Abnormal Psychology - Domain Quiz Flashcards
(192 cards)
1
Q
For individuals with Autism Spectrum Disorder, a better prognosis has been linked to which of the following?
a. No or minimal delay in motor development
b. An ability to communicate verbally by age 5 or 6
c. A brief period of active-phase symptoms
d. Strong family support
A
The correct answer is B.
2
Q
Research investigating the effectiveness of neurofeedback as a treatment for ADHD has generally found which of the following?
a. It is not an effective treatment for most individuals with this disorder
b. It is an effective treatment and exerts its strongest effects on inattention and impulsivity.
c. It is an effective treatment and exerts its strongest effects on hyperactivity.
d. It is an effective treatment only when used in conjunction with a CNS stimulant.
A
The correct answer is B.
3
Q
Compared to children in the general population, children with a Specific Learning Disorder are:
a. At lower risk for ADHD and other mental disorders.
b. At about the same risk for ADHD and other mental disorders
c. At about the same risk fo ADHD and other mental disorders but at higher risk for more severe symptoms.
d. At higher risk for ADHD and other mental disorder.
A
The correct answer is D.
4
Q
The mean age of onset of motor tics in Tourettes is:
a. 1-3 years
b. 5-7 years
c. 9-11 years
d. 12-14 years
A
The correct answer is B.
Onset of Vocal Ticks is:
11
5
Q
Of the brain abnormalities associated with Schizophrenia, which of the following has been found in the largest proportion of patients?
a. Enlarged hippocampus
b. Enlarged frontal lobes
c. Enlarged temporal lobes
d. Enlarged ventricles
A
The Correct answer is D.
6
Q
Mary Ann, age 29, seems very nervous during her fist therapy sessions with you. When she speaks, her hands shake and she blushes. She tells you that, while she isn’t afraid to be around people, she gets anxious and flustered whenever she has to speak to people she doesn’t know. Mary Ann also says she has trouble talking to her supervisor at work because he’s condescending and critical. Based on these symptoms, the most likely diagnosis for Mary Ann is which of the following?
a. Specific Phobia
b. Social Anxiety Disorder
c. Panic Disorder
d. Generalised Anxiety Disorder
A
The Correct Answer is B.
7
Q
A child with a Specific Learning Disorder is most likely to also receive a diagnosis of:
Select one:
a. OCD.
b. Enuresis.
c. Intellectual Disability.
d. ADHD.
A
Answer D is correct:Individuals with Specific Learning Disorder typically have an IQ in the average to above-average range but have higher-than-normal rates of other problems and disorders, with the most frequent comorbid disorder being ADHD.
The correct answer is: ADHD.
8
Q
A person with Tourette’s Disorder is MOST likely to also have which of the following?
Select one:
a. depressed mood
b. an eating disorder
c. aphasia and alcalulia
d. obsessions and compulsion
A
Answer D is correct:Many individuals with Tourette’s Disorder have comorbid symptoms and conditions, with the most common comorbid symptoms being obsessions and compulsions.
The correct answer is: obsessions and compulsion
9
Q
Difficulties in phonological processing have been linked to:
Select one:
a. stuttering.
b. Intellectual Disability.
c. dyslexia.
d. Tourette’s Disorder.
A
Answer C is correct:Phonological processing refers to the ability to process the phonological features of words (i.e., the ability to understand how sounds combine to form words). Problems in phonological processing have been linked to reading disabilities (e.g., dyslexia) and other learning disorders.
The correct answer is: dyslexia.
10
Q
Research by Brown and Madan-Swain (1993) found that which of the following is true about treatments for childhood leukemia?
Select one:
a. Chemotherapy is associated with neurocognitive deficits but irradiation is not.
b. Irradiation is associated with neurocognitive deficits but chemotherapy is not.
c. Chemotherapy and irradation are both associated with neurocognitive deficits.
d. Neither chemotherapy nor irradiation is associated with neurocognitive deficits.
A
Answer C is correct:Brown and Madan-Swain’s (1993) research found that intrathecal chemotherapy and CNS irradiation as treatments for leukemia were both associated with impaired neurocognitive functioning and an increased risk for a learning disability.
The correct answer is: Chemotherapy and irradation are both associated with neurocognitive deficits.
11
Q
The best prognosis for Autism Spectrum Disorder is associated with: Select one: a.an early onset of symptoms. b.a precipitating factor. c.verbal communication skills by age 6. d.normal adaptive functioning.
A
Answer C is correct:The prognosis for Autism Spectrum Disorder is generally poor, although certain characteristics have been linked to a better prognosis including the acquisition of verbal communication skills by age 5 or 6, an IQ of 70 or higher, and a later onset of symptoms.
The correct answer is: verbal communication skills by age 6.
12
Q
The DSM’s use of polythetic criteria sets is useful for:
Select one:
a. recognizing the heterogeneity of symptoms for a particular diagnosis.
b. identifying comorbid conditions.
c. recognizing the impact of medical conditions on a mental disorder.
d. prioritizing diagnoses.
A
Answer A is correct:A polythetic criteria set requires that an individual meet only a subset of the criteria for a given disorder to qualify for that diagnosis. Consequently, people with somewhat different symptoms can be assigned the same diagnosis.
The correct answer is: recognizing the heterogeneity of symptoms for a particular diagnosis.
13
Q
When using the DSM-5, severity of a child’s Intellectual Disability is determined by considering which of the following?
Select one:
a. the child’s score on an individual standardized intelligence test
b. the child’s adaptive functioning in conceptual, social, and practical domains
c. the etiology of the child’s disability
d. the discrepancy between the child’s cognitive and adaptive functioning
A
Answer B is correct:The DSM-5 distinguishes between four levels of severity for Intellectual Disability - mild, moderate, severe, and profound. An individual’s level of severity is based on his or her adaptive functioning in conceptual, social, and practical domains.
The correct answer is: the child’s adaptive functioning in conceptual, social, and practical domains
14
Q
Which of the following best describes ADHD in adults?
Select one:
a. Hyperactivity becomes less prominent while impulsivity and inattention stay the same or become more prominent.
b. Impulsivity becomes less prominent while hyperactivity and inattention stay the same or become more prominent.
c. Inattention becomes less prominent while hyperactivity and impulsivity stay the same or become more prominent.
d. Hyperactivity and impulsivity become less prominent while inattention stays the same or becomes more prominent.
A
Answer D is correct:The symptoms of ADHD vary somewhat over the lifespan. Hyperactivity and impulsivity decrease over time, while inattention predominates the symptom profile during adulthood, with common signs of inattention including inconsistency in the ability to concentrate, difficulty maintaining routines, and an inability to prioritize and complete important tasks.
The correct answer is: Hyperactivity and impulsivity become less prominent while inattention stays the same or becomes more prominent.
15
Q
A 28-year old male client presents with hallucinations and bizarre delusions. His parents report that his symptoms were not preceded by an unusual or stressful event and that he has had these symptoms for about six weeks. Your tentative diagnosis is:
Select one:
a. Schizophrenia.
b. Schizophreniform Disorder.
c. Brief Psychotic Disorder.
d. Schizoaffective Disorder.
A
Answer B is correct: The symptoms of Schizophreniform Disorder are similar to those of Schizophrenia, except that the duration of symptoms is between one and six months.
Answer A is incorrect: A diagnosis of Schizophrenia requires the presence of characteristic psychotic symptoms, impaired functioning, and the presence of symptoms for at least six months.
Answer C is incorrect: A diagnosis of Brief Psychotic Disorder requires the presence of characteristic psychotic symptoms for no more than one month.
Answer D is incorrect: Schizoaffective Disorder is the appropriate diagnosis when the individual has a history of concurrent symptoms of Schizophrenia and a manic or major depressive episode with at least two weeks without prominent mood symptoms.
The correct answer is: Schizophreniform Disorder.
16
Q
A 34-year-old woman is convinced that her boss is in love with her despite that fact that there is irrefutable evidence that her belief is false. The woman’s belief is an example of which of the following?
Select one:
a. grandiose delusion
b. erotomanic delusion
c. idea of reference
d. illusion
A
Answer B is correct: A person who believes that another person (usually of higher status) is in love with him or her despite incontrovertible evidence to the contrary is experiencing an erotomanic delusion.
Answer A is incorrect: A grandiose delusion is characterized by an inflated sense of worth, knowledge, power, or identity or the belief that one has made an important discovery.
Answer C is incorrect: An idea of reference is the belief that events, people, or objects in the environment have a special significance for the individual.
Answer D is incorrect: An illusion is a misperception or misinterpretation of an actual external stimulus.
The correct answer is: erotomanic delusion
17
Q
For a diagnosis of Schizophrenia, the DSM-5 requires the presence of two or more active phase symptoms for at least one month with at least one symptom being:
Select one:
a. hallucinations, delusions, or disorganized speech.
b. hallucinations, delusions, or grossly disorganized behavior.
c. anhedonia, avolition, or other negative symptom.
d. depersonalization or derealization.
A
Answer A is correct: The diagnosis of Schizophrenia requires the presence of two or more active phase symptoms for at least one month and continuous signs of the disturbance for at least six months. It also requires at least one active phase symptom to be hallucinations, delusions, or disorganized speech.
The correct answer is: hallucinations, delusions, or disorganized speech.
18
Q
For individuals with Schizophrenia, the poorest prognosis is associated with:
Select one:
a. female gender, younger age at onset, and predominant negative symptoms.
b. female gender, older age at onset, and predominant positive symptoms.
c. male gender, younger age at onset, and predominant negative symptoms.
d. male gender, older age at onset, and predominant positive symptoms.
A
Answer C is correct: The prognosis for Schizophrenia is generally poor with a worse prognosis being associated with several factors including male gender, an early onset, and the presence of negative symptoms.
The correct answer is: male gender, younger age at onset, and predominant negative symptoms.
19
Q
If a child has Schizophrenia, his or her biological sibling has a _____ percent chance of developing the disorder.
Select one:
a. 5
b. 10
c. 17
d. 48
A
Answer B is correct: The concordance rate for Schizophrenia for biological siblings is about 10%, which means that if one child has Schizophrenia, his or her biological sibling has a 10% chance of developing the disorder.
Answer A is incorrect: The concordance rate for a child who has one grandparent with Schizophrenia is about 5%.
Answer C is incorrect: The concordance rate for fraternal twins is about 17%
Answer D is incorrect: The concordance rate for identical twins is about 48%
The correct answer is: 10
20
Q
Schizophrenia has been linked to several structural brain abnormalities with the most consistent finding being:
Select one:
a. larger-than-normal prefrontal lobes.
b. an enlarged hippocampus.
c. enlarged ventricles.
d. smaller-than-normal ARAS.
A
Answer C is correct: Schizophrenia has been linked to a number of structural and functional brain abnormalities. Of the structural abnormalities, enlarged ventricles have been most frequently found.
The correct answer is: enlarged ventricles.
21
Q
A 63-year-old college professor exhibits impairments in memory and other cognitive functions and a depressed mood. Which of the following suggests that his symptoms are more likely due to “pseudodementia” than to a major or mild Neurocognitive Disorder?
Select one:
a. The onset of the man’s symptoms was insidious.
b. The man exaggerates his cognitive deficits and seems overly concerned about them.
c. The man has marked deficits in both recognition and recall memory.
d. The man exhibits greater impairment in declarative memory than in procedural memory.
A
Answer B is correct: The term pseudodementia is sometimes used to describe Major Depressive Disorder when it involves apathy and prominent cognitive symptoms (e.g., memory loss, impaired concentration, distractibility). A distinguishing feature is that people with pseudodementia are likely to exaggerate their cognitive problems, while those with a major or mild Neurocognitive Disorder tend to deny or minimize them.
Answers A and C are incorrect: An insidious onset of symptoms and deficits in both recognition and recall memory are characteristic of Neurocognitive Disorder.
Answer D is incorrect: This is the opposite of what is true. People with pseudodementia tend to have greater impairment in procedural than declarative memory.
The correct answer is: The man exaggerates his cognitive deficits and seems overly concerned about them.
22
Q
Abnormal levels of melatonin have been linked to which of the following?
Select one:
a. Bipolar I Disorder
b. Major Depressive Disorder with seasonal pattern
c. Major Depressive Disorder with peripartum onset
d. Cyclothymic Disorder
A
Answer B is correct: Melatonin is a hormone released by the pineal gland and is involved in the regulation of circadian rhythms. One explanation for Major Depressive Disorder with seasonal pattern (also known as seasonal affective disorder) is that it is related to elevated levels of melatonin.
The correct answer is: Major Depressive Disorder with seasonal pattern
23
Q
According to the DSM-5, the 12-month prevalence rate for Bipolar I Disorder in the United States is _____ percent.
Select one:
a. 0.6
b. 1.8
c. 3.2
d. 5
A
Answer A is correct: The DSM-5 reports the 12-month prevalence rate for Bipolar I Disorder in the United States as 0.6% and the prevalence rate across 11 countries as ranging from 0.0% to 0.6%.
The correct answer is: 0.6
24
Q
Anita A., age 16, is brought to therapy by her mother who says the girl has recently become “another person.” She says that Anita used to be friendly and cooperative and popular at school. However, for the last few weeks, Anita has been constantly irritable, is not doing her homework and has failed several tests, and has been getting very little sleep. When the therapist interviews Anita, her speech is loud and rapid and she is easily distracted. He learns that she has started drinking alcohol nearly every day and has engaged in high-risk sexual behavior. The most likely diagnosis for Anita is:
Select one:
a. Conduct Disorder.
b. ADHD.
c. Bipolar II Disorder.
d. Bipolar I Disorder.
A
Answer D is correct: The nature and sudden onset of Anita’s symptoms (e.g., irritability, substance use, school truancy and failure, and loud, rapid speech) are consistent with a manic episode. Therefore, the most likely diagnosis for Anita is Bipolar I Disorder.
Answer A is incorrect: The diagnosis of Conduct Disorder requires a persistent pattern of behavior that violates the basic rights of others and/or age-appropriate social norms and involves at least three characteristic symptoms from four categories - aggression to people and animals; destruction of property; deceitfulness or theft; and serious violation of rules.
Answer B is incorrect: The sudden onset of Anita’s symptoms and the presence of mood symptoms are more suggestive of Bipolar Disorder than of ADHD.
Answer C is incorrect: The diagnosis of Bipolar II Disorder requires at least one major depressive episode and one hypomanic episode.
The correct answer is: Bipolar I Disorder.
25
Lewinsohn's (1974) behavioral model attributes depression to:
Select one:
a. internal, stable, and global attributions for negative life events.
b. inadequate stimulus discrimination.
c. emotion dysregulation.
d. a low rate of response-contingent reinforcement.
Answer D is correct: Lewinsohn's theory is based on the principles of operant conditioning and attributes depression to low rates of response-contingent reinforcement.
Answer A is incorrect: Internal, stable, and global attributions for negative events is identified as a cause of depression by the learned helplessness model.
Answer B is incorrect: Pavlov found that difficult discriminations led to experimental neurosis, but Lewinsohn's theory does not link depression to inadequate stimulus discrimination.
Answer C is incorrect: Emotion dysregulation has been identified by Linehan as a cause of Borderline Personality Disorder.
The correct answer is: a low rate of response-contingent reinforcement.
26
The DSM-5 diagnosis of Persistent Depressive Disorder requires a duration of symptoms of at least ________ in adults and ________ in children and adolescents.
Select one:
a. three years; one year
b. three years; eighteen months
c. two years; one year
d. one year; six months
Answer C is correct: Persistent Depressive Disorder is also known as Dysthymia and is characterized by the presence of a depressed mood on most days for at least two years in adults and one year in children and adolescents.
The correct answer is: two years; one year
27
Which of the following is true about the prevalence of Major Depressive Disorder in adolescents and adults?
Select one:
a. The rates for males and females are about equal.
b. The rate for females is one and one-half to three times the rate for males.
c. The rate for males is about one and one-half to three times the rate for females.
d. The rate for females is four to five times the rate for males.
Answer B is correct: Prior to puberty, the rates of Major Depressive Disorder are about equal for males and females; but, beginning in adolescence, the rate for females becomes one and one-half to three times the rate for males.
The correct answer is: The rate for females is one and one-half to three times the rate for males.
28
Ella G. was involved in a serious car accident three weeks ago in which her best friend was killed. Since the accident, Ella has experienced a loss of positive feelings toward friends and family members, increased irritability, flashbacks of the accident, an inability to remember what happened in the days following the accident, nightmares about the accident, and derealization. She has been avoiding the intersection where the accident occurred, doesn't like to talk about the accident, and has been having trouble concentrating and sleeping. Based on these symptoms, the most likely diagnosis for Ella is which of the following?
Select one:
a. Brief Psychotic Disorder
b. Adjustment Disorder
c. PTSD
d. Acute Stress Disorder
Answer D is correct: The cause, nature, and duration of Ella's symptoms meet the diagnostic criteria for Acute Stress Disorder.
Answer A is incorrect: As its name implies, Brief Psychotic Disorder involves symptoms of psychosis such as delusions, hallucinations, and/or disorganized speech or behavior.
Answer B is incorrect: Adjustment Disorder is a residual category for symptoms that represent a response to a psychosocial stressor that does not meet the requirements for a diagnosis of Acute Stress Disorder or PTSD.
Answer C is incorrect: Although the woman's symptoms are characteristic of PTSD, their duration is not: A diagnosis of PTSD requires a duration of symptoms for more than one month.
The correct answer is: Acute Stress Disorder
29
Generalized Anxiety Disorder (GAD) is often manifested in children as excessive worry about:
Select one:
a. relationships with friends and family members.
b. injury and illness.
c. the future.
d. school or sports performance.
Answer D is correct: The symptoms of GAD are age-related, with children and adolescents most often worrying about performance in school and sports and about earthquakes, tornados, and other disasters.
The correct answer is: school or sports performance.
30
It is generally agreed that, when treating a child for school refusal, the initial intervention should be to:
Select one:
a. begin family therapy.
b. identify factors that are reinforcing nonattendance.
c. temporarily remove the child from the school environment.
d. get the child back to school as soon as possible.
Answer D is correct: When identifying an appropriate intervention for school refusal, it would be important to determine its cause. However, most experts agree that an initial intervention is to get the child back to school as soon as possible.
The correct answer is: get the child back to school as soon as possible.
31
Soon after losing his job, a 43-year-old man develops feelings of sadness and hopelessness. He has trouble even thinking about looking for another job and thinks his unemployment is already having an adverse effect on his marriage. The man's symptoms have lasted for ten days, and he has no previous history of a mental disorder. The most likely diagnosis is:
Select one:
a. Adjustment Disorder with depressed mood.
b. Adjustment Disorder, unspecified.
c. Major Depressive Disorder.
d. Acute Stress Disorder.
Answer A is correct: The man's symptoms suggest depression but do not meet the diagnostic criteria for Major Depressive Disorder. Also, the nature and duration of his symptoms and the fact that they were apparently the result of his job loss are most suggestive of Adjustment Disorder with depressed mood.
Answer B is incorrect: The man's feelings of sadness and hopelessness are consistent with the depressed mood specifier for Adjustment Disorder.
Answer C: The man's symptoms are not sufficiently severe or of sufficient duration for a diagnosis of Major Depressive Disorder.
Answer D is incorrect: The man's symptoms do not meet the criteria for a diagnosis of Acute Stress Disorder.
The correct answer is: Adjustment Disorder with depressed mood.
32
The diagnosis of Reactive Attachment Disorder requires:
Select one:
a. evidence of self-injurious behavior.
b. an onset of at least some symptoms prior to two years of age.
c. a persistence of symptoms for at least two months.
d. evidence that symptoms are due to extreme insufficient care.
Characterized by a consistent pattern of inhibited and emotionally withdrawn behavior toward adult caregivers. The diagnosis is assigned only if there is evidence that symptoms are related to exposure to a pattern of extreme insufficient care.
Answer A is incorrect: Self-injurious behavior is not a diagnostic criterion for Reactive Attachment Disorder.
Answer B is incorrect: For the diagnosis, the onset of symptoms must be prior to five years of age.
Answer C is incorrect: The DSM does not specify a minimum duration of symptoms for Reactive Attachment Disorder.
The correct answer is: evidence that symptoms are due to extreme insufficient care.
33
The rates of Obsessive-Compulsive Disorder are:
Select one:
a. higher for males in childhood but about equal for males and females in adulthood.
b. higher for females in childhood but about equal for males and females in adulthood.
c. about equal for males and females throughout the lifespan.
d. higher for females throughout the lifespan.
Answer A is correct: In adults, the rate of OCD is about equal for males and females. However, because the average age of onset is earlier for males, the rate for males is higher during childhood.
The correct answer is: higher for males in childhood but about equal for males and females in adulthood.
34
The treatment-of-choice for Agoraphobia is ordinarily:
Select one:
a. systematic desensitization.
b. covert sensitization.
c. exposure with response prevention.
d. EMDR.
Answer C is correct: For Agoraphobia and many other Anxiety Disorders, exposure with response prevention (ERP) alone or in conjunction with other interventions is the treatment-of-choice.
The correct answer is: exposure with response prevention.
35
When faced with a feared stimulus, a person with Specific Phobia, blood-injection-injury type will most likely:
Select one:
a. faint.
b. fall asleep.
c. scream.
d. have a seizure.
Answer A is correct: The blood-injection-injury type differs from other Specific Phobias in terms of the physical reaction to feared stimuli: For people with this type, feared stimuli produce an initial increase in heart rate and blood pressure that is immediately followed by a drop in both and, as a consequence, fainting.
The correct answer is: faint.
36
A hypnagogic hallucination is:
Select one:
a. a sense of detachment from oneself.
b. a drug-induced sensory perception.
c. a vivid dream that occurs just before waking up.
d. a vivid dream-like sensation that occurs just before falling asleep.
Answer D is correct: Hypnagogic hallucinations are vivid dreams that occur during the transition from an awake to a sleep state.
Answer C is incorrect: A hypnopompic hallucination is a vivid dream that occurs during the transition from sleep to wakefulness.
The correct answer is: a vivid dream-like sensation that occurs just before falling asleep.
37
At least eight times in the past month, Mark has experienced a sudden arousal from sleep that starts with a loud scream and is accompanied by signs of autonomic arousal. When his partner tries to comfort him during these episodes, Mark does not respond and, in the morning, does not remember what happened. Assuming that Mark's episodes usually happen in the first third of the night during stage 3 or 4 sleep, the most likely diagnosis is which of the following?
Select one:
a. Narcolepsy
b. Nightmare Disorder
c. Non-REM Sleep Arousal Disorder
d. REM Sleep Behavior Disorder
Answer C is correct: Mark's symptoms (sudden arousal from sleep that starts with a loud scream and is accompanied by autonomic arousal) and the fact that his arousal from sleep occurs during stage 3 or 4 sleep are consistent with a diagnosis of Non-REM Sleep Arousal Disorder, sleep terror type.
Answer A is incorrect: Narcolepsy involves recurrent episodes within the same day of an irrepressible need to sleep.
Answer B is incorrect: Non-REM Sleep Arousal Disorder and Nightmare disorder both involve awakening during sleep with autonomic arousal, but episodes associated with Nightmare Disorder usually occur later in the night during REM sleep. In addition, a person with Nightmare Disorder recalls having a dream that involved a threat to his or her survival or security.
Answer D is incorrect: REM Sleep Behavior Disorder is characterized by repeated episodes of arousal during REM sleep that are often accompanied by complex motor behavior or vocalizations that are consistent with the content of a dream.
The correct answer is: Non-REM Sleep Arousal Disorder
38
Dissociative Amnesia is most associated with:
Select one:
a. a loss of memory for events from the distant past.
b. an inability to recall personal information.
c. an inability to form new sensory memories.
d. an inability to attach emotions to memories.
Answer B is correct: Dissociative Amnesia differs from amnesias that have a physiological cause in terms of the nature of the memory loss. Specifically, Dissociative Amnesia is characterized by a loss of memory for personal (biographical) information.
The correct answer is: an inability to recall personal information.
39
Lead poisoning is associated with which of the following disorders?
Select one:
a. Tourette's Disorder
b. Rumination Disorder
c. Pica
d. Enuresis
Answer C is correct: Pica involves persistent eating of nonnutritive substances (e.g., lead-based paint) for at least one month, with the eating behavior being inappropriate for the individual's developmental level and not being part of a culturally supported practice.
Answer A is incorrect: Tourette's Disorder is a Tic Disorder and is not associated with lead poisoning.
Answer B is incorrect: Rumination Disorder is characterized by repeated regurgitation of food that is not attributable to a medical condition and does not occur exclusively during the course of another eating disorder.
Answer D is incorrect: Enuresis is an Elimination Disorder and is not associated with lead poisoning.
The correct answer is: Pica
40
Research evaluating the effects of imipramine as a treatment for Enuresis suggests that it is:
Select one:
a. more effective than the bell-and-pad.
b. less effective than the bell-and-pad in terms of long-term effects.
c. about equally effective as the bell-and-pad in terms of both short- and long-term effects.
d. ineffective in terms of both short- and long-term effects.
Answer B is correct: Although imipramine has good short-term effects for Enuresis, it does not have good long-term effects.
The correct answer is: less effective than the bell-and-pad in terms of long-term effects.
41
The intentional production of symptoms for the purpose of obtaining an external reward is characteristic of which of the following?
Select one:
a. Factitious Disorder
b. Malingering
c. Somatic Symptom Disorder
d. Illness Anxiety Disorder
Answer B is correct: Malingering is characterized by an intentional production of physical or psychological symptoms for the purpose of obtaining an external reward such as avoiding work, receiving financial compensation, or obtaining drugs.
Answer A is incorrect: Individuals with Factitious Disorder Imposed on Self falsify physical or psychological symptoms that are associated with their deception, present themselves to others as being ill or impaired, and engage in the deceptive behavior even in the absence of an obvious external reward for doing so.
Answer C is incorrect: The essential feature of Somatic Symptom Disorder is the presence of one or more somatic symptoms that cause distress or a significant disruption in daily life accompanied by excessive thoughts, feelings, or behaviors related to the symptoms. The DSM does not require symptoms to be linked to a desire to obtain an external reward.
Answer D is incorrect: Illness Anxiety Disorder is characterized by a preoccupation with having a serious illness, an absence of somatic symptoms or the presence of mild somatic symptoms, a high level of anxiety about one's health, and performance of excessive health-related behaviors or maladaptive avoidance of doctors and hospitals. The DSM does not require symptoms to be linked to a desire to obtain an external reward.
The correct answer is: Malingering
42
The research suggests that a person with Anorexia Nervosa restricts his or her food intake to alleviate restlessness, anxiety, and obsessive thinking, which are caused by:
Select one:
a. higher-than-normal levels of serotonin.
b. lower-than-normal levels of serotonin.
c. higher-than-normal levels of dopamine.
d. lower-than-normal levels of dopamine.
Answer A is correct: Research on the contributors to Anorexia Nervosa suggests that food restriction reduces higher-than-normal serotonin levels and thereby alleviates anxiety and other unpleasant feelings.
The correct answer is: higher-than-normal levels of serotonin.
43
Two weeks ago, Amy A., age 17, suddenly began experiencing weakness in both legs and a loss of balance, which causes her to fall down when she tries to walk. Amy hasn't been able to go to school because of her symptoms and says she thinks they started after she had an argument with her best friend. A thorough physical examination has not found a medical explanation for her symptoms, and the symptoms are not compatible with any known neurological or medical condition. The most likely diagnosis for Amy is:
Select one:
a. Conversion Disorder.
b. Somatic Symptom Disorder.
c. Body Dysmorphic Disorder.
d. Acute Stress Disorder.
Answer A is correct: Conversion Disorder involves one or more symptoms involving motor or sensory functioning that are incompatible with recognized neurological or medical conditions and cannot be better explained by a medical or other mental disorder.
Answer B is incorrect: The incompatibility of Amy's symptoms with any known medical or neurological conditions is more characteristic of Conversion Disorder than Somatic Symptom Disorder. In addition, no information is provided in the question indicating that Amy is having excessive thoughts and feelings about the symptoms, which is required for the diagnosis of Somatic Symptom Disorder.
Answer C is incorrect: Body Dysmorphic Disorder is characterized by a preoccupation with a defect or flaw in appearance that appears minor or is unobservable to others.
Answer D is incorrect: A diagnosis of Acute Stress Disorder requires exposure to actual or threatened death, severe injury, or sexual violation and at least nine symptoms from any one of five categories (intrusion, negative mood, dissociative symptoms, avoidance symptoms, arousal symptoms).
The correct answer is: Conversion Disorder.
44
According to Marlatt and Gordon (1985), relapse for an individual with an alcohol addiction is LEAST likely when:
Select one:
a. he or she is provided with an intervention that incorporates a 12-step program.
b. he or she is encouraged to view relapse as the result of external, controllable factors.
c. his or her denial is consistently and directly challenged.
d. he or she is in the "action" stage of change
Answer B is correct: Marlatt and Gordon's (1985) relapse prevention therapy focuses on identifying circumstances that increase the individual's risk for relapse and implementing strategies that will help him or her deal more effectively with those circumstances. According to Marlatt and Gordon, the potential for future relapse is reduced when the individual views lapses as resulting from specific, external, and controllable factors.
The correct answer is: he or she is encouraged to view relapse as the result of external, controllable factors.
45
A thiamine deficiency is associated with which of the following?
Select one:
a. Alcohol-Induced Major Neurocognitive Disorder.
b. Alcohol Withdrawal Delirium.
c. Alcohol Idiosyncratic Intoxication.
d. Alcohol-Induced Sleep Disorder.
Answer A is correct: Alcohol-Induced Major Neurocognitive Disorder is also known as Korsakoff Syndrome when its symptoms include anterograde and retrograde amnesia and confabulation. It is believed to be due to a thiamine deficiency.
The correct answer is: Alcohol-Induced Major Neurocognitive Disorder.
46
Moffitt (1993) attributes the adolescence-limited type of antisocial behavior to which of the following?
Select one:
a. a "psychopathic constitution"
b. observational learning
c. a "maturity gap"
d. neuropsychological impairment
Answer C is correct: Moffitt describes the adolescence-limited type of antisocial behavior as a temporary form of antisocial behavior that reflects a "maturity gap" between the adolescent's biological maturity and lack of opportunities for adult privileges and rewards.
Answer D is incorrect: Moffitt attributes the life-course persistent type of antisocial behavior to neuropsychological impairments (especially deficits in verbal and executive functions), a difficult temperament, and exposure to a criminogenic social environment.
The correct answer is: a "maturity gap"
47
Orgasmic reconditioning is used to treat which of the following?
Select one:
a. Erectile Disorder
b. Genito-Pelvic Pain or Penetration Disorder
c. Paraphilic Disorders
d. Gender Dysphoria
Answer C is correct: Orgasmic reconditioning is used to treat Paraphilic Disorders and involves redirecting sexual arousal to more acceptable sources of stimulation by having the individual replace an unacceptable sexual fantasy with a more acceptable one while masturbating.
The correct answer is: Paraphilic Disorders
48
Symptoms of __________ are similar to those associated with a moderate to severe case of the flu (e.g., muscle pain and cramps, diarrhea, chills, sneezing, lethargy).
Select one:
a. Opioid Intoxication
b. Opioid Withdrawal
c. Cocaine Intoxication
d. Cocaine Withdrawal
Answer B is correct: Symptoms of Opioid Withdrawal are uncomfortable but usually not life-threatening and are similar to those associated with a bad cold or the flu.
The correct answer is: Opioid Withdrawal
49
The research suggests that sex therapy is most effective for which of the following sexual dysfunctions?
Select one:
a. Male Erectile Disorder
b. Orgasmic Disorder
c. Hypoactive Sexual Desire Disorder
d. Premature Ejaculation
Answer D is correct: Most forms of sex therapy are based on the work of MASTERS & JOHNSON; and their research and research by others has found sex therapy to be most effective for Premature Ejaculation and Vaginismus (Genito-Pelvic Pain or Penetration Disorder in DSM-5).
The correct answer is: Premature Ejaculation
50
A patient whose corpus callous has been severed to control severe epilepsy is blindfolded. When a familiar object is placed in his left hand and he is asked to say its name, he is unable to do so. However, when an unfamiliar object is placed in his right hand, he is able to say its name. Which of the following terms describes this phenomenon?
a. pure Alexia
b. ideational apraxia
c. synesthesia
d. unilateral anomia
The correct answer is D.
a. pure alexia -- inability to read
b. ideational apraxia -- inability to carry out purposeful movements, despite ability to do so. Ideational apraxia -- inability to perform series of actions needed to perform a task (ex., making a sandwich, using a coffee maker).
c. synesthesia - stimulation of one sensory modality triggers an stimulation in another sensory modality (seeing blue when hearing the number 7).
d. unilateral (occurring on one side); anomia (inability to recall names of objects); this happens when the corpus callosum is severed.
51
Which of the following best describes the memory impairment associated with Mild Neurocognitive Disorder Due to Alzeimher's Disease?
a. Episodic, semantic, and procedural memory are adversely affected to the same degree.
b. Procedural memory is more adversely affected than episodic and semantic memory.
c. Episodic and semantic memory are more adversely affected than procedural memory.
d. Episodic and procedural memory are more adversely affected than semantic memory.
Answer C.
Mild Neurocog. Disorder is associated with greater impairment of declarative memory than procedural memory. *DECLARATIVE memory consists of EPISODIC and SEMANTIC MEMORY.
D(E+S) vs. Pro.
52
Mildred M, age 26, says she rarely experiences strong feelings, describes herself as a "loner," and says she doesn't really care what other people think of her. Based on these symptoms, the most likely diagnosis for Mildred is:
a. Avoidant Personality Disorder
b. Shizotypal Personality Disorder
c. Schizoid Personality Disorder
d. Borderline Personality Disorder
The Correct answer is C.
a. Avoidant (would like to have close relationships, but avoid them)
b. Schizotypal (may say they would like to have close relationships, but their behaviour shows otherwise; exhibit cog. distortions and eccentric behaviour
c. Schizoid (restricted range of emotional expression and detachment from relationships and not concerned with what others think of her)
d. borderline (history of unstable relationships)
53
Borderline Personality Disorder is most commonly diagnosed in individuals who are ages:
a. 19 - 34
b. 29 - 44
c. 39 - 54
d. 49 - 64
The Correct answer is A.
Rates are highest during young adult years.
54
Despite the extensive research on EMDR as a treatment for PTSD, it continues to be a controversial treatment. The best conclusion that can be drawn from the research is that EMDR:
a. is clearly less effective than Cognitive- Behavioural interventions that include exposure
b. seems to be effective only when it is applied within 24 hours after exposure to the traumatic event.
c. is effective, and eye movements are pivotal to its effectiveness
d. is effective, but the reason for its effectiveness remains unclear.
The Correct answer is D.
55
For the past four months, Samantha S., age 34, has insisted that she is pregnant and has several signs of pregnancy including abdominal distention, breast tenderness, menstrual irregularities, nausea, vomiting, and weight gain. However, pregnancy tests and an ultrasound have confirmed that she has done something to produce her symptoms. Based on the information, the appropriate DSM-5 diagnosis for Samantha is:
a. Facititious Disorder Imposed on Self
b. Somatic Symptom Disorder
c. Conversion Disorder
d. Other Specified Somatic Symptom and Related Disorder
The Correct answer is D.
False pregnancy - pseudocyesis (this qualifies for Other Specified Somatic Symptom and Related Disorder
a. Facititious Must be evidence of feigned or induced symptoms; associated with identified deception.
b. Somatic Symptom Disorder -- 1 or more somatic symptoms that interfere and cause excessive thoughts, feelings, behaviours related to symptoms
c. Conversion Disorder -- disturbance in motor functioning that suggest a serious neurological or medical condition (paralysis, blindness, etc.)
d. Symptoms don't meet the criteria for a specific diagnosis in this category.
56
The presence of which of the following is more suggestive of a DSM-5 diagnosis of Malingering than Factitious Disorder?
a. The motive for symptom production is to adopt the "sick role."
b. The motive for symptom production is "secondary gain."
c. The symptoms are physical rather than psychological in nature.
d. The symptoms are deliberately produced or feigned.
The Correct answer is B.
c. Both disorders can involve psychological or physical symptoms.
d. BOTH are deliberately produced or feigned. (e.g., "secondary gain" = benefit)
* Factitous - feign symptoms in the absence of an external reward
57
The distinction between Agoraphobia and Social Anxiety Disorder can be difficult because the two disorders share several characteristics. However, the presence of which of the following suggests that the correct diagnosis is Agoraphobia?
a. The person fears that he or she will exhibit embarrassing symptoms in certain social situations.
b. The person's symptoms do not include those associated with a panic attack.
c. The person is aware that his or her fears are excessive or unreasonable.
d. The person's anxiety in feared situations is alleviated when he or she is accompanied by a friend.
The Correct answer is D.
a. Characteristic of both. Agoraphobia (fear being able to get help); Soc. Anxiety Disorder (fear being judged).
b. Both may or may not include panic attacks.
c. Neither are required for either diagnosis.
d. This distinguishes agoraphobia from Social Anxiety Disorder.
58
Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder share which of the following?
a. repetitive rituals
b. anhedonia
c. prominent obsessions and/or compulsions
d. orderliness, perfectionism, and interpersonal control
The Correct answer is A.
a. Both involve rituals (OCD - to reduce anxiety); (OCPD - related to orderliness)
b. This is a negative symptom of Schizophrenia.
c. This is OCD.
d. This is OCPD.
59
Jenie J., age 15, is brought to therapy by her mother who says her daughter has recently become "a completely different person." She says Jenie used to be a good student and was easy to get along with and popular with her peers. But since the break-up with her boyfriend six weeks ago, Jenie has frequent "mood swings" that alternate between being very silly to being short-tempered and irritable. Jenie has also started sleeping only a couple of hours each night, is no longer talking to her best friend, and failed two exams at school. When you interview Jenie, you learn that she has started engaging in high-risk sexual behaviours with several boys but feels like "nothing bad" will ever happen to her. Based on these symptoms, the most likely diagnosis for Jenie is:
a. ADHD
b. Conduct Disorder
c. Bipolar I Disorder
d. Bipolar II Disorder
The Correct answer is C.
a. ADHD -- requires to onset of symptoms prior to age 12. She's 15 and her symptoms started a few weeks ago.
b. Conduct -- behaviour. that violates the rights of others. Symptoms for 6 weeks.
c. BP I (requires one manic episode) Her symptoms are more characteristic of mania rather than hypomania (having substantial negative impact on relationships and school).
d. BP II (requires combination of hypomanic and depressive episodes)
60
Your new client, Amanda A., age 16, is well-groomed, friendly, and cooperative. However, she shows some signs of depression and hopelessness, and she tell you that these symptoms have lasted for just over one year. Your provisional DSM-5 diagnosis is:
a. Cyclothymic Disorder
b. Persistent Depressive Disorder
c. Major Depressive Disorder
d. Bipolar II Disorder
The correct answer is B.
a. Cyclothymic D. (her symptoms don't include hypomania, therefore exclude this)
b. Persistent Depressive Disorder (symptoms = depression and hopelessness; duration 1 year)
c. Major Depressive Disorder (her symptoms are more mild and persistent)
d. BP II (requires hypomanic episode and one depressive episode)
61
If one of the children in a family develops Schizophrenia, what is the chance that a non-twin biological sibling of this child will also receive the diagnosis?
a. 1%
b. 10%
c. 25%
d. 45%
The correct answer is B.
1% is prevalence rate for Schizophrenia is the population.
62
Your new client is Robert R., age 22, who is brought to therapy by his mother. Robert's mother tells you that he recently lost his job at a bookstore because of bizarre comments he was making to customers and because of his increasingly sloppy appearance. During your interview with Robert, he often changes topics suddenly and sometimes requests the last few words of your questions. Robert tells you that voices in his head keep telling him that he can control other people with his thoughts. Assuming that Robert's symptoms began three months ago and that he had no previous history of similar symptoms, the most likely diagnosis is which of the following?
a. Schizophrenia
b. Delusional Disorder
c. Schizaffective Disorder
d. Schizophreniform Disorder
The correct answer is C.
a. Schizophrenia requires 6 month duration.
b. Delusional Disorder (1 or more delusions with none of the other symptoms associated with Schizophrenia)
c. Schizoaffective (requires combination of psychotic and moods symptoms with a period with at least 2 weeks without mood symptoms)
d. Schizophreniform (duration of 1-6 months)
63
A DSM-5 diagnosis of Intellectual Disability requires deficits in intellectual functioning that are confirmed by clinical assessment and performance on an individualized, standardized intelligence test. With regard to the latter, a deficit in intellectual functioning is suggested by a Wechsler or Stanford-Binet IQ score that is at least how many standard deviations below the population mean?
a. .5
b. 1.0
c. 2.0
d. 2.5
The correct answer is C.
64
Max, age 6, and his parents are referred to you by Max's pediatrician. Based on your interview with Max's parents, you determine that Max has had signs of overactivity and impulsivity since he was a toddler and that his behaviours at home are consistent with a diagnosis of ADHD, predominantly hyperactive impulsive presentation. To confirm this diagnosis, you would:
a. determine when Max's symptoms of hyperactivity and impulsivity began.
b. contact Max's teacher to discuss the nature of his behaviour at school.
c. have Max's pediatrician prescribe a stimulant drug for Max and observe his reactions to the drug.
d. determine if there is a family history of ADHD.
The correct answer is B.
* Two settings.
a. ADHD requires onset before age 12. This has been met.
b. Two settings
c. prescribing stimulant drugs is not a good tool.
d. not as useful as talking to his teachers.
65
Autism Spectrum Disorder is best described as being which of the following?
a. an idiopathic disorder
b. a psychosomatic disorder
c. a psychogenic disorder
d. a biogenic disorder
The correct answer is D.
a. idiopathic (unknown etiology); we have an idea about etiology of autism!
b. psychosomatic (physical symptoms due to psychological factors)
c. psychogenic is used interchangeably with psychosomatic
d. biogenic (due to biological factors)
66
A psychologist is using Linehan's dialectical behavior therapy to treat a patient with Borderline Personality Disorder. The essential components of her intervention will be:
Select one:
a. individual inpatient therapy and the token economy.
b. individual outpatient therapy and group skills training.
c. family therapy and psychotropic medication.
d. residential treatment and a self-help group.
Answer B is correct: Dialectical behavior therapy (DBT) includes three components - group skills training that focuses on the acquisition of social skills; individual outpatient therapy that targets motivational issues and the strengthening of social skills; and telephone consultations that help the client apply new skills to situations outside therapy. Other techniques may also be used, but these three make up the core of DBT.
The correct answer is: individual outpatient therapy and group skills training.
67
Early memory impairment associated with Neurocognitive Disorder due to Alzheimer's disease has been most consistently linked to a loss of neurons that secrete __________, especially in the hippocampus and certain areas of the cortex.
Select one:
a. GABA
b. norepinephrine
c. serotonin
d. acetylcholine
Answer D is correct: Although Neurocognitive Disorder due to Alzheimer's disease has been linked to several neurotransmitter abnormalities, a loss of cells that secrete acetylcholine (ACh) has been most consistently linked to early memory loss.
The correct answer is: acetylcholine
68
Early signs of Neurocognitive Disorder due to HIV infection are most likely to be:
Select one:
a. forgetfulness and impaired concentration.
b. focal neurological signs.
c. emotional over-reactivity and psychomotor agitation.
d. vertigo and tinnitus.
Answer A is correct: Early signs of Neurocognitive Disorder due to HIV infection include forgetfulness (e.g., difficulty keep track of daily activities), impaired concentration, impaired judgment, psychomotor slowing, and irritability.
Answer B is incorrect: Focal neurological signs are symptoms associated with damage to particular areas of the brain and are characteristic of Vascular Neurocognitive Disorder.
Answer C is incorrect: Emotional over-reactivity and psychomotor agitation are not symptoms associated with Neurocognitive Disorder due to HIV infection.
Answer D is incorrect: Vertigo and tinnitus are associated symptoms of Neurocognitive Disorder due to traumatic brain injury.
The correct answer is: forgetfulness and impaired concentration.
69
For a DSM-5 diagnosis of Delirium, a person must exhibit ___________ plus at least one other disturbance in cognition.
Select one:
a. an impairment in executive functioning
b. profound retrograde amnesia
c. aphasia or other language disorder
d. a disturbance in attention and awareness
Answer D is correct: A diagnosis of Delirium requires a disturbance in attention and awareness and at least one additional disturbance in cognition - e.g., impaired memory, disorientation, impaired language, deficits in visuospatial ability, or perceptual distortions.
The correct answer is: a disturbance in attention and awareness
70
For several years, a 26-year-old woman has exhibited cycles of overidealization and devaluation in interpersonal relationships, uncertainty about career plans, reckless driving, drug use, and frequent suicide attempts. The most likely diagnosis is:
Select one:
a. Histrionic Personality Disorder.
b. Borderline Personality Disorder.
c. Schizotypal Personality Disorder.
d. Narcissistic Personality Disorder.
Answer B is correct: The essential feature of Borderline Personality Disorder is a pervasive pattern of instability in interpersonal relationships, self-image, and affect and marked impulsivity.
Answer A is incorrect: Histrionic Personality Disorder is characterized by a pervasive pattern of emotionality and attention-seeking.
Answer C is incorrect: Schizotypal Personality Disorder is characterized by pervasive pattern of social and interpersonal deficits involving acute discomfort with and reduced capacity for close relationships and eccentricities in cognition, perception, and behavior.
Answer D is incorrect: Narcissistic Personality Disorder involves a pervasive pattern of grandiosity, a need for admiration, and a lack of empathy.
The correct answer is: Borderline Personality Disorder.
71
Magical thinking, depression, ideas of reference, paranoia, discomfort in social situations, and inappropriate affect are most characteristic of which of the following disorders?
Select one:
a. Schizoaffective Personality Disorder
b. Schizoid Personality Disorder
c. Schizotypal Personality Disorder
d. Borderline Personality Disorder
Answer C is correct: Schizotypal Personality Disorder is diagnosed in the presence of pervasive social and interpersonal deficits and eccentricities in cognition, perception, and behavior.
Answer A is incorrect: Schizoaffective Personality Disorder is not a DSM diagnosis.
Answer B is incorrect: Schizoid Personality Disorder involves a pervasive pattern of detachment from interpersonal relationships and a restricted range of emotional expression in social settings.
Answer D is incorrect: The essential features of Borderline Personality Disorder are a pervasive pattern of instability in interpersonal relationships, self-image, and affect and marked impulsivity
The correct answer is: Schizotypal Personality Disorder
72
The progression of Alzheimer's disease can be described in terms of three stages. A person in the second (middle) stage of the disease is most likely to exhibit:
Select one:
a. retrograde amnesia for recent long-term events, indifference or irritability, and anomia.
b. anterograde and retrograde amnesia, flat or labile mood, restlessness, and fluent aphasia.
c. anterograde amnesia, indifference or sadness, and urinary incontinence.
d. severely deteriorated intellectual functioning, apathy, and urinary and fecal incontinence.
Answer B is correct: The symptoms listed in this answer are characteristic of the second stage.
Answer A is incorrect: Indifference or irritability and anomia are more characteristic of the first stage.
Answer C is incorrect: Anterograde amnesia and indifference or sadness are characteristic of the first stage, and urinary incontinence is characteristic of the third stage.
Answer D is incorrect: Severely deteriorated intellectual functioning, apathy, and urinary and fecal incontinence are characteristic of the third stage.
The correct answer is: anterograde and retrograde amnesia, flat or labile mood, restlessness, and fluent aphasia.
73
Young adults who receive which of the following diagnoses are most likely to no longer meet the diagnostic criteria for the disorder when they reach middle-age?
Select one:
a. Schizotypal Personality Disorder
b. Paranoid Personality Disorder
c. Avoidant Personality Disorder
d. Antisocial Personality Disorder
Answer D is correct: Although Antisocial Personality Disorder is chronic, its symptoms usually become less evident and pervasive in adulthood beginning in middle-age.
The correct answer is: Antisocial Personality Disorder
74
The research suggests that, as a means of preventing the development of PTSD, single-session psychological debriefing (PD) immediately following exposure to a traumatic event:
Select one:
A. is effective only for individuals who have early signs of PTSD.
B. is an effective strategy when administered individually or in a group setting.
C. is more effective than multiple-session psychological debriefing.
D. is not effective when used alone and may actually increase the risk for PTSD.
Although single-session PD has been utilized as a prevention for PTSD following exposure to a traumatic event, the research has generally not supported its use for this purpose.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Based on their review of the research, Rose, Bisson, and Wessely (2001) conclude that single-session psychological debriefing is not effective for reducing the risk for PTSD when used alone and, for some individuals, may have negative effects. They recommend that PD be used cautiously and as part of a comprehensive treatment program.
The correct answer is: is not effective when used alone and may actually increase the risk for PTSD.
75
Which of the following is likely to be the most effective treatment for a client with Generalized Anxiety Disorder (GAD)?
Select one:
A. pharmacotherapy and insight-oriented psychotherapy
B. in vivo exposure with response prevention
C. covert sensitization, thought stopping, and relaxation training
D. relaxation training, worry exposure, and cognitive therapy
Multicomponent cognitive-behavioral therapy is usually the preferred treatment for GAD.
a. Incorrect Pharmacotherapy is usually necessary only for individuals whose anxiety results in significant impairment in daily functioning. In addition, insight-oriented therapy is not a treatment-of-choice for this disorder.
b. Incorrect Exposure therapy may be useful but is not as useful as a treatment that combines cognitive and behavioral techniques -- i.e., that combines exposure with cognitive strategies and other behavioral strategies.
c. Incorrect Covert sensitization is used to eliminate self-reinforcing behaviors such as substance abuse, gambling, and paraphilias and is not used to treat anxiety.
d. CORRECT Multimodal interventions that incorporate behavioral and cognitive strategies are generally most effective for clients with GAD. Of the answers given, this is the only one that includes both behavioral and cognitive techniques.
The correct answer is: relaxation training, worry exposure, and cognitive therapy
76
The primary feature that distinguishes Acute Stress Disorder from Posttraumatic Stress Disorder is:
Select one:
A. the shorter duration of symptoms in the former disorder.
B. a less severe precipitant in the former disorder.
C. reliving of the trauma in dreams or flashbacks in the latter disorder.
D. symptoms of increased arousal in the latter disorder.
The name of the disorder - Acute Stress Disorder - should have helped you identify the correct answer to this question.
a. CORRECT The symptoms of Acute Stress Disorder must have a duration no longer than one month. When symptoms last for more than one month and meet the criteria for PTSD, the diagnosis is changed to PTSD.
b. Incorrect Both disorders are precipitated by a very severe trauma.
c. Incorrect These are symptoms of both disorders.
d. Incorrect This is also characteristic of both disorders.
The correct answer is: the shorter duration of symptoms in the former disorder.
77
Orgasmic reconditioning is considered to be an effective treatment for which of the following disorders?
Select one:
A. Male Erectile Disorder
B. Orgasmic Disorder
C. Paraphilic Disorder
D. Gender Dysphoria
Answer C is correct: Orgasmic reconditioning is based on the assumption that orgasm reinforces sexual fantasies, and it is used to replace the stimuli that produce an orgasm. It is one of the techniques used to treat Paraphilic Disorders and involves having the individual replace an unacceptable sexual fantasy with a more acceptable one while masturbating.
The correct answer is: Paraphilic Disorder
78
One of the earliest signs of Alzheimer's disease is:
Select one:
A. impaired recent memory.
B. confabulation.
C. fluent aphasia.
D. gegenhalten.
Answer A is correct: Alzheimer's disease involves a relatively predictable progression of symptoms, with impairment of recent memory (anterograde amnesia) often being one of the first signs reported by relatives or clinical observers of patients with this disorder.
Answer B: Confabulation is associated with Korsakoff's syndrome and other memory disorders caused by damage to certain areas of the brain. It involves an inability to distinguish between actual memories and imagined or false memories and is not an early sign of Alzheimer's disease.
Answer C: Fluent aphasia is characteristic of the middle stage of Alzheimer's disease.
Answer D: Gegenhalten is a late symptom of some forms of dementia and involves irregular stiffening of the limbs.
The correct answer is: impaired recent memory.
79
An electrolyte imbalance is a possible complication of Bulimia Nervosa. The danger of this complication lies in the fact that it can lead to:
Select one:
A. cardiac arrhythmia and arrest.
B. blood dyscrasias.
C. permanent memory loss.
D. dehydration.
Of the conditions listed, only one is a consequence of an electrolyte imbalance.
a. CORRECT Electrolyte imbalances caused by vomiting and the use of laxatives and diuretics can have serious consequences, including, in extreme cases, cardiac arrhythmia and arrest.
b. Incorrect Blood dyscrasias are not caused by electrolyte imbalances.
c. Incorrect Permanent memory loss has not been linked to electrolyte imbalances.
d. Incorrect Dehydration is one of the causes (not consequences) of an electrolyte imbalance.
The correct answer is: cardiac arrhythmia and arrest.
80
Cataplexy:
Select one:
A. signals the end of a sleep attack.
B. involves maintaining the same body position over an extended period of time.
C. is accompanied by a simultaneous loss of consciousness.
D. is usually triggered by strong emotion.
Cataplexy is a symptom of Narcolepsy.
a. Incorrect Cataplexy occurs alone or at the onset of a sleep attack.
b. Incorrect This answer describes catalepsy (waxy flexibility), not cataplexy.
c. Incorrect This is the opposite of what is true. Full consciousness is preserved during an episode of cataplexy.
d. CORRECT In most cases, an episode of cataplexy is triggered by anger, surprise, laughter, or other strong emotion.
The correct answer is: is usually triggered by strong emotion.
81
If one of the offspring in a family develops Schizophrenia, what is the likelihood that his/her biological sibling will also develop this disorder?
Select one:
A. 0.02
B. 0.1
C. 0.25
D. 0.45
Answer B is correct: Although the reported concordance rates for Schizophrenia vary somewhat from study to study, 10% is most often reported in the literature for biological siblings.
Answers A, C, and D: See explanation for answer B.
The correct answer is: 0.1
82
Compared to adults experiencing nonpathological anxiety, an adult with Generalized Anxiety Disorder (GAD) is:
Select one:
A. likely to experience his/her worries as more difficult to control.
B. less likely to experience somatic symptoms.
C. more likely to experience his/her worries as ego-syntonic.
D. less likely to use drugs to reduce symptoms of anxiety.
Answer A is correct: GAD is characterized by excessive anxiety and worry about multiple events and activities. In contrast to individuals with nonpathological anxiety, those with GAD are more likely to report that they cannot control their worrying (e.g., cannot "put off" worrying until a later time).
Answer B: People with GAD are more likely to have somatic symptoms.
Answer C: People with GAD ordinarily don't experience their anxiety as ego-syntonic but, instead, experience their worrying as distressing.
Answer D: People with GAD often "self-medicate" to reduce their symptoms, and comorbid substance-related disorders are common.
The correct answer is: likely to experience his/her worries as more difficult to control.
83
A DSM-5 diagnosis of Disruptive Mood Dysregulation Disorder requires an onset of symptoms prior to ___ years of age.
Select one:
A. 6
B. 10
C. 16
D. 21
Answer B is correct: The diagnosis of Disruptive Mood Dysregulation Disorder cannot be assigned for the first time before the individual is six years of age or after he/she is 18 years of age, and the age of onset must be before age 10.
Answers A, C, and D: See explanation for answer B.
The correct answer is: 10
84
A diagnosis of Schizoaffective Disorder requires the presence of delusions and hallucinations for at least __________ without symptoms of a depressive or manic episode.
Select one:
A. one week
B. two weeks
C. one month
D. two months
Answer B is correct: As its name suggests, Schizoaffective Disorder is characterized by concurrent psychotic and mood symptoms. However, for the diagnosis, the individual must have experienced a period of at least two weeks without prominent mood symptoms.
Answers A, C, and D: See explanation for answer B.
The correct answer is: two weeks
85
Research suggests that which of the following has been found to be the strongest predictor of Intellectual Disability with an unknown etiology?
Select one:
A. maternal health
B. female gender
C. low birth weight
D. large family size
Answer C is correct: Croen et al. (2001) studied individual and family characteristics of children with a mild or severe Intellectual Disability that had an unknown etiology and found low birth weight to be the strongest predictor of both levels of disability.
Answers A, B, and D: See explanation for answer C.
The correct answer is: low birth weight
86
A 35-year old client has a history of relationship problems. Although he usually makes a good first impression, his friendships don't last very long. He attributes this problem to the fact that other people are jealous of what he has accomplished. The client has a great idea that will "revolutionize the field of telemarketing," but, so far, no one has recognized the potential importance of his contribution. He left his wife six months ago and spends very little time with his two-year old son. He has been busy "doing what he wants to do," which has included moving into an expensive condominium, buying a new sports car, and dating as many attractive women as possible. These characteristics are most suggestive of:
Select one:
A. Histrionic Personality Disorder.
B. Narcissistic Personality Disorder.
C. Schizotypal Personality Disorder.
D. Delusional Disorder, grandiose type.
The man's primary symptoms are grandiosity and lack of empathy.
a. Incorrect A diagnosis of Histrionic Personality Disorder requires a pattern of excessive emotionality and attention-seeking.
b. CORRECT These are core features of Narcissistic Personality Disorder.
c. Incorrect A diagnosis of Schizotypal Personality Disorder requires the presence of pervasive social and interpersonal deficits and eccentricities in cognition, perception, and behavior.
d. Incorrect A diagnosis of Delusional Disorder is made in the presence of one or more non bizarre delusions with unimpaired functioning apart from the impact of the delusions.
The correct answer is: Narcissistic Personality Disorder.
87
Many individuals with Major Depressive Disorder have EEG abnormalities during sleep that include which of the following?
Select one:
A. decreased REM latency
B. increased slow-wave sleep
C. reduced duration of REM sleep early in the sleep period
D. decreased REM density
Answer A is correct: EEG abnormalities during sleep are experienced by 40 to 60% of outpatients experiencing a major depressive episode (APA, 2000) and include decreased REM latency (i.e., an earlier onset of REM sleep).
Answers B, C, and D: These answers describe the opposite of what is true - i.e., people with Major Depressive Disorder often experience decreased slow-wave sleep, increased duration of REM sleep early in the sleep period, and increased REM density (increased frequency of rapid eye movements during REM sleep).
The correct answer is: decreased REM latency
88
Edgar E., age 24, told his family that he is gay two months ago, and, since then, his father has refused to talk to him. Also, six weeks ago, a man Edgar recently became involved with told him he will soon be moving to another state. Edgar says that, since these events occurred, he's been feeling depressed and hasn't been able to sleep well and is having trouble concentrating at work. Edgar also states that he hasn't felt like spending time with his friends and has been staying home alone much more than usual lately. Based on these symptoms, the most likely diagnosis for Edgar is:
Select one:
A. Adjustment Disorder.
B. Persistent Depressive Disorder.
C. PTSD.
D. Acute Stress Disorder.
Answer A is correct: The information presented in the question suggests that Edgar's symptoms are the result of two specific stressors: his father's rejection and the loss of his friend/lover. Adjustment Disorder is diagnosed when a person's symptoms are a reaction to an identifiable psychosocial stressor; when symptoms have persisted for no more than six months since the termination of the stressor or its consequences; and when the symptoms are interfering with the person's occupational and/or social functioning or are in excess of what might be expected.
Answer B: In adults, a diagnosis of Persistent Depressive Disorder requires a duration of symptoms of at least two years.
Answer C: Post-Traumatic Stress Disorder (PTSD) involves the development of specific symptoms (e.g., re-experiencing of the trauma, avoidance of stimuli associated with the trauma, and increased arousal) following exposure to a trauma that involves experiencing or witnessing threatened or actual death, severe injury, or sexual violence. Edgar's situation and symptoms are not characteristic of PTSD.
Answer D: The symptoms of Acute Stress Disorder are similar to those of PTSD but are of shorter duration.
The correct answer is: Adjustment Disorder.
89
Which of the following is NOT included in the DSM-5 as a symptom of Substance Use Disorder?
Select one:
A. persistent desire or unsuccessful efforts to cut down on substance use
B. a strong desire (craving) for the substance
C. tolerance for the substance
D. recurrent legal problems related to substance use
Answer D is correct: Recurrent legal problems is not identified as a symptom of Substance Use Disorder in the DSM-5.
Answers A, B, and C: Persistent desire or unsuccessful efforts to cut down on substance use, a strong desire (craving) for the substance, and tolerance for the substance are all included as symptoms of Substance Use Disorder in the DSM-5.
The correct answer is: recurrent legal problems related to substance use
90
Which of the following is an example of a delusion of reference?
Select one:
A. A 30-year old woman thinks that a weekly radio program is being broadcast directly to her.
B. A 45-year old man thinks that he is being conspired against by a group of co-workers.
C. A 22-year old woman thinks that her thoughts are being controlled by aliens.
D. A 28-year old man believes that just thinking about his mother's death will actually cause her to die.
Answer A is correct: A person is experiencing a delusion of reference when he/she believes that events, objects or other people in the immediate environment have unusual or particular significance for him or her.
Answer B: This is a persecutory delusion.
Answer C: This is an example of a delusion of being controlled.
Answer D: This is an example of magical thinking.
The correct answer is: A 30-year old woman thinks that a weekly radio program is being broadcast directly to her.
91
Dissociative Amnesia most commonly involves:
Select one:
A. short-term memory loss.
B. retrospective gaps in memory.
C. widespread retrograde and anterograde amnesia.
D. a period of unconsciousness.
Dissociative Amnesia is characterized by an inability to recall important personal information that is often related to a traumatic event.
a. Incorrect Short-term memory is usually not affected in Dissociative Amnesia.
b. CORRECT Dissociative Amnesia involves gaps in the recall of aspects of the individual's past, often aspects related to a traumatic event or severe stressor.
c. Incorrect Memory loss is most often related to a traumatic event and does not usually entail widespread retrograde and anterograde amnesia.
d. Incorrect A period of unconsciousness is not characteristic of this disorder.
The correct answer is: retrospective gaps in memory.
92
Dysphoria, vivid and frightening dreams, insomnia or hypersomnia, fatigue, psychomotor agitation or retardation, and increased appetite are most suggestive of __________ Withdrawal.
Select one:
A. Stimulant
B. Phencyclidine
C. Tobacco
D. Opioid
Answer A is correct: The symptoms presented in this question are most suggestive of Stimulant Withdrawal.
Answer B: Phencyclidine use is not associated with a withdrawal syndrome.
Answer C: Tobacco Withdrawal involves a dysphoric mood, increased appetite, and insomnia, but its other characteristic symptoms are irritability, anxiety, impaired concentration, and restlessness.
Answer D: Opioid Withdrawal also involves a dysphoric mood, but its other symptoms include nausea and vomiting, muscle aches, diarrhea, and fever.
The correct answer is: Stimulant
93
For children with a learning disorder, the most frequent co-diagnosis is ADHD, with approximately _____% of children with a learning disorder also receiving the latter diagnosis.
Select one:
A. 5 to 10
B. 20 to 30
C. 45 to 50
D. 65 to 75
Children with a learning disorder often have a co-diagnosis of ADHD, Tourette's Disorder, and/or a mood disorder.
a. Incorrect See explanation for response b.
b. CORRECT The studies have found that the most common co-diagnosis is ADHD, with about 20 to 30% of children with a learning disorder also receiving a diagnosis of ADHD.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: 20 to 30
94
A mother complains that she is afraid to let her 8-month old child out of his crib because, when he is allowed to crawl, he eats dirt and bugs off the floor even if he has just completed a normal meal. The child's symptoms are suggestive of the which of the following DSM diagnoses?
Select one:
A. Pica
B. Bulimia Nervosa
C. Rumination Disorder
D. Anorexia Nervosa
The symptoms given in this question are suggestive of only one of several eating disorders included in the DSM.
a. CORRECT The essential feature of Pica is the persistent eating of non-nutritive substances (e.g., paint, dirt, insects).
b. Incorrect Bulimia involves episodic binge eating followed by induced vomiting, the use of laxatives or diuretics, and/or excessive exercising.
c. Incorrect Rumination disorder involves repeated regurgitation and rechewing of food.
d. Incorrect Anorexia may involve the eating of non-nutritive substances but for the purpose of weight control.
The correct answer is: Pica
95
A cognitive therapist is treating a 20-year old woman who has received a diagnosis of Anorexia Nervosa. The therapist's first priority will be to give the woman graded task assignments designed to increase her food intake. Another initial intervention will be to:
Select one:
A. foster the woman's doubt about her belief that she is accomplishing something by staying thin.
B. challenge or refute the woman's belief that she is "too fat" and that eating will make her obese.
C. educate the woman about the underlying meaning of her attitudes and behaviors.
D. identify ways in which family members are reinforcing the woman's eating behaviors.
Approaches to treating Anorexia vary, even among cognitive therapists. However, by definition, cognitive therapy entails addressing the cognitions that underlie or support a disorder.
a. CORRECT Of the strategies given in the answers, this one is most similar to Garner and Bemis's (1982) approach, which is based on Beck's cognitive therapy. According to Garner and Bemis, an initial step in treatment is to foster doubt in the client about his or her assumption that it is worth the time and effort to deny one's appetite in order to stay thin. This is followed by addressing the validity of the client's beliefs regarding the consequences of becoming fat and the conviction that thinness is a primary determinant of self-worth and personal value.
b. Incorrect This is not totally inconsistent with a cognitive approach but is not the best answer since most cognitive therapists would not "challenge" a client's beliefs, especially at the outset of therapy. (Garner and Bemis emphasize fostering doubt rather than challenging or refuting the client's beliefs.)
c. Incorrect This approach isn't consistent with cognitive therapy.
d. Incorrect This approach isn't characteristic of cognitive therapy.
The correct answer is: foster the woman's doubt about her belief that she is accomplishing something by staying thin.
96
A woman believes that advertisements on television contain personal messages to her from her ex-husband who is currently living in another country. Assuming that the woman meets the diagnostic criteria for Delusional Disorder, which subtype best fits the nature of her delusion?
Select one:
A. erotomanic
B. grandiose
C. persecutory
D. unspecified
The woman's delusion is a delusion of reference.
a. Incorrect An erotomanic delusion is the belief that another person, usually of higher status, is in love with the individual.
b. Incorrect A grandiose delusion reflects an inflated sense of worth, power, knowledge, etc.
c. Incorrect Persecutory delusions involve a belief that one is being attacked, harassed, persecuted, etc.
d. CORRECT No specific subtype of Delusional Disorder is provided in the DSM for delusions of reference, and a person with this kind of delusion would be assigned the unspecified subtype.
The correct answer is: unspecified
97
In adults, Obsessive-Compulsive Disorder is:
Select one:
A. about equally common in males and females.
B. more common in males than in females.
C. about twice as common in females than in males.
D. about three times as common in females as in males.
The gender ratio for Obsessive-Compulsive Disorder is related to age.
a. CORRECT In adults, the gender ratio for this disorder is about equal. However, in children, it is more common in boys than in girls because the average age of onset is earlier for males than for females.
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: about equally common in males and females.
98
Alan A., age 10, and his parents are referred to you by Alan's pediatrician. Based on your interview with Alan's parents, you determine that the boy's behavior at home is consistent with a diagnosis Attention-Deficit/Hyperactivity Disorder (ADHD). To confirm this diagnosis, you would most likely:
Select one:
A. administer standardized IQ and achievement tests to Alan to determine if there are significant discrepancies in scores.
B. contact Alan's teacher to discuss the nature of his behavior at school.
C. have Alans pediatrician prescribe a CNS stimulant for Alan and observe his reactions to the drug.
D. determine if there is a family history of ADHD.
The diagnosis of ADHD requires the presence of symptoms of inattention and/or hyperactivity-impulsivity in at least two settings.
a. Incorrect This would be useful for confirming a diagnosis of a learning disorder.
b. CORRECT As noted above, the diagnosis of ADHD requires the presence of symptoms in two or more settings. Talking to Alan's teacher would determine if he exhibits signs of this disorder at school.
c. Incorrect The use of drugs as a diagnostic tool is not a good strategy. Because stimulants can have adverse side effects, they should be avoided until the diagnosis is certain. In addition, they have similar effects on individuals who do not have ADHD and, therefore, a positive response would not necessarily confirm the diagnosis.
d. Incorrect A family history would not be as useful for confirming the diagnosis as talking to Alan's teacher.
The correct answer is: contact Alan's teacher to discuss the nature of his behavior at school.
99
Which of the following drugs is most likely to be effective for alleviating the symptoms of Obsessive-Compulsive Disorder?
Select one:
A. a drug that blocks serotonin reuptake
B. a drug that blocks beta receptors
C. a drug that reduces activity at dopamine receptors
D. a drug that decreases norepinephrine and serotonin levels
Answer A is correct: Antidepressant drugs that block the reuptake of serotonin have been found effective for temporary relief of the symptoms of OCD. Since symptoms usually return when the drug is stopped, however, these drugs are rarely used alone.
Answers B, C, and D: See explanation for answer A.
The correct answer is: a drug that blocks serotonin reuptake
100
Lead poisoning, toxoplasmosis, and toxocara are possible complications of which of the following disorders?
Select one:
A. Tourette's Disorder
B. Pica
C. Rumination Disorder
D. Bulimia Nervosa
Of the disorders listed, only one is associated with the complications listed in this question.
a. Incorrect The primary features of Tourette's Disorder are multiple motor tics and one or more vocal tics.
b. CORRECT Pica involves a persistent consumption of a nonnutritive substance. Lead poisoning can result when the substance is paint; toxoplasmosis or toxocara can result when the substance is feces or dirt.
c. Incorrect Rumination Disorder involves repeated regurgitation and rechewing of food.
d. Incorrect Bulimia Nervosa is characterized by frequent episodes of binge eating and inappropriate compensatory behavior to avoid weight gain.
The correct answer is: Pica
101
A DSM diagnosis of Bipolar II Disorder requires the presence or history of:
Select one:
A. at least one major depressive episode and one hypomanic episode.
B. at least one major depressive episode and one mixed episode.
C. two or more mixed episodes without a manic, hypomanic, or major depressive episode.
D. two or more hypomanic episodes.
For the exam, you want to be familiar with the diagnostic criteria for both Bipolar Disorders.
a. CORRECT The diagnosis of Bipolar II Disorder requires the presence or history of major depressive and hypomanic episodes.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: at least one major depressive episode and one hypomanic episode.
102
Korsakoff syndrome has been attributed to which of the following?
Select one:
A. lead poisoning
B. carbon monoxide
C. antipsychotic drugs
D. thiamine deficiency
Answer D is correct: Korsakoff syndrome is associated with long-term alcohol use and is believed to be the result of poor nutrition. It's very likely that you'll encounter a question on its characteristics or etiology on the licensing exam and you'll want to be familiar with the information presented on this disorder in the Abnormal Psychology and Physiological Psychology chapters of the written study materials. Korsakoff syndrome is included in the DSM-5 as Alcohol-Induced Major Neurocognitive Disorder and involves disorientation, memory loss, and confabulation.
The correct answer is: thiamine deficiency
103
The research has shown that, when Generalized Anxiety Disorder (GAD) is comorbid with other psychiatric disorders, symptoms tend to be more severe and outcomes are often worse. The studies have also found that about _____ percent of people with GAD have a comorbid psychiatric disorder.
Select one:
A. 20 to 30
B. 40 to 50
C. 60 to 70
D. 80 to 90
Answer D is correct: GAD is highly comorbid with other psychiatric disorders, with studies reporting comorbidity rates ranging from about 80 to 90%. The National Comorbidity Study Replication (NCS-R), for example, found a comorbidity rate of 85% (Kessler et al., 2005).
Answers A, B, and C: See explanation for answer D.
The correct answer is: 80 to 90
104
Longitudinal studies have found that the symptoms of Borderline Personality Disorder tend to be most severe during the:
Select one:
A. early adolescent years.
B. early adult years.
C. middle adult years.
D. later adult years.
The research has shown that the severity of the symptoms of Borderline Personality Disorder (BPD) is related to age.
a. Incorrect See explanation for response b.
b. CORRECT Longitudinal research has shown that the symptoms of BPD are ordinarily most severe during the early adulthood years, although most individuals with this disorder continue to have some degree of impairment throughout their lives.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: early adult years.
105
```
Ella E. age 10, often says she doesn't want to go to school because she's afraid some of the children in her class will be "mean" to her. She seems overly concerned about her ability to perform well at school and in social situations and has trouble finishing her homework and other tasks because she keeps re-doing them because she wants them to be "perfect." Ella frequently says she has a headache and has trouble falling asleep at night. Her mother tries to keep Ella from watching the news because she's unwilling to go out of the house whenever there's a story about a local murder or accident. Based on these symptoms, the best diagnosis for Ella is:
Select one:
```
A. Separation Anxiety Disorder.
B. Agoraphobia.
C. Generalized Anxiety Disorder.
D. Specific Phobia.
This child is expressing excessive worry about multiple situations.
a. Incorrect A diagnosis of Separation Anxiety Disorder requires evidence of excessive anxiety concerning separation from those to whom the child is attached. This evidence is not provided in the description given in this question.
b. Incorrect The question does not indicate that the child has a fear of being in places where escape might be difficult or embarrassing or where help might not be available if panic-like symptoms develop, which are the essential features of Agoraphobia.
c. CORRECT Generalized Anxiety Disorder involves excessive worry or anxiety about a number of events or activities that the person finds difficult to control. Children with this disorder are often perfectionistic, filled with self-doubt, and typically exhibit physical signs of anxiety (e.g., headaches, stomachaches).
d. Incorrect Specific Phobia is characterized by a marked and persistent fear of a specific object or situation. The child's fears in this case are broader than this and, therefore, Generalized Anxiety Disorder is the better diagnosis.
The correct answer is: Generalized Anxiety Disorder.
106
A drug that reduces the effects of dopamine would have which effect on the symptoms of Schizophrenia?
Select one:
A. exacerbate symptoms
B. decrease or eliminate symptoms
C. have no effect on symptoms
D. affect negative symptoms only
According to the dopamine hypothesis, Schizophrenia is due to excessive dopamine or oversensitivity to dopamine. Consequently, drugs that reduce the effects of dopamine will decrease the symptoms of this disorder.
a. Incorrect This is the opposite of what is true.
b. CORRECT The traditional antipsychotic drugs exert beneficial effects by blocking the effects of dopamine.
c. Incorrect See explanation for response b.
d. Incorrect The traditional antipsychotics tend to have a greater impact on the positive symptoms than on the negative symptoms of Schizophrenia.
The correct answer is: decrease or eliminate symptoms
107
Dawn D. has recently received a diagnosis of Obsessive-Compulsive Personality Disorder. Most likely, her symptoms include:
Select one:
A. feeling helpless and distressed when she is alone.
B. being overly concerned about adhering to rules and schedules.
C. experiencing uncontrollable, recurrent thoughts and images.
D. being preoccupied with concerns about being blamed or criticized by others.
Obsessive-Compulsive Personality Disorder is characterized by a persistent preoccupation with orderliness, perfectionism, and control.
a. Incorrect These symptoms are characteristic of Dependent Personality Disorder.
b. CORRECT The symptoms described in this answer are consistent with a diagnosis of Obsessive-Compulsive Personality Disorder.
c. Incorrect These are symptoms of Obsessive-Compulsive Disorder (OCD), not Obsessive-Compulsive Personality Disorder.
d. Incorrect These symptoms are characteristic of Avoidant Personality Disorder.
The correct answer is: being overly concerned about adhering to rules and schedules.
108
During her first session with Dr. Hank Horvat, Stephanie S. tells him that she experiences severe anxiety whenever she's in an elevator or other enclosed space because she's afraid she won't be able to escape or get help if she develops a panic attack. Which of the following would help confirm a DSM-5 diagnosis of Agoraphobia for Stephanie?
Select one:
A. She tells Dr. Horvat that she also experiences severe anxiety when using public transportation which has restricted her ability to visit friends and family members who don't live in her neighborhood.
B. She tells Dr. Horvat that her panic attacks make her feel like shes having a heart attack but that her physician has reassured her that she has a healthy heart.
C. She tells Dr. Horvat that her fear of elevators began after a crowded elevator she was in was stuck between floors for over one hour.
D. She tells Dr. Horvat that she often experiences panic attacks at unexpected times and in unexpected places.
Answer A is correct: The DSM-5 diagnosis of Agoraphobia requires that the individual experiences marked fear or anxiety in at least two of the following situations: using public transportation, being in open spaces, being in enclosed spaces, standing in line or being part of a crowd, and being outside the home alone. In addition, the individual MUST FEAR OR AVOID THESE SITUATIONS DUE TO A CONCERN THAT ESCAPE MIGHT BE DIFFICULT OR HELP WILL BE UNAVAILABLE in case he or she develops panic-like, incapacitating, or embarrassing symptoms.
Answer B: Concern about panic attacks or their consequences (e.g., concern that symptoms are due to a heart attack) is characteristic of Panic Disorder and is not required for a diagnosis of Agoraphobia.
Answer C: When a person's fear of a situation is due to a concern about something other than an inability to escape or obtain help in case of panic-like symptoms (e.g., is due to an unpleasant experience in that situation), the likely diagnosis is Specific Phobia, situational type.
Answer D: Unexpected panic attacks are required for a diagnosis of Panic Disorder.
The correct answer is: She tells Dr. Horvat that she also experiences severe anxiety when using public transportation which has restricted her ability to visit friends and family members who don't live in her neighborhood.
109
The presence of which of the following is more suggestive of a diagnosis of Malingering than of Factitious Disorder?
Select one:
A. The motive for symptom production is to obtain an external reward.
B. The motive for symptom production is "primary gain."
C. Symptoms are relieved by hypnosis.
D. Symptoms are intentionally produced.
Answer A is correct: The motivation underlying the production of symptoms in Malingering is to obtain an external reward (e.g., to obtain a drug or avoid a specific activity). In Factitious Disorder, symptoms are produced or faked even in the absence of an external reward for doing so.
Answer B: Primary gain has not been linked to either disorder.
Answer C: The symptoms of Malingering are not relieved by hypnosis.
Answer D: Symptoms are intentionally produced in both disorders, so this symptom would not be useful for distinguishing between them.
The correct answer is: The motive for symptom production is to obtain an external reward.
110
As a treatment for insomnia and other sleep problems, sleep hygiene education focuses on __________ that may be interfering with sleep.
Select one:
A. health and environmental factors
B. dysfunctional cognitions
C. emotional factors
D. recent life events
Answer A is correct: Sleep hygiene education focuses on diet, substance use, exercise, and other health practices and light, temperature, noise, and other environmental factors that may interfere with sleep. Sleep hygiene education is usually combined with other interventions such as stimulus control, relaxation training, and cognitive strategies that focus on attitudes and beliefs that are contributing to sleep problems.
Answers B, C, and D: See explanation for answer A.
The correct answer is: health and environmental factors
111
Habit reversal is most likely to be used as a treatment for:
Select one:
A. alcohol addiction.
B. Pica.
C. stuttering.
D. frotteurism.
Answer C is correct: Habit reversal combines three strategies - awareness training, regulated breathing, and social support. It is used to treat stuttering, tics, and nervous habits but not the other disorders listed in the answers.
Answers A, B, and D: See explanation for answer C.
The correct answer is: stuttering.
112
In children, Generalized Anxiety Disorder (GAD) most often entails excessive worry about:
Select one:
A. family relationships.
B. illness or injury.
C. school or sports performance.
D. ghosts and other supernatural beings.
Answer C is correct: There are some age-related differences in the symptoms of Generalized Anxiety Disorder. Children with GAD most commonly worry about school and sports performance or natural disasters and other catastrophic events.
Answer A: Worry about family relationships is more common among adults with GAD.
Answer B: Illness and injury are also more common sources of worry among adults with this disorder.
Answer D: Ghosts and other supernatural beings have not been identified as a common cause of worry for children with GAD.
The correct answer is: school or sports performance.
113
Moffitt (1993) attributes the adolescent-limited type of Conduct Disorder to which of the following?
Select one:
A. a maturity gap
B. coercive family interactions
C. a difficult temperament
D. adolescent egocentrism
Moffitt (1993) distinguishes between two types of Conduct Disorder - life-course persistent and adolescent-limited.
a. CORRECT Moffitt describes the adolescent-limited type of Conduct Disorder as a temporary form of antisocial behavior that reflects a "maturity gap" between the adolescent's biological maturity and lack of opportunities for adult privileges and rewards.
b. Incorrect Patterson (1992) uses a coercive family interaction model to explain aggressive behaviors in children.
c. Incorrect Moffitt attributes the life-course persistent type of Conduct Disorder to neurological impairment, a difficult temperament, and certain adverse environmental circumstances.
d. Incorrect Elkind (1984) attributes certain behaviors of adolescents (e.g., the belief that one is unique and not subject to natural laws that govern others) to adolescent egocentrism.
The correct answer is: a maturity gap
114
Compared to children and adolescents in the general population, children and adolescents with a learning disorder have:
Select one:
A. a lower rate of psychopathology.
B. a higher rate of psychopathology.
C. the same rate of psychopathology.
D. the same rate of psychopathology but more severe symptoms.
Answer B is correct: Although the specific diagnoses that commonly co-occur with a learning disorder are relatively limited in number, the rates of these diagnoses are higher than the rates in the general population. For example, the prevalence rate for ADHD is 3 to 5% in the general population but between 20 and 25% for children with a learning disorder.
Answers A, C, and D: See explanation for answer B.
The correct answer is: a higher rate of psychopathology.
115
Which of the following would be most useful for monitoring the progression of Alzheimer's disease?
Select one:
A. structured interviews with family members
B. cognitive tests
C. CT scans
D. a self-report personality test
Answer B is correct: A number of techniques are used to track the progression of Alzheimer's disease and probably the best answer to this question would be "all of the above." Unfortunately, you're not given that choice. However, since the core features of Alzheimer's disease are disturbances in memory and other cognitive functions, the best way to follow its progression is with repeated measurement of cognitive abilities. Note that many of the newer techniques for assessing patients with this disorder incorporate other modes of assessment in addition to cognitive tests (e.g., interviews with family members, direct observations of the patient's behavior).
Answers A, C, and D: See explanation for answer B.
The correct answer is: cognitive tests
116
Washing and/or cleaning rituals associated with Obsessive-Compulsive Disorder (OCD) would probably be best treated with:
Select one:
A. thought stopping and desensitization.
B. exposure and satiation/habituation.
C. exposure with response prevention.
D. overcorrection.
Note that this question is asking about the treatment of compulsions, not obsessions.
a. Incorrect Thought stopping is useful for obsessions but is less useful than exposure with response prevention for compulsive behavior.
b. Incorrect Exposure and satiation are sometimes used with thought stopping to reduce obsessions.
c. CORRECT Exposure with response prevention is the treatment-of-choice for compulsions. It is often combined with participant modeling and/or pharmacotherapy.
d. Incorrect Overcorrection is not used in the treatment of OCD.
The correct answer is: exposure with response prevention.
117
Hypofrontality in individuals with Schizophrenia has been linked to which of the following?
Select one:
A. negative symptoms
B. hallucinations and delusions
C. high expressed emotion
D. somatic concerns
Answer A is correct: Some brain imaging studies have linked hypofrontality (decreased activity in the prefrontal cortex) to the negative symptoms of Schizophrenia and suggest that this link is most likely to be found in patients with chronic Schizophrenia.
Answer B: Hallucinations and delusions are positive symptoms and have not been linked to hypofrontality.
Answer C: A high level of expressed emotion by family members has been linked to an increased risk for relapse for patients with Schizophrenia.
Answer D: Hypofrontality has not been linked to concerns about digestion, elimination, and other somatic processes.
The correct answer is: negative symptoms
118
The assessment of patients with Alzheimer's disease is an ongoing process due to its degenerative nature and the consequent need to alter the treatment plan. During the fourth or fifth year of the disease, an assessment is most likely to reveal:
Select one:
A. deficits in new learning, mild to moderate impairment in remote memory, anomia, and sadness.
B. severe impairments in recent and remote memory, fluent aphasia, indifference or irritability, and restlessness.
C. severe impairments in memory and executive functioning, motor rigidity, confusion, and delusions.
D. severely impaired intellectual functioning, incontinence, apathy, and seizures.
Alzheimer's disease is a degenerative disease with symptoms that become progressively worse over time.
a. Incorrect These symptoms are more common during the first two to three years of the disorder.
b. CORRECT These are characteristic symptoms during the 3rd through 10th years.
c. Incorrect These are late-stage symptoms (8 to 12 years).
d. Incorrect Severely impaired intellectual functioning, limb rigidity, and apathy are also later symptoms; and seizures are not necessarily associated with this disorder.
The correct answer is: severe impairments in recent and remote memory, fluent aphasia, indifference or irritability, and restlessness.
119
Narcissistic, Borderline, and Histrionic Personality Disorders share in common which of the following characteristics?
Select one:
A. irresponsibility and impulsivity
B. affective instability
C. recurrent suicidal threats
D. a grandiose sense of self
Knowing that the three Personality Disorders listed in the question all involve dramatic, emotional, and/or erratic behaviors would have helped you identify the correct answer to this question. For the exam, you want to be familiar with the major characteristics of the Personality Disorders so that you can answer questions like this one.
a. Incorrect Impulsivity is characteristic of Borderline Personality Disorder only.
b. CORRECT Affective instability is a characteristic shared by all three disorders.
c. Incorrect This is characteristic of Borderline Personality Disorder only.
d. Incorrect This describes Narcissistic Personality Disorder but not the other two disorders (although both do involve disturbances in sense of self).
The correct answer is: affective instability
120
When deciding on an intervention plan for a client with Agoraphobia, it is important to keep in mind that which of the following seems to be the key element in treating this disorder?
Select one:
A. counterconditioning
B. progressive relaxation
C. in vivo exposure
D. cognitive restructuring
Most of the research on Agoraphobia and other phobic disorders has found the behavioral and cognitive-behavioral techniques to be most effective. However, the specific technique that is most effective depends on the exact nature of the disorder.
a. Incorrect Counterconditioning underlies systematic desensitization, which has not been identified as an effective treatment for Agoraphobia.
b. Incorrect Although relaxation might be a useful adjunct to in vivo exposure, it is not an effective treatment when used alone.
c. CORRECT In vivo exposure with response prevention has been consistently found to be an effective intervention for Agoraphobia.
d. Incorrect Cognitive restructuring has not been found to be particularly effective for Agoraphobia.
The correct answer is: in vivo exposure
121
The diagnosis of Adjustment Disorder requires the development of symptoms within ___ month(s) of the onset of the stressor.
Select one:
A. one
B. three
C. six
D. nine
Answer B is correct: The DSM requires that symptoms develop within three months of the onset of the stressor and that symptoms do not persist for more than six months after the stressor or its consequences have ended.
Answers A, C, and D: See explanation for answer B.
The correct answer is: three
122
For most age groups, the suicide rate is highest for Whites. However, for individuals ages 15 to 34, the highest rate in recent years has been for:
Select one:
A. Latino/Hispanic Americans.
B. Asian Americans.
C. African Americans.
D. American Indians/Alaskan Natives.
Answer D is correct: For individuals 15 to 34 years of age, the CDC (2012) has reported a suicide rate for American Indians/Alaskan Natives that is higher than the rate for Whites and 2.5 times higher than the national average.
Answers A, B, and C: See explanation for answer D.
The correct answer is: American Indians/Alaskan Natives.
123
A person with Tourette's Disorder is most likely to have:
Select one:
A. orthopedic problems.
B. a learning disorder.
C. obsessive-compulsive symptoms.
D. a lower-than-average IQ.
For the exam, you want to be familiar with the common associated features of Tourette's Disorder, which are described in the Abnormal Psychology chapter of the written study materials.
a. Incorrect Orthopedic problems are not a common associated condition of Tourette's Disorder.
b. Incorrect Although academic performance is often impaired, an actual learning disorder is less common than are obsessive-compulsive symptoms.
c. CORRECT According to the DSM, obsessions and compulsions are the most common associated symptoms of Tourette's Disorder.
d. Incorrect Low IQ is not a common associated feature of Tourette's Disorder.
The correct answer is: obsessive-compulsive symptoms.
124
When a client exhibits psychotic symptoms, it is important to keep in mind that Schizophreniform Disorder is a more appropriate diagnosis than Schizophrenia when:
Select one:
A. the duration of symptoms is less than six months.
B. the client has experienced distinct periods of major depression and/or mania.
C. the onset of symptoms is traceable to one or more specific events.
D. the symptoms interfere with social and/or occupational functioning.
The essential features of Schizophreniform Disorder and Schizophrenia are very similar, and the key distinguishing feature is the duration of symptoms.
a. CORRECT When the duration of symptoms is between one and six months, a diagnosis of Schizophreniform Disorder is appropriate.
b. Incorrect This describes Schizoaffective Disorder.
c. Incorrect This is often characteristic of Brief Psychotic Disorder.
d. Incorrect The interference of symptoms with social or occupational functioning is required for a diagnosis of Schizophrenia but not for a diagnosis of Schizophreniform Disorder.
The correct answer is: the duration of symptoms is less than six months.
125
The feeling that one is an outside observer of one's own mental processes or body is referred to as:
Select one:
A. disorientation.
B. depersonalization.
C. delusion.
D. a fugue state.
Answer B is correct: Depersonalization is characterized by a feeling of detachment or estrangement from oneself or feeling like an observer of one's own thoughts, feelings, etc.
Answer A: Disorientation refers to confusion about time of day, date, place, etc.
Answer C: Delusions are false but firmly sustained beliefs based on incorrect inferences about external reality. Depersonalization can achieve delusional proportions, but that is not implied by the question.
Answer D: A dissociative fugue involves sudden, unexpected travel away from home with an inability to recall some or all of one's past.
The correct answer is: depersonalization.
126
To reduce the risk of relapse for a 23-year old man who has been hospitalized with a diagnosis of Schizophrenia and who will now be returning home to live with his parents, the best intervention would be:
Select one:
A. individual psychotherapy plus pharmacotherapy.
B. family therapy plus pharmacotherapy.
C. milieu therapy plus pharmacotherapy.
D. pharmacotherapy alone.
Schizophrenia is one of the disorders that responds best when biologic and psychosocial treatments are combined.
a. Incorrect Individual psychotherapy has not been found to be particularly effective for Schizophrenia.
b. CORRECT Because certain family characteristics (e.g., a high degree of "expressed emotion") have been linked to a higher risk for relapse, family therapy combined with pharmacotherapy (which alleviates the positive symptoms of Schizophrenia) is the best treatment. See, e.g., C. Barrowclough and N. Tarrier, Psychosocial interventions with families and their effects on the cause of Schizophrenia: A review, Psychological Medicine, 14, 629-642, 1984.
c. Incorrect Milieu therapy is another name for hospitalization.
d. Incorrect A combined treatment is more effective than pharmacotherapy alone for preventing relapse.
The correct answer is: family therapy plus pharmacotherapy.
127
Chronic otitis media in early childhood has been linked to:
Select one:
A. Pica.
B. autism.
C. learning disorders.
D. Tourettes disorder.
Answer C is correct: Otitis media is an infection of the middle ear. It can cause hearing loss and speech and language problems and has been linked to reading and other learning disorders.
Answers A, B, and D: See explanation for answer C.
The correct answer is: learning disorders.
128
The DSM-5 diagnosis of Reactive Attachment Disorder requires which of the following?
Select one:
A. the presence of symptoms in at least two settings.
B. evidence that symptoms are related to extreme insufficient care.
C. an onset of symptoms prior to age 12.
D. exposure to a traumatic event prior to age five.
Answer B is correct: Reactive Attachment Disorder involves a consistent pattern of inhibited and emotionally withdrawn behavior toward adult caregivers that is believed to be the result of extreme insufficient care.
Answers A, C, and D: See explanation for answer B.
The correct answer is: evidence that symptoms are related to extreme insufficient care.
129
Which of the following is generally considered to be the most effective treatment for nocturnal enuresis?
Select one:
A. night-lifting
B. EEG biofeedback
C. bladder strengthening exercises
D. the night alarm
Behavioral interventions, antidepressants, and antidiuretics are the most common treatments for enuresis.
a. Incorrect Night-lifting involves waking the child periodically throughout the night, walking him/her to the bathroom to urinate, and then walking the child back to the bed. It is considered by some experts to be punishing for both the child and the parent; and it has not been found to be more effective than the night alarm.
b. Incorrect Although some investigators report that EEG (brainwave) biofeedback is useful for treating enuresis, there is more consistent evidence for the effectiveness of the night alarm.
c. Incorrect Bladder strengthening exercises are used to treat enuresis but usually in conjunction with the night alarm or other treatment.
d. CORRECT Of the treatments listed, the night alarm (also known as the urine alarm and the bell-and-pad) has been identified as the most effective treatment for nocturnal enuresis. Although relapse is a problem for the night alarm, relapse rates are lower than the rates associated with antidepressants and other drugs.
The correct answer is: the night alarm
130
The misperception of an actual environmental event (e.g., interpreting the trickling of water as voices) is referred to as:
Select one:
A. magical thinking.
B. an idea of reference.
C. an illusion.
D. a hallucination.
Note that this question is asking about a perceptual disturbance, not a thought disorder.
a. Incorrect Magical thinking occurs when a person believes that his or her thoughts, words, or actions will affect a specific outcome in a way that defies laws of cause and effect.
b. Incorrect An idea of reference is the belief that events, objects, or other people have a special or unusual significance for oneself.
c. CORRECT An illusion as a misperception or misinterpretation of an actual external stimulus. Illusions are characteristic of several disorders including Delirium and Alcohol Withdrawal.
d. Incorrect A hallucination, like an illusion, is a perceptual disturbance. However, it involves a sensory perception without the presence of an actual stimulus.
The correct answer is: an illusion.
131
Tobacco Withdrawal is characterized by which of the following symptoms?
Select one:
A. depressed mood, insomnia, and increased appetite
B. autonomic hyperactivity, psychomotor agitation, and nausea or vomiting
C. apathy, impaired judgment, and dizziness
D. affective blunting, muscle weakness, and elevated or lowered blood pressure
Answer A is correct: Tobacco Withdrawal is one of the Substance-Induced Disorders that you're likely to encounter on the licensing exam. It is characterized by the symptoms listed in this answer, and the rapid onset of these symptoms is considered to be a primary reason why regular smokers find it so difficult to stop smoking.
Answer B: These are symptoms of Alcohol Withdrawal.
Answer C: These are symptoms of Inhalant Intoxication.
Answer D: These are symptoms of Stimulant Intoxication.
The correct answer is: depressed mood, insomnia, and increased appetite
132
An individual with Neurocognitive Disorder due to Alzheimer's disease has more neurofibrillary tangles than would be expected for his or her age, especially in the:
Select one:
A. hypothalamus
B. caudate nucleus
C. cerebellum
D. hippocampus
Answer D is correct. A definitive diagnosis of Alzheimer's disease requires an autopsy or brain biopsy that confirms extensive neuron loss and the presence of amyloid-predominant neuritic plaques and tau-predominant neurofibrillary tangles, especially in the medial temporal structures (entorhinal cortex, hippocampus, and amygdala). Neurofibrillary tangles are most dense in the hippocampus which plays an important role in memory consolidation.
Answers A, B, and C: See explanation for answer D.
The correct answer is: hippocampus
133
Malcolm M., age 36, says he rarely experiences strong emotions, describes himself as a "loner," and states that he doesn't care what other people think of him. Based on these symptoms, the most likely diagnosis for Malcolm is _________ Personality Disorder.
Select one:
A. Avoidant
B. Schizotypal
C. Schizoid
D. Obsessive-Compulsive
Answer C is correct: Malcolm's symptoms suggest a restricted range of emotional expression and detachment from social relationships.
Answer A: A person with Avoidant Personality Disorder avoids social relationships due to a fear of being embarrassed or humiliated.
Answer B: Schizotypal Personality Disorder involves interpersonal deficits, cognitive or perceptual distortions, and behavioral eccentricities.
Answer D: Obsessive-Compulsive Personality Disorder involves a preoccupation with orderliness, perfectionism, and control.
The correct answer is: Schizoid
134
The diagnosis of Bulimia Nervosa requires which of the following?
Select one:
A. binge eating and purging for at least six months
B. compulsive eating and compensatory behavior for at least four months
C. binge eating and inappropriate compensatory behavior for at least three months
D. binge eating and purging or excessive exercising for at least two months
Answer C is correct: Bulimia Nervosa involves recurrent episodes of binge eating followed by behaviors aimed at preventing weight gain - e.g., purging, excessive exercise, and/or the use of laxatives. The DSM diagnostic criteria for the disorder include binge eating and inappropriate compensatory behavior for at least three months.
Answers A, B, and D: See explanation for answer C.
The correct answer is: binge eating and inappropriate compensatory behavior for at least three months
135
Recent research investigating treatments for Generalized Anxiety Disorder suggests that the most effective intervention is:
Select one:
A. EMDR.
B. systematic desensitization.
C. stress inoculation training.
D. cognitive-behavioral therapy.
A number of well-designed studies on interventions for Generalized Anxiety Disorder confirm that the best treatment is cognitive or cognitive-behavioral in nature.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT The studies have consistently found that a multicomponent cognitive or cognitive-behavioral approach is most effective for Generalized Anxiety Disorder. See, e.g., D. H. Barlow, J. Esler, and A. Vitali, Psychosocial treatments for panic disorders, phobias, and generalized anxiety disorder, in P. E. Nathan and J. M. Gorman (eds.), A guide to treatments that work, New York, Oxford University Press, 1998.
The correct answer is: cognitive-behavioral therapy.
136
For a diagnosis of Panic Disorder, the individual must have experienced:
Select one:
A. recurrent unexpected panic attacks.
B. recurrent unexpected or expected panic attacks.
C. at least one unexpected and one expected panic attack.
D. multiple panic attacks.
Answer A is correct: For a DSM diagnosis of Panic Disorder, the individual must have had two or more unexpected panic attacks.
Answers B, C, and D: See explanation for answer A.
The correct answer is: recurrent unexpected panic attacks.
137
A delusion of the erotomanic type is illustrated by which of the following?
Select one:
A. A woman is convinced that her pastor at church is madly in love with her even though he has told her that he's not.
B. A woman believes that every man she comes into contact with wants to have sexual relations with her.
C. A man is preoccupied with sexual fantasies about a co-worker who has shown no interest in him.
D. A man is concerned about reaching orgasm far too quickly even though his wife repeatedly reassures him that he doesn't have this problem.
A delusion of the erotomanic type involves a false belief that another person, usually of higher status, is in love with the individual.
a. CORRECT Of the situations described, this one comes closest to an erotomanic delusion.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: A woman is convinced that her pastor at church is madly in love with her even though he has told her that he's not.
138
Research on cigarette smoking has found that:
Select one:
A. only 50% of self-quitters remain abstinent for two or more days following an attempt to quit.
B. the nicotine patch and other forms of nicotine replacement therapy are beneficial only for smokers who are highly nicotine dependent.
C. on the average, men and women gain about 6 and 8 pounds, respectively, after they stop smoking.
D. the risks for coronary and lung disease fall to about the same as those for people who never smoked three to five years after a smoker quits smoking.
This question is difficult because it requires you to be familiar with the results of several different studies.
a. Incorrect According to the American Psychiatric Association, for self-quitters, only about 33% remain abstinent for two days or more (Practice guidelines for the treatment of patients with nicotine dependence, Washington, D.C., APA, 1996).
b. Incorrect Nicotine replacement therapy has benefits for smokers whether they are highly or less nicotine dependent (although the greater the dependence, the greater the benefits).
c. CORRECT These are the weight gain figures reported in a recent report by the Center for Disease Control (cited in the APA's Guidelines).
d. Incorrect Although the risk for coronary heart disease does drop rapidly once a smoker has stopped smoking, this is not true for lung disease. See, e.g., U. S. Department of Health and Human Services, Health consequences of smoking cessation: A report of the U.S. Surgeon General, Washington, D.C., U.S. Government Printing Office, 1990.
The correct answer is: on the average, men and women gain about 6 and 8 pounds, respectively, after they stop smoking.
139
Which of the following paraphilias is characterized by intense sexually arousing fantasies, sexual urges, or behaviors that involve touching or rubbing against a nonconsenting person?
Select one:
A. scoptophilia
B. sitophilia
C. fetishism
D. frotteurism
Paraphilias involve intense sexually arousing fantasies, sexual urges, or behaviors related to unusual objects, activities, or situations. Note that in the DSM-5, paraphilias are referred to as Paraphilic Disorders.)
a. Incorrect Scoptophilia is not included in the DSM but refers to obtaining sexual pleasure by watching others having sex.
b. Incorrect Sitophilia is also not included in the DSM but refers to becoming sexually aroused by food.
c. Incorrect Fetishism is characterized by intense sexually arousing fantasies, sexual urges, or behaviors involving the use of nonliving objects (e.g., shoes, gloves).
d. CORRECT The information in the question accurately describes frotteurism.
The correct answer is: frotteurism
140
Which of the following is most true about the research on Conduct Disorder?
Select one:
A. Individuals with childhood-onset type are more likely than those with adolescent-onset type to develop adult Antisocial Personality Disorder.
B. Individuals with adolescent-onset type are more likely than those with childhood-onset type to develop adult Antisocial Personality Disorder.
C. The majority of individuals with Conduct Disorder receive a diagnosis of Antisocial Personality Disorder in adulthood, regardless of age of onset.
D. Conduct Disorder is normally associated with Antisocial Personality Disorder only when there is a family history of antisocial behavior.
Answer A is correct. According to the DSM, the long-term outcomes for Conduct Disorder vary but, for the majority of individuals, it remits by adulthood. This is the best answer since there is evidence that an early onset of symptoms places the child at greatest risk for Antisocial Personality Disorder in adulthood.
Answer B: Adolescent onset is less associated with antisocial behavior in adulthood.
The correct answer is: Individuals with childhood-onset type are more likely than those with adolescent-onset type to develop adult Antisocial Personality Disorder.
141
Grandiosity is NOT a characteristic symptom of which of the following disorders?
Select one:
A. Bipolar I Disorder
B. Narcissistic Personality Disorder
C. Schizoaffective Disorder
D. Schizoid Personality Disorder
Grandiosity involves an exaggerated sense of self-importance. It is characteristic of three of the four disorders listed in the answers to this question.
a. Incorrect Mania often involves a sense of grandiosity.
b. Incorrect Grandiosity is characteristic of Narcissistic Personality Disorder.
c. Incorrect When Schizoaffective Disorder includes manic episodes, grandiosity may be a symptom.
d. CORRECT Schizoid Personality Disorder is characterized by restricted emotional experience and expression. Although people with this disorder may seem self-absorbed, they don't exhibit grandiosity.
The correct answer is: Schizoid Personality Disorder
142
As defined in the DSM, the primary difference between a manic episode and hypomanic episode is that, in the latter:
Select one:
A. the duration of symptoms is longer.
B. the symptoms are characterized by a fluctuating course.
C. there is no marked impairment in social or occupational functioning.
D. delusions and hallucinations, if present, are fragmentary and less severe.
Answer C is correct: Mania and hypomania both involve an abnormally and persistently elevated, expansive, or irritable mood, However, a manic episode (but not a hypomanic episode) involves impairment in functioning, requires hospitalization to avoid danger to self or others, or includes psychotic symptoms.
Answer A: A manic episode lasts at least one week while a hypomanic episode lasts at least four days.
Answer B: A "fluctuating course" does not distinguish mania from hypomania.
Answer D: Delusions and hallucinations may be present during a manic episode but not during a hypomanic episode.
The correct answer is: there is no marked impairment in social or occupational functioning.
143
Which of the following is true about hallucinations?
Select one:
A. The sensory experience may or may not be perceived as real by the individual.
B. The sensory experience is always perceived as real by the individual.
C. The sensory experience is not perceived as real by the individual.
D. The sensory experience may or may not be related to an actual external stimulus.
Answer A is correct: An hallucination is a sensory perception that seems real but occurs without external stimulation of the relevant sensory organ. The person experiencing an hallucination may or may not be aware that the perceived stimulus is not real.
Answers B, C, and D: See explanation for answer A.
The correct answer is: The sensory experience may or may not be perceived as real by the individual.
144
Research by Geller and associates (2004) found that five symptoms are useful for distinguishing prepubertal and early adolescent Bipolar Disorder from ADHD. Which of the following is NOT one of these five symptoms?
Select one:
A. elation
B. decreased need for sleep
C. accelerated speech
D. flight of ideas
Answer C is correct: The differential diagnosis of ADHD and Bipolar Disorder is often difficult in children and adolescents due to an overlap of symptoms of the two disorders in these populations. For example, B. Geller et al. found that hyperactivity, irritability, distractibility, and accelerated speech are common in both disorders and, therefore, not useful for distinguishing between them. In contrast, symptoms that are characteristic of pediatric Bipolar Disorder but are uncommon in ADHD are elation, grandiosity, flight of ideas, decreased need for sleep, and hypersexuality in the absence of sexual abuse or overstimulation (DSM-IV mania symptoms in a prepubertal and early adolescent bipolar disorder phenotype compared to attention-deficit hyperactive and normal controls, Focus, 2, 586-595, 2004).
The correct answer is: accelerated speech
145
The severity level (mild, moderate, severe, or extreme) for a DSM-5 diagnosis of Bulimia Nervosa is based on which of the following?
Select one:
A. duration of the disorder
B. current body mass index
C. average number of weekly episodes of inappropriate compensatory behavior
D. average number of weekly episodes of binge eating
Answer C is correct: The DSM-5 provides specifiers for Bulimia Nervosa for course (in partial remission or full remission) and for severity (mild, moderate, severe, or extreme) based on average number of episodes of inappropriate compensatory behavior per week.
Answers A and D: See explanation for answer C.
Answer B: Level of severity for Anorexia Nervosa is based on current body mass index.
The correct answer is: average number of weekly episodes of inappropriate compensatory behavior
146
Lee L., age 33, is brought to therapy by his sister. She reports that, following the loss of his home in a fire two weeks ago, Lee has experienced hallucinations, is incoherent, and is uncharacteristically aggressive and sloppy in appearance. In this situation, before assigning a diagnosis of Brief Psychotic Disorder, you would want to rule out alternative explanations for Lee's symptoms. Therefore, you would want to determine if Lee:
Select one:
A. has been using alcohol or drugs.
B. is able to answer questions coherently.
C. is experiencing delusions.
D. is experiencing rapid shifts in mood.
Answer A is correct: Although Lee's history and symptoms are suggestive of Brief Psychotic Disorder, you would want to rule out other explanations including the possibility that his symptoms are due to an alcohol- or drug-induced psychotic disorder. Note that this question is asking you to identify the information that would rule out (not confirm) a diagnosis of Brief Psychotic Disorder.
Answers B, C, and D: An inability to speak coherently, delusions, and rapid shifts in attention are symptoms or associated features of Brief Psychotic Disorder and, therefore, would not be useful for ruling it out as the appropriate diagnosis.
The correct answer is: has been using alcohol or drugs.
147
Which of the following is considered to be a negative symptom of Schizophrenia?
Select one:
A. catatonic behavior
B. derealization
C. disorganized speech
D. avolition
Answer D is correct: Negative symptoms include restrictions in the range and intensity of emotional expression (affective flattening), in the fluency and productivity of thought and speech (alogia), and in the initiation of goal-directed behavior (avolition).
Answers A, B, and C: Catatonic behavior, derealization, and disorganized speech are not included in the DSM as negative symptoms of Schizophrenia.
The correct answer is: avolition
148
When using the DSM-5, __________ is coded when a clinician wants to indicate why a client's symptoms do not meet the criteria for a specific disorder.
Select one:
A. diagnosis deferred
B. disorder NOS
C. unspecified disorder
D. other specified disorder
Answer D is correct. When using the DSM-5, other specified disorder is coded when the clinician wants to indicate the reason why the client's symptoms do not meet the criteria for a specific diagnosis - e.g., other specified bipolar disorder, short-duration manic episodes.
Answers A and B: See explanation for answer D.
Answer C: When using the DSM-5, unspecified disorder is coded to indicate diagnostic uncertainty when the clinician does not want to specify the reason why the client's symptoms do not meet the criteria for a specific diagnosis.
The correct answer is: other specified disorder
149
A number of relapse prevention models have been proposed for alcoholism, cigarette smoking, and other addictive disorders. According Marlatt and Gordon's (1985) model, the most effective way to increase the likelihood of recovery after relapse is to:
Select one:
A. increase access to social support.
B. emphasize the negative consequences of relapse.
C. shift attention from internal to external antecedents.
D. address motivational issues related to abstinence.
Marlatt and Gordon's (1985) model emphasizes the impact of cognitive and situational factors on relapse.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Marlatt and Gordon"s (1985) "abstinence violation effect " (AVE) model considers recovery after relapse to be related to attributions about the cause of the relapse - i.e., successful recovery is more likely when the person attributes relapse to external, unstable, and specific (high-risk) factors than when he/she attributes it to internal, stable, and global factors.
d. Incorrect See explanation for response c.
The correct answer is: shift attention from internal to external antecedents.
150
Vivid dreamlike images that occur at the beginning of sleep are referred to as:
Select one:
A. hypnagogic hallucinations.
B. hypnopompic hallucinations.
C. release hallucinations.
D. irritative hallucinations.
Dreamlike imagery at the onset of sleep is a normal phenomenon in many people but is also associated with sleep deprivation, Narcolepsy, and several other conditions.
a. CORRECT The information presented in this question accurately describes hypnagogic hallucinations.
b. Incorrect Hypnopompic hallucinations occur just after awakening.
c. Incorrect Release hallucinations are caused by spontaneous activity in the auditory or visual cortex and usually affect people with auditory or visual impairments.
d. Incorrect Irritative hallucinations are caused by abnormal electrical activity in the brain as the result of a tumor, migraine headache, or other condition.
The correct answer is: hypnagogic hallucinations.
151
Use of __________ may produce Intoxication, which is characterized by mood lability, impaired judgment, slurred speech, impaired coordination, and deficits in memory and attention.
Select one:
A. a sedative
B. an amphetamine
C. cannabis
D. an opioid
Answer A is correct: The symptoms listed in the question are characteristic of Sedative, Hypnotic, or Anxiolytic Intoxication.
Answer B: Intoxication due to an amphetamine or other stimulant is characterized by hypervigilance, psychomotor agitation, tachycardia, elevated blood pressure, and nausea and vomiting.
Answer C: Cannabis Intoxication involves anxiety, impaired judgment, social withdrawal, tachycardia, and increased appetite.
Answer D: Opioid Intoxication shares some symptoms with Sedative Intoxication. However, it is also characterized by an initial euphoria followed by apathy, dysphoria, and psychomotor retardation or agitation.
The correct answer is: a sedative
152
For a person with Bipolar I Disorder who is intolerant of or nonresponsive to lithium carbonate, the most appropriate medication would most likely be which of the following?
Select one:
A. carbamazepine
B. propranolol
C. lorazepam
D. donepezil
Answer A is correct: Lithium is ordinarily the first-line drug treatment for Bipolar I Disorder. However, when an individual is lithium intolerant or has symptoms that are non-responsive to lithium, an anticonvulsant drug (e.g., carbamazepine, valproic acid, gabapentin) is often prescribed.
Answer B: Propranolol is a beta-blocker and is used to treat hypertension, angina, and other cardiovascular disorders and to alleviate the physical symptoms of anxiety.
Answer C: Lorazepam is a benzodiazepine and is used to treat anxiety, alcohol withdrawal, and chronic insomnia.
Answer D: Donepezil is a cholinesterase inhibitor that is used to treat cognitive impairment experienced by individuals with mild to moderate Alzheimer's disease.
The correct answer is: carbamazepine
153
Electroconvulsive shock therapy (ECT):
Select one:
A. is as or more effective than drug therapy for acute Schizophrenia.
B. has been found to be more effective for treating mania than depression.
C. is considered useful for treating depression that involves suicidal preoccupation.
D. is no longer used as a treatment for depression because of its negative effects on memory and executive functioning.
Although ECT was originally used as a treatment for Schizophrenia, it is now used primarily as a treatment for severely depressed individuals who have not responded to other forms of treatment.
a. Incorrect Because ECT is less effective than pharmacological treatments for Schizophrenia, it is no longer considered a useful treatment for this disorder.
b. Incorrect The research has found ECT to be less effective for mania than for depression.
c. CORRECT Although its effects are still not understood, ECT continues to be used to treat depression, especially severe forms involving suicidal preoccupation and vegetative symptoms. Some studies suggest that ECT is more effective in these cases than are antidepressant drugs.
d. Incorrect See explanation for response c.
The correct answer is: is considered useful for treating depression that involves suicidal preoccupation.
154
A diagnosis of Vascular Neurocognitive Disorder requires:
Select one:
A. evidence of an endocrine disorder.
B. evidence of cerebrovascular disease.
C. a disturbance in attention and awareness.
D. the presence of delusions.
Answer B is correct: As its name implies, the diagnosis of Vascular Neurocognitive Disorder requires evidence of cerebrovascular disease - i.e., the symptoms must be consistent with a vascular etiology and evidence of a cerebrovascular disease must be provided by a physical exam, neuroimaging, etc.
Answer A: Evidence of an endocrine disorder is not required for this diagnosis.
Answer C: A disturbance in attention and awareness is characteristic of Delirium.
Answer D: Although delusions may occur, they are not required for the diagnosis.
The correct answer is: evidence of cerebrovascular disease.
155
A Latino with Major Depressive Disorder is most likely to say that his symptoms include which of the following?
Select one:
A. a problem of the heart
B. weakness, tiredness, and an imbalance
C. confusion, agitation, and a sense of disorientation
D. headaches, sleep problems, and nervousness
Culture may influence the experience and manifestation of depression and other mental disorders.
a. Incorrect Individuals from Middle Eastern cultures may describe depression as a "problem of the heart."
b. Incorrect These terms may be used by members of Chinese and other Asian cultures to describe depression.
c. Incorrect These symptoms are not typical manifestations of depression for Latinos.
d. CORRECT "Nervios" is a common idiom of distress for Latinos and may be indicative of depression or other mental disorder. It is manifested primarily in terms of somatic complaints such as headache, sleep problems, and nervousness.
The correct answer is: headaches, sleep problems, and nervousness
156
Janice J., age 23, has to be at work by 8:30 a.m. but she wakes up each work day by 5:30 a.m. so that she can wash her face and apply make-up to cover up her "bad skin." Often, this involves removing and reapplying the make-up several times and causes her to be late for work two or three times a month. At work, she takes frequent bathroom breaks so she can check her face in the mirror and re-apply make-up. Janice is always "broke" because she spends so much of her salary on skin-care products and at tanning salons. She is afraid that, if people see her without make-up, they won't want to have anything to do with her, and as a result, she avoids all social activities that will not allow her to frequently check her face. Janice has seen two dermatologists in the past six months and both have reassured her that her skin is fine, that she does not have acne, and that the scar above her eyebrow is not noticeable because it's so small and is usually covered by her bangs. The most likely diagnosis for Janice is:
Select one:
A. Illness Anxiety Disorder
B. Somatic Symptom Disorder
C. Body Dysmorphic Disorder
D. Adjustment Disorder
Answer C is correct: Body Dysmorphic Disorder involves a preoccupation with a defect or flaw in appearance that appears minor or is unobservable to others. The person performs repetitive behaviors or mental acts related to the defect or flaw (e.g., mirror checking, excessive grooming), and his/her preoccupation causes clinically significant distress or impaired functioning.
Answer A: People with Illness Anxiety Disorder are preoccupied with having or acquiring a serious illness. Although Janice is overly concerned about her skin, she does not seem to be concerned that the flaws she perceives are signs of a serious illness.
Answer B: People with Somatic Symptom Disorder have one or more somatic symptoms that cause distress or a significant disruption in daily life and are accompanied by excessive thoughts, feelings, or behaviors that are related to the symptoms. As noted in the DSM-5, a person with Somatic Symptoms Disorder is concerned that an illness underlies his/her somatic symptoms, while a person with Body Dysmorphic Disorder is concerned about a flaw or defect in appearance.
Answer D: Adjustment Disorder involves the development of emotional or behavioral symptoms in response to one or more identifiable psychosocial stressors. No information is provided in the question that suggests that Janice's symptoms developed after exposure to a stressor.
The correct answer is: Body Dysmorphic Disorder
157
During her first therapy session, Maria M., age 47, says she has experienced several periods in the last six or seven years during which she was irritable and depressed, had little energy, was unable to concentrate at work, and slept and ate too much. She also states that, at least for the last three years, the episodes began right around the time that the last leaves fell off the trees in the fall and since "fall is just around the corner," she's afraid she's going to have another episode. Maria tell her therapist that she feels "fine" between the episodes and is quite productive at work and socially active. Maria's symptoms are most suggestive of:
Select one:
A. Bipolar I Disorder.
B. Cyclothymic Disorder.
C. Major Depressive Disorder with atypical features.
D. Major Depressive Disorder with seasonal pattern.
Answer D is correct: Maria's symptoms are most suggestive of Major Depressive Disorder and, because her episodes began during the fall for the last few years, the specifier "with seasonal pattern" applies.
Answers A, B, and C: See explanation for answer D.
The correct answer is: Major Depressive Disorder with seasonal pattern.
158
Which of the following is listed in the DSM as a diagnostic (versus associated) feature for Antisocial Personality Disorder?
Select one:
A. inflated sense of self
B. lack of remorse
C. lack of empathy
D. superficial charm
A diagnosis of Antisocial Personality Disorder (APD) requires a pervasive pattern of disregard for and violation of the rights of others.
a. Incorrect Inflated sense of self is listed as an associated feature in the DSM, not a diagnostic feature.
b. CORRECT For this diagnosis, the DSM requires the presence of at least three of seven characteristic behaviors. One of the seven is a lack of remorse.
c. Incorrect Lack of empathy is another associated feature of APD.
d. Incorrect Superficial charm is also a common associated feature.
The correct answer is: lack of remorse
159
Reported concordance rates for Schizophrenia for identical (monozygotic) twins range from:
Select one:
A. 8 to 15%.
B. 20 to 25%.
C. 45 to 50%.
D. 70 to 75%.
A genetic contribution to Schizophrenia is supported by research showing that, as genetic similarity increases, concordance rates increase.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The reported concordance rates for Schizophrenia vary somewhat from study to study, but most report a rate between 45-50% for identical twins. For the exam, you want to memorize the concordance rates for Schizophrenia presented in the Abnormal Psychology chapter of the written study materials.
d. Incorrect See explanation for response c.
The correct answer is: 45 to 50%.
160
The tendency to sexualize all relationships, have irrational emotional outbreaks, be highly suggestible, and exhibit overly dramatic and chaotic behaviors is most suggestive of which of the following Personality Disorders?
Select one:
A. Obsessive-Compulsive
B. Narcissistic
C. Schizoid
D. Histrionic
The symptoms presented in this question are characteristic of Histrionic Personality Disorder.
a. Incorrect Obsessive-Compulsive Personality Disorder involves a preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency.
b. Incorrect Narcissistic Personality Disorder involves a pervasive pattern of grandiosity, need for admiration, and lack of empathy.
c. Incorrect Schizoid Personality Disorder is characterized by a pervasive pattern of detachment from social relationships and a restricted range of emotional expression.
d. CORRECT Histrionic Personality Disorder involves the dramatic, overemotional, over sexualized, attention-seeking behaviors described in this question.
The correct answer is: Histrionic
161
The specifier "with delayed expression" is appropriate for a DSM-5 diagnosis of PTSD when the individual's symptoms do not meet all diagnostic criteria for the disorder until at least _____ after his/her exposure to the traumatic event.
Select one:
A. 30 days
B. 90 days
C. 6 months
D. 12 months
Answer C is correct: The specifier "for delayed expression" is applied to the diagnosis of PTSD when the full diagnostic criteria are not met until at least six months after the traumatic event.
Answers A, B, and D: See explanation for answer C.
The correct answer is: 6 months
162
The primary advantage of the DSM's use of polythetic criteria sets is that they:
Select one:
A. facilitate differential diagnosis.
B. reduce excessive co-morbidity/co-diagnoses.
C. reflect the heterogeneity of symptoms characteristic of many mental disorders.
D. facilitate consideration of relevant associated characteristics and features.
Most diagnoses in the DSM have a polythetic criteria set, which means that an individual is required to exhibit only a subset of the diagnostic criteria for a specific diagnosis in order to be assigned the diagnosis.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT An assumption underlying the use of polythetic criteria sets in the DSM is that people with the same disorder are heterogeneous with regard to symptoms. In other words, while individuals with the same diagnosis share some symptoms, they may differ with regard to others.
d. Incorrect See explanation for response c.
The correct answer is: reflect the heterogeneity of symptoms characteristic of many mental disorders.
163
A young man can't recall certain personal information (such as where he lives and who he lives with) but says he has just started working as a dishwasher at a local diner. Presence of which of the following would help confirm that the man is experiencing a dissociative fugue?
Select one:
A. You learn that the man has recently traveled unexpectedly from another state and has assumed a new identity.
B. You learn that the onset of the mans memory loss was sudden and seems to have been precipitated by the death of his mother.
C. The young man exhibits a sense of detachment and says he feels like he's "in a dream."
D. The young man insists that spirits have entered and taken over his body.
Answer A is correct: A dissociative fugue is characterized by sudden, unexpected travel away from home with an inability to recall one's past. In DSM-5, dissociative fugue is a specifier for Dissociative Amnesia.
The correct answer is: You learn that the man has recently traveled unexpectedly from another state and has assumed a new identity.
164
A 71-year old retired college professor obtains a score of 90 on an IQ test, exhibits deficits in both judgment and abstract thinking, and has significant memory loss that he does not seem to be aware of. His wife says that, in the past year, he "just hasn't seemed like himself." Based on these symptoms, the most likely diagnosis is:
Select one:
A. Korsakoff's syndrome.
B. pseudodementia.
C. Alzheimer's disease.
D. normal age-related cognitive decline.
Additional information would be needed to determine the appropriate diagnosis for this man but, of the conditions listed in the answers, Alzheimer's disease is most consistent with his symptoms and age.
a. Incorrect Korsakoff's syndrome is associated with chronic alcoholism, which isn't suggested by the information presented in the question.
b. Incorrect Pseudodementia is a term used to describe Major Depressive Disorder that has prominent cognitive symptoms. This man's symptoms (especially his lack of awareness of his deficits) are not characteristic of Major Depressive Disorder.
c. CORRECT As noted above, the man's symptoms and age suggest Alzheimer's disease.
d. Incorrect The man's impairments are more severe than what would be expected for his age.
The correct answer is: Alzheimer's disease.
165
Jalia J., age 34, is often very irritable with family members and friends, has trouble controlling her anger, gets drunk at least twice a week, has a history of frequent job changes and brief sexual affairs, and often complains that she is bored. Based on these symptoms, the most likely diagnosis is _____ Personality Disorder.
Select one:
A. Schizoid
B. Narcissistic
C. Histrionic
D. Borderline
Jalia's behavior is characterized by instability - which, unfortunately, is characteristic of three of the four disorders listed. Therefore, you have to consider her other symptoms to identify the most likely diagnosis.
a. Incorrect Schizoid Personality Disorder should have been the easiest to eliminate as a correct answer since it is characterized by a restricted range of emotional expression.
b. Incorrect Jalia is not exhibiting the key features of Narcissistic Personality Disorder - i.e., a pattern of grandiosity, lack of empathy, and need for admiration.
c. Incorrect Histrionic Personality Disorder is characterized by a pattern of excessive emotionality and attention-seeking.
d. CORRECT Jalia's symptoms are most consistent with the diagnostic criteria for Borderline Personality Disorder which is characterized by instability in self-image, interpersonal relationships, and affect and marked impulsivity.
The correct answer is: Borderline
166
The primary feature of which of the following DSM-5 diagnoses is a preoccupation with a fear of having a serious disease despite an absence of symptoms of the disease?
Select one:
A. Somatic Symptom Disorder
B. Illness Anxiety Disorder
C. Hypochondriasis
D. Factitious Disorder
Answer B is correct: A DSM-5 diagnosis of Illness Anxiety Disorder requires a preoccupation with having a serious illness, an absence of somatic symptoms or the presence of mild somatic symptoms, a high level of anxiety about health, and either performance of excessive health-related behaviors or maladaptive avoidance of medical care.
Answer A: Somatic Symptom Disorder is characterized by the presence of one or more somatic symptoms that cause distress or a significant disruption in daily life accompanied by excessive thoughts, feelings, or behaviors related to the symptoms.
Answer C: Hypochondriasis is not a DSM-5 diagnosis.
Answer D: Factitious Disorder is characterized by falsification or induction of symptoms that are associated with an identified deception that does not involve an external reward.
The correct answer is: Illness Anxiety Disorder
167
In prepubertal children, Major Depressive Disorder is:
Select one:
A. about twice as common in girls than in boys.
B. about three times as common in girls than in boys.
C. about equally common in boys and girls.
D. about 1-1/2 times as common in boys than in girls.
Answer C is correct: The gender ratio for Major Depressive Disorder is related to age: In adolescents and adults, the disorder is more common in females than in males but, in prepubertal children, the rates are about equal for boys and girls.
*Beginning in early adolescence, the rates for females is 1.5 - 3 times the rates for males.
Answers A, B, and D: See explanation for answer C.
The correct answer is: about equally common in boys and girls.
168
A 16-year-old suddenly exhibits a change in behavior that includes irritability, concentration problems at school, a decreased need for sleep, and sexual promiscuity. Her mother says that the girl has had behavioral problems at school for the past few years but that her current symptoms are new and developed about ten days ago. Based on this information, the most likely diagnosis is:
Select one:
A. ADHD.
B. Conduct Disorder.
C. Bipolar I Disorder.
D. Bipolar II Disorder.
The girl's symptoms and their sudden onset are most suggestive of Bipolar Disorder.
a. Incorrect For a diagnosis of ADHD, there would have to be some evidence of hyperactivity-impulsivity and/or inattention in at least two settings.
b. Incorrect A diagnosis of Conduct Disorder requires a persistent pattern of antisocial behavior. Although the question mentions that the girl has had "behavioral problems," there is not sufficient evidence to conclude that they meet the criteria for this diagnosis.
c. CORRECT The girl's symptoms are suggestive of mania which, in adolescents, is sometimes preceded by a history of behavioral problems.
d. Incorrect A diagnosis of Bipolar II disorder requires a history of both major depressive and hypomanic episodes.
The correct answer is: Bipolar I Disorder.
169
Sleep terror episodes:
Select one:
A. usually begin during REM sleep.
B. usually begin with a panicky scream.
C. are associated with vivid frightening dreams that the individual can recall in detail upon awakening.
D. are associated with rhythmic, stereotyped motor activity during the episode and upon awakening from it.
Answer B is correct: Sleep terror episodes are characterized by an abrupt awakening from sleep that usually begins with a panicky scream or cry. Sleep terror is a type of Non-REM Sleep Arousal Disorder.
Answer A: Sleep terrors usually begin during stage 3 or 4 NREM sleep.
Answer C: The individual usually does not have a detailed memory of a dream upon awakening but may have amnesia for the episode or may recall only fragmentary images of a dream.
Answer D: Awakening from sleep with rhythmic, stereotyped motor activity is not characteristic of sleep terrors.
The correct answer is: usually begin with a panicky scream.
170
Social isolation associated with Avoidant Personality Disorder is most related to:
Select one:
A. fear of embarrassment and rejection.
B. excessive self-preoccupation.
C. a lack of interest in close personal relationships.
D. interpersonal suspiciousness and paranoia.
Answer A is correct: Avoidant Personality Disorder is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and oversensitivity to negative evaluations. People with Avoidant Personality Disorder desire intimate relationships but avoid them because they fear rejection, humiliation, etc.
Answer B: Excessive self-preoccupation is more characteristic of Narcissistic Personality Disorder.
Answer C: A lack of interest in social relationships is characteristic of Schizoid Personality Disorder.
Answer D: Suspiciousness and paranoia are not characteristic of Avoidant Personality Disorder.
The correct answer is: fear of embarrassment and rejection.
171
During your first session with Bernard B., age 33, he reports feeling hopeless and very sad for the past three or four weeks and says he doesn't feel like "doing anything." Bernard tells you that he's lost his appetite and has been eating only one meal a day. He says that he thinks he has a fatal disease and is going to die soon and that he often hears Satan's voice at night telling him he's going to go to hell when he dies. Based on these symptoms, the most likely diagnosis is:
Select one:
A. Major Depressive Disorder with mood-congruent psychotic features.
B. Major Depressive Disorder with atypical features.
C. Schizophrenia.
D. Schizoaffective Disorder.
Answer A is correct: Bernard's symptoms (e.g., hopelessness, sadness, loss of appetite) are most suggestive of Major Depressive Disorder. Also, the presence of delusions and hallucinations that are congruent with his mood indicate that the "with mood-congruent psychotic features" specifier applies.
Answer B: The atypical features specifier is appropriate when the individual experiences mood reactivity, increased appetite and weight gain, hypersomnia, and leaden paralysis.
Answer C: Schizophrenia is diagnosed when psychotic symptoms are present without prominent affective symptoms.
Answer D: A diagnosis of Schizoaffective Disorder requires a period of at least two weeks when psychotic symptoms were present in the absence of mood symptoms.
The correct answer is: Major Depressive Disorder with mood-congruent psychotic features.
172
A DSM-5 diagnosis of Erectile Disorder requires the presence of characteristic symptoms for a minimum duration of approximately _____ months.
Select one:
A. three
B. six
C. nine
D. twelve
Answer B is correct: The DSM-5 requires the presence of characteristic symptoms for a minimum duration of about six months for all of the Sexual Dysfunctions except Substance/Medication-Induced Sexual Dysfunction.
Answers A, C, and D: See explanation for answer B.
The correct answer is: six
173
Alterations in perception are most associated with which of the following disorders?
Select one:
A. Generalized Anxiety Disorder
B. Tourette's Disorder
C. Adjustment Disorder
D. Panic Disorder
Answer D is correct: Perceptual distortions (depersonalization and derealization) are potential symptoms of a panic attack, which is the essential feature of Panic Disorder.
Answers A, B, and C: Perceptual distortions are not associated with GAD, Tourette's Disorder, or Adjustment Disorder.
The correct answer is: Panic Disorder
174
For a DSM-5 diagnosis of Separation Anxiety Disorder in adults, symptoms must have a duration of about ________ or more.
Select one:
A. four weeks
B. six weeks
C. four months
D. six months
Answer D is correct: For a diagnosis of Separation Anxiety Disorder, the DSM-5 requires a duration of symptoms of at least four weeks for children and adolescents or about six months or more for adults.
Answers A, B, and C: See explanation for answer D.
The correct answer is: six months
175
A young man who has received a diagnosis of Antisocial Personality Disorder is most likely to have exhibited which of the following during childhood?
Select one:
A. stuttering
B. hyperactivity/impulsivity
C. cruelty to animals
D. social isolation
Antisocial Personality Disorder is characterized by superficial charm, lying, lack of regard for others, an absence of shame or remorse, an inability to form close personal relationships, and an inability to learn from experience
a. Incorrect Stuttering has not been identified as a predictor of antisocial behavior.
b. Incorrect Hyperactivity and impulsivity are not characteristic precursors of Antisocial Personality Disorder.
c. CORRECT Cruelty to animals is one symptom of Conduct Disorder, which is a precursor to Antisocial Personality Disorder.
d. Incorrect Social isolation has not been linked to a high risk for Antisocial Personality Disorder.
The correct answer is: cruelty to animals
176
The pathological and apparently senseless repetition of a word or phrase just spoken by another person is referred to as:
Select one:
A. alogia.
B. aphonia.
C. echopraxia.
D. echolalia.
You may have been able to figure this one out simply because the correct term "sounds like" what it means.
a. Incorrect Alogia is characterized by an impoverishment in thinking that is inferred from the person's speech and language.
b. Incorrect Aphonia is an inability to produce speech sounds that require the use of the larynx and that is not due to a lesion in the CNS.
c. Incorrect Echopraxia involves an imitation of the movements of another person with the movements having a semiautomatic or uncontrollable quality.
d. CORRECT The description in this question defines echolalia, which is a symptom of autism and several other disorders.
The correct answer is: echolalia.
177
Lewinsohn's behavioral theory emphasizes the role of which of the following in the etiology of depression?
Select one:
A. the adoption of overly perfectionist goals
B. negative self-statements about oneself, the world, and the future
C. a low rate of response-contingent positive reinforcement
D. a tendency to attribute negative life events to global, stable, and internal factors
Answer C is correct: Knowing that Lewinsohn's theory is based on the principles of operant conditioning would have helped you identify low rate of response-contingent positive reinforcement as the correct answer.
Answer A: Perfectionism has been linked to a dysphoric mood but was not identified by Lewinsohn as a cause of depression.
Answer B: Beck identified a depressive cognitive triad consisting of negative self-statements about oneself, the world, and the future as a contributor to depression.
Answer D: The tendency to attribute negative events to global, stable, and internal factors was identified as a causal factor by Seligman's original learned helplessness model of depression.
The correct answer is: a low rate of response-contingent positive reinforcement
178
In the DSM-5, dissociative fugue is included:
Select one:
A. with Dissociative Disorders as a separate diagnosis.
B. as a specifier for Dissociative Amnesia.
C. as a specifier for Depersonalization/Derealization Disorder.
D. as an example of disorders that may be coded as Other Specified Dissociative Disorder.
Answer B is correct: Dissociative fugue is a specifier for Dissociative Amnesia in the DSM-5.
The correct answer is: as a specifier for Dissociative Amnesia.
179
An individual's functioning in conceptual, social, and practical domains is evaluated to determine the appropriate severity level for which of the following diagnoses?
Select one:
A. Autism Spectrum Disorder
B. Specific Learning Disability
C. Intellectual Disability
D. Posttraumatic Stress Disorder
Answer C is correct: DSM-5 distinguishes between four levels of severity for Intellectual Disability (mild, moderate, severe, and profound) with severity being based on the individual's functioning in conceptual, social, and practical domains.
Answers A, B, and D: See explanation for answer C.
The correct answer is: Intellectual Disability
180
The intense "sleep attack" associated with Narcolepsy is often accompanied by:
Select one:
A. cataplexy.
B. dyskinesia.
C. ataxia.
D. muscular rigidity.
Narcolepsy involves frequent intense periods of irresistible sleep.
a. CORRECT Sleep attacks in Narcolepsy may include cataplexy, which is a sudden loss of muscle tone.
b. Incorrect See explanation for response a.
c. Incorrect See explanation for response a.
d. Incorrect See explanation for response a.
The correct answer is: cataplexy.
181
A physician is most likely to prescribe which of the following for a 36-year old man who has just received a diagnosis of Premature Ejaculation?
Select one:
A. a drug that stimulates dopamine receptors
B. a drug that inhibits GABA receptors
C. a drug that inhibits the reuptake of serotonin
D. a drug that stimulates the reuptake of endorphins
Premature ejaculation has been linked to low serotonin levels.
a. Incorrect Increased dopamine activity can cause or exacerbate premature ejaculation.
b. Incorrect GABA helps reduce anxiety. Therefore, it would likely be more effective to stimulate (rather than inhibit) GABA receptors.
c. CORRECT SSRIs (e.g., dapoxetine) are currently used to treat premature ejaculation.
d. Incorrect Endorphins have not been linked to premature ejaculation.
The correct answer is: a drug that inhibits the reuptake of serotonin
182
Recent research suggests that higher rates of Schizophrenia among African-Americans is most likely attributable to:
Select one:
A. heredity.
B. family dynamics.
C. socioeconomic factors.
D. misdiagnosis of hallucinations and delusions.
Studies in both the United States and England have found that members of certain minority groups (especially groups devalued by the dominant culture) are more likely to receive a diagnosis of Schizophrenia.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Research suggests that the discrepancy in rates of Schizophrenia is due to misdiagnosis rather than to actual differences in the prevalence of the disorder. A contributing factor to misdiagnosis may be that African-Americans have a higher incidence of hallucinations and delusions that are actually due to other disorders such as mania, depression, and alcohol abuse.
The correct answer is: misdiagnosis of hallucinations and delusions.
183
Based on their meta-analysis of the research, Faraone, Biederman, and Mick (2005) concluded that up to _____ percent of children meet the criteria for a diagnosis of ADHD in partial remission as young adults.
Select one:
A. 15
B. 35
C. 60
D. 99
Answer C is correct: Faraone and colleagues concluded that the rate of persistence of ADHD into adulthood depends on how persistence is defined. The results of their meta-analysis indicated that about 15% of children with ADHD continue to meet the full diagnostic criteria for the disorder in early adulthood and that between 40 and 60% meet the criteria for ADHD in partial remission.
Answers A, B, and D: See explanation for answer C.
The correct answer is: 60
184
When developing a treatment plan for an 11-year-old with Conduct Disorder, you will most likely include which of the following interventions?
Select one:
A. interpersonal and social rhythm therapy
B. parent management training
C. stress inoculation
D. pharmacotherapy
Answer B is correct: As with many disorders, a multimodal approach is generally most effective for Conduct Disorder and ordinarily includes parent management training and/or other family intervention.
Answers A, C, and D: See explanation for answer B.
The correct answer is: parent management training
185
In their prospective study of patients who underwent sex reassignment surgery, Smith et al. (2005) found that:
Select one:
A. the majority of patients no longer expressed gender dysphoria following surgery.
B. the majority of patients continued to express gender dysphoria following surgery.
C. the majority of patients expressed an increase in gender dysphoria following surgery.
D. the majority of female-to-male (but not male-to-female) patients expressed an increase in gender dysphoria following surgery.
This is a difficult question because it's asking about a particular study. However, being generally familiar with the research on outcomes of sex reassignment surgery would have helped you identify the correct response.
a. CORRECT Y. Smith and colleagues found that the 162 adults in their study reported that they no longer experienced gender dysphoria following sex reassignment surgery, and the majority were functioning well psychologically, socially and sexually [Sex reassignment: Outcomes and predictors of treatment for adolescent and adult transsexuals, Psychological Medicine, 35(1), 89-99, 2005]. The outcomes of this study are consistent with the findings of other recent research.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: the majority of patients no longer expressed gender dysphoria following surgery.
186
It is often difficult to distinguish delirium, dementia (major neurocognitive disorder), and depression in older adults. However, the presence of which of the following suggests that delirium is the appropriate diagnosis?
Select one:
A. sudden loss of energy
B. memory impairment
C. deficits in executive cognitive functioning
D. a disturbance in attention and awareness
Answer D is correct. A diagnosis of delirium requires a disturbance in attention and awareness plus a disturbance in cognition (e.g., memory deficit, disorientation, perceptual abnormality).
Answer A: A loss of energy is characteristic of depression and is not a diagnostic criterion for delirium.
Answer B: Memory impairment is characteristic of all three disorders.
Answer C: Deficits in executive cognitive functioning are characteristic of dementia.
The correct answer is: a disturbance in attention and awareness
187
Mia M., age 28, has just received a diagnosis of Obsessive-Compulsive Disorder. She tells her therapist that she knows that this disorder is often treated with medication but that she doesn't want to take a drug because of the side effects. Which of the following would likely be the most effective treatment for Mia?
Select one:
A. interpersonal therapy
B. mentalization-based therapy
C. exposure with response prevention
D. panic control therapy
Answer C is correct: Exposure with response prevention (ERP) is an empirically supported and first-line treatment for OCD.
Answer A: Interpersonal therapy was originally developed as a treatment for depression. Although it is now used to treat other disorders as well, it is not considered to be a preferred treatment for OCD.
Answer B: Mentalization-based therapy (MBT) is a form of psychodynamic therapy that was developed as a treatment for Borderline Personality Disorder.
Answer D: Panic control therapy is a form of cognitive-behavioral therapy that, as its name suggests, is used to treat Panic Disorder and is not considered a first-line treatment for OCD.
The correct answer is: exposure with response prevention
188
The research suggests that the most effective treatment for cigarette smoking in terms of both short- and long-term effects combines:
Select one:
A. a 12-step program with individual psychotherapy.
B. a 12-step program with relapse prevention.
C. nicotine replacement therapy with individual psychotherapy.
D. nicotine replacement therapy with behavioral interventions.
Answer D is correct: Based on a review of the empirical research, the American Psychiatric Association (1996) concluded that a multimodal intervention that combines nicotine replacement therapy, multicomponent behavior therapy, and support and assistance from a clinician is the most successful approach for treating cigarette smoking.
Answers A, B, and C: See explanation for answer D.
The correct answer is: nicotine replacement therapy with behavioral interventions.
189
With regard to Schizophrenia, negative "expressed emotion" has been linked to:
Select one:
A. a sudden onset of the disorder.
B. a predominance of negative symptoms.
C. a high risk for relapse.
D. a better response to traditional antipsychotic drugs.
Expressed emotion refers to the attitudes and behaviors that family members express toward a patient with Schizophrenia (or other disorder).
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The family's expressed emotion is an important factor during the recovery process for patients with Schizophrenia. A high degree of negative expressed emotion (which involves hostility and criticism or emotional over-involvement) is associated with an increased risk for relapse.
d. Incorrect See explanation for response c.
The correct answer is: a high risk for relapse.
190
A 12-year old who has received a diagnosis of Oppositional Defiant Disorder is LEAST likely to exhibit which of the following?
Select one:
A. arguing with authority figures
B. blaming others for his/her own transgressions
C. an angry and irritable mood
D. stealing from friends and family members
Answer D is correct: Oppositional Defiant Disorder is one of the disorders that "sounds like" what it is -- i.e., it involves oppositional behaviors. Stealing from friends and family members is more indicative of Conduct Disorder.
Answers A, B, and C: The behaviors listed in these answers are characteristic of Oppositional Defiant Disorder.
The correct answer is: stealing from friends and family members
191
The presence of which of the following symptoms would suggest a diagnosis of Conduct Disorder rather than a diagnosis of Oppositional Defiant Disorder?
Select one:
A. frequent lying and running away from home
B. low frustration tolerance and temper outbursts
C. drug use
D. onset of symptoms after age 12
Conduct Disorder involves a pattern of behavior in which the basic rights of others and major age-appropriate social norms or rules are violated.
a. CORRECT Lying and running away are characteristic of Conduct Disorder. Behaviors associated with Oppositional Defiant Disorder are less severe and include negativism, defiance, and hostility.
b. Incorrect Low tolerance for frustration and temper outbursts are characteristic of both disorders.
c. Incorrect The use of drugs does not help distinguish between the two disorder.
d. Incorrect The onset of both disorders is typically prepubertal.
The correct answer is: frequent lying and running away from home
192
Abnormal melatonin levels have been linked to which of the following?
Select one:
A. Korsakoff's syndrome
B. Schizophrenia
C. Obsessive-Compulsive Disorder
D. seasonal affective disorder
Answer D is correct: Melatonin is a hormone released by the pineal gland and is involved in the regulation of circadian rhythms. Seasonal affective disorder seems to have some relation to circadian rhythms; and there is evidence that higher-than-normal levels of melatonin play a role in this disorder. Note that, in the DSM, this disorder is indicated with the specifier "with seasonal pattern."
Answers A, B, and C: See explanation for answer D.
The correct answer is: seasonal affective disorder
