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ANM / Multi-Purpose Health Assistant (Female) · Chapter 3

Psychology and Sociology

What to remember

  • Psychology is the study of mind and behaviour; sociology is the study of society and social relationships. A health worker uses both to understand why people act as they do and how families and communities shape health.
  • Standard theories are asked by name: Pavlov (classical conditioning), Skinner (operant conditioning), Freud (personality), Maslow (needs), Erikson (life stages), Piaget (thinking in children).
  • IQ = (Mental age ÷ Chronological age) × 100. Numerical questions on IQ are common and easy once the formula is clear.

Basics of psychology

Psychology studies the mind, behaviour and experience. Wilhelm Wundt set up the first psychology laboratory (1879, Leipzig). Behaviour can be overt (visible, such as walking) or covert (hidden, such as thinking). Main branches: clinical, child, social, educational, industrial and health psychology.

Sensation and perception. Sensation is the first contact of a stimulus with a sense organ. Perception is giving meaning to what is sensed. Attention is focusing on one thing. Memory has three steps: encoding (taking in), storage (keeping) and retrieval (recalling). Types are sensory, short-term and long-term memory. Forgetting grows with time and with lack of use.

Learning is a lasting change in behaviour due to experience.

TheoryPersonKey ideaExample
Classical conditioningPavlovA neutral stimulus linked with a natural one gives the same responseDog salivates at a bell
Operant conditioningSkinnerBehaviour is shaped by reward or punishmentA child repeats good behaviour when praised
Trial and errorThorndikeLearning by trying and keeping what worksCat escaping a puzzle box
Insight learningKöhlerSudden understanding of a problemChimpanzee stacking boxes
Social learningBanduraLearning by watching othersChild copies an elder

Motivation is the drive that starts and directs behaviour. Maslow's hierarchy of needs, from bottom to top: physiological (food, water, sleep), safety, love and belonging, esteem, self-actualisation. A lower need must be met before the next one is felt strongly. A woman with no food at home will not attend a talk on child spacing until her basic needs are looked after.

Emotion is a strong feeling with body changes, such as fear, anger, joy and sadness. Stress is the body's response to demand. Mild stress can help work; long-term stress harms health. Signs are headache, poor sleep, irritability and loss of appetite. Ways to cope: rest, talk to someone, regular exercise, relaxation and breathing exercises.

Intelligence and personality

Intelligence is the ability to learn, understand and solve problems. Binet and Simon made the first intelligence test. The mental age idea led to the IQ formula.

IQ = (Mental age ÷ Chronological age) × 100.

Worked examples. A child of 10 years with a mental age of 12 years has IQ = 12 ÷ 10 × 100 = 120. A child of 8 years with a mental age of 6 years has IQ = 6 ÷ 8 × 100 = 75.

IQ rangeUsual description
130 and aboveVery superior or gifted
90 to 109Average
70 to 79Borderline
50 to 69Mild intellectual disability
35 to 49Moderate intellectual disability
20 to 34Severe intellectual disability
Below 20Profound intellectual disability

An average IQ is about 100.

Personality is the stable pattern of thought, feeling and behaviour of a person. Freud described three parts: id (instinct, wants pleasure at once), ego (reason, deals with reality) and superego (conscience). Jung described introverts (turn inward, quiet) and extroverts (turn outward, sociable).

Defence mechanisms are unconscious ways of reducing anxiety.

MechanismMeaningExample
DenialRefusing to accept a factPatient says "I am not ill"
RepressionPushing painful memory out of mindForgetting a bad event
ProjectionBlaming one's own fault on another"He made me fail"
RationalisationGiving false but acceptable reasons"The test was unfair"
RegressionGoing back to childish behaviourOlder child begins bed-wetting after a new baby
DisplacementShifting feeling to a safer targetAngry at the boss, shouts at family
SublimationTurning an urge into a useful actAnger turned into sport

Growth, development and mental health

Growth is increase in size. Development is increase in skill and function. Both go from head to foot (cephalocaudal) and from centre to the limbs (proximodistal).

Erikson's eight stages (each has a crisis): trust vs mistrust (infancy), autonomy vs shame (toddler), initiative vs guilt (preschool), industry vs inferiority (school age), identity vs role confusion (adolescence), intimacy vs isolation (young adult), generativity vs stagnation (adult), integrity vs despair (old age).

Piaget's stages of thinking: sensorimotor (birth to 2 years), preoperational (2 to 7), concrete operational (7 to 11), formal operational (11 onward).

Adolescence is a time of body change, identity search and peer influence. A health worker should talk with respect, listen and keep privacy.

Mental health is a state of well-being in which a person can cope with normal stress, work well and help the community. Common problems are anxiety, depression, schizophrenia and substance use. Signs needing referral: long sadness, talk of self-harm, hearing voices, extreme fear or sudden change in behaviour. Always refer such a person and never label them as "mad".

Communication and counselling

Communication has a sender, message, channel, receiver and feedback. Barriers are language, noise, fear, status gap and cultural beliefs. Good practice: use local language, simple words, eye contact, listening, and checking whether the person understood. Counselling is helping a person take her own decision. Steps: greet, listen, give information, help the person choose, and follow up. It must be private and non-judgemental. Empathy means understanding another person's feelings; sympathy is only feeling sorry.

Basics of sociology

Sociology studies society. Auguste Comte is called the father of sociology. Society is a web of social relationships. Community is a group living in one area with a sense of belonging. A group is two or more people in regular contact. A primary group (family, close friends) is small and face-to-face. A secondary group (office, trade union) is large and formal.

Family is the basic unit of society. Types by structure: nuclear (parents and children), joint (many generations and relatives living together) and extended. Types by authority: patriarchal (father's line) and matriarchal (mother's line). In health work the family is the unit of care, and its head and decision-makers must be involved.

Culture is the way of life of a group: beliefs, customs, food, dress and language. Norms are accepted rules of behaviour. Values are ideas of what is good. Customs are old social habits; taboos are strong prohibitions. Status is a person's position; role is the behaviour expected from that position.

Socialisation is the process of learning the ways of society. The family is the first agent; school, peers, media and religion follow. Social control keeps order through laws, customs and opinion. Social stratification ranks people into layers such as caste and class. Caste is by birth; class is by income and occupation and is open to change.

Social change is a change in social relationships and structures. Causes: education, technology, urbanisation and law. Urbanisation has brought slums, crowding and poor sanitation. Social problems include poverty, illiteracy, child marriage, dowry, alcoholism, gender bias and unemployment.

Social factors in health. Poverty, poor education, early marriage, poor sanitation and food taboos affect health. Beliefs about illness, such as treating measles or smallpox as a goddess's wrath, delay care. A health worker respects belief, finds the local leader (opinion leader) and gives correct information with patience. Women's groups and self-help groups can support health goals.

Behaviour change and health education

People change habits in stages: they first learn about a health message, then become interested, think about it, try it and finally adopt it if it works. A health worker supports each step. Repeat messages, use examples from the village, and involve husbands and mothers-in-law, who often decide on care. Fear and shame are barriers, so speak gently. Role models and opinion leaders such as the village head, school teacher or a respected woman can persuade others. Home visits, group meetings, folk songs, street plays and wall posters are all useful channels. Always check understanding by asking the person to repeat the advice in her own words.

Exam traps

  • Pavlov is classical conditioning. Skinner is operant conditioning.
  • Id is instinct, ego is reason, superego is conscience.
  • IQ is mental age divided by chronological age, multiplied by 100, not the other way.
  • Maslow's top level is self-actualisation; the base is physiological need.
  • Projection blames others; rationalisation gives false reasons; denial refuses the fact.
  • Growth is size; development is function.
  • Primary group is face-to-face and close; secondary group is formal.
  • Role is behaviour; status is position.
  • Sympathy is feeling sorry; empathy is understanding the feeling.
  • Caste is by birth; class is by achievement.

One-liners

  • 1. Wundt opened the first psychology laboratory.
  • 2. Comte is called the father of sociology.
  • 3. Memory steps are encoding, storage and retrieval.
  • 4. Average IQ is about 100.
  • 5. Superego is the conscience.
  • 6. Family is the first agent of socialisation.
  • 7. A nuclear family has parents and children only.
  • 8. Norms are rules of accepted behaviour.
  • 9. Counselling helps a person reach her own decision.
  • 10. Piaget's last stage is formal operational.
  • 11. Erikson's adolescence stage is identity vs role confusion.
  • 12. Bandura stressed learning by watching others.

Practice questions

  1. Who is known as the father of sociology?

    1. Sigmund Freud
    2. Jean Piaget
    3. Ivan Pavlov
    4. Auguste Comte
    Answer

    D. Auguste Comte

    Comte coined the term sociology and is called its father.

  2. Classical conditioning was described by

    1. Bandura
    2. Skinner
    3. Thorndike
    4. Pavlov
    Answer

    D. Pavlov

    Pavlov's dog experiment showed classical conditioning.

  3. Operant conditioning is associated with

    1. Pavlov
    2. Skinner
    3. Freud
    4. Maslow
    Answer

    B. Skinner

    Skinner studied how reward and punishment shape behaviour.

  4. In Freud's theory, the conscience part of personality is the

    1. Libido
    2. Ego
    3. Id
    4. Superego
    Answer

    D. Superego

    Superego is the moral conscience.

  5. At the base of Maslow's hierarchy of needs are the

    1. Esteem needs
    2. Safety needs
    3. Physiological needs
    4. Self-actualisation needs
    Answer

    C. Physiological needs

    Food, water and sleep come first.

  6. The top level of Maslow's hierarchy is

    1. Safety
    2. Self-actualisation
    3. Love and belonging
    4. Esteem
    Answer

    B. Self-actualisation

    Self-actualisation is the highest need.

  7. The first psychology laboratory was set up by

    1. Alfred Binet
    2. John Watson
    3. William James
    4. Wilhelm Wundt
    Answer

    D. Wilhelm Wundt

    Wundt opened it in Leipzig in 1879.

  8. A child of 10 years has a mental age of 12 years. What is the IQ?

    1. 112
    2. 100
    3. 120
    4. 83
    Answer

    C. 120

    IQ = 12 ÷ 10 × 100 = 120.

  9. A child of 8 years has a mental age of 6 years. What is the IQ?

    1. 60
    2. 75
    3. 133
    4. 86
    Answer

    B. 75

    IQ = 6 ÷ 8 × 100 = 75.

  10. A child with chronological age 12 years has IQ 125. What is the mental age?

    1. 15 years
    2. 10 years
    3. 9.6 years
    4. 12.5 years
    Answer

    A. 15 years

    MA = IQ × CA ÷ 100 = 125 × 12 ÷ 100 = 15 years.

  11. A child with mental age 9 years and IQ 90 has what chronological age?

    1. 8.1 years
    2. 9 years
    3. 11 years
    4. 10 years
    Answer

    D. 10 years

    CA = MA × 100 ÷ IQ = 9 × 100 ÷ 90 = 10 years.

  12. A child has mental age 14 and chronological age 10. What is the IQ?

    1. 104
    2. 71
    3. 140
    4. 114
    Answer

    C. 140

    14 ÷ 10 × 100 = 140.

  13. The usual average IQ value is about

    1. 100
    2. 70
    3. 150
    4. 50
    Answer

    A. 100

    The population average is set near 100.

  14. The correct order of Piaget's stages is

    1. Formal operational, concrete operational, preoperational, sensorimotor
    2. Sensorimotor, preoperational, concrete operational, formal operational
    3. Preoperational, sensorimotor, formal operational, concrete operational
    4. Sensorimotor, concrete operational, preoperational, formal operational
    Answer

    B. Sensorimotor, preoperational, concrete operational, formal operational

    Piaget's order goes from birth through to abstract thinking.

  15. Erikson's crisis in infancy is

    1. Identity versus role confusion
    2. Autonomy versus shame
    3. Trust versus mistrust
    4. Industry versus inferiority
    Answer

    C. Trust versus mistrust

    The first Erikson stage is trust versus mistrust.

  16. Erikson's crisis during adolescence is

    1. Intimacy versus isolation
    2. Initiative versus guilt
    3. Integrity versus despair
    4. Identity versus role confusion
    Answer

    D. Identity versus role confusion

    Adolescents search for who they are.

  17. A woman blames her neighbour for her own mistake. This defence mechanism is

    1. Projection
    2. Sublimation
    3. Denial
    4. Regression
    Answer

    A. Projection

    Projection puts one's own fault on someone else.

  18. An elder child starts bed-wetting after a new baby is born. This is

    1. Repression
    2. Regression
    3. Rationalisation
    4. Displacement
    Answer

    B. Regression

    Going back to childish behaviour under stress is regression.

  19. A man angry with his employer shouts at his wife at home. This is

    1. Denial
    2. Projection
    3. Displacement
    4. Sublimation
    Answer

    C. Displacement

    The feeling is shifted to a safer target.

  20. Turning aggressive energy into sport is called

    1. Sublimation
    2. Denial
    3. Repression
    4. Rationalisation
    Answer

    A. Sublimation

    Sublimation redirects an urge into a socially useful act.

  21. Which is the correct sequence of memory?

    1. Storage, encoding, retrieval
    2. Encoding, storage, retrieval
    3. Retrieval, storage, encoding
    4. Encoding, retrieval, storage
    Answer

    B. Encoding, storage, retrieval

    Information is taken in, kept, then recalled.

  22. Giving false but acceptable reasons for one's failure is

    1. Projection
    2. Regression
    3. Identification
    4. Rationalisation
    Answer

    D. Rationalisation

    Rationalisation gives a reasonable-sounding excuse.

  23. A family of parents and unmarried children is a

    1. Nuclear family
    2. Joint family
    3. Extended family
    4. Stem family
    Answer

    A. Nuclear family

    Two generations living together form a nuclear family.

  24. A group such as family or close friends, with face-to-face contact, is a

    1. Reference group
    2. Primary group
    3. Interest group
    4. Secondary group
    Answer

    B. Primary group

    Primary groups are small, close and personal.

  25. The first agent of socialisation is the

    1. School
    2. Mass media
    3. Peer group
    4. Family
    Answer

    D. Family

    A child first learns society's ways at home.

  26. Behaviour expected from a person holding a position is her

    1. Status
    2. Custom
    3. Role
    4. Norm
    Answer

    C. Role

    Status is the position; role is the behaviour that goes with it.

  27. Ranking of people in layers such as caste and class is called

    1. Social stratification
    2. Socialisation
    3. Urbanisation
    4. Social control
    Answer

    A. Social stratification

    Stratification is the layering of society.

  28. Which of the following is the best example of empathy by a health worker?

    1. Telling her not to worry
    2. Feeling sorry and giving a tablet
    3. Ignoring her fear and giving advice
    4. Understanding how a frightened mother feels and saying so
    Answer

    D. Understanding how a frightened mother feels and saying so

    Empathy is understanding another person's feelings.

  29. In health counselling, the client should be helped to

    1. Accept a ready decision
    2. Take her own decision
    3. Avoid asking questions
    4. Follow the worker's orders
    Answer

    B. Take her own decision

    Counselling supports a person's own informed choice.

  30. Which is a barrier to good communication in a village?

    1. Use of the local language
    2. Listening carefully
    3. Use of technical language
    4. Asking for feedback
    Answer

    C. Use of technical language

    Technical words confuse the listener.

  31. Statements: 1. Growth is increase in size. 2. Development is increase in skill and function. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    C. Both 1 and 2

    Both are standard definitions.

  32. Statements: 1. Id works by reason. 2. Ego deals with reality. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    B. 2 only

    Id seeks instant pleasure; ego deals with reality.

  33. Statements: 1. Caste is decided by birth. 2. Class is open to change by income or occupation. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    C. Both 1 and 2

    Both statements are true.

  34. Statements: 1. Mild stress can sometimes help performance. 2. Long-term stress is harmless to health. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    A. 1 only

    Prolonged stress harms health.

  35. Statements: 1. Pavlov's work is on classical conditioning. 2. Bandura stressed learning by observing others. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    C. Both 1 and 2

    Both are standard associations.

  36. Statements: 1. A secondary group is formal and large. 2. A family is a secondary group. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    A. 1 only

    Family is a primary group.

  37. Statements: 1. Sympathy and empathy mean exactly the same. 2. Counselling should be private and non-judgemental. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    B. 2 only

    Empathy is understanding the feeling; sympathy is feeling sorry.

  38. Statements: 1. Development proceeds from head to foot. 2. Development proceeds from the centre to the limbs. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    C. Both 1 and 2

    These are cephalocaudal and proximodistal trends.

  39. Match the mechanism with its example: 1. Denial, 2. Repression, 3. Sublimation. Which set is correct?

    1. 1 forgetting a painful event, 2 refusing to accept illness, 3 anger turned into sport
    2. 1 anger turned into sport, 2 forgetting a painful event, 3 refusing to accept illness
    3. 1 refusing to accept illness, 2 anger turned into sport, 3 forgetting a painful event
    4. 1 refusing to accept illness, 2 forgetting a painful event, 3 anger turned into sport
    Answer

    D. 1 refusing to accept illness, 2 forgetting a painful event, 3 anger turned into sport

    Denial refuses the fact, repression forgets, sublimation channels.

  40. Match the person with the idea: 1. Thorndike, 2. Köhler, 3. Skinner. Which set is correct?

    1. 1 operant conditioning, 2 insight, 3 trial and error
    2. 1 insight, 2 trial and error, 3 operant conditioning
    3. 1 trial and error, 2 operant conditioning, 3 insight
    4. 1 trial and error, 2 insight, 3 operant conditioning
    Answer

    D. 1 trial and error, 2 insight, 3 operant conditioning

    Thorndike cat box, Köhler chimpanzee, Skinner reinforcement.

  41. Match the Piaget stage with the age: 1. Sensorimotor, 2. Preoperational, 3. Concrete operational. Which set is correct?

    1. 1 2 to 7 years, 2 birth to 2 years, 3 7 to 11 years
    2. 1 birth to 2 years, 2 7 to 11 years, 3 2 to 7 years
    3. 1 7 to 11 years, 2 2 to 7 years, 3 birth to 2 years
    4. 1 birth to 2 years, 2 2 to 7 years, 3 7 to 11 years
    Answer

    D. 1 birth to 2 years, 2 2 to 7 years, 3 7 to 11 years

    Ages follow the order of stages.

  42. Statements: 1. A taboo is a strong social prohibition. 2. Norms are accepted rules of behaviour. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    C. Both 1 and 2

    Both are standard definitions.

  43. Statements: 1. Auguste Comte is called the father of sociology. 2. Wundt founded the first sociology school. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    A. 1 only

    Wundt is linked to the first psychology laboratory.

  44. Statements: 1. A person hearing voices or speaking of self-harm should be referred. 2. Such a person should be labelled as mad. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    A. 1 only

    Labelling is stigma; referral is correct.

  45. Statements: 1. An extrovert is sociable and outward-looking. 2. An introvert turns inward. Which is/are correct?

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    C. Both 1 and 2

    These are Jung's types.

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