Introduction to Psychiatry Practice Questions

Q: White-coat hypertension is an example of:

A conditioned response. **Explanation:** White-coat hypertension is a classic clinical example of **Classical Conditioning** (Pavlovian conditioning). **Why the correct answer is right:** In classical conditioning, a neutral stimulus becomes associated with an unconditioned stimulus to elicit a specific response. 1. **Unconditioned Stimulus (UCS):** Medical procedures or pain (which naturally cause anxiety/stress). 2. **Unconditioned Response (UCR):** Increased blood pressure/tachycardia due to that stress. 3. **Conditioned Stimulus (CS):** The "White Coat" or the clinical environment (previously neutral). 4. **Conditioned Response (CR):** The elevation of blood pressure occurring simply upon seeing the doctor, even without any painful procedure. Thus, the hypertension itself is the **Conditioned Response**. **Analysis of Incorrect Options:** * **A. Unconditioned Stimulus:** This is a stimulus that naturally triggers a response without prior learning (e.g., a painful injection). The white coat is learned, not innate. * **B. Unconditioned Response:** This is the natural, unlearned reaction to a UCS (e.g., fainting when seeing blood). * **C. Conditioned Stimulus:** This refers to the **White Coat itself** or the doctor’s presence, which triggers the reaction, not the physiological elevation of blood pressure. **Clinical Pearls for NEET-PG:** * **Classical Conditioning:** Deals with involuntary, visceral responses (autonomic nervous system). * **Operant Conditioning:** Deals with voluntary behaviors and consequences (Rewards/Punishments). * **Extinction:** If the patient visits the doctor repeatedly without any stressful event, the white-coat hypertension may gradually disappear. * **Diagnosis:** White-coat hypertension is confirmed using **Ambulatory Blood Pressure Monitoring (ABPM)**, which shows normal readings outside the clinic.

Q: All of the following are mature defense mechanisms except?

Projection. This question pertains to **Vaillant’s Classification of Ego Defense Mechanisms**, a high-yield topic in Psychiatry and Behavioral Sciences (often integrated into Community Medicine/Mental Health). ### **Explanation of the Correct Answer** **Projection (Option C)** is the correct answer because it is classified as an **Immature Defense Mechanism**. It involves attributing one’s own unacknowledged, unacceptable feelings or impulses to others. For example, a person who feels internal hostility may believe that everyone else is out to get them. ### **Analysis of Incorrect Options (Mature Defenses)** Mature defense mechanisms are healthy, adaptive ways of dealing with stress. * **Anticipation (Option A):** Realistically planning for future inner discomfort or external stressors (e.g., studying in advance for NEET-PG to reduce anxiety). * **Suppression (Option B):** The **conscious** decision to delay paying attention to an emotion or need (e.g., "I will deal with this personal problem after my exam"). Note: This is different from *Repression*, which is unconscious and immature. * **Humor (Option D):** Using comedy to express feelings and thoughts without personal discomfort or an unpleasant effect on others. ### **High-Yield Clinical Pearls for NEET-PG** To master defense mechanisms, remember the **"SASH"** mnemonic for Mature Defenses: 1. **S**ublimation (Channeling impulses into socially acceptable actions, e.g., boxing to vent anger). 2. **A**ltruism (Constructive service to others). 3. **S**uppression (Conscious postponement). 4. **H**umor (Lightening the situation). * *Note:* **Anticipation** is also a key mature defense often tested. **Key Distinction:** * **Suppression:** Conscious (Mature) * **Repression:** Unconscious (Intermediate/Neurotic) * **Projection:** Attributing to others (Immature) * **Reaction Formation:** Doing the exact opposite of the impulse (Neurotic)

Q: A person buys gifts for their spouse the day after an argument. This behavior is an example of which of the following defense mechanisms?

Undoing. **Explanation:** The correct answer is **Undoing**. **1. Why Undoing is correct:** Undoing is a **neurotic defense mechanism** where a person attempts to "cancel out" or "erase" an unacceptable action, thought, or impulse by performing a contrary behavior. It acts as a symbolic ritual to alleviate guilt or anxiety associated with a previous act. In this scenario, the individual feels guilt over the argument and attempts to "undo" the emotional damage by buying gifts, effectively trying to reset the relationship to its state before the conflict. **2. Why other options are incorrect:** * **Reaction Formation:** This involves transforming an unacceptable impulse into its polar opposite (e.g., being excessively kind to someone you secretly hate). It is a long-term character trait rather than a specific "tit-for-tat" corrective action like buying a gift after a fight. * **Aim Inhibition:** This involves accepting a partially modified or "toned down" version of one's original goal (e.g., wanting to be a surgeon but settling for becoming a surgical technician). * **Suppression:** This is a **mature** defense mechanism involving the *conscious* decision to delay paying attention to an emotion or conflict (e.g., "I won't think about the argument until I finish my workday"). **Clinical Pearls for NEET-PG:** * **Undoing** is classically associated with **Obsessive-Compulsive Disorder (OCD)**, where compulsions (like handwashing) serve to "undo" the anxiety of obsessions (contamination). * **Hierarchy of Defense Mechanisms:** * **Mature:** Suppression, Sublimation, Altruism, Humor. * **Neurotic:** Undoing, Reaction Formation, Displacement, Rationalization. * **Immature/Narcissistic:** Projection, Denial, Splitting (common in Borderline PD). * **Key Distinction:** Suppression is **conscious**, whereas almost all other defense mechanisms (including Repression) are **unconscious**.

Q: Which of the following structures of the mind work on an unconscious level?

The id, ego, and superego. ### Explanation This question pertains to **Sigmund Freud’s Structural Model of the Mind**, which divides the psyche into three components: the Id, Ego, and Superego. **Why the correct answer is right:** While the **Id** is entirely unconscious (operating on the pleasure principle), the **Ego** and **Superego** are not limited to the conscious mind. * **The Ego:** Operates primarily at the conscious and preconscious levels to mediate reality, but it also employs **unconscious defense mechanisms** (e.g., repression, denial) to manage anxiety. * **The Superego:** Represents internalized moral standards. While we are aware of some moral thoughts, much of the Superego’s function—such as the generation of unconscious guilt—occurs below the level of awareness. Therefore, all three structures have components that function at an **unconscious level**. **Why incorrect options are wrong:** * **Option A:** Incorrect because it ignores the unconscious defense mechanisms of the Ego and the unconscious moral pressures of the Superego. * **Option B & D:** Incorrect because they exclude one of the three components. All three structures interact within the unconscious realm to influence behavior. **NEET-PG High-Yield Pearls:** * **The Id:** Present at birth; works on the **Pleasure Principle**; uses **Primary Process Thinking** (illogical, symbolic). * **The Ego:** Develops after birth; works on the **Reality Principle**; uses **Secondary Process Thinking** (logical, rational). * **The Superego:** Develops around age 5 (during the Phallic stage/Oedipus complex resolution); dictates conscience and the "Ego Ideal." * **Topographical Model vs. Structural Model:** Do not confuse these. The Topographical model consists of Conscious, Preconscious, and Unconscious. The Structural model (Id, Ego, Superego) maps across these layers.

Q: According to the National Trust Act, patients suffering from which of the following conditions are eligible for disability benefits?

Mental retardation. **Explanation:** The **National Trust Act (1999)** is a specific piece of legislation in India designed to provide welfare, guardianship, and support for individuals with a specific subset of developmental disabilities. **Why the Correct Answer is Right:** The National Trust Act covers exactly **four** categories of disabilities: 1. **Autism** 2. **Cerebral Palsy** 3. **Mental Retardation** (now clinically referred to as Intellectual Disability) 4. **Multiple Disabilities** (a combination of two or more of the above) Individuals with Mental Retardation are eligible for benefits under this Act, including legal guardianship and the "Niramaya" health insurance scheme. **Why the Incorrect Options are Wrong:** * **Schizophrenia and Bipolar Disorder (Options A & B):** These are classified as **Mental Illnesses**. While they are covered under the **Rights of Persons with Disabilities (RPwD) Act, 2016** and the **Mental Healthcare Act, 2017**, they are specifically excluded from the National Trust Act. * **Dementia (Option C):** This is a neurodegenerative condition. Like mental illness, it may qualify for disability benefits under the RPwD Act 2016 but does not fall under the four specific categories of the National Trust Act. **High-Yield Clinical Pearls for NEET-PG:** * **RPwD Act 2016:** Covers **21 disabilities** (including Mental Illness, Chronic Neurological conditions, and Blood disorders). * **National Trust Act 1999:** Covers only **4 disabilities** (Developmental in nature). * **Mental Healthcare Act 2017:** Focuses on the right to treatment and prohibits the use of "Direct ECT" (modified ECT is mandatory). * **Disability Certificate:** For Mental Retardation, the **IDEAS** (Indian Disability Evaluation and Assessment Scale) is not used; instead, IQ testing (e.g., Binet-Kamat Test) is the standard. IDEAS is used for Mental Illness (Schizophrenia, OCD, etc.).

Q: Who is the scientist credited with a Nobel Prize for his contributions to psychosurgery?

Egas Moniz. **Explanation:** **Correct Answer: D. Egas Moniz** António Egas Moniz was a Portuguese neurologist who is credited as the founder of modern psychosurgery. He developed the **prefrontal leucotomy** (later known as lobotomy) in 1935 to treat severe psychiatric disorders like schizophrenia and refractory depression. For this contribution, he was awarded the **Nobel Prize in Physiology or Medicine in 1949**. He is also famously known for developing **cerebral angiography**. **Analysis of Incorrect Options:** * **A. Erik Erikson:** A developmental psychologist known for the **Theory of Psychosocial Development**, which outlines eight stages of the human life cycle (e.g., Trust vs. Mistrust). * **B. Alfred Adler:** A neo-Freudian who founded **Individual Psychology**. He is best known for concepts like the **Inferiority Complex** and the importance of birth order. * **C. Manfred Bleuler:** The son of Eugen Bleuler (who coined the term 'Schizophrenia'). Manfred is known for his extensive longitudinal studies on the course and prognosis of schizophrenia. **High-Yield Clinical Pearls for NEET-PG:** * **Psychosurgery Today:** While Moniz’s crude leucotomy is obsolete, modern stereotactic psychosurgery (e.g., **Deep Brain Stimulation** or **Cingulotomy**) is used as a last resort for treatment-resistant OCD and Depression. * **Eugen Bleuler (Father):** Coined the "4 As" of Schizophrenia (Affect, Autism, Ambivalence, Association). * **Walter Freeman:** The American neurologist who popularized the "transorbital" (ice-pick) lobotomy, though he did not win the Nobel Prize.

Q: Which of the following is NOT a mature defense mechanism?

Projection. **Explanation:** Defense mechanisms are unconscious psychological strategies used to cope with anxiety. According to Vaillant’s classification, they are categorized into four levels: Pathological, Immature, Neurotic, and Mature. **Why Projection is the Correct Answer:** **Projection** is classified as an **Immature defense mechanism**. It involves attributing one's own unacknowledged unacceptable feelings, impulses, or thoughts to another person (e.g., a patient who feels angry at their doctor may claim, "My doctor hates me"). Because it distorts reality and shifts internal conflict onto the external world, it is not considered mature. **Analysis of Incorrect Options:** * **Humor (Mature):** Using comedy to express feelings and thoughts without personal discomfort or an unpleasant effect on others. * **Altruism (Mature):** Dealing with stressors by dedicating oneself to meeting the needs of others, providing a sense of vicarious satisfaction. * **Asceticism (Mature):** Eliminating the pleasurable effects of experiences. It is often seen in adolescents who renounce immediate gratifications to focus on higher goals or values. **High-Yield Clinical Pearls for NEET-PG:** * **Mnemonic for Mature Defenses (SASH):** **S**ublimation, **A**ltruism, **S**uppression, **H**umor. (Note: **Asceticism** and **Anticipation** are also mature). * **Suppression vs. Repression:** Suppression is the only **conscious** defense mechanism (Mature), while Repression is **unconscious** (Neurotic). * **Sublimation:** Channeling socially unacceptable impulses into socially productive ones (e.g., an aggressive person becoming a boxer). This is frequently tested as the "most mature" mechanism.

Q: Which of the following is associated with Madonna-Putana complex?

Male erectile disorder. ### Explanation The **Madonna-Putana complex** (also known as the Madonna-Whore complex) is a psychological concept first described by **Sigmund Freud**. It refers to a specific psychological conflict in men where they cannot experience sexual desire and romantic love simultaneously for the same woman. **Why Male Erectile Disorder is Correct:** In this complex, the man categorizes women into two groups: 1. **The Madonna:** Women he loves and respects (e.g., wife, mother figures). He views them as "pure" and "saintly," making it psychologically impossible for him to desire them sexually. 2. **The Putana (Whore):** Women he finds sexually attractive but cannot love or respect. Clinically, this manifests as **situational male erectile disorder**. The individual is physically capable of an erection but fails to achieve or maintain one with his partner (the "Madonna") because sexual arousal feels "degrading" or "incestuous" to her image. However, he remains fully potent with casual partners or sex workers (the "Putana"). **Why Other Options are Incorrect:** * **A & D (Female Arousal Disorder/Anorgasmia):** These are female sexual dysfunctions. The Madonna-Putana complex is specifically described in the context of male psychology and its impact on male sexual performance. * **B (Male Hypoactive Sexual Desire Disorder):** These patients do not lack desire entirely. They often have high libido but suffer from a "split" in their ability to direct that desire toward a loved partner. **High-Yield Clinical Pearls for NEET-PG:** * **Origin:** Psychoanalytic theory (Freud). * **Underlying Mechanism:** It is considered a failure of the integration of the **affectionate** and **sensual** currents of libido. * **Key Symptom:** Selective or situational impotence (Erectile Disorder). * **Treatment:** Long-term psychoanalytic psychotherapy to resolve unconscious conflicts regarding the perception of women.

Question 1

White-coat hypertension is an example of:

Accepted Answer

A conditioned response

Answer

An unconditioned stimulus

Answer

An unconditioned response

Answer

A conditioned stimulus

Question 2

All of the following are mature defense mechanisms except?

Accepted Answer

Projection

Answer

Anticipation

Answer

Suppression

Answer

Humor

Question 3

A person buys gifts for their spouse the day after an argument. This behavior is an example of which of the following defense mechanisms?

Accepted Answer

Undoing

Answer

Reaction formation

Answer

Aim inhibition

Answer

Suppression

Question 4

Which of the following structures of the mind work on an unconscious level?

Accepted Answer

The id, ego, and superego

Answer

The id only

Answer

The id and the ego only

Answer

The ego and superego only

Question 5

According to the National Trust Act, patients suffering from which of the following conditions are eligible for disability benefits?

Accepted Answer

Mental retardation

Answer

Schizophrenia

Answer

Bipolar disorder

Answer

Dementia

Question 6

What is the most important cause of neurotic reaction?

Accepted Answer

Regression

Answer

Projection

Answer

Suppression

Answer

Sublimation

Question 7

Who is the scientist credited with a Nobel Prize for his contributions to psychosurgery?

Accepted Answer

Egas Moniz

Answer

Erik Erikson

Answer

Alfred Adler

Answer

Manfred Bleuler

Question 8

A father forced his reluctant son to bring a glass of water, and the child dropped the glass on the way. This is an example of which defense mechanism?

Accepted Answer

Passive aggression

Answer

Reaction formation

Answer

Denial

Answer

Acting out

Question 9

Which of the following is NOT a mature defense mechanism?

Accepted Answer

Projection

Answer

Humor

Answer

Asceticism

Answer

Altruism

Question 10

Which of the following is associated with Madonna-Putana complex?

Accepted Answer

Male erectile disorder

Answer

Female arousal disorder

Answer

Male hypoactive sexual desire disorder

Answer

Anorgasmia

Introduction to Psychiatry — MCQs

Introduction to Psychiatry — MCQs

On this page

Practice by Chapter

Want unlimited practice?