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