STUDY MODE - Practice Exam 2 Flashcards
A client tells a clinician that she’s having a “lot of problems” with food. She states that she’s been on numerous diets over the years and, even when she’s achieved her desired weight, she always gains it back. She says that she has been evaluated for medical problems such as hypothyroidism, but all of the tests have been negative. When determining if the client’s symptoms meet the criteria for Binge Eating Disorder or Bulimia Nervosa, the clinician should keep in mind that:
Select one:
A. binges are more severe in Binge Eating Disorder than in Bulimia Nervosa.
B. a disturbance in body image is not characteristic of Bulimia Nervosa.
C. compensatory behavior is not a requirement for Binge Eating Disorder.
D. a sense of a lack of control over eating during binges is not characteristic of Binge Eating Disorder.
Answer C is correct: Compensatory behavior is a diagnostic criterion for Bulimia Nervosa but not for Binge Eating Disorder and, therefore, differentiates the two disorders.
Answer A: Binges can be severe in both disorders and, therefore, is not a distinguishing characteristic.
Answer B: The disturbance in body image associated with Bulimia Nervosa involves an excessive emphasis on body shape and weight in self-evaluation.
Answer D: A sense of a lack of control is characteristic of both disorders.
The correct answer is: compensatory behavior is not a requirement for Binge Eating Disorder.
Research investigating the effectiveness of treatments for Conduct Disorder has demonstrated that:
Select one:
A. boot camps and “tough love” policies are more effective than parent management training and multisystems therapy.
B. boot camps and “tough love” policies are as effective as parent management training and multisystems therapy.
C. boot camps and “tough love” policies are less effective than parent management training and multisystems therapy.
D. boot camps and “tough love” policies are effective only when they are combined with parent management training or multisystems therapy.
The research has clearly demonstrated that long-term multimodal or multisystems treatments - e.g., parent management training, functional family therapy, and multisystems therapy - are most effective for children and adolescents with Conduct Disorder.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Boot camps and other inoculation techniques have not been found to be effective and, in some cases, may actually be injurious. Therefore, they are not recommended as a stand-alone treatment or as elements of a multimodal intervention. See, e.g., AACAP, Practice parameters for the assessment and treatment of children and adolescents with Conduct Disorder, Journal of the American Academy of Child and Adolescent Psychiatry, 36(10), 122S-139S, 1997.
d. Incorrect See explanation for response c.
The correct answer is: boot camps and “tough love” policies are less effective than parent management training and multisystems therapy.
As described in the DSM-5, the characteristic symptoms of Substance Use Disorder can be categorized in terms of which of the following?
Select one:
A. impaired control, social impairment, risky use, and pharmacological criteria
B. functional impairment, denial of consequences, impaired control, and pharmacological criteria
C. impaired control, tolerance, withdrawal, and functional impairment
D. functional impairment, tolerance and withdrawal, risky use, and marked distress
Answer A is correct: The DSM-5 categorizes the indicators of problematic substance use in terms of the four categories listed in this answer. Impaired control refers to the tendency of the individual to use more of the substance than intended, inability to cut down on substance use, craving for the substance, and tendency to spend a great deal of time obtaining, using, or recovering from the effects of the substance. Social impairment refers to difficulties with social, occupational, and/or recreational activities due to the substance use. Risky use refers to use of the substance in situations that are potentially physically hazardous or despite knowing that physical or psychological problems may be exacerbated by substance use. Pharmacological criteria are tolerance and withdrawal.
Answers B, C, and D: See explanation for answer A.
The correct answer is: impaired control, social impairment, risky use, and pharmacological criteria
A 58-year old woman is brought to the mental health clinic where you work by her husband. She seems agitated and, during your interview with her, she paces back and forth and engages in frequent hand-wringing. The woman says she’s been feeling very sad and hopeless, and she also tells you that she thinks her next door neighbor has tried to poison her food several times because she has been so unfriendly toward him. The woman’s husband says that his wife has been gradually losing interest in her usual activities over the past several weeks but that her symptoms became worse a few days ago. Based on this information, the most likely diagnosis is:
Select one:
A. Major Depressive Disorder.
B. Schizoaffective Disorder.
C. Bipolar II Disorder.
D. Delusional Disorder.
The woman’s pervasive depressed mood and common associated symptoms (agitation, impaired memory) suggest a major depressive episode.
a. CORRECT Delusions are not uncommon in Major Depressive Disorder and often involve a belief that one is being persecuted because of immorality or a personal inadequacy.
b. Incorrect In Schizoaffective Disorder there are periods of at least two weeks duration in which there have been delusions or hallucinations in the absence of a mood disturbance.
c. Incorrect Bipolar II Disorder requires a history of hypomanic and major depressive episodes. The woman’s symptoms are not suggestive of hypomania.
d. Incorrect A diagnosis of Delusional Disorder requires the presence of delusions that are not due to Major Depressive Disorder or other disorder. This woman’s delusion seems to be part of her depression.
The correct answer is: Major Depressive Disorder.
The use of Haloperidol or other dopamine blocking agent for the treatment of Tourette’s Disorder:
Select one:
A. is uncommon since these drugs are rarely effective for alleviating tics.
B. can be problematic in many cases because of the severe side effects of these drugs.
C. is contraindicated because these drugs exacerbate tics in most patients.
D. should be considered only in the presence of psychotic symptoms.
Antipsychotic drugs are associated with a number of unpleasant side effects.
a. Incorrect Antipsychotic drugs are effective in about 80% of cases of Tourette’s Disorder.
b. CORRECT About 50% of people with Tourette’s Disorder who take Haloperidol or similar drug develop intolerable side effects.
c. Incorrect This is not true.
d. Incorrect This is not true. Antipsychotic drugs are useful for alleviating tics in most cases.
The correct answer is: can be problematic in many cases because of the severe side effects of these drugs.
Research investigating the usefulness of phototherapy as a treatment for seasonal affective disorder has generally found that it is:
Select one:
A. substantially less effective than antidepressant drugs.
B. an effective treatment and produces results comparable to those produced by antidepressant drugs.
C. effective only when administered in conjunction with a low- to moderate-dose of an antidepressant drug.
D. effective only for individuals who have atypical symptoms.
Many of the studies investigating the effectiveness of phototherapy (light therapy) for seasonal affective disorder (SAD) have been criticized on methodological grounds. However, the general consensus is that phototherapy is an effective treatment for this disorder.
a. Incorrect The studies suggest that phototherapy is as effective as antidepressants for reducing the symptoms of SAD.
b. CORRECT Of the answers given, this one best summarizes the existing research. See, e.g., R. N. Golden et al., The efficacy of light therapy in the treatment of mood disorders: A review and meta-analysis of the evidence, The American Journal of Psychiatry, 2005, 162, 656-662.
c. Incorrect The research has not found this to be true.
d. Incorrect The research has not found this to be true.
The correct answer is: an effective treatment and produces results comparable to those produced by antidepressant drugs.
A DSM-5 diagnosis of Posttraumatic Stress Disorder or Acute Stress Disorder requires the development of characteristic symptoms following exposure to:
Select one:
A. actual or threatened death, serious injury, or sexual violence.
B. actual or threatened death, serious injury, or a threat to the physical integrity of self or others.
C. one or more severe psychosocial stressors.
D. a threat to the physical integrity of self or others.
Answer A is correct: This answer (exposure to actual or threatened death, serious injury, or sexual violence) accurately describes the requirement for a DSM-5 diagnosis of PTSD or Acute Stress Disorder.
The correct answer is: actual or threatened death, serious injury, or sexual violence.
Psychological autopsies suggest that about ____% of people who complete suicide had one or more mental disorders at the time of their death.
Select one:
A. 25
B. 55
C. 70
D. 90
Psychological autopsy (PA) was originally developed as a method for identifying the mode of death in equivocal cases (i.e., homicide, suicide, natural causes, or accident) but has become the primary method for identifying the proximate cause of completed suicide.
Answer D is correct: Based on their comprehensive review of PA studies, J. T. O. Cavanagh and colleagues concluded that that about 90% of people who commit suicide had at least one diagnosable mental disorder, and this conclusion has been confirmed by a number of subsequent studies (Psychology autopsy studies of suicide: A systematic review. Psychological Medicine, 33, 395-405, 2003).
The correct answer is: 90
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.
Two weeks after witnessing the murder of a co-worker, Mrs. Cee develops a number of symptoms including a sense of detachment, flashbacks of the event, sleep problems, impaired concentration, a depressed mood, and an unwillingness to talk about the murder. She has had these symptoms for seven days. Based on these symptoms, the most likely diagnosis is:
Select one:
A. PTSD.
B. Brief Psychotic Disorder.
C. Acute Stress Disorder.
D. Conversion Disorder.
Mrs. Cee’s symptoms followed (and were apparently the result of) exposure to a traumatic event that is outside the range of normal human experience.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Because the duration of the woman’s symptoms are less than one month (the minimum duration required for PTSD), Acute Stress Disorder is the most likely diagnosis.
d. Incorrect See explanation for response c.
The correct answer is: Acute Stress Disorder.
The presence of which of the following would suggest that the appropriate diagnosis is Social Anxiety Disorder rather than Agoraphobia?
Select one:
A. fear of humiliation or embarrassment in social situations
B. increased anxiety in feared situations when accompanied by a trusted companion
C. anxiety is perceived as excessive and temporarily controllable
D. an absence of the physiological symptoms associated with a panic attack
Social Anxiety Disorder (also known as Social Phobia) and Agoraphobia are sometimes difficult to distinguish because they share several symptoms.
a. Incorrect Fear of humiliation or embarrassment in social situations is characteristic of both disorders (although the fear is not necessarily limited to social situations in Agoraphobia).
b. CORRECT The effects of having a companion in anxiety-arousing situations can help distinguish the two disorders. In Agoraphobia, the presence of a trusted companion often alleviates anxiety. In Social Anxiety Disorder, a companion can actually increase anxiety.
c. Incorrect These symptoms are not useful for distinguishing between Social Anxiety Disorder and Agoraphobia.
d. Incorrect Both disorders may or may not involve panic attacks.
The correct answer is: increased anxiety in feared situations when accompanied by a trusted companion
The diagnosis of Cyclothymic Disorder requires a minimum duration of symptoms for:
Select one:
A. one year in adults and eight months in children and adolescents.
B. one year in adolescents and adults and six months in children.
C. two years in adults and one year in children and adolescents.
D. two years in adolescents and adults and one year in children.
You’re likely to encounter one or two questions on the licensing exam that require you to know the duration requirements for a specific diagnosis. To prepare for these questions, focus on questions in the AATBS practice tests that address this issue.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT For the exam, you want to know that the minimum duration of symptoms for Cyclothymic Disorder is two years for adults and one year for children and adolescents.
d. Incorrect See explanation for response c.
The correct answer is: two years in adults and one year in children and adolescents.
Depression has been linked to:
Select one:
A. decreased REM latency and increased REM density.
B. decreased REM latency and decreased REM density.
C. increased REM latency and increased REM density.
D. increased REM latency and decreased REM density.
Depression has been linked to a number of alterations in sleep quantity and quality.
a. CORRECT The research has consistently shown that depression (especially endogenous depression) is associated with decreased sleep continuity, reduced slow-wave sleep, shortened REM latency (earlier onset of REM sleep), and increased REM density (increased frequency of rapid eye movements).
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: decreased REM latency and increased REM density.
Compared to adolescents and adults without ADHD, those with ADHD:
Select one:
A. are at an equal or reduced risk for substance use and substance use disorders.
B. are at a higher risk for substance use disorders only when they have a comorbid internalizing disorder.
C. are at a higher risk for substance use disorders only when they received psychostimulant medication as a treatment for ADHD in childhood.
D. are at a higher risk for substance use disorders with the risk being greatest for those with comorbid conduct problems.
Although the research confirms an association between ADHD and substance use and abuse in adolescents and adults, the studies have also found that several factors mediate this relationship.
a. Incorrect The research on this issue is not entirely consistent, but a number of studies have found that adolescents and adults with ADHD (especially adults in their 20s) have higher rates of substance use and substance use disorders than do those without ADHD.
b. Incorrect A higher risk for substance abuse individuals with ADHD has been established for comorbid externalizing (conduct/antisocial) disorders, not for comorbid internalizing disorders.
c. Incorrect In fact, there is evidence that children with ADHD who receive psychostimulant medication are at lower risk for developing a substance use disorder than are those with ADHD who do not receive medication. See, e.g., J. Biederman et al., Pharmacotherapy of attention deficit/hyperactivity disorder reduces risk for substance use disorders, Pediatrics, 104, 293-294, 1999.
d. CORRECT There is evidence that the link between ADHD and substance abuse is mediated by conduct problems - i.e., that the risk for substance abuse is substantially greater for those individuals with comorbid conduct disturbances. See, e.g., J. J. McGough et al., Psychiatric comorbidity in adult attention deficit hyperactivity disorder: Findings from multiplex families, American Journal of Psychiatry, 162, 1621-1627, 2005.
The correct answer is: are at a higher risk for substance use disorders with the risk being greatest for those with comorbid conduct problems.
A new client tells the clinician that she’s been feeling “down in the dumps” and “completely worthless” for the last five or six days. She also says she’s having trouble sleeping, has lost her appetite, and feels anxious “all the time.” The client denies having previous mood problems and states that there are no particular stressors in her life. The client’s symptoms are most suggestive of which of the following DSM-5 diagnoses?
Select one:
A. Major Depressive Disorder
B. Other Specified Depressive Disorder
C. Other Specified Anxiety Disorder
D. Major Depressive Episode, single episode
Answer B is correct: This client has symptoms of Major Depressive Disorder, but they have persisted for less than two weeks which is the minimum duration required for the diagnosis. Consequently, a diagnosis of Other Specified Depressive Disorder with the reason “short-duration depressive episode” is the best fit for her symptoms.
Answer A: A diagnosis of Major Depressive Disorder requires a duration of symptoms of at least two weeks.
Answer C: Although the client is experiencing anxiety, her symptoms do not meet the criteria for an anxiety disorder. Also, the DSM-5 states that “anxious distress has been noted as a prominent feature of both bipolar and major depressive disorder” (p. 184), and the client is exhibiting several symptoms that are typical of depression.
Answer D: Major depressive episode is not a DSM-5 diagnosis but, instead, is an essential feature of Major Depressive Disorder and Bipolar II Disorder and a possible feature of Bipolar I Disorder.
The correct answer is: Other Specified Depressive Disorder
On a measure that assesses the “Big Five” personality factors, a high score on neuroticism, a low score on agreeableness, and a low score on conscientiousness are most likely to be obtained by a person with ____________ Personality Disorder.
Select one:
A. Obsessive-Compulsive
B. Narcissistic
C. Schizoid
D. Antisocial
Answer D is correct: The match between the Big Five personality traits and DSM’s personality disorders is summarized in T. Widiger et al., A description of the DSM-III-R and DSM-IV personality disorders with the five-factor model of personality, in P. T. Costa and T. A. Widiger (eds.), Personality disorders and the five-factor model of personality, Washington, DC, American Psychological Association, 1994. This is the pattern reported by these investigators for individuals with Antisocial Personality Disorder.
Answer A: A person with Obsessive-Compulsive Personality Disorder is likely to obtain a high score on some aspects of neuroticism, a low score on some aspects of agreeableness, and a high score on conscientiousness.
Answer B: A person with Narcissistic Personality Disorder would obtain a high score on some aspects of neuroticism, a low score on agreeableness, and a high score on some aspects of conscientiousness.
Answer C: A person with Schizoid Personality Disorder would obtain a low score on some aspects of neuroticism, a high score on one aspect of agreeableness (compliance), and a low score on one aspect of conscientiousness (achievement striving).
The correct answer is: Antisocial
A DSM-5 diagnosis of Schizophrenia requires the presence of two or more active-phase symptoms during a one-month period with at least one symptom being ____________ plus continuous signs of disturbance for least six months.
Select one:
A. negative symptoms
B. disorganized speech or disorganized behavior
C. delusions or hallucinations
D. delusions, hallucinations, or disorganized speech
Answer D is correct: The DSM-5 specifies that at least one of the active-phase symptoms must be delusions, hallucinations, or disorganized speech.
The correct answer is: delusions, hallucinations, or disorganized speech
“In periods of crisis, such as loss, abandonment, separation, failure, and loneliness, the individual can temporarily fall back on his internal world.” This statement reflects the basic assumptions of which of the following approaches?
Select one:
A. Gestalt therapy
B. reality therapy
C. object relations theory
D. cognitive-behavioral therapy
This statement was made by Otto Kernberg (Object relations theory and clinical psychoanalysis, New York: Jason-Aronson, 1976).
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Kernberg’s statement reflects the object relations view that early social relations impact future social situations.
d. Incorrect See explanation for response c.
The correct answer is: object relations theory
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.
The characteristic symptoms of Tobacco Withdrawal include all of the following except:
Select one:
A. irritability or anger.
B. hypersomnia.
C. impaired concentration.
D. increased appetite.
Answer B is correct: As described in the DSM-5, Tobacco Withdrawal is characterized by the development of at least four characteristic symptoms within 24 hours of abrupt cessation or reduction in the use of tobacco - i.e., irritability or anger, anxiety, impaired concentration, increased appetite, restlessness, depressed mood, and/or insomnia.
Answers A, C, and D: See explanation for answer B.
The correct answer is: hypersomnia.
The presence of which of the following symptoms would be more suggestive of a diagnosis of Caffeine-Induced Anxiety Disorder than Caffeine Intoxication?
Select one:
A. tachycardia or cardiac arrhythmia
B. psychomotor agitation
C. panic attacks
D. rambling flow of thoughts and speech
The differential diagnosis of Caffeine-Induced Anxiety Disorder and Caffeine Intoxication can be difficult due the overlap between the symptoms for the two disorders.
a. Incorrect A diagnosis of Caffeine Intoxication requires the presence of at least five characteristic symptoms that develop during or shortly after the consumption of caffeine. Tachycardia or cardiac arrhythmia is one of the characteristic signs of Caffeine Intoxication.
b. Incorrect Psychomotor agitation is a symptom of Caffeine Intoxication.
c. CORRECT Caffeine-Induced Anxiety Disorder would be the more likely diagnosis when the patient’s symptoms of anxiety are in excess of those associated with Caffeine Intoxication - e.g., when the patient has signs of Generalized Anxiety Disorder, panic attacks, or obsessive-compulsive symptoms.
d. Incorrect Rambling flow of thoughts and speech are also characteristic of Caffeine Intoxication.
The correct answer is: panic attacks
The core feature of the DSM-5 diagnosis of Gender Dysphoria is which of the following?
Select one:
A. persistent preference for cross-gender roles
B. strong desire to be treated as the opposite gender
C. incongruence between assigned and experienced/expressed gender
D. cross-gender identification
Answer C is correct: Incongruence between assigned gender and experienced/expressed gender is identified as the core feature of Gender Dysphoria in the DSM-5.
Answer A: A persistent preference for cross-gender roles in make-believe or fantasy play is one of the possible symptoms for children with Gender Dysphoria, but it is not the core feature.
Answer B: The DSM-5 lists “a strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender)” (p. 452) as one of the possible symptoms of Gender Dysphoria for adolescents or adults.
Answer D: Cross-gender identification is not identified as the core feature of this disorder in the DSM-5.
The correct answer is: incongruence between assigned and experienced/expressed gender
In comparison to bilateral ECT, unilateral ECT to the right (nondominant) hemisphere:
Select one:
A. produces similar levels of anterograde and retrograde amnesia.
B. produces greater anterograde amnesia for nonverbal tasks only.
C. produces greater anterograde and retrograde amnesia for both verbal and nonverbal tasks.
D. produces less anterograde amnesia for both verbal and nonverbal tasks.
Memory loss is considered one of the primary negative side-effects of ECT. There is evidence, however, that memory loss with right unilateral ECT is less severe than with bilateral ECT.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Right unilateral ECT not only produces less retrograde amnesia but also less anterograde amnesia for verbal and nonverbal tasks.
The correct answer is: produces less anterograde amnesia for both verbal and nonverbal tasks.
The intentional production of a physical symptom for the specific purpose of obtaining financial benefits is characteristic of which of the following?
Select one:
A. Malingering
B. Factitious Disorder
C. Conversion Disorder
D. Somatic Symptom Disorder
Answer A is correct: A characteristic that distinguishes Malingering from other disorders with somatic symptoms is that the goal of Malingering is to obtain an external incentive.
Answer B: Although Factitious Disorder involves the intentional production of symptoms, its goal is not to obtain an external reward.
Answers C and D: Conversion Disorder and Somatic Symptom Disorder both involve somatic symptoms, but the goal is not to obtain an external incentive.
The correct answer is: Malingering
A child with Oppositional Defiant Disorder is least likely to exhibit which of the following?
Select one:
A. frequent conflicts with his/her parents
B. a high degree of physical aggression toward peers
C. frequently blames others for his/her mistakes
D. often loses temper
Answer B is correct: Oppositional Defiant Disorder is characterized by a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness. Although children with this disorder may be verbally aggressive, a high degree of physical aggression is not characteristic and may be a sign of comorbid Conduct Disorder.
Answers A, C, and D: See explanation for answer B.
The correct answer is: a high degree of physical aggression toward peers
Which of the following is not a DSM-5 diagnostic criterion for Conversion Disorder?
Select one:
A. one or more symptoms that involve an alteration in sensory or motor functioning
B. evidence of incompatibility between the symptoms and known medical conditions
C. symptoms are not better explained by a medical condition or other mental disorder
D. evidence that the symptoms are related to a psychological need or conflict.
Answer D is correct: This was a requirement for a diagnosis of Conversion Disorders in previous versions of the DSM, but it is not a diagnostic criterion in DSM-5.
Answers A, B, and C: These answers describe the DSM-5’s diagnostic criteria for Conversion Disorder.
The correct answer is: evidence that the symptoms are related to a psychological need or conflict.
Which of the following is NOT included as an Alcohol-Related Disorder in the DSM-5?
Select one:
A. Alcohol Dependence
B. Alcohol Intoxication
C. Alcohol Withdrawal
D. Alcohol-Induced Major Neurocognitive Disorder
Answer A is correct: Alcohol Dependence was a separate diagnosis in previous versions of the DSM but was replaced in the DSM-5 by Alcohol Use Disorder.
Answer B: Alcohol Intoxication is included as a diagnosis in the DSM-5 and involves maladaptive behavioral and psychological changes with at least one characteristic symptom (e.g., slurred speech; unsteady gait; nystagmus; impaired attention or memory).
Answer C: The DSM-5 describes Alcohol Withdrawal as involving the development of at least two characteristic symptoms within several hours to a few days following cessation or reduction of alcohol consumption (e.g., autonomic hyperactivity, hand tremor, insomnia, transient illusions or hallucinations, seizures).
Answer D: Alcohol-Induced Major Neurocognitive Disorder is described in the DSM-5 as involving a significant decline in one or more cognitive domains that interferes with independence in everyday activities.
The correct answer is: Alcohol Dependence
In its early stages, Alzheimer’s disease shares several characteristics with Korsakoff’s syndrome. Specifically, both disorders are characterized by:
Select one:
A. anterograde amnesia that affects declarative memories but not procedural memories.
B. anterograde amnesia that affects both declarative and procedural memories.
C. retrograde amnesia for recent and remote declarative (but not procedural) memories.
D. retrograde amnesia for recent (but not remote) declarative and procedural memories.
Alzheimer’s disease and Korsakoff’s syndrome share several characteristics.
a. CORRECT In Alzheimer’s disease, anterograde amnesia for declarative knowledge is often the first neurological finding. It is also characteristic of Korsakoff’s syndrome.
b. Incorrect Procedural memory is left relatively intact in both disorders, and confabulation is characteristic of Korsakoff’s syndrome but not Alzheimer’s disease.
c. Incorrect In Alzheimer’s disease, there is a “flat” retrograde amnesia that emerges once the disorder has progressed to moderate levels of impairment (i.e., the amnesia affects both remote and recent memories). In Korsakoff’s syndrome, the retrograde amnesia affects recent memories while remote memories remain intact. See, e.g., N. Butters and D. C. Delis, Clinical assessment of memory disorders in amnesia and dementia, Annual Review of Psychology, 46, 493-523, 1995.
d. Incorrect See explanation for response c.
The correct answer is: anterograde amnesia that affects declarative memories but not procedural memories.
Research examining the relationship between mild depression and autobiographical memory has found that, in comparison to the memories of people who are nondysphoric, the memories of people who are dysphoric are:
Select one:
A. less detailed and more negative.
B. more detailed and more negative.
C. less detailed and more neutral.
D. more detailed and more neutral.
Not surprisingly, the studies have linked depression to an increased memory for negative events.
a. CORRECT People who are dysphoric are also likely to have autobiographical memories that are less detailed than those of people who are nondysphoric. See, e.g., J. M. G. Williams & J. Scott, Autobiographical memory in depression, Psychological Medicine, 18,689-695, 1986.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: less detailed and more negative.
For a diagnosis of Separation Anxiety Disorder, the DSM-5 requires symptoms of fear, anxiety, or avoidance that have lasted for at least __________ in children and adolescents or about __________ in adults.
Select one:
A. one week; six months
B. four weeks; six months
C. six weeks; eight months
D. two months; eight months
Answer B is correct: The DSM-5 specifies a minimum duration of symptoms for Separation Anxiety Disorder of “4 weeks in children and adolescents and typically 6 months in adults” (p. 191).
Answers A, C, and D: See explanation above.
The correct answer is: four weeks; six months
An emphasis on contact, awareness, and experimentation is central to which of the following?
Select one:
A. Gestalt therapy
B. solution-focused therapy
C. Adlerian therapy
D. rational-emotive therapy
This is one of those questions you may have been able to answer correctly even if you had incomplete information - i.e., if you knew that the goal of Gestalt therapy is to achieve conscious awareness, you would have been able to identify response a as the correct answer.
a. CORRECT Contact, conscious awareness, and experimentation are key targets in Gestalt therapy. Contact refers to being in touch with what is happening in the here-and-now; awareness refers to focused attention in situations requiring it; and experimentation is the act of trying something new in order to increase understanding.
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: Gestalt therapy
Sue and Sue (1990) describe the worldview of counselors and their clients in terms of two dimensions - locus of control and locus of responsibility - and propose that members of minority groups are becoming increasingly more likely to exhibit which of the following worldviews?
Select one:
A. internal locus of control/internal locus of responsibility
B. external locus of control/internal locus of responsibility
C. internal locus of control/external locus of responsibility
D. external locus of control/external locus of responsibility
D. W. Sue and D. Sue (Counseling the culturally different, New York, John Wiley, 1990) propose that an understanding of different worldviews and their impact adds to the effectiveness of cross-cultural counseling.
a. Incorrect- An internal locus of control/internal locus of responsibility is characteristic of the Westernized approach to counseling, white counselors, and white middle-class clients.
b. Incorrect- An external locus of control/internal locus of responsibility is characteristic of “marginal” individuals who have been oppressed by the dominant group.
c. CORRECT- Sue and Sue propose that minority group members are becoming increasingly aware of their own ethnic identity and the impact of racism on their lives - i.e., they are adopting a worldview that reflects an internal locus of control and an external locus of responsibility.
d. Incorrect- An external locus of control/external locus of responsibility is characteristic of a “placater” who adopts a passive role.
The correct answer is: internal locus of control/external locus of responsibility
You are conducting a therapy group and you are now in the middle stage. You ask group members to shift from answering direct questions to talking freely about themselves. The group members show resistance to this. You should:
Select one:
A. allow them to express their resistance.
B. explain to them the developmental process of the group.
C. tell them that resistance is not allowed.
D. go back to asking direct questions.
In group therapy, resistance can take several forms and occurs most often in the early middle stage of therapy when members try to establish their preferred position in the group.
a. CORRECT By definition, resistance is a covert effort to undermine change; thus, it is best handled by being brought out into the open. Discussions should focus on the here-and-now and deal with what the resistance implies.
b. Incorrect While the developmental process of the group might be of interest to some members, this approach would do little, if anything, to deal with resistance.
c. Incorrect This strategy would probably engender more intense resistance.
d. Incorrect Capitulation to resistance amounts to reinforcement and is likely to increase its occurrence.
The correct answer is: allow them to express their resistance.
For members of minority groups, long-term exposure to racial oppression is most likely to result in:
Select one:
A. downplaying the importance of ethnicity and adopting a “culture-free” identity.
B. focusing on satisfying physiological needs and acquiring basic survival skills.
C. attempting to earn acceptance by acquiring material goods and other signs of status.
D. becoming socially withdrawn and isolated.
The impact of long-term racial oppression has been discussed by J. Landrum and V. Batts (Helping blacks cope with and overcome the personal effects of racism, paper presented at the annual meeting of the American Psychological Association, Los Angeles, 1985).
a. Incorrect According to Landrum and Batts, it is more likely that an individual who has been oppressed will identify with the dominant culture or, alternatively, reject the dominant culture and develop a separate ethnic identity.
b. Incorrect This is not one of the outcomes identified by Landrum and Batts.
c. CORRECT One response to racism is internalized oppression, which can be manifested in several ways including denying the impact of race and racism and attempting to earn acceptance of the dominant group through material possessions and educational or occupational status.
d. Incorrect This has not been identified as a common response to oppression.
The correct answer is: attempting to earn acceptance by acquiring material goods and other signs of status.
For Hispanic/Latino American families, the strongest family bond is most often between:
Select one:
A. husband and wife.
B. parent and child.
C. brother and sister.
D. grandparent and grandchild.
There is, of course, considerable variability in Hispanic/Latino American families, but, traditionally, family structure and relationships have had a predictable pattern.
a. Incorrect See explanation for response b.
b. CORRECT In traditional Hispanic/Latino and Hispanic/Latino American families, the parent-child relationship (and especially the mother-son and father-son relationship) is stronger than the husband-wife and other relationships listed in the answers to this question. See, e.g., C. Falicov, Latino families in therapy, New York, Guilford, 1998.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: parent and child.
During the first session with a new client, a solution-focused therapist will:
Select one:
A. conduct a thorough screening and history-taking.
B. help the client identify and describe therapy goals in concrete, positive terms.
C. educate the client about the causes of his/her presenting problem and alternative techniques for alleviating the problem.
D. identify the client’s stage of change.
As its name implies, solution-focused therapy focuses on solutions to problems rather than on the problems themselves.
a. Incorrect See explanation for response b.
b. CORRECT Stating goals in positive concrete (behavioral) terms helps the client recognize when he/she is accomplishing his/her goals and has been found to be a good predictor of outcome in solution-focused therapy.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: help the client identify and describe therapy goals in concrete, positive terms.
In schools, psychological consultants are often hired to help teachers or other school personnel resolve problems related to specific individual students. This is referred to as:
Select one:
A. consultee-centered case consultation.
B. client-centered case consultation.
C. consultee-centered administrative consultation.
D. client-centered administrative consultation.
In this situation, a consultant is working with a consultee to resolve a problem with a particular client (case).
a. Incorrect In consultee-centered consultation, the focus is on the consultee’s skills, abilities, and objectivity so that he/she can work more effectively with a particular group of clients in the future.
b. CORRECT The question describes client-centered case consultation, which is the most common form of consultation in schools and elsewhere.
c. Incorrect This type of consultation focuses on helping consultees (administrators) develop the skills they need to more effectively develop and implement programs.
d. Incorrect This is a “made-up” term.
The correct answer is: client-centered case consultation.
A client is acting in a passive-aggressive way toward a psychology intern who, in turn, becomes unconsciously passive-aggressive toward her supervisor. This is an example of which of the following?
Select one:
A. transference
B. countertransference
C. over-involvement
D. parallel process
In this situation, the intern’s behavior with the counselor is “mirroring” the client’s behavior with the intern.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This type of mirroring is referred to as parallel process and is conceptualized as a reflection of the transference/countertransference process (which makes responses a and b only partially correct).
The correct answer is: parallel process
An African American adult in which stage of Cross’s (1991) Black Racial Identity Development Model denigrates all aspects of White culture while idealizing all aspects of African American culture?
Select one:
A. internalization
B. encounter
C. immersion-emersion
D. reintegration
Cross distinguishes between four stages of identity development: pre-encounter, encounter, immersion-emersion, and internalization.
a. Incorrect A person in the internalization stage has adopted an African American worldview but is flexible in his/her attitudes toward Whites.
b. Incorrect During the encounter stage, the individual becomes increasingly aware of his/her racial heritage.
c. CORRECT During the immersion-emersion stage, the individual withdraws from the dominant (White) culture and becomes immersed in African American culture.
d. Incorrect Reintegration is not one of the stages included in Cross’s model.
The correct answer is: immersion-emersion
For Salvador Minuchin, “psychosomatic families” (e.g., those in which asthma, diabetes, or anorexia threaten the life of one child) are most likely to be characterized by which of the following?
Select one:
A. frequent intense open conflicts between family members
B. weak boundaries between family members and limited opportunities for individual autonomy
C. family roles that are inflexible and stereotyped
D. marked emotional distance between the husband and wife who are both emotionally immature
Minuchin is associated with structural family therapy, which emphasizes the nature of the family structure including the boundaries between family members.
a. Incorrect In fact, according to Minuchin, psychosomatic families are characterized by a consistent avoidance of conflict.
b. CORRECT According to Minuchin, diffuse (weak) boundaries are common in psychosomatic families.
c. Incorrect Ackerman is more associated with the importance of roles in family dysfunction.
d. Incorrect This describes “emotional divorce,” which is a term used by Bowen.
The correct answer is: weak boundaries between family members and limited opportunities for individual autonomy
From the perspective of Cross’s (1991, 2001) Black Racial Identity Development Model, change in the direction of greater racial or ethnic awareness is:
Select one:
A. a natural consequence of a person’s developmental level.
B. the result of exposure to events that increased the salience of race.
C. the result of peer influence.
D. one of the possible resolutions of an identity crisis.
Cross’s model distinguishes between four stages of identity development: pre-encounter, encounter, immersion-emersion, and internalization.
a. Incorrect See explanation for response b.
b. CORRECT The stages of Cross’s model are associated with different levels of race salience. For example, during the pre-encounter stage, race has low salience; but then exposure to one or more race-related events increases the salience of race and the individual progresses into the encounter stage.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: the result of exposure to events that increased the salience of race.
Which of the following terms is least descriptive of the Lockean tradition underlying the Western approach to individual psychotherapy?
Select one:
A. linear-cause effect
B. reductionistic
C. individualistic
D. relativistic
Most individual therapies - e.g., Freudian psychoanalysis, Jung’s analytical psychology, Adler’s individual psychology, and Rogerian therapy - reflect a Lockean approach, which emphasizes linear cause-effect relationships, value-free science, and a deterministic and reductionistic perspective. See, e.g., D. Becvar and R. Becvar, Family therapy: A Systemic integration, Boston: Allyn and Bacon, 1993.
a. Incorrect This is characteristic of the Lockean tradition.
b. Incorrect This is also characteristic of the Lockean tradition.
c. Incorrect The Lockean tradition emphasizes individualism over collectivism.
d. CORRECT Relativism is more characteristic of non-western and systems approaches. The Lockean tradition reflects an absolutist approach.
The correct answer is: relativistic
Gregory Herek (1992) attributes violence against gays and lesbians to cultural and psychological: Select one:
A. heterosexism.
B. homophobia.
C. paranoia.
D. bigotry.
In his discussion of violence against gays and lesbians, G. Herek distinguishes between cultural and psychological heterosexism [Psychological heterosexism and anti-gay violence: The social psychology of bigotry. In G. M. Herek & K. T. Berrill, Hate crimes: Confronting violence against lesbians and gay men (pp. 149-169), Newbury Park, Sage, 1992].
a. CORRECT As defined by Herek, heterosexism is an “ideological system that denies, denigrates, and stigmatizes among nonheterosexual forms of behavior, identity, relationships, or community” (p. 150). He views violence against gays and lesbians to be due to a combination of psychological (individual) and cultural heterosexism.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: heterosexism.
For Carl Jung, transference is:
Select one:
A. a form of projection.
B. sexual “acting out.”
C. symbolization.
D. a fantasy.
For Jung, transference is a specific form of the more general process of projection.
a. CORRECT Jung believed that, when transference occurs in therapy, elements of the client’s personal and collective (transpersonal) unconscious are projected onto the therapist.
b. Incorrect Jung disagreed with Freud that all transferences have a sexual nature.
c. Incorrect Although symbols are an important part of Jung’s theory, he did not describe transference as “symbolization.”
d. Incorrect Jung did not describe transference as a form of fantasy.
The correct answer is: a form of projection.
In terms of group therapy, premature termination has been found to depend most on the members’:
Select one:
A. locus of control.
B. expectations.
C. psychological mindedness.
D. diagnosis
One of the most consistent findings of the research on group therapy is that people who terminate prematurely from group treatment are those who have unrealistic expectations and unfavorable attitudes.
a. Incorrect See explanation for response b.
b. CORRECT Because of the relationship between unrealistic expectations and premature termination, experts suggest that, to ensure the success of a therapy group, members should be selected through prescreening or should be given some type of pregroup training.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: expectations.
For an extended family systems (Bowenian) therapist, when a family exhibits a high degree of fusion but one member is more differentiated than the others, the likely approach would be to:
Select one:
A. work with the least differentiated family members.
B. work with the most differentiated family member.
C. work with all members of the extended family as a group.
D. work with all family members in individual therapy until they reach a similar level of differentiation.
According to Murray Bowen, a high degree of fusion (emotional “stuck togetherness”) is the source of family dysfunction. The goal of Bowen’s form of family therapy, therefore, is to help family members become less fused, or more differentiated (individuated). In contrast to many other family therapists, Bowen’s form of therapy typically does not involve seeing all of the family members.
a. Incorrect Followers of Bowen would likely work first with the most differentiated family member.
b. CORRECT Bowen often worked with the most differentiated family member on the assumption that, when that member changed in a positive way, his/her change would motivate other family members to move toward greater differentiation.
c. Incorrect In contrast to many other family therapists, Bowen typically worked with the two most significant adult family members, usually the parents, or the parent who was the most differentiated, even when the “identified patient” was a child.
d. Incorrect This is not a technique used by Bowen.
The correct answer is: work with the most differentiated family member.
Nonsexist therapy, in comparison to feminist therapy, places greater emphasis on:
Select one:
A. the impact of sex roles and sexism.
B. modification of personal behavior.
C. treating men and women the same.
D. the egalitarian nature of the therapeutic relationship.
To a large degree, nonsexist therapy and feminist therapy overlap.
a. Incorrect This is characteristic of both forms of therapy.
b. CORRECT Of the answers given, this is the best choice. While feminist therapy produces change in personal behavior, that change is more consistently framed within the sociopolitical arena in which it occurs. In contrast, nonsexist therapy, while recognizing sociopolitical influences, also looks at personal change separately.
c. Incorrect Both types of therapy advocate that men and women be treated as equals but not necessarily the same.
d. Incorrect This is an explicit goal of feminist therapy and, perhaps to a lesser degree, a characteristic of nonsexist therapy.
The correct answer is: modification of personal behavior.
Which of the following best describes the results of research on client and provider satisfaction with the use of videoconferencing and other forms of telehealth to deliver mental health services?
Select one:
A. Clients express high levels of satisfaction with telehealth but providers express low levels of satisfaction.
B. Providers express high levels of satisfaction with telehealth but clients express low levels of satisfaction.
C. Clients and providers both express satisfaction with telehealth and most clients express a stronger preference for telehealth than for in-person services.
D. Clients and providers both express satisfaction with telehealth but some providers also express concerns about its effectiveness.
Research on telehealth (which, in the context of mental health, is also known as telepsychology, telepsychiatry, and telemental health) has generally found that satisfaction ratings are high among both clients and providers.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect Although clients are satisfied with telehealth, they express similar levels of preference for telehealth and in-person services.
d. CORRECT The research has focused primarily on clients and has found that they generally express high levels of satisfaction with telehealth. Studies looking at providers has confirmed that they also tend to be satisfied but that there is greater variability in their satisfaction ratings due to concerns about its effectiveness. See, e.g., J. Monnier, R. G. Knapp, and B. C. Frueh, Recent advances in telepsychiatry: An updated review, Psychiatric Services, 54, 1604-1609, 2003.
The correct answer is: Clients and providers both express satisfaction with telehealth but some providers also express concerns about its effectiveness.
As defined by Wrenn (1985), a “culturally encapsulated” counselor:
Select one:
A. has had little or no exposure to individuals from different cultures.
B. disregards cultural differences and his/her own cultural biases.
C. prioritizes culture as an etiological factor in mental illness.
D. recognizes that universal principles of behavior do not apply to everyone.
For the exam, you want to be familiar with the characteristics of a culturally encapsulated counselor. Additional information about these characteristics is provided in the Clinical Psychology chapter of the written study materials.
a. Incorrect See explanation for response b.
b. CORRECT According to Wrenn, a culturally encapsulated counselor disregards cultural differences and defines everyone’s reality according to his/her own cultural assumptions and stereotypes.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: disregards cultural differences and his/her own cultural biases.
Although the various models of homosexual (gay/lesbian) identity development differ somewhat in terms of the number and nature of the stages they propose, most (or all) describe a person in the initial stage as:
Select one:
A. revealing to another person that he/she is not sexually attracted to people of the opposite gender.
B. actively denying his/her sexual attraction toward same-gender individuals.
C. recognizing that he/she is different from same-gender peers.
D. first realizing that he/she is sexually attracted to people of the same gender.
Being familiar with Troiden’s (1988) homosexual identity development model would have helped you recognize the correct answer to this question.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT Troiden’s initial stage is the sensitization stage and occurs prior to puberty. During this stage, the individual feels socially different from same-gender peers. For example, a girl may say that, unlike her female friends, she’s not interested in boys or that she’s more independent or aggressive than other girls; while a boy might say that he’s less interested in sports and more interested in arts than his male peers.
d. Incorrect See explanation for response c.
The correct answer is: recognizing that he/she is different from same-gender peers.
A therapy client’s negative transference is most likely to be manifested in which of the following ways?
Select one:
A. The client will criticize the therapist and be pessimistic about the outcomes of therapy.
B. The client will be more willing to talk about anxiety-arousing events.
C. The client will say whatever comes to his/her mind.
D. The client will express unrealistic positive expectations for the outcomes of therapy.
The interpretation of a client’s transferences is an important part of psychodynamic psychotherapy.
a. CORRECT Negative transference involves the projection of negative emotions onto the therapist and may manifest itself several ways including making direct, negative comments about the effectiveness of therapy or being late for or missing appointments.
b. Incorrect Transference is a form of resistance and, consequently, is not likely to increase a client’s willingness to talk about anxiety-arousing events.
c. Incorrect This describes the psychodynamic technique of free association and is not how a client would be likely to manifest transference.
d. Incorrect Unrealistic positive expectations for the outcomes of therapy are more likely to be a manifestation of positive transference.
The correct answer is: The client will criticize the therapist and be pessimistic about the outcomes of therapy.
Structural family therapy entails three overlapping steps or stages. Which of the following techniques is/are most useful during the first step?
Select one:
A. reframing and relabeling
B. tracking and mimesis
C. constructing a family map
D. enactment
The three steps in structural family therapy are joining, evaluating/diagnosing, and restructuring.
a. Incorrect Reframing and relabeling are restructuring techniques.
b. CORRECT Tracking (identifying and using the family’s values, life themes, etc.) and mimesis (adopting the family’s affective and behavioral style) are methods used to join the family system. Joining is the initial step in structural family therapy.
c. Incorrect A family map is used to facilitate the structural diagnosis of the family.
d. Incorrect Enactment is a technique used to facilitate diagnosis and restructuring of the family.
The correct answer is: tracking and mimesis
A client who is a member of a minority group expresses negative feelings about her own culture and positive feelings toward the dominant (Anglo) culture. From the perspective of Atkinson, Morten, and Sue’s (1993) Racial/Cultural Identity Development Model, this client is in which stage?
Select one:
A. conformity
B. dissonance
C. immersion
D. denial
The Racial/Cultural Identity Development Model distinguishes between five stages: conformity; dissonance; resistance and immersion; introspection; and integrative awareness.
a. CORRECT This stage is characterized by a preference for the dominant culture over one’s own culture.
b. Incorrect This stage is characterized by cultural conflict and confusion.
c. Incorrect The immersion stage is marked by an active rejection of the dominant (Anglo) society and acceptance of one’s own culture.
d. Incorrect Denial is not one of the stages of this model.
The correct answer is: conformity
A therapist tells a client who wants to quit smoking that he should keep his only pack of cigarettes in a place that is accessible only by walking for more than one mile. This is an example of which of the following paradoxical techniques?
Select one:
A. reframing
B. symptom prescription
C. ordeal
D. restraining
In this situation, smoking becomes self-punishing because of the amount of work (walking one mile) it will take in order to smoke.
a. Incorrect Reframing involves helping the client see a behavior in a different (and usually more positive) way.
b. Incorrect Symptom prescription (aka prescribing the symptom) involves instructing the client to engage in the undesirable behavior in order to help the client recognize that the behavior is under his/her control.
c. CORRECT Haley (1984) described several types of ordeals. One type involves having the individual perform an unpleasant or inconvenient act in order to engage in the target behavior - which is what this question describes.
d. Incorrect Restraining involves encouraging the client not to change in order to elicit resistance and thereby facilitate change.
The correct answer is: ordeal
Dr. Wilson has been treating a heterosexual couple for sexual problems for three weeks. His first intervention was to instruct the couple to use the squeeze technique. When this technique had beneficial results, he then instructed the couple to attempt intercourse using the female-superior position. Based on this information, you can conclude that:
Select one:
A. the husband met the diagnostic criteria for Premature Ejaculation.
B. the husband met the diagnostic criteria for Erectile Disorder.
C. the wife met the diagnostic criteria for Sexual Arousal Disorder.
D. the wife met the diagnostic criteria for Vaginismus.
Standard treatments for the sexual dysfunctions are based primarily on the work of Masters and Johnson (1970).
a. CORRECT Knowing that the squeeze technique is a treatment for Premature Ejaculation would have enabled you to identify this as the correct response. Note that the woman-superior (woman-on-top) position is used for this disorder as well as several other sexual dysfunctions.
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: the husband met the diagnostic criteria for Premature Ejaculation.
Harry Stack Sullivan’s interpersonal approach to psychiatry identifies ____________ as the primary cause of psychopathology.
Select one:
A. unconscious conflicts
B. excessive anxiety
C. obstacles to self-actualization
D. avoidance of ultimate concerns
Sullivan believed that human behavior is motivated by two needs - the need for satisfaction and the need for security. The need for satisfaction is fulfilled by things that meet the individual’s biological needs (food, water, shelter, etc.), while the need for security is fulfilled by gratifying experiences with others.
a. Incorrect See explanation for response b.
b. CORRECT Sullivan emphasized the role of anxiety in personality development and psychopathology. As described by Sullivan, excessive anxiety is the result of interpersonal insecurity that can be traced to problems in interpersonal relationships (especially during infancy and childhood) and is the basis for most psychiatric problems.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: excessive anxiety
Dr. Wright, a licensed psychologist, has been seeing Aimee Ames in individual therapy for nearly six months. Aimee has just decided to divorce her husband and asks Dr. Wright if he will conduct custody evaluations of her three children. As an ethical psychologist, Dr. Wright:
Select one:
A. should conduct the custody evaluations only if he obtains the consent of Mr. Ames.
B. should conduct the custody evaluations only if he also evaluates Mr. Ames.
C. should conduct the custody evaluations only if he determines that his professional relationship with Mrs. Ames will not interfere with his objectivity.
D. should not conduct the custody evaluations.
This issue is addressed in Paragraph 7 of the Guidelines for Child Custody Evaluations in Family Law Proceedings (APA, 2010).
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This response is most consistent with Paragraph 7 of the Guidelines, which states that “psychologists strive to avoid conflicts of interest and multiple relationships in conducting evaluations.”
The correct answer is: should not conduct the custody evaluations.
During her first therapy session, a client tells you that she wants to pay for her sessions in cash and that she doesn’t want you to keep a record of her sessions or payments. If you agree to this arrangement:
Select one:
A. you are acting ethically as long as you ascertain that her reason for making this request is valid.
B. you are acting ethically since it is up to you to decide what to include in a client’s records.
C. you are acting ethically and legally as long as you report her payments as income on your income tax forms.
D. you are acting unethically and possibly illegally.
Record keeping is addressed in laws, organizational regulations, and ethical guidelines.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This answer is most consistent with legal and ethical requirements. For example, Guideline 2 of the APA’s (2007) Record Keeping Guidelines states that a “psychologist strives to maintain accurate, current, and pertinent records of professional services as appropriate to the circumstances and may be required by the psychologist’s jurisdiction”; and Standard 6.01 of the APA’s (2002) Ethic Code presents reasons why it is important for psychologists to create and maintain adequate records.
The correct answer is: you are acting unethically and possibly illegally.
You are asked to assist with a single-parent therapy group. The therapist leading the group is also conducting a study designed to evaluate the psychological problems of parents who are raising their children alone. You become aware that the therapist has not informed group participants that they do not have to be included as subjects in the research project. Your first action should be to:
Select one:
A. immediately discontinue your participation in the group.
B. advise participants that they may withdraw from the group.
C. advise the therapist that he is acting unethically.
D. report the therapist to the local ethics committee.
APA’s Ethics Code requires that research participants be informed that they may withdraw at any time from the research. Thus, the therapist is acting unethically and appropriate action should be taken.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT In terms of response to an ethical violation, the Ethics Code recommends that a psychologist first attempt an informal resolution by discussing the violation with the violator. Thus, this response is most consistent with the provisions of the Ethics Code.
d. Incorrect See explanation for response c.
The correct answer is: advise the therapist that he is acting unethically.
A licensed psychologist who provides individual and group therapy to adolescents and adults learns that she is HIV+. In terms of ethical requirements, the psychologist:
Select one:
A. should refrain from initiating any professional activities that might be adversely affected by her medical condition.
B. should obtain supervision to ensure that her medical condition does not impair her ability to provide effective services to clients.
C. should inform her clients of her medical condition “as early as is feasible.”
D. is not obligated to take any special actions or precautions in this situation.
Standard 2.06 of the Ethics Code applies to this situation.
a. CORRECT Standard 2.06 requires psychologists to “refrain from initiating an activity when they know or should know there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner.” Personal problems include emotional, social, health-related and other personal issues.
b. Incorrect Although the psychologist should “take appropriate measures” if she believes her condition may interfere with the performance of her work-related duties, supervision may not be the best course of action.
c. Incorrect It is not necessary for the psychologist to inform her clients of her condition and, in some cases, may not be in the best interests of the clients to do so.
d. Incorrect See explanation for response a.
The correct answer is: should refrain from initiating any professional activities that might be adversely affected by her medical condition.
The brother of a former client of yours calls you requesting that you release the client’s therapy records to him. The client died several months prior to this request. As an ethical psychologist, you:
Select one:
A. release the records to him since he is a family member.
B. release the records to him since requirements for maintaining confidentiality do not extend beyond a client’s death.
C. release the records only after obtaining a waiver from the executor or administrator of the client’s estate.
D. refuse to release the records under any circumstance.
Although this situation is not explicity addressed by the Ethics Code, Standard 4.05(a) states that “psychologists may disclose information with the appropriate consent of the organizational client, the individual client/patient, or another legally authorized person on behalf of the client/patient unless prohibited by law. (Also, keep in mind that, on the exam, it’s always best to choose the most “conservative” response - i.e., the response that best protects the client’s welfare.)
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This response is most consistent with ethical requirements as well as with state laws. For example, a Massachusetts statute relevant to the practice of psychology states that “all communications … shall be deemed to be treated as confidential in perpetuity” (251 CMR 1.11). And, in jurisdictions that have similar laws, the records of a deceased client cannot (usually) be released to a family member or other person without a court order or release from the executor or administrator of the client’s estate.
d. Incorrect See explanation for response c.
The correct answer is: release the records only after obtaining a waiver from the executor or administrator of the client’s estate.
The Ethics Code requires that a psychologist discuss the issue of fees and billing policies with a new client:
Select one:
A. prior to the first consultation.
B. during the first session.
C. when the psychologist deems it appropriate.
D. as early as is feasible.
This issue is addressed in Standard 6.04(a): Fees and Financial Arrangements.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT “As early as is feasible” is the language used in the Ethics Code and, therefore, is the best answer to this question.
The correct answer is: as early as is feasible.
The best predictor of whether a client will become sexually involved with a therapist is:
Select one:
A. the client’s level of physical attractiveness.
B. the client’s history of sexual abuse.
C. the therapist’s professional experience and status.
D. the therapist’s past history with regard to sexual involvement with a client.
Once again, past behavior is the best predictor of future behavior which narrows your choices down to responses b and d.
a. Incorrect The client’s physical attractiveness does not appear to be a factor in sexual misconduct among therapists.
b. Incorrect Although certain client behaviors and background factors may place them at higher risk for sexual involvement with a therapist, client characteristics are not as good as the therapist’s history at predicting whether or not the client will become sexually involved with his/her therapist.
c. Incorrect The therapist’s experience and status have not been found to correlate highly with sexual misconduct.
d. CORRECT The research shows that recidivism rates for sexual misconduct among therapists are quite high, leading to the conclusion that a therapist’s history with regard to sexual involvement with clients is the best predictor of future involvement.
The correct answer is: the therapist’s past history with regard to sexual involvement with a client.
According to the APA’s General Guidelines for Providers of Psychological Services, a “user” of clinical and counseling psychological services includes:
Select one:
A. direct users of services only (“patients” and “clients”).
B. direct users and third party purchasers of such services.
C. direct users, third party purchasers, and sanctioners (people who have legitimate concern related to the provision of psychological services).
D. direct users, third party purchasers, sanctioners, and public/private facilities and organizations receiving psychological services.
According to the General Guidelines, a “user” of clinical and counseling psychological services includes direct users, third party purchasers, sanctioners, and public/private facilities and organizations receiving psychological services.
a. Incorrect The users of psychological services are not limited to direct users only.
b. Incorrect The users of psychological services are not limited to direct users and third party purchasers only.
c. Incorrect The users of psychological services are not limited to direct users, third party purchasers, and sanctioners only.
d. CORRECT All of these are defined as users of psychological services in the General Guidelines.
The correct answer is: direct users, third party purchasers, sanctioners, and public/private facilities and organizations receiving psychological services.
The APA’s (2007)Record Keeping Guidelines recommends that, in the absence of superseding laws or regulations, psychologists should retain:
Select one:
A. the full record of an adult client until seven years after termination of therapy.
B. the full record of an adult client until 12 years after termination of therapy.
C. the full record of an adult client until three years after termination and a summary of the record for at least four additional years.
D. the full record of an adult client until five years after termination and a summary of the record for at least seven additional years.
Paragraph 7 of the 2007 version of the APA’s Record Keeping Guidelines specifies that a “psychologist strives to be aware of applicable laws and regulations and to retain records for the period required by legal, regulatory, institutional, and ethical requirements.”
a. CORRECT In comments on the application of Paragraph 7, the Guidelines states that, in the absence of superseding laws or institutional regulations, “psychologists may consider retaining full records until 7 years after the last date of service delivery for adults or until 3 years after a minor reaches the age of majority, whichever is later. In some circumstances, the psychologist may wish to keep records for a longer period, weighing the risks associated with obsolete or outdated information, or privacy loss, versus potential benefits associated with preserving the records.” This answer is most consistent with these recommendations.
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: the full record of an adult client until seven years after termination of therapy.
A client reveals to you that he and a friend robbed a convenience store six months ago. He says he knows that what he did was wrong and will never do it again. He also says that he notices that you “make notes” while he is talking, and he asks that you not keep any written record of the robbery. You should:
Select one:
A. agree to exclude information about the robbery from his file.
B. determine whether the robbery is clinically relevant before deciding whether or not to include information about it in his file.
C. inform the client that you are legally required to report the matter to the authorities before you actually do so.
D. reassure the client that anything he tells you is confidential and will not be revealed without his consent.
Psychologists are generally not required to report criminal conduct unless it is conduct explicitly addressed by the law (e.g., child abuse, danger to others).
a. Incorrect Omitting client information from the record at the client’s request is not necessarily in the best interests of the client or the therapist.
b. CORRECT This is the best response of those given. A similar situation is discussed by R. Woody, who notes that client records are for the benefit of both the client and the therapist and that, if the client “communicates information that is relevant to the services provided, it should be entered into the record” (Legally safe mental health practice: Psycholegal questions and answers, Madison, CT, Psychosocial Press, 1997, p. 70).
c. Incorrect See explanation above.
d. Incorrect It is important to keep in mind that it is impossible to guarantee that any client information will never be revealed under any circumstance.
The correct answer is: determine whether the robbery is clinically relevant before deciding whether or not to include information about it in his file.
When conducting group therapy, you should remind group members:
Select one:
A. that they are legally bound to maintain confidentiality.
B. that, since they are not legally bound to maintain confidentiality, they should not expect other members to do so.
C. that, as members of a therapy group, they are ethically required to maintain confidentiality.
D. of the importance of maintaining the confidentiality of statements made during group sessions.
Confidentiality is an important issue in therapy but poses special problems in multi-client situations.
a. Incorrect Legally, privilege is waived in many states if a third party (e.g., other group member) is present at the time the information is revealed. Also, other group members are not governed by privilege laws. Consequently, there is no legal requirement for confidentiality by group members.
b. Incorrect This would NOT be a particularly useful approach in helping to ensure that clients do maintain the confidentiality of other group members.
c. Incorrect Group members are not bound by professional codes regarding confidentiality.
d. CORRECT Of the responses given, this is the best approach and is most consistent with Standard 10.03 of the Ethics Code.
The correct answer is: of the importance of maintaining the confidentiality of statements made during group sessions.
With regard to informed consents in research, APA’sEthics Code:
Select one:
A. requires psychologists to provide potential research participants with specific information in “reasonably understandable language” prior to consenting to participate.
B. requires psychologists to “ensure that potential research participants understand” the information they have been given prior to consenting to participate.
C. requires psychologists to provide potential research participants with specific information prior to consenting to participate.
D. requires psychologists to provide potential research participants with specific information in “reasonably understandable language” and to ensure that they understand the information prior to consenting to participate.
With certain exceptions, psychologists must obtain informed consents from individuals prior to their participation in a research study.
a. CORRECT The issue of language and informed consent is addressed in Standard 3.10 of the Ethics Code. It outlines the specific information that psychologists must give potential participants, therapy clients, and others as part of the informed consent process and states that the information must be supplied in “reasonably understandable language.” The Code does not, however, explictly state that psychologists must ensure that participants understand the information.
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: requires psychologists to provide potential research participants with specific information in “reasonably understandable language” prior to consenting to participate.
Dr. Goodman has been dating Billy Bob for seven weeks when she realizes that he is the brother of a client she has been seeing in therapy for nearly three months. Dr. Goodman’s best course of action would be to:
Select one:
A. refer the client to another therapist immediately.
B. stop seeing Billy Bob immediately.
C. discuss the matter with the client as soon as possible.
D. do nothing until it becomes evident that the situation is creating a conflict.
The APA’s Ethics Code warns against becoming involved in multiple relationships. However, it does not directly address this particular situation.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT This response is most consistent with the spirit of Standard 3.05(b) of the Ethics Code which states, “If a psychologist finds that, due to unforeseen factors, a potentially harmful multiple relationship has arisen, the psychologist takes reasonable steps to resolve it with due regard for the best interests of the affected person and maximal compliance with the Ethics Code.” It may be necessary, eventually, to refer the client to another therapist or end the relationship with Billy Bob, but neither of these would be the best initial action.
d. Incorrect See explanation for response c.
The correct answer is: discuss the matter with the client as soon as possible.
You assessed a defendant who is accused of rape using a single standardized personality inventory. The defendant’s profile does not seem to be consistent with the nature of the crime. You should:
Select one:
A. testify as an expert witness that you believe the defendant is not guilty.
B. testify as a character witness.
C. should not disclose the results of this personality inventory.
D. should not base a conclusion on the results of a single assessment profile.
According to Standard 9.01(a) of the APA’s Ethics Code, “psychologists base the opinions contained in their recommendations, reports, and diagnostic or evaluative statements, including forensic testimony, on information and techniques sufficient to substantiate their findings.” Consequently, you should not draw a conclusion in this situation based solely on the results of a single assessment test.
a. Incorrect See explanation above.
b. Incorrect See explanation above.
c. Incorrect See explanation above.
d. CORRECT See explanation above.
The correct answer is: should not base a conclusion on the results of a single assessment profile.
According to the APA’s Guidelines for Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations, when a client belonging to a different ethnic or cultural group comes to therapy, a therapist is best advised to:
Select one:
A. treat the client like any other person unless there is reason to do otherwise.
B. alter the diagnostic and treatment processes to coincide with the client’s ethnic or cultural background.
C. recognize that ethnic and cultural forces can have an impact on both the therapist’s and the client’s psychological processes.
D. refer the client to another therapist from the same ethnic or cultural background whenever it is feasible to do so.
The Guidelines for Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations addresses several issues related to assessment, intervention, and research with clients from different ethnic and cultural backgrounds.
a. Incorrect Although there are times when this would be the appropriate course of action (e.g., when the client exhibits a high degree of acculturation into the “mainstream” culture), it is not a recommended strategy.
b. Incorrect This may be appropriate in some situations, but not all of them.
c. CORRECT Paragraph 3a states that “Psychologists recognize ethnicity and culture as significant parameters underlying psychological processes,” and this refers not only to the processes of the client but also to those of the therapist (e.g., therapists must be aware of their own prejudices and stereotypes when working with clients from different ethnic and cultural groups).
d. Incorrect This may be appropriate in some situations but is not a general requirement.
The correct answer is: recognize that ethnic and cultural forces can have an impact on both the therapist’s and the client’s psychological processes.
Responsibility for the validity of information provided by an automated test scoring and interpretation service lies with:
Select one:
A. the test scoring and interpretation service.
B. the psychologist who is in charge of the test scoring and interpretation service.
C. the psychologist who uses the test scoring and interpretation service.
D. the test scoring and interpretation service and the psychologist who uses the service.
This issue is addressed in Standard 9.09(c) of the Ethics Code.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT According to the Code, “psychologists retain responsibility for the appropriate application, interpretation, and use of assessment instruments, whether they score and interpret such tests themselves or use automated or other services.”
d. Incorrect See explanation for response c.
The correct answer is: the psychologist who uses the test scoring and interpretation service.
A new client of yours, who is homosexual, tells you that he overheard his previous therapist make derogatory remarks about his sexual orientation to a co-worker. Your best course of action would be to:
Select one:
A. discuss his option of filing a complaint against the psychologist with the Ethics Committee.
B. file a complaint against the psychologist with the Ethics Committee yourself.
C. call the psychologist and tell him that your client overheard his remarks.
D. provide the client with support and remind him that there are many prejudiced people in the world.
This is a difficult question that requires a careful reading of the responses.
a. CORRECT This is usually an acceptable course of action when a client reveals that a previous therapist has acted unethically. Note that responses b and c can be eliminated because they do not address the issue of the client’s confidentiality: Before talking to the psychologist yourself or contacting the Ethics Committee, you would want to get a waiver from the client.
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: discuss his option of filing a complaint against the psychologist with the Ethics Committee.
You are starting a new program for children of recently divorced parents. You tell the editor of the local newspaper (who has just divorced her husband) that her two children can attend the program for free if she puts an article about the program in the paper. According to the Ethics Code, this is:
Select one:
A. unethical because it constitutes coercion.
B. unethical because psychologists are prohibited from compensating a newspaper employee for publicity in a news item.
C. unethical only if you influence the content of the article.
D. ethical as long as the arrangement doesn’t compromise your objectivity when working with the editor’s children.
This issue is addressed in Standard 5.02(b) of the APA’s Ethics Code.
a. Incorrect See explanation for response b.
b. CORRECT The Code prohibits psychologists from compensating employees of the press for providing publicity about the psychologist or his/her work in a news item.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: unethical because psychologists are prohibited from compensating a newspaper employee for publicity in a news item.
Providing therapy to a former sex partner:
Select one:
A. is not directly addressed by the Ethics Code but is covered by the prohibition against multiple relationships.
B. is permissible only when it is not clinically contraindicated and the chance of exploitation is minimal.
C. is permissible under “unusual circumstances” when at least two years have passed since the sexual relationship ended.
D. is explicitly prohibited by the Code.
Standard 10.07 of the Ethics Code addresses the issue of therapy with former sexual partners.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect If you picked this response, you’ve mixed up the situation asked about in this question with becoming involved sexually with a former client.
d. CORRECT According to the Code, “Psychologists do not accept as therapy clients/patients persons with whom they have engaged in sexual intimacies.” There are no exceptions to this prohibition.
The correct answer is: is explicitly prohibited by the Code.
You are meeting with the parents of a teenage daughter who is suffering from an eating disorder. All of their children have attended this first session. You should:
Select one:
A. obtain a release of information from all family members.
B. clarify at the outset your relationship with each family member.
C. refer the daughter who is the identified patient for individual therapy.
D. include only the parents and identified patient in family therapy
According to Standard 10.02(a) of the APA’s Ethics Code, “When psychologists agree to provide services to several persons who have a relationship (such as spouses, significant others, or parents and children), they take reasonable steps to clarify at the outset (1) which of the individuals are clients/patients and (2) the relationship the psychologist will have with each person. This clarification includes the psychologist’s role and the probable uses of the services provided or the information obtained.”
a. Incorrect See explanation above.
b. CORRECT See explanation above.
c. Incorrect See explanation above.
d. Incorrect See explanation above.
The correct answer is: clarify at the outset your relationship with each family member.
A psychologist acts as both a consultant to the court and a fact witness for the defense in a criminal case. This:
Select one:
A. represents a clear conflict of interest and is prohibited by APA guidelines.
B. represents a “multiple relationship” and is explicitly prohibited by APA guidelines.
C. may be acceptable as long as the psychologist clarifies her roles with the court and the defense.
D. may be acceptable as long as the psychologist gets written permission from the court to act as a fact witness.
Dual (multiple) relationships in forensic settings are addressed in the Ethics Code and the Specialty Guidelines for Forensic Psychology.
a. Incorrect Although a conflict of interest should always be avoided, this particular situation does not necessarily constitute a conflict of interest.
b. Incorrect This situation may be described as a “multiple relationship,” but it is not one that is explicity prohibited by APA guidelines.
c. CORRECT Accepting dual roles (e.g., acting as a consultant for one party and a fact witness for another) may be acceptable as long as the psychologist clarifies his/her roles with both parties and acts in a way that does not compromise his/her judgment and objectivity.
d. Incorrect See explanation for response c.
The correct answer is: may be acceptable as long as the psychologist clarifies her roles with the court and the defense.
Dr. Passe is hired by a company to evaluate an employee for promotion into a high-level position. The company manager tells Dr. Passe that the employee was evaluated six years ago prior to his last promotion, and the company wants Dr. Passe to make a recommendation based on those results without an additional evaluation. Dr. Passe is concerned that some of the information from the evaluation is no longer relevant. He should:
Select one:
A. comply with the manager’s request since it is up to her (the manager) to decide what is relevant.
B. comply with the manager’s request but warn her of any potential limitations of her recommendation.
C. comply with the manager’s request only if the employee agrees to the conditions.
D. discuss with the manager the possibility that the data are obsolete and that new data should be collected.
This question is pretty straightforward. It is unethical to base decisions on obsolete data.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Psychologists have a responsibility to ensure that their recommendations are accurate, which would not be the case if they are based on obsolete data. Providing information about the possible limitations (response b) of a recommendation would be insufficient.
The correct answer is: discuss with the manager the possibility that the data are obsolete and that new data should be collected.
Dr. Looby receives a letter from the Ethics Committee stating that the Committee has received a complaint from a current client who is concerned about Dr. Looby’s office staff and procedures. The client has found two members of the staff to be consistently rude, and they have made comments to her that imply they have access to confidential information. Dr. Looby should:
Select one:
A. discuss the matter with the staff members.
B. set up an appointment with the client to discuss the matter.
C. send a letter of apology to the client and inform her that changes will be made.
D. respond to the Committee in writing.
This question is difficult to answer because none of the responses describes an entirely inappropriate action. However, only one response addresses APA requirements.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT This response addresses the requirements of APA’s Ethics Code and Rules and Procedures - i.e., both documents require psychologists to cooperate with the Ethics Committee. Specifically, Part II, Standard 8.2 of the Rules and Procedures requires psychologists to respond to charges of unethical conduct personally and Standard 9 requires full cooperation “in a timely fashion.” How Dr. Looby responds to the client’s charges - e.g., by talking to the client, discussing the matter with the staff - depends on the situation.
The correct answer is: respond to the Committee in writing.
A 13-year old client tells his therapist that he wants to kill himself and that he has access to his father’s gun collection. The therapist believes the boy’s threat is a serious one and tells him that she will have to contact his parents. The boy gets very angry and says he thought they had agreed that everything he said in therapy was confidential. If the therapist contacts the boy’s parents, she has:
Select one:
A. acted ethically only if the limits of confidentiality were discussed with the boy at the beginning of therapy.
B. acted ethically because a breach of confidentiality is justified in this situation.
C. acted unethically if confidentiality was, in fact, guaranteed to the boy at the outset of therapy.
D. acted unethically if she contacts the boy’s parents without his consent.
In this situation, a breach of confidentiality is both ethical and legal.
a. Incorrect See explanation for response b.
b. CORRECT A psychologist must take appropriate action whenever a client is a danger to him/herself. Contacting the boy’s parents would be an appropriate action.
c. Incorrect See explanation for response b.
d. Incorrect See explanation for response b.
The correct answer is: acted ethically because a breach of confidentiality is justified in this situation.
During his first therapy session, an Asian American client tells his non-Asian therapist that he would prefer to see an Asian psychologist. The therapist’s best course of action would be to:
Select one:
A. discuss the issue with the client and make a referral if, after the discussion, the client says he still wants to see an Asian therapist.
B. tell the client that she’s had experience working with members of minority groups and suggest that they see each other for at least two or three more sessions.
C. realize that the client’s preference is a manifestation of resistance and tell him that she thinks it would be best if they saw each other for a few sessions before a referral is made.
D. tell the client that it would be discriminatory, and therefore unethical, for her to make a referral to another therapist on the basis of race alone.
This question is fairly simple: It is never ethical to coerce a client into remaining in therapy.
a. CORRECT This is the best course of action in this type of situation. The client will not benefit from treatment if he is not comfortable with the therapist, and it would be unethical to try to “talk him into” additional sessions.
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: discuss the issue with the client and make a referral if, after the discussion, the client says he still wants to see an Asian therapist.
The police arrive at your office with an arrest warrant for one of your clients. They tell you that they need the client’s most recent address and telephone number. You should:
Select one:
A. provide them with the information they request.
B. make a copy of the warrant for your files before providing them with the information they request.
C. tell them you will have to get a signed waiver from the client before you can release the information.
D. not give them any information about the client.
An arrest warrant does not constitute an exception to the therapist-client privilege.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT In order to provide any information about the client (including the fact that he/she is a client) would require either a signed release from the client or a court-order.
The correct answer is: not give them any information about the client.
At the end of her first therapy session, a middle-aged woman tells you she is presently receiving treatment from a psychiatrist. You, as an ethical psychologist, should:
Select one:
A. inform the woman that it would be unethical to continue seeing her while she is seeing another professional.
B. call the psychiatrist to inform him of the situation and obtain his permission to continue therapy with her.
C. discuss the issues related to the woman’s relationship with the psychiatrist during your next session with her.
D. allow the woman to decide when to terminate treatment with the psychiatrist.
Standard 10.04 of the Ethics Code states, “In deciding whether to offer or provide services to those already receiving mental health services elsewhere, psychologists carefully consider the treatment issues and the potential client’s/patient’s welfare. Psychologists discuss these issues with the client/patient or another legally authorized person on behalf of the client/patient in order to minimize the risk of confusion and conflict, consult with the other service providers when appropriate, and proceed with caution and sensitivity to the therapeutic issues.”
a. Incorrect Accepting the woman for treatment in this situation is not prohibited by the Ethics Code.
b. Incorrect Obtaining the permission of the psychiatrist to see the woman is not required by the Ethics Code and would violate the client’s confidentiality if it is done without her consent.
c. CORRECT This response is most consistent with the requirements of Standard 10.04.
d. Incorrect This is less consistent than answer c with Standard 10.04.
The correct answer is: discuss the issues related to the woman’s relationship with the psychiatrist during your next session with her.
Which of the following statements is most consistent with the requirements of the APA’s Ethics Code with regard to the use of deception in research?
Select one:
A. Psychologists may not deceive participants about possible risks that may affect their willingness to participate.
B. Psychologists are not required to disclose any possible risks if they have taken all possible steps to reduce those risks.
C. Psychologists must provide an explanation of the use of any deception in an experiment immediately after participation.
D. Psychologists may not use deception in research.
Answer A is correct. Standard 8.07 (Deception in Research) states that “
(a) Psychologists do not conduct a study involving deception unless they have determined that the use of deceptive techniques is justified by the study’s significant prospective scientific, educational, or applied value and that effective nondeceptive alternative procedures are not feasible.
(b) Psychologists do not deceive prospective participants about research that is reasonably expected to cause physical pain or severe emotional distress.
(c) Psychologists explain any deception that is an integral feature of the design and conduct of an experiment to participants as early as is feasible, preferably at the conclusion of their participation, but no later than at the conclusion of the data collection, and permits participants to withdraw their data.”
The correct answer is: Psychologists may not deceive participants about possible risks that may affect their willingness to participate.
“Vicarious liability” is most likely to be of concern when a psychologist is acting in the role of:
Select one:
A. collaborator.
B. consultant.
C. advocate.
D. supervisor.
The doctrine of vicarious liability (“respondeat superior”) applies to settings in which a psychologist has ethical and legal responsibility for the services provided by another person.
a. Incorrect See explanation for response d.
b. Incorrect See explanation for response d.
c. Incorrect See explanation for response d.
d. CORRECT Ethical and legal responsibility is most likely to be an issue in a supervisory relationship in which there is a large discrepancy between the skills, knowledge, etc. of the supervisor and those of the supervisee. In this situation, the supervisor is in a position of authority or control. (Vicarious liability can also be an issue in employer-employee relationships.)
The correct answer is: supervisor.
Nadler’s (1988) systems model of planned change proposes that, to successfully implement change, managers must attend to four factors. One of these is informal organizational elements which consist of:
Select one:
A. external (environmental) driving and restraining forces.
B. the employees’ knowledge, skills, and expectations.
C. the organization’s implicit beliefs, values, and behaviors.
D. the organization’s structures, processes, and methods.
The four factors identified by Nadler (1988) are informal organizational elements, formal organizational elements, individuals (employees and managers), and tasks.
a. Incorrect See explanation for response c.
b. Incorrect See explanation for response c.
c. CORRECT The informal organizational elements include implicit beliefs, values, and behaviors (e.g., communication patterns, leadership approach, and work-related norms).
d. Incorrect See explanation for response c.
The correct answer is: the organization’s implicit beliefs, values, and behaviors.
Hollander’s (1960) concept of “idiosyncrasy credits” is useful for understanding why:
Select one:
A. a person exerts less effort when working as a group member than when working alone.
B. a person acts in a way that is opposite of what is requested or expected.
C. a group member is allowed to deviate from group norms without receiving disapproval from other group members.
D. a group member adopts the group decision even when he/she disagrees with it.
Even if you’re unfamiliar with Hollander’s (1960) concept, the word “idiosyncrasy” may have helped you identify the correct answer to this question.
a. Incorrect This answer describes “social loafing.”
b. Incorrect This answer describes “psychological reactance.”
c. CORRECT According to Hollander, group members are allowed to deviate from group norms without negative consequences in certain circumstances - for example, when the member has a history of conformity or is serving as the leader of the group.
d. Incorrect This answer is not relevant to idiosyncrasy credits.
The correct answer is: a group member is allowed to deviate from group norms without receiving disapproval from other group members.
Studies investigating the relationship between job performance and job satisfaction have most consistently found that:
Select one:
A. correlations between job satisfaction and performance are positive, and coefficients are usually moderate to high.
B. correlations between satisfaction and performance are negative, although negative coefficients are usually low.
C. correlations between job satisfaction and performance are positive, although coefficients are usually low.
D. correlations between job satisfaction and performance are negative, and negative coefficients are usually quite high.
Contrary to what might be expected, a strong relationship between job satisfaction and performance has not been supported by the research.
a. Incorrect While correlations between job satisfaction and performance are usually positive, coefficients are not usually large.
b. Incorrect Correlations between job satisfaction and performance are usually positive, not negative.
c. CORRECT Correlations between job satisfaction and performance are usually positive but small. Vroom (1964), for example, reported an average correlation coefficient of .14.
d. Incorrect Correlations between job satisfaction and performance are usually positive, not negative.
The correct answer is: correlations between job satisfaction and performance are positive, although coefficients are usually low.
The Taylor-Russell tables will indicate that a new selection test is most likely to be helpful in choosing job applicants who will be satisfactory employees when:
Select one:
A. the proportion of current employees who are considered satisfactory is less than 25%.
B. there are only a few job openings and many applicants for the job.
C. the majority of applicants have jobs skills in the moderate (average) range.
D. the test has adequate “differential validity.”
Use of the Taylor-Russell tables estimates the percent of employees who will be satisfactory if a new selection technique is used, and requires three pieces of information - the test’s validity coefficient, the selection ratio, and the base rate.
a. Incorrect The proportion of current employees who are considered successful is the “base rate.” A new selection test will be most useful when the base rate is moderate (around 50%).
b. CORRECT All other things being equal, a new selection test will be most useful for selecting job applicants when the selection ratio is low (i.e., there are few jobs and many applicants).
c. Incorrect This is not a factor that is considered when using the Taylor-Russell tables to evaluate the usefulness of a selection test.
d. Incorrect This is not a factor that is considered when using the Taylor-Russell tables.
The correct answer is: there are only a few job openings and many applicants for the job.
Overtraining is most associated with:
Select one:
A. peak performance.
B. enhanced transfer of training.
C. a drug-like “high.”
D. decreased motivation and performance.
Note that this question is asking about overtraining, not overlearning. The term overtraining appears in the sports psychology literature; overlearning is used in the learning and training literature.
a. Incorrect This would be the best answer if the question were asking about overlearning.
b. Incorrect This also better fits overlearning.
c. Incorrect This is not associated with overtraining or overlearning.
d. CORRECT In the sports psychology literature, overtraining (staleness) refers to excessive training and the resulting physical and psychological symptoms. The undesirable effects of overtraining include premature fatigue during exercise, reduced performance, emotional instability, decreased motivation, and increased susceptibility to infection.
The correct answer is: decreased motivation and performance.
