** for persons with mental illness (Chapter I). - Ensures care with **dignity, respect, and freedom from discrimination** as core principles. - Aligns with WHO's mental health action plan and human rights framework. *Communication regarding care and treatment* - **Section 4** emphasizes the right to information and **informed consent** for all treatment decisions. - Patients must receive clear communication about their **diagnosis, treatment options, and care plans**. - Includes provisions for **advance directives** and involvement in treatment decisions. *Social support* - **Chapter V** addresses rehabilitation and community-based services, emphasizing the role of **social support systems**. - Promotes **community integration** and access to social resources for recovery. - Recognizes family and community support as essential for long-term mental health management.

Question 174: Which of the following best describes a situation that would trigger General Adaptation Syndrome (GAS)?

A. Chronic Stress from Work Pressure (Correct Answer)
B. Acute Stress from a Traumatic Event
C. Temporary Anxiety due to Exam Preparation
D. Brief Adjustment Stress from Moving to a New City

Explanation: ***Chronic Stress from Work Pressure*** - The **General Adaptation Syndrome (GAS)**, described by Hans Selye, represents the body's response to **prolonged/chronic stress** evolving through three stages: alarm, resistance, and exhaustion. - **Chronic work pressure** is a classic example of sustained stressor exposure that triggers the full GAS response, particularly maintaining the resistance phase where the body attempts long-term adaptation. - Prolonged exposure eventually leads to the exhaustion phase if stress continues unabated. *Acute Stress from a Traumatic Event* - An **acute traumatic event** primarily triggers only the initial **"alarm" phase** of GAS, involving immediate physiological responses (increased heart rate, adrenaline release, fight-or-flight activation). - While it initiates stress response, it does not typically progress through the subsequent resistance and exhaustion phases that characterize the complete GAS. *Temporary Anxiety due to Exam Preparation* - **Temporary/short-term anxiety** is a brief stressor that evokes an acute stress response but resolves quickly. - Unlikely to progress beyond the alarm phase or lead to the prolonged resistance and exhaustion phases characteristic of full GAS. - The body typically recovers rapidly once the exam period ends. *Brief Adjustment Stress from Moving to a New City* - While moving involves adjustment, the **initial relocation stress** is typically **time-limited** and resolves as adaptation occurs. - Does not represent the sustained chronic stress exposure required to trigger the complete GAS progression through resistance to exhaustion phases. - Differs from chronic stressors like sustained work pressure that persist over extended periods.

Question 175: Which of the following excludes painful stimuli from awareness?

A. Repression (Correct Answer)
B. Reaction formation
C. Projection
D. Rationalization

Explanation: ***Repression*** - **Repression** is a defense mechanism where the mind unconsciously blocks disturbing thoughts, memories, or impulses from entering awareness. - It serves to remove painful stimuli or unacceptable desires from conscious perception, preventing emotional distress. - This is the primary mechanism that **excludes painful stimuli from awareness**. *Reaction formation* - **Reaction formation** is a defense mechanism where a person unconsciously replaces an unacceptable impulse with its opposite. - For example, showing excessive kindness to someone one dislikes. - This does not directly exclude painful stimuli from awareness but transforms the expression of the impulse. *Projection* - **Projection** involves attributing one's own unacceptable thoughts, feelings, or impulses to another person. - This mechanism shifts blame or undesirable traits onto others rather than blocking the original painful stimulus from awareness. - The person remains aware of the trait but misattributes its source. *Rationalization* - **Rationalization** is the cognitive distortion of facts to make an unacceptable action or impulse appear more acceptable or logically justifiable. - It involves constructing a plausible but false reason for one's actions. - While it reduces anxiety, it doesn't exclude the original painful stimulus from awareness—rather, it reinterprets it.

Question 176: The Oedipus complex is a concept primarily associated with which psychoanalyst?

A. Plato
B. Freud (Correct Answer)
C. Huxley
D. Socrates

Explanation: ***Freud*** - The **Oedipus complex** is a central concept in **Sigmund Freud's psychoanalytic theory**, describing a child's unconscious sexual desire for the parent of the opposite sex and feelings of rivalry with the parent of the same sex. - This concept is foundational to his theory of **psychosexual development**, particularly during the **phallic stage**. *Plato* - Plato was an ancient **Greek philosopher**, student of Socrates, and teacher of Aristotle, whose work focused on metaphysics, ethics, politics, and epistemology. - His ideas, such as the theory of **Forms** and the **Allegory of the Cave**, are central to classical philosophy but do not relate to psychological complexes. *Socrates* - Socrates was a classical **Greek philosopher** credited as one of the founders of Western philosophy. - His contributions include the **Socratic method** of inquiry and the pursuit of virtue and self-knowledge, not psychological theories of development. *Huxley* - There are two prominent Huxleys: **Aldous Huxley**, known for his dystopian novel *Brave New World*, and **Thomas Henry Huxley**, known as "Darwin's Bulldog" for his advocacy of evolution. - Neither of them are primarily associated with the development of psychological theories like the Oedipus complex.

Question 177: Which of the following is considered a fundamental defense mechanism in psychology?

A. Alienation
B. Confabulation
C. Repression (Correct Answer)
D. Suppression

Explanation: ***Repression*** - **Repression** is the **fundamental unconscious defense mechanism** where unacceptable thoughts, feelings, or memories are pushed out of conscious awareness to protect the ego. - It is considered the foundational defense mechanism because it operates automatically and without conscious effort, forming the basis for many other defense mechanisms. *Alienation* - **Alienation** refers to a feeling of estrangement or disconnection from others, society, or oneself, often due to social or psychological factors, but it is not a defense mechanism. - It describes a state of being rather than an active psychological process used to cope with anxiety. *Confabulation* - **Confabulation** is the creation of false autobiographical memories without the intent to deceive, often seen in neurological conditions like **Korsakoff's syndrome**. - It is a symptom of memory impairment, not an active psychological defense mechanism. *Suppression* - **Suppression** is a defense mechanism but is considered a mature/conscious defense; it involves deliberately and consciously putting unwanted thoughts or feelings out of mind. - Unlike **repression**, **suppression** is an intentional and relatively aware act of avoiding disturbing thoughts.

Practice by Chapter

History of Psychiatry

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Classification Systems in Psychiatry

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Psychiatric Assessment and Interview

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Mental Status Examination

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Psychiatric Rating Scales

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Formulation and Diagnosis

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Ethics in Psychiatry

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Legal Aspects of Psychiatric Practice

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Psychiatric Epidemiology

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Cultural Psychiatry

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Stigma and Mental Illness

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Public Mental Health

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