from reportlab.lib.pagesizes import A4
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import cm
from reportlab.lib import colors
from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, HRFlowable, Table, TableStyle, PageBreak
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY

doc = SimpleDocTemplate(
    "/tmp/workspace/bpt-psychology/BPT205T_Psychology_Answers.pdf",
    pagesize=A4,
    leftMargin=2*cm, rightMargin=2*cm,
    topMargin=2*cm, bottomMargin=2*cm
)

styles = getSampleStyleSheet()

# Custom styles
title_style = ParagraphStyle(
    'TitleStyle', parent=styles['Title'],
    fontSize=16, textColor=colors.HexColor('#1a3a6e'),
    spaceAfter=4, spaceBefore=4, alignment=TA_CENTER
)
subtitle_style = ParagraphStyle(
    'SubtitleStyle', parent=styles['Normal'],
    fontSize=11, textColor=colors.HexColor('#2c5282'),
    spaceAfter=2, alignment=TA_CENTER
)
q_style = ParagraphStyle(
    'QuestionStyle', parent=styles['Normal'],
    fontSize=12, textColor=colors.HexColor('#7b2d00'),
    spaceAfter=6, spaceBefore=14, fontName='Helvetica-Bold',
    leftIndent=0
)
sub_q_style = ParagraphStyle(
    'SubQStyle', parent=styles['Normal'],
    fontSize=11, textColor=colors.HexColor('#1a5276'),
    spaceAfter=4, spaceBefore=8, fontName='Helvetica-Bold',
    leftIndent=10
)
heading_style = ParagraphStyle(
    'HeadingStyle', parent=styles['Normal'],
    fontSize=11, textColor=colors.HexColor('#154360'),
    spaceAfter=3, spaceBefore=6, fontName='Helvetica-Bold',
    leftIndent=10
)
body_style = ParagraphStyle(
    'BodyStyle', parent=styles['Normal'],
    fontSize=10, textColor=colors.black,
    spaceAfter=4, spaceBefore=2, leading=15,
    alignment=TA_JUSTIFY, leftIndent=10
)
bullet_style = ParagraphStyle(
    'BulletStyle', parent=styles['Normal'],
    fontSize=10, textColor=colors.black,
    spaceAfter=2, spaceBefore=1, leading=14,
    leftIndent=22, bulletIndent=12
)
table_header_style = ParagraphStyle(
    'TableHeader', parent=styles['Normal'],
    fontSize=9, fontName='Helvetica-Bold',
    textColor=colors.white, alignment=TA_CENTER
)
table_cell_style = ParagraphStyle(
    'TableCell', parent=styles['Normal'],
    fontSize=9, alignment=TA_LEFT, leading=12
)

def Q(text):
    return Paragraph(text, q_style)

def SQ(text):
    return Paragraph(text, sub_q_style)

def H(text):
    return Paragraph(text, heading_style)

def B(text):
    return Paragraph(text, body_style)

def BL(text):
    return Paragraph(f"• {text}", bullet_style)

def SP(n=6):
    return Spacer(1, n)

def HR():
    return HRFlowable(width="100%", thickness=0.5, color=colors.HexColor('#aaaaaa'), spaceAfter=4, spaceBefore=4)

story = []

# ─── HEADER ───────────────────────────────────────────────────────────────────
story.append(Paragraph("BPT205T – Psychology and Psychiatry", title_style))
story.append(Paragraph("End Term Examination – May 2026 | Year II | BPT Course", subtitle_style))
story.append(Paragraph("Detailed Answers to All 12 Questions", subtitle_style))
story.append(HRFlowable(width="100%", thickness=2, color=colors.HexColor('#1a3a6e'), spaceAfter=10, spaceBefore=6))

# ══════════════════════════════════════════════════════════════════════════════
# Q1 – Perceptual Processes and Factors Influencing Perception
# ══════════════════════════════════════════════════════════════════════════════
story.append(Q("Q1. Describe perceptual processes and factors influencing perception."))
story.append(HR())
story.append(H("Definition of Perception"))
story.append(B("Perception is the process by which sensory information is organised, interpreted, and consciously experienced. It is not a simple recording of stimuli; rather, it involves active mental processing that gives meaning to raw sensory data. Perception bridges sensation (reception of stimuli) and cognition (higher-level thinking)."))

story.append(H("Stages / Processes of Perception"))
story.append(BL("<b>1. Selection (Attention):</b> The brain cannot process all available stimuli at once. It selects certain stimuli based on their intensity, novelty, or personal relevance while ignoring others. This is called selective attention."))
story.append(BL("<b>2. Organisation:</b> Selected stimuli are organised into a meaningful pattern. The Gestalt psychologists described key principles: Figure-Ground (separating an object from its background), Proximity (grouping nearby objects), Similarity (grouping similar objects), Closure (completing incomplete figures), and Continuity (perceiving smooth continuous lines)."))
story.append(BL("<b>3. Interpretation:</b> The organised pattern is given meaning based on past experience, expectations, context, and emotional state. Two people may perceive the same stimulus differently based on their cognitive framework."))
story.append(BL("<b>4. Response:</b> Based on interpretation, the individual formulates an appropriate behavioural or cognitive response."))

story.append(H("Factors Influencing Perception"))
story.append(B("<b>(A) External / Stimulus Factors:</b>"))
story.append(BL("Intensity: A louder sound or brighter light is more easily perceived."))
story.append(BL("Size: Larger objects attract attention more readily."))
story.append(BL("Contrast: A stimulus that differs from its background stands out."))
story.append(BL("Movement: Moving objects capture attention more than stationary ones."))
story.append(BL("Novelty and Familiarity: Both unusual and well-known stimuli can attract attention for different reasons."))
story.append(BL("Repetition: Repeated stimuli are more likely to be noticed."))

story.append(B("<b>(B) Internal / Person Factors:</b>"))
story.append(BL("Needs and Motives: A hungry person perceives food-related cues more readily (perceptual sensitisation)."))
story.append(BL("Past Experience / Learning: Prior knowledge shapes how we interpret new stimuli."))
story.append(BL("Expectations (Perceptual Set): We tend to perceive what we expect to perceive."))
story.append(BL("Emotions and Mood: Fear or anxiety can distort perception (e.g., seeing a rope as a snake)."))
story.append(BL("Personality: Introverts and extroverts may perceive social situations differently."))
story.append(BL("Cultural and Social Factors: Cultural background influences the interpretation of symbols, colours, and social cues."))
story.append(BL("Age: Perceptual abilities change across the lifespan."))

story.append(H("Perceptual Errors"))
story.append(BL("Illusions: Misinterpretation of a real external stimulus (e.g., Müller-Lyer illusion)."))
story.append(BL("Hallucinations: Perception without any external stimulus – seen in psychotic disorders."))
story.append(BL("Perceptual Defence: Tendency to suppress perception of threatening stimuli."))

# ══════════════════════════════════════════════════════════════════════════════
# Q2 – Scope and Branches of Psychology
# ══════════════════════════════════════════════════════════════════════════════
story.append(Q("Q2. Describe the scope and branches of Psychology in detail."))
story.append(HR())
story.append(H("Definition"))
story.append(B("Psychology is the scientific study of behaviour and mental processes. The word derives from Greek: psyche (mind/soul) and logos (study). It covers how individuals think, feel, perceive, learn, remember, and interact with others."))

story.append(H("Scope of Psychology"))
story.append(BL("Studying normal and abnormal behaviour across all ages."))
story.append(BL("Understanding cognitive processes: perception, attention, memory, language, problem-solving, reasoning."))
story.append(BL("Examining biological bases of behaviour (neuropsychology)."))
story.append(BL("Exploring social influences on behaviour."))
story.append(BL("Applying psychological principles to health, education, industry, law, and sports."))

story.append(H("Major Branches of Psychology"))
story.append(BL("<b>Clinical Psychology:</b> Diagnosis, assessment, and treatment of mental disorders using psychotherapy and counselling. Deals with anxiety, depression, schizophrenia, personality disorders."))
story.append(BL("<b>Abnormal Psychology:</b> Study of maladaptive behaviour, its causes (biological, psychological, sociocultural), classification (DSM-5, ICD-11), and treatment."))
story.append(BL("<b>Developmental Psychology:</b> Changes in behaviour, cognition, and emotion across the life span from infancy to old age. Includes theories by Piaget, Erikson, and Vygotsky."))
story.append(BL("<b>Social Psychology:</b> How individuals' thoughts, feelings, and behaviours are influenced by others. Topics include attitudes, conformity, obedience, group dynamics, and aggression."))
story.append(BL("<b>Educational Psychology:</b> Application of psychological principles to learning and teaching. Includes learning theories, motivation, classroom management, and assessment."))
story.append(BL("<b>Industrial / Organisational Psychology:</b> Workplace behaviour – selection, training, motivation, leadership, organisational culture, and occupational stress."))
story.append(BL("<b>Health / Medical Psychology:</b> Role of psychological factors in health, illness, and healthcare. Stress-disease relationship, pain management, rehabilitation psychology."))
story.append(BL("<b>Neuropsychology / Biological Psychology:</b> Relationships between brain structure/function and behaviour. Neurotransmitters, brain lesions, and behavioural outcomes."))
story.append(BL("<b>Forensic Psychology:</b> Application of psychology to legal and criminal justice issues – criminal profiling, competency assessment, eyewitness testimony."))
story.append(BL("<b>Sports Psychology:</b> Mental factors affecting athletic performance: motivation, concentration, anxiety management, team cohesion."))
story.append(BL("<b>Counselling Psychology:</b> Helping individuals cope with everyday problems, life transitions, and mild mental health issues through guidance and counselling."))
story.append(BL("<b>Experimental Psychology:</b> Use of controlled experiments to study basic psychological processes such as perception, learning, memory, and motivation."))
story.append(BL("<b>Community Psychology:</b> Promoting mental health at the community level through prevention, social change, and resource development."))

# ══════════════════════════════════════════════════════════════════════════════
# Q3 – Classical Conditioning
# ══════════════════════════════════════════════════════════════════════════════
story.append(Q("Q3. Describe classical conditioning with its principles and applications."))
story.append(HR())
story.append(H("Introduction"))
story.append(B("Classical conditioning is a type of associative learning discovered by Ivan Pavlov (1849–1936) while studying salivation in dogs. He found that a neutral stimulus (bell) could elicit a response (salivation) after being repeatedly paired with an unconditioned stimulus (food)."))

story.append(H("Key Terms"))
story.append(BL("<b>Unconditioned Stimulus (UCS):</b> A stimulus that naturally and automatically triggers a response (e.g., food)."))
story.append(BL("<b>Unconditioned Response (UCR):</b> The natural, unlearned response to the UCS (e.g., salivation to food)."))
story.append(BL("<b>Conditioned Stimulus (CS):</b> A previously neutral stimulus that, after association with UCS, triggers a response (e.g., bell)."))
story.append(BL("<b>Conditioned Response (CR):</b> The learned response to the CS (e.g., salivation to the bell alone). The CR is usually weaker than the UCR."))

story.append(H("Principles of Classical Conditioning"))
story.append(BL("<b>1. Acquisition:</b> The phase where the conditioned response is established. Requires repeated pairing of CS and UCS. The CS should be presented slightly before the UCS (forward conditioning) for best results."))
story.append(BL("<b>2. Extinction:</b> When the CS is repeatedly presented without the UCS, the CR gradually weakens and disappears. This is not forgetting – the association is suppressed, not erased."))
story.append(BL("<b>3. Spontaneous Recovery:</b> After extinction, the CR may reappear on its own after a rest period, though it is typically weaker."))
story.append(BL("<b>4. Stimulus Generalisation:</b> The tendency to respond to stimuli similar to the CS. (Pavlov's dog salivated to sounds similar to the bell.)"))
story.append(BL("<b>5. Stimulus Discrimination:</b> The ability to distinguish between the CS and similar stimuli that have not been paired with the UCS."))
story.append(BL("<b>6. Higher-Order Conditioning:</b> A well-established CS is used as a UCS to condition a new neutral stimulus."))

story.append(H("Applications of Classical Conditioning"))
story.append(BL("<b>Behaviour Therapy:</b>"))
story.append(Paragraph("    - <b>Systematic Desensitisation:</b> Used to treat phobias. Gradual exposure to the feared stimulus while maintaining relaxation.", bullet_style))
story.append(Paragraph("    - <b>Aversion Therapy:</b> Pairing an undesirable behaviour (e.g., alcohol consumption) with an aversive stimulus (nausea-inducing drug) to eliminate the behaviour.", bullet_style))
story.append(Paragraph("    - <b>Flooding / Implosion:</b> Intense exposure to the feared stimulus until anxiety is extinguished.", bullet_style))
story.append(BL("<b>Advertising:</b> Products are repeatedly shown with pleasant stimuli (attractive people, music) to create positive associations."))
story.append(BL("<b>Medical/Physiotherapy:</b> Understanding pain conditioned responses; classically conditioned fear of movement (kinesiophobia) in chronic pain patients."))
story.append(BL("<b>Immune System:</b> Research shows immune responses can be conditioned (psychoneuroimmunology)."))
story.append(BL("<b>Watson's Little Albert Experiment:</b> Demonstrated conditioning of fear in humans – showed that emotional responses can be learned."))

# ══════════════════════════════════════════════════════════════════════════════
# Q4 – Personality
# ══════════════════════════════════════════════════════════════════════════════
story.append(Q("Q4. Define personality. Explain types and methods of personality assessment."))
story.append(HR())
story.append(H("Definition of Personality"))
story.append(B("Personality is defined as the consistent and enduring pattern of thoughts, feelings, and behaviours that characterise an individual and distinguish them from others. Allport defined it as 'the dynamic organisation within the individual of those psychophysical systems that determine his unique adjustment to the environment.'"))

story.append(H("Types of Personality"))
story.append(B("<b>A. Type Theory (Hippocrates/Galen):</b>"))
story.append(BL("Sanguine: Optimistic, sociable, cheerful."))
story.append(BL("Choleric: Aggressive, irritable, impulsive."))
story.append(BL("Melancholic: Sad, pessimistic, anxious."))
story.append(BL("Phlegmatic: Calm, slow, unemotional."))

story.append(B("<b>B. Eysenck's Dimensions:</b>"))
story.append(BL("<b>Introversion-Extraversion:</b> Introverts are inward-focused, reserved; extraverts are outward-focused, sociable."))
story.append(BL("<b>Neuroticism-Stability:</b> High neuroticism = emotional instability, anxiety; low = emotional stability."))
story.append(BL("<b>Psychoticism:</b> Aggression, impulsivity, antisocial tendencies."))

story.append(B("<b>C. Big Five (OCEAN) Model:</b>"))
story.append(BL("Openness, Conscientiousness, Extraversion, Agreeableness, Neuroticism."))

story.append(B("<b>D. Type A and Type B Personality:</b>"))
story.append(BL("<b>Type A:</b> Competitive, time-pressured, hostile – higher risk of coronary heart disease."))
story.append(BL("<b>Type B:</b> Relaxed, non-competitive, patient."))

story.append(H("Methods of Personality Assessment"))
story.append(B("<b>1. Observation Method:</b> Direct observation of behaviour in natural or controlled settings. Useful but time-consuming."))
story.append(B("<b>2. Interview Method:</b> Structured, semi-structured, or unstructured conversations to explore personality traits. Clinical interviews used in psychiatry."))
story.append(B("<b>3. Self-Report Inventories (Questionnaires):</b>"))
story.append(BL("Minnesota Multiphasic Personality Inventory (MMPI): Widely used; 567 true/false items; 10 clinical scales."))
story.append(BL("Eysenck Personality Questionnaire (EPQ): Measures E, N, P dimensions."))
story.append(BL("NEO-PI-R: Measures Big Five traits."))
story.append(B("<b>4. Projective Tests:</b> Present ambiguous stimuli; responses are thought to reveal unconscious personality aspects."))
story.append(BL("Rorschach Inkblot Test: 10 inkblot cards; responses analysed for content and style."))
story.append(BL("Thematic Apperception Test (TAT): 30 ambiguous pictures; subject tells a story; reveals needs, motives, conflicts."))
story.append(BL("Sentence Completion Test: Incomplete sentences completed by the subject."))
story.append(BL("Draw-a-Person Test: Projective drawing technique."))
story.append(B("<b>5. Psychophysiological Methods:</b> Measuring skin conductance, heart rate, EEG to assess personality-related arousal levels."))
story.append(B("<b>6. Situational Tests:</b> Placing individuals in controlled situations to observe how they respond (used in military/corporate assessment centres)."))

# ══════════════════════════════════════════════════════════════════════════════
# Q5 – Learning, Memory, Forgetting
# ══════════════════════════════════════════════════════════════════════════════
story.append(Q("Q5. Describe learning and memory in detail. Explain types of learning and the process, types, and causes of forgetting in memory."))
story.append(HR())
story.append(H("Learning – Definition"))
story.append(B("Learning is a relatively permanent change in behaviour or behavioural potential resulting from experience. It excludes changes due to maturation, fatigue, or drugs."))

story.append(H("Types of Learning"))
story.append(BL("<b>Classical Conditioning (Pavlov):</b> Learning through stimulus-response association (explained in Q3)."))
story.append(BL("<b>Operant / Instrumental Conditioning (Skinner):</b> Learning through consequences. Behaviour is strengthened by reinforcement (positive or negative) and weakened by punishment."))
story.append(BL("<b>Trial and Error Learning (Thorndike):</b> Repeated attempts until the correct response is found. Governed by Laws of Readiness, Exercise, and Effect."))
story.append(BL("<b>Observational / Social Learning (Bandura):</b> Learning by observing and imitating others. Involves attention, retention, reproduction, and motivation."))
story.append(BL("<b>Latent Learning (Tolman):</b> Learning that occurs without obvious reinforcement and is not immediately demonstrated."))
story.append(BL("<b>Insight Learning (Kohler):</b> Sudden understanding of a problem – the 'aha' moment. Higher-order cognitive learning seen in apes and humans."))
story.append(BL("<b>Verbal / Conceptual Learning:</b> Learning through language, symbols, and concepts. Most human learning is of this type."))

story.append(H("Memory – Definition and Stages"))
story.append(B("Memory is the mental ability to encode, store, and retrieve information. The Atkinson-Shiffrin model describes three stages:"))
story.append(BL("<b>Sensory Memory:</b> Very brief (< 1 second). Holds raw sensory information (iconic for visual, echoic for auditory). Capacity is large but duration is very short."))
story.append(BL("<b>Short-Term Memory (STM):</b> Duration: 15-30 seconds; Capacity: 7 ± 2 items (Miller's Magic Number). Information is held here for active processing. Encoding is primarily acoustic."))
story.append(BL("<b>Long-Term Memory (LTM):</b> Virtually unlimited capacity and duration. Encoding is primarily semantic. Subdivided into:"))
story.append(Paragraph("    - <b>Declarative (Explicit):</b> Episodic (personal events) and Semantic (facts, concepts).", bullet_style))
story.append(Paragraph("    - <b>Non-declarative (Implicit):</b> Procedural memory (skills), priming, conditioned responses.", bullet_style))

story.append(H("Process of Memory"))
story.append(BL("<b>Encoding:</b> Converting information into a memory code (acoustic, visual, or semantic)."))
story.append(BL("<b>Storage:</b> Maintaining encoded information over time."))
story.append(BL("<b>Retrieval:</b> Recovering stored information. Types: recall (free, cued) and recognition."))

story.append(H("Forgetting – Types and Causes"))
story.append(B("Forgetting is the inability to recall or recognise previously learned information."))
story.append(BL("<b>1. Decay Theory:</b> Memory traces (engrams) fade over time due to disuse. Time alone causes forgetting."))
story.append(BL("<b>2. Interference Theory:</b> Other memories disrupt retrieval. <i>Proactive interference</i>: old memories interfere with new ones. <i>Retroactive interference</i>: new memories interfere with old ones."))
story.append(BL("<b>3. Retrieval Failure / Cue-Dependent Forgetting:</b> Information is stored but cannot be accessed without the right cue (context or state-dependent memory)."))
story.append(BL("<b>4. Motivated Forgetting / Repression (Freud):</b> Unconscious suppression of painful or threatening memories."))
story.append(BL("<b>5. Encoding Failure:</b> Information was never properly encoded in the first place."))
story.append(BL("<b>6. Consolidation Failure:</b> Disruption of the consolidation process (e.g., brain injury, electroconvulsive shock) prevents transfer to LTM."))
story.append(BL("<b>7. Organic Causes:</b> Amnesia due to brain injury (anterograde – cannot form new memories; retrograde – cannot recall old memories), dementia, Korsakoff's syndrome (due to thiamine deficiency/alcoholism)."))

# ══════════════════════════════════════════════════════════════════════════════
# Q6 – Schizophrenia and Major Psychiatric Disorders
# ══════════════════════════════════════════════════════════════════════════════
story.append(Q("Q6. Explain schizophrenia and other major psychiatric disorders along with their management."))
story.append(HR())
story.append(H("Schizophrenia"))
story.append(B("Schizophrenia is a severe, chronic psychotic disorder characterised by disturbances in thought, perception, affect, behaviour, and sense of self. Prevalence is about 1% globally."))
story.append(B("<b>Symptoms (DSM-5 requires 2+ for ≥1 month):</b>"))
story.append(BL("<b>Positive Symptoms (excess/distortion of normal functions):</b> Hallucinations (most commonly auditory), delusions (persecutory, grandiose, referential), disorganised thinking and speech, grossly disorganised or catatonic behaviour."))
story.append(BL("<b>Negative Symptoms (diminution of normal functions):</b> Flat affect, alogia (poverty of speech), avolition (lack of motivation), anhedonia, social withdrawal."))
story.append(B("<b>Management:</b>"))
story.append(BL("<b>Pharmacological:</b> Antipsychotics – Typical (Haloperidol, Chlorpromazine) block D2 receptors; Atypical (Clozapine, Risperidone, Olanzapine) block both D2 and 5-HT2 receptors with fewer extrapyramidal side effects."))
story.append(BL("<b>Psychological:</b> Cognitive Behavioural Therapy (CBT) for psychosis, family therapy, psychoeducation, social skills training."))
story.append(BL("<b>Rehabilitation:</b> Occupational therapy, vocational training, community support, supported employment."))

story.append(H("Other Major Psychiatric Disorders"))
story.append(B("<b>1. Mood Disorders:</b>"))
story.append(BL("<b>Major Depressive Disorder (MDD):</b> Persistent low mood, anhedonia, sleep/appetite disturbance, worthlessness, suicidal ideation for ≥2 weeks. Treatment: SSRIs (Fluoxetine), SNRIs, CBT, ECT for severe cases."))
story.append(BL("<b>Bipolar Disorder:</b> Episodes of mania (elevated mood, grandiosity, decreased sleep, impulsivity) alternating with depression. Treatment: Mood stabilisers (Lithium, Valproate), antipsychotics."))

story.append(B("<b>2. Anxiety Disorders:</b>"))
story.append(BL("<b>Generalised Anxiety Disorder (GAD):</b> Excessive worry about multiple areas for ≥6 months. Treatment: SSRIs, Buspirone, CBT."))
story.append(BL("<b>Panic Disorder:</b> Recurrent unexpected panic attacks with intense physical symptoms. Treatment: SSRIs, Clonazepam, CBT."))
story.append(BL("<b>Phobias:</b> Specific (objects/situations), Social (social situations), Agoraphobia. Treatment: Systematic desensitisation, exposure therapy."))

story.append(B("<b>3. Obsessive-Compulsive Disorder (OCD):</b> Recurrent obsessions (intrusive thoughts) and compulsions (repetitive behaviours) causing significant distress. Treatment: SSRIs (Fluvoxamine, high-dose), Exposure and Response Prevention (ERP)."))

story.append(B("<b>4. Post-Traumatic Stress Disorder (PTSD):</b> Following a traumatic event – intrusive memories (flashbacks), avoidance, negative cognitions, hyperarousal. Treatment: Trauma-focused CBT, EMDR, SSRIs."))

story.append(B("<b>5. Personality Disorders:</b> Enduring maladaptive patterns. Borderline PD (emotional instability), Antisocial PD, Narcissistic PD. Treatment: Dialectical Behaviour Therapy (DBT), psychotherapy."))

story.append(B("<b>6. Substance Use Disorders:</b> Dependence and abuse. Treatment: Detoxification, pharmacotherapy (Methadone, Naltrexone), motivational interviewing, 12-step programmes."))

# ══════════════════════════════════════════════════════════════════════════════
# Q7 – Trial and Error Learning / Memory and its Stages
# ══════════════════════════════════════════════════════════════════════════════
story.append(Q("Q7. A. Trial and Error Learning   B. Memory and its Stages"))
story.append(HR())
story.append(SQ("A. Trial and Error Learning"))
story.append(B("Proposed by E.L. Thorndike based on experiments with a hungry cat placed in a puzzle box. The cat tried various random movements, and eventually pressed the latch that opened the box. On repeated trials, errors decreased and the correct response was made faster. Thorndike called this 'connectionism' – the strengthening of stimulus-response (S-R) bonds."))
story.append(B("<b>Thorndike's Laws:</b>"))
story.append(BL("<b>Law of Readiness:</b> Learning is efficient when the learner is ready and motivated."))
story.append(BL("<b>Law of Exercise:</b> Repetition strengthens the S-R bond (Law of Use); disuse weakens it (Law of Disuse)."))
story.append(BL("<b>Law of Effect:</b> Responses followed by a satisfying state of affairs are strengthened; those followed by annoyance are weakened. This is the basis of operant conditioning."))
story.append(B("<b>Characteristics of Trial and Error Learning:</b>"))
story.append(BL("Goal-directed behaviour."))
story.append(BL("Multiple attempts and errors before correct response."))
story.append(BL("Gradual reduction of errors with practice."))
story.append(BL("Motivation is essential."))
story.append(B("<b>Applications:</b> Rehabilitation in physiotherapy (patients relearn movements through repeated trials), problem-solving in daily life, animal training."))

story.append(SQ("B. Memory and its Stages"))
story.append(B("Memory is the ability to encode, store, and retrieve information. The Atkinson-Shiffrin Three-Stage Model describes:"))
story.append(BL("<b>Stage 1 – Sensory Memory:</b> The initial brief register of sensory information. Iconic memory (visual, ~0.5 sec) and echoic memory (auditory, ~3-4 sec). Large capacity but rapidly decays unless attended to."))
story.append(BL("<b>Stage 2 – Short-Term Memory (STM) / Working Memory:</b> Holds information currently being processed. Capacity: 7±2 chunks (Miller). Duration: ~20-30 seconds without rehearsal. <i>Maintenance rehearsal</i> keeps information active; <i>elaborative rehearsal</i> transfers it to LTM."))
story.append(BL("<b>Stage 3 – Long-Term Memory (LTM):</b> Relatively permanent storage. Episodic memory stores autobiographical events; Semantic memory stores facts and general knowledge; Procedural memory stores skills. Encoding is mainly semantic. Retrieval involves recall and recognition."))
story.append(B("<b>Baddeley's Working Memory Model</b> expanded STM into four components: Central Executive (attentional control), Phonological Loop (verbal/acoustic), Visuospatial Sketchpad (visual/spatial), and Episodic Buffer (linking STM and LTM)."))

# ══════════════════════════════════════════════════════════════════════════════
# Q8 – OCD / Illusion and Hallucination
# ══════════════════════════════════════════════════════════════════════════════
story.append(Q("Q8. A. Obsessive-Compulsive Disorder   B. Illusion and Hallucination"))
story.append(HR())
story.append(SQ("A. Obsessive-Compulsive Disorder (OCD)"))
story.append(B("OCD is an anxiety-related disorder characterised by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviours or mental acts (compulsions) that the person feels compelled to perform to reduce anxiety."))
story.append(B("<b>Obsessions:</b> Intrusive, ego-dystonic thoughts/images/impulses that cause marked anxiety (e.g., contamination fears, doubts about locks, aggressive/sexual thoughts, need for symmetry)."))
story.append(B("<b>Compulsions:</b> Repetitive behaviours (hand-washing, checking, ordering) or mental acts (counting, praying, repeating words) aimed at reducing distress or preventing a feared event."))
story.append(B("<b>Epidemiology:</b> Lifetime prevalence ~2-3%. Equal in men and women. Often onset in late adolescence/early adulthood."))
story.append(B("<b>Aetiology:</b> Serotonin dysfunction, hyperactivity of orbitofrontal cortex and caudate nucleus. Genetic predisposition. Learning (negative reinforcement of compulsions)."))
story.append(B("<b>Management:</b>"))
story.append(BL("Pharmacological: SSRIs (Fluvoxamine, Fluoxetine, Sertraline) at higher doses than for depression; Clomipramine (TCA) if SSRIs fail."))
story.append(BL("Psychotherapy: Exposure and Response Prevention (ERP) – most effective psychological treatment; CBT."))
story.append(BL("In severe, refractory cases: deep brain stimulation."))

story.append(SQ("B. Illusion and Hallucination"))
story.append(B("<b>Illusion:</b> A misinterpretation or false perception of a real external stimulus. The stimulus actually exists but is wrongly interpreted."))
story.append(BL("Examples: Müller-Lyer illusion (two lines of equal length appearing unequal), Ponzo illusion, seeing a rope as a snake in dim light."))
story.append(BL("Illusions can be normal (optical illusions experienced by everyone) or pathological (occur in delirium, high fever, intoxication)."))
story.append(BL("Types: Visual, auditory, tactile, gustatory, olfactory illusions."))
story.append(B("<b>Hallucination:</b> A perception that occurs without any external stimulus. It has the quality of a real perception but occurs in the absence of any sensory input."))
story.append(BL("<b>Auditory hallucinations:</b> Most common in schizophrenia; hearing voices (command, commenting, conversing hallucinations)."))
story.append(BL("<b>Visual hallucinations:</b> Common in delirium, organic psychosis, substance intoxication."))
story.append(BL("<b>Tactile (haptic) hallucinations:</b> Feeling of insects on skin (formication) – seen in cocaine/alcohol withdrawal."))
story.append(BL("<b>Olfactory/Gustatory:</b> Smelling/tasting things that aren't there – may occur in temporal lobe epilepsy."))
story.append(BL("<b>Hypnagogic hallucinations:</b> At sleep onset; <b>Hypnopompic:</b> On awakening – can occur in normal individuals."))
story.append(B("<b>Key Difference:</b> In an illusion, a real stimulus is misinterpreted; in a hallucination, there is no real stimulus at all."))

# ══════════════════════════════════════════════════════════════════════════════
# Q9 – Group Therapy / STM vs LTM
# ══════════════════════════════════════════════════════════════════════════════
story.append(Q("Q9. A. Group Therapy   B. Differentiate between STM and LTM"))
story.append(HR())
story.append(SQ("A. Group Therapy"))
story.append(B("Group therapy is a form of psychotherapy in which a small group of clients (typically 6-12) meet regularly with one or more trained therapists to discuss problems, share experiences, and support each other. Developed significantly by Jacob Moreno and Irvin Yalom."))
story.append(B("<b>Therapeutic Factors (Yalom's Curative Factors):</b>"))
story.append(BL("Instillation of hope: Seeing others improve gives hope."))
story.append(BL("Universality: Realising others have similar problems."))
story.append(BL("Imparting information: Psychoeducation within the group."))
story.append(BL("Altruism: Helping others enhances self-worth."))
story.append(BL("Corrective recapitulation of the primary family group."))
story.append(BL("Socialising techniques and interpersonal learning."))
story.append(BL("Group cohesiveness: Sense of belonging and acceptance."))
story.append(BL("Catharsis: Emotional release within a safe environment."))
story.append(B("<b>Types of Group Therapy:</b>"))
story.append(BL("Psychoeducational groups (e.g., chronic disease management)."))
story.append(BL("Support groups (e.g., Alcoholics Anonymous, cancer support)."))
story.append(BL("Cognitive-Behavioural Group Therapy."))
story.append(BL("Psychodrama (Moreno)."))
story.append(BL("Encounter groups / sensitivity training groups."))
story.append(B("<b>Advantages:</b> Cost-effective, provides social learning, peer support, reduces stigma, allows practice of interpersonal skills."))
story.append(B("<b>Applications in Physiotherapy:</b> Chronic pain groups, stroke rehabilitation groups, pulmonary rehabilitation groups."))

story.append(SQ("B. Differentiate between STM and LTM"))

stm_ltm_data = [
    [Paragraph("<b>Feature</b>", table_header_style),
     Paragraph("<b>Short-Term Memory (STM)</b>", table_header_style),
     Paragraph("<b>Long-Term Memory (LTM)</b>", table_header_style)],
    [Paragraph("Duration", table_cell_style),
     Paragraph("15–30 seconds", table_cell_style),
     Paragraph("Minutes to lifetime", table_cell_style)],
    [Paragraph("Capacity", table_cell_style),
     Paragraph("7 ± 2 items (Miller)", table_cell_style),
     Paragraph("Virtually unlimited", table_cell_style)],
    [Paragraph("Encoding", table_cell_style),
     Paragraph("Primarily acoustic (sound)", table_cell_style),
     Paragraph("Primarily semantic (meaning)", table_cell_style)],
    [Paragraph("Forgetting", table_cell_style),
     Paragraph("Displacement, decay", table_cell_style),
     Paragraph("Interference, retrieval failure", table_cell_style)],
    [Paragraph("Retrieval", table_cell_style),
     Paragraph("Fast, immediate", table_cell_style),
     Paragraph("May require effort; cue-dependent", table_cell_style)],
    [Paragraph("Brain region", table_cell_style),
     Paragraph("Prefrontal cortex", table_cell_style),
     Paragraph("Hippocampus, amygdala, cortex", table_cell_style)],
    [Paragraph("Types", table_cell_style),
     Paragraph("Unitary (or working memory components)", table_cell_style),
     Paragraph("Episodic, semantic, procedural", table_cell_style)],
    [Paragraph("Rehearsal effect", table_cell_style),
     Paragraph("Maintains items in STM", table_cell_style),
     Paragraph("Transfers items to LTM", table_cell_style)],
]

t = Table(stm_ltm_data, colWidths=[3.5*cm, 7*cm, 7*cm])
t.setStyle(TableStyle([
    ('BACKGROUND', (0,0), (-1,0), colors.HexColor('#1a3a6e')),
    ('TEXTCOLOR', (0,0), (-1,0), colors.white),
    ('GRID', (0,0), (-1,-1), 0.5, colors.grey),
    ('ROWBACKGROUNDS', (0,1), (-1,-1), [colors.HexColor('#f0f4ff'), colors.white]),
    ('VALIGN', (0,0), (-1,-1), 'MIDDLE'),
    ('TOPPADDING', (0,0), (-1,-1), 4),
    ('BOTTOMPADDING', (0,0), (-1,-1), 4),
]))
story.append(SP(4))
story.append(t)

# ══════════════════════════════════════════════════════════════════════════════
# Q10 – Intelligence Test / Mood Disorders / CBT / Heredity & Environment
# ══════════════════════════════════════════════════════════════════════════════
story.append(Q("Q10. A. Intelligence Test   B. Mood Disorders   C. Cognitive Behavioural Therapy   D. Heredity & Environment"))
story.append(HR())
story.append(SQ("A. Intelligence Test"))
story.append(B("Intelligence is the global capacity to act purposefully, think rationally, and deal effectively with the environment (Wechsler). Intelligence tests (IQ tests) measure this capacity numerically."))
story.append(B("<b>Intelligence Quotient (IQ):</b> IQ = (Mental Age / Chronological Age) × 100 (Binet-Simon formula). Modern tests use deviation IQ (mean 100, SD 15)."))
story.append(BL("<b>Stanford-Binet Scale:</b> Revised by Terman; measures verbal/non-verbal reasoning, quantitative, and working memory."))
story.append(BL("<b>Wechsler Scales:</b> WAIS (adults), WISC (children), WPPSI (preschool). Provides Full Scale IQ, Verbal Comprehension, Perceptual Reasoning, Working Memory, Processing Speed."))
story.append(BL("<b>Raven's Progressive Matrices:</b> Non-verbal, culture-fair test measuring abstract reasoning."))
story.append(BL("<b>Cattell Culture-Fair Intelligence Test.</b>"))
story.append(B("<b>IQ Classification:</b> < 70 = Intellectual disability; 70–79 = Borderline; 80–89 = Low average; 90–109 = Average; 110–119 = High average; 120–129 = Superior; ≥130 = Very superior/Gifted."))
story.append(B("<b>Applications in Physiotherapy/Healthcare:</b> Assess cognitive function, guide rehabilitation, identify patients needing special communication strategies."))

story.append(SQ("B. Mood Disorders"))
story.append(B("Mood disorders (affective disorders) are characterised by significant disturbances in emotional state."))
story.append(BL("<b>Major Depressive Disorder (MDD):</b> Depressed mood and/or anhedonia most of the day, nearly every day for ≥2 weeks, plus 4+ of: weight/appetite change, insomnia/hypersomnia, psychomotor agitation/retardation, fatigue, worthlessness/guilt, poor concentration, recurrent thoughts of death. Biological basis: monoamine deficiency (serotonin, norepinephrine, dopamine). Treatment: SSRIs, SNRIs, TCAs, MAOIs, CBT, ECT."))
story.append(BL("<b>Bipolar I Disorder:</b> At least one manic episode (elevated/irritable mood, decreased sleep, grandiosity, pressured speech, flight of ideas, increased activity, reckless behaviour for ≥1 week). May have depressive episodes. Treatment: Lithium, Valproate, Lamotrigine, atypical antipsychotics."))
story.append(BL("<b>Bipolar II Disorder:</b> Hypomanic + depressive episodes (no full mania)."))
story.append(BL("<b>Cyclothymia:</b> Chronic mild mood fluctuations (hypomania + dysthymia) for ≥2 years."))
story.append(BL("<b>Persistent Depressive Disorder (Dysthymia):</b> Chronic low-grade depression for ≥2 years."))

story.append(SQ("C. Cognitive Behavioural Therapy (CBT)"))
story.append(B("CBT is a structured, short-term, goal-oriented psychotherapy that addresses the relationship between thoughts (cognitions), feelings, and behaviours. Developed by Aaron Beck for depression and Albert Ellis (REBT)."))
story.append(B("<b>Core Principles:</b>"))
story.append(BL("Psychological problems are maintained by faulty or unhelpful thinking patterns (cognitive distortions)."))
story.append(BL("Behaviours that reinforce those patterns can be changed."))
story.append(BL("Patients learn and practice skills to manage symptoms."))
story.append(B("<b>Common Cognitive Distortions:</b> All-or-nothing thinking, overgeneralisation, mental filter, mind reading, catastrophising, personalisation, 'should' statements."))
story.append(B("<b>Techniques:</b>"))
story.append(BL("Cognitive restructuring: Identifying and challenging negative automatic thoughts."))
story.append(BL("Behavioural activation: Scheduling pleasurable activities to combat depression."))
story.append(BL("Exposure hierarchy: For anxiety disorders."))
story.append(BL("Thought diary / ABC model (Ellis)."))
story.append(BL("Relaxation training, problem-solving, social skills training."))
story.append(B("<b>Applications:</b> Depression, anxiety, OCD, PTSD, eating disorders, phobias, chronic pain, insomnia. Also used in physiotherapy for kinesiophobia and chronic pain management."))

story.append(SQ("D. Heredity and Environment"))
story.append(B("The nature vs. nurture debate concerns the relative contributions of genetic inheritance (heredity) and environmental factors to human development and behaviour."))
story.append(B("<b>Heredity (Nature):</b>"))
story.append(BL("Genetic inheritance determines physical characteristics, temperament, certain cognitive abilities, and predispositions to various disorders."))
story.append(BL("Twin studies: Monozygotic (MZ) twins share 100% genes; dizygotic (DZ) share ~50%. Higher concordance rates in MZ twins for schizophrenia (~50%), depression, and intelligence support genetic influence."))
story.append(BL("Adoption studies: Adopted children resemble biological parents more than adoptive parents in certain traits."))
story.append(B("<b>Environment (Nurture):</b>"))
story.append(BL("Prenatal environment, nutrition, upbringing, education, culture, peer groups, socioeconomic status all shape development."))
story.append(BL("Early childhood experiences are particularly formative (critical/sensitive periods)."))
story.append(BL("Enriched environments improve IQ scores; deprived environments impair cognitive development."))
story.append(B("<b>Interactionist View (Modern consensus):</b> Genes and environment interact dynamically. Gene-environment interaction: certain genes are only expressed in specific environments. Epigenetics: environmental factors can switch genes on or off. Neither alone fully explains behaviour."))

# ══════════════════════════════════════════════════════════════════════════════
# Q11 – Motivation / Nature vs Nurture / Causes of Forgetting / Theories of Emotion
# ══════════════════════════════════════════════════════════════════════════════
story.append(Q("Q11. A. Motivation   B. Nature vs. Nurture Controversy   C. Causes of Forgetting   D. Theories of Emotion"))
story.append(HR())
story.append(SQ("A. Motivation"))
story.append(B("Motivation is the internal state or condition that activates, directs, and sustains behaviour toward a goal. It involves biological drives, psychological needs, and social incentives."))
story.append(B("<b>Types of Motivation:</b>"))
story.append(BL("<b>Intrinsic Motivation:</b> Engaging in activity for its own sake, for enjoyment or personal satisfaction."))
story.append(BL("<b>Extrinsic Motivation:</b> Behaviour driven by external rewards (salary, grades, praise) or to avoid punishment."))
story.append(BL("<b>Conscious vs. Unconscious:</b> Some motivations are conscious (hunger, thirst) while others operate below awareness (defence mechanisms, Freud)."))
story.append(B("<b>Maslow's Hierarchy of Needs (1943):</b>"))
story.append(BL("Physiological needs (food, water, sleep) – base."))
story.append(BL("Safety needs (security, order)."))
story.append(BL("Love/Belonging needs (relationships, social connection)."))
story.append(BL("Esteem needs (self-respect, achievement, recognition)."))
story.append(BL("Self-Actualisation (reaching full potential) – apex."))
story.append(B("Lower needs must be met before higher ones become motivating. Relevance to healthcare: patients' compliance with physiotherapy depends on their perception of need and safety."))

story.append(SQ("B. Nature vs. Nurture Controversy"))
story.append(B("(Covered in detail in Q10-D above. Summary:)"))
story.append(B("The central question: are human traits primarily determined by genetic endowment (nature) or by environmental experiences and learning (nurture)? Historical extremes (pure nativism vs. pure empiricism) have given way to the modern interactionist position. Evidence from twin, adoption, and molecular genetic studies shows that most traits involve complex gene-environment interactions. Epigenetic research shows environment can modify gene expression without changing DNA sequence."))

story.append(SQ("C. Causes of Forgetting"))
story.append(B("(Explained in full detail in Q5. Summary of major theories:)"))
story.append(BL("<b>Decay Theory:</b> Memory traces fade with time and disuse."))
story.append(BL("<b>Interference Theory:</b> Proactive (old interferes with new) and Retroactive (new interferes with old)."))
story.append(BL("<b>Retrieval Failure:</b> Lack of appropriate retrieval cues; context/state-dependent forgetting."))
story.append(BL("<b>Motivated Forgetting (Repression):</b> Psychodynamic concept; unconscious suppression of anxiety-provoking memories."))
story.append(BL("<b>Encoding Failure:</b> Information never properly encoded."))
story.append(BL("<b>Consolidation Failure:</b> Disruption before memory is fully consolidated (e.g., head injury)."))
story.append(BL("<b>Organic/Pathological:</b> Amnesia, dementia, Korsakoff's syndrome."))

story.append(SQ("D. Theories of Emotion"))
story.append(B("Emotion is a complex state involving subjective experience (feeling), physiological arousal, and expressive behaviour."))
story.append(BL("<b>1. James-Lange Theory:</b> We feel emotion because we perceive our physiological responses. 'I am afraid because I tremble.' (peripheral feedback theory)."))
story.append(BL("<b>2. Cannon-Bard Theory:</b> Emotion and physiological arousal occur simultaneously and independently when a stimulus is processed by the thalamus. Challenges James-Lange."))
story.append(BL("<b>3. Schachter-Singer (Two-Factor) Theory:</b> Emotion = Physiological arousal + Cognitive label. The same arousal can be labelled differently depending on context. Supported by the Dutton and Aron 'bridge study.'"))
story.append(BL("<b>4. Lazarus's Cognitive-Appraisal Theory:</b> Primary appraisal (is the situation threatening?) and secondary appraisal (can I cope?) determine the emotional response. Cognition precedes emotion."))
story.append(BL("<b>5. Zajonc's Theory:</b> Affect can precede and occur without cognition ('affective primacy')."))
story.append(BL("<b>6. Plutchik's Wheel of Emotions:</b> Eight basic emotions arranged in opposing pairs: joy-sadness, anger-fear, trust-disgust, surprise-anticipation."))
story.append(BL("<b>7. Evolutionary Theories (Darwin):</b> Emotions have adaptive value – fear triggers fight-or-flight, joy reinforces beneficial behaviours."))

# ══════════════════════════════════════════════════════════════════════════════
# Q12 – Need and Drive Motivation / Delusional Disorder / Personality Disorder / Stress Management
# ══════════════════════════════════════════════════════════════════════════════
story.append(Q("Q12. A. Need and Drive Motivation   B. Delusional Disorder   C. Personality Disorder   D. Stress Management"))
story.append(HR())
story.append(SQ("A. Need and Drive Motivation"))
story.append(B("<b>Need:</b> A state of deprivation or deficit that creates psychological or physiological tension. Needs can be biological (hunger, thirst, oxygen) or psychological (achievement, affiliation, power)."))
story.append(B("<b>Drive:</b> An internal state of tension or arousal that motivates behaviour aimed at reducing the need. When a need arises, it creates a drive that pushes the organism toward goal-directed behaviour."))
story.append(B("<b>Hull's Drive Reduction Theory (1943):</b>"))
story.append(BL("Behaviour is motivated by biological drives (derived from primary needs: food, water, sex, pain avoidance)."))
story.append(BL("Goal: reduce the drive and restore homeostasis."))
story.append(BL("Formula: Behaviour (B) = Drive (D) × Habit (H). Later added incentive motivation."))
story.append(BL("<b>Primary drives:</b> Based on biological needs (hunger, thirst)."))
story.append(BL("<b>Secondary drives:</b> Acquired through learning (money, power, status become secondary drives)."))
story.append(B("<b>Maslow vs. Hull:</b> Hull emphasises tension reduction (deficit model); Maslow emphasises growth and self-actualisation (beyond just deficit reduction)."))
story.append(B("<b>Murray's Theory of Needs:</b> Proposed 20+ psychogenic needs including Achievement (nAch), Affiliation (nAff), Power (nPow) – tested via the TAT."))

story.append(SQ("B. Delusional Disorder"))
story.append(B("Delusional disorder is characterised by the presence of one or more delusions for ≥1 month without meeting criteria for schizophrenia. Hallucinations, if present, are not prominent. Functioning is not markedly impaired outside the delusion."))
story.append(B("<b>Types of Delusions:</b>"))
story.append(BL("<b>Persecutory:</b> Belief of being plotted against, spied on, or harassed. Most common type."))
story.append(BL("<b>Grandiose:</b> Belief of having exceptional abilities, wealth, fame, or a special relationship with a deity."))
story.append(BL("<b>Erotomanic:</b> Belief that another person (usually of higher status) is in love with the individual (de Clérambault's syndrome)."))
story.append(BL("<b>Jealous (Othello Syndrome):</b> Belief that one's partner is unfaithful without adequate evidence."))
story.append(BL("<b>Somatic:</b> Belief of having a physical defect or medical condition (e.g., parasites, foul odour, deformed body part)."))
story.append(BL("<b>Mixed or Unspecified:</b> No dominant theme."))
story.append(B("<b>Management:</b>"))
story.append(BL("Antipsychotic medication (Risperidone, Olanzapine, Pimozide particularly for somatic type)."))
story.append(BL("Building a therapeutic alliance is challenging as the patient usually does not accept the delusional nature."))
story.append(BL("CBT to challenge delusional thinking."))
story.append(BL("Social support and family psychoeducation."))

story.append(SQ("C. Personality Disorder"))
story.append(B("Personality disorders are enduring, pervasive, inflexible patterns of inner experience and behaviour that deviate markedly from cultural norms, cause significant distress or functional impairment, and are stable over time (DSM-5)."))
story.append(B("<b>DSM-5 Clusters:</b>"))
story.append(BL("<b>Cluster A (Odd/Eccentric):</b>"))
story.append(Paragraph("    - <b>Paranoid PD:</b> Pervasive distrust and suspicion.", bullet_style))
story.append(Paragraph("    - <b>Schizoid PD:</b> Detachment from social relationships, restricted affect.", bullet_style))
story.append(Paragraph("    - <b>Schizotypal PD:</b> Magical thinking, odd speech, social anxiety.", bullet_style))
story.append(BL("<b>Cluster B (Dramatic/Emotional/Erratic):</b>"))
story.append(Paragraph("    - <b>Antisocial PD:</b> Disregard for rights of others, deceitfulness, lack of remorse.", bullet_style))
story.append(Paragraph("    - <b>Borderline PD:</b> Emotional instability, fear of abandonment, impulsivity, self-harm, identity disturbance.", bullet_style))
story.append(Paragraph("    - <b>Histrionic PD:</b> Excessive emotionality, attention-seeking.", bullet_style))
story.append(Paragraph("    - <b>Narcissistic PD:</b> Grandiosity, need for admiration, lack of empathy.", bullet_style))
story.append(BL("<b>Cluster C (Anxious/Fearful):</b>"))
story.append(Paragraph("    - <b>Avoidant PD:</b> Social inhibition, feelings of inadequacy, hypersensitivity to criticism.", bullet_style))
story.append(Paragraph("    - <b>Dependent PD:</b> Excessive need for care and submissive behaviour.", bullet_style))
story.append(Paragraph("    - <b>Obsessive-Compulsive PD (OCPD):</b> Preoccupation with orderliness, perfectionism (distinct from OCD).", bullet_style))
story.append(B("<b>Management:</b>"))
story.append(BL("Dialectical Behaviour Therapy (DBT): most evidence for Borderline PD."))
story.append(BL("Schema Therapy: identifying and changing maladaptive schemas."))
story.append(BL("CBT, Mentalization-Based Therapy (MBT)."))
story.append(BL("Pharmacotherapy: Targets specific symptoms (antidepressants for mood, antipsychotics for brief psychosis, mood stabilisers)."))

story.append(SQ("D. Stress Management"))
story.append(B("<b>Stress</b> is the non-specific response of the body to any demand placed upon it (Selye). The stressor can be physical (injury, disease) or psychological (exams, conflict, loss). Stress involves cognitive appraisal (Lazarus and Folkman) – primary appraisal (threat?) and secondary appraisal (coping?)."))
story.append(B("<b>Selye's General Adaptation Syndrome (GAS):</b>"))
story.append(BL("Alarm Reaction: Activation of fight-or-flight response (sympathetic arousal, cortisol release)."))
story.append(BL("Resistance Stage: Body adapts and resists the stressor; cortisol levels remain elevated."))
story.append(BL("Exhaustion Stage: Resources depleted; susceptibility to illness increases; may lead to burnout."))
story.append(B("<b>Stress Management Techniques:</b>"))
story.append(B("<i>Problem-Focused Coping:</i> Addressing the source of stress directly."))
story.append(BL("Time management and prioritisation."))
story.append(BL("Problem-solving skills."))
story.append(BL("Assertiveness training."))
story.append(B("<i>Emotion-Focused Coping:</i> Managing the emotional response to stress."))
story.append(BL("Relaxation Techniques: Progressive Muscle Relaxation (PMR – Jacobson), deep diaphragmatic breathing."))
story.append(BL("Mindfulness and Meditation: Mindfulness-Based Stress Reduction (MBSR)."))
story.append(BL("Yoga and physical exercise: Reduce cortisol and increase endorphins."))
story.append(BL("CBT: Identifying and challenging stress-inducing cognitive distortions."))
story.append(BL("Biofeedback: Learning to control physiological stress responses."))
story.append(BL("Social support: Sharing problems with friends, family, or support groups."))
story.append(BL("Journaling and expressive writing."))
story.append(BL("Sleep hygiene: Adequate sleep is essential for stress resilience."))
story.append(B("<b>Relevance to Physiotherapy:</b> Stress increases muscle tension, lowers pain threshold, delays healing, and reduces rehabilitation compliance. Physiotherapists should incorporate stress management into patient education."))

# ─── FOOTER NOTE ──────────────────────────────────────────────────────────────
story.append(SP(14))
story.append(HRFlowable(width="100%", thickness=1, color=colors.HexColor('#1a3a6e'), spaceAfter=4, spaceBefore=4))
story.append(Paragraph("BPT205T – Psychology & Psychiatry | Year II | May 2026 End Term Examination | Detailed Answer Key", subtitle_style))

doc.build(story)
print("PDF generated successfully.")