TEST BANK for Psychopathology An Integrative Approach to Understanding, Assessing, and Treating Psyc

Chapter 01: Psychopathology in Historical Context

Indicate the answer choice that best completes the statement or answers the question.

1. When using the psychological disorder criteria, when would an individual be assessed as having psychological dysfunction? a. when their behavioural functioning is breaking down b. when they are extremely distressed c. when their behaviour violates social norms d. when they avoid interactions with other people 2. Kai, a college student, began feeling sad and lonely. Although he is still able to go to classes and work at his job, Kai finds himself feeling down much of the time and he worries about what is happening to him. Which part of the definition of a psychological disorder applies to his situation? a. personal distress b. lack of social support c. impaired functioning d. violation of societal norms 3. Which of the following is NOT considered to be part of the definition of a psychological disorder? a. personal distress b. rarity c. psychological dysfunction d. violation of societal norms 4. Frank drinks three bottles of wine each day and believes he would be fine if people would just “mind their own business.” Which criterion for a psychological disorder is absent from this scenario? a. objective harm to others b. personal distress c. maladaptiveness d. qualitative uniqueness 5. Popular musician Lady Gaga attended an awards show wearing a dress made completely of meat. Why might Lady Gaga wearing a meat dress be considered disordered? a. Her behaviour demonstrates a sense of subjective discomfort. b. She has an inability to distinguish right from wrong. c. It is a deviation from what is typical in her society. d. She shows an inability to function effectively.

6. In most Western societies, what happens when a person enters a trance state and believes they are possessed? a. The person is believed to be suffering from a psychotic disorder. b. The person is diagnosed with a dissociative disorder. c. The person may be viewed as having a psychological disorder. d. The person can be cured with antipsychotic medication.

7. According to Wakefield, harmful dysfunction includes the consideration of harm, distress, and which of the following? a. the failure of biological and psychological mechanisms

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Chapter 01: Psychopathology in Historical Context b. the success of treatment c. that the behaviour is beyond the individual's control d. that the behaviour is protective 8. Rina has just been diagnosed with schizophrenia and hospitalized. Which of the following would Thomas Szasz most likely argue? a. Rina should not be hospitalized because doing so will only make their symptoms worse. b. Rina’s behaviour does not represent an illness like diabetes, and schizophrenia is merely a label applied on the basis of highly subjective judgments. c. Rina’s schizophrenia is a serious illness that is best treated with a combination of drugs and family therapy. d. Rina should be assessed further because mistakes in diagnosis are made frequently.

9. What is the formal definition of psychopathology? a. the medications used to treat some psychological disorders b. the criteria used to define psychological disorders c. the psychological therapies used to treat psychological disorders d. the scientific study of psychological disorders 10. What does the term psychotherapist describe? a. clinical psychologists and psychiatrists only b. people who provide therapy but who do not hold medical degrees c. people who follow the traditions of Sigmund Freud d. anyone who can provide therapy to members of the public 11. After graduation, two of your friends express an interest in psychology careers. Rohan wants to work with relatively healthy individuals who are experiencing adjustment or vocational difficulties. Anna wants to focus on the more severe psychological disorders and conduct research into their causes. Because you are studying psychopathology, they ask you for career advice. What do you tell them? a. Rohan should study psychology at the graduate level, and Anna should apply to medical school. b. Rohan should study clinical psychology at the graduate level, and Anna should study counselling psychology at the graduate level. c. Both of them should apply to medical school. d. Anna should study clinical psychology at the graduate level, and Rohan should study counselling psychology at the graduate level.

12. What is one of the three ways a mental health practitioner can function as a scientist-practitioner? a. by writing textbooks b. by evaluating clinical practice c. by prescribing medications d. by teaching students 13. A scientist-practitioner that evaluates their own treatment procedures to see whether they work and to generate new knowledge is engaging in which approach? a. prescription b. evidence-based practice Powered by Cognero

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Chapter 01: Psychopathology in Historical Context c. creation of research d. practice-based evidence 14. A client was feeling very depressed. A professional thought the cause of the client's problem was an excess of a specific neurotransmitter and prescribed a drug to treat them. What kind of professional was this most likely to be? a. a clinical psychologist b. a social worker c. a psychiatric social worker d. a psychiatrist 15. Along with those who are registered with their provincial or territorial board or college, university professors are also permitted to call themselves which of the following? a. therapists b. psychiatrists c. psychologists d. psychotherapists 16. Which of the following mental health professions had the greatest number of practising professionals in Canada in 2019? a. psychiatrists b. psychologists c. psychiatric nurses d. social workers 17. What is the relationship between a presenting problem and a clinical description? a. Obtaining the patient’s clinical description is the first step in determining what the patient’s presenting problem is. b. Describing the patient’s presenting problem is the first step in determining the patient’s clinical description. c. The presenting problem refers to the current status of a distressed individual; the clinical description refers to the treatment plan. d. The presenting problem refers to symptoms that last only a short time, whereas the clinical description refers to symptoms that are chronic.

18. Statistical data are relevant to researchers. For example, one major epidemiological study found that about 7.8 percent of people in North America have had a mood disorder at some point in their lives and that 3.7 percent have experienced a mood disorder over the past year. What do the 7.8 percent and 3.7 percent statistics refer to, respectively? a. incidence; prevalence b. incidence; recurrence c. proportion; prevalence d. prevalence; incidence 19. Psychological disorders can be described as following a typical course or an individual pattern. Disorders that tend to last a long time follow one type of course, whereas disorders that show a discontinuous, recurrent pattern follow another type of course. What are these courses, respectively? a. chronic; episodic b. chronic; time-limited Powered by Cognero

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Chapter 01: Psychopathology in Historical Context c. pervasive; time-limited d. insidious; recurrent 20. Soren's symptoms of insomnia have improved without treatment over a short period of time. Which type of course would Soren's insomnia be considered to have? a. time-limited course b. chronic course c. episodic course d. sporadic course 21. If a psychological disorder is said to have an acute onset, how did the symptoms develop? a. atypically b. suddenly c. gradually d. sporadically 22. When 20-year-old Panya was first identified as having schizophrenia, her family wanted to know how the disorder would progress and how it would affect her in the future. In medical terms, what did the family want to know? a. Panya's psychosocial profile b. Panya's pathology c. Panya's diagnosis d. Panya's prognosis 23. Why is a patient’s age important information in the clinical description? a. Young children do not experience true psychological disorders. b. Older adults are reluctant to report psychological symptoms. c. Children are not reliable sources of information about symptoms. d. Disorders occurring in childhood may present differently at older ages.

24. Which term refers to the study of the origins of a disorder? a. prognosis b. etiology c. symptomology d. prevalence 25. During more superstitious times, which of the following was thought to be the cause of atypical behaviour? a. a demonic possession b. black bile c. homosexuality d. punishment of the illiterate 26. Which of the following terms for mental illness is related to movements of the moon and stars? a. lunatic b. mental defective c. maniac Powered by Cognero

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Chapter 01: Psychopathology in Historical Context d. idiot 27. In 14th- and 15th-century Europe, to what was inexplicable behaviour attributed? a. evil b. stupidity c. humors d. astrology 28. In the Middle Ages, one of the chief advisers to France’s King Charles V, Nicholas Oresme, suggested that which of the following was responsible for bizarre behaviour? a. the moon b. religion c. melancholy d. greed 29. In the 14th and 15th centuries, in addition to attributing mental illness to the supernatural, some people suggested that mental illness was caused by what other factor? a. an unhealthy lifestyle b. head injuries c. stress d. genes 30. In 14th- and 15th-century Europe, if someone was treated with rest, sleep, and various potions, what did they likely believe the cause of the psychological disorder to be? a. demons b. witches c. stress d. possession 31. In the 14th century, what did the physician who first treated France’s King Charles VI suggest as a cure? a. reducing his responsibilities b. bloodletting c. exorcism d. sexual abstinence 32. Who was considered to be “The Mad King”? a. King Charles VI b. Edward VIII c. Harold II d. Henry VIII 33. Why were snake pits built in many institutions? a. The snakes were a form of torture for patients, thus decreasing their symptoms. b. Hanging people over a pit of poisonous snakes sometimes gave them relief from their symptoms, thus reinforcing the process.

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Chapter 01: Psychopathology in Historical Context c. It was considered to be a form of faith healing. d. They were used as a form of phobia treatment.

34. Alonso believes that Hedwig’s behaviour is due to an excess of black bile. Whose ideas does Alonso's belief best align with? a. Blueler b. Aristotle c. Newton d. Hippocrates 35. According to the ancient Greek physician Hippocrates, which factor could negatively influence psychological functioning? a. bodily fluids b. birth order c. belief in astrology d. supernatural forces 36. Who was the first theorist to argue that genetics were related to psychological disorders? a. Hippocrates b. Galen c. Freud d. Grey 37. You are listening to old songs, including “Melancholy Baby.” Your friends are impressed when you tell them that melancholic, referring to a depressive personality, derives from the Greek term melancholer. What does this term mean? a. yellow bile b. phlegm c. blood d. black bile 38. According to Hippocrates’s humoral theory, which term best characterizes the choleric personality? a. hot tempered b. kind c. lacking affect d. easygoing 39. Based on Hippocrates’s humoral theory, what type of person does the term sanguine describe? a. humorous b. pessimistic c. pale d. cheerful 40. Bloodletting, often through the use of leeches, was a treatment devised centuries ago. What was this treatment used for? a. to reduce excessive blood in the brain Powered by Cognero

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Chapter 01: Psychopathology in Historical Context b. to correct a chemical imbalance in the brain c. to reduce the negative effects of stress d. to restore the balance of humors 41. Induced vomiting was a 17th-century treatment for depression. As described in Anatomy of Melancholy (1621), this could be accomplished by eating what? a. tobacco b. ice c. raw meat d. onions 42. The concept of hysteria traditionally meant physical symptoms for which no organic pathology could be found. Which term is now used to refer to this concept? a. neurosis b. anxiety disorders c. delusions d. somatic symptom disorders 43. Why are hysterical disorders no longer considered to be caused by a “wandering” uterus? a. Men also develop hysterical disorders. b. There is a greater knowledge of physiology. c. The theory is considered insulting to women. d. When the uterus is removed, symptoms tend to remain.

44. In ancient Greece, a woman with hysteria might be told that her condition could be cured by which of the following? a. induced seizures b. bloodletting c. marriage d. rest and relaxation 45. William lived in the 19th century and had the cognitive disorder known as general paresis. Based on this information, what other disease do you know William suffered from? a. epilepsy b. hysteria c. malaria d. syphilis 46. John P. Grey was an important figure in 19th-century psychiatry in the United States. What did he believe was always the cause of mental illness? a. physical causes b. social/environmental influences c. psychological factors d. unknown influences 47. You are a psychiatrist in the 1930s who has decided to begin treating your patients diagnosed with schizophrenia with Powered by Cognero

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Chapter 01: Psychopathology in Historical Context a new treatment known as electroconvulsive therapy instead of the traditional insulin shock therapy. What is the most likely reason for this decision? a. You believe that insulin therapy is too expensive. b. You believe that insulin therapy is too dangerous. c. You believe that insulin therapy is not effective. d. You believe that insulin therapy is unethical.

48. Why was electroconvulsive therapy originally used as a therapy for schizophrenia? a. It was (mistakenly) observed that schizophrenia was rarely found in people with epilepsy. b. It was (mistakenly) observed that it could reduce brain seizures, providing a cure. c. It was (mistakenly) observed to induce convulsions and stimulate appetite in psychotic patients. d. It was (mistakenly) observed to alleviate the depression that often accompanies schizophrenia.

49. In the middle of the 20th century, what were some of the first effective drugs for psychological disorders? a. benzodiazepines to treat depression b. bromides and opium for sedation c. insulin and neuroleptics for sedation d. neuroleptics for psychotic symptoms 50. In many parts of the world during the 1970s, what would an individual who had an anxiety disorder most likely have been prescribed? a. bromides b. neuroleptics c. benzodiazepines d. electroconvulsive therapy 51. The discovery of certain tranquilizers made it possible to control psychotic symptoms, including hallucinations and delusions. What kind of drugs were these tranquilizers? a. neuroleptics b. bromides c. benzodiazepines d. opiates 52. In the late 1800s, there was an emphasis on biological causes of mental disorders, which ironically reduced interest in treatments for mental patients. Why did this happen? a. It was thought that hospital staff were not adequately trained to administer new treatments. b. It was thought that patients would improve more rapidly if they were not hospitalized. c. It was thought that mental illness caused by brain pathology was incurable. d. It was thought that physicians should devote more time to the physically ill.

53. Why was Emil Kraeplin’s lasting contribution to modern psychiatry in the area of diagnosis and classification of psychological disorders, rather than that of treatment? a. because of his discomfort with actually working with patients b. because of his conviction that better diagnosis was necessary for more effective treatment c. because of his belief that these disorders were due to brain pathology Powered by Cognero

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Chapter 01: Psychopathology in Historical Context d. because of his belief in the influence of the social environment in mental illness 54. Which Greek philosopher suggested that maladaptive behaviour was rooted in social and cultural factors? a. Galen b. Hippocrates c. Plato d. Aristotle 55. Moral therapy as a system originated with which of the following individuals? a. Benjamin Rush b. Hippocrates c. William Tuke d. Philippe Pinel 56. Who is considered to be the founder of North American psychiatry? a. Benjamin Rush b. Hippocrates c. William Tuke d. Philippe Pinel 57. In the psychosocial approach called moral therapy, what does the term moral mean? a. emotional b. ethical c. religious d. story 58. Whose work led to a decline in moral therapy? a. John P. Grey b. Dorothea Dix c. Aristotle d. Sigmund Freud 59. As a result of moral therapy, what was eliminated in asylums in the mid-18th century? a. physical restraints and seclusion b. individual attention from the hospital staff c. lectures on interesting subjects for hospitalized patients d. opportunities for normal social interaction 60. When did moral therapy work best? a. when it was used with groups of patients, rather than one on one b. when the number of patients in an institution was 200 or fewer c. when it was used in populations of immigrants and the poor d. when it was supplemented by the use of restraint and seclusion

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Chapter 01: Psychopathology in Historical Context 61. What movement did Dorothea Dix start? a. the mental hygiene movement b. the moral movement c. the humane therapy movement d. the deinstitutionalization movement 62. What is the most notable contribution of Clarence Hincks? a. He argued that mental illness is treatable with a combination of drugs and individualized attention. b. He argued that mental illness was incurable, but more humane institutions were needed to care people with mental illnesses. c. He argued that mental illness was caused by brain pathology and, therefore, was incurable and that therapy should consist of learning to cope with symptoms. d. He argued that mental illness was treatable, which was contrary to the prevailing view at the time.

63. Anton Mesmer, an early 18th-century physician, purported to cure patients by unblocking the flow of a bodily fluid he called animal magnetism. Benjamin Franklin’s double-blind experiment indicated that any effectiveness of Mesmer’s methods was actually because of which of the following? a. undetectable magnetic fields b. chemically induced humoral balance c. the power of suggestion d. mental telepathy 64. What did Jean Charcot find when he used a variation of Mesmer’s techniques? a. These methods were effective in treating a number of psychological disorders. b. These methods were no more effective than previous methods he had used. c. Patients were better able to understand the link between their emotional problems and their psychological disorder. d. The symptoms of some patients actually worsened.

65. Realizing patients are often unaware of material previously recalled under hypnosis, Breuer and Freud hypothesized the existence of a concept considered one of the most important developments in the history of psychopathology. What was that concept? a. psychosis b. the unconscious mind c. catharsis d. repression 66. What did Freud and Breuer discover about the process known as catharsis? a. They discovered that it reduces psychotic symptoms such as hallucinations and delusions. b. They discovered that it occurs beyond the conscious awareness of the patient. c. They discovered that it leads to insight. d. They discovered that the power of suggestion subconsciously changed behaviour.

67. In 1895, how did neurologist Josef Breuer treat Anna O.’s hysterical symptoms? a. using mesmerism Powered by Cognero

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Chapter 01: Psychopathology in Historical Context b. using hydrotherapy c. using the placebo effect d. using hypnosis 68. Freud and Breuer’s ideas were based on which of the following? a. case observations b. healthy individuals c. biological theory d. institutionalized individuals 69. Which of the following is NOT included as part of Freud’s structure of the mind? a. psyche b. superego c. ego d. id 70. In Freudian theory, the terms libido and thanatos represent two basic but opposing drives. What are they? a. life and death b. pleasure and pain c. sex and celibacy d. good and evil 71. You have just read a newspaper article about a murder. You wonder how anyone could commit such a horrible crime.

Then you recall from your study of Freudian theory that anyone could be a killer if certain impulses are not well controlled. Which term best describes these impulses? a. intrapsychic forces b. a libidinous desire c. the drive of the id d. primitive forces 72. The ego operates according to one principle, and the id operates according to another principle. What are they, respectively? a. reality; pleasure b. conscious; unconscious c. pleasure; aggression d. reality; aggression 73. According to psychoanalytic theory, what function does a person develop early in life to ensure that they can adapt to the demands of the real world while still finding ways of meeting their basic needs? a. id b. conscience c. superego d. ego 74. According to psychoanalytic theory, the id operates according to the pleasure principle. What does that mean?

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Chapter 01: Psychopathology in Historical Context a. It uses secondary-process thinking. b. It thinks in an unemotional, logical, and rational manner. c. It is sexual, aggressive, selfish, and envious. d. It adheres to social rules and regulations.

75. A classmate in your psychology course is worried about the selfish and sometimes dangerous drives of the id. What should you say to your classmate to address this fear? a. Because id impulses are usually part of conscious awareness, we can learn to control them. b. Id fantasies never become part of conscious awareness, so we never act on them. c. Each of us develops an ego to help us behave more realistically. d. The selfish drives of the id are transformed to positive emotional expressions.

76. According to psychoanalytic theory, what is the role of the ego? a. to counteract the aggressive and sexual drives of the id b. to maximize pleasure and reduce tension c. to mediate conflict between the id and the superego d. to increase self-esteem and a strong sense of identity 77. In Freud’s structure of the mind, which two elements are almost entirely unconscious? a. the ego and the id b. the id and the superego c. the conscience and the ego d. the superego and the ego 78. Because the purpose of the superego is to counteract the aggressive and sexual drives of the id that are potentially dangerous, which of the following often results? a. logic b. aggression c. conflict d. pleasure 79. According to psychoanalytic theory, what do the conflicts between the id and the superego often lead to? a. anxiety b. anger c. violent behaviour d. depression 80. According to Freudian theory, anxiety is a signal for the ego to marshal its mechanisms of defence. This is a function of which of the following? a. reality-based actions b. conscious efforts to maintain control c. unconscious protective processes d. primitive emotional responses 81. Which of the following is a characteristic of how defence mechanisms affect coping styles?

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Chapter 01: Psychopathology in Historical Context a. They are dependent upon the age of the person and how they are used. b. They can be either adaptive or maladaptive. c. They are self-defeating. d. They are adaptive.

82. Trent is in psychoanalysis and states to his therapist that he thinks that his partner is considering having an affair with their co-worker. Later in the session, Trent admits that he is tempted to start an affair with his own co-worker. What defence mechanism was Trent displaying when he accused his partner of thinking about being unfaithful? a. sublimation b. projection c. displacement d. denial 83. Mrs. Babcock received a very poor rating from her supervisor, who had been constantly criticizing her in front of her co-workers. When she got home, her children ran up to greet her, all talking at once. She responded by yelling, “Leave me alone! Can’t you see I’m tired?” According to psychoanalytic theory, which defence mechanism does this situation illustrate? a. projection b. displacement c. repression d. rationalization 84. Remi and Nina have been dating for six months. Nina is not interested in continuing their relationship. She calls Remi and informs him that although she cares about him, she must end their relationship. Remi laughs and says, “Funny joke.”

Nina states, “This is not a joke; I am serious.” Remi then says, “I’ll pick you up in an hour for dinner.” Which defence mechanism does this example illustrate? a. displacement b. projection c. denial d. repression 85. After receiving the results of four different sets of tests, Amaya's doctor tells her that she has cancer. Amaya states, “This can’t be true; I’m going to get a second opinion.” Which defence mechanism does this example illustrate? a. displacement b. denial c. projection d. repression 86. In which defence mechanism does an individual substitute behaviour, thoughts, or feelings that are the direct opposite of unacceptable ones? a. displacement b. repression c. rationalization d. reaction formation 87. Which of the following is an example of a healthy defence mechanism?

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Chapter 01: Psychopathology in Historical Context a. sublimation b. projection c. denial d. repression 88. When Tyra is feeling frustrated, they often channel their aggressive impulses into something more productive, like boxing or martial arts. What type of defense mechanism would this represent? a. projection b. repression c. denial d. sublimation 89. Vera was playing piano in a large concert recital and froze. Later when asked about the situation, Vera had no recollection of this happening. Which defence mechanism does this example illustrate? a. denial b. repression c. projection d. reaction formation 90. A four-year-old girl sucks her thumb, a teenager binges on food, and an adult woman bites her fingernails. According to the Freudian theory of psychosexual development, what underlies all these behaviours? a. repression of aggressive impulses b. a fixation at the oral stage of psychosexual development c. a trauma during the toilet-training phase d. denial of unacceptable feelings, thoughts, or wishes 91. The Oedipus complex is the psychosexual conflict occurring during the phallic stage of development in boys. How is this complex characterized? a. by love for the mother and feelings of anger and envy toward the father b. by a repressed need for oral gratification c. by a love for the father and feelings of repulsion toward the mother d. by a conscious need for genital self-stimulation 92. The Electra complex is the psychosexual conflict that occurs at the phallic stage of development in girls. How is this complex characterized? a. by latency lust b. by feelings of anger and envy toward the mother c. by castration anxiety d. by a desire to replace the mother and possess the father 93. According to Freud, how is the Electra complex partially resolved? a. by developing healthy relationships b. by therapy c. by developing penis envy d. by developing neuroses Powered by Cognero

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Chapter 01: Psychopathology in Historical Context 94. According to Freud, what are all nonpsychotic psychological disorders called? a. anxiety b. neuroses c. thanatos d. intrapsychic conflict 95. As compared to her father, Sigmund Freud, Anna Freud (1895–1982) focused her work on the way our behaviour is influenced. Which of the following did she write? a. Id and the Mechanisms of Defense b. Our Neurosis and the Mechanisms of Defense c. Our Self-Actualization and the Mechanisms of Defense d. Ego and the Mechanisms of Defense 96. According to Anna Freud's ego psychology, when does disordered behaviour develop? a. when the ego does not develop normally because of psychosexual conflicts at the oral stage of development b. when the ego is deficient in regulating such functions as delaying and controlling impulses c. when there are social and psychological barriers to achieving self-actualization d. when maladaptive defence mechanisms are not overridden by adaptive defence mechanisms 97. In contrast to Freud, how did Jung and Adler view human nature? a. They believed that cognitive and personality factors shape human potential. b. They believed that humans are born with a strong drive toward self-actualization. c. They believed that the ego is much stronger than Freud postulated. d. They believed that humans are shaped through learning by their environment.

98. What was Erikson’s greatest contribution to psychoanalytical theorizing? a. his idea that development occurs across the lifespan b. his idea that sexual arousal and interest occur during the latency stage c. his idea that societal factors influence our behaviour d. his idea that intrapsychic conflicts are resolved in early childhood 99. Your therapist asks you to say whatever comes to mind in an attempt to reveal emotionally charged material that may be repressed because it is too painful to bring into consciousness. What is this technique referred to as? a. dream analysis b. transference c. free association d. countertransference 100. In classical psychoanalysis, why is the process whereby the therapist interprets a patient’s dreams often difficult? a. The patient may resist uncovering repressed material and deny the interpretation. b. Patients often forget their dreams. c. The patient may relate to the therapist much as they did toward a parent figure. d. The therapist may want not to upset the patient with a negative interpretation.

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Chapter 01: Psychopathology in Historical Context 101. In psychoanalytic psychotherapy, which of the following is most important for patients? a. to strive to reach their full potential b. to remain emotionally detached from the analyst c. to find an effective medication d. to reveal the nature of unconscious mental processes and conflicts 102. In classical psychoanalysis, what does the concept of transference refer to? a. the process whereby the patient falsely attributes their own unacceptable feelings or thoughts to the therapist b. the process whereby the therapist projects some of their own personal feelings onto the patient c. the process whereby the patient relates to the therapist as they would toward a parent figure d. the process whereby the patient directs potentially maladaptive impulses to socially acceptable behaviour 103. How does psychodynamic psychotherapy differ from classical (Freudian) psychoanalysis? a. It emphasizes the goal of personality reconstruction. b. It focuses more on social and interpersonal issues. c. It considers past experiences important. d. It requires a long-term commitment on the part of the person being analyzed.

104. How do most mental health professionals view psychoanalysis as a treatment technique? a. It has been proven effective. b. It has been subject to careful measurement criteria. c. It is basically unscientific. d. It is noted for consistency in analytic interpretation.

105. The underlying assumption that we all can reach our highest potential, in all areas of functioning, if we have the freedom to grow is referred to as which of the following? a. empathy b. Gestalt c. person-centred d. self-actualizing 106. Who is the concept of a hierarchy of needs most strongly associated with? a. Carl Rogers b. Anna Freud c. Abraham Maslow d. Carl Jung 107. According to Abraham Maslow’s hierarchy of needs, individuals will be unable to achieve high levels of selfactualization and self-esteem unless which of the following has taken place? a. unless they have been raised with unconditional positive regard from primary caregivers b. unless they have first met more basic human requirements such as food, sex, and friendship c. unless they have developed sufficient ego strength d. unless they have gratified their basic needs and satisfied their drive for physical pleasure through the five psychosexual stages of development Powered by Cognero

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Chapter 01: Psychopathology in Historical Context 108. Which of the following is associated with the humanistic theories of Carl Rogers? a. hierarchy of needs b. dream analysis c. moral hygiene d. person-centred therapy 109. What do humanistic therapists regard as the most positive influence in facilitating human growth? a. a therapist's interpretations of the patient's verbalizations b. self-esteem c. ego development d. relationships (including the therapeutic relationship) 110. A therapist is showing complete and almost unqualified acceptance of most of their client's feelings and actions.

What is the therapist demonstrating? a. therapeutic alliance b. unconditional positive regard c. empathy d. conditional positive regard 111. How does Gestalt therapy differ from psychoanalytic therapy? a. In Gestalt therapy, there is no delving into past experiences. b. In Gestalt therapy, the critical element is the therapist’s unconditional positive regard for the patient. c. In Gestalt therapy, there is little emphasis on the here and now. d. In Gestalt therapy, there is little or no training required for therapists.

112. As Maslow noted, traditional person-centred therapy has found its greatest application among which population? a. those with anxiety b. those without psychological disorders c. those dealing with trauma d. those who have had training in psychotherapy 113. Current therapies, including experiential and emotion-focused therapies, have their roots in which approaches? a. behavioural and Gestalt b. behavioural and psychoanalytic c. person-centred and Gestalt d. psychoanalytic and person-centred 114. Pavlov's experiment of the salivation response in dogs initiated the study of which type of learning? a. classical conditioning b. operant conditioning c. social learning d. cognitive-behavioural learning 115. Mei underwent chemotherapy treatment for cancer. She now reports experiencing mild nausea when she drives by the hospital and severe nausea when she enters the hospital where her chemotherapy was administered. What phenomenon Powered by Cognero

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Chapter 01: Psychopathology in Historical Context best explains these reactions to stimuli she associates with her chemotherapy? a. reconditioning b. introspection c. operant conditioning d. stimulus generalization 116. A patient undergoing chemotherapy now reports experiencing mild nausea when they interact with the nurse who administered their chemotherapy. What best describes the nurse in this situation? a. unconditioned stimulus b. unconditioned response c. conditioned stimulus d. conditioned response 117. A dog had been conditioned to salivate to the sound of a bell because of its association with the presentation of food.

Later, when exposed to the bell without food for a long period, the dog eventually stopped salivating to the sound of the bell. What is this phenomenon known as? a. extinction b. response fading c. conditioned forgetting d. stimulus fading 118. The process of reporting on inner thoughts and feelings after experiencing stimuli is referred to as which of the following? a. extinction b. generalization c. classical conditioning d. introspection 119. Why is Watson and Rayner’s experiment in which they induced a fear of white, furry objects in Little Albert famous? a. It was the first real-life demonstration of operant conditioning. b. It was the first recorded lawsuit made against the psychology profession for unethical behaviour. c. It was the first recorded example of inducing fear of an object in a laboratory setting. d. It proved the law of effect.

120. What does Wolpe’s technique of systematic desensitization involve? a. reinforcing successive approximations to a final behaviour or set of behaviours b. gradually introducing the feared objects or situations so that fear can decline c. gradually reinforcing fearless behaviour and punishing fear responses d. reinforcing an incompatible response to a feared situation 121. Jason has been having a lot of difficulty because of his irrational fears. His doctor advises Jason to participate in an anxiety-reduction procedure based on the work of Joseph Wolpe. What is this procedure? a. aversive conditioning b. person-centred therapy Powered by Cognero

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Chapter 01: Psychopathology in Historical Context c. systematic desensitization d. mesmerism 122. You are in a mall when a young child begins to scream and shout because his parents will not buy him the latest toy.

What would B. F. Skinner most likely say about the child’s behaviour? a. It is an expression of repressed Oedipal anger toward his father, and it will diminish naturally as he gets older. b. It is a classically conditioned response to being in the mall. c. It would be most effectively altered over the long term by simply ignoring it. d. It would be most effectively altered over the long term by scolding him and positively reinforcing more appropriate behaviour.

123. What is the name for the idea that behaviour is either strengthened or weakened depending on the consequences of that behaviour? a. law of effect b. classical conditioning c. systematic desensitization d. behaviour therapy 124. Why are operant conditioning techniques being applied in Canadian hospital settings? a. to increase patients’ insight into their fears and wishes b. to reduce psychiatric patients’ undesirable behaviour and increase their desirable behaviour c. to reduce patients’ fear of surgery d. to increase nursing staff’s empathy 125. Which approach brought the systematic development of a more scientific approach to psychological aspects of psychopathology? a. behavioural b. psychoanalytic c. humanistic d. Gestalt 126. Which method would be the most successful in teaching a pigeon to play Ping-Pong? a. classical conditioning b. shaping c. systematic desensitization d. introspection 127. What is the name for learning in which a neutral stimulus is paired with a response until it elicits that response? a. operant conditioning b. classical conditioning c. systematic desensitization d. extinction 128. What are two recent developments that have contributed to a multidimensional, integrative approach to psychopathology?

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Chapter 01: Psychopathology in Historical Context a. the introduction of highly specialized drugs and more sophisticated training for mental health workers b. increasingly sophisticated scientific tools and methodology and the realization that no one influence on behaviour ever occurs in isolation c. deinstitutionalization and the growth of humanistic therapies d. an increase in public mental health education and less reliance on drugs to control disordered behaviour

129. Discuss the criteria for psychological disorders and the meanings of psychological dysfunction, personal distress, and atypical or not culturally expected behaviour.

130. Discuss the controversy surrounding the use of medical diagnoses in the case of psychological disorders. Explain the position taken by Thomas Szasz.

131. Describe the educational and professional differences between psychologists and psychiatrists. In Canada, who is permitted to hold themselves out to the public as a psychologist (e.g., in advertising)?

132. Discuss the evolution of biological treatments for psychological disorders across the 20th century. Explain the development and use of insulin shock therapy and electroconvulsive therapy in the first part of the century, and describe the major drug therapies developed in the latter half.

133. Describe the psychosocial approach to mental disorders called moral therapy. Mention key figures who contributed to or promoted this approach. Discuss whether this approach was effective in improving conditions for people with mental illnesses. Explain the reasons for the decline of moral therapy.

134. Explain the basic assumptions of psychoanalytic theory. Refer to concepts such as anxiety, defence mechanisms, and psychosexual development. Use specific examples to illustrate these concepts.

135. Compare and contrast the three traditional models of disordered behaviour: supernatural, psychological, and biological. Mention key aspects of the explanations of disordered behaviour and treatments of people with mental illnesses associated with each model.

136. Compare and contrast classical psychoanalysis and psychodynamic psychotherapy. Note the criticisms of classical psychoanalysis and explain why it is more of historical than of current interest.

137. Compare the basic assumptions and techniques of behaviour therapy versus humanistic therapy. Mention significant figures who contributed to each approach and the key concepts associated with those individuals.

138. Compare and contrast classical and operant conditioning. Mention significant figures who contributed to each approach and how shaping and systematic desensitization relate to these types of learning.

139. Identify and explain the developments in the 1990s that contributed to a multidimensional, integrative approach to psychopathology. Describe the contributions that cognitive science and neuroscience have made to our expanding knowledge about psychopathology.

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Chapter 01: Psychopathology in Historical Context Answer Key 1. a 2. a 3. b 4. b 5. c 6. c 7. a 8. b 9. d 10. d 11. d 12. b 13. d 14. d 15. c 16. d 17. b 18. d 19. a 20. a 21. b 22. d 23. d 24. b 25. a Powered by Cognero

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Chapter 01: Psychopathology in Historical Context 26. a 27. a 28. c 29. c 30. c 31. a 32. a 33. b 34. d 35. a 36. a 37. d 38. a 39. d 40. d 41. a 42. d 43. b 44. c 45. d 46. a 47. b 48. a 49. d 50. c 51. a Powered by Cognero

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Chapter 01: Psychopathology in Historical Context 52. c 53. c 54. c 55. d 56. a 57. a 58. b 59. a 60. b 61. a 62. d 63. c 64. a 65. b 66. c 67. d 68. a 69. a 70. a 71. c 72. a 73. d 74. c 75. c 76. c Powered by Cognero

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Chapter 01: Psychopathology in Historical Context 77. b 78. c 79. a 80. c 81. b 82. b 83. b 84. c 85. b 86. d 87. a 88. d 89. b 90. b 91. a 92. d 93. a 94. b 95. d 96. b 97. b 98. a 99. c 100. a 101. d 102. c Powered by Cognero

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Chapter 01: Psychopathology in Historical Context 103. b 104. c 105. d 106. c 107. b 108. d 109. d 110. b 111. a 112. b 113. c 114. a 115. d 116. c 117. a 118. d 119. c 120. b 121. c 122. d 123. a 124. b 125. a 126. b 127. b Powered by Cognero

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Chapter 01: Psychopathology in Historical Context 128. b 129. Student responses will vary.

130. Student responses will vary.

131. Student responses will vary.

132. Student responses will vary.

133. Student responses will vary.

134. Student responses will vary.

135. Student responses will vary.

136. Student responses will vary.

137. Student responses will vary.

138. Student responses will vary.

139. Student responses will vary.

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Chapter 02: An Integrative Approach to Psychopathology

Indicate the answer choice that best completes the statement or answers the question.

1. Your very shy and withdrawn uncle spent most of his teen years in a hospital undergoing treatment for a severe physical injury. He has been diagnosed with social phobia that you believe is entirely due to his lack of socialization during his teen years. Which of the following best describes your theory? a. one-dimensional b. integrative c. multidimensional d. empirical 2. According to the text, which of the following was discussed as a biological influence for Jody’s blood-injury-injection phobia? a. an increase in heart rate and blood pressure leading to vasovagal syncope b. a genetic tendency to fear situations involving blood and injury c. a conditioned response of fear resulting from exposure to blood and injury d. increased fear and anxiety pertaining to situations involving blood and injury 3. Which statement is the best analogy for the influence of genes on our cognitive development? a. They are like an ignition switch on a rocket that can go forever. b. They are like a fence that holds us within a boundary. c. They are like a door that leads us to our destiny. d. They are like a hurdle that we must jump over.

4. Our complete set of genetic instructions is referred to as which of the following? a. phenotype b. chromosomes c. autosomes d. genome 5. The outward appearance of the person’s genetic makeup is called? a. genome b. genotype c. phenotype d. autosome 6. Colour-blindness is caused by which of the following? a. dominant allele on the X chromosome b. recessive allele on the X chromosome c. dominant allele on the Y chromosome d. recessive allele on the Y chromosome 7. Why are behaviour and personality described as polygenic? a. Both are rarely influenced by individual genes. b. Both are influenced by many genes, with each individual gene contributing a relatively small effect. c. Both are influenced by a few select genes, each exerting a large effect.

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Chapter 02: An Integrative Approach to Psychopathology d. Both are a result of our genetic structure.

8. What does recent evidence regarding the genetic influence on most psychological disorders indicate? a. Multiple genes interact, with each gene contributing a small effect. b. Single genes are usually responsible for psychological disorders. c. Genes that influence psychopathology are usually recessive. d. Little evidence suggests that genes actually influence psychopathology.

9. Dr. Naima’s research focuses on the effects of genes, individual differences, and heritability of depression but does not examine which genes are responsible for the disorder. Which type of research does Dr. Naima’s focus fall under? a. quantitative genetics b. molecular genetics c. cross-fostering d. psychopathology 10. If Luka and Lev are identical twins and you know that Luka has autism, what can you say about Lev? a. Lev will definitely have the disorder as well. b. Lev has the same probability of having the disorder as the rest of the population. c. Lev has approximately a 70 percent chance of also having the disorder. d. Lev has no genetic likelihood of developing the disorder and will only develop the disorder if exposed to the right environmental factors.

11. According to current research, what is the best estimate of the influence of genetic influence on personality, cognitive, and emotional traits? a. Approximately 10 percent b. Approximately 25 percent c. Approximately 50 percent d. Approximately 75 percent 12. Although not the first to propose it, Eric Kandel is credited with which of the following ideas? a. The genetic functioning of cells may actually change as a result of learning. b. Individual differences are based on environmental factors. c. Genes are involved in the etiology of psychological disorders. d. The contributions of genes come from many genes.

13. In the diathesis–stress model, what does diathesis refer to? a. conditions in the environment that can trigger a disorder depending upon how severe the stressors are b. an inherited, subclinical disease state that has the potential for developing into a full-blown psychological disorder, given certain environmental conditions c. an inherited tendency or condition that makes a person susceptible to developing a disorder d. the interaction of social and psychological influences 14. Who speculated that the process of learning affects more than behaviour and suggested that the genetic structure of cells may change as the result of learning? a. B. F. Skinner Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology b. Gregor Mendel c. Sigmund Freud d. Eric Kandel 15. Which term refers to the inherited tendency or vulnerability toward developing a disorder? a. disposition b. diathesis c. stress d. trigger 16. In the diathesis–stress model, what does stress refer to? a. life events that, in combination with an inherited tendency, trigger a disorder b. inherited tendencies that, in combination with life events, trigger a disorder c. the fact that without a diathesis, a disorder will not develop d. exposure to very unusual and extreme environmental conditions, which trigger a disorder 17. Dr. Jenkins argues that it is possible to inherit certain genes that could develop into a disorder, even though the disorder may never be activated unless conditions of trauma, challenge, or anxiety are experienced. Which model supports Dr. Jenkins’s hypothesis? a. the diathesis–stress model b. the psycho–social model c. the genetic model d. the reciprocal gene–environment model 18. Based on the diathesis–stress model, which of the following is correct? a. The smaller the vulnerability, the greater the life stress required to produce the disorder. b. The larger the vulnerability, the greater the life stress required to produce the disorder. c. The smaller the vulnerability, the lower the life stress required to produce the disorder. d. There is no relationship between the amount of vulnerability and the amount of life stress required to produce a disorder.

19. The study by Kilpatrick et al. (2007) found that individuals were more likely to develop PTSD after the Florida hurricanes of 2004 if they had which of the following genetic makeups? a. SS (two short alleles) b. LL (two long alleles) c. SL (one short allele and one long allele) d. SSL (a mutation of three alleles, two short and one long) 20. Which model is characterized by the idea that our inherited tendencies influence the probability that we will encounter anxious life events? a. the psycho–social model b. the genetic model c. the diathesis–stress model d. the gene–environment correlation model Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology 21. John has inherited a personality trait that makes him more likely to keep to himself than to socialize. As a result, he does not have many friends and spends a lot of time alone. If John were to develop depression, which model would best explain this situation and the cause of his depression? a. the interpersonal model b. the gene–environment correlation model c. the biological model d. the diathesis–stress model 22. Which genetic structure has been found to be correlated to lifespan? a. telomere length b. autosome length c. telomere width d. chromosome width 23. Suppose you are a researcher who has bred rats to be emotional and reactive and then you cross-foster those rats so they are raised by calm mothers. What result would you expect? a. The young animals will tend to be emotional and reactive as youths but calm when raising their own young. b. The young animals will tend to be calm throughout their lives. c. The young animals will tend to be mostly calm but emotional and reactive when faced with stressful situations. d. The young animals will tend to be emotional and reactive.

24. Which term refers to the process by which DNA can be influenced as a result of the environment influencing gene expression? a. stress b. diathesis c. epigenetics d. polygenics 25. Which of the following has been implicated in intergenerational trauma experienced by some Indigenous groups? a. environmental influences b. diathesis–stress c. neurotransmitters d. epigenetics 26. Loise has experienced an injury and can no longer process and react to some sensory information. Which of Loise’s nervous systems is damaged? a. her peripheral nervous system b. her central nervous system c. her sympathetic nervous system d. her parasympathetic nervous system 27. Which nervous system processes all information received from our sense organs and reacts as necessary? a. the peripheral nervous system b. the central nervous system Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology c. the sympathetic nervous system d. the parasympathetic nervous system 28. What do we call the area between the axon of one neuron and the dendrite of another neuron? a. the neural cleft b. the dendritic opening c. the axon terminal d. the synaptic cleft 29. Why are neurotransmitters important? a. They allow one nerve cell to transmit an impulse to another. b. They are converted into electrical impulses. c. They nurture the neuronal structures of the brain. d. They allow the brain to maintain its structural integrity.

30. How can neurotransmitters negatively affect psychological functioning? a. when they are chemically transformed and not recognizable by the brain b. when the wrong neurotransmitters come in contact with a neuron c. when production of neurotransmitters is either excessive or insufficient d. when an individual produces antibodies that make neurotransmitters ineffective 31. Which of the following occupations is an analogy for the main function of neurotransmitters? a. a doorperson at a hotel b. a messenger in a city c. a conductor of a train d. an actor in a play 32. What are neurotransmitters that decrease the likelihood that a connecting neuron will fire called? a. excitatory b. inhibitory c. insufficient d. vesicles 33. A client is experiencing a lot of anxiety. Early researchers would have argued that the client's anxiety was a result of which of the following? a. reduced levels of norepinephrine b. excessive levels of dopamine c. reduced levels of GABA d. excessive levels of serotonin 34. If you had to choose one brain area to protect so that you could stay alive, which would it be? a. the frontal lobes b. the brain stem c. the forebrain Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology d. the midbrain 35. Maya has experienced brain damage that has left her with difficulty sleeping and the problem of being hyperaroused.

Which area of the brain was most likely damaged? a. the pons b. the medulla c. the hypothalamus d. the reticular activating system 36. What part of the brain stem regulates vital activities such as heartbeat, breathing, and digestion? a. the forebrain b. the thalamus c. the reticular activating system d. the hindbrain 37. A gymnast is having difficulty maintaining their balance and coordinating muscle movements. Assuming their problems result from a brain injury, which of the following would you first examine? a. the cerebellum b. the medulla c. the thalamus d. the midbrain 38. Javier has a form of epilepsy that affects his limbic system. What sort of behaviour is Javier most likely to display while having a seizure? a. lack of body posture and uncoordinated movement b. unusual emotional expressions and aggression c. disturbed sleep d. difficulty breathing 39. Many of the limbic structures have been named based on their approximate shape. What system resembles a sea horse? a. septum b. amygdala c. hippocampus d. caudate 40. If you put all the neurons from a brain in a hat and randomly selected one, which area would the neuron most likely have come from? a. the basal ganglia b. the midbrain c. the cerebral cortex d. the brain stem 41. A student is writing a paper on philosophical theories of morality. Which part of their brain would a PET scan show to be most active at this time?

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Chapter 02: An Integrative Approach to Psychopathology a. the hindbrain b. the cerebral cortex c. the midbrain d. the limbic system 42. Where in the brain are verbal and cognitive processes usually controlled? a. across the entire cortex b. in the midbrain c. in the left hemisphere of the cortex d. in the right hemisphere of the cortex 43. Yara had part of her brain removed to control epilepsy and, as a result, she can no longer solve problems that require visual imagery. What area of the brain did Yara have removed? a. part of the left hemisphere of the cortex b. part of the right hemisphere of the cortex c. part of the pons d. part of the midbrain 44. A patient suffered a serious head injury and has since experienced difficulty recognizing specific sights and sounds.

Which lobe of their brain has most likely been damaged? a. the temporal lobe b. the parietal lobe c. the frontal lobe d. the occipital lobe 45. Which part of the brain is most associated with memory, thought, and reasoning? a. the left parietal lobe b. the brain stem c. the occipital lobe d. the frontal lobe 46. When studying areas of the brain for clues to psychological disorders, which lobe of the brain do researchers most often focus on? a. the temporal lobe b. the parietal lobe c. the frontal lobe d. the occipital lobe 47. What is the major function of the peripheral nervous system? a. to control hormonal activity b. to regulate arousal c. to coordinate with the brain stem to ensure the body is working properly d. to process information received from the central nervous system 48. What does the peripheral nervous system include?

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Chapter 02: An Integrative Approach to Psychopathology a. the somatic and autonomic nervous system b. the brain stem and cortex c. the brain and spinal cord d. the endocrine system 49. Which term refers to the system comprised of the somatic nervous system and the autonomic nervous system? a. peripheral nervous system b. central nervous system c. sympathetic nervous system d. parasympathetic nervous system 50. Which of the following is most likely to be hindered by damage to the somatic nervous system? a. voluntary movement b. thinking and reasoning c. the fight-or-flight response d. breathing and sleeping 51. You read in the newspaper that a parent lifted a car to free their trapped child. Which of the parent's systems was highly activated to perform this feat? a. the central nervous system b. the sympathetic nervous system c. the limbic system d. the parasympathetic nervous system 52. You are home alone late at night when you hear a loud, frightening noise. Your heart begins pounding, your muscles tense up, and your senses sharpen. Which system is causing your reaction? a. the sympathetic nervous system b. the limbic system c. the parasympathetic nervous system d. the central nervous system 53. Christina sits down to relax in her soft chair after a long, tiring day. As she sits reading a book, she grows more relaxed. Her breathing and heart rate slow down and her muscles loosen. Which system is causing Christina’s relaxation? a. the limbic system b. the central nervous system c. the parasympathetic nervous system d. the sympathetic nervous system 54. Which term refers to chemical messengers released directly into the bloodstream? a. an agonist b. an antagonist c. neurotransmitters d. hormones 55. Which of the following controls the endocrine system?

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Chapter 02: An Integrative Approach to Psychopathology a. the limbic system b. the central nervous system c. the somatic nervous system d. the autonomic nervous system 56. If a patient has a tumour on their adrenal glands that is affecting their production of cortisol, which system is most impacted by this tumour? a. the limbic system b. the central nervous system c. the HPA axis d. the parasympathetic nervous system 57. A client takes a medication that causes the neurotransmitter to remain in the synapse rather than being drawn back into the neuron. What process is being affected by the medication? a. neural stimulation b. reuptake c. systematic manipulation d. neural inhibition 58. Dr. Molina wants to increase the amount of serotonin circulating in a client's brain. What specific type of drug will Dr. Molina choose to prescribe? a. an antagonist b. a decelerator c. an agonist d. a placebo 59. Dr. Amin wants to decrease the amount of dopamine circulating in Rashid’s brain. Which specific type of drug will Dr. Amin prescribe? a. a blocker b. an agonist c. an antagonist d. a reuptake inhibitor 60. Which of the following blocks neurotransmitter activity? a. blockers b. agonists c. antagonists d. reuptake inhibitors 61. A doctor prescribed their patient a drug that will produce effects opposite to dopamine. Which type of drug did they prescribe? a. blocker b. agonist c. antagonist d. inverse agonist Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology 62. What type of neurotransmitters are synthesized in the nerve? a. excitatory b. agonist c. antagonist d. classic 63. Which two types of neurotransmitters are most relevant to psychopathology? a. monoamines and amino acids b. agonists and antagonists c. excitatory and inhibitory d. steroids and chemicals 64. In addition to reducing anxiety, what broader role does GABA play? a. It reduces overall arousal and tempers emotional responses. b. It eases depression. c. It lessens psychotic behaviours associated with schizophrenia. d. It moderates emergency reactions and alarm responses.

65. Which two neurotransmitters are in the amino acid category of neurotransmitters? a. GABA and dopamine b. dopamine and serotonin c. serotonin and norepinephrine d. GABA and glutamate 66. Although GABA and glutamate are both in the amino acid category of neurotransmitters, they differ in which of the following ways? a. GABA and glutamate have a generalized excitatory function. b. GABA has a generalized excitatory function, and glutamate has a generalized inhibitory function. c. GABA is related to psychopathology, and glutamate is not. d. GABA has a generalized inhibitory function, and glutamate has a generalized excitatory function.

67. Which of the following is an excitatory neurotransmitter that turns on many different neurons? a. GABA b. glutamate c. dopamine d. serotonin 68. Which neurotransmitter is associated with the regulation of mood, behaviour, and thought processes? a. GABA b. norepinephrine c. dopamine d. serotonin 69. In which of the following cases is low serotonin activity NOT likely to lead to destructive or impulsive behaviours?

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Chapter 02: An Integrative Approach to Psychopathology a. if the parasympathetic system is activated b. if adrenalin levels remain high c. if the individual exercises sufficient self-control d. if other biological, social, or psychological influences compensate for the low serotonin activity 70. Sean’s doctor thinks that Sean has low serotonin levels. What sorts of behaviour would lead the doctor to suspect serotonin is low? a. Sean is showing aggression, suicidal ideation, and impulsive behaviour. b. Sean is showing symptoms of schizophrenia. c. Sean is exhibiting anxiety and nervousness. d. Sean is exhibiting mania.

71. The herbal medication St. John’s wort is believed to affect levels of which neurotransmitter? a. GABA b. glutamate c. dopamine d. serotonin 72. Which hallucinogen primarily influences glutamate? a. LSD b. mescaline c. ketamine d. ecstasy 73. Psychedelics have been explored as possible drugs that may reduce symptoms of severe depression, anxiety, and PTSD. What is the current concern with the use of these drugs? a. Little is known about the efficacy of these drugs and the underlying mechanisms. b. These drugs produce high levels of dependency. c. They cause unusual emotional and cognitive experiences. d. They impact the serotonin system.

74. Which neurotransmitter is thought to regulate or moderate certain behavioural tendencies rather than directly influencing specific patterns of behaviour or psychological disorders? a. norepinephrine b. GABA c. serotonin d. dopamine 75. If you are prescribed a drug that stimulates either the alpha-adrenergic or beta-adrenergic receptors, you have likely been prescribed a drug that targets which of the following neurotransmitters? a. GABA b. glutamate c. norepinephrine d. serotonin Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology 76. Beta-blockers, prescribed for hypertension, work by reducing the response to which of the following neurotransmitters? a. glutamate b. norepinephrine c. serotonin d. GABA 77. Which of the following has dopamine NOT been implicated in? a. attention deficit hyperactive disorder b. schizophrenia c. disorders of addiction d. anxiety 78. Dopamine is also termed a catecholamine because it resembles the chemical structure of which of the following? a. GABA b. glutamate c. norepinephrine d. serotonin 79. A patient has been given a medication that reduces dopamine; however, doctors suspect that the patient has taken too much of the medication because of the side effects they are showing. Which described side effects could they be showing? a. muscle rigidity, tremors, and impaired judgment b. extreme aggression c. compulsive pleasure-seeking behaviours d. delusions and hallucinations 80. Why is it unlikely that damage in specific structures of the brain itself causes a psychological disorder? a. Psychological disorders typically involve a mix of emotional, behavioural, and cognitive symptoms. b. Genetic factors exert an overriding influence on the development of most psychological disorders. c. Other parts of the brain will compensate for the damage. d. Environmental factors are the major factor in the development of most psychological disorders.

81. In the 1992 studies conducted by Baxter and colleagues, patients with obsessive-compulsive disorder (OCD) were provided with a type of cognitive-behavioural therapy known as exposure and response prevention but no drugs. What important result did the brain imaging show? a. Neither OCD symptoms nor neurotransmitter function had improved. b. Neurotransmitter circuits are the direct and only cause of OCD. c. The patients’ OCD symptoms improved without changes in neurotransmitter function. d. The neurotransmitter circuits of the brain had been made more typical.

82. What has brain-imaging research revealed about cognitive-behavioural therapy? a. Psychosocial factors such as therapy can change brain circuits. b. Drugs are the most essential means to alter faulty neurotransmitter circuits. c. Neurotransmitters affect how people feel and act. d. Neurotransmitters are a result of how people feel and act, not a cause.

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Chapter 02: An Integrative Approach to Psychopathology 83. Petrovic and colleagues (2002) conducted an experiment in which participants were subjected to a harmless but painful condition followed by either a placebo or an opioid. What did they find regarding pain relief and pain-related areas of the brain? a. Both the placebo and the opioid drug relieved pain, but only the opioid affected the region responsible for the control of the pain response in the brain. b. The placebo reduced pain but didn’t relieve pain as well as the opioid drug. c. Both the placebo and the opioid drug relieved pain, and they affected overlapping regions in the brain. d. Both the placebo and the opioid drug relieved pain, but they affected completely different regions in the brain.

84. In their study comparing a placebo to opioid drugs, what did Petrovic and colleagues (2002) conclude? a. Psychological factors can affect brain function. b. Drugs should not be prescribed for most painful conditions. c. Pain is more of a psychological phenomenon than it is physical. d. Opioid drugs may relieve pain only through the expectation of pain relief.

85. Dr. Friedmont raised two groups of rhesus monkeys. One group had the ability to control their environment, while the other group had no control. What will likely happen when the monkeys are injected with a drug that produces a feeling of severe anxiety? a. The monkeys raised with a sense of control will be calm, while the monkeys raised without a sense of control will appear very anxious. b. The monkeys raised with a sense of control will appear angry and aggressive, while the monkeys raised without a sense of control will appear very anxious. c. The monkeys raised with a sense of control will appear anxious, while the monkeys raised without a sense of control will appear angry and aggressive. d. The monkeys in both groups will appear angry and aggressive.

86. Insel and colleagues (1988) conducted a study in which rhesus monkeys were raised either with a sense of control or without a sense of control, and they were later exposed to an anxiety-inducing drug. What did the researchers conclude? a. Chemicals such as neurotransmitters influence behaviour in different ways depending upon the psychological history of the individual. b. Chemicals such as neurotransmitters may have little or no effect on behaviours related to anxiety. c. Chemicals such as neurotransmitters have only indirect effects on behaviour. d. Chemicals such as neurotransmitters have few reliable and consistent effects on observed behaviour.

87. The influence of the microbiome of the gut on psychological well-being is often referred to as which of the following? a. microbiota b. psychobiome c. brain-gut psychology d. neuroendocrine influence 88. There is circumstantial evidence to suggest that those frequently taking antibiotics may experience which of the following? a. depression b. anxiety c. mania Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology d. schizophrenia 89. Rescorla’s experiment regarding classical conditioning demonstrated the importance of which of the following factors? a. psychosocial factors b. contiguity c. behaviour d. physiology 90. Which of the following can be created by placing a rat in a cage where occasionally electrical shocks are administered through the floor, over which the rat has no control? a. unconscious learning b. operant conditioning c. stimulus generalization d. learned helplessness 91. It is important to understand the process of how learned helplessness is created in laboratory animals because learned helplessness in animals resembles a psychological disorder in humans. What is this disorder? a. mania b. depression c. schizophrenia d. generalized anxiety disorder 92. Terri believes that no matter how hard she studies, she will never succeed in college. What does this example illustrate? a. learned helplessness b. unconscious learning c. negative reinforcement d. vicarious learning 93. What term did Seligman coin to refer to people’s tendency to display a positive, upbeat attitude even when they are faced with considerable stress and difficulty in their lives? a. positive attribution b. resilience c. optimistic coping style d. learned optimism 94. Which of the following is most likely if Jose has a more optimistic personality than his brother Juan? a. Jose will likely live seven and a half years longer than Juan. b. Jose is less likely to have a heart attack than Juan. c. Jose is likely to have had fewer stressful events in his life so far than Juan. d. Jose is likely to have experienced significantly more stressful events in his life than Juan.

95. Who is responsible for the research that conceptualized the term modelling? a. Donald Meichenbaum Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology b. Albert Bandura c. Aaron Beck d. Martin Seligman 96. What did Albert Bandura teach us about modelling, or observational learning? a. Learning acquired through observation is much more resistant to extinction than behaviour acquired through classical or operant conditioning. b. Much of our learned behaviour depends upon our interactions with those around us. c. Our learned behaviour has much more to do with the types of consequences (reinforcements and punishments) of our actions than with our interactions with those around us. d. It is impossible to learn behavioural patterns without observing those around us.

97. Swedish psychologist Arne Öhman demonstrated that we learn to fear some objects more easily than others. To which concept did his experiments contribute? a. classical conditioning b. observational learning c. prepared learning d. learned helplessness 98. Professor Knots is talking to her class about the tendency for people to fear spiders but not flowers.Which of the following could be an excerpt from her lecture? a. “Over the course of evolution, we have become highly prepared for learning about certain types of objects or situations.” b. “We are taught to fear because of vicarious learning.” c. “We are taught to fear certain stimuli because of frequent exposure.” d. “We fear spiders because we are reinforced in our environment to fear them over other objects.”

99. Blind sight is a good example of cognitive science’s conception of the unconscious. If an individual is affected by blind sight, what is that person doing? a. retrieving explicit memories of episodic experiences b. demonstrating that they have primitive emotional conflicts c. processing and storing information and acting on it without awareness d. using implicit memories of visual stimuli 100. What does research imply about the nature of the unconscious? a. It clearly exists but in a very different way than Freud imagined. b. It clearly exists in much the same way that Freud imagined. c. It clearly exists in much the same way that Jung envisioned it. d. It may or may not exist as it is impossible to study material of which we are not aware.

101. Which of the following is an example of the unconscious as it is conceptualized by cognitive science that is relevant to psychopathology? a. classical conditioning b. implicit memory c. ego development Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology d. vicarious learning 102. What is the Stroop colour-naming paradigm often use to study? a. classical conditioning b. learned helplessness c. implicit cognition d. vicarious learning 103. When the Stroop paradigm was used in a study of women who were chronic dieters or restrained eaters, what did Francis and colleagues (1997) find about the restrained eaters, as compared to women who were not restrained eaters? a. The restrained eaters showed substantially slowed colour naming for food-related words. b. The restrained eaters were able to name significantly more food-related words. c. The restrained eaters showed substantially faster colour naming for food-related words. d. The restrained eaters were able to name significantly fewer food-related words.

104. What did Aaron Beck, one of the originators of cognitive-behavioural therapy, assume that depression and learned helplessness are associated with? a. an interaction between maladaptive neurotransmitter pathways and behaviours b. thinking too much about one’s failures in life c. unconscious thoughts that lead to maladaptive life situations d. faulty attributions and attitudes 105. Which therapy approach, developed by Albert Ellis, emphasizes cognitive procedures and techniques focused on irrational beliefs? a. cognitive-behavioural therapy b. rational-emotive therapy c. self-instructional training d. relaxation therapy 106. What did Albert Ellis believe were at the root of maladaptive feelings and behaviour? a. dysfunctional relationships b. attention control problems c. faulty attributions d. irrational beliefs 107. Donald Meichenbaum developed self-instructional training for the treatment of depression. What is the goal of this treatment? a. to help the client develop more meaningful interpersonal relationships on their own b. to help the client identify unconscious conflicts from childhood c. to help the client identify faulty attributions regarding negative life events d. to help the client modify what they say to themselves about the consequences of their behaviour 108. Donald Meichenbaum developed self-instructional training by combining techniques from which therapies? a. psychodynamic and behaviour b. cognitive and humanistic Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology c. humanistic and behaviour d. psychodynamic and humanistic 109. A patient treated for an anxiety disorder has been directed to monitor their thoughts and stop thinking so much about how many things can go wrong. At the same time, they are practising relaxation exercises and trying to spend more time in situations that they fear. What type of treatment are they receiving? a. cognitive-behavioural therapy b. behavioural reconditioning c. classical conditioning d. psychoanalytic therapy 110. Which term refers to the process of uncovering automatic thoughts and developing a different set of attitudes and attributions? a. social learning b. behavioural reconditioning c. classical conditioning d. cognitive restructuring 111. You are standing on your roof and almost fall off. In this instance, you feel an incredible surge of arousal. Which term refers to the alarm reaction that activates during potentially life-threatening emergencies? a. fear b. hostility c. flight or fight d. adrenaline 112. The definition of emotion, which is agreed upon by most researchers, includes an external event, a feeling state, a behaviour, and which of the following? a. fear b. hostility c. expectation d. physiological response 113. What is the difference between emotions and mood? a. Emotions are usually temporary states, whereas mood is a more persistent period of affect. b. Emotion and mood can be used interchangeably. c. Mood is a temporary state, whereas emotions last for a longer period of time. d. Mood is used to describe pathological states of emotion.

114. Which of the following describes affect? a. temporary states lasting from several minutes to several hours in response to an external event b. a persistent period of emotionality c. an enduring pathological state of emotion d. a momentary emotional tone that accompanies what we say or do 115. What is emotion generally thought to comprise?

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Chapter 02: An Integrative Approach to Psychopathology a. behaviour, physiology, and mood b. behaviour, physiology, and cognition c. mood and affect d. cognition, behaviour, and affect 116. Felix has enduring states of depression that last for persistent periods of time. Which term best describes Felix’s persistent state of depression? a. mood b. emotion c. affect d. cognition 117. Richard Lazarus is noted for adding which of the following to the cognitive aspects of emotion? a. mood b. belief c. behaviour d. appraisal 118. What do the evil eye, the Latin American disorder susto, and the Haitian phenomenon of voodoo death all exemplify? a. unsubstantiated myths that people can become ill without physical cause b. the influence of the social and cultural environment on our physical and psychological health c. isolated cultural phenomena with little practical significance d. the power of the supernatural model of psychopathology 119. Why are women more likely than men to suffer from insect phobias? a. because of cultural and gender expectations b. because of their traditional role in the home, where they are more likely to encounter insects c. because of differences in neurochemical pathways d. because of hormonal differences 120. What is one reason why men are less likely than women to experience depression in response to stress? a. Men are more likely to engage in activity to take their minds off the negative event. b. Men are more likely to drink alcohol to relieve stress. c. Men are more likely to think about the negative event afterward and solve the problem. d. Men are less likely to experience stressful events in the first place.

121. Michael and Marie lost their parents in a tragic accident. Marie has developed depression while Michael has not. Dr. Guthrie thinks that the difference is due to the siblings’ genders. Which of the following is Dr. Guthrie likely to cite to support her claim? a. Men have fewer social relationships than women, which may protect them from additional stress. b. When experiencing a negative event, women tend to ruminate about it and to blame themselves. c. Men are less likely to self-medicate their depressive feelings with alcohol. d. Men are more likely to simply endure feelings of depression, which makes the feelings pass more quickly.

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Chapter 02: An Integrative Approach to Psychopathology 122. Research by Felmingham and Bryant (2012) found that after exposure therapy for PTSD, both men and women benefited, but women maintained their gains significantly better at the follow-up period. What was the proposed reason for this difference? a. Women were more likely to continue to discuss the emotion, thus prolonging the exposure compared to men. b. Men were less likely to reflect on therapy as being a positive experience than did women. c. Men are less likely to practise the skills learned in therapy than women. d. The ability of women to recall emotional memories somewhat better than men may facilitate emotional processing and long-term gains.

123. Research by Taylor described a unique way in which women cope with stress through nurturing behaviour and forming alliances (particularly with other females). This response was called which of the following? a. familial responding b. tend and befriend c. affiliative behaviour d. caregiving coping 124. What has research found about people who have many social contacts and live their lives continually interacting with others? a. They tend to ruminate about negative life events less often. b. They tend to have lower overall rates of alcohol use disorder. c. They tend to live longer and healthier lives. d. They tend to be at a higher risk for some psychological disorders such as dependency.

125. Research has demonstrated that it is not just the absolute number of social contacts that is important in predicting health, but the perception of which of the following? a. physical health b. health behaviours c. loneliness d. substance use 126. In their research exposing subjects to the virus that causes the common cold, what did Cohen and colleagues (1997) demonstrate? a. The quality of social contact predicted whether the individual would contract a cold, but the frequency of social contact did not. b. The frequency of social contact and chances of contracting a cold were unrelated. c. The less frequent the individual’s social contact, the lower the chances of contracting a cold. d. The greater the extent of an individual’s social ties, the lower the chances of contracting a cold.

127. Research by Grant and colleagues (1988) found that older adults who have fewer social contacts were more likely to suffer from depression than those who have more frequent social contacts. If the individuals with fewer social contacts became physically ill, what tended to happen? a. They were less likely to ask their families for support. b. They were even less likely to receive support from their families. c. They were more likely to receive substantial social support from their families than those who were not ill. d. They were more likely to recover from the depression.

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Chapter 02: An Integrative Approach to Psychopathology 128. Depression seems to appear in all cultures but tends to be characterized by different symptoms within individual cultures. For example, individuals from Asian cultures tend to report fewer affective and cognitive symptoms of depression. What is the most likely cause of this disparity? a. the perception in many Asian cultures that the affective expression of depression is self-centred and threatening to the social structure b. the differences in diagnostic measures used in different cultures c. a history of oppression, which deters reporting d. the genetic differences between individuals living in different cultures 129. According to the text, the elevated rates of some psychological disorders in Indigenous individuals are probably due to the contributions of poverty and another factor. What is this second factor? a. differences in diagnostic criteria used in assessments of Indigenous individuals b. genetic differences between Indigenous individuals and non-Indigenous individuals c. a history of oppression or generational trauma d. cultural differences in the expression of mental illnesses 130. Because psychological disorders are still associated with social stigma, which of the following becomes more likely to happen? a. People with psychological disorders will not seek and receive the treatment and support of others that are most needed for recovery. b. People with psychological disorders will be ignored by mental health professionals when they seek help. c. People with psychological disorders will be far more easily treated than those with physical disorders. d. People with psychological disorders will seek help for their disorders but be more likely to receive insufficient treatment than those with physical illness.

131. According to a lifespan psychopathologist, to understand a patient’s disorder, what must one also understand? a. how the individual has resolved interpersonal conflict throughout life b. how experiences during different periods of development may influence the individual’s vulnerability to some psychological disorders c. how the individual mastered key developmental tasks throughout various life stages d. how the individual developed during psychosexual stages 132. When therapists ask patients how they are feeling and how they are experiencing their disorder today, patients are essentially taking snapshots of their lives at that moment. Who considers this approach incomplete in our understanding of psychopathology? a. lifespan psychopathologists b. humanists c. cognitive behaviourists d. existentialists 133. Kolb and colleagues (2003) exposed juvenile, adult, and very old animals to challenging and complex environments.

What did they find about this kind of environment? a. It had different effects on the animals’ brains depending on their developmental stage. b. It had a negative effect on the older animals’ brains but had no effect on the younger animals. c. It had a negative effect on the young animals’ cognitive functioning when they became adults. d. It had positive effects on the cognitive functioning of all the animals, regardless of age.

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Chapter 02: An Integrative Approach to Psychopathology 134. Dr. Tran is explaining that sleep problems can be a symptom of many different psychological disorders. What phenomenon is she describing? a. pathogenesis b. equifinality c. orthogonal causation d. psychopathology 135. Like a fever, a particular behaviour or disorder may have several causes. What is the name of this principle from a developmental viewpoint? a. equifinality b. psychopathology c. causation d. pathogenesis 136. What does the term equifinality refer to? a. the fact that many causes of psychopathology are equal in influence b. the fact that all forms of psychopathology have similar causes c. the fact that a number of paths can lead to the same outcome d. the fact that the same path can lead to different outcomes

137. Describe the diathesis–stress model. Use the model to explain how one monozygotic twin has clinical depression while the other does not.

138. Describe the basic components of the reciprocal gene–environment model. Describe the method and findings of one study described in the text that illustrates this model. How might this model be misinterpreted by some people?

139. Identify and describe the two major components of the peripheral nervous system and discuss their roles in various psychological disorders. Explain how the sympathetic and parasympathetic divisions often operate in a complementary fashion during periods of stress.

140. Psychoactive medications (drugs that impact our thoughts, emotions, and behaviour) usually work as either agonists or antagonists for various neurotransmitters. Explain how both an agonist and an antagonist operate on a neurotransmitter.

Explain the process of reuptake inhibition and the effect it has on a neurotransmitter.

141. Name three important neurotransmitters and describe what impact each one is thought to have on human experience.

142. Describe learned helplessness. How is it developed in laboratory animals and how does it help us to understand human depression?

143. Explain the difference between the modern cognitive science view of the unconscious and the Freudian idea of the unconscious.

144. What does the cognitive-behavioural model assume to be the cause of depression, and what basic therapy strategy is used in this model for depressed patients? What are “automatic thoughts” and from where do they arise? Give an illustrative example.

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Chapter 02: An Integrative Approach to Psychopathology 145. Socialization is considered one of the most important parts of human experience. Describe gender differences in animal phobias, depression, and eating disorders. Give examples of how differential gender socialization may contribute to these differences.

146. Describe the concept of equifinality. What does this concept say regarding the causes of psychopathology?

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Chapter 02: An Integrative Approach to Psychopathology Answer Key 1. a 2. a 3. b 4. d 5. c 6. b 7. b 8. a 9. a 10. c 11. c 12. a 13. c 14. d 15. b 16. a 17. a 18. a 19. a 20. d 21. b 22. a 23. b 24. c 25. d Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology 26. b 27. b 28. d 29. a 30. c 31. b 32. b 33. c 34. b 35. d 36. d 37. a 38. b 39. c 40. c 41. b 42. c 43. b 44. a 45. d 46. c 47. c 48. a 49. a 50. a 51. b Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology 52. a 53. c 54. d 55. d 56. c 57. b 58. c 59. c 60. c 61. d 62. d 63. a 64. a 65. d 66. d 67. b 68. d 69. d 70. a 71. d 72. c 73. a 74. a 75. c 76. b Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology 77. d 78. c 79. a 80. a 81. d 82. a 83. c 84. a 85. b 86. a 87. b 88. a 89. b 90. d 91. b 92. a 93. d 94. a 95. b 96. b 97. c 98. a 99. c 100. a 101. b 102. c Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology 103. a 104. d 105. b 106. d 107. d 108. a 109. a 110. d 111. c 112. d 113. a 114. d 115. b 116. a 117. d 118. b 119. a 120. a 121. b 122. d 123. b 124. c 125. c 126. d 127. c Powered by Cognero

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Chapter 02: An Integrative Approach to Psychopathology 128. a 129. c 130. a 131. b 132. a 133. a 134. b 135. a 136. c 137. Student responses will vary.

138. Student responses will vary.

139. Student responses will vary.

140. Student responses will vary.

141. Student responses will vary.

142. Student responses will vary.

143. Student responses will vary.

144. Student responses will vary.

145. Student responses will vary.

146. Student responses will vary.

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Chapter 03: Clinical Assessment and Diagnosis

Indicate the answer choice that best completes the statement or answers the question.

1. What do we call the systematic evaluation and measurement of psychological, biological, and social factors in a person with a possible psychological disorder? a. clinical interpretation b. clinical diagnosis c. clinical assessment d. clinical standardization 2. Which of the following is NOT part of a clinical assessment? a. evaluation of financial factors b. evaluation of biological factors c. evaluation of social factors d. evaluation of psychological factors 3. What do we call the process of determining whether an individual’s symptoms meet the criteria for a specific psychological disorder? a. prognosis b. diagnosis c. analysis d. classification 4. What is the Diagnostic and Statistical Manual of Mental Disorders? a. a guide for training psychology students in assessment techniques b. a textbook about the etiology of psychological disorders c. a classification system for mental illnesses d. an encyclopedia of treatment approaches for psychological disorders 5. What organization publishes the Diagnostic and Statistical Manual of Mental Disorders? a. the International Medical Association b. the American Psychological Association c. the American Psychiatric Association d. the National Institute of Mental Health 6. For what purpose does the process of clinical assessment result in narrowing the focus? a. to consider a broad range of problems b. to focus on inter- and intra-personal problems equally c. to concentrate on problem areas that seem most relevant d. to uncover all possible causes of stress in the person’s life 7. The process of clinical assessment in psychopathology has been likened to which of the following? a. a mystery b. a funnel c. a scale d. a broom Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis 8. A patient who had recurrent headaches, fatigue, and loss of appetite received different diagnoses from several psychiatrists. In terms of assessment, what type of problem does this example illustrate? a. a problem with classification b. a problem with reliability c. a problem with validity d. a problem with standardization 9. When Ms. Rath was seeking employment, a job consultant gave her a standard IQ test. The following year, the same consultant gave Ms. Rath the same IQ test. Ms. Rath’s score was similar on both occasions. What does this indicate? a. The test has concurrent validity. b. The test has long-term validity. c. The test has interrater reliability. d. The test has test–retest reliability.

10. Naema is given a diagnosis of major depressive disorder by her psychologist and wants another opinion. After seeing a psychiatrist, the diagnosis is confirmed. What can be said about the diagnoses of the psychologist and psychiatrist? a. They have predictive validity. b. They have test–retest reliability. c. They have interrater reliability. d. They have concurrent validity.

11. Dr. Evans conducts a study that showed his colleague’s depression screening tool does NOT predict depressive symptoms. What is the problem with the depression screening tool? a. validity b. standardization c. reliability d. classification 12. Which term best describes an assessment that measures what it is intended to measure? a. valid b. reliable c. standardized d. clinical 13. An IQ test indicates a level of intelligence that closely corresponds with a student’s high school grades and with teachers’ ratings of the student’s intelligence. In this instance, what does this IQ test have? a. concurrent validity b. reliability c. predictive validity d. standardization 14. A new IQ test is available, but it fails to inform clinicians about what will happen regarding success in school for the individuals that take the test. What is missing in this assessment? a. test–retest reliability Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis b. concurrent validity c. standardization d. predictive validity 15. Mr. Lopez, a 40-year-old recent immigrant to Canada, is learning to speak English. He applies for a job and is given a test. His score is compared with those of other test takers who are mostly college graduates whose native language is English. Mr. Lopez thinks this is unfair. What kind of problem does this situation illustrate? a. a problem with classification b. a problem with standardization c. a problem with validity d. a problem with reliability 16. A clinician completes an assessment and states that the client's scores were consistent with those of a group of people who are similar to the client in gender, age, and cultural background. What would the clinician be using to make this claim? a. interrater reliability b. subjective judgment c. norms d. extraneous factors 17. As part of a psychological assessment, a mental status exam is often used to find out how a person thinks, feels, and behaves. What is the primary purpose of a mental status exam? a. to determine what type of treatment should be used b. to determine whether a psychological disorder might be present c. to determine whether the individual also has a medical condition d. to determine which medication would be most effective 18. How is a mental status exam related to a clinical interview? a. A mental status exam score is important information for hospitalizations. b. A mental status exam is used to elicit spontaneous information that is not usually obtained in the interview. c. A mental status exam is administered immediately following the interview. d. A mental status exam is used to organize the information obtained during the interview.

19. In a mental status exam, a clinician can make a rough estimate of the patient’s intellectual functioning. What aspects of intellectual functioning does the clinician attempt to detect by listening to the patient’s speech? a. the ability to talk about their problems logically and objectively b. insight into their problems c. the tendency to use abstractions and metaphors d. the ability to speak slowly and clearly 20. Which of the following is NOT a category covered in a mental status exam? a. physical symptoms b. behaviour c. appearance d. intellectual functioning Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis 21. With regard to a mental status exam, which of the following questions is NOT related to the concept of sensorium? a. Who are you? b. Where are you? c. How old are you? d. What is today’s date?

22. Which of the following is a part of the thought processes component of a mental status exam? a. noting a person’s vocabulary b. noting the appropriateness of a person’s attire c. noting a person’s mood d. noting the content of what a person is saying 23. The term sensorium refers to part of the mental status exam. What does sensorium mean? a. a person’s impairment in visual or auditory functioning b. a person’s general awareness of their surroundings c. a person’s level of emotional sensitivity d. a person’s ability to make reasonable judgments 24. Determining mood and affect is an important part of the mental status exam. Although both terms refer to feeling states of the individual, how does mood differ from affect? a. Mood is more changeable than affect. b. Mood is more frequent than affect. c. Mood is more pervasive than affect. d. Mood is more severe than affect.

25. Dr. Ashton has assessed Mr. Tindale and sees that while Mr. Tindale knows his name and the date, he doesn’t know where he is. Dr. Ashton writes something in Mr. Tindale’s chart that the nurses are having trouble reading. What do you think Dr. Ashton wrote? a. “patient oriented times one” b. “patient oriented times two” c. “patient oriented times three” d. “patient sensorium clear” 26. Dr. Wu is conducting a mental status exam on Marek. When he asks Marek to talk about the death of his sister, Marek begins to laugh uncontrollably. Based on this laughter, what does Dr. Wu note? a. Marek is exhibiting atypical mood. b. Marek is exhibiting atypical affect. c. Marek is exhibiting atypical sensorium. d. Marek is exhibiting atypical behaviour.

27. Asking specific questions—such as “Who are you?” “Where are you?” and “What’s the weather like today?”—is an important part of a mental status exam. What component of the exam are such questions addressing? a. the intellectual functioning component b. the mood and affect component Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis c. the thought process component d. the sensorium component 28. How do semistructured interviews differ from unstructured interviews? a. In the semistructured format, clinicians develop their own methods of collecting necessary information; in the unstructured interview, the clinician does not develop their own method of collecting unnecessary information. b. In the semistructured format, clinicians try to keep the client from straying from specific issues identified by the therapist as essential; in the unstructured interview, these rules are not in place. c. In the semistructured format, clinicians rely on the organizational structure of a mental status exam; in the unstructured interview, they do not use mental status exams. d. In the semistructured format, clinicians use questions that have been tested to elicit useful information in a consistent manner; in the unstructured interview, they do not.

29. A clinician follows a general outline of questions designed to gather essential information but is free to ask the questions in any particular order and to branch off into other directions to follow up on clinically important information.

What type of interview is being used in this example? a. an unstructured interview b. a structured interview c. a behavioural interview d. a semistructured interview 30. What is a disadvantage of semistructured interviews? a. They don’t allow for comparison with similar individuals. b. They initiate treatment plans. c. They decrease confidentiality. d. They may inhibit the patient from volunteering useful information.

31. If a clinician deviates from a semistructured interview, what type of assessment are they likely using? a. an unstructured interview assessment b. naturalistic observations c. a conversational inventory assessment d. an individual-engagement therapeutic assessment 32. Which of the following medical conditions might also produce symptoms that mimic anxiety disorders, such as generalized anxiety disorder? a. hyperthyroidism b. cocaine withdrawal c. heart attack d. fibromyalgia 33. A client reports they have been feeling depressed. When asked if they have any medical conditions, they report that they do but cannot remember which one. What is a likely condition based on what is known about the links between medical conditions and psychological disorders? a. brain tumour b. hyperthyroidism Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis c. cocaine withdrawal d. hypothyroidism 34. Many problems presenting as disorders of behaviour, cognition, or mood may, on careful physical examination, have a clear relationship to which of the following? a. poor interpersonal relationships b. addiction c. a temporary toxic state d. a history of trauma 35. A clinical psychologist decides to conduct a behavioural assessment of a five-year-old, instead of a clinical interview, after her parents report that she has had repeated and often physical conflicts with other children on the playground. Why is a behavioural assessment preferable in this case? a. The parents could be exaggerating the problem. b. A structured interview might be too stressful for a young child. c. Young children are less able to verbally communicate their problems and experiences. d. Young children often deliberately withhold information from authority figures.

36. What are the ABCs of behavioural observation? a. antecedent, behaviour, consequences b. affect, behaviour, consequences c. antecedent, behaviour, causes d. affect, behaviour, cognition 37. Researcher David Wolfe used contrived situations to assess the emotional reactions of parents with a history of abuse toward their children. His goal of creating these situations was to use the observations to develop which of the following? a. an interview b. an observable behaviour c. target behaviour d. treatment plans 38. A clinician asks a child to sit at a desk in a simulated classroom situation to complete a difficult task. The clinician is using this technique to discover the reasons the child has been engaging in self-hitting (self-injurious) behaviour. In behavioural assessment terms, what type of behaviour has the self-hitting been identified as? a. measurable behaviour b. target behaviour c. resultant behaviour d. observable behaviour 39. Compared with informal observation, what is an advantage of formal observation? a. Formal observations provide more perspective because they are written after an open-ended, out-of-office interview in a non-clinical setting. b. Formal observations rarely require the use of naturalistic settings. c. Formal observations are more reliable because of the focus on behaviours that are both observable and measurable.

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Chapter 03: Clinical Assessment and Diagnosis d. Formal observations give more information about an individual because they require a three-hour minimum time commitment.

40. When behaviours only occur in private, what type of observation is essential? a. informal observation b. formal observation c. self-monitoring d. naturalistic observation 41. What has the reactivity phenomenon of self-monitoring procedures been shown to do? a. increase desired behaviours b. decrease undesired behaviours c. increase emotional responses to external stressors d. both increase desired behaviours and decrease undesired behaviours 42. With respect to monitoring procedures, which of the following is an example of the reactivity phenomenon? a. On parents’ visiting day in a classroom, the previously well-behaved children continue to show good behaviour. b. A man quits smoking after his father dies of lung cancer. c. After joining a fitness club, a woman stops exercising in her home and instead walks two kilometres a day by herself. d. A man begins to eat less after joining a clinic weight-loss program in which each participant’s weight is recorded weekly by a staff member.

43. What assessment tools are used before treatment and periodically during treatment to assess changes in behaviour? a. behaviour rating scales b. mental status examination c. psychological testing d. projective testing 44. Many popular magazines include “psychological” or “personality” tests to help readers better understand themselves or others. How does the text view most of these tests? a. They are reliable. b. They are for entertainment only. c. They are informative and educational. d. They are valid.

45. Dr. Gallagher has decided to use a projective test on a client to explore the client’s unconscious. Why has Dr. Gallagher chosen a projective test in this case? a. It is important to use tests that are structured, objective, and valid. b. Many people are too embarrassed to reveal highly personal information openly. c. By definition, unconscious processes can only be measured through projection onto ambiguous stimuli. d. Clinical interviews are always insufficient to reveal a person’s problems.

46. When an individual describes what they see in the ambiguous stimuli of the Rorschach test, what is assumed to be Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis revealed? a. the person’s preconscious thoughts b. the person’s unconscious thoughts c. the person’s conscious thoughts d. the person’s subconscious thoughts 47. Dr. Gupta is a psychoanalytic therapist who wants to assess the unconscious thoughts and feelings of a patient. What type of test would Dr. Gupta most likely use? a. the Bender Visual-Motor Gestalt Test b. the Rhythm Test c. the MMPI d. the Thematic Apperception Test 48. Why was the Comprehensive System for administering and scoring the Rorschach inkblot test developed? a. It was discovered that interrater reliability had increased significantly. b. The previous scoring system was found to be difficult and time consuming. c. Hermann Rorschach was dissatisfied with the way his test was being administered. d. There was a lack of standardized procedures, which can affect the way the test-taker responds to the questions.

49. The Thematic Apperception Test differs from the Rorschach inkblot test in that the person taking the TAT is asked to use their imagination to do which of the following? a. tell a dramatic story about a picture b. tell how a descriptive sentence applies to them c. identify the theme that is common to a set of pictures d. speculate about the relationships between various people shown in a picture 50. A therapist has chosen to employ the Thematic Apperception Test with one of their clients. What is the most likely reason for this decision? a. He wants to reveal their unconscious mental processes in their stories. b. He wants to develop a comprehensive, empirically sound clinical intervention for his client. c. He wants to allow his client to perform and score a private self-assessment. d. He wants to use the test to diagnose the client.

51. Which of the following is a projective test? a. the WAIS b. the MMPI c. the TAT d. the PCL-R 52. What is one problem with projective tests? a. They are often too rigid. b. They make participants feel uncomfortable. c. They are expensive to administer. d. They are used inconsistently across clinicians.

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Chapter 03: Clinical Assessment and Diagnosis 53. In contrast to projective tests, personality inventories such as the MMPI are based on the collection and evaluation of data. What type of approach is this? a. an analytic approach b. a predictive approach c. an empirical approach d. a descriptive approach 54. In contrast to projective tests, which rely heavily on theory for an interpretation, what are the MMPI and similar inventories based on? a. skills a person needs to function in day-to-day life b. clinical experience and intuition c. the collection and evaluation of data d. the person’s psychiatric and social history 55. Dr. DuPont is researching an assessment instrument. Which of the following is she most likely conducting research on? a. the MMPI b. the TAT c. the Rorschach inkblot test d. the PCL-R 56. How does the assessment concept known as reliability increase in the MMPI? a. The MMPI is often interpreted by computer. b. The MMPI is non-sexist. c. The MMPI is well-researched. d. The MMPI is made up of many scales.

57. What is used to assess results on the Minnesota Multiphasic Personality Inventory (MMPI)? a. the correspondence between the individual’s pattern of answers and that of people diagnosed with a specific disorder b. the frequency at which the individual refers to specific ideas, such as aggression or sexuality c. the degree of emotionality associated with results d. the frequency with which the individual responds to questions that reflect aggression or some other concept 58. On which scale of the Minnesota Multiphasic Personality Inventory (MMPI) would you expect an antisocial and dishonest person to get a high score? a. paranoia scale b. psychopathic deviate scale c. psychasthenia scale d. social introversion scale 59. Suppose an individual taking the MMPI is very guarded and defensive. On which scale will they most likely obtain an elevated score? a. Correction (K) b. Infrequency (F) Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis c. Back F (Fb) d. Lie (L) 60. Suppose an individual taking the MMPI falsifies answers to look good. On which scale will they most likely have a high score? a. Correction (K) b. Infrequency (F) c. Superlative Self-Presentation (S) d. Lie (L) 61. While taking the MMPI, James tried to give himself an unrealistic positive image by falsifying answers and trying to appear as though he had no psychological problems. On which scale(s) did James receive a high score? a. L (Lie), K (Correction), and F (Infrequency) scales b. F (Infrequency) scale c. K (Correction) scale d. L (Lie) and K (Correction) scales 62. Which of the following was a cause of problems with the original version of the MMPI? a. the lack of standardized instructions for administration b. clinicians’ subjective interpretations of scale scores c. selective sampling for the standardization group and the biased wording of questions d. low reliability and validity 63. Although the MMPI has been researched excessively, some researchers stated which of the following caution regarding the assessment? a. There is a lack of standardized instructions for administration. b. The scores are based on subjective clinician interpretation. c. The wording in the MMPI is biased for certain populations. d. The information in the MMPI may not change how clients are treated and may not improve their outcomes.

64. Individuals who are cunning and manipulative pathological liars would be unlikely to respond truthfully on a selfreport measure of personality. Hare’s PCL-R is an instrument that measures the characteristics of psychopathy. What does Hare’s PCL-R use? a. behavioural observation in the person’s natural environment b. interviews with the client, along with material from institutional files and people close to the person c. projective tests to tap into unconscious processes d. lie detector equipment along with a verbal form of the personality test 65. Hare’s PCL-R is an instrument that measures the characteristics of which of the following? a. panic attacks b. psychopathy c. paranoia d. psychasthenia 66. The calculation of an IQ, previously done by using a child’s mental age, is now done by using a deviation IQ. What is Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis the child’s score now compared with? a. the scores of others who took the test at the same time b. the scores of others in the same grade c. the scores of others with the same level of intelligence d. the scores of others of the same age 67. Dividing mental age by a child’s chronological age and multiplying by 100 leads to which of the following scores? a. intelligence quotient (IQ) b. deviation IQ c. WAIS score d. WISC score 68. The Wechsler tests include verbal and which other type of scales? a. vocabulary b. knowledge of facts c. performance d. verbal reasoning 69. In both American and Canadian samples, the adult version of the Wechsler intelligence test have been found to tap four distinct intellectual abilities. Which of the following is NOT one of these abilities? a. verbal comprehension b. perceptual organization c. working memory d. reasoning speed 70. What is the focus of the continuing controversy about the WAIS? a. whether the WAIS tests have portability to people from other countries and cultures b. whether the WAIS tests measure emotional intelligence c. whether the WAIS tests measure distinct cognitive skills d. whether the WAIS tests should be used with adults and children 71. What does an IQ score tell us? a. an individual’s intelligence b. an individual’s emotional intelligence c. an individual’s likelihood of doing well in the educational system d. an individual’s attentional capacity 72. What kind of test is the Stanford-Binet test? a. a personality test b. a projective test c. an intelligence test d. a mental status test 73. What have researchers found regarding the Wechsler Intelligence Scale for Children (WISC) 5? a. There are significant gender differences on this test that are not observed on other IQ tests.

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Chapter 03: Clinical Assessment and Diagnosis b. Scores on this test do not predict academic success well at all. c. The WISC is fully portable across cultural boundaries. d. That caution should be taken in using these tests with cultural groups outside those on whom the test was normed.

74. Which technique would be appropriate if you wanted to look for possible cognitive impairments in a client? a. MMPI b. PET scan c. WAIS-IV d. a projective test 75. What is a limitation of IQ tests? a. They do not assess a person’s ability to adapt to the environment or generate new ideas. b. They do not provide predictive validity with respect to academic success. c. They do not measure abilities such as attention and memory. d. They do not measure abilities such as reasoning and perception.

76. What are neuropsychological tests used to assess? a. whether an individual might have had a psychotic episode b. whether an individual might have a brain dysfunction c. whether an individual might have an intellectual development disorder d. whether an individual might be in a depressed state 77. If it were important to determine the exact location of brain impairment, which of the following would most likely be used? a. the Thematic Apperception Test b. the Halstead-Reitan Neuropsychological Battery c. the Stanford-Binet Intelligence Scale d. the Bender Visual-Motor Gestalt Test 78. A clinician suspects brain dysfunction in a seven-year-old based on a neuropsychological test they administered.

Which test was the child likely given? a. the Luria-Nebraska Neuropsychological Battery b. the Halstead-Reitan Neuropsychological Battery c. the Tactile Performance Test d. the Bender Visual-Motor Gestalt Test 79. One of the problems of using neuropsychological tests to detect organic damage and cognitive disorders involves the possibility of false negatives. Which of the following is most likely to result from a false negative? a. A patient undergoes completely unnecessary and expensive procedures. b. A clinician misses an important medical problem that needs to be treated. c. A patient is diagnosed with a condition that does not exist. d. Cell damage occurs due to repeated radiation exposure.

80. Why are neuropsychological tests used?

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Chapter 03: Clinical Assessment and Diagnosis a. to map blood flow and other metabolic activity in the brain b. to help differentiate those who have a given cognitive disorder from those people who do not c. to predict who will develop a specific cognitive disorder five or ten years later d. to take accurate pictures of brain structure and function 81. Sarah’s family doctor has suggested to her parents that they see a specialist to have a neuropsychological test completed. What is this type of test intended to do? a. use imaging to assess brain structure and/or function b. determine the possible contribution of brain impairment to her condition c. ascertain the structure and patterns of cognition d. assess long-standing patterns of behaviour 82. Marguerite is given a neuropsychological test. Although her test results indicate that she has no brain dysfunction, she actually does have a brain tumour. Her test results indicate a false negative. What is the most likely outcome? a. Marguerite will become discouraged and put off following up on medical care. b. Marguerite may end up paying for costly treatment that is not necessary. c. Marguerite will not get the treatment she needs. d. Marguerite may seek out an additional medical opinion.

83. Although false positives and false negatives may occur in neuropsychological testing, the issue is mitigated in which of the following ways? a. As neuropsychological tests are primarily used as screening, they are routinely paired with other assessments. b. Neurological damage can be countered through the plasticity of the brain, so there is less concern. c. The disorders that neuropsychological tests identify are mild, so there is little concern about accuracy. d. The only issue with false positives and false negatives is a false sense of well-being, which can be countered with psychotherapy.

84. How does the CAT scan neuroimaging technique work? a. It uses X-rays to portray brain structures. b. It uses magnetic fields to portray brain structures. c. It follows tracer elements in the nervous system. d. It uses magnetic fields to portray brain functions.

85. What is the main difference between neuropsychological tests and neuroimaging techniques? a. Neuropsychological tests help identify the location of the brain dysfunction, whereas neuroimaging shows us the structure and functioning of the brain. b. Neuropsychological tests help identify the structure and functioning of the brain, whereas neuroimaging shows us the location of the brain dysfunction. c. Neuropsychological tests help identify the nature of the brain dysfunction, whereas neuroimaging shows us the reasons for the brain dysfunction. d. Neuropsychological tests help identify patterns of dysfunctional cognitions, whereas neuroimaging shows us the structure of dysfunctional cognitions.

86. What have recent research studies used PET scans for? a. to look at patterns of brain metabolism that might be associated with different disorders Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis b. to locate brain tumours and injuries c. to detect tissue variations associated with disorders d. to locate abnormalities in the structure or shape of the brain 87. Which neuroimaging device would be used to examine dopamine activity in individuals with bipolar disorder? a. CAT b. MRI c. PET d. TAT 88. Which of the following refers to an imaging technique that uses a radioactive tracer to measure the functioning of parts of the brain? a. a PET scan b. a CT scan c. a CAT scan d. an MRI scan 89. Which of the following is single photon emission computed tomography most similar to in technique and purpose? a. EEG b. MRI c. CAT d. PET 90. Despite the exciting uses of PET for understanding psychopathology, PET is limited in availability. What is a reason for the limited accessibility? a. Special facilities must be onsite so that the radioactive tracers can be transported quickly. b. The procedure takes hours to complete, limiting the number of people that can be scanned in one day. c. PET is only a screening tool and must be used in conjunction with another, more elaborate, measure. d. Only a few people are trained in using PET technology.

91. How does the fMRI procedure differ from the traditional MRI? a. The fMRI procedure uses X-rays to show the brain from different angles. b. The fMRI procedure measures brain metabolism. c. The fMRI procedure measures brain wave activity. d. The fMRI procedure can take pictures of the brain at work, recording changes from one second to the next.

92. In studies using fMRI, how did post-traumatic stress disorder (PTSD) participants who report primarily dissociative (numbing-type) responses to listening to scripts about their traumas compare with PTSD participants who experienced primarily hyperarousal patterns to trauma scripts? a. They had more atrophied parts of the brain. b. They had less electrical activity in the limbic system. c. They had slower and more irregular delta waves. d. They had very different patterns of brain activation.

93. Why has fMRI largely replaced PET scans in leading brain-imaging centres?

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Chapter 03: Clinical Assessment and Diagnosis a. fMRI is cheaper than PET. b. fMRI allows researchers to see the immediate response of the brain. c. fMRI is easier to implement than PET. d. fMRI is more accurate than PET. 94. Which of the following is used to measure electrical activity in the brain? a. an electroencephalograph b. an electrocardiograph c. an electromyogram d. an electroencephalogram 95. A researcher wants to examine brain wave patterns associated with seizures. What should they use? a. a CAT scan b. an EEG c. a PET scan d. an MRI 96. Many types of stress-reduction treatments, through the process of relaxation, attempt to increase the frequency of which wave pattern? a. alpha b. beta c. delta d. theta 97. Which form of assessment measures changes in the nervous system that reflect emotional or psychological events? a. neuropsychological b. psychological c. psychophysiological d. neuroimaging 98. Why is assessing psychophysiological responding very important in the assessment of many sexual dysfunctions and disorders? a. Misdiagnosis of sexual disorders can be devastating for the patient. b. It avoids having to ask patients direct and possibly embarrassing questions about their sexuality. c. Many people are unaware that they have a true sexual disorder. d. Sometimes the individual is unaware of their specific patterns of sexual arousal.

99. A patient being treated for hypertension is given blood pressure readings on a continuous basis. The goal is to have the patient learn to regulate their blood pressure responses. What type of physiological measurement is the patient undergoing? a. biofeedback b. an electrocardiograph c. an electromyogram d. an electroencephalogram Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis 100. What is the main goal of a prognosis? a. to provide information about the likely course of the disorder b. to gain clinical experience c. to examine diagnosis options available to the patient d. to determine the client’s desire to reform 101. What do the terms taxonomy and nosology refer to? a. the classification of entities or disorders in a scientific context b. the process of identifying specific psychological disorders c. the process of testing the validity and reliability of a classification system d. the measurement of changes in the nervous system 102. The names anxiety disorders and mood disorders fall under which of the following terms in classification systems? a. taxonomy b. nosology c. nomenclature d. clinical description 103. Which classification system is most used worldwide? a. ICD-11 b. DSM-5-TR c. DSM-III d. WHO-7 104. How does the ICD differ from the DSM? a. The ICD classifies only neurodevelopmental disorders. b. The ICD is also used to categorize health conditions. c. There are no differences other than the fact that the ICD is published by the WHO and the DSM is published by the APA. d. The DSM is more valid and reliable than the ICD. 105. What does the classical categorical approach to diagnosis assume about each person with a particular disorder? a. They will experience very few of the same symptoms. b. They will respond to the same treatments equally. c. They will be helped by recognizing the cause of the disorder. d. They will experience the same symptoms with little or no variation.

106. What does the dimensional approach to classification of mental disorders provide that the categorical approach does not? a. The dimensional system provides scales that indicate the degree to which patients are experiencing various cognitions, moods, and behaviours. b. The dimensional system provides diagnostic labels based on the presence of specific symptoms. c. The dimensional system provides lists of symptoms that are associated with all the forms of psychopathology that are currently believed to exist. d. The dimensional system provides information that is used to determine the cause and treatment of the disorder.

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Chapter 03: Clinical Assessment and Diagnosis 107. Which approach allows some variation in symptoms without changing classification? a. a categorical approach b. a dimensional approach c. a multidimensional approach d. a prototypical approach 108. Which classification approach does the DSM-5-TR most often take? a. a categorical approach b. a dimensional approach c. a multidimensional approach d. a prototypical approach 109. Polythetic is another term for which approach in classification systems? a. the prototypical approach b. the dimensional approach c. the multidimensional approach d. the categorical approach 110. If two people are both diagnosed with the same disorder using the DSM-5-TR, how will the two people be similar? a. They will have experienced identical symptoms of the disorder. b. They will have experienced similar distress because of the disorder. c. They will have lost the ability to function in a similar way. d. They will have some of the same symptoms as each other.

111. Accurate diagnoses are partly dependent on the reliability and validity of the diagnostic system being used (e.g., the DSM-5-TR). What else does diagnostic accuracy depend on? a. the patient’s ability to describe their symptoms clearly and honestly b. the skills and training of the clinician c. valid statistics regarding the prevalence of the disorder d. the efficacy of treatments available for a given psychological disorder 112. Using a new diagnostic system, several clinicians interview a patient and independently provide the same diagnosis.

What can we assume about the new diagnostic system? a. It appears to be standardized. b. It appears to be reliable. c. It appears to be normed. d. It appears to be valid.

113. Which category in the DSM-5-TR is the most unreliable? a. personality disorders b. anxiety disorders c. neurodevelopmental disorders d. mood disorders Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis 114. Suppose a clinician creates criteria for a diagnosis that reflects what most experts in the field consider to be a particular prototypical patient. What is the clinician doing? a. creating content validity b. creating predictive validity c. creating criteria validity d. creating consensus validity 115. If an assessment is shown to measure what it is intended to measure, it can be said to be which of the following? a. reliable b. sensitive c. standardized d. valid 116. What important change was made in the DSM versions that followed DSM-III? a. a change from a dimensional to a categorical system b. the inclusion of the humanistic view of pathology c. greater emphasis on validity and less concern for reliability d. the distinction between organically based disorders and psychologically based disorders was eliminated 117. How did the DSM-III and DSM-IV facilitate a more complete picture of the individual? a. by emphasizing biological factors b. by emphasizing cultural factors c. by emphasizing levels of stress in the environment d. by emphasizing a dimensional approach 118. Allowing a disorder to be described from the perspective of the patient’s personal experience and in terms of their primary social and cultural group is referred to as which of the following? a. multiaxial approach b. cultural formulation c. cultural reference d. dimensional approach 119. What type of disorder is the condition in the Inuit culture known as kayak-angst? a. bipolar disorder b. personality disorder c. depressive disorder d. anxiety disorder 120. What is often the outcome of the fuzzy categories that blur in the classification systems? a. a comorbidity diagnosis b. one disorder is missed c. validity is compromised d. an inability to treat an individual 121. Your 70-year-old father is recounting a childhood story when he describes affectionately the boy down the street as Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis an imbecile. You respond to your father by saying, “In classifying mental disorders, we don’t use labels such as moron, imbecile, or idiot anymore.” When he asks you why, how do you respond? a. People will refuse treatment for mental disorders that have a negative connotation. b. There were no effective treatments for these disorders in the past. c. Mental health professionals are reluctant to assign a diagnosis that upsets people. d. Labels can take on a negative connotation and be used as insults.

122. Why was a mixed anxiety-depression diagnosis originally considered for DSM inclusion? a. The disorder was theoretically sound. b. The symptoms were often seen in primary care settings. c. The disorder was scientifically based. d. The disorder had construct validity.

123. You are attending a mental health lecture at your school when a heated debate erupts over the inclusion of premenstrual dysphoric disorder in the DSM. Why does this controversy exist? a. because of issues related to religion b. because of issues related to pregnancy and birth c. because of issues related to stigmatization d. because of issues related to racism 124. Which statement best describes a difficulty with diagnosing premenstrual dysphoric disorder (PMDD)? a. Di Guilio and Reissing (2006) found little evidence that PMDD is a distinct diagnostic entity. b. Symptoms occur only during the late luteal phase and thus it does not qualify as a genuine endocrine disorder. c. It is difficult to distinguish PMDD from premenstrual exacerbations of other disorders, such as binge eating disorder or mood disorders. d. It has less severe symptomatology than premenstrual syndrome and thus does not warrant a DSM-5-TR diagnostic label.

125. Describe the major objectives and procedures of clinical assessment. Be sure to include the typical activities of the assessor and the intended outcomes of the process.

126. Describe the concepts of reliability and validity. Why are the reliability and the validity of an assessment procedure important?

127. Describe the major objectives and typical procedures of the mental status exam. Be sure to include the typical activities of the examiner and the intended outcomes of the process.

128. Discuss the concept of confidentiality and the limits of confidentiality with regard to clinical assessment. Be sure to include the situation that would cause a clinician to break confidentiality.

129. Discuss fully how behavioural assessment takes the clinical interview one step further. What kinds of clinical populations and clinical problems might be especially well suited for behavioural assessment? Explain how target behaviours are identified and observed, using an illustrative example.

130. Identify and describe the ABCs of observational assessment. Using illustrative examples, explain how informal observation, differs from formal observation and the strengths and weaknesses of each.

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Chapter 03: Clinical Assessment and Diagnosis 131. Projective tests such as the Thematic Apperception Test and the original Rorschach inkblot test are often criticized regarding their reliability. Explain why the reliability of these tests may not be as good as a personality measure such as the MMPI. 132. A psychiatrist orders a series of tests including an IQ test, personality inventory (MMPI), neuropsychological test (Halstead-Reitan), and a brain scan (CT scan) for a 10-year-old boy who has recently been acting aggressively. Explain what each test measures and how the psychiatrist would use the results of each test to help diagnose or rule out potential causes of the boy’s behaviour.

133. Explain the difference between neuropsychological testing and neuroimaging. Describe the procedures involved in computerized axial tomography (CAT), magnetic resonance imaging (MRI), positron emission tomography (PET), and functional MRI (fMRI), and explain what each procedure allows us to examine.

134. Describe the differing methods of classification and which approach the current DSM-5-TR uses.

135. Describe the influence of culture on the experience of psychopathology. Why is it important for the clinician to acknowledge and appreciate the patient’s culture before determining a diagnosis?

136. Explain the advantages and disadvantages (to the patient) of a diagnostic label.

137. Identify some of the changes that have occurred in the DSM throughout the years. Explain some of the current controversies with the DSM-5-TR.

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Chapter 03: Clinical Assessment and Diagnosis Answer Key 1. c 2. a 3. b 4. c 5. c 6. c 7. b 8. b 9. d 10. c 11. a 12. a 13. a 14. d 15. b 16. c 17. b 18. d 19. c 20. a 21. c 22. d 23. b 24. c 25. b Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis 26. b 27. d 28. d 29. d 30. d 31. a 32. a 33. d 34. c 35. c 36. a 37. d 38. b 39. c 40. c 41. d 42. d 43. a 44. b 45. c 46. b 47. d 48. d 49. a 50. a 51. c Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis 52. d 53. c 54. c 55. a 56. a 57. a 58. b 59. a 60. d 61. d 62. c 63. c 64. b 65. b 66. d 67. a 68. c 69. d 70. a 71. c 72. c 73. d 74. c 75. a 76. b Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis 77. b 78. d 79. b 80. b 81. b 82. c 83. a 84. a 85. a 86. a 87. c 88. a 89. d 90. a 91. d 92. d 93. b 94. d 95. b 96. a 97. c 98. d 99. a 100. a 101. a 102. c Powered by Cognero

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Chapter 03: Clinical Assessment and Diagnosis 103. a 104. b 105. d 106. a 107. d 108. d 109. a 110. d 111. b 112. b 113. a 114. a 115. d 116. a 117. c 118. b 119. d 120. a 121. d 122. b 123. c 124. c 125. Student responses will vary.

126. Student responses will vary.

127. Student responses will vary.

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Chapter 03: Clinical Assessment and Diagnosis 128. Student responses will vary.

129. Student responses will vary.

130. Student responses will vary.

131. Student responses will vary.

132. Student responses will vary.

133. Student responses will vary.

134. Student responses will vary.

135. Student responses will vary.

136. Student responses will vary.

137. Student responses will vary.

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Chapter 04: Research Methods in Psychopathology

Indicate the answer choice that best completes the statement or answers the question.

1. A researcher is testing the effects of violent media images on tolerance for aggressive behaviour by showing either nonviolent or violent movie scenes to participants and then asking the participants to rate the level of aggression they perceive in children interacting on a playground. Which of the following is the independent variable? a. the type of movie scene that is shown b. how aggressive the children are behaving on the playground c. the participants’ rating of aggression d. tolerance for aggression 2. A researcher interested in understanding the relationship between panic attacks and alcohol misuse might choose to study the effects of anxiety induction in the lab on how much alcohol research participants choose to drink. Which statement would be most accurate, given this information? a. The amount of alcohol participants choose to drink is the independent variable. b. The level of anxiety induced is the dependent variable. c. The amount of alcohol participants choose to drink is the dependent variable. d. The number of panic attacks is the independent variable.

3. Your friend has trouble making commitments in relationships, and you believe that this is because their parents had a bitter divorce when they were young. What is exemplified by your belief that a child who lives through a bitter parental divorce will have trouble making commitments in relationships as an adult? a. an applied theory b. an independent variable c. a hypothesis d. an empirical inference 4. Which of the following hypotheses would have adequate testability? a. All people see a bright light before they die. b. Behaviour is influenced by unconscious thoughts. c. Supernatural forces influence our behaviour every day. d. Children who view aggression are more likely to act in an aggressive manner.

5. Professor García is asked by a student to describe the meaning of a hypothesis. What should Professor García say? a. A hypothesis is a question. b. A hypothesis is a statement of fact c. A hypothesis is an educated guess d. A hypothesis is an established theory.

6. What is a hypothesis? a. a research question tested through experimentation b. a theory that is based on available information c. an educated guess about the world, often informed by previous research d. a research question formulated through observation of daily occurrence 7. What do you call any factor in a research study that makes the results uninterpretable?

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Chapter 04: Research Methods in Psychopathology a. a null variable b. a dependent variable c. a correlate d. a confound 8. While studying the impact of nutrition on intelligence, a researcher gives one group of rats a vitamin-rich diet while the other rat group eats Big Macs. While observing the rats run a complicated maze, the researcher notes that the vitaminenhanced rats’ maze is more brightly lit than the Big Mac rats’ maze. What is the difference in lighting in this study? a. a hypothesis b. an independent variable c. a dependent variable d. a confound 9. A confound in a study makes the results uninterpretable and affects which of the following? a. testability b. test–retest reliability c. internal validity d. external validity 10. The internal validity of a study can be increased by using which of the following to create different research groups? a. valid measures b. generalizable methods c. randomization d. the personal characteristics of potential participants 11. Dr. Nguyen says that a study he is reviewing has good internal validity. What does Dr. Nguyen believe? a. The independent variable is causing the dependent variable to change. b. The dependent variable is causing the independent variable to change. c. The sampling procedure is supported by the study. d. the hypothesis is supported by the study.

12. Why is randomization used to assign research participants to groups? a. to improve internal validity by eliminating any systematic bias in assignment b. to make sure that all participants in the study are the same on the dependent variable when the study is concluded c. to make sure that all participants are the same on the independent variable before the study begins d. to prevent any differences in the way the independent variable is manipulated for all research subjects 13. Why do researchers use control groups? a. to compare previously completed academic studies b. to rule out alternative explanations for results c. to randomize the experiment d. to control the hypothesis 14. What is the purpose of random assignment?

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Chapter 04: Research Methods in Psychopathology a. to ensure that each research participant spends an equal amount of time in the treatment and control groups b. to ensure that each research participant has an equal chance of being in the treatment or control group c. to ensure that everyone in each group is exactly the same on the independent variable d. to ensure that everyone in each group is exactly the same on the dependent variable 15. Why are analogue models used? a. to create laboratory studies that are comparable to the real-life phenomenon being studied b. to create laboratory studies that replicate earlier conducted studies c. to create laboratory studies that produce reliable results d. to create laboratory studies that include and observe both treatment and control groups 16. What does the term external validity refer to? a. the degree to which we can attribute the results to the effects of the independent variable b. the degree to which the dependent variable was changed in the study c. the power of the independent variable to cause a change in the dependent variable d. the extent to which the results apply to people other than the participants in the study and in other settings 17. A researcher studies the impact of stress on college students’ exam scores. Whether the results of this study help us to understand the relationship between job performance and stress levels of real-life organizational workers is a question of which of the following? a. external validity b. a clinical hypothesis c. study confounds d. random sampling 18. The more a researcher controls internal validity by restricting the study to participants who are similar to one another, the less of which type of validity will the study generally contain? a. internal validity b. clinical validity c. external validity d. sequential validity 19. In a lab setting, a researcher examines the effects of violent media on aggressive behaviour. The experimental group views a violent video clip, and the control group views a nonviolent video clip. This method is used instead of asking participants to monitor their naturally occurring TV viewing to reduce the possibility of confounds, such as variations in the level and number of aggressive images they watch. In doing so, the researcher will increase the internal validity of their study, but what do they risk reducing? a. the confounds of the results b. the statistical significance of the results c. the generalizability of the results d. the clinical significance of the results 20. In well-designed research studies, medications that enhance serotonin functioning have been found to help groups of patients recover from episodes of depression. Based on this information, which statement offers the most appropriate conclusion?

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Chapter 04: Research Methods in Psychopathology a. Only the most severely depressed patients will be helped by these medications. b. Medication is always appropriate treatment for psychological disorders. c. Medication can potentially be a treatment for depression. d. Serotonin malfunctioning causes depression.

21. In research, what does the term clinical significance refer to? a. whether the effects observed in the study are due to controlled sampling b. whether the effects observed in the study are due to the manipulation of the independent variable c. whether the effects observed in the study are due to chance d. how meaningful the difference was for those affected 22. The effects of a study on sleep finds that research participants who took a supplement slept an average of 7 hours and 25 minutes per night. The participants who were given a placebo pill slept for an average of 7 hours and 20 minutes. How are these findings best described? a. clinically significant b. statistically significant c. not clinically significant d. not valid 23. Anton and colleagues (2006) found that a combination of medication and psychotherapy helped people stay abstinent 77 days on average compared with those receiving a placebo and psychotherapy who stayed abstinent 75 days on average.

While the difference was statistically significant, it is important to look at the clinical significance of this finding by using another statistic that measures how large the difference is. This statistic is referred to as which of the following? a. external validity b. social validity c. effect size d. generalizability 24. Montrose Wolf (1978) advocated for the assessment of what he called social validity, a subjective way of determining which of the following concepts? a. clinical significance b. statistical significance c. external validity d. analogue models 25. Joe has been diagnosed by his psychiatrist as having an anxiety disorder. His psychiatrist prescribes a medication that has been found to help reduce anxiety. Joe takes the medication, but his anxiety level does not improve at all. Because an anxiety medication did not work, Joe concludes that his psychiatrist must be wrong and that he, Joe, must be suffering from some other disorder. What is the problem with Joe’s conclusion? a. He is failing to consider the external validity of the prior research. b. He is failing to consider the internal validity of the research studies. c. He is failing to consider the lack of clinical significance of many research findings. d. He is failing to consider the patient uniformity myth.

26. Dr. Ishmael wants to use a case study design. Which of the following is a possible problem with this chosen method?

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Chapter 04: Research Methods in Psychopathology a. It includes the use of the experimental method. b. It has high internal validity but external validity is frequently compromised. c. The results may be unique to the particular person(s) being studied. d. The characteristics of one individual can rarely tell you anything meaningful about a disorder.

27. One of the major problems with the case study method is that it is too easy to make false conclusions based on which of the following? a. statistical significance b. poorly defined dependent variables c. correlations d. coincidences 28. Sigmund Freud developed psychoanalytic theory and the methods of psychoanalysis on the basis of which of the following? a. case studies b. correlations c. prior research d. statistical significance 29. Historical case studies have provided new knowledge that has often eliminated existing societal myths. Whose research contributed to eliminating myths regarding human sexual behaviour? a. Nisbett and Ross b. Freud and Johnson c. Durand and Car d. Masters and Johnson 30. If you study two variables using the correlation method, what can you determine? a. how one variable causes change in the other variable b. how the variables are related to each other c. whether both variables are affected by a third variable d. whether one variable produces a confound in studying the second variable 31. Researchers predicted that the parents of children who act out at school would see a decrease in that behaviour if they themselves were to take problem-solving skills training. In this example, what were the researchers hypothesizing about parental problem-solving skills and children’s acting-out behaviours? a. They are weakly correlated. b. They are positively correlated. c. They are strongly correlated. d. They are negatively correlated.

32. A researcher has found that the more hours students spend socializing, the lower their exam scores tend to be. What do the findings of this study illustrate? a. no correlation b. a causal correlation c. a positive correlation Powered by Cognero

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Chapter 04: Research Methods in Psychopathology d. a negative correlation 33. Consider the correlation between the amount of time university students study and their heights in centimetres. What kind of correlation would this indicate? a. no correlation b. a causal correlation c. a positive correlation d. a negative correlation 34. Consider the idea that as people grow older, they tend to have more sleep problems. What kind of correlation would this indicate? a. no correlation b. a causal correlation c. a positive correlation d. a negative correlation 35. Dr. Eso finds that as scores on one depression scale increase by 1, scores on a different depression scale also increase by 1. What is the correlation between the scores on the two depression scales? a. 0 b. causal c. +1.00 d. –1.00 36. Which of the following would be the most likely correlation between the number of hours that a student studies for their tests and their exam grades? a. –0.50 b. 0.00 c. +0.50 d. +1.20 37. In the early 20th century, many people displayed symptoms of a disorder similar to drug-induced psychosis.

Goldberger found correlations between the disorder and diet and identified the cause of the disorder as a deficiency of the B vitamin niacin. What was this research study an early example of? a. clinical psychology b. experimental research c. the case study method d. epidemiology 38. Dr. Ahmed, an epidemiological researcher, is studying the psychological experiences of the residents of Fort McMurray, Alberta, following the devastating fire that engulfed the town. What research method is Dr. Ahmed most likely using? a. the experiment b. the repeated measures study c. the correlational model d. the case study Powered by Cognero

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Chapter 04: Research Methods in Psychopathology 39. What techniques have researchers used to examine the psychological effects of the stress of the September 11, 2001, terrorist attacks? a. experiments b. clinical research c. epidemiological research d. a case study 40. What does the incidence of a disorder refer to? a. the predicted number of new cases during the coming year b. the estimated number of new cases during a specific period of time c. the distribution and consequences of a problem in a population d. the number of people with a disorder at any one time 41. What does the prevalence of a disorder refer to? a. the relative seriousness of one disorder to other disorders b. the number of people with a disorder at any one time c. the estimated number of new cases during a specific period of time d. the incidence, distribution, and consequences of a problem in a population 42. What type of research led us to understand that there was relationship between geographical proximity and the impact of trauma following the events of September 11, 2001? a. experimental research b. clinical research c. epidemiological research d. case study research 43. In what type of study does a researcher manipulate an independent variable and observe the effects on a dependent variable? a. a case study b. a correlational study c. an experiment d. an epidemiological study 44. While trying to discover the nature of the relationship between stress and blood pressure, a researcher asks participants to complete a difficult task. The researcher monitors the participants’ blood pressure while exposing some participants to noisy distractions and other participants to a quiet environment. What type of research study is this? a. a correlational study b. a case study c. a placebo control study d. an experiment 45. To answer the question of causality, what type of research must be conducted? a. a case study b. a correlational study c. an experiment Powered by Cognero

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Chapter 04: Research Methods in Psychopathology d. an epidemiological study 46. When studying the treatment of psychological disorders, what type of studies are most typically used? a. case studies b. correlational studies c. clinical trials d. epidemiological studies 47. Dr. Stone is conducting a clinical trial regarding sleep. Each of the participants will be randomized to either the treatment or the control group. What type of clinical trial is Dr. Stone conducting based on this information? a. a randomized clinical trial b. a controlled clinical trial c. an experimental clinical trial d. a randomized controlled trial 48. When a control group is used in experimental research, how will the members of the control group be treated? a. the same as the control group in any other psychology study b. the same as the treatment group except that they will be given psychological therapy c. the same as the treatment group except that they will not be exposed to the independent variable d. the same as the treatment group except that they will be exposed to the independent variable 49. What is the purpose of a control group in experimental research? a. to reduce demand characteristics b. to determine whether an independent variable actually caused a change in the dependent variable c. to keep constant the level of the independent variable being tested in the treatment group d. to control all the factors that might affect the treatment outcome 50. In a control group, participants are similar to the experimental group in every way EXCEPT which of the following? a. They have been exposed to the independent variable but have been told they are receiving a placebo. b. They are not exposed to the dependent variable at all. c. They have not been exposed to the independent variable but have been told they are receiving a placebo. d. They are not exposed to the independent variable at all.

51. Why are placebos used in experiments? a. to control for the expectations of some research participants that they will improve just because they are in a research study b. to make certain that the treatment and control groups receive the same number of subjects c. to make certain that the treatment and control groups receive the same treatment d. to control for the variability of individuals who tend to volunteer for research studies 52. Florian is taking part in a clinical trial for a new medication for depression. Florian starts to feel better after the 8week treatment but is shocked when he discovers he was in the control group. What can explain Florian’s improvement? a. Florian is experiencing the post-treatment effect. b. Florian experienced the placebo effect. c. There was a mistake and Florian received the treatment.

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Chapter 04: Research Methods in Psychopathology d. Florian’s depression went into spontaneous remission.

53. What is the key element in a double-blind control study? a. Neither the treatment provider nor the research participants know whether the treatment will be effective. b. Neither the treatment provider nor the research participants can ever be made aware of the research findings. c. Neither the treatment provider nor the research participants are aware of who is in the treatment group and who is in the control group. d. The research participants are not aware that they are participating in a research study.

54. Why is it important to use a double-blind procedure in some research studies? a. to prevent the participants’ expectations from biasing the expectations of the researcher b. to prevent the independent variable from influencing the dependent variable c. to prevent the investigator from biasing the outcome d. to prevent the confusion of correlation with causation 55. In which situation might you observe the allegiance effect in a double-blind study? a. The researcher tries to replicate the results of an earlier study. b. A treatment doesn’t seem to be working, so the researcher puts less effort into that treatment group. c. The participants in the treatment group show a greater commitment to the study than do participants in the control group. d. The researcher and the participants in the control group work together to bring about a treatment effect.

56. A researcher conducts a study in which two groups of older adults are selected, with one group given medication for insomnia and the other given CBT, and then the results are compared. What type of research would this be? a. a clinical trial b. comparative treatment research c. correlational research d. case study research 57. Which of the following is an example of outcome research? a. determining whether a medication actually has any impact on the function of the brain b. examining the changes in serotonin levels from taking medication c. exploring the parts of cognitive-behavioural therapy homework that are most difficult for patients to perform d. examining the impact of medication on depression 58. Which of the following is an example of process research? a. determining which treatment reduces patients’ anxiety in the fewest sessions b. examining the impact of Prozac on serotonin levels c. determining how many therapy sessions it takes for most people with anxiety to feel better d. examining the impact of Prozac on depression 59. We want to answer the question “why does it work?” Which type of research should we consider? a. treatment process research b. outcome research c. comparative treatment research Powered by Cognero

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Chapter 04: Research Methods in Psychopathology d. clinical trials 60. Single-case experimental designs use several strategies to improve their internal validity. Which of the following is one of these strategies? a. repeated measures b. random assignment c. process measures d. placebo controls 61. Why do repeated measures improve internal validity in a single-case experiment? a. They provide increased interaction between the researcher and the participant. b. They provide a check on the randomization procedure. c. They provide a more reliable measure of behaviour both before and after treatment. d. They provide more data for statistical significance tests.

62. What is the advantage of using a withdrawal design as part of a single-case experiment? a. The researcher can determine whether improvements gained with treatment are lost when the treatment is withheld. b. The researcher can counterbalance the research design with additional measures to improve internal and external validity. c. The researcher can conduct a true double-blind experiment. d. The researcher can control for the placebo effect.

63. Dr. Seto is considering using a withdrawal design as part of a single-case experiment, but she has one major concern about this method. What concern does Dr. Seto most likely have? a. She would be concerned that it is impossible to remove the treatment equally for the treatment and control subjects. b. She would be concerned that it is difficult to measure changes that are associated with removal of a treatment. c. She would be concerned about the placebo effect when the treatment is removed. d. She would be concerned about removing treatment that appears to be helping the patient.

64. Which of the following is NOT an important part of repeated measurements? a. level b. process c. variability d. trend 65. A drug holiday is similar to which of the following processes in single-case experimental designs? a. repeated measures b. withdrawal designs c. multiple baselines d. outcome research 66. A child is having temper tantrums at home, at school, and at his grandparents’ house. After working with the parents for a while, the therapist believes that the child is being rewarded for his tantrums in each setting because his teacher, Powered by Cognero

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Chapter 04: Research Methods in Psychopathology parents, and grandparents generally give him what he wants just to make him stop yelling. The therapist devises a plan to stop his tantrums but implements the plan at home first, at school the following week, and at the grandparents’ home several weeks later. From a research perspective, what is this strategy an example of? a. multiple baseline b. repeated measures c. withdrawal method d. placebo control 67. What is one way in which researchers attempt to address the issue of external validity with single-case experimental designs? a. multiple baselines b. repeated measures c. withdrawal methods d. multiple individuals undergoing the single-case design at once 68. Approximately how many genes were discovered in the human genome project? a. 10 000 b. 20 000 c. 75 000 d. 125 000 69. What does phenotype refer to? a. hidden characteristics b. cognitive influences c. observable characteristics d. environmental influences 70. Unlike her mother, Mary has bright red hair; however, Mary’s maternal grandmother has the same colour of hair.

What describes the colour of hair we see in Mary and her grandmother? a. endophenotypes b. phenotype c. genotype d. proband types 71. A researcher is interested in studying the genetics of behaviour. Which profession would study this relationship? a. behavioural geneticist b. genome psychologist c. epidemiologist d. genetic linkage analyst 72. Which genetic mechanism contributes to the underlying problems that cause the difficulties experienced by people with psychological disorders? a. electrolytes b. phenotypes c. endophenotypes Powered by Cognero

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Chapter 04: Research Methods in Psychopathology d. genotypes 73. What is one reason that we can expect rapid increases in our understanding of the genetic influences of psychopathology over the next several years? a. the new brain-scanning technology b. the discovery of the double helix c. the recent availability of fast, high-tech computers d. the progress of the human genome project 74. At this point, the human genome project has been successful in producing which of the following? a. a map of the structure of human genes, but little success in mapping gene locations b. a map of some but not all human genes c. a rough draft of the mapping of all human genes d. a complete listing of each human gene and its function 75. Family studies are often used to help determine whether a psychological disorder has a genetic component. Which of the following patterns is typical for a disorder that is influenced by genetics? a. Siblings of the person with the disorder will almost always have the same or similar disorders, and cousins are more likely than the general public to have the disorders. b. Siblings will almost always have the same or similar disorders, while cousins may have a similar rate of the disorder as the general public. c. Siblings of the person with the disorder are more likely than cousins to have the disorder, and cousins are more likely to have the disorder than the general public. d. Siblings of the person with the disorder are more likely to have the disorder than cousins, and cousins are just as likely to have the disorder as the general public.

76. The family member with the trait singled out for study is called which of the following? a. genotype b. proband c. endophenotype d. phenotype 77. What do genetic researchers examine in family studies? a. genetic influences on family behavioural patterns b. the genetic mapping of a disorder across relatives of the proband c. environmental influences on the genotype d. a behavioural pattern or an emotional trait in the context of the family 78. Which of the following makes it difficult to determine the genetic components of psychological disorders by using family studies? a. physical similarities b. shared genes c. the same socioeconomic conditions d. the fact that family members live together

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Chapter 04: Research Methods in Psychopathology 79. Why are adoption studies often used when attempting to study the influence of genetic factors on psychological disorders? a. They allow examination of genetic influences of psychopathology using more sophisticated statistical techniques. b. They allow examination of genetic influences of psychopathology without the typical confound of having siblings raised in the same environment. c. They allow examination of genetic influences of psychopathology without the typical confound of common biological parents. d. They allow examination of genetic influences of psychopathology through direct examination of genetic causes.

80. Two monozygotic twins are raised in very different environments. One is adopted into a loving, healthy environment, and the other is raised in a war-ravaged country where food, safety, and family support are hard to find. Compared to the child raised in the war-ravaged country, the child raised in the healthy environment will most likely be which of the following? a. significantly taller b. physically weaker c. quite similar in almost every way d. about the same height because height is completely heritable 81. Combining twin and adoption studies, researchers often study monozygotic twins raised in different families. Using this method, what do similarities in behaviours, traits, and psychological disorders between monozygotic twins raised apart help researchers to determine? a. whether it is detrimental to separate twins at birth b. the effects of genes on psychological functioning c. whether genes impact likelihood of adoption d. the effects of adoption on a child’s psychological functioning 82. Which of the following can family, twin, and adoption studies NOT identify? a. whether a particular form of psychopathology is influenced by genes b. the approximate degree of influence of genetics for a specific psychological disorder c. the location of a gene associated with psychopathology d. whether a particular form of psychopathology is influenced by the environment 83. What kind of study is conducted to identify the location of genes that may be associated with specific psychological disorders? a. a single-case genetic experiment b. a genetic linkage analysis c. a family DNA study d. a comparative gene analysis 84. A researcher studying a family with a history of obsessive-compulsive disorder (OCD) records data for each person in the family with OCD and for those who have been diagnosed with OCD in the past. The researcher is interested in genetic markers of the disorder within the family. What type of research is being conducted? a. an association study b. a chromosome analysis Powered by Cognero

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Chapter 04: Research Methods in Psychopathology c. a genetic linkage analysis d. a family DNA analysis 85. What type of research compares people with a specific disorder to those without the disorder and then identifies markers that occur significantly more often in people with the disorder? a. a genetic linkage study b. a family study c. a heritability analysis d. an association study 86. Genetic linkage analysis has not yet provided the types of answers scientists hope for in terms of understanding the specific genetic influences of psychopathology. Why is this so? a. Psychopathology is easier to measure than to understand. b. Psychopathology will be impossible to understand until the entire human genome is sequenced. c. Psychopathology will be difficult to understand with the limited statistical models available. d. Psychopathology is based on more than a single gene.

87. Your friend was the recipient of a nine-month research grant. Based on their interests, they can choose one of four areas of concentration in prevention research. They have always wanted to work with street youth. Based on this fact, what prevention strategy will they most likely choose? a. a selective prevention strategy b. a universal prevention strategy c. a positive development strategy d. an indicated prevention strategy 88. Which of the following is another name for health promotion in prevention research? a. a selective prevention strategy b. a universal prevention strategy c. a positive development strategy d. an indicated prevention strategy 89. Dr. Allen is lobbying the government to start a reading program for all children who live in regions where school achievement is lower than average. What type of program would this be? a. a universal prevention strategy b. a selective prevention strategy c. a health promotion strategy d. an experimental prevention strategy 90. A researcher is studying how people of different ages tend to experience anxiety. The researcher interviews anxious adolescents, young adults, individuals in their 30s and 50s, and those over 70. What do the individuals in each age group represent? a. a cross-section b. a cohort c. a longitudinal group d. an experimental group Powered by Cognero

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Chapter 04: Research Methods in Psychopathology 91. Which of the following is an example of a cohort effect? a. the confounding of age and experience b. the confounding of age and cultural difference c. the confounding of age and environmental influence d. the confounding of age and genetic influence 92. Brown and Finn (1982) found that attitudes regarding alcohol were somewhat different for 12-, 15-, and 17-year-olds.

All measures were taken during the same year from children of different ages. What kind of research method is this? a. experimental b. cross-sectional c. case study d. longitudinal 93. Which of the following research designs would be best suited to assessing individual change? a. a longitudinal study b. a sequential study c. a correlational study d. a cross-sectional study 94. “I remember being a very shy child, keeping to myself, and reading books. As an adolescent, I became more serious and quieter. As a young adult, I became more confident and outgoing.” What type of research would this kind of information be used for? a. a longitudinal study b. a sequential study c. a correlational study d. a cross-sectional study 95. To compare treatment strategies in various psychiatric settings, researchers are evaluating the psychiatric patients’ levels of depression every four months for four years in three different hospitals. What type of research are they applying? a. cross-sequential research b. longitudinal research c. cross-sectional research d. naturalistic research 96. To study how anxiety disorders develop in individuals, a researcher asks a group of adults whether they were anxious about school when they were children and then measures their current functioning with respect to symptoms of anxiety.

What is one significant limitation of this approach? a. The information about childhood experiences is retrospective in nature and may not be accurate. b. It confuses age differences with cohort effects. c. It measures only change within individuals, not differences between groups. d. Genetics and early life experiences are confounded.

97. Which of the following questions could be answered using a cross-sectional design? a. What early behaviours did people with adult panic disorder tend to display when they were young? b. Are the cognitive triggers for panic disorder different in children and adults?

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Chapter 04: Research Methods in Psychopathology c. How does panic disorder develop from childhood to adulthood in an individual? d. Does the severity of anxiety change over time?

98. What are the main advantages of longitudinal research over cross-sectional research? a. Longitudinal research can assess individual change and allows examination of cohort effects. b. Longitudinal research can distinguish between cause and effect and allow examination of cohort effects. c. Longitudinal research can assess individual change and avoid cohort effects. d. Longitudinal research is easier to use and allows examination of causal influences.

99. Which research design is most helpful in determining how individuals with particular disorders change over time? a. the experimental method b. the cross-sectional design c. the longitudinal method d. the cohort design 100. What is one reason why cross-sectional studies are more common than longitudinal studies? a. Cross-sectional studies involve a very small number of subjects. b. Cross-sectional studies produce more accurate results. c. Longitudinal studies take many years to complete. d. Longitudinal studies involve very sophisticated statistical procedures.

101. What is one problem, noted in the textbook, with longitudinal research? a. The research question may be confounded with cohort effects. b. The research question may become less valid as people age. c. The research question may become irrelevant by the time the study is complete. d. The research question may not be answerable and the time spent will be wasted.

102. One of the problems with longitudinal research is that it may be difficult to generalize the findings to other cohorts whose life experiences are very different from those of the study participants. What is this phenomenon known as? a. the cross-generational effect b. the cross-cultural effect c. the peer effect d. the cohort effect 103. Which term refers to the prevention-based interventions that may help avert later problems? a. preintervention strategies b. process-focused strategies c. outcome-focused strategies d. selective prevention strategies 104. In prevention research, what are the two most frequently used methods for examining psychopathology across time? a. longitudinal and case study b. longitudinal and experimental c. longitudinal and sequential Powered by Cognero

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Chapter 04: Research Methods in Psychopathology d. longitudinal and cross-sectional 105. Krank and colleagues (2005, 2006, 2011) studied the development of alcohol and drug use in British Columbia youth. To do this, they collected cross-sectional survey data from more than 1300 students in Grades 7 to 9. For the longitudinal part of the study, they then retested the students once a year for the next two academic years. What is this combination of longitudinal and cross-sectional methods in one study called? a. a cross-linkage research design b. a cohort research design c. a sequential research design d. an association research design 106. In cross-cultural research, what is the usual independent variable? a. the method used to treat the disorder b. the disorder c. the environment d. the culture 107. According to the text, what is one of the most important reasons to conduct cross-cultural research in psychopathology? a. The differences in behaviour of people from different cultures can tell us a great deal about the origins and possible treatments of psychological disorders. b. Genetic influences of disorders can be best determined through careful comparison of the different environmental stressors found in various cultures. c. The stigma of psychopathology can be removed by understanding that psychopathology exists in all cultures. d. We can gain a better appreciation for the virtues of various cultures by examining how psychopathology is viewed by different cultures.

108. In Malaysia, psychological disorders are commonly believed to have what type of origin? a. supernatural b. biological c. psychological d. environmental 109. Which of the following is a problem in understanding variations in behaviour among individuals from different cultural groups? a. The differences may be due to environmental factors. b. The differences may be due to genetic or cultural factors or a combination of both. c. Different cultural research methods are used to study and define psychopathology. d. Different research methods are used to study psychopathology across cultures.

110. How are significant issues often resolved in research? a. through multiple longitudinal designs over a period of time b. through a combination of well-controlled correlational studies and cross-sectional research c. through a program of research that uses multiple research designs over a period of time d. through multiple, well-controlled, double-blind experiments Powered by Cognero

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Chapter 04: Research Methods in Psychopathology 111. A new research study is published and becomes the hot daily news story. This story concerns you because the researchers report that they are the first scientists to find a higher incidence of depression for individuals taking a particular vitamin—the same vitamin that your physician has had you taking for years. While this may be cause for you to investigate further, why should you probably NOT panic? a. Unless it was a double-blind experiment, the results are probably in error. b. Research like this is rarely accurate. c. Without replication, the finding could be due to coincidence. d. Your physician would have also relied on his own patient feedback throughout the years.

112. Your professor’s research team has reason to celebrate. A similar team at another university has been able to replicate their findings. What did the second team do? a. They identified the strengths and weaknesses of the original research. b. They used the research of the first team to take the project to a new level. c. They repeated the research of the first team and generated identical results. d. They found that the negative correlations were actually positive.

113. What problem is shared by the placebo, control method, and the withdrawal design method? a. the concern about withholding treatment from those who need it b. the issue of tricking people into thinking that they will get better c. the fact that the individual will likely respond to the unique circumstances of the research setting d. the lack of control of the independent variable 114. According to the requirements of “informed consent,” what are research participants in a blind, placebo-controlled study told? a. that their results may or may not be incorporated into the research evaluation b. that they will definitely be receiving the treatment c. that they will not receive the treatment until the research study is over d. that they may or may not receive treatment in the study 115. There are four basic components of informed consent; competence and voluntarism are two of these. What are the other two? a. anonymity and full information b. full information and comprehension c. knowledge of results and anonymity d. comprehension and knowledge of results 116. Your psychology professor is conducting research and desperately needs more research participants because the existing subjects keep running from the building screaming. She tells the class that everyone must be a subject to get a grade in the class and that there are no exceptions. In terms of ethical treatment of research subjects, what would you say about her policy? a. It violates the informed consent concept of voluntarism. b. It violates the informed consent concept of competence. c. It is acceptable if she carefully explains the experiment to each participant and allows participants to quit if they are uncomfortable during the procedure. d. It is acceptable if her procedures are presented to the research ethics board.

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Chapter 04: Research Methods in Psychopathology 117. When conducting research with adults who have been diagnosed with a psychological disorder, which of the following is essential regarding consent? a. You need to ensure that the psychological disorder they have would not impair their ability to give free and informed consent. b. Informed consent must be given by a mentally competent family member or guardian. c. Informed consent is not necessary. d. It is necessary to have the research procedures approved by the Canadian Psychological Association.

118. What is the purpose of a research ethics board? a. to see that the potential research will benefit society b. to see that the rights of research participants are protected c. to see whether the research question is valid d. to see whether participants are assigned to research groups randomly 119. Four-year-old Jane took part in a research study that investigated the effects of junk food on obesity in children.

When the study was published in a research journal, Jane’s name appeared in the article. What guideline of ethical research involving children was violated? a. The researchers must receive proper approval for conducting the study. b. Children and parents must be informed of the purposes of the research. c. Parental participation must be obtained. d. A child’s identity must remain confidential.

120. Regarding research ethics and informed consent, are researchers allowed to use deception in a study? a. Yes, if the benefits outweigh the costs. b. Yes, if the participants are debriefed. c. No, deception defies the principle of informed consent. d. No, because deception causes psychological harm.

121. Define the term hypothesis, and state two different testable hypotheses regarding possible causes of depression.

122. Describe the differences between the statistical and clinical significance of research findings. Explain why it is important to make a distinction between statistical and clinical significance when interpreting research findings and how researchers use the concept of effect size to aid in this distinction 123. Describe the case study as a research method. Explain several advantages and disadvantages of the case study as a research method.

124. Describe correlational research. Explain the statistic used to represent the relationship between variables. Provide and explain an illustrative example of two variables that are negatively correlated. Discuss the advantages and limitations of the correlational method.

125. Describe the experiment as it is used in research. Explain the procedures, advantages, and disadvantages of the experiment as a research method.

126. Differentiate between the three different parts of repeated measurements in single-case experimental designs.

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Chapter 04: Research Methods in Psychopathology 127. Describe the three strategies used to increase internal validity within single-case experimental designs.

128. Explain how family studies are used to help determine the role of genetic factors in psychopathology. Describe the limitations of family studies in determining the genetic factors influencing psychopathology.

129. Explain the unique ways that monozygotic twins raised in separate environments help us to understand the genetic influences of psychopathology.

130. Describe how genetic linkage studies are conducted and how these studies may help identify the specific locations of genes influencing a particular form of psychopathology.

131. Describe the differences between the cross-sectional and longitudinal research methods. What are the uses and limitations of each of these methods? Provide an illustrative example of a research question that would be better addressed by a longitudinal study than by a cross-sectional study and explain why.

132. Explain the importance of studying cross-cultural psychopathology. Describe at least two significant obstacles to studying a disorder across cultures.

133. Describe each of the four components of informed consent for research participants. Explain the difficulties involved with obtaining informed consent from child participants and how the Society for Research in Child Development has addressed this problem.

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Chapter 04: Research Methods in Psychopathology Answer Key 1. a 2. c 3. c 4. d 5. c 6. c 7. d 8. d 9. c 10. c 11. a 12. a 13. b 14. b 15. a 16. d 17. a 18. c 19. c 20. c 21. d 22. c 23. c 24. a 25. d Powered by Cognero

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Chapter 04: Research Methods in Psychopathology 26. c 27. d 28. a 29. d 30. b 31. d 32. d 33. a 34. c 35. c 36. c 37. d 38. c 39. c 40. b 41. b 42. c 43. c 44. d 45. c 46. c 47. d 48. c 49. b 50. d 51. a Powered by Cognero

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Chapter 04: Research Methods in Psychopathology 52. b 53. c 54. c 55. b 56. b 57. d 58. b 59. a 60. a 61. c 62. a 63. d 64. b 65. b 66. a 67. d 68. b 69. c 70. c 71. a 72. c 73. d 74. c 75. c 76. b Powered by Cognero

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Chapter 04: Research Methods in Psychopathology 77. d 78. d 79. b 80. a 81. b 82. c 83. b 84. c 85. d 86. d 87. a 88. c 89. a 90. b 91. a 92. b 93. a 94. a 95. b 96. a 97. b 98. c 99. c 100. c 101. c 102. a Powered by Cognero

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Chapter 04: Research Methods in Psychopathology 103. d 104. d 105. c 106. d 107. a 108. a 109. b 110. c 111. c 112. c 113. a 114. d 115. b 116. a 117. a 118. b 119. d 120. b 121. Student responses will vary.

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Chapter 04: Research Methods in Psychopathology 128. Student responses will vary.

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133. Student responses will vary.

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Chapter 05: Anxiety

Indicate the answer choice that best completes the statement or answers the question.

1. Which of the following psychological disorders is anxiety most closely related to? a. psychosis b. depression c. schizophrenia d. dementia 2. Which term refers to the experience of a negative mood state characterized by physical tension and apprehension about the future? a. fear b. depression c. anxiety d. panic 3. According to research on anxiety, who will most likely perform best in the following scenarios? a. Aleksi, who was a bit anxious for a test on Monday b. Shelia, who had a big basketball game but was not anxious at all c. Jim, who was very anxious about a presentation last week d. Lida, who was not anxious about a job interview yesterday 4. When a person feels intense fear, which of the following will activate to cause a surge of energy? a. the somatic nervous system b. the parasympathetic nervous system c. the peripheral nervous system d. the autonomic nervous system 5. According to the text, how is fear experienced? a. as a neurotic response b. as culturally specific phenomenon c. as a future-oriented mood state d. as an immediate emotional reaction to danger 6. Eddie is walking down a dark alley. Suddenly, a figure jumps out from behind a trash bin and points a gun at him.

Eddie turns and runs away fast. What does this example illustrate? a. anxiety b. compulsion c. panic d. alarm response 7. In an interview, performer Alanis Morissette said she was once returning home from Los Angeles to Canada for the holidays, when she suddenly began crying and shaking uncontrollably, and she felt as if she was going to faint. What was she most likely experiencing? a. an unexpected panic attack b. a situationally bound panic attack Powered by Cognero

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Chapter 05: Anxiety c. a specific panic attack d. a situationally predisposed panic attack 8. Sanvi suffers from panic disorder and is prone to panic attacks. Which type of panic attack will Sanvi typically experience? a. an unexpected panic attack b. a situationally bound panic attack c. an expected panic attack d. a situationally predisposed panic attack 9. Marlon has episodes of sheer terror when riding on subway trains. He breaks into a cold sweat and often feels like he is about to have a heart attack. Marlon imagines he is losing control of himself during these attacks. What is Marlon most likely experiencing? a. compulsion b. alarm response c. panic d. anxiety 10. Roberta is standing in a shopping mall when she begins having difficulty breathing. She feels her heart pounding, feels weak and dizzy, and notices that she is perspiring heavily. She thinks she might be having a heart attack. What does this situation illustrate? a. an alarm response b. a panic attack c. dissociation d. anxiety 11. In the last several years, research has increasingly focused on the role of a neurotransmitter system associated with both anxiety and depression. What neurotransmitter system is this? a. the GABA-benzodiazepine system b. the corticotropin-releasing factor system c. the serotonergic system d. the noradrenergic system 12. What area of the brain is most often associated with anxiety? a. the reticular activating system b. the left frontal lobe c. the temporal lobe d. the limbic system 13. According to British neuropsychologist Jeffrey Gray, what part of the brain does the fight/flight system originate in? a. the hippocampus b. the amygdala c. the brain stem d. the temporal lobe Powered by Cognero

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Chapter 05: Anxiety 14. British neuropsychologist Jeffrey Gray identified a brain circuit in the limbic system of animals that seems heavily involved in anxiety and may be relevant to humans. What name did Gray give to this system? a. the behavioural inhibition system b. the corticotropin-releasing factor system c. the serotonergic system d. the noradrenergic system 15. Enzo was walking home one evening and heard a noise behind him. He froze, experienced anxiety, and apprehensively evaluated the situation to confirm that danger was present. What system was activated to create this sequence of events? a. the behavioural inhibition system b. the fight/flight system c. the parasympathetic nervous system d. the dopaminergic system 16. Johnson and colleagues (2000) found an increased risk of developing anxiety disorders among certain teenagers. What was significant about these teenagers? a. They smoked 20 or more cigarettes daily. b. They used anabolic steroids for six months or more. c. They drank alcohol every day. d. They smoked cannabis more than once per week.

17. What does research by Johnson and colleagues (2000) on cigarette smoking by teenagers and anxiety disorders suggest? a. the possibility that brain circuits are permanently wired b. the possibility that sensitivity of brain circuits can be affected by environmental factors c. the possibility that respiratory disorders cause changes in neurotransmitter systems d. the possibility that neurotransmitter systems operate independently of nonbiological influences 18. Based on brain-imaging procedures, there is now general agreement that anxiety disorders are due in part to which of the following? a. abnormal bottom-up and top-down processing in the limbic system and cortex b. overly responsive stimulation of the amygdala c. new information in the limbic system d. inadequate down-regulation of the amygdala 19. Research by Barlow (2014) and others suggests that the actions of parents may play an important role in helping to reduce their children’s risk of developing anxiety disorders. How do parents do this? a. by receiving treatment for their own problems with anxiety b. by ensuring that their children experience as few unexpected negative events as possible c. by interacting in a positive and predictable way when responding to their needs d. by praising their children frequently and thereby increasing their self-esteem 20. According to research on the actions of parents in early childhood, what is one of the biggest factors that makes children less vulnerable to anxiety in later life?

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Chapter 05: Anxiety a. unconditional positive regard b. being overprotective c. positive modelling d. a sense of control 21. Which term refers to the general tendency for some patients to respond fearfully to anxiety symptoms? a. behavioural inhibition b. fight or flight c. anxiety sensitivity d. reticular activation 22. Jill responds more fearfully to her anxiety symptoms than does James. What trait is Jill likely higher in compared to James? a. behavioural inhibition b. fight or flight c. anxiety sensitivity d. reticular activation 23. An individual who has panic disorder might become anxious about climbing stairs, exercising, or being in hot rooms because these activities produce sensations similar to those accompanying a panic attack. In psychological terms, what have the exercise and hot rooms become? a. conditioned stimuli b. unconditioned responses c. conditioned responses d. unconditioned stimuli 24. Which term refers to the integrated theory of the development of anxiety? a. psychological vulnerability theory b. triple vulnerability model c. integrated model of anxiety d. biological vulnerability model 25. Which of the following is NOT included in the triple vulnerability theory of anxiety? a. generalized psychological vulnerability b. generalized biological vulnerability c. specific psychological vulnerability d. specific biological vulnerability 26. Carlos grew up believing the world was dangerous and out of control. He has problems coping when things go wrong.

Based on these early experiences, which vulnerability is Carlos prone to? a. generalized psychological vulnerability b. generalized biological vulnerability c. specific psychological vulnerability d. specific biological vulnerability Powered by Cognero

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Chapter 05: Anxiety 27. Why are the rates of comorbidity (co-occurrence) among various anxiety disorders and depression high? a. The same psychological interventions should be used on all of them. b. They share some of the same biological and psychological vulnerabilities for developing them. c. The diagnostic criteria for these disorders are too ambiguous. d. They may not be distinct disorders at all.

28. What did the 2015–2016 First Nations Regional Health Survey reveal about proportions of the population diagnosed with an anxiety disorder in comparison to the Canadian Community Health Survey? a. The proportions of adults in both surveys were similar, but there were higher proportions of First Nations youth diagnosed. b. The proportions of adults and youth were higher in the Canadian survey than the First Nations survey. c. The proportions of adults and youth were similar in both surveys. d. The proportions of adults and youth were higher in the First Nations survey than in the Canadian survey.

29. Which statement best describes research on anxiety and comorbidity with physical disorders? a. People with physical conditions (e.g., thyroid disease, respiratory disease) are more likely to have an anxiety disorder than any other psychological disorder. b. The anxiety disorder most often begins after the physical disorder. c. There is no greater impact on quality of life with a comorbid anxiety disorder and physical disorder than with either alone. d. There does not seem to be a relationship between developing a physical disorder following from anxiety disorders.

30. What is the risk of someone with panic disorder attempting suicide? a. It is comparable to that for individuals with major depression. b. It is less than that for individuals with panic disorder who also demonstrate agoraphobic avoidance. c. It is higher than that for individuals with major depression. d. It is less than that for individuals with agoraphobia alone.

31. Which statement best describes the relationship between generalized anxiety disorders and suicide ideation? a. There is no relationship between generalized anxiety disorder and suicide ideations once we account for the effects of other mental disorders. b. One must meet all the criteria for generalized anxiety disorder to show a relationship. c. Only if the individual also has depression will there be a relationship. d. Even after accounting for the effects of other mental disorders, generalized anxiety disorder is related to suicide ideation.

32. Which of the following terms is most associated with generalized anxiety disorder? a. depression b. panic c. emotion d. worry 33. Which of the following is a symptom of generalized anxiety disorder? a. impulsivity Powered by Cognero

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Chapter 05: Anxiety b. muscle tension c. multiple specific phobias d. paranoia 34. Which physiological measure consistently distinguishes individuals with generalized anxiety disorder from nonanxious normal subjects? a. increased heart rate b. decreased EEG beta activity c. increased muscle tension d. heightened autonomic arousal 35. How does the diagnosis of GAD in children differ from that of adults? a. The length of time that symptoms have been present is longer for adults than for children. b. Three or more physical symptoms must be present for adults but only one for children. c. The length of time that symptoms have been present is shorter for adults than for children. d. You cannot diagnose GAD in children.

36. Jack constantly worries about his health, finances, and job security, and the stability of his marriage. Often, his worries keep him awake at night, causing him so much fatigue he cannot perform his work duties adequately. His preoccupation with his worries has left his partner feeling frustrated. What would be the most likely diagnosis of Jack’s problem? a. obsessive-compulsive disorder b. generalized anxiety disorder c. simple phobia d. panic disorder 37. Adults with generalized anxiety disorder (GAD) typically focus on possible misfortune to their children, family health, job responsibilities, and household chores. What is most often the focus of worry for children with GAD? a. sleep b. monsters c. competence in their performance d. family members dying 38. Where do most individuals with generalized anxiety disorder likely seek help? a. psychiatrists b. psychologists c. emergency rooms d. primary care doctors 39. Which of the following groups is generalized anxiety disorder most prevalent in? a. 5- to 15-year-olds b. 15- to 24-year-olds c. 45- to 65-year-olds d. those 65+ 40. What are older adults most at risk of with increased benzodiazepine use?

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Chapter 05: Anxiety a. sleeping difficulties b. falls c. memory loss d. confusion 41. Which of the following is NOT included in the model of generalized anxiety disorder developed by researchers Dugas, Ladouceur, and their colleagues (1999)? a. intolerance of uncertainty b. positive beliefs about worry c. poor problem orientation d. focus on internal images of the threat 42. Daphne believes that her worrying about her parents’ health is useful because if something should happen to one of them, then at least she would not be surprised. Which cognitive characteristic of the Dugas, Ladouceur, and colleagues’ (1999) model is she demonstrating? a. intolerance of uncertainty b. positive beliefs about worry c. poor problem orientation d. cognitive avoidance 43. Which cognitive characteristic of the Dugas, Ladouceur, and colleagues' (1999) model is an individual demonstrating if they struggle to work through their problems and arrive at solutions? a. intolerance of uncertainty b. positive beliefs about worry c. poor problem orientation d. cognitive avoidance 44. Research has indicated diagnostic specificity for which cognitive characteristic of GAD that is not seen in panic disorder with agoraphobia? a. intolerance of uncertainty b. positive beliefs about worry c. poor problem orientation d. cognitive avoidance 45. Research following from the recent COVID-19 pandemic revealed which of the following regarding GAD? a. More men than women screened positive for symptoms of GAD. b. Over half of Canadians screened positive for moderate to severe symptoms of GAD. c. The number of positive screens increased with age. d. The highest percentage of positive screens was among Canadians 18 to 24 years of age.

46. “Something might go wrong, and I’m not sure I can deal with it, but I’ve got to be ready to try.” Which aspect of anxiety does this statement reveal? a. future-oriented mood state b. immediate control reaction c. fight/flight response Powered by Cognero

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Chapter 05: Anxiety d. panic attack 47. Your friend has been diagnosed with a generalized anxiety disorder. Which category of drugs is the typical pharmacological treatment for this condition? a. SSRIs b. benzodiazepines c. phenothiazines d. MAO inhibitors 48. According to the text, what is the consensus on the optimal use of benzodiazepines? a. Long-term use is recommended to ensure the user becomes adapted to the drug. b. Short-term use is recommended to avoid dependence. c. Use is determined on a case-by-case basis as not all individuals will gain relief quickly. d. Use will depend on the medication level needed to cope with the anxiety.

49. Which drug shows the strongest evidence for usefulness in treating generalized anxiety disorder? a. antidepressants b. benzodiazepines c. antipsychotics d. neuroleptics 50. How does cognitive-behavioural treatment help someone with generalized anxiety disorder? a. It helps the patient confront anxiety-provoking thoughts and images. b. It helps the patient analyze the unconscious sources of the anxiety. c. It helps the patient avoid feelings of anxiety, as well as the negative images associated with those feelings. d. It helps the patient adjust medication levels as needed to cope with the anxiety.

51. Which statement best describes research comparing psychological based treatments to drug treatments for generalized anxiety disorder? a. Drug treatments are more effective in reducing symptoms than psychological treatments. b. Psychological treatments are more effective long-term than drug treatments. c. A combination of the two is necessary for effective long-term treatment. d. Both treatments are equally effective in the long-term.

52. Research by Hofmann (2020) compared CBT, yoga, and stress education for treatment of GAD. What did these results show? a. CBT and yoga were more effective than stress education. b. Yoga was more effective than CBT or stress education. c. All treatments were equally effective. d. CBT worked only if presented in conjunction with stress education.

53. Research has shown that psychological treatment focused on teaching the patient to be more tolerant of their distressing thoughts and feelings may have a higher success rate than all other treatments for GAD that have appeared in the literature. Which approach is at the core of this treatment? a. cognitive therapy Powered by Cognero

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Chapter 05: Anxiety b. emotive therapy c. mindfulness d. conditioning 54. In a major clinical trial on children with GAD, which of the following was NOT listed as a factor leading to less favourable treatment outcomes? a. more severe and impairing anxiety b. greater caregiver strain c. principal diagnosis of social anxiety disorder d. behavioural problems 55. Panic disorder includes which of the following? a. the experience of unexpected panic attacks b. the experience of expected panic attacks c. the experience of both unexpected and expected panic attacks d. the experience of panic attacks and agoraphobia 56. The term agoraphobia is derived from the Greek word agora. What does agora mean? a. home b. workplace c. people d. marketplace 57. Studies have found that individuals with panic disorder may be more susceptible than others to the anxiety-reducing effects of alcohol when they are experiencing panic-like bodily sensations. Which of the following might this finding explain? a. why alcohol-based medications are so effective in treating panic disorder b. why these individuals are more likely to experience panic attacks while they are consuming alcohol c. why these individuals are more likely to develop alcohol use problems d. why people with a history of alcohol use problems rarely go on to develop panic disorder 58. A university student was attending a horror movie when they started to experience anxiety symptoms (rapid heartbeat, sweating, and shallow breathing). They were so upset that they went to a psychologist who told them that they probably had had a panic attack. In the following weeks, they became apprehensive about sitting in lecture halls, crowded rooms, and even classrooms. To be diagnosed with panic disorder, what also would have to happen? a. They would also need to become severely depressed about their problem. b. They would also need to develop substantial anxiety over the possibility of having another panic attack. c. They would also need to repress the anxious feelings and pretend the experience never happened. d. They would also need to achieve a high score on the anxiety sensitivity index.

59. According to the text, all the evidence points to what conclusion about agoraphobic avoidance behaviour? a. It is conceptually unrelated to panic disorder; it is a coincidence that they often occur together. b. It is similar to the behaviour of people with generalized anxiety disorder. c. It is a way of coping with unexpected panic attacks. d. It is a principal cause of panic disorder.

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Chapter 05: Anxiety 60. What does agoraphobic avoidance behaviour appear to be determined by? a. the number of panic attacks the person has had in the past b. the extent to which the person expects another panic attack to occur c. how recently the last panic attack occurred d. how severe the panic attacks have been 61. Blaze reports being terrified to go anywhere that does not have a bathroom, for fear that he will begin vomiting and not be able to stop. He had one panic attack, and a week later, he felt no residual effects from the attack. Which of the following DSM-5-TR diagnoses would Blaze most likely receive? a. agoraphobia b. interoceptive agoraphobia c. panic disorder d. panic disorder and agoraphobia 62. Research on coping methods indicates that a high comorbidity exists between panic disorder and which of the following? a. depression b. alcohol use disorder c. self-harm d. dissociation 63. What does the term interoceptive avoidance refer to? a. the phenomenon in which individuals with severe agoraphobia reduce panic-like symptoms through the use of alcohol b. the phenomenon in which individuals with severe agoraphobia avoid internal physical sensations c. the phenomenon in which individuals with severe agoraphobia avoid situations where panic attacks may occur d. the phenomenon in which individuals with severe agoraphobia avoid new situationsbecause they are unsure if panic-like symptoms will occur 64. A teenage girl had been experiencing depression and having panic attacks. Her doctor prescribed medication. A friend suggested that they go to an exercise class to see if would help her mood. Shortly after the warm-up started, she had another panic attack. What is the best explanation for this occurrence? a. She was angry with the friend for insisting that she go out. b. The physical sensations experienced during exercise were an internal cue for panic to occur. c. The medication that had been prescribed for her was treating only the depression, not the anxiety. d. The exercise class was an unconditioned stimulus that resulted in a panic attack.

65. Which of the following is an example of an interoceptive avoidance activity that may be observed in someone with agoraphobia? a. eating heavy meals b. fishing from docks but not in lakes or streams c. standing slowly from a sitting position d. staying indoors in nice weather 66. A client has just recently been diagnosed as having panic disorder. Which statement best describes what we will likely Powered by Cognero

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Chapter 05: Anxiety know about the client? a. The client is likely female, as 75 percent of those with the disorder are female. b. The client is likely in their late 50s. c. We will know very little about the client, as the disorder is extremely rare. d. The client will likely have had unexpected panic attacks from childhood.

67. Who of the following is at the greatest risk of having panic disorder? a. a male between the ages of 15 and 40 b. a female between the ages of 15 and 40 c. a male over the age of 60 d. a female over the age of 60 68. Ira has just recently been diagnosed as having panic disorder. Which statement best describes what we will know about Ira? a. Ira is rare because only a small percentage of individuals develop this disorder. b. Ira is in his late 50s. c. Ira will be more likely to cope with the panic by drinking alcohol because men choose this as a means of coping more so than women. d. Ira will be much more fearful of anxiety symptoms than would a woman.

69. Which term refers to a culture-bound syndrome occurring in the Inuit of northern Canada that bears some relation to panic disorder? a. susto b. ataques de nervios c. kayak-angst d. sibrava 70. Which countries show the lowest prevalence rates of panic disorder? a. Asian and African countries b. African and European countries c. European and North American countries d. North American and Asian countries 71. What percentage of those with panic disorder have experienced nocturnal panic? a. 10 b. 40 c. 60 d. 100 72. What is the cause of nocturnal panic? a. The change to slow-wave sleep produces physical sensations of “letting go” that are frightening to the individual. b. Nightmares induce panic in those with panic disorder. c. Repression of dream material because of trauma causes the panic. d. A condition called isolated sleep paralysis causes the panic.

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Chapter 05: Anxiety 73. Mandeep had a panic attack while he was asleep last night. What sleep event was Mandeep most likely experiencing when the attack occurred? a. a dream b. a nightmare c. deep sleep d. REM sleep 74. If someone stated that they were visited by the "Old Hag" last night, what would they likely be describing? a. a dream b. a nightmare c. isolated sleep paralysis d. REM sleep 75. Which of the following is NOT an explanation for isolated sleep paralysis? a. The individual is experiencing vivid dreams. b. REM sleep is spilling over into the waking cycle. c. The individual is being pressed down upon by a ghost. d. The changes of sleep to slow-wave sleep produce “letting go” feelings that are frightening.

76. Which factors determine whether agoraphobia actually develops following panic attacks and how severe it becomes? a. biological b. psychological c. medical d. sociocultural 77. Which term refers to panic-based cues that become associated with several different internal and external stimuli through a learning process? a. vulnerabilities b. psychological factors c. stress factors d. learned alarms 78. According to David Clark, which process is the most important in perpetuating panic disorder? a. biological processes b. physiological processes c. cognitive processes d. developmental processes 79. What is the current indicated drug for panic disorder? a. a tricyclic antidepressant b. a benzodiazepine c. a phenothiazine d. an SSRI Powered by Cognero

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Chapter 05: Anxiety 80. Although SSRIs are currently the indicated drug for panic disorder, there are disadvantages to all drugs. What is the major disadvantage of SSRIs? a. sexual dysfunction b. cognitive dysfunction c. confusion d. memory loss 81. What is the relationship between the drugs that are indicated for panic disorder and those that are most commonly used in practice? a. Benzodiazepines are indicated and most commonly used. b. SSRIs are indicated and most commonly used. c. SSRIs are indicated, but benzodiazepines are most commonly used. d. Benzodiazepines are indicated, but SSRIs are most commonly used.

82. Which of the following statements is correct regarding the effectiveness of drugs on panic disorder? a. Approximately 20 percent of patients are free of panic as long as they stay on an effective drug. b. Approximately 40 percent of patients are free of panic as long as they stay on an effective drug. c. Approximately 60 percent of patients are free of panic as long as they stay on an effective drug. d. Approximately 90 percent of patients are free of panic as long as they stay on an effective drug.

83. What is the relapse rate of those who stop taking benzodiazepines for panic disorder? a. 20 percent b. 50 percent c. 60 percent d. 90 percent 84. To address panic symptoms, a panic-control treatment (PCT) was developed at one of Barlow’s clinics. Which of the following would be included in this therapy? a. exposure to the interoceptive sensations b. minimizing heart rate at all times c. anti-anxiety medication d. psychoanalysis 85. A friend stated that when she went to a clinic, she had to spin in a chair to make herself dizzy. What is she receiving treatment for? a. post-traumatic stress disorder b. specific phobia c. social anxiety disorder d. panic disorder 86. In a major double-blind National Institute of Mental Health research study looking at the separate and combined effects of both psychological and drug treatments (Barlow et al., 2000), patients were randomized into five different treatment conditions. Which of the following was one of these treatment conditions? a. psychoanalysis b. hypnosis Powered by Cognero

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Chapter 05: Anxiety c. flooding d. placebo 87. A relative who has panic disorder asks you what treatment would have the most long-lasting benefits. Because you have just read about the double-blind National Institute of Mental Health research study evaluating psychological treatments with and without medication, what would you say? a. First, try any available treatment because patients in all treatment conditions achieved the same long-lasting gains. b. First, try the drug imipramine. c. First, try psychological treatment along with medication. d. First, try cognitive-behavioural therapy.

88. The studies discussed for treating panic disorder suggest which of the following may be superior at the beginning of treatment? a. stepped care approach b. medication-based treatments c. psychological treatments d. combining treatments 89. Cedella just fainted because of a phobia. What type of phobia does Cedella likely have? a. a blood-injury-injection phobia b. a situational phobia c. a natural environment phobia d. an animal phobia 90. In the type of specific phobia called blood-injury-injection, there is an inherited vasovagal response and a tendency to faint. What causes this tendency? a. a decrease in blood pressure b. an increase in blood pressure c. a decrease in body temperature d. an increase in body temperature 91. For which type of phobia does the age of onset peak at about seven years of age? a. blood-injury-injection phobias b. situational phobias c. choking and illness phobias d. animal and natural environment phobias 92. What is the main difference between situational phobia and panic disorder with agoraphobia? a. People with situational phobia experience phobias at random times, and people with panic disorder with agoraphobia experience panic attacks only at specific times. b. People with situational phobia experience panic attacks when confronted with the phobic situation and at other times, and people with panic disorder with agoraphobia only experience panic when in public places. c. People with panic disorder with agoraphobia experience panic attacks only in specific situations, and people with situational phobia can experience phobias anywhere.

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Chapter 05: Anxiety d. People with situational phobia never experience panic attacks outside the context of the phobic situation, and people with panic disorder with agoraphobia can experience panic even when not in a public place.

93. Phobias are not classified as such if they are only passing fears. How long must be present for to be considered persistent? a. three months b. six months c. one year d. two years 94. While more women than men experience fear of snakes, for which of the following fears is the sex ratio approximately equal? a. fear of flying b. fear of heights c. fear of enclosures d. fear of storms 95. Even though phobias may interfere with an individual’s functioning, only the most severe cases come for treatment.

Why? a. Affected people tend to arrange their life to avoid the phobic object or situation. b. Less extreme phobias tend to fade over time without treatment. c. The continuing shame and stigma surrounding mental disorders results in affected people avoiding treatment. d. Most people with less severe cases tend to believe their fears are normal and reasonable.

96. Which typical childhood fear correctly matches the corresponding approximate age of onset? a. infancy: fear of monsters and other imaginary creatures b. age four: fear of loud noises and strangers c. age five: fear of separation from parents, of animals, and of the dark d. age ten: fear of evaluation by others and anxiety over physical appearance 97. A culture-bound syndrome in Chinese cultures is known as Pa-leng. What most often characterizes those who have this disorder? a. They appear naked in public. b. They wear many layers of clothing. c. They exercise compulsively. d. They hoard food.

98. Which of the following is an example of how a phobia may develop? a. experiencing a panic attack in a variety of settings b. observing someone else experience severe fear c. inheriting a gene related to the phobia d. having a terrifying experience and not talking about it very much 99. As noted by Rachman (1977), which of the following is NOT an example of how a phobia may develop? a. direct conditioning Powered by Cognero

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Chapter 05: Anxiety b. vicarious experience c. experiencing panic attacks in many situations d. informational transmission 100. A man who has an extreme snake phobia was told repeatedly as a child about the dangers of snakes in high grass. He also was encouraged to wear rubber boots to protect himself, even on city streets. What mode of developing a phobia does this example illustrate? a. adaptive preparedness b. interoceptive communication c. developmental shaping d. information transmission 101. Which treatment plan do almost all clinicians agree is required for treatment of specific phobias? a. avoidance until they feel more comfortable b. structured and consistent exposure c. developmental shaping d. information transmission 102. In the case of a blood-injury-injection phobia, in which fainting is a possibility, graduated exposure-based exercises must be done in a specific way. What are these exercises called? a. vicarious experiencing b. structured exposure c. applied muscle tension d. information transmission 103. For those who may avoid vaccinations as a result of a fear of needles, what type of treatment would be suggested? a. gradual exposure with applied muscle tension b. virtual reality c. analogue modelling d. vicarious experience 104. Which of the following areas of the brain show increased responding following phobia treatment? a. amygdala b. insula c. cingulate cortex d. prefrontal cortex 105. Based on the fact that in vivo exposure has risks and limitations, which treatment has been suggested as an effective alternative therapy for some phobias? a. analogue modelling b. fear desensitization c. developmental shaping d. virtual reality 106. What psychological disorder in children is characterized by unrealistic and persistent worry that something will Powered by Cognero

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Chapter 05: Anxiety happen to the child’s parents or other important people in their life and may result in a child refusing to leave home? a. separation anxiety b. school phobia c. situational phobia d. globus hystericus 107. Which of the following would be considered an example of social anxiety disorder? a. a student who is reluctant to ride in elevators b. an individual who has difficulty urinating in a public washroom when others are present c. an individual who is invited to a party but decides to stay home because they feel shy d. a person who has a fear of blood 108. Which of the following is a diagnostic symptom associated with social anxiety disorders? a. strong and persistent feeling of worry b. significant attempts by the individual to avoid going outdoors c. the fear or anxiety out of proportion in comparison to the actual threat d. heightened activity of the parasympathetic nervous system 109. What is the approximate sex ratio of individuals who experience social anxiety disorder at some point in their lives? a. Slightly more males than females experience social anxiety disorder. b. About twice as many males as females experience social anxiety disorder. c. Slightly more females than males experience social anxiety disorder. d. About three times as many females as males experience social anxiety disorder.

110. What is the most prevalent psychological disorder in the general population? a. panic disorder b. agoraphobia c. school phobia d. social anxiety disorder 111. At what age does social anxiety disorder usually begin? a. It usually begins in childhood. b. It usually begins in adolescence. c. It usually begins in young adulthood. d. It usually begins in middle age.

112. What did the Heinrichs and colleagues (2006) cross-cultural study of social anxiety disorder find? a. The more that attention-avoiding behaviours were accepted in a given culture, the greater were the levels of social anxiety. b. There was no relationship between social acceptance of attention-avoiding behaviours and levels of social anxiety. c. The more that attention-avoiding behaviours were accepted in a given culture, the lower were the levels of social anxiety. d. The less that attention-avoiding behaviours were accepted in a given culture, the greater were the levels of social anxiety.

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Chapter 05: Anxiety 113. In Japan, what does the anxiety syndrome termed taijin kyõfushõ involve? a. a fear of embarrassing oneself b. a fear of embarrassing others c. a fear of performing onstage d. a fear of speaking to females 114. According to research, what area of the brain had greater activation in people with social anxiety disorder who viewed angry and contemptuous faces? a. the temporal lobe b. the frontal lobe c. the hippocampus d. the amygdala 115. Which term refers to the process outlined by University of British Columbia researcher Lynn Alden to explain why social environments can contribute to and maintain social anxiety? a. avoidance mechanism b. interpersonal connections c. social behaviour response d. interpersonal transaction cycle 116. Which statement best describes individuals with social anxiety disorder? a. They are more likely to make upward comparisons. b. They are more likely to make downward comparisons. c. They will behave in a cold and unfriendly manner to others. d. Socially anxious individuals are rated as being equally intelligent by peers during social interactions.

117. What did research on the treatment for social anxiety disorder by Davidson and colleagues (2004) reveal? a. The combination of CBT and SSRIs is more effective than either treatment alone. b. CBT and SSRIs were comparable in efficacy, but the combination is no better than the two individual treatments. c. CBT is more efficacious than SSRIs as a treatment. d. SSRIs are a more efficacious treatment method than CBT. 118. Which of the following is important for long-term impacts when treating adolescents with social anxiety disorder? a. having a parent involved in the process b. using SSRIs and CBT in combination c. training in role-playing d. education about anxiety and their disorder 119. Although the causes of social anxiety disorder are similar to those of specific phobia, the treatment often has a different focus. What is included as a treatment for SAD and specific phobias? a. exposure b. medication c. role-playing Powered by Cognero

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Chapter 05: Anxiety d. mindfulness 120. Kyla experiences an inability to speak while at school but communicates effectively at home and when with friends.

What disorder would Kyla likely be diagnosed with? a. social anxiety disorder b. specific phobia c. panic disorder with agoraphobia d. selective mutism

121. Why is anxiety termed “a future-oriented mood state,” and fear an “alarm reaction to actual present danger”? Discuss biological and psychological similarities and differences between these emotional events.

122. Discuss the genetic factors involved in anxiety disorders. Cite current research into the neurobiology of anxiety and panic and the role of the corticotropin-releasing factor system and other brain circuits.

123. Describe the triple vulnerability model for the development of anxiety disorders and provide an example of each component.

124. Define generalized anxiety disorder (GAD). Compare and contrast GAD with phobic disorders, noting how avoidance behaviour is manifested differently in each.

125. Outline the cognitive model of generalized anxiety disorder proposed by Ladouceur and Dugas. Provide examples of each component.

126. Describe panic disorder, including symptoms and causes. Explain the concepts of biological vulnerability and generalized psychological vulnerability and their contributions to the development of this disorder.

127. Define agoraphobia and discuss fully how and why it develops. In your answer, include gender differences in the development of this disorder and explain what is meant by interoceptive avoidance.

128. Identify and give illustrative examples of the five categories of specific phobias.

129. Discuss the differences between situational phobia and agoraphobia. What are the specific factors involved in the development of a phobia?

130. Define social anxiety disorder. Explain how social anxiety disorder differs from shyness. Using illustrative examples, describe how social anxiety impairs functioning. What types of treatments are effective for social anxiety?

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Chapter 05: Anxiety Answer Key 1. b 2. c 3. a 4. d 5. d 6. d 7. a 8. a 9. c 10. b 11. b 12. d 13. c 14. a 15. a 16. a 17. b 18. a 19. c 20. d 21. c 22. c 23. a 24. b 25. d Powered by Cognero

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Chapter 05: Anxiety 26. a 27. b 28. c 29. a 30. a 31. d 32. d 33. b 34. c 35. b 36. b 37. c 38. d 39. c 40. b 41. d 42. b 43. d 44. a 45. d 46. a 47. b 48. b 49. a 50. a 51. b Powered by Cognero

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Chapter 05: Anxiety 52. a 53. c 54. d 55. a 56. d 57. c 58. b 59. c 60. b 61. a 62. b 63. b 64. b 65. c 66. a 67. b 68. c 69. c 70. a 71. c 72. a 73. c 74. c 75. c 76. d Powered by Cognero

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Chapter 05: Anxiety 77. d 78. c 79. d 80. a 81. c 82. c 83. d 84. a 85. d 86. d 87. d 88. a 89. a 90. a 91. d 92. d 93. b 94. b 95. a 96. d 97. b 98. b 99. c 100. d 101. b 102. c Powered by Cognero

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Chapter 05: Anxiety 103. a 104. d 105. d 106. a 107. b 108. c 109. c 110. d 111. b 112. a 113. b 114. d 115. d 116. a 117. b 118. a 119. c 120. d 121. Student responses will vary.

122. Student responses will vary.

123. Student responses will vary.

124. Student responses will vary.

125. Student responses will vary.

126. Student responses will vary.

127. Student responses will vary.

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Chapter 05: Anxiety 128. Student responses will vary.

129. Student responses will vary.

130. Student responses will vary.

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Chapter 06: Preoccupation and Obsession

Indicate the answer choice that best completes the statement or answers the question.

1. What is the common aspect among all somatic symptom and related disorders? a. a pathological belief that one’s appearance is ugly b. a pathological concern with appearance or functioning of the body c. a pathological concern with the meaning of a physical pain d. a pathological belief that a serious medical condition will cause death 2. What was somatic symptom disorder previously called? a. Briquet’s syndrome b. Munchausen syndrome by proxy c. imagined ugliness d. koro 3. What is the important factor in diagnosing somatic symptom disorder? a. the medical cause of the pain b. the help-seeking behaviours they engage in c. psychological or behavioural factors are compounding the severity and impairment of the physical symptoms d. the level of suffering the individual is experiencing 4. Based on DSM-5 recommendations, what is the most important target for treatment in somatic symptom disorder? a. the pain b. the psychological experiences of anxiety and distress c. interpersonal relationships d. decreasing help-seeking behaviours 5. Mark injured his back at work several years ago. Although he was treated and considered healed by his physicians, he still complains of severe and debilitating back pain. Other than some minor scar tissue, his doctors cannot find anything that could be causing more than some minor stiffness. What is Mark’s most likely diagnosis? a. somatic symptom disorder b. illness anxiety disorder c. functional neurological symptom disorder d. factitious disorder 6. When would Lev be most likely to be diagnosed with a somatic symptom disorder with predominant pain? a. if he is convinced that he has a serious illness because of the mild pain he is experiencing b. if he has physical reasons for pain but psychological factors play a major role as well c. if he has physical reasons for pain, but knowingly exaggerates the pain to gain sympathy, attention, or some other benefit d. if he has an unrealistic fear of experiencing pain or discomfort 7. In 1962, Anya was diagnosed with hypochondriasis. What disorder would she likely be diagnosed with today? a. blood-injection-injury disorder b. somatic health disorder c. illness anxiety disorder Powered by Cognero

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Chapter 06: Preoccupation and Obsession d. persistent health delusional disorder 8. Milo has somatic symptom disorder, while Nara has illness anxiety disorder. What will be the main difference in the presentation of symptoms between these two individuals? a. Milo will have severe physical symptoms, while Nara will only have mild symptoms, if any. b. Milo and Nara will have similar physical symptoms, but Nara will have higher anxiety. c. Milo is concerned with the idea of being sick, while Nara is concerned with the symptoms they are experiencing. d. Milo will seek reassurance for his symptoms more often than Nara will.

9. Ruan has illness anxiety disorder. What are his symptoms? a. When he is truly ill, he represses the knowledge. b. Ruan interprets normal bodily sensations as a sign of a serious illness. c. Real physical illness is exaggerated to the point where Ruan can only focus on the pain. d. Ruan has an unrealistic fear of infection and disease.

10. What is the essential element of illness anxiety disorder? a. dissociation b. disease conviction c. depression d. physical pain or discomfort 11. Of those that met the DSM-IV-TR criteria of hypochondriasis, how many now meet the DSM-5-TR criteria for illness anxiety disorder? a. 15 percent b. 30 percent c. 50 percent d. 75 percent 12. Which of the following is a central feature of illness anxiety disorder? a. the interpretation of harmful stimuli as nonthreatening b. the interpretation of almost any physical sensation or symptom as threatening c. a distrust of medical personnel d. more acute physical sensations than someone without hypochondriasis 13. Bo just ate six chili dogs and drank a litre of soda. If Bo had illness anxiety disorder, how would he most likely interpret any resulting stomach discomfort? a. as yet another sign of numerous vague, chronic infections that have plagued him for years, which no one seems to be able to properly diagnose b. as a sign that something is probably seriously wrong with his stomach, and he would calmly phone in sick to work c. as a sign that something is seriously wrong with his stomach and, feeling very anxious, he would immediately call his doctor d. as a sign that someone is trying to poison him

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Chapter 06: Preoccupation and Obsession 14. If Jane has illness anxiety disorder, how frequently can we expect her to see her physician and how will she feel as a result of these visits? a. She will rarely see her physician, but she will continue to believe that she is quite ill. b. She will often see her physician, but she will continue to be anxious about her health anyway. c. She will almost never see her physician because she does not trust physicians. d. She will often see her physician, and she will feel completely reassured that there is nothing wrong with her health.

15. Anona is constantly worried that they will get sick. Although they feel fine now and believe that they are healthy, they still worry endlessly about developing a serious illness. What would Anona most likely be diagnosed with? a. somatic symptom disorder b. body dysmorphic disorder c. illness phobia d. illness anxiety disorder 16. While patients with panic disorder and patients with illness anxiety disorder both tend to misinterpret bodily sensations, how do the two kinds of patients differ? a. Those with panic disorder have imagined physical sensations, while those with illness anxiety disorder experience real physical sensations. b. Those with panic disorder tend to fear immediate catastrophe, while those with illness anxiety disorder tend to fear long-term illness. c. Those with panic disorder tend to ignore the symptoms of their first attacks, while those with illness anxiety disorder tend to seek immediate medical treatment following the first indication of pain. d. Those with panic disorder have real physical sensations, while those with illness anxiety disorder experience sensations that are all in their minds.

17. Eder has intense anxiety about his health. He focuses on slight changes in his heartbeat and greatly exaggerates minor aches and pains. He frequently visits multiple doctors because he resents doctors telling him that nothing is physically wrong with him. What condition does Eder appear to have? a. somatic symptom disorder b. functional neurological symptom disorder c. illness anxiety disorder d. Munchausen syndrome 18. You hear two colleagues talking, and one of them states that a friend has just been diagnosed with somatic symptom disorder. What is your colleague’s friend’s gender and status most likely to be? a. The friend is likely to be an unmarried woman. b. The friend is likely to be a wealthy man. c. The friend is likely to be a wealthy woman. d. The friend is just as likely to be a man or woman but unmarried.

19. Gisele has somatic symptom disorder. Which statement most likely describes Gisele? a. She has schizophrenia. b. She has illness anxiety disorder. c. She is married. d. She is from a low socioeconomic group.

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Chapter 06: Preoccupation and Obsession 20. The knowledge regarding prevalence rates of somatic symptom disorder and illness anxiety disorder comes from examination of the lifetime prevalence of hypochondriasis. What was this prevalence estimated to be? a. 1 to 5 percent b. 2 to 7 percent c. 5 to 10 percent d. 10 to 15 percent 21. Which of the following describes the disorder dhat, a culture-specific disorder prevalent in India? a. anxious concern about losing semen b. hot sensations in the head c. a sensation of something crawling in the head d. sensation of burning in the hands and feet 22. Illness anxiety disorder is essentially a disorder of perception. What triggers it? a. dysfunctional family interactions b. misinterpretation of mostly normal physical sensations c. physical pathology d. misinterpretations of severe or unusual physical sensations 23. Which of the following is common in the childhoods of those with somatic symptom disorder and illness anxiety disorder? a. dysfunctional family interactions b. childhood abuse c. disproportionate incidence of disease in their family in childhood d. parental separation 24. What are the positive consequences of a sick role sometimes called? a. disease conviction b. secondary gain c. learned anxiety d. hypochondriasis 25. Studies suggest the best therapy for treating somatic symptom disorder is which of the following? a. hypnosis b. Prozac c. traditional psychotherapy d. cognitive-behavioural therapy 26. Dr. Banks has chosen a treatment for a patient’s illness anxiety disorder based on its proven effectiveness. Which treatment did Dr. Banks most likely select? a. operant conditioning b. cognitive-behavioural therapy c. emotional restructuring d. psychosurgery Powered by Cognero

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Chapter 06: Preoccupation and Obsession 27. Which of the following is NOT a focus of the therapy provided by Barlow and his colleagues for somatic symptom disorder and illness anxiety disorder? a. providing reassurance b. reducing stress c. reducing help-seeking behaviours d. focusing on the origin of symptoms 28. Which disorder is most important to eliminate when diagnosing an individual with psychological factors affecting medical condition? a. somatic symptom disorder b. illness anxiety disorder c. adjustment disorder d. functional neurological symptom disorder 29. Arjun was diagnosed with diabetes over a year ago. He is in denial about the need to regularly check his insulin levels and intervene when necessary. This consistent pattern of neglect, inappropriate monitoring, and intervention is consistent with which of the following? a. psychological factors affecting medical condition b. illness anxiety disorder c. somatic symptom disorder d. functional neurological disorder 30. Which of the following is referred to as functional neurological symptom disorder? a. psychological factors affecting medical condition b. conversion disorder c. somatic symptom disorder d. hysterical disorder 31. Fred has been having seizures, but tests show no known cause. What is the most likely diagnosis for Fred? a. functional neurological symptom disorder b. malingering c. illness anxiety disorder d. somatic symptom disorder 32. Doctors suspect that a client has functional neurological symptom disorder. What symptoms is the client most likely displaying? a. problems with their sensory-motor systems b. problems with their cognitive functioning c. problems with their digestive system d. problems regulating emotions under stress 33. A person who is blind but has no underlying cause for their blindness may have which of the following? a. functional neurological symptom disorder b. illness anxiety disorder Powered by Cognero

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Chapter 06: Preoccupation and Obsession c. somatic symptom disorder d. malingering 34. Jai complained to his doctor that he had weakness in his legs and difficulty keeping his balance, with the result that he fell frequently. Medical examinations revealed no physical problems. What is this type of conversion symptom called? a. globus hystericus b. aphasia c. aphonia d. astasia-abasia 35. Bai tells Paul that he has been diagnosed with globus hystericus? What symptom did Bai most likely complain about to his doctor? a. blurred vision b. the sensation of a lump in his throat c. unexplained lumps all over the body d. generalized numbness 36. Anne feels as though she has a lump in her throat, but the doctors can find no obstructions. What diagnosis is a psychiatrist most likely to give Anne? a. la belle indifférence b. globus hystericus c. astasia-abasia d. malingering 37. When do functional neurological symptom disorder symptoms generally appear? a. following a misinterpretation of physical symptoms b. following a period of depression. c. following a traumatic event d. following a serious illness 38. Li’s doctor accused her of malingering. What is her doctor suggesting she is doing? a. exaggerating b. being extremely emotional c. faking d. becoming fixated on a symptom 39. Manuel has been under a lot of stress. One morning he awakens to find he is totally blind. At his physician’s office, Manuel says he is upset by the loss of his eyesight, but he appears to be totally calm. Which of the following can best explain Manuel’s lack of emotional reaction? a. malingering b. la belle indifférence c. emotional compensation d. Munchausen syndrome 40. Leilani shows up at an emergency room demanding immediate treatment for bleeding and abdominal cramps. Later, Powered by Cognero

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Chapter 06: Preoccupation and Obsession hospital workers find evidence that Leilani injected herself with a blood thinner to cause the bleeding and then she faked the cramps just to gain admission to the hospital. Leilani denies everything and leaves the hospital to find someone who will “treat me properly!” What condition does Leilani most likely have? a. illness anxiety disorder b. factitious disorder c. functional neurological symptom disorder d. somatization disorder 41. Why might someone develop a factitious disorder? a. to have a doctor believe them about the seriousness of the symptoms b. to receive increased attention c. an unawareness of producing the symptoms d. to try to avoid punishment for lying 42. Which of the following characterizes factitious disorder imposed on another? a. deliberate actions directed toward making a child sick b. a parent developing the same symptoms that the child has c. a parent intentionally lying to a doctor (e.g., saying that the child has had symptoms that never really existed) d. convincing a child to lie to a doctor about symptoms 43. Susan has a sick daughter who has been in and out of hospital four times in the last six months, but no cause for her illnesses can be found. At first, the doctors suspect that Susan may have factitious order imposed on another; however, Susan exhibits a behaviour that contradicts that diagnosis. What is that behaviour? a. appearing extremely concerned and caring toward the child b. purposefully making the child sick c. helping medical staff to discover the true nature of the child’s illness d. developing a positive relationship with medical staff 44. Although functional neurological symptom disorder is quite rare, the prevalence of this disorder is quite high in neurological settings. What is the average prevalence rate in these settings? a. 20 percent b. 30 percent c. 40 percent d. 50 percent 45. Which of the following would be typical for a patient who had a functional neurological symptom disorder? a. the ability to identify everything in the visual field even though the patient reports that she is blind b. great concern with the loss of function and belief that it is a symptom of a potentially fatal disease c. the ability to avoid walking into things even though he reports being unable to see anything d. the ability to see some bright objects when calm, but suffering complete loss of sight during a stressful period or emergency 46. Who is most likely to develop functional neurological symptom disorder? a. a 16-year-old female b. a 25-year-old male Powered by Cognero

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Chapter 06: Preoccupation and Obsession c. a 50-year-old male d. a 60-year-old female 47. How did Freud explain functional neurological symptom disorder? a. He argued that people with the disorder had converted unconscious conflicts into defence mechanisms expressed as physical symptoms. b. He argued that people with the disorder experienced real physical illness as a result of internal conflict. c. He argued that people with the disorder experienced physical symptoms as a result of the superego. d. He argued that people with the disorder converted unconscious conflicts into physical symptoms.

48. What research evidence contradicted Freud’s explanation of the cause of functional neurological symptom disorder? a. Functional neurological symptom disorder patients display la belle indifférence. b. There is great variability in the amount of concern that functional neurological symptom disorder patients display regarding their symptoms. c. La belle indifférence is a myth, and few patients show it. d. Functional neurological symptom disorder patients actually are upset about their symptoms.

49. Which statement best provides evidence for the influence of social and cultural factors in functional neurological symptom disorder? a. Functional neurological symptom disorder tends to occur in lower socioeconomic groups where there is less medical knowledge. b. Functional neurological symptom disorder is being diagnosed more frequently in our society. c. Functional neurological symptom disorder is almost exclusively experienced by women. d. Functional neurological symptom disorder tends to occur more frequently in wealthy populations who have easy access to sophisticated medical tests.

50. Why is it difficult to describe effective treatments for functional neurological symptom disorder? a. Extensive research has found drugs work for some patients while cognitive-behavioural therapy works for others. b. Extensive research has found that there are no effective treatments for the disorder. c. Research in the 1970s suggested drug treatments worked; however, recent research suggests that drug treatments do not work. d. There have been very few systematic, controlled studies evaluating treatment.

51. Treatment of functional neurological symptom disorder most closely resembles the treatment for which disorder? a. malingering b. somatic symptom disorder c. illness anxiety disorder d. factitious disorder 52. Current fMRI research has shown that brain activity during a conversion tremor differs from a voluntary mimicked tremor in which area of the brain? a. parietal cortex b. occipital cortex c. temporal cortex Powered by Cognero

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Chapter 06: Preoccupation and Obsession d. frontal cortex 53. Which of the following is important when treating functional neurological symptom disorder? a. removing any benefits that patients receive for limitations imposed by the disorder b. applying a strict behavioural program that includes reinforcement for each display of progress and punishment when necessary c. conducting an in-depth exploration of psychological conflicts concerning the patient’s relationships d. regressing the patient to the early stages of psychosexual development, where the conflicts originated 54. According to current research, what type of therapy holds promise in the treatment of functional neurological symptom disorders? a. hypnosis b. Prozac c. traditional psychotherapy d. cognitive-behavioural therapy 55. Which symptom often accompanies obsessive-compulsive disorder? a. panic attacks b. delusions c. specific phobia d. social anxiety disorder 56. Many people have occasional intrusive thoughts, but they would not be considered to have obsessive-compulsive disorder (OCD). What is required for someone to be diagnosed with OCD? a. The person must find the thoughts unacceptable or even dangerous and experience panic symptoms at the thought of carrying them out. b. The person must find the thoughts intrusive and persistent and try to resist or eliminate them. c. The person must find the thoughts unacceptable or even dangerous and develop insomnia and nightmares. d. The person must find the thoughts unacceptable or even dangerous and seek help to eliminate them.

57. What do we call actions, or sometimes thoughts, that an individual with obsessive-compulsive disorder uses to reduce anxiety? a. perseverative movements b. conditioned responses c. compulsions d. obsessions 58. Compulsions can be behavioural in nature. What else could they be? a. mental b. emotional c. positive d. unconscious 59. Which term refers to the compulsions that people with obsessive-compulsive disorder (OCD) perform because they believe they will help their obsession, when in reality the behaviours have no effect?

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Chapter 06: Preoccupation and Obsession a. imagined b. superstitious c. magical d. placebo 60. For months, Hugo has been plagued by worries as he drives to work. He thinks he forgot to lock the door, close the windows, or turn off the stove. Often, he returns home and double-checks the house before he can rid himself of these worries. Which term best describes Hugo’s worries? a. obsessive b. impulsive c. compulsive d. magical 61. Which major type of obsession is the most common? a. forbidden thoughts or actions b. cleaning and contamination c. symmetry d. hoarding 62. Regarding the obsessions seen in patients with obsessive-compulsive disorder, what does the term need for symmetry refer to? a. the need to put everything on one’s right and nothing on the left b. the need to keep things in perfect order c. the need to do something a number of different ways d. the need to touch some things before others 63. In obsessive-compulsive disorder, certain types of obsessions lead to certain types of compulsions. Which of the following matches an obsession and its consequent rituals? a. symmetry: hoarding b. sexual obsessions: checking c. contamination: checking d. aggression obsessions: hoarding 64. A woman was obsessed with the idea that if she did not eat in a consistent calculated way, some disaster would befall her family. What is the symptom subtype of this aspect of obsessive-compulsive disorder? a. checking thinking b. forbidden thinking c. contamination thinking d. symmetrical thinking 65. A man who has obsessive-compulsive disorder was compelled to take very small steps as he walked and to look back repeatedly. What was he trying to do? a. reduce the possibility of contamination b. ward off an imagined disaster c. make sure he didn’t make a mistake Powered by Cognero

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Chapter 06: Preoccupation and Obsession d. restore a sense of safety and control 66. Comedian Howie Mandel has discussed that his obsessions centre on the theme of which of the following? a. forbidden actions b. contamination c. symmetry d. hoarding 67. What is the obsession in tic-related obsessive-compulsive disorder almost always related to? a. self-harm b. cleaning c. symmetry d. unacceptable behaviour 68. Tourette’s disorder is linked to which of the following? a. tic-related obsessive compulsive disorder b. anxiety c. depression d. body dysmorphic disorder 69. Children presenting with obsessive-compulsive disorder and tics, referred to as Pandas, suggest that these problems occurred after a bout of which of the following? a. influenza b. high fevers for longer than a week c. strep throat d. chicken pox 70. How many individuals in a community sample did Spinella (2005) find had moderate levels of obsessions or compulsions that were not severe enough to meet the diagnostic criteria for OCD? a. 5 percent b. 13 percent c. 22 percent d. 33 percent 71. In which country have researchers found obsessive-compulsive behaviours to be most often related to religious rituals? a. Saudi Arabia b. Ireland c. Russia d. Somalia 72. Remi, who has obsessive-compulsive disorder, holds fundamentalist religious beliefs. Which concern is Remi most likely to present with? a. nonequivalence of obsessive thoughts and compulsive actions b. an attitude of inflated responsibility Powered by Cognero

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Chapter 06: Preoccupation and Obsession c. both checking and hoarding rituals d. a reduced sense of responsibility for his actions 73. What does the term thought-action fusion mean when used to describe the obsessional thinking pattern of persons with obsessive-compulsive disorder? a. using rituals to suppress or eliminate unacceptable or persistent thoughts b. being unable to put one’s thoughts into action without severe anxiety c. equating thoughts with the specific activity represented by the thoughts d. behaving compulsively even when no obsession has been identified 74. A young child has thoughts about hating her younger brother and wishing he would die. She becomes very anxious about these thoughts because she has developed the idea that if anything really happened to him, it would be her fault.

Which pattern of thinking is she exhibiting? a. fundamental responsibility b. intentional thought c. neutralizing d. thought-action fusion 75. Tony has thoughts about hating his younger brother and wishing he would die. He becomes anxious about these thoughts because he now thinks if anything really happened to his brother, it would be his fault. For no explainable reason, Tony starts mentally counting by odd numbers each time he walks past his brother’s room and discovers that this activity makes him less anxious. How would you describe Tony’s behaviour? a. Tony is attempting to stop himself from actually hurting his brother. b. Tony has developed a mental strategy designed to neutralize his bad thoughts. c. Tony has a phobia of going into his brother’s room because he is afraid his hatred will actually hurt him. d. Tony has a compulsive ritual designed to make him like his brother more.

76. What is consistent with obsessive-compulsive disorder, panic disorder, and post-traumatic stress disorder? a. engagement in ritualistic behaviour b. neutralization of thoughts c. anxiety about the possibility of having additional intrusive thoughts d. early experiences leading to development of the disorder 77. Some people with obsessive-compulsive disorder attempt to neutralize or suppress disturbing, intrusive thoughts. How successful do these strategies tend to be? a. These strategies usually cause other kinds of obsessive thinking to occur. b. These strategies are usually effective in permanently reducing the obsessive thoughts. c. These strategies usually increase the frequency of the obsessive thoughts. d. These strategies usually have no effect on the obsessive thoughts.

78. What did Purdon and Clark’s research show had a link to obsessive-compulsive disorder? a. inflated responsibility and compulsive rituals b. attempted thought suppression and obsessional thinking c. attempted thought suppression and thought-action fusion d. attempted thought suppression and compulsive rituals Powered by Cognero

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Chapter 06: Preoccupation and Obsession 79. According to one model of the etiology of obsessive-compulsive disorder (OCD), what is necessary for an individual to develop OCD? a. both a generalized psychological vulnerability and social vulnerability b. both specific biological vulnerability and social vulnerability c. the presence of OCD in other family members d. both generalized biological vulnerability and psychological vulnerability 80. Regarding pharmacological treatments for obsessive-compulsive disorder, the most effective drugs are those that inhibit the reuptake of which neurotransmitter? a. dopamine b. epinephrine c. serotonin d. noradrenaline 81. Which statement illustrates one problem with using pharmacological treatments in treating obsessive-compulsive disorder (OCD)? a. Relapse frequently occurs when the drug is discontinued. b. The drugs have extreme side effects. c. Many patients develop a physical dependency on the drugs. d. There is a very high rate of noncompliance (not taking the drug) among patients with OCD. 82. In which behavioural treatment are patients with obsessive-compulsive disorder NOT permitted to carry out their compulsions while in the presence of the anxiety-producing stimulus or situation? a. behavioural inhibition conditioning b. anxiety-reduction therapy c. exposure and ritual prevention d. thought-stopping technique 83. Which treatment teaches the person with obsessive-compulsive disorder that no harm will result if they do not perform the ritual? a. hypnosis b. exposure and ritual prevention c. drug therapy d. psychoanalytic therapy 84. Which cognitive change seems to occur by preventing rituals and teaching the person with obsessive-compulsive disorder that no harm will result if they do not perform the ritual? a. inflated sense of responsibility b. emotional level decreases c. overestimation of threat d. need for perfection 85. Reality testing is facilitated in which of the following treatments for obsessive-compulsive disorder? a. drug therapy b. cognitive-behavioural therapy Powered by Cognero

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Chapter 06: Preoccupation and Obsession c. exposure and ritual prevention d. mindfulness 86. When treating patients with obsessive-compulsive disorder, how effective is combining exposure and ritual prevention (ERP) with medication? a. Combining the two is better than ERP alone. b. Combining the two causes patients to discontinue treatment. c. Combining the two is better than drug treatment alone. d. Combining the two does not produce any additional therapeutic advantage.

87. Mr. Chen has a severe case of obsessive-compulsive disorder. His symptoms have not responded to either medication or psychological therapies. As a last resort, his doctor suggests the possibility of a psychosurgical procedure that has substantially benefited 30 percent of his patients. What is this procedure called? a. cingulotomy b. lobotomy c. limbicotomy d. temporal lesioning 88. The neurosurgical procedure called a cingulotomy is sometimes used to relieve severe symptoms of obsessivecompulsive disorder (OCD). Why would a cingulotomy usually be considered only after drugs and psychological treatments had failed? a. Only about 30 percent of patients who undergo this procedure benefit substantially. b. There is a high risk of mortality associated with this procedure. c. Neuroscientists still aren’t sure whether the cingulate bundle is involved in OCD. d. There are ethical concerns over the use of neurosurgery.

89. Psychosurgeries such as cingulotomies and deep brain stimulation have shown which of the following in relation to the treatment of obsessive-compulsive disorder? a. Results are similar, but deep brain stimulation is reversible. b. There is a high risk of mortality associated with the deep brain stimulation if overused compared to the psychosurgeries. c. Neither treatment is overly successful but can provide temporary relief. d. Psychosurgeries are more successful than deep brain stimulation.

90. Gabriel has a preoccupation with his hair. Although his hair has not changed at all, he is convinced that he has begun going bald. He checks his hair frequently throughout the day and always insists on wearing a hat at all times. Both his career and his social life have been affected by his insisting on wearing a hat and avoiding direct sunlight and wind. What disorder does Gabriel most likely have? a. agoraphobia b. obsessive-compulsive disorder c. body dysmorphic disorder d. somatic symptom disorder 91. Which term often refers to body dysmorphic disorder? a. trichotillomania b. checking disorder Powered by Cognero

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Chapter 06: Preoccupation and Obsession c. aesthetic preoccupation d. imagined ugliness 92. A client has body dysmorphic disorder. How many areas of their body are likely a concern? a. 1 to 2 areas b. 2 to 3 areas c. 3 to 4 areas d. 5 to 7 areas 93. In body dysmorphic disorder, which location has the highest proportion of imagine defects? a. skin b. stomach c. nose d. teeth 94. In addition to imagined ugliness, what other feature is common in those with body dysmorphic disorder? a. contamination thoughts b. ideas of reference c. tics d. hoarding 95. Professor Patel is giving a lecture to her class about body dysmorphic disorder. She asks the class how many students would report at least some dissatisfaction with their bodies. Based on previous research, how many students will likely respond yes to the question? a. 20 percent b. 50 percent c. 70 percent d. 90 percent 96. Which of the following is NOT common among those with body dysmorphic disorder? a. mild psychological suffering b. an interest in aesthetics c. suicide attempts d. increased risk of depression and substance use 97. What does research suggest about the etiology of body dysmorphic disorder? a. There is a strong genetic component, as it often runs in families. b. The etiology seems to be similar to obsessive-compulsive disorder. c. There are strong psychological vulnerabilities. d. It is caused by unconscious conflict.

98. In treating body dysmorphic disorder, which neurotransmitter should be targeted for the most effective treatment? a. norepinephrine b. dopamine c. GABA Powered by Cognero

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Chapter 06: Preoccupation and Obsession d. serotonin 99. When treating patients with body dysmorphic disorder, how effective is combining CBT with medication? a. Combining the two is better than CBT alone. b. Combining the two causes patients to discontinue treatment. c. Combining the two is better than drug treatment alone. d. Combining the two does not produce any additional therapeutic advantage.

100. In the Rosen and colleagues (1995) study, how many individuals with body dysmorphic disorder were successfully treated with exposure and response prevention? a. 50 percent b. 67 percent c. 75 percent d. 82 percent 101. Studies examining body dysmorphic disorder (BDD) from a cross-cultural perspective have discovered that studying the Japanese disorder, taijin kyofusho, may provide insight into the link between BDD and which other disorder? a. social anxiety disorder b. depression c. specific phobia d. somatic symptom disorder 102. What is one of the main concerns about the patients with body dysmorphic disorder who seek plastic surgery? a. They often are not satisfied with the results and return for additional surgery. b. There is a high risk of mortality with these procedures. c. There is a large amount of money made by the surgeons on these procedures. d. These procedures increase negative evaluations by others.

103. It is estimated that body dysmorphic disorder is present in approximately how many individuals who seek plastic surgery? a. as many as 5 percent b. as many as 10 percent c. as many as 25 percent d. as many as 50 percent 104. Which of the following characteristics is NOT associated with hoarding? a. excessive acquisition of things b. difficulty discarding anything c. living with excessive clutter d. loss of personal hygiene 105. A client has come in for treatment for hoarding. Based on the average age that individuals typically seek treatment, how old would the client likely be? a. 15 to 20 years old b. 25 to 30 years old Powered by Cognero

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Chapter 06: Preoccupation and Obsession c. 30 to 40 years old d. 50 years old 106. Donna has 12 cats (and would happily accept more), but her cats live in unsanitary conditions and some are not very healthy. Donna often attributes human characteristics to her cats and has dysfunctional relationships with people. Based on her poor mental health, along with the symptoms mentioned, what would Donna’s diagnosis most likely be? a. obsessive-compulsive disorder b. trichotillomania c. hoarding disorder d. excoriation disorder 107. Which of the following treatments is the most promising for hoarding disorder? a. cognitive-behavioural therapy b. drug therapy c. exposure therapy d. hypnosis 108. Micah’s doctor notices that Micah has no eyelashes. The doctor questions Micah about this and Micah admits that he sometimes has an irresistible urge to pull out body hair. What would Micah’s diagnosis most likely be? a. somatic symptom disorder b. trichotillomania c. body dysmorphic disorder d. excoriation disorder 109. When Sarah gets anxious, she compulsively picks at her skin. She must now seek medical attention for the tissue damage her picking has caused. Sarah’s doctor will most likely diagnose her with which of the following? a. somatic symptom disorder b. trichotillomania c. body dysmorphic disorder d. excoriation 110. Before the DSM-5-TR, trichotillomania and excoriation disorder were classified under which of the following? a. somatic symptom disorder b. impulse-control disorders c. body dysmorphic disorder d. obsessive-compulsive disorder 111. Which approach has shown the most evidence for success in treating trichotillomania and excoriation disorder? a. exposure and ritual prevention (ERP) b. cognitive-behavioural therapy c. habit reversal training d. SSRIs

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Chapter 06: Preoccupation and Obsession 112. Describe the similarities and differences between somatic symptom disorder, illness anxiety disorder, and psychological factors affecting a medical condition.

113. Shannon brings an extremely long list of physical complaints, with which she is inordinately preoccupied, to all her frequent appointments with medical practitioners. However, extensive medical examinations have shown no physical basis for these complaints. With which disorder would Shannon likely be diagnosed? Provide at least three areas of functioning that therapy should address for the most effective treatment of Shannon’s disorder. Include a rationale for each recommendation.

114. Discuss some of the ways in which it is sometimes difficult to distinguish between functional neurological symptoms disorder, real physical disorders, and malingering (faking). Describe some of the ways that can help a clinician make an accurate diagnosis.

115. Both psychological and physical processes are involved in the perception of pain. Explain how this makes the DSM5-TR diagnosis of somatic symptom disorder difficult and partially subjective.

116. Define the terms obsession and compulsion. Describe the four types of obsessions and provide examples of each, and of associated compulsions. Explain how they are related to each other (i.e., why and how compulsions often develop after obsessional thinking develops).

117. Discuss the two vulnerabilities that must be present to cause OCD and provide examples.

118. Explain the treatment for obsessive-compulsive disorder called exposure and ritual prevention. Discuss what current research states in terms of the effectiveness of this treatment over other treatment possibilities and provide some examples.

119. What types of drugs are used to treat OCD, and how effective are these treatments?

120. Define body dysmorphic disorder (BDD), and discuss why there is concern regarding individuals with BDD obtaining plastic surgery.

121. Describe trichotillomania and excoriation disorders and the treatment that has the most evidence for success with these two disorders.

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Chapter 06: Preoccupation and Obsession Answer Key 1. b 2. a 3. c 4. b 5. a 6. b 7. c 8. a 9. b 10. b 11. b 12. b 13. c 14. b 15. d 16. b 17. c 18. a 19. d 20. a 21. a 22. b 23. c 24. b 25. d Powered by Cognero

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Chapter 06: Preoccupation and Obsession 26. b 27. d 28. c 29. a 30. b 31. a 32. a 33. a 34. d 35. b 36. b 37. c 38. c 39. b 40. b 41. b 42. a 43. c 44. b 45. c 46. a 47. d 48. d 49. a 50. d 51. b Powered by Cognero

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Chapter 06: Preoccupation and Obsession 52. a 53. a 54. d 55. a 56. b 57. c 58. a 59. c 60. a 61. c 62. b 63. b 64. d 65. b 66. b 67. c 68. a 69. c 70. b 71. a 72. b 73. c 74. d 75. b 76. c Powered by Cognero

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Chapter 06: Preoccupation and Obsession 77. c 78. b 79. d 80. c 81. a 82. c 83. b 84. a 85. c 86. d 87. a 88. a 89. a 90. c 91. d 92. d 93. a 94. b 95. c 96. a 97. b 98. d 99. c 100. d 101. a 102. a Powered by Cognero

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Chapter 06: Preoccupation and Obsession 103. c 104. d 105. d 106. c 107. a 108. b 109. d 110. b 111. c 112. Student responses will vary.

113. Student responses will vary.

114. Student responses will vary.

115. Student responses will vary.

116. Student responses will vary.

117. Student responses will vary.

118. Student responses will vary.

119. Student responses will vary.

120. Student responses will vary.

121. Student responses will vary.

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Chapter 07: Trauma and Dissociation

Indicate the answer choice that best completes the statement or answers the question.

1. Which of the following is a common symptom of people with post-traumatic stress disorder? a. memories and nightmares of the event b. chronic worrying c. psychosis d. difficulty learning to do new things 2. Which individual would be the least likely to meet the criterion of having post-traumatic stress disorder? a. an individual who was in a car accident b. a first responder who was first on scene following a plane crash c. a parent whose son was killed in a school shooting d. an individual who has been watching the events of a terrorist attack unfold on television 3. Jody continues to re-experience a traumatic event. These memories come on very suddenly and he finds himself reliving the event. What symptom is Jody experiencing? a. dissociation b. nightmares c. flashbacks d. psychosis 4. Which of the following is NOT a symptom of post-traumatic stress disorder? a. avoidance of anything that reminds the individual of the trauma b. experiencing extreme fluctuations in their range of emotions c. being chronically overaroused d. experiencing changes in the way the world is viewed 5. Which is the subtype of post-traumatic stress disorder described by an individual who is experiencing less arousal than normal and feelings of unreality? a. psychotic subtype b. neurotic subtype c. dissociative subtype d. reactive subtype 6. If individuals meet the criteria for a dissociative subtype of PTSD, what do we need to keep in mind? a. They will respond differently to treatment. b. They will have a limited range of emotions. c. They will be more likely to engage in reckless behaviour. d. They are more likely to be comorbid with depression.

7. Darrel is a war veteran. He wakes up in the middle of the night in a cold sweat because of dreams in which he relives his most frightening war experiences. He refuses to talk about the war with anyone and is constantly fidgety and “on edge.” He is unable to enjoy himself or develop intimacy with friends or romantically. What disorder does Darrel appear to have? a. adjustment reactive disorder Powered by Cognero

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Chapter 07: Trauma and Dissociation b. dissociative disorder c. obsessive-compulsive disorder d. post-traumatic stress disorder 8. Although evidence for post-traumatic stress disorder has a long history, it was not recognized in the DSM until when? a. 1950 b. 1980 c. 1990 d. 2000 9. Your friend was a recent victim of a sexual assault. According to the DSM-5-TR, at what point can a diagnosis of PTSD be made? a. immediately following the traumatic event b. one month after the trauma c. three months after the trauma d. six months after the trauma 10. How long do PTSD symptoms need to be present to be considered chronic? a. 3 months b. 6 months c. 9 months d. one year 11. Which of the following is common for those experiencing chronic PTSD? a. more predominant flashbacks b. more predominant avoidance behaviours c. more dissociative symptoms d. more hypervigilance 12. Shania has been diagnosed with chronic PTSD. In addition to the PTSD, what disorder does she have a high likelihood of being diagnosed with? a. obsessive-compulsive disorder b. dissociative identity disorder c. social phobia d. panic disorder 13. Jeremiah returned from war a year ago. Immediately after returning, he showed few, if any, symptoms. For a month and a half, though, he has been experiencing intrusive memories, having difficulties sleeping, and does not want to see any of his friends from the army or discuss anything to do with war. What diagnosis will Jeremiah likely receive? a. acute stress disorder b. post-traumatic stress disorder with dissociative symptoms c. post-traumatic stress disorder with delayed onset d. chronic post-traumatic stress disorder 14. According to a recent survey, which statement best describes the relationship between acute stress disorder and postPowered by Cognero

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Chapter 07: Trauma and Dissociation traumatic stress disorder? a. Acute stress disorder is a prerequisite for developing PTSD. b. Approximately half of the individuals with acute stress disorder go on to develop PTSD. c. Treatment is beneficial only for those with PTSD and not acute stress disorder. d. All individuals diagnosed with PTSD demonstrate acute stress disorder preceding their diagnosis.

15. Why was acute stress disorder included in the DSM-IV? a. Acute stress disorder is a prerequisite for developing PTSD. b. A diagnostic label was required for the less severe symptoms of PTSD. c. So that clinicians and doctors are aware of the impending PTSD diagnoses for these individuals. d. Many people with severe reactions could not otherwise be diagnosed and thus could not receive insurance coverage for immediate treatment.

16. In the study by Kilpatrick and colleagues (1985), which traumatic event was reported to have the most significant emotional impact? a. accident b. robbery c. aggravated assault d. rape 17. One U.S. national survey reported that eight percent of the population has experienced post-traumatic stress disorder.

What were the most common traumatic events experienced? a. sexual assault and auto accidents that included fatalities b. combat and sexual assault c. aggravated assault and sexual assault d. aggravated assault and combat 18. Why were there lower rates of post-traumatic stress disorder (PTSD) than expected in citizens who endured bombing and shelling in wartime England? a. Many people may not have directly experienced the horrors of death or direct attack during the wartime air raids. b. Social cohesion during wartime minimizes its traumatic impact. c. Effective treatments for PTSD were made available immediately following the bombings. d. Many did not come forward to report their symptoms.

19. What was the biggest factor in predicting who was most affected by the terrorist attacks on September 11, 2001? a. how quickly they sought help following the attacks b. their age c. personal and direct experience d. acknowledgement of the emotional impact 20. According to Wilcox and colleagues (2009), what is the relationship between PTSD diagnoses and suicide? a. There is no greater risk for suicide in those with PTSD than other disorders. b. The greater direct exposure to the trauma, the greater likelihood of suicide. c. A diagnosis of PTSD predicts suicide attempts independently of any other problem, including alcohol misuse.

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Chapter 07: Trauma and Dissociation d. Those with delayed onset PTSD are less likely to die by suicide than others diagnosed with PTSD. 21. Which theory provides the best explanation for the etiology of post-traumatic stress disorder? a. biological vulnerability b. psychological vulnerability c. sociocultural factors d. diathesis–stress 22. Which biological component was found to be related to an increased probability of experiencing acute stress in female undergraduates who witnessed a tragic campus shooting? a. two short alleles (SS) related to the serotonin transporter gene b. a monozygotic twin, who showed signs of PTSD c. a generalized biological vulnerability d. a sensation-seeking gene 23. In a study of male and female Vietnam War veterans, which factor related to generalized psychological vulnerability was found to be common in these individuals? a. family instability b. depression c. rumination d. risky behaviour 24. According to Fedoroff and colleagues (2000), there will be a better outcome in treatment if a patient is able to decrease which of the following? a. perceived control b. anxiety sensitivity c. family instability d. stress in interpersonal relationships 25. What is an important factor in determining whether an individual will develop post-traumatic stress disorder following a traumatic event? a. the individual’s gender b. the individual’s age at time of the trauma c. the number of relatives with psychological disorders d. the extent of emotional support from family and friends 26. Numerous studies of social factors have demonstrated the impact that support from loved ones can have on the development of PTSD. What specifically have these studies shown? a. The more support from loved ones, the more likely you are to discuss what happened. b. The support from loved ones decreases cortisol secretion and HPA activity. c. Support from loved ones decreases anxiety sensitivity. d. Those receiving support from loved ones seem to experience fewer flashbacks.

27. Which of the following may be related to reports of PTSD among Canadians during the COVID-19 pandemic? a. poor coping strategies Powered by Cognero

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Chapter 07: Trauma and Dissociation b. lack of social support c. personality biomarkers d. high anxiety sensitivity 28. The “alarm reactions” experienced in both post-traumatic stress disorder and panic disorders are similar and result in conditioned responses. However, which statement best describes the alarm in panic disorder? a. It is more prolonged. b. It is physically painful. c. It is more intense. d. It is false.

29. Which area of the brain seems to be the most changed as a direct result of experiencing PTSD? a. amygdala b. prefrontal cortex c. hippocampus d. hypothalamus 30. An individual is seeking help for post-traumatic stress disorder. Based on the most clinically agreed upon approach, what will their clinician most likely use in therapy? a. cognitive-behavioural therapy b. exposure c. medication d. exercise 31. As traumatic events are difficult to recreate, therapists often rely on which of the following in treating post-traumatic stress disorder? a. exercise b. medication c. imaginal exposure d. cognitive-behavioural therapy 32. Portia is undergoing therapy for her PTSD. During therapy she developed a narrative of the trauma and then reviewed it extensively in the process. What type of treatment did Portia receive? a. cognitive-behavioural therapy b. exposure and ritual prevention c. prolonged exposure therapy d. interpersonal therapy 33. According to Pace-Schott and colleagues (2015), the effects of the exposure practices may be strengthened if timed effectively during which point of the day? a. first thing in the morning b. before a nap c. early afternoon d. following a meal Powered by Cognero

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Chapter 07: Trauma and Dissociation 34. What does cognitive therapy seek to correct in individuals with post-traumatic stress disorder? a. negative assumptions about the trauma b. relief of the anxiety and panic attacks often associated with the disorder c. reluctance to discuss the event d. fear associated with the event 35. What does the evidence suggest about a single debriefing session, in which a trauma survivor is forced to express whether or not they are feeling distressed, following trauma? a. That one session is not sufficient. b. That one session is just as effective as multiple sessions. c. That one session can be harmful. d. That one session is all that is required to provide some benefit.

36. Donald Meichenbaum’s CBT treatment for PTSD includes which of the following modifications to traditional imaginal exposure therapy? a. a constructivist-narrative approach b. a single debriefing session c. EMDR d. an intervention immediately after the trauma 37. Which technique for treating PTSD facilitates rapid reprocessing of the traumatic event? a. prolonged exposure therapy b. cognitive-behavioural therapy c. eye-movement desensitization and reprocessing d. exposure and ritual prevention 38. Which drugs have been shown to have some efficacy in treating post-traumatic stress disorder? a. antipsychotics b. benzodiazepines c. anticonvulsants d. SSRIs 39. What is the name for the new DSM-5-TR disorder that describes the experience of grief as an intense longing for and preoccupation with the deceased along with a range of other symptoms that make it difficult to move on with life even after a year or more has passed? a. integrated grief disorder b. prolonged grief disorder c. trauma related grief disorder d. complex grief disorder 40. How many adults who are experiencing grief are estimated to have prolonged grief disorder? a. 70 percent b. 50 percent c. 30 percent d. 10 percent Powered by Cognero

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Chapter 07: Trauma and Dissociation 41. Jori, who is nine, lost their mother. Their psychologist believes that they may be experiencing prolonged grief disorder. How long has Jori been showing symptoms if their psychologist is considering this diagnosis? a. two years b. one year c. six months d. three months 42. Which term refers to anxious or depressive reactions to life stress that are generally milder than seen in acute stress disorder or PTSD but are still considered impairing? a. adjustment disorders b. anxiety disorders c. attachment disorders d. depressive disorders 43. Jenessa is four years old, in her third foster home, and unable to form relationships with any of her caregivers. Her current foster parents have been told she is likely dealing with which of the following? a. an adjustment disorder b. separation anxiety c. an attachment disorder d. a depressive disorder 44. Aarav is five years old and shows behaviours that are atypical in his relationships with adults. Aarav often wanders off with others and recently accompanied an adult on the playground to the washroom without asking his caregiver. Based on his behaviours, what might Aarav be diagnosed with? a. an adjustment disorder b. separation anxiety c. reactive attachment disorder d. disinhibited social engagement disorder 45. Gail tells Bill that she has experienced dissociation before and goes on to describe it in detail. What sorts of experiences did Gail likely describe to Bill? a. numbness in her hands b. extreme withdrawal from the external world c. experiencing gross misrepresentations of external reality d. feeling detached from herself and her surroundings 46. Ivan is experiencing dissociation. Before this problem occurred, Ivan was healthy and well-adjusted. What likely happened in Ivan’s recent past? a. a minor illness b. an episode of binge drinking c. an extremely stressful event d. a period of major depression 47. A client experienced an episode of dissociation. Their doctor asks them if they have experienced a list of events to try to determine what may have caused the episode. Which event would NOT be on that list?

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Chapter 07: Trauma and Dissociation a. being extremely tired b. an episode of binge drinking c. an extremely stressful event d. staying up late to study for an exam 48. Greta occasionally has sensations of detachment from her surroundings, as if she were in a dream. This feeling of unreality most often occurs when she is overtired. What diagnosis best fits Greta’s symptoms? a. conversion hysteria b. a dissociative experience c. neurosis d. dysmorphic disorder 49. Craig suddenly notices that the world looks weird to him. Some objects look bigger than normal and others look smaller. Cars passing by seem oddly shaped and people appear dead or mechanical. What is Craig experiencing? a. classic early psychosis symptoms b. depersonalization c. derealization d. mania 50. While driving alone in her car, Sadia suddenly looks around and, for a moment, she can’t remember where she is, how she arrived at this point on the road, or even why she is driving her car. What is Sadia experiencing? a. neurotic distortion b. derealization c. depersonalization d. early onset psychosis 51. Sam has depersonalization-derealization disorder. Which of the following complaints will Sam most likely report? a. memory loss b. detachment c. an inability to compare their own experience to reality d. hallucinations 52. Jenna, a recently married young woman, described episodes of “spacing out.” During these episodes, she feels as if she is observing herself from outside her body. Her experiences seem “dream-like,” and she reports feeling completely separated from what is going on around her. What diagnosis best fits Jenna’s symptoms? a. stress associated with being newly married b. post-traumatic episodes c. detachment disorder d. depersonalization-derealization disorder 53. In their study of individuals experiencing depersonalization-derealization, what did Charbonneau and O’Connor (1999) find in the majority of cases? a. The age of onset was in the 20s. b. Onset occurred following a traumatic life event, sexual abuse, or giving birth. c. These individuals eventually developed symptoms of schizophrenia.

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Chapter 07: Trauma and Dissociation d. There were additional dissociative disorders.

54. Although surveys suggest that the prevalence of depersonalization-derealization disorder is approximately 0.8 to 2.8 percent, a meta-analysis of which population showed that it could be as high as 11.4 percent? a. college students b. single mothers c. older adults d. children 55. In their study of individuals with depersonalization-derealization disorder, Guralnick and colleagues (2000) found that those with the disorder showed cognitive deficits in many areas. Which of the following was NOT one of those areas? a. intelligence b. attention c. short-term memory d. spatial reasoning 56. What has research found regarding the effect of Prozac on depersonalization-derealization disorder? a. It is equally as effective as psychotherapy in treatment. b. It is not any more effective than when compared to a placebo. c. It is the most effective treatment option. d. Combined with psychotherapy it is the most effective treatment approach.

57. Felicia has localized amnesia. What does she likely have no memory of? a. events before a trauma b. anything, including who she is c. events following a trauma d. selective events, particularly those involving trauma 58. What is the main difference between a dissociative fugue and dissociative amnesia? a. Fugue involves travel; dissociative amnesia does not necessarily involve travel. b. Fugue states are the result of trauma; dissociative amnesia is the result of guilty feelings. c. Fugue states are associated with anxiety; dissociative amnesia is not. d. Memories return after a fugue state but not after an occurrence of dissociative amnesia.

59. In the absence of any physical trauma to the brain or drug intoxication, what is the most likely cause of sudden loss of ability to recall important personal information? a. depersonalization disorder b. dissociative fugue c. dissociative amnesia d. retrograde amnesia 60. In dissociative amnesia, memory loss can be partial or total. How long may it be present for? a. It is permanent. b. It lasts a fleeting moment. c. It is brief.

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Chapter 07: Trauma and Dissociation d. It can be temporary or lifelong.

61. In 2003, Kenneth Mackay was convicted of murdering Crystal Paskemin in Saskatoon. Although he admitted to having run over the victim with his truck, which he claims was an accident, his defence lawyer argued that Mackay had no memory of burning the victim’s body because of the trauma of the accident. What did a memory expert testify in court that Mackay might have suffered? a. a dissociative fugue state b. dissociative amnesia c. an episode of extreme depersonalization d. a dissociative trance state 62. Which of the following is Agatha Christie believed to have experienced? a. a dissociative fugue state b. dissociative amnesia c. an episode of extreme depersonalization d. a dissociative trance state 63. Lamar was in a fugue state for six months. What did he likely do in those six months? a. travelled, assumed a new identity while remembering who he really was b. felt compelled to travel but did not experience memory loss c. experienced memory loss and identity confusion, but did not travel d. travelled, experienced memory loss, and experienced identity confusion 64. During a dissociative fugue state, what is it common for individuals to do? a. leave an intolerable situation b. speak in a different tone of voice and use different physical gestures than they did previously c. die by suicide d. brutally assault people 65. Which dissociative disorder is suggested to be the most prevalent? a. a dissociative fugue state b. dissociative amnesia c. depersonalization-derealization d. dissociative identity disorder 66. Your professor is discussing the dissociative state referred to as “amok.” Which statement will most likely be a part of the lecture? a. It is a dissociative state that is seen across the globe. b. Males and females are diagnosed equally with this disorder. c. Females are diagnosed more often with this disorder. d. Individuals in this trance-like state often brutally assault people and animals.

67. An individual in a trance state that is undesirable and considered pathological by members of the culture may be diagnosed with which of the following? a. dissociative trance disorder Powered by Cognero

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Chapter 07: Trauma and Dissociation b. dissociative amnesia c. dissociative amnesia with dissociative fugue d. depersonalization-derealization 68. When is a dissociative trance disorder diagnosed? a. only when the trance is undesirable and considered pathological in the individual’s culture b. only when the trance causes harm to the individual or others c. whenever an individual repeatedly enters a trance state d. only when the trance is unpredictable in terms of when it appears (e.g., if the individual goes into a trance without prior religious ritual) 69. Amok, pivloktoq, and frenzy witchcraft are all referred to as which of the following? a. running disorders b. possession c. dissociative derealization disorder d. depersonalization-derealization disorder 70. Which of the following are a common part of some traditional religious and cultural practices and are often not considered pathological in that context? a. dissociative amnesia b. trance and possession c. dissociative derealization disorder d. depersonalization-derealization disorder 71. The DSM-5-TR diagnostic criteria for dissociative identity disorder include a fragmentation of identity and which of the following? a. a history of sexual abuse b. a lack of awareness about the distinct personalities c. the existence of three or more alter personalities d. dissociative amnesia 72. With regard to dissociative identity disorder, what does the term “alter” mean? a. the most complete personality, apart from the original personality b. the most dominant of the personalities c. the different personalities in dissociative identity disorder d. the ability to switch to other personalities at will 73. In dissociative identity disorder, who is the “host” personality? a. It is usually the one who “nurtures” the other personalities. b. It is usually the one who is the most frequently seen of the personalities. c. It is usually the one who is the most aggressive of the personalities. d. It is usually the one who asks for treatment and becomes the patient.

74. In dissociative identity disorder, who is usually the first personality to seek treatment? a. the person’s original personality Powered by Cognero

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Chapter 07: Trauma and Dissociation b. someone other than the person’s original personality c. the host personality d. the first alter personality to develop 75. In dissociative identity disorder, what is the definition of a switch? a. a change in handedness from one personality to another b. the transition to someone other than the person’s original personality c. the transition from the host personality to another d. the transition from one personality to another 76. What sort of behaviour do the “impulsive alters” often exhibit? a. They handle sexuality. b. They engage in self-harm. c. They refuse treatment. d. They instigate the switches.

77. Pat has dissociative identity disorder and lives with her parents. Her parents observe her “switch” from one personality to another on a regular basis. How do her parents describe the “switches”? a. They are usually instantaneous. b. They are subtly done by the host personality. c. They usually occur at the will of the original personality. d. They are usually gradual.

78. Shireen, who is 40, appears to believe she is a 20-year-old woman. Suddenly, however, she starts to speak and behave very differently and says she no longer thinks of herself as “Shireen.” Instead, she claims to be Elise, a 10-year-old child.

What has Shireen most likely just experienced? a. an alter trance b. a switch c. a conversion reaction d. a host reaction 79. In the “Hillside Strangler” case, what did Kenneth Bianchi claim to be suffering from? a. dissociative identity disorder b. dissociative trance disorder c. dissociative fugue d. dissociative derealization 80. All EXCEPT which of the following transformations may occur during a switch? a. changes in posture b. strong migraines c. the emergence of physical disabilities d. changes in handedness 81. Regarding dissociative identity disorder, what research is Carleton University psychologist Nicolas Spanos most known for?

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Chapter 07: Trauma and Dissociation a. the influence of genetics on dissociative identity disorder b. the ability of individuals to fake dissociative experiences c. the events that precipitate a switch d. the efficacy of SSRIs in treating the disorder 82. Dr. Arnold follows the sociocognitive explanation of alter personalities in dissociative identity disorder. Which statement would Dr. Arnold most likely make about the development of alters? a. The creation of alters is directly influenced by dysfunctional patterns of family communication. b. The creation of alters is the result of hypnotically inserted (false) memories. c. The creation of alters is the result of social reinforcement by the therapist. d. The creation of alters is consciously and voluntarily simulated by suggestible individuals.

83. What do we call the model that suggests that most symptoms of dissociative identity disorder can be accounted for by therapists who inadvertently suggest the existence of alters to suggestible individuals? a. the observational learning model b. the psychosocial model c. the sociocognitive model d. the therapeutic induction model 84. What happens during interpersonality amnesia? a. Specific events experienced by one personality are remembered only by that personality and not others. b. Some alter personalities have total recall of past events, whereas some other personalities have only partial recall of past events. c. Traumatic events experienced by one personality are remembered only by that personality and not others. d. Specific events experienced by one personality are not remembered by that personality but are recalled by alter personalities.

85. Research by Condon and colleagues (1969) and by Miller (1989) showed that DID subjects can demonstrate changes in which of the following biological functions? a. medial temporal functioning b. hippocampal functioning c. galvanic skin response d. optical functioning 86. What is one of the clinical strategies used to distinguish malingerers from patients with DID? a. Observe the fluidity of symptom presentation. b. Provide a neuropsychological assessment. c. Conduct a structured clinical interview. d. Suggest treatment, as malingerers will often refuse treatment.

87. According to Ross (1997) and others, what is the average number of alter personalities (i.e., in addition to the original personality) in individuals with dissociative identity disorder? a. 5 b. 15 c. 25 Powered by Cognero

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Chapter 07: Trauma and Dissociation d. 50 88. Case study data suggests that the ratio of females to males with DID is which of the following? a. nine to one b. one to two c. five to three d. two to seven 89. Dr. Little has a new patient who has just developed dissociative identity disorder. Which individual is most likely Dr. Little’s patient? a. a 3-year-old girl b. a 9-year-old girl c. a 13-year-old girl d. a 17-year-old girl 90. What is the average length of time between an individual’s first symptoms of dissociative identity disorder and the identification and diagnosis of the disorder by a professional? a. less than a month b. one year c. seven years d. 20 years 91. What does the current epidemiological research on the prevalence of DID suggest? a. That DID is extremely rare. b. That DID may be more common than previously thought. c. That DID is decreasing in the number of diagnoses. d. That DID diagnoses have tripled since the mid-1900s.

92. If left untreated, what course does dissociative identity disorder usually take across the lifespan? a. Its form does not change substantially, but the frequency of switching decreases with age. b. The natures of the alter personalities change as the person ages, but the number of them stays about the same. c. The number of alter personalities stays about the same, but the host personality becomes increasingly aggressive. d. Its form does not change substantially, but the number of alter personalities increases substantially.

93. Chris claims to have 16 different personalities, each with their own unique traits and memories, living inside her. If her claims are accurate, what condition is she most likely suffering from? a. dissociative depersonalization b. dissociative identity disorder c. dissociative fugue d. dissociative trance disorder 94. A patient has dissociative identity disorder. What do they most likely also have? a. depression b. at least one other psychological disorder Powered by Cognero

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Chapter 07: Trauma and Dissociation c. antisocial personality disorder d. a history of problems with the law 95. According to the text, what is the main reason that dissociative identity disorder (DID) patients tend to have many additional psychological disorders? a. The more personalities associated with the DID, the more additional disorders will develop. b. Most DID patients misuse drugs and alcohol, which leads to other disorders. c. Most have suffered horrible child abuse, which leads to many problems in later life. d. They appear to have an extreme genetic vulnerability to psychopathology.

96. Ang has dissociative identity disorder (DID). What is most likely part of Ang’s history? a. drug and alcohol misuse b. delusions c. childhood trauma d. a family history of DID 97. What is one reason that dissociative identity disorder can be misdiagnosed as a psychotic disorder? a. Both disorders are in the same DSM-5-TR category. b. Mental health professionals generally do not believe that dissociation is possible. c. Auditory hallucinations (hearing voices) are common in both. d. Substance misuse makes it difficult to differentiate these disorders.

98. Auditory hallucinations (hearing voices) occur in people with dissociative identity disorder (DID) and those with psychotic disorders. How do these hallucinations in DID patients differ from those in patients with psychotic disorders? a. DID patients report that the voices are from familiar figures in their past, such as parents. b. DID patients report that the voices are coming from outside their own heads. c. DID patients report that the voices are coming from inside their own heads. d. DID patients report that the voices frequently tell the patient to kill or harm others.

99. In some ways, for those patients with dissociative identity disorder (DID) and who have suffered horrific childhood abuse, DID can be seen as an adaptive response. Why? a. The patient receives a great deal of attention for the past abuse they suffered. b. Overall, mental health is improved. c. Psychologically, at least, the child can escape an intolerable situation. d. Family problems are identified and acknowledged for the first time.

100. In many areas of the world, what are dissociative symptoms, such as sudden changes in personality, attributed to? a. experiencing possession b. being in league with the devil c. hallucinogenic substances used in some spiritual rituals d. punishment from God 101. There is growing opinion that DID is an extreme subtype of which of the following? a. attachment disorder b. PTSD Powered by Cognero

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Chapter 07: Trauma and Dissociation c. psychosis d. panic disorder 102. According to the autohypnotic model, who may be able to use dissociation as a defence against extreme trauma? a. people who have frequent “out-of-body” experiences b. people who have had a head injury and resulting brain damage c. people who are highly suggestible d. people who have certain neurological disorders, such as seizure disorders 103. What is one factor that helps explain who is likely to develop dissociative identity disorder following childhood trauma? a. number of siblings b. number of abusers c. suggestibility d. socioeconomic status 104. According to a literature review by McLewin and Muller (2006), which of the following is more common among those with DID? a. being an only child b. having an imaginary childhood playmate c. being less susceptible to pain d. growing up in a foster home 105. A student has stayed up all night studying for an exam and is now experiencing sleep deprivation. As a result, they are more likely to experience which of the following? a. an increase in pain sensitivity b. migraines c. dissociative symptoms d. amnesia 106. In a study conducted by Loftus and colleagues (1996), individuals were told about false events that had supposedly occurred when they were children. What did the results of this study reveal? a. Individuals with previously diagnosed disorders can be convinced of events that never happened. b. People cannot be convinced of events that did not happen. c. People can become quite convinced they experienced events that never happened. d. People can become convinced of events that did not happen, but only during hypnosis or other dissociative states.

107. When interviewing 129 women with documented histories of childhood sexual abuse, what did Williams (1994) find? a. Thirty-eight percent of the women did not recall the abuse. b. The women remembered minute details of the abuse. c. Seventy-five percent of the women did not recall the abuse. d. Almost none of the women recalled the abuse.

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Chapter 07: Trauma and Dissociation 108. Which statement best describes the accuracy of recovered memories? a. There is evidence that false memories can be created, but there is no evidence of selective dissociative amnesia for early traumatic experiences. b. There is no evidence that false memories can be created or that individuals develop selective dissociative amnesia for early trauma. c. There is no evidence that false memories can be created, but there is evidence that individuals can develop selective dissociative amnesia for early trauma. d. There is evidence that false memories can be created, and that selective dissociative amnesia can occur for early traumatic experiences.

109. Based on research into and debate about the issue of recovered memories, what official position has the Canadian Psychiatric Association taken? a. The mental health profession is in no position to judge the validity of recovered childhood memories of abuse. b. Childhood memories later recovered in adulthood are of questionable reliability and should never be accepted without corroboration. c. There is no evidence whatsoever to support the notion of recovered memories of childhood abuse. d. There is overwhelming evidence to support the validity of recovered childhood memories.

110. In the Williams (1994) study involving 129 women who had documented cases of sexual abuse as children, what percentage of these women reported having no recollection of the abuse incident? a. 0 percent b. 38 percent c. 72 percent d. 100 percent 111. Suriya has dissociative identity disorder and is starting treatment. She asked her psychiatrist what the treatment will involve. What is the psychiatrist likely to say? a. addressing the patient’s negative thoughts about the abuse b. confrontation of the abuser c. integration of the personality fragments d. hypnotic regression of the host and each alter 112. Jonas has dissociative amnesia. What is the most likely outcome for him? a. He will only get better with extensive therapy and will not remember what he has forgotten. b. He will get better on his own and remember what he has forgotten. c. He will get better on his own but not remember what he has forgotten. d. He will require hypnosis to get better but will remember what he has forgotten.

113. What is the fundamental goal of treatment for dissociative identity disorder? a. to help the patient to more successfully repress the traumatic memories b. to relieve the depression and anxiety that frequently accompanies this disorder c. to identify cues or triggers that provoke memories of the trauma or dissociation and to neutralize them d. to develop more effective coping strategies for future negative events 114. Although there is little clinical evidence for the efficacy of medication, research suggests which of the following may be an appropriate treatment for DID? Powered by Cognero

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Chapter 07: Trauma and Dissociation a. antidepressants b. anxiolytics c. antipsychotics d. mood stabilizers 115. What does the current evidence suggest in regard to hypnosis as a treatment for DID? a. There is no solid evidence that hypnosis is a necessary part of treatment. b. Hypnosis may be appropriate in some cases. c. Hypnosis is the only effective treatment for DID. d. Hypnosis is only effective if the individual has less than 10 alters.

116. Which of the following is essential in the treatment of DID? a. medication b. trust c. hypnosis d. social support

117. Discuss the major criteria for a diagnosis of post-traumatic stress disorder (PTSD) and distinguish it from acute stress disorder.

118. Discuss the etiology of PTSD, including the roles of biological, psychological, and sociocultural factors.

119. Describe the two most common treatment methods for PTSD. Discuss what research shows in terms of implantation and efficacy for each of the treatment options.

120. Describe the differences and similarities between depersonalization and derealization.

121. Compare and contrast dissociative amnesia and a dissociative fugue. Provide some examples of cultural variations of dissociative disorders related to amnesia and fugue states.

122. Explain the current thinking regarding the environmental and psychological mechanisms in the development of dissociative identity disorder.

123. Describe the relationship between post-traumatic stress disorder and dissociative identity disorder. How are the two disorders similar? How are they different?

124. A 30-year-old woman “recovers” memories of childhood sexual abuse, the existence of which she was previously unaware. Explain what is currently known about the accuracy of recovered memories. Can we determine whether these memories are accurate?

125. Describe the treatment that is generally used to treat patients with dissociative identity disorder. What is the rationale for each part of the treatment?

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Chapter 07: Trauma and Dissociation Answer Key 1. a 2. d 3. c 4. b 5. c 6. a 7. d 8. b 9. b 10. a 11. b 12. c 13. c 14. b 15. d 16. d 17. b 18. a 19. c 20. c 21. d 22. a 23. a 24. b 25. d Powered by Cognero

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Chapter 07: Trauma and Dissociation 26. b 27. b 28. d 29. c 30. b 31. c 32. c 33. b 34. a 35. c 36. a 37. c 38. d 39. b 40. d 41. c 42. a 43. c 44. d 45. d 46. c 47. b 48. b 49. c 50. c 51. b Powered by Cognero

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Chapter 07: Trauma and Dissociation 52. d 53. b 54. a 55. a 56. b 57. d 58. a 59. c 60. d 61. b 62. a 63. d 64. a 65. b 66. d 67. a 68. a 69. a 70. b 71. d 72. c 73. d 74. c 75. d 76. a Powered by Cognero

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Chapter 07: Trauma and Dissociation 77. a 78. b 79. a 80. b 81. b 82. c 83. c 84. a 85. d 86. a 87. b 88. a 89. b 90. c 91. b 92. a 93. b 94. b 95. c 96. c 97. c 98. c 99. c 100. a 101. b 102. c Powered by Cognero

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Chapter 07: Trauma and Dissociation 103. c 104. b 105. c 106. c 107. a 108. d 109. b 110. b 111. c 112. b 113. c 114. a 115. a 116. b 117. Student responses will vary.

118. Student responses will vary.

119. Student responses will vary.

120. Student responses will vary.

121. Student responses will vary.

122. Student responses will vary.

123. Student responses will vary.

124. Student responses will vary.

125. Student responses will vary.

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Chapter 08: Mood

Indicate the answer choice that best completes the statement or answers the question.

1. Dr. Yu is giving a lecture on depression. According to the text, what is she most likely to emphasize? a. The best treatment for depression is always medication. b. Depression is mostly a problem of university-age women and the elderly. c. Depression does not increase the risk of suicide. d. Feelings of depression are universal.

2. Selina has been in a very down mood for the last two months. She has lost weight, has no appetite, and is constantly fatigued. She has lost interest in most of her regular activities and hobbies, and they no longer give her any joy. She seems indifferent to her family and friends and has recurrent thoughts of suicide. What does Selina appear to be experiencing? a. bipolar disorder b. persistent depressive disorder c. cyclothymia disorder d. major depressive disorder 3. Allison’s family has been told Allison has the most severe form of depression. Which disorder has Allison been diagnosed with? a. cyclothymia b. persistent depressive disorder c. profound depression d. major depressive disorder 4. A client has just been diagnosed with depression. How long is their first depressive episode likely to last? a. three months b. up to nine months c. two years d. more than two years 5. According to the text, what is the average length of a major depressive episode if left untreated? a. 3 to 5 months b. 5 to 7 months c. 4 to 9 months d. 10 to 12 months 6. Jacques has depression and is having a particularly hard time with anhedonia. What does this mean? a. Jacques cannot concentrate. b. Jacques feels worthless. c. Jacques can’t experience pleasure. d. Jacques has an altered pattern of sleep.

7. Although all symptoms are important, which symptoms does evidence suggest are the most central indicators of a full major depressive episode? a. loss of interest in activities b. downcast mood Powered by Cognero

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Chapter 08: Mood c. inability to experience pleasure d. physical changes and low behavioural activation 8. Kwan has been diagnosed with mania. Which of the following symptoms might Kwan be exhibiting? a. grandiosity b. visual hallucinations c. hypersomnia d. hypoactive behaviour 9. Dr. Thompson is observing Reid’s behaviour and notes that Reid is displaying a flight of ideas. What does flight of ideas mean? a. extremely creative thinking b. inability to concentrate c. talking about grandiose plans d. rapid speech expressing many subjects at once 10. Anne has major depression and her friend Gail is experiencing mania. Both are refusing drug treatment. If both Anne and Gail began feeling symptoms on the same day, what can you predict about when the symptoms will end? a. Anne’s symptoms will go away first. b. Gail’s symptoms will go away first. c. Anne’s and Gail’s symptoms will end around the same time. d. When untreated, the duration of both depression and mania is highly variable so a prediction cannot be made.

11. Which behaviour is NOT likely to lead to hospitalization for mania? a. recurrent thoughts of suicide b. self-destructive buying sprees c. taking extreme physical risks d. persistently increased goal-directed activity or energy 12. Isaac has just started a manic episode. How long will the episode likely last? a. two to four weeks b. four to eight weeks c. three to four months d. six to nine months 13. Which of the following is characteristic of the manic state? a. anhedonia b. hyposensitivity c. irritability d. decreased energy 14. Thirty-five-year-old Randall recently formulated an elaborate plan to cure AIDS with vitamin therapy. To provide funding, he withdrew all his money from his bank and purchased thousands of jars of vitamins and small boxes to put them in. When he appeared at a hospital emergency room loudly demanding names of patients with AIDS, Randall was hospitalized for psychiatric observation. What is Randall’s most likely diagnosis?

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Chapter 08: Mood a. hypomanic episode b. schizophrenic mania c. depressive psychosis d. manic episode 15. David is with his sister Debbie, who is having a hypomanic episode. He is trying to estimate how many days he will need to take off work to stay with Debbie. What estimate would you give him? a. two days b. four days c. six days d. twelve days 16. Sima experiences dysphoric mania. What type of manic episodes will Sima experience? a. manic episodes related to a medical condition b. very mild manic episodes c. extremely severe manic episodes d. manic episodes accompanied by depression or anxiety 17. In newer models of bipolar disorder, what is the general viewpoint of the condition? a. Bipolar disorder is an evolving condition, proceeding through different at-risk stages with mild symptoms early and progressing to a later chronic disorder. b. Bipolar disorder follows different stages with a severe acute onset, followed by mild symptoms later in life. c. Many individuals can suffer from unipolar mania alone. d. Most manic episodes are accompanied by depression or anxiety.

18. How long does an individual need to show full recovery from symptoms between depressive or manic episodes to be considered to be in full remission? a. two weeks b. two months c. six months d. one year 19. How do individuals with recurrent major depression and those who experience a single episode of depression differ? a. They differ in terms of gender prevalence; more males have the recurrent episode type. b. They differ in terms of gender prevalence; more females have the single episode type. c. They differ in the severity of symptoms. d. They differ in terms of family history of depression.

20. What is the median lifetime number of major depressive episodes? a. 1 to 3 b. 3 to 4 c. 4 to 7 d. 7 to 10 21. Katarina informed her doctor that she has had three major depressive episodes, which were separated by a two-month Powered by Cognero

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Chapter 08: Mood period when she did not feel depressed. What is Katarina’s most likely diagnosis? a. persistent depressive disorder b. major depressive disorder, single episode c. major depressive disorder, recurrent d. double depression 22. Last year, Debbie experienced a three-month period of depressed mood, feelings of worthlessness, difficulty concentrating, recurrent thoughts of death, sleep difficulties, and loss of energy. Four weeks ago, she began to experience the same severe symptoms. What is Debbie’s most likely diagnosis? a. major depressive disorder, recurrent b. dysphoric mania c. persistent depressive disorder, recurrent d. major depressive disorder, chronic 23. Marieke has persistent depressive disorder while Jackie has major depressive disorder. How will the experiences of the two women differ? a. Marieke will have episodic symptoms of depression. b. Marieke will have longer-lasting symptoms of depression. c. Marieke will have more symptoms of depression. d. Marieke will have temporary symptoms of depression.

24. Persistent depressive disorder is considered more severe than major depressive disorder for all of the following reasons EXCEPT which one? a. Those with persistent depressive disorder present with higher rates of comorbidity. b. Those with persistent depressive disorder are less responsive to treatment. c. Those with persistent depressive disorder show a slower rate of improvement. d. Those with persistent depressive disorder will experience no gaps in their symptoms unlike those with major depressive disorder.

25. Jin has experienced recurrent episodes of major depressive disorder. In the intervals between the episodes, he does not seem to return to not feeling depressed. In fact, during those periods, he has been diagnosed as dysthymic. What condition does Jin most likely have? a. bipolar disorder b. atypical depression c. persistent depressive disorder d. double depression 26. Which of the following individuals will be the most difficult to treat? a. Jack, who has persistent depressive disorder b. Raj, who has double depression c. Marty, who has major depressive disorder d. Gunter, who has major depressive disorder, recurrent 27. Jenny has experienced long-standing feelings of depression over the past five years. During the past 20 days, she has experienced a severely depressed mood, feelings of emptiness, and significant weight loss. Jenny confided in a neighbour that she is considering suicide. What is Jenny most likely experiencing?

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Chapter 08: Mood a. major depressive disorder, postpartum type b. major depressive disorder, rapid cycling type c. double depression d. persistent depressive disorder 28. Which statement does NOT accurately describe the additional defining criteria for depressive disorders? a. They are helpful in determining the most effective treatment. b. They allow clinicians to rate the disorder as mild, moderate, or severe. c. A specifier accompanies all depressive disorders. d. They can help provide information about the likely course of the disorder.

29. Sonita has been diagnosed with major depressive disorder but is also hearing voices telling her she is evil and sinful.

Which specifier will Sonita likely be given? a. psychotic features b. melancholic features c. mixed features d. atypical features 30. Dr. Jones is asked by a patient about her chances of experiencing peripartum depression. What should Dr. Jones tell her? a. She has a 1 in 30 chance b. She has a 1 in 20 chance c. She has a 1 in 8 chance d. She has a 1 in 5 chance 31. Janet had a baby two weeks ago and is explaining to her doctor that she was often tearful and had some minor mood swings in the first couple of days, but they seem to have subsided. What is Janet likely experiencing? a. hormonal rebalance b. minor depressive episode c. peripartum depression d. baby blues 32. The general guidelines for treating and preventing peripartum depression include cognitive behavioural therapy and which of the following? a. hormonal rebalance b. interpersonal therapy c. medication d. exposure therapy 33. What do the symptoms present in the seasonal pattern specifier of a depressive disorder resemble? a. a mix of anxiety and depression b. persistent depressive disorder c. atypical features d. melancholic features Powered by Cognero

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Chapter 08: Mood 34. What percent of the population is believed to be affected by the winter depression type of seasonal affective disorder? a. 3 percent b. 5 percent c. 8 percent d. 10 percent 35. More Canadians report symptoms of depression in the winter months than in the summer months, and this effect is more evident within which group? a. adults b. youth c. children d. older adults 36. Lara has major depressive disorder, and her doctor says that she is the average age for someone with major depression.

How old is Lara most likely to be? a. 15 b. 25 c. 35 d. 45 37. In severe cases of depression in which the episode lasts five years or longer, approximately what percentage of patients can be expected to recover? a. 18 percent b. 38 percent c. 53 percent d. 98 percent 38. Jamie is six years old and has persistent mild depressive symptoms. What disorder is Jamie highly likely to develop as he gets older? a. cyclothymia b. mania c. major depressive disorder d. bipolar disorder 39. Although persistent depressive disorder may last 20 to 30 years or more, the median duration for adults is how many years? a. 5 years b. 8 years c. 10 years d. 12 years 40. It has been 60 days since Diana’s mother died. Diana has good days and bad days but is starting to adjust to the loss.

What is Diana experiencing? a. integrated grief b. pathological grief Powered by Cognero

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Chapter 08: Mood c. prolonged grief disorder d. pathological grief reaction 41. Ms. Barr experienced the death of a close friend a year ago. She is so depressed that she has no appetite or energy, and she is suicidal. What might a mental health professional conclude that Ms. Barr is experiencing? a. a depressive episode that is unrelated to the loss, because it has been a year b. a grief reaction within normal limits c. prolonged grief disorder d. a grief reaction that is considered within normal limits, unless she attempts suicide 42. What was the major concern about including premenstrual dysphoric disorder (PMDD) in the DSM-5? a. It is just a typical monthly physiological cycle as part of being female. b. It would be very stigmatizing. c. It should be considered a physical disorder not a psychological disorder. d. The impairment in functioning is not significant enough to be considered disordered.

43. Which of the following is NOT considered as a part of the incapacitation occurring with PMDD? a. anxiety b. severe mood swings c. aggression d. physical symptoms 44. Children diagnosed with disruptive mood dysregulation disorder were often misdiagnosed with which of the following disorders? a. conduct disorder b. ADHD c. depression d. bipolar disorder 45. Which concerning fact is NOT a reason that researchers sought a new diagnosis for children in the framework of disruptive mood dysregulation disorder? a. From 1995 to 2005 the diagnosis of bipolar disorder in children increased 40-fold. b. Children diagnosed with bipolar disorder often showed no evidence of mania. c. There is no evidence of excessive rates of bipolar disorder in their families. d. They were not being treated as doctors realized bipolar was not an accurate diagnosis.

46. Bipolar II disorder is characterized by major depressive episodes alternating with hypomanic episodes, while bipolar I disorder is characterized by alternating episodes of major depression and another symptom. What is the other symptom? a. dysthymia b. mania c. cyclothymic disorder d. periods of remission 47. What distinguishes bipolar I disorder from bipolar II disorder? a. Only bipolar I disorder includes episodes of clinical depression.

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Chapter 08: Mood b. Only bipolar I disorder has episodes of mania. c. Only bipolar II disorder is linked to cyclothymic disorder. d. Only bipolar I disorder involves periods of hypomania.

48. Jalah is diagnosed with bipolar II disorder. What can we most likely expect her to experience? a. She will experience hypomanic episodes and major depressive episodes. b. She will experience manic episodes and major depressive episodes. c. She will experience hypomanic episodes alternating with mild depressive symptoms. d. She will experience hypomanic episodes predominantly.

49. Jerry experienced a manic episode six months ago, which was followed by a major depressive episode. What would they most likely be diagnosed with? a. cyclothymic disorder b. rapid cycling disorder c. bipolar II disorder d. bipolar I disorder 50. Dr. Hammond is frustrated because he is having the same problem with the medical treatment he prescribed for three different patients with bipolar disorder. What is the most likely source of Dr. Hammond’s frustration? a. His patients are taking too much medication during a severe manic state. b. His patients are stopping the medical treatment and becoming depressed. c. His patients are having problems with addiction to the medication while in a manic state. d. His patients often stop taking the medication to bring on a manic state.

51. For several years now, 20-year-old Cynthia has been considered by her family and friends to be moody, high-strung, explosive, or hyperactive, yet never out of control. Her last pattern of moodiness has been consistent for over two years.

What is Cynthia’s most likely diagnosis? a. cyclothymia b. mania c. major depressive disorder d. dysthymia 52. Which statement best describes the terms used to differentiate mood disorders? a. Cyclothymic disorder is to persistent depressive disorder as manic is to hypomanic. b. Cyclothymic disorder is to persistent depressive disorder as major depressive is to bipolar. c. Cyclothymic disorder is to persistent depressive disorder as bipolar is to major depressive. d. Cyclothymic disorder is to persistent depressive disorder as bipolar I is to bipolar II. 53. When referring to the mood disorders, which term would most likely be used to describe cyclothymia? a. moody b. depressing c. hyperactive d. focused 54. Which of the following individuals is showing signs of cyclothymic disorder?

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Chapter 08: Mood a. Abe, who alternates between depression and hypomania every three months b. Jamal, who seems to be either depressed or manic but neither his depression nor his mania meets the clinical criteria for a disorder c. Claire, who alternates between depression and mania with a month of neutral mood in between d. Dina, who alternates between manic and hypomanic states at irregular intervals 55. Jaden had cyclothymia and was not treated for it. He now has been diagnosed with another, more serious disorder.

What disorder is that most likely to be? a. antisocial personality disorder b. major depression c. bipolar I disorder d. borderline personality disorder 56. The peripartum specifier with bipolar disorder is most likely to be given during which period of the peripartum period? a. in pregnancy b. during childbirth c. after childbirth d. at any time during the peripartum period 57. Jerimiah has just been diagnosed with rapid-cycling manic-depressive episodes. How many manic episodes must Jerimiah have had in the past year? a. at least two b. at least four c. at least six d. at least ten 58. Patient X has rapid cycling bipolar I disorder. Patient X is most likely to be which of the following? a. an adolescent b. male c. an older adult d. female 59. When is the rapid-cycling specifier added to the diagnosis of bipolar disorder? a. when the patient has had at least two episodes within a year b. when the patient has had at least four episodes within a year c. when the patient has had at least six episodes within a year d. when the patient has had at least eight episodes within a year 60. Some evidence suggests that patients with rapid-cycling specifier may be effectively treated with which of the following? a. anticonvulsants b. antidepressants c. cognitive behavioural therapy d. interpersonal therapy Powered by Cognero

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Chapter 08: Mood 61. Which of the following may be a precipitant of rapid cycling in bipolar disorder? a. anticonvulsants b. antidepressants c. mood stabilizers d. alcohol 62. Which of the following statements is accurate concerning the chronicity of rapid cycling in bipolar disorder? a. Rapid cycling is chronic and treatment resistant. b. Some individuals will return to a non-rapid-cycling pattern, but the majority will remain in a rapid-cycling pattern. c. The majority of individuals will return to a non-rapid-cycling pattern within two years. d. Rapid-cycling is chronic but can be reduced through treatment.

63. An individual with bipolar disorder has cycles that last a couple of days. Which specifier is likely to be given in this case? a. rapid-cycling specifier b. ultra-rapid cycling specifier c. ultra-ultra-rapid cycling specifier d. circadian-based cycling specifier 64. What is ultra-ultra-rapid cycling in bipolar disorder linked to? a. seasonal changes b. hormonal changes c. circadian rhythms d. lack of sleep 65. Jackie is 18 years old and is demonstrating mania symptoms after experiencing a major depressive episode. Based on her age, what diagnosis is most likely? a. bipolar I b. bipolar II c. cyclothymia d. rapid-cycling bipolar 66. Which statement does NOT accurately describe the onset of bipolar disorders? a. The onset for bipolar I is typically earlier than bipolar II. b. About half of the cases of bipolar disorder begin in adolescence. c. It is relatively rate for someone to develop bipolar disorder after the age of 40. d. The onset of bipolar disorders tends to be more acute than onset of major depressive disorder.

67. Prevalence rates for mood disorders vary, but the best estimates of the worldwide prevalence suggest that approximately what percent of the population experience major depressive disorder over a lifetime? a. 8 percent b. 16 percent c. 22 percent Powered by Cognero

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Chapter 08: Mood d. 28 percent 68. The risk of dying by suicide among people with bipolar disorder is how many times that of the general population? a. 5 to 10 times b. 10 to 20 times c. 20 to 30 times d. 30 to 35 times 69. Evidence suggests that even infants may show signs of depression. How early have depressive symptoms been documented in infants? a. two days old b. one month old c. three months old d. six months old 70. What is the general conclusion regarding depression and prevalence rates in children and adolescents? a. Depressive disorders occur less frequently in children than adults but rise dramatically in adolescence. b. Depressive disorders occur more frequently in adults than children and adolescents. c. Depression is not common in childhood or adolescence. d. Prevalence in depressive disorders increases with age.

71. Children under the age of nine that present with more irritability and emotional swings in mania are often mistaken to be which of the following? a. depressed b. hyperactive c. anxious d. dissociative 72. Which disorder puts adolescents at a higher risk for aggression, sexual promiscuity, and accidental injury? a. bipolar disorder b. major depression c. cyclothymia d. dysthymia 73. It can be difficult to diagnose depression in older adults because the presentation of mood disorders is often complicated by another variable. What is that variable? a. substance misuse b. symptoms of menopause c. the presence of medical illnesses or symptoms of dementia d. family members who are unwilling to admit there are psychological problems in their older relatives 74. Depression that appears after the age of 60 is referred to as? a. lifespan depression b. late-onset depression c. chronic depression Powered by Cognero

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Chapter 08: Mood d. senior depression 75. What has research revealed about depression in older adults who have had a heart attack or stroke? a. It doubles the risk of death. b. It increases the risk of another heart attack or stroke. c. They are more likely to suffer from anxiety as well. d. It increases the risk of severe depression but only for those over the age of 75.

76. When is the gender difference in the prevalence of depression the greatest? a. childhood b. adolescence c. middle adulthood d. old age 77. Which symptoms of mood disorders are roughly equivalent across cultures? a. somatic symptoms b. cognitive symptoms c. emotional symptoms d. psychological symptoms 78. There is some evidence to suggest that many famous creative people have suffered from bipolar disorders. What has this finding led researchers to speculate? a. Mania is at the heart of all creativity. b. The genetic vulnerability to mood disorders is associated with a predisposition to creativity. c. Creative endeavours may create sufficient stress such that they contribute to the development of mood disorders. d. The same gene that causes bipolar disorder causes creativity.

79. If a person has symptoms of major depression and anxiety, what are you more likely to find in their family than in the family of someone without depression or anxiety? a. people with major depression but not anxiety b. people with any psychological disorder c. people with major depression or anxiety d. people with anxiety but not depression 80. The best evidence that genes have something to do with mood disorders comes from twin studies What have studies shown regarding the impact of genetics and the environment on mood disorders? a. Shared environmental factors have a great deal of influence. b. Unique nonshared events interact with biological vulnerability to cause depression. c. The heritability of depression is low, approximately 10 percent. d. If one twin responds poorly to treatment, the chances of their twin presenting with a mood disorder is greater.

81. What does current research suggest about gender differences in the genetic contributions to depression? a. The genetic contribution is similar for men and women, but less than the environmental influence. b. The genetic contribution is similar for men and women.

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Chapter 08: Mood c. The genetic contribution seems to be higher for men than men. d. The genetic contribution seems to be higher for women than men.

82. Current research into neurotransmitter systems has produced the permissive hypothesis. What does this hypothesis state? a. The norepinephrine system regulates serotonin levels; if norepinephrine is low, depression will occur. b. The absolute levels of neurotransmitters are more significant in mood regulation than the overall balance of the various neurotransmitters. c. Low levels of serotonin are sufficient to explain the etiology of mood disorders. d. When serotonin levels are low, other neurotransmitter systems become dysregulated and contribute to mood irregularities.

83. If Sarah has a low level of serotonin in her system, can we expect her to show symptoms of depression? a. Yes, if the levels of other neurotransmitters are low as well. b. Only if the levels are low compared to other neurotransmitters. c. No, low levels of serotonin are linked to mania, not depression. d. No, serotonin is not linked to depression.

84. A friend states that he thinks he is mildly depressed but he’s not sure, and he asks if there is any kind of laboratory test that could determine whether or not someone is depressed. What would you tell him? a. Cortisol levels are decreased in depression; he could have his cortisol levels checked by a blood test. b. Currently, there is no way of diagnosing depression with a laboratory test. c. The dexamethasone suppression test can be used only to diagnose severe cases of depression. d. The dexamethasone suppression test is a biological test for depression.

85. Which of the following hormones has been found to be elevated in patients with depression? a. cortisol b. estrogen c. testosterone d. melatonin 86. Recent research has noted that neurotransmitter activity in the hypothalamus regulates the release of hormones that affect the HPA axis. This discovery has led to the focus on the role of which substance in the endocrine system? a. cortisol b. serotonin c. neurohormones d. dopamine 87. One symptom of depression is an increase in sleeping. What other symptoms related to sleep occur in depression? a. slow wave sleep, the deepest stage of sleep, occurs later, if at all b. stages of deepest sleep occurring earlier in the sleep cycle c. less intense REM activity d. slower onset of REM sleep 88. There are indications that the nature of sleep and circadian disturbances linked to depression differ across the lifespan.

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Chapter 08: Mood Which finding provides evidence of this statement? a. The loss of slow-wave sleep impacts depressed children to a greater capacity than depressed adults. b. Depressed children experience more intense REM than depressed adults. c. Depressed children tend to experience hypersomnolence, while depressed adults experience insomnia. d. The increase in REM and reduction in slow-wave sleep seem to be less pronounced in depressed children than in adults.

89. Atypical sleep profiles predict which of the following in individuals with mood disorders? a. the severity of the mood disorder b. the type of mood disorder c. the response to treatment d. the chronicity of the disorder 90. In which area of the brain may activation represent a vulnerability to depression? a. right-sided anterior activation b. left-sided posterior activation c. left-sided temporal activation d. right-sided parietal activation 91. What do we call the phenomenon in which individuals who are biologically vulnerable to depression tend to place themselves in high-risk, stressful environments? a. humoral theory b. the cognitive-behavioural model c. a stress-depression linkage effect d. the gene–environment correlation model 92. Research has revealed that stressful life events are common to all individuals; however, some individuals will become depressed while others will not after an event. Which factor influences this likelihood? a. the level of trauma b. the meaning of the event c. how bad the event was d. the age of the individual 93. Racine and colleagues (2021) conducted a meta-analytic review of youth during the COVID-19 pandemic. What was their estimate of the number of youth who experienced clinically significant depressive symptoms during the pandemic? a. one in four b. one in five c. one in ten d. one in twenty 94. Wendy usually says, “It’s all my fault,” when anything goes wrong. Which dimension of the depressive attributional style is she reflecting? a. hopeless b. global c. stable Powered by Cognero

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Chapter 08: Mood d. internal 95. According to Martin Seligman, people become anxious and depressed because they believe that they have no control over the stress in their lives. Which model of depression is this? a. learned helplessness theory b. control theory c. hopelessness bias theory d. cognitive-behavioural theory 96. In 1989, Abramson and his colleagues revised Seligman’s theory of learned helplessness, which had focused on specific attributions as the crucial factor in depression. What did Abramson and his colleagues change the focus to? a. repressed anger b. lack of control c. a sense of hopelessness d. a feeling of failure 97. Mack almost always draws conclusions that emphasize the negative rather than the positive. What is Mack exemplifying? a. overgeneralization b. learned helplessness c. cognitive triad d. arbitrary inference 98. A student who has been doing very well in class receives a minor critical comment on an essay they wrote. The student thinks, “This is terrible. I’m probably going to fail the course.” What is this type of cognitive error in thinking? a. overgeneralization b. internalization c. globalizing d. arbitrary inference 99. Consider Aaron Beck’s depressive cognitive triad. Which of the following is NOT one of the factors that individuals think negatively about? a. their future b. their past c. themselves d. their immediate world 100. According to recent research on the development of depression, what type of vulnerability to depression do dysfunctional attitudes (a negative outlook) and hopelessness attributions (explaining things negatively) constitute? a. cognitive vulnerability b. biological vulnerability c. sociological vulnerability d. behavioural vulnerability 101. In their study of individuals who experienced a marital separation or divorce, but who had no previous history of Powered by Cognero

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Chapter 08: Mood severe depression, what did Bruce and Kim (1992) find? a. a higher rate of depression in men b. a higher rate of depression in women c. an approximately equal and a significant rate of depression for males and females d. no serious symptoms of depression in either males or females 102. Conflict within a marriage seems to have different effects on men and women. What does depression seem to do to men within the relationship? a. Their depression increases their aggression. b. Their depression increases their tendency to cheat. c. Their depression causes them to withdraw. d. Their depression increases their rumination.

103. Why does the Canadian National Population Health Survey suggest that men and women have different rates of depression? a. Women tend to experience less overall stress in their work situations. b. Men tend to experience less overall stress in their work situations. c. Work-related depression is rarely reported by women. d. Different types of work demands predict depression in women versus men.

104. According to several studies, which of the following has been found to show a strong association with depression in women? a. a tendency to engage in activities that take their minds off negative feelings b. a history of childhood sexual abuse c. the size of their extended families d. brain damage 105. How can marriage and employment affect the prevalence rates of depression in women? a. Marriage and employment can increase the prevalence rates of depression because of the pressure of both. b. Marriage and employment can bring prevalence rates to the levels of employed married men. c. Marriage, but not employment, can impact the prevalence of depression in women. d. Employment, but not marriage, can impact the prevalence of depression in women.

106. Hannah and Greg are the same age and are both facing job insecurity. What can you predict about the likelihood of each of them developing depression? a. Hannah is more likely to develop depression than Greg. b. Greg is more likely to develop depression than Hannah. c. Hannah and Greg are equally likely to develop depression. d. Whether Hannah or Greg is more likely to develop depression will depend entirely on their genetic makeup.

107. How much higher is the risk of depression for those who live alone compared to those that live with others? a. 40 percent higher b. 50 percent higher c. 70 percent higher d. 80 percent higher Powered by Cognero

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Chapter 08: Mood 108. How does social support impact those with bipolar disorder? a. It can speed up recovery of depressive episodes but not manic episodes. b. It can speed up recovery of manic episodes but not depressive episodes. c. It can speed up recovery of both manic and depressive episodes. d. It has no impact on recovery for those with bipolar disorder.

109. Which class of drugs includes the antidepressant medications known as imipramine (Tofranil) and amitriptyline (Elavil)? a. tricyclics b. tranquilizers c. MAO inhibitors d. SSRIs 110. Kelly has just been prescribed a tricyclic antidepressant for her depression. When can she expect to start feeling benefits from the medication? a. immediately b. within 24 hours c. two to eight weeks from now d. three months from now 111. How are MAO inhibitors and tricyclic antidepressants similar? a. They both result in the pooling of neurotransmitters at the synapse. b. They both have an effectiveness rate of about 60 percent. c. They are both more effective in men than women. d. They both result in similar side effects including increased sex drive and loss of appetite.

112. What is the most concerning issue with tricyclic antidepressants? a. They can cause sexual dysfunction. b. They can cause blurred vision. c. They can be lethal if taken in excessive doses. d. They can cause constipation.

113. Which of the following is a side effect of tricyclic antidepressants? a. sexual dysfunction b. insomnia c. excessive urination d. weight loss 114. Anita is taking an MAO inhibitor and has been advised by her physician to avoid certain foods because the combination can cause severe hypertensive episodes, and occasionally death. What foods did she likely advise Anita to avoid? a. sugar b. anything with caffeine c. protein Powered by Cognero

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Chapter 08: Mood d. foods containing tyramine 115. Ambrose has just been prescribed selective serotonin reuptake inhibitor (SSRI). Which of the following medications may have been prescribed to Ambrose? a. Prozac b. hypericum c. Thorazine d. Valium 116. Reports in the 1990s suggested that the use of Prozac might lead to suicidal preoccupations, paranoid reactions, and occasionally, violence. According to the text, what do more recent findings suggest? a. They substantiate the early claims. b. They suggest that the benefits outweigh substantial risks. c. They indicate that the risks of suicide are no greater than with any other antidepressant. d. They show that Prozac is associated with far less risk of suicide than other antidepressants.

117. A patient reports that they want to stop taking their SSRI because of a specific side effect that is bothersome. What side effect are they likely experiencing? a. sexual dysfunction b. hypersomnolence c. weight gain d. suicidal ideation 118. A new antidepressant, Venlafaxine, has been found to reduce some of the major side effects associated with previous tricyclic antidepressants including which of the following? a. reducing risk of damage to the cardiovascular system b. improving sleep efficiency c. reducing the risk of overdose d. decreasing suicidal ideation 119. Which statement best describes what is known regarding drug treatment for depression? a. Drug treatments for mood disorders are effective for adults, but drug treatments are seldom effective with children. b. Drug treatments that are effective for adults are equally effective for children. c. Drug treatments for mood disorders that are effective for adults are even more effective for children. d. Drug treatments for mood disorders can be effective for adults but have sometimes caused sudden deaths in children.

120. Which herbal treatment has recently gained considerable interest as a treatment for depression? a. milk thistle b. St. John’s wort (Hypericum) c. gingko biloba d. saw palmetto 121. Which psychedelic drug has shown some promise as a stand-alone treatment for treatment-resistant patients with Powered by Cognero

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Chapter 08: Mood severe suicide ideation? a. MDMA b. psilocybin c. ketamine d. mescaline 122. Why is the antidepressant medication lithium also referred to as a mood stabilizer? a. It increases the availability of both dopamine and norepinephrine in the brain b. It increases thyroid functioning, which results in improved mood stabilization c. It helps to prevent and treat manic episodes d. It elevates serotonin levels, which prevents depression 123. A patient has bipolar I disorder. Which medication has most likely been prescribed as a treatment? a. an antidepressant b. lithium c. Prozac d. valproate 124. Carbamazepine and valproate, drugs with antimanic properties, can be given to individuals who don't respond to lithium. What drug category do these drugs fall under? a. antidepressants b. psychedelics c. anticonvulsants d. anxiolytics 125. Although valproate has overtaken lithium as the most commonly prescribed mood stabilizer, which of the following is the distinct disadvantage of these drugs? a. They are less effective overall. b. They are less effective in preventing suicide. c. They increase the risk of overdose in combination with antidepressant drugs. d. We do not know how valproate works.

126. A psychiatrist prescribing a drug to a client with bipolar disorder states that they will be prescribing the more preferred drug for treatment. What drug will the client be prescribed? a. an antidepressant b. lithium c. Prozac d. valproate 127. Although the mood-stabilizing drugs are the preferred treatment for bipolar disorder, patient compliance has been a problem. Why do patients often stop taking their medication, even though it is effective in stabilizing their moods? a. They become anxious that the drug is too toxic. b. They cannot organize their daily routine and forget their medication. c. They start to have panic attacks. d. They miss the euphoric feelings that mania produces.

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Chapter 08: Mood 128. Although electroconvulsive therapy has been a controversial issue for decades, it is an effective treatment for depression. In which of the following cases is it especially effective? a. when patients with severe depression do not improve with other treatments b. when patients are noncompliant in taking their antidepressant medication c. when symptoms of depression are mild d. when a bipolar patient is currently experiencing a manic episode 129. Which of the following is NOT a nondrug approach suggested for treatment-resistant depression? a. interpersonal therapy b. deep brain stimulation c. transcranial magnetic stimulation (TMS) d. vagus nerve stimulation 130. Which approach does a cognitive therapist purposefully take? a. a Socratic approach b. an interpersonal approach c. a humanistic approach d. a psychodynamic approach 131. What is the first step of cognitive therapy? a. recognizing negative thinking b. correcting cognitive errors c. substituting with realistic thoughts d. acknowledging depressive errors 132. Where is mindfulness-based cognitive therapy (MBCT) found to be the most effective in depression? a. in preventing relapse b. in being able to acknowledge negative thinking c. in the monitoring and logging of thought processes d. in helping with interpersonal strategies 133. What does research show regarding exercise as a treatment for depression? a. Exercise is less effective than antidepressant treatment. b. Exercise is effective as treatment when combined with an antidepressant. c. Exercise is as effective as treatment with an antidepressant and better at preventing relapse at six months. d. Exercise is as effective as an antidepressant but only as a short-term treatment strategy.

134. There is some evidence that exercise increases neurogenesis in which area of the brain? a. prefrontal cortex b. amygdala c. the pons d. hippocampus 135. Interpersonal psychotherapy (IPT) helps depressed patients resolve relationship problems. Which of the following Powered by Cognero

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Chapter 08: Mood issues is NOT a likely focus of IPT? a. death of a loved one b. deficits in social skills c. marital conflict d. problems in past relationships 136. Interpersonal psychotherapy (IPT) requires the therapist to determine the stage of the dispute. Which of the following is NOT one of these stages? a. negotiation b. impasse c. dispute d. resolution 137. Recent research suggests that it might be possible to psychologically “immunize” at-risk children and adolescents against depression. What intervention was provided to form the basis of this position? a. Children who were at risk for depression were given art therapy before they entered puberty. b. Children who were at risk for depression were given family counselling before they entered puberty. c. Children who were at risk for depression were taught cognitive and social problem-solving skills before they entered puberty. d. Children who were at risk for depression were treated with psychoanalytic therapy before they entered puberty.

138. Seligman and his colleagues conducted a course in which university students at risk for depression were taught cognitive and social problem-solving skills. What criterion was used to determine whether students in the study were at risk for depression? a. a low score on a test of learned helplessness b. a poor response to antidepressant medication c. a pessimistic cognitive style d. a family history of depression 139. To prevent relapse or recurrence of depression over the long term, a client may undergo which of the following? a. interpersonal therapy b. maintenance treatment c. compliance therapy d. cognitive behavioural therapy 140. Which of the following is NOT a goal achieved by psychosocial treatments used for bipolar disorder? a. managing marital and job difficulties b. helping families understand symptoms c. increasing compliance with medication regimens such as lithium d. learning how to recognize and prevent manic symptoms from developing 141. Which of the following is a psychosocial treatment approach for bipolar disorder that focuses on circadian rhythms? a. mindfulness-based cognitive therapy b. interpersonal and social rhythm therapy Powered by Cognero

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Chapter 08: Mood c. cognitive-behavioural analysis system of psychotherapy d. interpersonal therapy 142. Which of the following puts you at the greatest risk for committing suicide if you are Inuit in Nunavik? a. being male b. being between 24 and 36 c. being female d. a history of criminal behaviour 143. According to the text, who struggles with depression, despite having many successes, but is determined to decrease the high rates of suicide among young people in many Canadian Indigenous communities? a. Sarah McLachlan b. Zindel Segal c. James Bartleman d. Margaret Trudeau 144. What is the gender difference in dying by suicide attributed to? a. the methods used b. the neurobiological differences c. the social role expectations d. psychological disorder differences 145. In a study of First Nations living on reserve, which group showed the highest proportion of suicide ideation? a. those not affected by residential schools b. those who had at least one grandparent who attended residential schools c. those with at least one parent who attended residential schools d. survivors of residential schools 146. Based on sociologist Émile Durkheim's definitions, an individual who died by suicide following the loss of social support would be defined under which suicide type? a. anomic b. altruistic c. egoistic d. fatalistic 147. Where does a great deal of what we know about the risk factors for suicide come from? a. clinical experience b. psychological autopsies c. neurochemical analyses d. twin and adoption studies 148. Research has found that low levels of a neurotransmitter may be related to increased risk of suicide.What is that neurotransmitter? a. serotonin b. dopamine Powered by Cognero

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Chapter 08: Mood c. norepinephrine d. GABA 149. Darren wants to help reduce suicides in his town. He decides to try to find ways to tackle something that is associated with approximately one-quarter to one-half of all suicides. What might Darren’s plan be? a. to reduce alcohol misuse among citizens b. to reduce gun ownership among citizens c. to reduce work stress among citizens d. to reduce divorce among citizens 150. Which of the following is NOT listed in the text as a risk factor for suicide? a. family history b. stressful life events c. existing psychological disorders d. low self-esteem 151. Which personality disorder is impulsive suicidal behaviour often a symptom of? a. borderline personality disorder b. obsessive-compulsive personality disorder c. paranoid personality disorder d. schizoid personality disorder 152. Although glorifying and romanticizing suicide in the media contributes to copycat suicides, which of the following is more likely? a. The person copying the suicide is trying to impress others. b. The person copying the suicide is doing it as a cry for help. c. The person copying the suicide is not really serious about the suicide attempt. d. The person copying the suicide is vulnerable due to an existing psychological disorder.

153. What does the research suggest is the most promising prevention method for people who are at risk of suicide? a. programs targeted to at-risk individuals b. educational programs c. crisis phone lines d. screening measures

154. Compare and contrast the clinical symptoms of major depression and mania. Explain what is meant by dysphoric (or mixed) mania.

155. Explain the differences between mania and hypomania in terms of symptoms and severity.

156. Compare and contrast persistent depressive disorder (dysthymia) and cyclothymia. Explain how each differs from either major depression or bipolar disorder. Explain what is meant by double depression.

157. Explain the differences between bipolar I disorder and bipolar II disorder, referring to the nature of episodes Powered by Cognero

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Chapter 08: Mood associated with each.

158. Compare the symptoms, frequency, and treatment of depression in children/adolescents and older adults, as it compares with depression in young and middle-aged adults.

159. Explain the neurobiological basis of depression. Describe the role of specific neurotransmitters implicated in mood disorders.

160. Explain Aaron Beck’s cognitive theory of depression. What is the cognitive triad? Give examples of the different types of cognitive errors.

161. Discuss the pattern of gender differences in the various mood disorders. Explain some of the proposed psychosocial theories of gender differences in depression.

162. Describe several of the medical and psychological treatments for depression. Compare the treatments in terms of effectiveness.

163. Discuss the risk factors of suicide. Describe the significance of stressful life events in suicidal behaviour.

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Chapter 08: Mood Answer Key 1. d 2. d 3. d 4. b 5. c 6. c 7. d 8. a 9. d 10. b 11. d 12. c 13. c 14. d 15. b 16. d 17. a 18. b 19. d 20. c 21. c 22. a 23. b 24. d 25. d Powered by Cognero

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Chapter 08: Mood 26. b 27. c 28. c 29. a 30. c 31. d 32. b 33. c 34. a 35. b 36. b 37. b 38. c 39. a 40. a 41. c 42. b 43. c 44. d 45. d 46. b 47. b 48. a 49. d 50. d 51. a Powered by Cognero

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Chapter 08: Mood 52. c 53. a 54. b 55. c 56. c 57. b 58. d 59. b 60. a 61. b 62. c 63. b 64. c 65. a 66. b 67. b 68. c 69. c 70. a 71. b 72. a 73. c 74. b 75. a 76. b Powered by Cognero

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Chapter 08: Mood 77. a 78. b 79. c 80. b 81. d 82. d 83. b 84. b 85. a 86. c 87. a 88. d 89. c 90. a 91. d 92. b 93. a 94. d 95. a 96. c 97. d 98. a 99. b 100. a 101. a 102. c Powered by Cognero

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Chapter 08: Mood 103. d 104. b 105. b 106. b 107. d 108. a 109. a 110. c 111. a 112. c 113. a 114. d 115. a 116. c 117. a 118. a 119. d 120. b 121. c 122. c 123. d 124. c 125. b 126. b 127. d Powered by Cognero

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Chapter 08: Mood 128. a 129. a 130. a 131. a 132. a 133. c 134. d 135. d 136. c 137. c 138. c 139. b 140. d 141. b 142. a 143. c 144. a 145. c 146. c 147. b 148. a 149. a 150. d 151. a 152. d 153. a Powered by Cognero

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Chapter 08: Mood 154. Student responses will vary.

155. Student responses will vary.

156. Student responses will vary.

157. Student responses will vary.

158. Student responses will vary.

159. Student responses will vary.

160. Student responses will vary.

161. Student responses will vary.

162. Student responses will vary.

163. Student responses will vary.

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Chapter 09: Eating

Indicate the answer choice that best completes the statement or answers the question.

1. Anne has anorexia nervosa and Julie has bulimia nervosa. What do both women have in common? a. a desire to be beautiful b. a desire to be adored and loved c. an overwhelming drive to be thin d. an aversion to eating 2. Dr. Anderson runs a support group for people with anorexia nervosa in a large city. Currently, the group has 100 people. About how many of Dr. Anderson’s group members will die from the disorder? a. 2 b. 5 c. 20 d. 40 3. How does the death rate (including suicide) from eating disorders compare to the death rates for other psychological disorders? a. It is lower than that of most psychological disorders. b. It is the highest of all the psychological disorders. c. It is higher than that for any other psychological disorder except depression. d. It is higher than that of most psychological disorders.

4. How many times as likely are women with anorexia nervosa to die by suicide as 15- to 34-year-old females in the general population? a. 6 times as likely b. 12 times as likely c. 18 times as likely d. 24 times as likely 5. In what year did Sir William Withey Gull, a British physician, first use the term anorexia nervosa? a. 1863 b. 1872 c. 1902 d. 1970 6. When did Canada see the first documented case of anorexia nervosa? a. 1872 b. 1895 c. 1920 d. 1970 7. Eating disorders were first recognized in which edition of the DSM as a separate entity in the context of psychological disorders? a. DSM-III b. DSM-IV Powered by Cognero

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Chapter 09: Eating c. DSM-IV-TR d. DSM-5 8. Which statement best summarizes the most recent data on eating disorders? a. Incidence of anorexia nervosa diagnoses have steadied while bulimia nervosa diagnoses are decreasing. b. Eating disorders are yet to be found in developing countries where food is scarce. c. Eating disorders are increasing in many countries associated with industrialization and urbanization. d. The data on eating disorders suggests they are the most prevalent psychological disorder.

9. Asha has just started showing signs of an eating disorder. Which stage of development is Asha likely in right now? a. early childhood b. late childhood c. adolescence d. early adulthood 10. Which of the following is a key characteristic of people who typically develop eating disorders? a. The come from socially disadvantaged environments. b. They come from Eastern countries. c. They are female. d. They tend to be naturally slightly overweight.

11. What is the hallmark symptom of bulimia nervosa? a. eating a large amount of food b. attempting to compensate c. experiencing out-of-control eating d. eating more than 20,000 calories in one sitting 12. Which of the following may occur but is NOT discussed as an important criterion in the definition of binge eating? a. eating a large amount of food b. attempting to compensate c. experiencing out-of-control eating d. hoarding food 13. Which compensation technique can occur in individuals with bulimia nervosa but is more characteristic of anorexia nervosa? a. self-induced vomiting b. use of laxatives c. use of diuretics d. excessive exercise 14. What did Caroline Davis and colleagues (2004) find during their research on exercise in eating disorders? a. Excessive exercise may be an early warning sign for anorexia nervosa development. b. Approximately equal numbers of individuals with anorexia nervosa and bulimia nervosa use excessive exercise as a compensatory activity. c. Excessive exercise is only a feature of individuals with comorbid anxiety and anorexia nervosa.

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Chapter 09: Eating d. Activity level is correlated with the severity of the eating disorder.

15. What two factors did Garfinkel and colleagues (1996) find that differ between people with bulimia who purge and those with bulimia who do not purge? a. the age of onset and the existence of comorbid psychological disorders b. the average weight of the person and the age of onset c. the socioeconomic class of the individual and comorbid psychological disorders d. the male-to-female ratio and the age of onset 16. Regarding bulimia nervosa, what was dropped from the diagnostic criteria in the DSM-5? a. specification of a psychological characteristic in the individual b. the nonpurging subtype distinction c. the time criteria of showing behaviours for three months d. comorbid specifications 17. Purging is not a particularly efficient method of reducing caloric intake. What percentage of calories that were just consumed will vomiting eliminate? a. 10 percent b. 20 percent c. 40 percent d. 50 percent 18. Cadence is a competitive young woman from a high-achieving, wealthy family. She is social and likes the fact that she is popular. She believes that her popularity is dependent on her weight and body shape. Cadence has a boyfriend, but she worries that she may care more about their relationship than he does. Which of these features highlights the psychological characteristic that must be present for a diagnosis of bulimia nervosa? a. her successful and wealthy family status b. her competitive nature c. her belief that her boyfriend cares less about the relationship than she does d. her belief that her weight and body shape influence her popularity 19. Which of the following is the most serious medical consequence of bulimia? a. potential tooth erosion b. potential brain damage c. potential electrolyte imbalance d. potential intestinal disorders 20. What is the most obvious medical consequence of bulimia? a. tooth erosion b. chubby face c. electrolyte imbalance d. renal failure 21. Why is electrolyte imbalance in bulimia nervosa concerning? a. It can lead to cardiac arrhythmia and renal failure.

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Chapter 09: Eating b. It can erode the dental enamel. c. It can lead to salivary gland enlargement and a resulting chubby face appearance. d. It can lead to severe constipation or permanent colon damage.

22. Which of the following is NOT a medical complication related to bulimia? a. sudden death b. electrolyte imbalance c. renal failure d. calluses on the fingers 23. What was discovered when comparing young women with bulimia to age- and weight-matched controls without bulimia? a. The young women with bulimia were more anxious than the matched controls. b. The young women with bulimia were more impulsive than the matched controls. c. The young women with bulimia were more competitive than the matched controls. d. The young women with bulimia had more body fat than the matched controls.

24. Although for several years a prominent theory held that eating disorders were a way of expressing depression, what does almost all evidence now indicate? a. Depression follows bulimia and may be a reaction to it. b. Depression may be a way of expressing displeasure with one’s body. c. Very few people with bulimia suffer from depression. d. Depression precedes bulimia.

25. A counsellor runs a support group for women with bulimia who are receiving inpatient treatment at a psychiatric facility. What percentage of women in the support group are likely to also have an anxiety or mood disorder? a. 15 b. 25 c. 50 d. 75 26. Which of the following disorders was NOT discussed in the text as an associated psychological disorder with bulimia nervosa? a. borderline personality disorder b. alcohol use disorder c. nicotine dependence d. post-traumatic stress disorder 27. Toronto psychiatrists Kaplan and Woodside have examined the relationship between smoking and bulimia and have discovered which of the following traits is also important in the relationship? a. anxiety b. impulsivity c. competitiveness d. shame Powered by Cognero

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Chapter 09: Eating 28. Sheena is at their doctor for a physical and will be weighed as a part of their appointment. As Sheena has been diagnosed with bulimia nervosa, what will their weight likely be? a. within 10 percent of their typical weight b. within 15 percent of their typical weight c. within 20 percent of their typical weight d. within 25 percent of their typical weight 29. Susan, a woman of relatively typical weight, sometimes eats huge quantities of junk food and has no ability to stop herself. She follows this habit with long periods of complete fasting. Based on this information, which of the following is most likely to happen? a. Susan will be diagnosed with binge-eating disorder. b. Susan will not be diagnosed with any disorder because she is of typical weight. c. Susan will not be diagnosed with bulimia nervosa because she is not purging. d. Susan will be diagnosed with bulimia nervosa.

30. What is most likely to cause people with bulimia NOT to seek treatment as early as they should? a. the fear of weight gain b. the pride associated with efforts at weight loss c. the denial of illness d. the shame and secrecy 31. What is the core feature of anorexia? a. intentional weight loss reaching 15 percent less than expected body weight b. rapid, intentional weight loss and the belief that more weight needs to be lost c. an intense fear of obesity d. food refusal 32. Which emotion is often present in individuals who are diagnosed with anorexia nervosa? a. shame b. pride c. anxiety d. impulsivity 33. The DSM-5-TR specifies two subtypes of anorexia nervosa. Which of the following occurs in the restricting type? a. Individuals do not limit caloric intake but engage in excessive exercising and fitness regimes. b. Individuals diet to limit calorie intake. c. Individuals use purging and limit calorie intake. d. Individuals rely on purging.

34. Morgan has an intense fear of being overweight. Although she talks a lot about food, she hardly eats. She also sees herself as fat, even though her doctor says she is 20 percent underweight for her height, age, and bone structure. Morgan exercises excessively and obsessively diets, despite being seven kilograms lighter than her original dieting goal. What condition does Morgan most likely have? a. anorexia nervosa b. binge-eating bulimia Powered by Cognero

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Chapter 09: Eating c. nonpurging anorexia d. bulimia nervosa 35. Jeanie’s doctor is attempting to determine which subtype of anorexia she has. Which time frame will her doctor consider for the diagnosis? a. behaviours from the last three months b. behaviours from the last six months c. behaviours from the last year d. behaviours from the moment Jeanie displayed weight loss 36. Which of the following is NOT a feature of anorexia nervosa? a. intense fear of obesity b. relentless pursuit of thinness c. satisfaction with any weight loss d. marked disturbance in body image 37. How many individuals who meet the criteria for anorexia engage in binge eating and purging? a. 10 percent b. 25 percent c. 50 percent d. 75 percent 38. By the time treatment is sought, what is the average body mass index (BMI) of an individual with anorexia nervosa? a. approximately 10 b. approximately 13 c. approximately 16 d. approximately 18 39. Which medical consequence can occur in both anorexia nervosa and bulimia? a. amenorrhea b. lanugo c. dry skin d. brittle nails 40. What is the most common medical complication of anorexia? a. cessation of menstrual cycle b. electrolyte imbalance c. increased heart rate d. downy hair on limbs 41. What is the definition of lanugo, a relatively common medical consequence of anorexia? a. cessation of menstrual cycle b. electrolyte imbalance c. increased heart rate Powered by Cognero

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Chapter 09: Eating d. downy hair on limbs 42. Dr. Cowan treats patients with anorexia but also specializes in treating another disorder that commonly co-occurs with anorexia. What is that disorder most likely to be? a. anxiety disorder b. personality disorder c. obsessive-compulsive disorder d. depressive disorder 43. Sarina loses control when she eats and consumes great quantities of food, but she does not engage in any attempts to compensate for her excess food intake. What condition does Sarina appear to have? a. binge-eating anorexia b. an eating disorder not otherwise specified c. bulimia, non-purging type d. binge-eating disorder 44. Gideon is 28 years old. He is obese, describes himself as a compulsive overeater, and has a history of depression and unsuccessful attempts at weight loss. While Gideon has repeated episodes of binge eating, he does not vomit afterwards.

What condition does Gideon most likely have? a. binge-eating anorexia b. an eating disorder not otherwise specified c. bulimia, non-purging type d. binge-eating disorder 45. Mike and George met recently and discovered they both have binge-eating disorder. Where did they most likely meet? a. at the gym b. at the pool c. at a weight loss group d. at a weight room 46. What percentage of candidates of bariatric surgery have been reported to engage in binge eating behaviour? a. 20 percent b. 30 percent c. 50 percent d. 80 percent 47. Which disorder is common for individuals with binge-eating disorder to cross over to? a. bulimia b. anorexia binge-eating/purging type c. anorexia restricting type d. obsessive-compulsive disorder 48. Jody sometimes eats more than just about any other girl you know. What would you have to know to determine whether she has binge-eating disorder? a. the situations under which she eats a great deal Powered by Cognero

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Chapter 09: Eating b. whether she is eating mostly junk foods or mostly healthy foods c. the caloric intake of the foods d. whether she feels a lack of control in her eating 49. A friend who uses laxatives to influence their weight, but doesn't engage in food limiting or binge-behaviours prior, may be diagnosed with which disorder? a. anorexia nervosa b. bulimia nervosa c. binge-eating disorder d. purging disorder 50. What is the approximate percentage of individuals with binge-eating disorder who binge to alleviate bad moods or negative affect? a. 25 b. 33 c. 50 d. 66 51. Dr. Nagata is conducting a group for individuals dealing with an eating disorder. Of the ten individuals in the group, how many are likely women? a. five b. six c. seven d. nine 52. Which males are most likely to develop an eating disorder such as bulimia? a. those who are depressed b. those who are overweight c. those who are gay or bisexual d. those who are single and heterosexual 53. Professor Denefeld is lecturing to her class about eating disorders. She provides a list of statistics concerning eating disorders but believes one of the statistics is inaccurate. Which statement does NOT accurately describe eating disorders? a. The onset of bulimia is typically later in adolescence compared to anorexia. b. Anorexia is more resistant to treatment than bulimia. c. The prevalence of eating disorders seems to be highest in urban areas. d. Bulimia tends to resolve on its own when left untreated.

54. Fairburn and colleagues (2003) found that bulimia tends to be chronic if untreated. Which two factors were found to be the strongest predictors in persistence? a. a history of childhood obesity and a continuing overemphasis on the importance of being thin b. a history of childhood abuse and a body mass index (BMI) over 20 c. being an older female and consistently consuming over 25 000 calories a day d. low self-esteem and poor interpersonal relationships Powered by Cognero

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Chapter 09: Eating 55. According to Canada’s National Institute for Eating Disorders, approximately how many Canadians have an eating disorder? a. 200 000 b. 500 000 c. 750 000 d. 1 000 000 56. Although there are cross-cultural differences in eating disorders, research suggests that the major risk factors for eating disorders include being overweight, acculturating to the Western majority, and which of the following? a. poor body image b. being in a higher social class c. country of origin d. cultural preference 57. In research on cross-cultural considerations, survey data have revealed that Black adolescent girls demonstrate which of the following compared with white adolescent girls? a. greater body dissatisfaction b. more weight concerns c. more negative self-image d. perceptions of being thinner 58. In traditional Chinese cultures what is often reported as a precipitant for anorexia? a. acne b. fear of being fat c. body image disturbances d. cultural standards 59. In their cross-cultural study of eating disorders, Gupta and colleagues (2001) found that the drive for thinness and body dissatisfaction did not differ between Canadian and Indian women. However, there were cultural differences. What were the cultural differences? a. differences in compensatory practices after bingeing, such as purging b. differences in the acceptability of eating disorders c. differences in the areas of the body most related to body satisfaction d. differences in the frequency of bingeing behaviour 60. Negative attitudes toward weight have been seen as early as what age? a. three years of age b. five years of age c. seven years of age d. ten years of age 61. Which DSM-5 eating disorder involves a lack of interest in eating food, oversensitivity to certain aspects of food, or concerns about the consequences of eating? a. anorexia restricting type b. avoidant/restrictive food intake disorder Powered by Cognero

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Chapter 09: Eating c. eating disorder not otherwise specified d. bulimia restricting type 62. Shannon is not concerned about her appearance, but she restricts her food intake because she has no interest in eating food, is oversensitive to the taste of food, and is concerned about choking every time she eats. Based on these symptoms, what disorder does Shannon likely have? a. anorexia restricting type b. avoidant/restrictive food intake disorder c. eating disorder not otherwise specified d. bulimia restricting type 63. Which statement best explains the increase in the incidence of anorexia and bulimia over the past 30 years? a. Pharmaceutical companies have expanded their marketing of laxatives and diuretics. b. Today’s beauty standards are increasingly difficult to achieve because the size and weight of the average woman has increased. c. There have been concurrent increases in the rate of depression. d. There has been an increase in weight loss programs and fad diets.

64. What percentage of Playboy centrefolds met the weight criteria for anorexia between 1979 and 1988? a. 45 percent b. 57 percent c. 69 percent d. 84 percent 65. Levine and Smolak (1996) coined which phrase to refer to the way women are portrayed in magazines and on television? a. the slenderness effect b. the glorification of slenderness c. the model phenomenon d. the Playboy effect 66. How can we tell that the media’s message to be thin is aimed clearly at women? a. by the fact that overweight men are two to five times more common as television characters than are overweight women b. by the fact that there are relatively few physical appearance competitions for men c. by the fact that there are significantly more thin women in popular magazines than thin men d. by the fact that most men prefer to date thin women 67. The increase in the incidence of eating disorders such as anorexia and bulimia has been referred to as a “collision between our culture and our physiology.” What does this mean? a. People are fed up with being told how they should look. b. People have become too dependent on media determinations of beauty. c. Media standards of beauty are increasingly unattainable for the average woman. d. Dieting has become a fad that has been taken to an extreme.

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Chapter 09: Eating 68. According to Forestell and colleagues (2004), what are undergraduate women most critical of when making evaluations of physical attractiveness? a. women’s body fat b. women’s overall weight c. women’s waist size d. women’s hip size 69. In their classic study on undergraduate students, Fallon and Rozin (1995), found which of the following? a. Women rated their current figures as much heavier than the most attractive figure, compared to men's ratings, which were approximately equal. b. Women and men rated their current figures as much heavier than the most attractive figure. c. Men rated their ideal body weight as lighter than the weight females thought most attractive in men. d. Women rated their ideal figure as heavier than what they believed to be attractive in other females.

70. When men are asked to identify the ideal male body, what do they typically select? a. a body weight that is heavier than the weight females think is most attractive b. a body weight that is the same as their own weight c. a body weight that is lighter than the weight females think is most attractive d. a body weight that is roughly seven kilograms lighter than their own weight 71. What did Paxton and colleagues (1999) discover in relation to the social transmission of attitudes about body image in adolescent girls? a. Adolescent girls tend to choose friends who share similar attitudes toward body image. b. Problematic attitudes and disordered eating are caused by friendship cliques. c. There is no relationship between friendship cliques and eating behaviours. d. Friendship cliques can influence body image but do not appear to impact diet or attempts to lose weight.

72. What does research suggest as a reason why dieting causes weight gain? a. People tend not to be aware of appropriate dieting strategies. b. Repeated cycles of dieting seem to produce stress-related withdrawal symptoms in the brain. c. Limiting and controlling food is too difficult for most people. d. Individuals are unaware of how many calories are in the foods they ingest.

73. According to Polivy and Herman, what does the “false hope syndrome” refer to? a. an unrealistic belief that weight loss can be maintained b. the goal to exercise excessively, which will help shed unwanted weight c. the belief that losing weight will make one into a person that others admire and love d. when initial success at losing weight is reinforced by others and it leads to unrealistic goals for further weight loss 74. According to research by Livesley and colleagues (2005), what do we know about the relationship between genetics and body size? a. There is a small correlation between genetics and body size. b. There is a strong genetic contribution to body size. c. Diet and exercise can override any genetic contributions to body size.

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Chapter 09: Eating d. There is no relationship between genetics and body size; the relationship is entirely environmental.

75. According to Kerr and colleagues (2006), disordered eating patterns were particularly common among gymnasts who encountered which of the following? a. a family who is perfectionistic b. a weight gain of five pounds or more c. negative comments about their weight d. team members who pressured them to be smaller 76. Which young woman appears to be most at risk for developing an eating disorder? a. Maya, whose parents are both constantly dieting b. Jane, whose family is hard driving, successful, and eager to maintain harmony c. Emily, whose parents recently divorced d. Tess, whose family emphasizes achievement, support, and communication 77. Mothers of girls with disordered eating are more likely to show a pattern of which of the following? a. depression b. perfectionism c. unstable relationships d. disinterest 78. How many times as likely are the relatives of patients with eating disorders, compared with individuals in the general population, to develop eating disorders? a. two to three times as likely b. three to four times as likely c. four to five times as likely d. five to six times as likely 79. Which area of the brain plays an important role in eating disorders? a. hippocampus b. amygdala c. prefrontal cortex d. hypothalamus 80. Which neurotransmitter is most often associated with eating disorders? a. dopamine b. glutamate c. serotonin d. norepinephrine 81. Pri's doctor prescribed her medication for binge eating. What system will likely be targeted with this drug? a. dopamine b. glutamate c. serotonin d. norepinephrine Powered by Cognero

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Chapter 09: Eating 82. In their twin study of eating disorders, what did Bulik and colleagues (2006) estimate heritability to be? a. 0.20 b. 0.41 c. 0.56 d. 0.77 83. What do genetic influences on eating disorders most likely involve? a. a specific gene for each actual eating disorder b. inherited, nonspecific personality traits that may make development of an eating disorder more likely c. multiple genes interacting in ways not yet determined that directly produce eating disordered behaviour d. recessive genes 84. Mandy has activity anorexia. What does Mandy do on a daily basis? a. She restricts food except for meals with family members to keep up an illusion that she does not have a problem. b. She uses excessive physical activity to take away her appetite. c. She uses excessive physical activity to decrease the metabolic rate, resulting in atypical weight loss. d. She uses excessive physical activity to relieve feelings of hunger.

85. What role does perfectionism play in the development of eating disorders? a. Perfectionism does not play a role. b. Perfectionism is weakly associated with the development of eating disorders. c. Perfectionism is the key psychological factor in the development of eating disorders. d. Perfectionism only plays a role only if the individual is also anxious.

86. In individuals with bulimia, what do we know about their specific distortions in perception of body shape? a. They are negative and stable. b. They are altered by major events. c. They change frequently, depending on day-to-day experience. d. They can change but only when the individual is highly anxious.

87. Which factor most strongly contributes to the etiology of eating disorders? a. developmental b. biological c. psychological d. sociocultural 88. What has research indicated regarding the effectiveness of drug treatments for adult patients with anorexia nervosa? a. Anti-anxiety medications have been found to be effective. b. Medications have not been found to be effective. c. Antidepressants have been found to be effective. d. Antipsychotic medications have been found to be effective.

89. Alissa has bulimia. She asked her doctor whether there are any medications that she can take to help her manage the Powered by Cognero

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Chapter 09: Eating disorder. What was most likely her doctor’s response? a. Antidepressants can be effective. b. Benzodiazepines can be effective. c. Antipsychotic medications can be effective. d. Medications have not been found to be effective for the treatment of bulimia.

90. Jessica is 13 years old and has begun a cycle of binging and purging. Her doctor is so concerned that he has prescribed a medication for her that has been shown to help other people with eating disorders. What medication did he prescribe? a. a placebo b. an SSRI c. a benzodiazepine d. Ritalin 91. According to Fairburn and Cooper (2014), which treatment protocol directed at causal factors common to all eating disorders was targeted in an integrated way? a. cognitive-behavioural therapy–enhanced b. behavioural therapy c. cognitive-behavioural therapy d. interpersonal therapy 92. What would an early stage of cognitive-behavioural therapy–enhanced treatment for bulimia most likely involve? a. inpatient treatment b. family therapy c. small, frequent meals d. antidepressant medication 93. Which of the following is an important aspect of the cognitive-behavioural therapy–enhanced approach to the treatment of bulimia? a. changing the type and frequency of reinforcement associated with being an identified patient b. ending the false hope syndrome c. changing the patient’s dysfunctional thoughts and attitudes about body shape, weight, and eating d. helping the patient’s family learn new ways of interacting with each other and with the patient 94. Which statement best describes the effectiveness of cognitive-behavioural therapy–enhanced treatment for bulimia? a. Cognitive-behavioural therapy–enhanced is not effective in the short or long term. b. Cognitive-behavioural therapy–enhanced is effective in the short term but not the long term. c. Cognitive-behavioural therapy–enhanced is effective in the long term but not the short term. d. Cognitive-behavioural therapy–enhanced is effective in the short and long term.

95. If given the choice between cognitive-behavioural therapy–enhanced (CBT-E), behaviour therapy (BT), and interpersonal therapy (IPT) for the treatment of bulimia for a friend, which would be the best choice based on current available research? a. CBT-E is the best choice. b. IPT is the best choice. c. IPT or BT are both good choices.

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Chapter 09: Eating d. CBT with BT. 96. According to research by Agras and colleagues (1997), Marcus and colleagues (1990), and others, which of the following is critical to sustaining weight loss in obese patients? a. increasing self-esteem b. using antidepressants c. starting a regular exercise program d. stopping binge eating 97. What does the research state about widely available behavioural weight-loss programs, such as Weight Watchers, for patients with binge-eating disorders? a. They have some positive effect on bingeing but not as much as CBT. b. They are equally as effective as CBT. c. They have no impact on bingeing. d. They are only effective if an individual is only mildly obese.

98. Which type of therapy should be used as a first step for people who binge eat? a. drug therapy b. cognitive-behavioural therapy c. self-help procedures d. interpersonal therapy 99. What is the difference between rapid and nonrapid responders when comparing outcomes in IPT? a. IPT is effective for both rapid and nonrapid responders. b. IPT is effective for rapid responders. c. IPT is effective for nonrapid responders d. IPT is effective for both rapid and nonrapid responders, but only if they are also engaged in CBT as well.

100. What does a rapid response mean in terms of binge eating treatment? a. At least 50 percent reduction in binge eating by week 4. b. At least 50 percent reduction in binge eating by week 2. c. At least 70 percent reduction in binge eating by week 2. d. At least 70 percent reduction in binge eating by week 4.

101. A patient has just been admitted to a psychiatric facility to be treated for anorexia. What will be the first goal in their treatment plan? a. weight gain b. motivation to change c. resuming regular menstrual cycles d. acceptance that there is a problem 102. In which case would an individual be a candidate for outpatient treatment for anorexia? a. if the individual lost weight gradually b. if the individual is below 75 percent of the average body weight c. if the individual is experiencing minimal medical complications Powered by Cognero

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Chapter 09: Eating d. if the individual has accepted there is a problem 103. Jill has been in treatment for anorexia for the past two months. Over this time, she has gained weight to the point where her weight is in the average range for a woman of her height. What does the fact that she gained weight fairly quickly in treatment mean? a. It means she is probably in need of little, if any, further treatment. b. It means her prognosis for a full recovery is very good. c. It means little in terms of how likely she is to be successful in the long term. d. It means she has completed the most difficult part of her treatment.

104. What do clinicians usually suggest is the most difficult part of treatment for anorexia, and the part of treatment where many anorexics are NOT successful? a. admitting that there is a problem and agreeing to begin treatment b. changing their attitudes regarding body shape c. accepting counselling for their childhood traumas d. initial weight gain 105. Because patients with anorexia nervosa are often difficult to treat, which of the following does research suggest is an important area of assessment? a. their readiness to change b. their willpower c. their anxiety over becoming obese d. their negative expectations about change 106. What does research on the long-term prognosis for people treated for anorexia or bulimia suggest? a. Both anorexia and bulimia patients typically make a full and long-term recovery after treatment. b. Patients with anorexia who receive treatment tend to have a better prognosis than patients with bulimia. c. Patients with bulimia were thought to have a better prognosis than patients with anorexia, but that is changing. d. Treatment for both types of eating disorders tends to work in the short term only.

107. Which of the following has shown the most support from clinical trials in treating adolescents with anorexia? a. family-based treatment (FBT) b. cognitive-behavioural therapy (CBT) c. interpersonal therapy (IPT) d. behavioural therapy (BT) 108. In their review of prevention programs for young adolescent girls, what did Stice and colleagues (2007) find to be one of the most likely factors for predicting success in preventing eating disorders? a. changing negative and dysfunctional attitudes about food and eating b. increasing self-esteem c. eliminating an exaggerated focus on body shape or weight d. decreasing levels of competitiveness 109. What was the outcome of a study that attempted to increase body-image satisfaction and reduce dieting for Grade 6 girls in Canada?

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Chapter 09: Eating a. Changes were noted only in girls who were identified as being at high risk before the study. b. Increased body-image satisfaction and reduced dieting attitudes were immediately noticed and maintained up until the next year. c. Changes to increased body-image satisfaction were initially noted in the control group as well as the intervention group. d. The initial increased body-image satisfaction and reduced dieting attitudes and benefits were not maintained one year after the intervention.

110. In what ways do anorexia and bulimia patients tend to be similar, and in what ways do they differ? Make certain to include similarities and differences in the symptoms of the disorders and the dysfunctional thoughts typically associated with each disorder.

111. Compare and contrast the three prevalent eating disorders. In which ways are they similar, and in what ways do they differ?

112. Describe binge-eating disorder and discuss the reasons it became a full-fledged disorder in the DSM-5-TR? 113. Discuss the evidence that eating disorders are largely the result of culture and society.

114. Eating disorders are generally “blamed” on culture and society. At the same time, there appears to be genetic and psychological influences as well. Explain how culture, genetics, and psychological factors may interact in the development of eating disorders.

115. Describe the typical treatment goals and treatment methods implemented for bulimia nervosa.

116. Describe the typical treatment goals and treatment methods implemented for anorexia nervosa.

117. Describe the typical treatment goals and treatment methods implemented for binge-eating disorder.

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Chapter 09: Eating Answer Key 1. c 2. c 3. b 4. c 5. b 6. b 7. b 8. c 9. c 10. c 11. a 12. d 13. d 14. a 15. a 16. b 17. d 18. d 19. c 20. b 21. a 22. a 23. d 24. a 25. c Powered by Cognero

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Chapter 09: Eating 26. d 27. b 28. a 29. d 30. d 31. c 32. b 33. b 34. a 35. a 36. c 37. c 38. c 39. a 40. a 41. d 42. c 43. d 44. d 45. c 46. c 47. a 48. d 49. d 50. b 51. d Powered by Cognero

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Chapter 09: Eating 52. c 53. d 54. a 55. d 56. b 57. d 58. a 59. c 60. a 61. b 62. b 63. b 64. c 65. b 66. a 67. c 68. d 69. a 70. a 71. a 72. b 73. d 74. b 75. c 76. b Powered by Cognero

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Chapter 09: Eating 77. b 78. c 79. d 80. c 81. c 82. c 83. b 84. b 85. b 86. c 87. d 88. b 89. a 90. b 91. a 92. c 93. c 94. d 95. a 96. d 97. a 98. c 99. a 100. d 101. a 102. a Powered by Cognero

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Chapter 09: Eating 103. c 104. b 105. a 106. c 107. a 108. c 109. d 110. Student responses will vary.

111. Student responses will vary.

112. Student responses will vary.

113. Student responses will vary.

114. Student responses will vary.

115. Student responses will vary.

116. Student responses will vary.

117. Student responses will vary.

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Chapter 10: Sleeping

Indicate the answer choice that best completes the statement or answers the question.

1. What percentage of young adults are achieving the recommended number of hours of sleep a night? a. 65 percent b. 70 percent c. 75 percent d. 80 percent 2. How much sleep do people need each night? a. It depends on the individual and their age. b. They need under six hours. c. They need between seven and eight hours. d. They need more than eight hours.

3. Compared to people who sleep well, what are people who do not get enough sleep most likely to experience? a. more health problems and more frequent hospitalization b. a reduced number of hours of sleep per night in early adulthood and increases in hours of sleep in middle adulthood c. more physical health problems but average levels of productivity d. weight loss 4. Why are health problems arguably linked to sleep problems? a. the number of accidents increases substantially b. the loss of even a few hours of sleep reduces immune functioning c. the loss of sleep causes heart irregularities over time d. lack of sleep causes rapid weight loss 5. Sleep can be divided into which two broad states? a. slow-wave and long-wave sleep b. alpha and theta c. slow-wave and REM d. REM and rapid-wave sleep 6. Patricia has just been woken from sleep; however, she reported that she didn’t think she was asleep but was just “dozing and thinking.” Which stage of sleep was she likely in? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4 7. Raz just spent 10 hours asleep. How much of that time did they likely spend dreaming? a. 2 hours b. 3 hours c. 4 hours d. 5 hours Powered by Cognero

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Chapter 10: Sleeping 8. Typical sleepers spend how much of their time in deep sleep? a. 20 percent b. 30 percent c. 40 percent d. 50 percent 9. What type of sleep do we typically awaken from when we wake up in the morning? a. deep, slow-wave sleep b. REM sleep, during a dream c. Stage 2 sleep, where we were just dozing and thinking d. deep, slow-wave sleep, during a dream 10. What is the relationship between sleep problems and ADHD in children? a. Sleep problems cause behavioural symptoms in children with ADHD. b. ADHD symptoms keep children from dreaming during REM sleep. c. Very few children with ADHD experience sleep problems, but those that do seem to have more severe symptoms. d. Sleep problems are prevalent although the exact nature of these problems is unknown.

11. In which area of the brain do we see a mutual neurobiological connection with anxiety and dream sleep? a. prefrontal cortex b. pons c. limbic system d. HPA axis 12. Andreas’s therapist is suggesting therapy for his insufficient sleep and depression. What therapy is the therapist likely to suggest based on prior research? a. cognitive-behavioural therapy b. medication c. relaxation training d. sleep hygiene training 13. Professor Thompson is explaining how lack of sleep can contribute to obesity. In her explanation, she discusses that the release of a specific hormone because of poor sleep can ultimately lead to weight gain. What hormone is she referring to? a. growth hormone b. testosterone c. cortisol d. estrogen 14. In the study by Miller and colleagues (2002), what percentage of patients with schizophrenia reported sleep disturbances before the onset of their psychotic episode? a. 22 percent b. 37 percent Powered by Cognero

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Chapter 10: Sleeping c. 46 percent d. 62 percent 15. Which of the following sleep disorders is most accurately described? a. parasomnia—not getting enough REM sleep b. parasomnia—difficulties in getting enough sleep c. dyssomnia—sleepwalking and nightmares d. dyssomnia—difficulties in getting enough sleep 16. Jose reports not feeling refreshed and rested even though he has slept the whole night. What type of disorder might Jose have? a. primary insomnia b. some type of parasomnia c. a disorder not related to sleep d. some type of dyssomnia 17. How is the most comprehensive evaluation of sleep performed? a. by a polysomnographic evaluation b. by an electromyographic evaluation c. by an electroencephalographic evaluation d. by an actigraphic evaluation 18. While a patient sleeps, which of the following is NOT collected in the data of a polysomnographic evaluation? a. muscle movements b. respiration c. brain waves d. metabolic rate 19. Shara’s doctor is sending her home with a wristwatch-sized device to record her arm movements during sleep to determine the length and quality of her sleep. What assessment tool is her doctor using? a. a polysomnograph b. an electromyograph c. an electroencephalograph d. an actigraph 20. Your doctor wants to assess your sleep patterns and suggests a less-time consuming and less-costly assessment. What assessment are you likely to be given? a. a polysomnograph b. an electromyograph c. an electroencephalograph d. an actigraph 21. If a person spends 10 percent of time in bed awake, what is their sleep efficiency? a. 10 b. 40 Powered by Cognero

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Chapter 10: Sleeping c. 60 d. 90 22. How are sleep disorders diagnosed? a. according to the quantity of sleep versus the amount of sleep time the individual believes is desirable b. according to the quality and quantity of sleep and polysomnographic results c. according to the quality and quantity of sleep, as well as daytime sequelae d. according to the clinical experience of the clinician 23. When may a sleep problem be considered a disorder? a. when the individual is spending less than 50 percent of the time spent lying in bed actually being asleep b. when the individual experiences daytime fatigue c. when the sleep problems are accompanied by symptoms of depression and/or anxiety d. when the individual experiences anxiety and experiences daytime fatigue 24. What occurs after an individual goes without sleep for one or two nights? a. They start to hallucinate. b. They will experience microsleeps. c. They will be diagnosed with insomnia. d. A potential medical condition will be explored.

25. The term insomnia can apply to a number of complaints, which of the following is NOT one of those complaints? a. an individual who has difficulty initiating sleep b. an individual who has difficulty maintaining sleep c. an individual who sleeps all night but still feels like they have been awake for hours d. an individual who frequently sleepwalks 26. Which term refers to the very rare degenerative brain disorder that causes a total lack of sleep, eventually leading to death? a. primary insomnia b. atypical insomnia c. medical insomnia d. fatal familial insomnia 27. What does the term primary in the diagnosis of primary insomnia refer to? a. the fact that two co-occurring disorders are not present b. the fact that the sleep disorder is a major cause of other medical or psychiatric conditions that the individual is experiencing c. the fact that the sleep disturbance is not due to another medical or psychiatric condition d. the fact that the person has never been diagnosed with insomnia before 28. According to the Canadian Health Measures Survey (CHMS, 2014–2015) what percentage of Canadians experienced nighttime insomnia symptoms that lasted at least one year? a. 12 percent b. 24 percent Powered by Cognero

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Chapter 10: Sleeping c. 36 percent d. 53 percent 29. Which individual is least likely to experience insomnia? a. a male child b. a female teenager c. a female adult d. a male senior 30. How are alcohol and sleep related? a. Alcohol may help initiate sleep and enhance ongoing sleep, but it leads to addiction if used as a sleep aid. b. Alcohol may help initiate sleep, but it interrupts ongoing sleep and can cause a vicious cycle. c. Alcohol increases REM sleep. d. Alcohol increases total sleep time in an effective manner, but continued use produces tolerance, which negates this beneficial effect.

31. Carrie has insomnia and her doctor thinks that a biological factor is contributing to the problem. What might that biological factor be? a. higher body temperature b. low body weight c. percentage of body fat d. genetics 32. How many respondents in the 15- to 19-year-old age range reported losing sleep because of their social media use? a. approximately 10 percent b. approximately 25 percent c. approximately 50 percent d. approximately 75 percent 33. How does stress impact insomnia? a. It is one of the three strongest predictors of insomnia. b. Only high levels of stress are related to insomnia. c. It can increase insomnia but only for those who have been experiencing insomnia already. d. It only impacts ongoing sleep but has no relationship to falling asleep.

34. Research on the impact of the COVID-19 pandemic on sleep demonstrated an increase in use of sleeping medications by what percentage compared to pre-pandemic use? a. 4 percent b. 6 percent c. 8 percent d. 10 percent 35. Although many individuals reported an increase in sleep difficulties because of the COVID-19 pandemic, how many individuals reported a clinically meaningful improvement in their global sleep quality? a. 4 percent Powered by Cognero

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Chapter 10: Sleeping b. 6 percent c. 8 percent d. 10 percent 36. Studies of the impact of the COVID-19 pandemic on sleep have revealed that all EXCEPT which of the following factors were related to higher rates of insomnia? a. being male b. being a caregiver c. consuming large amounts of alcohol d. higher stress levels 37. People who have unrealistic expectations such as “I must sleep a full eight hours every night, or I will be unable to function” are more likely to experience insomnia. What does this example show might influence insomnia? a. cognition b. early learning c. self-fulfilling prophecy d. cultural norms 38. Which of the following is NOT typically included in the reciprocal model to explain how children’s sleep problems are produced and maintained? a. personality characteristics b. sleep difficulties c. parental reaction d. diet 39. Recent Canadian data suggests that many mothers frequently bed-share with their infant in their first year. What is the approximate percentage of mothers that engage in this behaviour? a. 25 percent b. 33 percent c. 50 percent d. 66 percent 40. Rose has been taking over-the-counter sleeping pills for several weeks because of the disrupted sleep patterns she experienced from frequent international travelling. When she stopped the medication, she experienced difficulty falling and staying asleep. What do we call this condition? a. primary hypersomnia b. primary insomnia c. primary dyssomnia d. rebound insomnia 41. Milner and Cote (2009) discuss the benefits that napping can have; which of the following was NOT discussed as one of these benefits? a. improved mood b. improved alertness c. improved cognitive performance Powered by Cognero

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Chapter 10: Sleeping d. improved sleep hygiene 42. Which of the following is NOT necessary to rule out before a clinician can diagnose hypersomnolence disorder? a. family history of similar sleep problems b. other reasons that would account for the symptoms c. insomnia d. sleep apnea 43. Although relatively little research has been done on the etiology of hypersomnolence disorder, a subgroup of individuals with the disorder have been exposed to a viral infection. Which of the following is NOT one of these viral infections discussed in the text? a. mononucleosis b. hepatitis c. viral pneumonia d. meningitis 44. Which of the following is NOT something people with narcolepsy commonly experience? a. cataplexy b. hypnagogic hallucinations c. hypersomnolence d. sleep paralysis 45. Omar has narcolepsy. In which of the following situations is he is most likely to experience cataplexy? a. when placed in a physical environment with little sun or light b. immediately upon waking up after a long, restful sleep c. while jumping up and cheering for his favourite team d. under hypnosis 46. While suddenly and unexpectedly falling asleep during normal waking hours, Sarah experiences vivid hallucinations of being in a horrible car crash. The experience is so realistic that she actually feels physical sensations as if the hallucination was real. What is Sarah’s most likely diagnosis? a. hypersomnia b. sleep apnea c. narcolepsy d. a psychotic disorder 47. Research shows that sleep paralysis and hypnagogic hallucinations may play a role in explaining UFO or alien abduction experiences. What percentage of intense UFO stories are associated with sleep episodes? a. 20 percent b. 40 percent c. 60 percent d. 80 percent 48. Research with Doberman pinschers and Labrador retrievers, who also inherit the disorder, has contributed to specific genetic models of which of the following?

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Chapter 10: Sleeping a. narcolepsy b. insomnia c. REM sleep disturbances d. sleep apnea 49. Simon sometimes wakes up feeling that there are other people in the room, but he is unable to move or say anything.

What is Simon most likely experiencing? a. sleep paralysis and hypnagogic hallucinations associated with narcolepsy b. hypnagogic hallucinations associated with hypersomnia c. cataplexy associated with narcolepsy d. sleep paralysis and hypnagogic hallucinations associated with hypersomnia 50. Which of the following is NOT a typical sign that someone may be experiencing breathing-related sleep problems? a. heavy sweating during the night b. morning headaches c. sleep attacks d. cataplexy 51. Which of the following is NOT one of the three types of sleep apnea? a. obstructive b. central c. cessation d. mixed 52. What characterizes obstructive sleep apnea? a. interruption of air flow without cessation of respiratory activity b. central nervous system disorders and trauma c. complete cessation of respiratory activity for brief periods d. interruption of air flow and brief cessation of respiratory activity 53. Which individual is most likely to be suffering from obstructive sleep apnea? a. Ming, a 32-year-old male who recently suffered head trauma in a car accident b. John, a 64-year-old overweight male c. Karen, a 64-year-old overweight female d. Harpreet, an 88-year-old female with cerebral vascular disease 54. As noted by Michael Antle (2005) at the University of Calgary, our internal clock is in which area of the brain? a. suprachiasmatic nucleus b. amygdala c. pons d. hippocampus 55. Our internal clock, the suprachiasmatic nucleus, is in which area of the brain? a. hypothalamus Powered by Cognero

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Chapter 10: Sleeping b. amygdala c. pons d. hippocampus 56. What is often is impacted when we shift to daylight savings time? a. REM sleep b. dreams c. circadian rhythm d. physical health 57. What are two factors that help regulate our natural sleep/wake cycles? a. light and psychological factors b. melatonin and light c. psychological factors and melatonin d. melatonin and serotonin 58. What does research suggest about crossing time zones and the likelihood of jet lag? a. Travelling more than two time zones westward usually affects people the most. b. Travelling less than three time zones westward is usually tolerated better. c. Travelling any number of time zones eastward is tolerated better than travelling westward. d. Travelling in either direction is not tolerated well.

59. Jack has always been the “early to bed and early to rise” type of person. Which type of circadian rhythm does he demonstrate? a. premature sleep phase b. delayed sleep phase c. advanced sleep phase d. average sleep phase pattern 60. Which hormone has been nicknamed the Dracula hormone? a. melatonin b. cortisol c. insulin d. testosterone 61. According to a study by Morin and colleagues (2011), what was the estimated number of Canadians that had used prescribed medications to help them sleep? a. 5 percent b. 10 percent c. 15 percent d. 20 percent 62. A case study reports that a client reporting insomnia had a fall after taking their medication. You predict that the person in the case study was older based on the prescription the person was given. What was that prescription most likely to be?

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Chapter 10: Sleeping a. benzodiazepine b. nonmedical treatment c. stimulant d. antidepressant 63. Which statement does NOT accurately explain a drawback of medical treatment for insomnia? a. Benzodiazepine medications can actually cause insomnia. b. People can easily become dependent on them and misuse them. c. The medications are meant only for short-term use. d. They may increase the likelihood of sleepwalking-related problems.

64. Why are antidepressant medications sometimes used to treat cataplexy associated with narcolepsy? a. Antidepressant medications promote progressive muscle relaxation. b. These medications suppress REM sleep. c. The anti-anxiety properties of these medications reduce narcolepsy. d. Narcolepsy is often caused by depression.

65. What is often prescribed to treat hypersomnolence or narcolepsy? a. benzodiazepines b. nonmedical treatments c. stimulants d. antidepressants 66. In addition to medication and mechanical devices, what other medical treatment is used for severe sleep apnea? a. surgery b. progressive relaxation c. changes in the patient’s sleep schedule d. exercise of the neck muscles 67. Which treatment is described as the gold standard for treating obstructive sleep apnea? a. surgery b. progressive relaxation c. tricyclic antidepressants d. a continuous positive air pressure (CPAP) machine 68. When attempting to reset the physical clock of an individual with a circadian rhythm sleep disorder, what is it generally best to do? a. Keep the person awake for several days in a row. b. Leave the patient’s bedtime alone and change the duration of sleep. c. Make the patient’s bedtime earlier. d. Make the patient’s bedtime later.

69. Which of the following is a general principle for treating circadian rhythm disorders? a. Sleeping for a few days can rest the internal clock.

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Chapter 10: Sleeping b. Medication is best for long-term use. c. Phase delays are easier than phase advances. d. Phase advances are easier than phase delays.

70. Bright light treatment for sleep disorders falls under which treatment approach? a. medical b. environmental c. psychological d. time-based 71. According to Palermo and Sharkey (2021), what is a newer treatment that may help people with circadian rhythm problems readjust their sleep patterns? a. bright light b. Ritalin c. Ambien d. phase changes 72. Research by Viens and colleagues (2003) comparing progressive relaxation and anxiety management training for treating insomnia found which of the following? a. The two treatments were equally effective. b. As anxiety is highly connected to insomnia, only anxiety management was shown to be effective. c. Progressive relaxation resulted in falling asleep quicker, but anxiety management training was linked to staying asleep. d. Both treatments increased slow-wave sleep but had no impact on sleep satisfaction.

73. Jones is undergoing therapy for his sleep disorder. During therapy, he is instructed to lie in bed and try to stay awake for as long as he can. Which type of therapy would employ this strategy? a. cognitive relaxation b. graduated extinction c. paradoxical intention d. progressive relaxation 74. What might a sleep expert discussing stimulus control recommend for better sleep? a. learning as much as possible about all the various sleep disorders b. spending a bit of time thinking about sleep before going to bed c. using the bed for sleep and sex only d. rewarding yourself every time you sleep the recommended number of hours the previous night 75. What does the term stimulus control refer to when discussing sleep? a. using the bedroom only for sleeping and for sex b. keeping noise to a minimum during the sleeping hours c. quietly listening to the radio while trying to fall asleep d. decorating the bedroom in neutral shades and a minimum of furniture 76. Which type of treatment has the best long-term success for treating sleep disorders in older adults?

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Chapter 10: Sleeping a. medical treatment b. medical combined with psychological treatments c. psychological treatments d. self-help treatments 77. What type of therapy would seven-year-old Jaxon most likely receive for treatment of his tantrums at bedtime and constant waking during the night? a. cognitive relaxation b. graduated extinction c. paradoxical intention d. progressive relaxation 78. What does sleep hygiene refer to? a. lifestyle behaviours that facilitate or interfere with sleep b. the purity of a person’s melatonin level c. the effects of the physical environment of the bedroom on sleep d. the use of medications to induce sleep 79. What did the research by Adachi and colleagues (2009) show in relation to the value of educating parents about the sleep of their young children? a. Children whose parents received education about sleep experienced few sleep problems. b. Children need to be at least six to show benefits of sleep education. c. Education can be effective if multiple follow-ups occur to ensure the parents retain the information. d. There was no real effect because the sleep-deprived parents were unable to retain the information.

80. What do we call events such as nightmares, sleep terrors, and sleepwalking that occur during sleep or during the twilight time between sleep and waking? a. REM disorders b. catalepsy c. parasomnias d. dyssomnias 81. Jessie constantly grinds their teeth at night and their doctor is concerned they might be experiencing a sleep problem.

What might their doctor suggest Jessie is dealing with? a. a REM disorder b. catalepsy c. a parasomnia d. a dyssomnia 82. What is the difference between a bad dream and a nightmare? a. Bad dreams occur in REM and nightmares occur in NREM sleep. b. Nightmares awaken the sleeper, bad dreams do not. c. There is no difference between the two; they are different terms to describe the same experience. d. Nightmares are a dyssomnia while bad dreams are parasomnias.

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Chapter 10: Sleeping 83. A patient has been consistently been experiencing nightmares and is trying to uncover why these are occurring. Which of the following would NOT be explored as a common reason for nightmares? a. trauma b. medication use c. genetics d. food consumed during the day 84. Children sometimes experience intense episodes of sitting up during deep sleep, appearing frightened, showing signs of extreme arousal, talking, thrashing wildly, and then remembering nothing of the episode the next morning. What do such episodes indicate? a. sleepwalking b. sleep terrors c. REM disorders d. nightmare disorder 85. When do sleep terrors and sleepwalking generally occur? a. during NREM sleep b. during twilight stages between sleep and waking c. during REM sleep d. after some severe daytime stressor 86. Joa is a six-year-old child who cries out in the middle of the night, appearing frightened and inconsolable. Her parents are unable to comfort her during these episodes, and Joan has no memory of the event in the morning. What does Joa appear to be experiencing? a. temporary amnesia b. dyssomnia c. sleep terrors d. nightmares 87. In a stepped approach to treating sleep terrors, which of the following would be the first step? a. wait to see if they disappear on their own b. antidepressants c. stimulus control d. progressive relaxation 88. What is one approach to successfully reducing the frequency of sleep terrors? a. Make sure that the child is very tired before going to bed. b. Wake the child during the attack. c. Make sure the child does not eat one hour before bedtime; diet matters. d. Use scheduled awakenings to briefly awaken the child before an attack occurs.

89. Which of the following does NOT characterize sleepwalking? a. occurrence primarily in children b. no memory of the sleepwalking event c. occurrence during the deepest stage of sleep Powered by Cognero

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Chapter 10: Sleeping d. acting out a dream 90. What is another term for somnambulism? a. sleep terrors b. sleepwalking c. nightmare d. parasomnia 91. When does sleepwalking most often occur? a. during the deepest stages of sleep. b. during REM sleep c. at any point d. typically from 1 a.m. to 3 a.m.

92. Out of 100 school-age children, how many would you expect to experience sleepwalking? a. 10 b. 25 c. 40 d. 50 93. What did Kenneth Parks use as a defense in his trial for killing his mother-in-law and attempting to kill his father-inlaw? a. sleep terrors b. sleepwalking c. dyssomnia d. parasomnia 94. Which of the following has NOT been implicated as a factor that may cause sleepwalking? a. extreme fatigue b. stress c. sedative or hypnotic drugs d. amphetamines 95. Which of the following is NOT a parasomnia? a. nocturnal eating syndrome b. sexsomnia c. somnambulism d. hypopnea syndrome 96. What is the main difference between NREM disorders and REM sleep behaviour disorder? a. The only difference is the timing of the behaviours, specifically REM or NREM stages. b. With REM sleep behaviour disorder, the individual is not confused or anxious when awakened. c. In NREM sleep disorders the individual talks or moves while sleeping, which does not occur in REM sleep behaviour disorder. d. NREM disorders occur only in children.

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Chapter 10: Sleeping

97. Compare and contrast parasomnia and dyssomnia. Provide one example of each disorder along with a suggested treatment for each example.

98. Anxiety and primary insomnia often co-exist in a “chicken and egg” cycle, where it seems impossible to determine whether the anxiety is causing the sleep disorder or whether the sleep disorder is causing the anxiety. Describe the process of how anxiety and primary insomnia might interact within a patient. Why would it be difficult to determine which came first?

99. Describe the narcolepsy-related phenomena of sleep paralysis and hypnagogic hallucinations. Discuss their possible relationship to UFO experiences.

100. Describe the problems associated with using medications such as benzodiazepines as a treatment for primary insomnia.

101. Describe the psychological treatments that are generally used for the treatment of primary insomnia.

102. What are the differences between nightmares and sleep terrors? Describe what we know about sleep terrors, including the age at which they generally occur and how they have been treated.

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Chapter 10: Sleeping Answer Key 1. a 2. a 3. a 4. b 5. c 6. b 7. b 8. a 9. b 10. d 11. c 12. a 13. c 14. b 15. d 16. d 17. a 18. d 19. d 20. d 21. d 22. c 23. d 24. b 25. d Powered by Cognero

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Chapter 10: Sleeping 26. d 27. c 28. b 29. a 30. b 31. a 32. c 33. a 34. c 35. b 36. a 37. a 38. d 39. b 40. d 41. d 42. a 43. d 44. c 45. c 46. c 47. c 48. a 49. a 50. d 51. c Powered by Cognero

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Chapter 10: Sleeping 52. a 53. b 54. a 55. a 56. c 57. b 58. b 59. c 60. a 61. b 62. a 63. a 64. b 65. c 66. a 67. d 68. d 69. c 70. b 71. a 72. a 73. c 74. c 75. a 76. c Powered by Cognero

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Chapter 10: Sleeping 77. b 78. a 79. a 80. c 81. c 82. b 83. d 84. b 85. a 86. c 87. a 88. d 89. d 90. b 91. a 92. a 93. b 94. d 95. d 96. b 97. Student responses will vary.

98. Student responses will vary.

99. Student responses will vary.

100. Student responses will vary.

101. Student responses will vary.

102. Student responses will vary.

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Chapter 10: Sleeping

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Chapter 11: Sex and Gender

Indicate the answer choice that best completes the statement or answers the question.

1. According to the Global Study of Sexual Attitudes and Behaviors, how many Canadian men and women experience sexual dysfunction? a. 18 percent and 28 percent, respectively b. 24 percent and 16 percent, respectively c. 39 percent and 45 percent, respectively d. 41 percent and 33 percent, respectively 2. Dr. Mukherjee teaches a class with 100 adult women in it. About how many women in the class are likely to have some sort of sexual dysfunction? a. 10 b. 16 c. 24 d. 28 3. Which stage of the sexual response is NOT associated with specific sexual dysfunctions? a. desire b. arousal c. plateau d. orgasm 4. Which statement best describes sexual dysfunction? a. Sexual dysfunction is more common in other-sex than same-sex relationships. b. Males and females experience parallel versions of all sexual dysfunction disorders. c. Sexual dysfunction is one of the rarest of all psychological or physical disorders. d. Sexual dysfunction can be either lifelong or acquired.

5. Although Maria fantasizes about sex and has no lack of sexual desire, when she and her husband attempt to have intercourse, she has difficulty becoming vaginally lubricated. This has been a persistent problem for several months now.

What problem does Maria appear to have? a. female sexual interest/arousal disorder b. female orgasmic disorder c. vaginismus d. genito-pelvic pain/penetration disorder 6. David has no interest in sex at all. He has no sexual fantasies and no desire to engage in sexual activity. While he does not find sex disgusting or revolting, he does not understand what others find so exciting about it. He feels just fine remaining celibate. What best describes David? a. David is experiencing male orgasmic disorder b. David may have male hypoactive sexual disorder c. David is asexual d. David has sexual aversion disorder 7. Which individual is most likely to have a hypoactive sexual desire disorder?

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Chapter 11: Sex and Gender a. a 30-year-old female b. a 40-year-old male c. a 60-year-old female d. a 65-year-old male 8. What happens to the prevalence of hypoactive sexual desire disorder with age? a. For men, it stays the same; for women, it decreases. b. For men, it increases; for women, it decreases. c. For men, it increases; for women, it stays the same. d. For men, it increases; for women, it increases.

9. What is NOT typically reported with hypoactive sexual desire disorder? a. The person rarely has sexual fantasies. b. The person seldom masturbates. c. The person attempts intercourse once a month or less. d. The person is disgusted at the thought of sex.

10. Approximately how many people visit sexuality clinics because of low sexual arousal or interest? a. 10 percent b. 25 percent c. 50 percent d. 70 percent 11. How does asexuality differ from low sexual desire? a. They are synonyms. b. Asexuality does not cause distress or impairment. c. Asexuality is generalized and low sexual desire is situational. d. Asexuality is mild whereas low sexual desire is considered severe.

12. Jeff has just sought professional help for a sexual problem. Based on what is most prevalent in society today, what problem did Jeff most likely report? a. an orgasm problem b. erectile dysfunction c. a pain problem d. a paraphilia-related problem 13. When are sexual arousal disorders most likely to be diagnosed? a. when there is a lack of desire for sex in either men or women b. when there is an inability to achieve or maintain an erection in males and a lack of desire for sex in females c. when there is clinically significant distress in the individual d. when there is an inability to achieve or maintain an erection in males and a lack of orgasm in females 14. Although Anwar constantly fantasizes about having sex with his wife, when he actually attempts intercourse, he cannot maintain an erection. This has been a persistent problem for several months now. What problem does Anwar appear to have?

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Chapter 11: Sex and Gender a. male orgasmic disorder b. male hypoactive sexual desire c. premature ejaculation d. erectile disorder 15. What is the common outcome of occasional sexual dysfunction in married couples? a. It does not necessarily lead to sexual dissatisfaction. b. It is extremely stressful for any marriage. c. It is a normal though stressful part of every marriage. d. It is the greatest single cause of marital discord.

16. What is the approximate prevalence of erectile dysfunction in Canadian men? a. 1 percent b. 3 percent c. 7 percent d. 11 percent 17. A therapist is thinking about holding a seminar about erectile dysfunction at an adult living centre. There are 200 men over 70 who use this facility. How many men could this therapist expect would be affected by erectile dysfunction? a. 80 b. 100 c. 140 d. 180 18. Basson and Brotto (2004) suggest that the current definition of female arousal disorder focuses too much on “genital events” and not enough on subjective arousal. Which statement summarizes their argument? a. Many women do not consider absence of physical arousal to be a problem. b. The DSM-5’s emphasis on genital events reflects a male bias. c. Most women who meet the criteria for female arousal disorder are nevertheless able to reach orgasm during intercourse. d. Studies have shown that women with arousal disorder often show normal vaginal response to erotic movies despite reporting low subjective arousal.

19. What is the most common complaint among females who seek therapy for sexual problems? a. inability to reach orgasm b. sexual desire difficulties c. sexual arousal difficulties d. lubrication issues 20. According to the Global Study of Sexual Attitudes and Behaviors, what percentage of Canadian females report a sexual dysfunction involving an inability to achieve orgasm? a. 5 percent b. 11 percent c. 20 percent d. 25 percent Powered by Cognero

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Chapter 11: Sex and Gender 21. Approximately what percentage of women do not achieve orgasm with every sexual encounter? a. 35 percent b. 50 percent c. 75 percent d. 90 percent 22. In diagnosing orgasm disorder in women, why is it necessary to determine whether the woman never or almost never reaches orgasm? a. Only 50 percent of all women regularly experience orgasm from intercourse. b. Female orgasm difficulties are usually due to an inexperienced partner. c. It would be a different orgasm disorder if the problem is only occasional. d. Most women regularly experience orgasms from intercourse.

23. Sandra and Jim have been happily married for several years. Sandra reports that she reaches orgasm from intercourse only about half of the time and she wonders if something is “wrong” with her. What should Sandra do? a. She should realize that this is normal. b. She should have a medical exam before assuming that she has a diagnosable psychological disorder. c. She should seek counselling regarding her feelings for Jim to try to understand why she does not reach orgasm more regularly. d. She should seek treatment for inhibited orgasm disorder.

24. Oliver can ejaculate while masturbating but not with a partner. What disorder do they likely have? a. male orgasmic disorder b. male hypoactive sexual desire disorder c. premature (early) ejaculatory d. retrograde ejaculation 25. What is the most common of all the male sexual dysfunctions? a. male orgasmic disorder b. erectile dysfunction c. premature (early) ejaculation d. male hypoactive sexual desire disorder 26. One reason that it is difficult to provide a precise diagnosis of premature ejaculation is that the concept of “too soon” varies across individuals. What does the text suggest that the more important psychological determinant of this complaint may be? a. a perception of lack of control over orgasm b. whether the individual is aware of what is a typical amount of time c. whether the individual’s partner is sexually satisfied d. cultural differences in expectations 27. Winston is having difficulties with his sex life because he climaxes as soon as he enters his partner. Sometimes he climaxes even before he enters his partner. What is Winston experiencing? a. erectile disorder Powered by Cognero

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Chapter 11: Sex and Gender b. premature (early) ejaculation c. male hypoactive sexual desire disorder d. male orgasmic disorder 28. According to the DSM-5-TR, what is the duration that defines premature? a. approximately one minute or less b. approximately two minutes or less c. approximately three minutes or less d. approximately four minutes or less 29. The work of Grenier and Byers (2001) suggests that self-identifying with premature ejaculation has three components.

Which of the following was NOT one of these components? a. behavioural component b. emotional component c. psychological component d. efficiency component 30. Which of the following sexual disorders are gender specific? a. vaginismus and sexual arousal disorder b. hypoactive sexual desire disorder and erectile dysfunction c. genito-pelvic pain/penetration disorder and premature ejaculation d. orgasmic disorder and premature ejaculation 31. How many women would be expected to have pain during sexual intercourse during the past 12 months? a. approximately one in five b. approximately one in six c. approximately one in nine d. approximately one in ten 32. Which of the following is NOT described under the sexual pain disorder category? a. vulvodynia b. genito-pelvic pain/penetration disorder c. vaginismus d. retrograde ejaculation 33. Which type of sexual pain is related to pelvic muscle tension? a. erectile dysfunction b. retrograde ejaculation c. vaginismus d. sexual arousal disorder 34. Amaya is convinced she has a sexual pain disorder. Before providing a diagnosis, her doctor must rule out other factors. Which of the following is NOT one of these factors? a. other sexual dysfunctions, such as sexual aversion disorder, which has almost identical symptoms b. relationship issues that could be the cause of the dysfunction Powered by Cognero

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Chapter 11: Sex and Gender c. a medical cause of the pain d. anxiety 35. Dr. Muntz studies sexual behaviour. She gathers much of her data from questionnaires. Why does she use this method? a. They are less expensive than a clinical interview. b. There are so many aspects to sexuality that it is easier to keep all the information organized if a questionnaire is used. c. More sexual therapists are also conducting research and the questionnaires help with the research. d. Individuals may volunteer information when answering a questionnaire in writing that they are not ready to talk about.

36. Both Alex and Phyllis are seeing clinicians for the assessment and treatment of sexual arousal disorders. How is it likely that their sexual responsivity will be assessed? a. through interviews with their partners as well as subjective self-reports b. through the use of psychophysiological measurements c. through the use of psychophysiological measurements and subjective self-reports d. through the use of self-reports 37. How are psychophysiological assessments of sexual dysfunction generally conducted? a. by using a device to measure a patient’s physical arousal while exposed to an erotic video or audio tape b. by asking patients to keep a diary of their sexual activities c. by using a device to measure a patient’s brain waves while exposed to an erotic video or audio tape d. by a physician during a medical exam 38. What are the penile strain gauge and the vaginal photoplethysmograph used to measure? a. physical arousal b. strength c. pain responses d. hormone levels 39. In physically healthy men, in which phase of sleep do erections most often occur in? a. stage 1 b. stage 3 c. stage 4 d. REM 40. Which of the following is an inexpensive but crude way to monitor nocturnal erections? a. photoplethysmograph b. nocturnal penile tumescence c. snap gauge d. penile strain gauge 41. Enzo went to the doctor complaining of erectile dysfunction. A subsequent sleep study found that Enzo does not have penile erections while sleeping. What can be concluded by Enzo’s doctor?

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Chapter 11: Sex and Gender a. The erectile dysfunction is not simply the result of worrying about sexual performance while in a sexual setting b. A side effect of a prescribed medication is the cause of the erectile dysfunction. c. The erectile dysfunction is caused by a medical problem. d. A psychological difficulty may be the cause of the erectile dysfunction.

42. What is a major biological contribution to the development of sexual dysfunctions? a. endocrine deficiencies b. neurological diseases c. anxiety d. androgen deficiencies 43. Frank is upset because he thinks he may have more than one sexual dysfunction and he thinks that this makes his case very unusual. How is Frank’s doctor likely to respond to Frank’s concern? a. It is difficult to know because patients are reluctant to report more than one problem because of the stigma they feel. b. It is difficult to answer because some symptoms of sexual dysfunction are caused by medication but are, in fact, not true sexual dysfunctions. c. Seldom does one sexual dysfunction present in isolation. d. He is right; it is very uncommon but each condition can still most likely be treated.

44. How can chronic illness indirectly affect sexual functioning? a. by causing fatigue, which then contributes to lack of sexual desire b. by separating sexual partners when one is hospitalized c. by making individuals overly cautious about the physical exertion involved in sexual activity d. by gradually creating an emotional distance between the sexual partners, which in turn, lessens sexual desire 45. Mario has erectile dysfunction. Which medical conditions should be screened for in relation to his erectile dysfunction? a. vascular disease and depression b. vascular disease and diabetes c. arthritis and diabetes d. depression and diabetes 46. Which medication causes some degree of sexual dysfunction in up to 80 percent of individuals taking them? a. beta blockers b. anti-hypertensives c. tricyclic antidepressants d. SSRIs 47. Which recreational drug has been shown to produce widespread sexual dysfunction in more than 60 percent of users? a. cocaine b. MDMA c. marijuana d. psilocybin Powered by Cognero

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Chapter 11: Sex and Gender 48. What is the relationship between alcohol and sexual arousal? a. At low and moderate levels, alcohol reduces social inhibitions, so people feel more like having sex. b. Alcohol can facilitate sexual arousal by acting as a nervous system stimulant. c. Alcohol may increase testosterone levels long term in individuals who present with low levels. d. Alcohol increases sexual desire by increasing serotonin levels in the brain.

49. What has been suggested about the effects of marijuana on sexual pleasure? a. It is unlikely that the chemical effects increase pleasure. b. There is no impact of marijuana on sexual pleasure. c. Marijuana enhances sexual pleasure. d. Marijuana decreases the likelihood of sexual dysfunction.

50. Kelly and Leo have been having some sexual difficulties lately. Both have experienced some symptoms of sexual arousal disorders. They decide to have a few glasses of wine before engaging in sex tonight. How would you rate this idea? a. It is a bad idea, as it could further impair arousal. b. It is a bad idea, as it tends to decrease desire. c. It is a good idea, as it could help performance. d. It is a good idea, as it could help desire.

51. What does our current understanding of the psychological causes of sexual dysfunction suggest is the primary psychological factor in sexual dysfunction? a. unreasonable expectations b. performance anxiety c. suppressed anger d. distraction 52. Which of the following is NOT a component of the psychological concept of performance anxiety? a. arousal b. cognitive processes c. distraction d. negative affect 53. How can psychological factors, particularly cognitive and emotional factors, play a powerful role in sexual arousal? a. by decreasing levels of androgen in males and estrogen in females b. by determining whether blood flows to the appropriate areas of the body, such as the genitals c. by lowering the threshold for ejaculation d. by suppressing the central nervous system 54. Noah often has problems with premature (early) ejaculation. As he becomes more anxious about his problem, what will most likely happen to the amount of time between initiating intercourse and ejaculation? a. It will decrease. b. It will increase. c. It will depend upon what is making him anxious.

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Chapter 11: Sex and Gender d. It will depend upon what is causing the premature ejaculation in the first place.

55. Tori has erotophobia. What does this mean for Tori? a. She has a fear of emotional intimacy. b. She has negative and threatening feelings toward sexuality. c. She has reoccurring thoughts of being raped. d. She experiences vomiting sensations when she thinks about physical contact.

56. According to Laumann and colleagues (1999), what is one of the most important factors in predicting later sexual functioning? a. attachment in childhood b. pre-existing anxiety c. early traumatic sexual events d. cognitions surrounding sexual intimacy 57. How do sexual dysfunctions compare across cultures? a. Sexual dysfunctions in women are common across all cultures; sexual dysfunctions in men are more culture specific. b. Sexual dysfunctions of arousal are common across all cultures; sexual dysfunctions of performance are culture specific. c. Sexual dysfunctions are more likely in cultures with restrictive attitudes toward sex. d. Sexual dysfunctions reflect moral disapproval of a given culture.

58. According to research by Brotto and colleagues, what is one cultural difference between Euro-Canadian women and Asian women regarding sexual attitudes? a. Asian women have more sexual knowledge. b. Asian women have more sexual experiences. c. Asian women have higher rates of desire. d. Asian women have greater sexual anxiety.

59. Dr. Lee is a health care provider who works with a community that has very conservative views about sexual behaviour. Which disorder will Dr. Lee see more often among this group than in a less conservative community? a. vaginismus b. asexuality c. premature ejaculation. d. fetishistic disorder 60. Which group of men is most likely to believe common sexual myths, such as “good sex requires orgasm”? a. men who do not have sexual disorders b. men with conservative sexual attitudes c. men who are gay d. men who have sexual disorders 61. Tom thinks he shows his love and worthiness as a sex partner by working hard at the office and keeping the house in good repair. His wife Maria can’t feel sexy unless he woos her with gifts and loving words. According to theorist John Powered by Cognero

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Chapter 11: Sex and Gender Gagnon, in what way do Tom and Maria differ? a. in their cognitive structuring b. in their irrational beliefs c. in their texts d. in their scripts 62. How does the interaction of psychological and physical factors unfold with the typical development of sexual dysfunction? a. Initial dysfunction may be triggered by an event such as substance use; concern about the dysfunction then leads to more dysfunction, and sex itself becomes associated with negative feelings. b. A general medical condition triggers the first dysfunction, which is followed by increased anxiety; as the anxiety increases, the sexual dysfunction becomes more severe over time and causes loss of interest in sex. c. Initial dysfunction may be triggered by an event such as substance use; this causes a strain on the relationship and reduces the intimacy in the relationship, which then leads to anxiety about one’s desirability. d. Initial dysfunction occurs through slow and gradual deterioration, possibly due to a medical condition; as the medical condition develops, the individual’s concern with failing sexuality increases, resulting in relationship problems.

63. What is one of the most effective treatments for many sexual dysfunctions? a. masturbatory training and exposure to erotic material b. anti-anxiety medication c. education regarding the sexual response cycle d. improvements in the relationship with the patient’s partner 64. Sensate focus and nondemand pleasuring were designed by Masters and Johnson (1970) to treat sexual dysfunctions.

How did these techniques work? a. primarily through increasing sexual desire and decreasing sexual performance b. primarily through elimination of psychologically based performance anxiety c. primarily through creating suspense and excitement in the sexual experience d. primarily through improving a couple’s sexual skills 65. Masters and Johnson (1970) used sensate focus therapy for the treatment of premature ejaculation. In what percentage of cases did Masters and Johnson claim this therapy was effective? a. 50 b. 65 c. 75 d. almost 100 66. Lea and Manon have started sex therapy to deal with Manon’s recent erectile dysfunction. The therapist instructed them to refrain from intercourse or genital touching but to spend the next several days enjoying each other through hugging, kissing, and mutual massage. What is this an example of? a. an erotic body awareness technique b. disinhibition exercises c. foreplay exercises d. stage one of sensate focus treatment Powered by Cognero

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Chapter 11: Sex and Gender 67. Stage two of sensate focus involves genital pleasuring but prohibits intercourse or orgasm. What is the main purpose of this stage? a. to provide increased anticipation of intercourse b. to re-establish arousal c. to provide a break from the “usual” way that the couple has sex d. to allow each individual to communicate their desires to their partner 68. Fred and Diane have just completed stage two of sensate focus therapy. What are they instructed to do following this stage? a. Return to full, prior sexual activity. b. Take a break from sexual activity for several weeks and then slowly return to typical sexuality. c. Begin the “genital pleasuring” stage of the treatment. d. Slowly begin sexual activity.

69. In Masters and Johnson’s (1970) therapy for lifelong generalized erectile dysfunction, approximately what percentage of cases did they claim to have a positive treatment outcome? a. 25 percent b. 45 percent c. 60 percent d. 85 percent 70. What is involved in the sex therapy technique designed specifically to treat premature ejaculation? a. the squeeze technique b. sensate focus c. directed imagery and relaxation exercises d. nondemand pleasuring 71. Roderick and his partner are seeking treatment for Roderick’s premature ejaculation. The therapist encourages the couple to stimulate Roderick’s penis to nearly full erection and then to compress the penis firmly to quickly reduce arousal. After repeating this process, insertion is to be attempted without thrusting, and the penis withdrawn if arousal proceeds too quickly. What is this treatment called? a. erotic desensitization b. stimulus removal c. the squeeze technique d. retrograde ejaculation 72. What treatment is found to be most effective in the treatment of female orgasmic disorder? a. directed imagery and relaxation exercises b. the regular use of vibrators c. explicit training in masturbatory procedures d. sensate focus 73. Sarah was sent home from sex therapy with an assignment to purchase a vibrator and practise masturbating. What disorder is Sarah most likely being treated for? a. female orgasmic disorder Powered by Cognero

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Chapter 11: Sex and Gender b. vaginismus c. hypoactive sexual desire disorder d. clitoral dysfunction 74. What percentage of women with female orgasmic disorder is estimated to benefit from some form of treatment? a. 10 to 30 percent b. 30 to 50 percent c. 50 to 70 percent d. 70 to 90 percent 75. What are dilators of gradually increasing sizes used for? a. the treatment of hyperactive sexual desire disorder b. the treatment of genito-pelvic pain/penetration disorder c. the treatment of female orgasmic disorder d. the treatment of hypoactive sexual desire disorder 76. Reissing and colleagues (1999) have been critical of the focus on the achievement of penile–vaginal intercourse as the sole indicator of sex therapy “success.” What do they argue that additional outcomes should include? a. whether the couple is experiencing greater sexual satisfaction b. improvement of sexual skills c. whether the original relationship problems have been resolved d. increasing the length of time spent by the couple in foreplay 77. In the subtype of vaginismus for which cognitive-behavioural techniques are used, what is thought to be at the core? a. phobia of penetration b. chronic pain c. interpersonal issues d. performance anxiety 78. Brotto and colleagues are showing some success in treating low sexual desire or genital pain with which treatment? a. mindfulness intervention b. sexual skill training c. cognitive therapy d. medication 79. How do drugs used to treat erectile dysfunction work? a. by inhibiting PDE-5 b. by increasing testosterone c. by decreasing estrogen d. by decreasing GABA related to performance anxiety 80. Which hormone has preliminary evidence that it may alleviate hypoactive sexual desire in women? a. cortisol b. testosterone Powered by Cognero

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Chapter 11: Sex and Gender c. estrogen d. progesterone 81. Vasodilating drugs such as papaverine and prostaglandin are used in the treatment of erectile dysfunction. How are these drugs delivered to the patient? a. by injection into the arm or hip b. by injection directly into the penis c. in a capsule taken orally d. as a dietary supplement 82. Although vasodilating drugs, such as papaverine and prostaglandin, are effective in producing an erection for patients with erectile dysfunction, about 50 to 60 percent of patients discontinue using these drugs. Why do they usually discontinue use? a. because of the expense of the drug b. because they become more confident about their sexual abilities c. because of painful side effects d. because the effectiveness of the drug decreases with continued use 83. What has proven useful for individuals who have had their cancerous prostrate removed? a. Viagra b. Cialis c. vasoactive substances d. penile prostheses 84. Ahmed has been undergoing prostate cancer treatment and is experiencing erectile dysfunction. As a first line of treatment, what might his doctor recommend? a. Viagra b. vasodilating drugs c. penile prosthesis d. vacuum device therapy 85. Which term refers to a group of disorders in which sexual arousal occurs in the context of atypical objects? a. paraphilic disorders b. gender dysphoria c. transvestic fetishism d. sexual dysfunction 86. What is a paraphilia? a. a sexual attraction to a wide variety of atypical stimuli b. an atypical sexual fantasy c. an unusually high level of sexual activity d. a long-standing and persistent sexual attraction to an atypical target 87. What is required for a paraphilia to be considered disordered? a. a sexual attraction to a wide variety of atypical stimuli Powered by Cognero

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Chapter 11: Sex and Gender b. an atypical sexual fantasy c. an unusually high level of sexual activity d. distress and impairment or harm or the threat of harm to others 88. Felix likes to take the subway during very busy times with the goal of touching and rubbing himself against nonconsenting individuals. What would a psychologist say about this behaviour? a. He likely has exhibitionistic disorder. b. He likely has frotteuristic disorder. c. He likely has voyeuristic disorder. d. He is demonstrating pedophilic behaviours.

89. What is a fetish? a. a sexual desire that dominates the personality b. a sexual dysfunction c. a sexual attraction to nonliving objects or nongenital body parts d. a sexual attraction to inappropriate individuals 90. Charles gets very sexually excited by women’s shoes. While he used to fantasize about women wearing particular shoes, he now focuses almost exclusively on the shoes themselves. What does Charles likely have? a. sexual arousal disorder b. a frotteuristic obsession c. an unusual interest but not a diagnosable disorder d. fetishistic disorder 91. Sven’s fetish can also be referred to as partialism. Based on this information, what is the source of attraction? a. an inanimate object b. a source of specific tactile stimulation c. a part of the body d. women-specific items 92. Greg and Diana often begin their sexual activity with Greg putting on a striptease show for Diana. Greg says that he gets aroused by exposing himself, and Diana reports getting aroused when she watches him undress. What would a sex therapist say about Greg and Diana? a. Neither Greg nor Diana should be diagnosed with a fetish because these behaviours do not cause clinical distress. b. Greg is an exhibitionist, and Diana is a voyeur. c. Greg is a voyeur, and Diana is an exhibitionist. d. Both Diana and Greg have nonspecific fetishes because they admit to getting sexually excited by their atypical behaviours.

93. Last Friday, Lukas became intoxicated and exposed himself to a stranger. He became sexually aroused by this situation but has not engaged in this behaviour since. What would a clinician likely say about Lukas? a. Lukas has a sexual arousal disorder b. Lukas has exhibitionistic disorder c. Lukas’s behaviour was problematic but not a diagnosable disorder Powered by Cognero

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Chapter 11: Sex and Gender d. Lukas has a fetishistic disorder 94. According to Docter and Prince (1997), what percentage of men presenting with transvestic disorder were married? a. 10 percent b. 25 percent c. 50 percent d. 60 percent 95. Jonas is sexually aroused by thoughts and images of himself as female. What specifier of transvestic disorder would Jonas be given? a. fetishism b. gender dysphoria c. autogynephilia d. voyeurism 96. Zach and Pam become sexually excited only when Pam spanks Zach or ties him up and hits him. However, these acts are more pretend than real, and no actual harm or pain is inflicted on Zach. Which of the following is the correct diagnostic pairing? a. Pam—no diagnosis; Zach—masochist b. Pam—sadist; Zach—masochist c. Pam—no diagnosis; Zach—no diagnosis d. Pam—masochist; Zach—sadist 97. What is the goal of autoerotic asphyxia? a. to reduce the flow of oxygen to the brain and enhance the sensation of orgasm b. to achieve pleasure out of the pain inflicted on another c. to achieve a level of pleasure that one is unable to achieve in any other way d. to injure oneself 98. Which statement best describes the relationship between sexual offending and pedophilic disorder? a. All sexual offenders have pedophilic disorder. b. A requirement for diagnosis of pedophilic disorder is offending against a child. c. The pattern of behaviour is directed at other-sex children. d. A person who offends may or may not have the disorder.

99. What proportion of sexual offenders are women? a. 1 to 2 percent b. 5 to 10 percent c. 10 to 12 percent d. 15 to 20 percent 100. Thomas rationalizes his paraphilic disorder by watching religious programs on television, while masturbating to child pornography. Which term often refers to this practice? a. moral cleansing b. uncontrollable rituals Powered by Cognero

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Chapter 11: Sex and Gender c. nonexclusive focus d. paraphilic sadism 101. Although most sexual abuse survivors do not commit sexual crimes, males who do commit sexual crimes are how many times as likely to have experienced sexual abuse as a child? a. 2 b. 3 c. 4 d. 5 102. Which biological system are psychopathologists starting to examine to explain paraphilic behaviours? a. the amygdala b. the prefrontal cortex c. the behavioural inhibition system d. the sex chromosomes 103. How does atypical sexual arousal, such as paraphilic disorders, appear to be learned? a. through exposure to pornography b. through social “scripts” that are transferred from one generation to the next c. through masturbatory fantasies about the object d. through poor social skills 104. When assessing individuals with paraphilic disorder, along with the presence of paraphilic arousal, what is another factor that is assessed in these individuals? a. sexual orientation b. attachment c. social skills d. personality disorders 105. Which procedure is carried out entirely in the patient’s imagination and is used to reduce the atypical sexual arousal that exists in fetishistic behaviour? a. covert sensitization b. sensate focus c. classical conditioning d. sexual retraining 106. What is the basic concept behind the covert sensitization method of treating unwanted sexual arousal? a. to replace the immediate reinforcement of the behaviour with the unpleasant consequences that ordinarily take longer to be experienced b. to improve family functioning, social skills, and overall effectiveness of appropriate adult relations c. to create empathy and sensitivity for the victim of the behaviour d. to create a physically painful experience to replace the immediate reinforcement that the unwanted behaviour has previously produced 107. Matthew is undergoing the procedure called orgasmic reconditioning. What will Matthew’s therapist instruct him to Powered by Cognero

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Chapter 11: Sex and Gender do? a. Masturbate to his usual fantasies but substitute images of the consequences associated with his behaviour (such as getting caught, hurting someone else, etc.) just before ejaculation. b. Substitute images of the consequences associated with his behaviour (such as getting caught, hurting someone else, etc.) every time he feels aroused by thoughts of his atypical desires. c. Masturbate to his usual fantasies but substitute more socially desirable ones just before ejaculation. d. Watch videotapes of average adult sexuality repeatedly until such images result in arousal.

108. What procedure is used to strengthen more typical patterns of sexual arousal? a. the squeeze technique b. visual stimulation c. relapse prevention d. orgasmic reconditioning 109. Orgasmic reconditioning and covert sensitization are effective methods for treating which of the following? a. paraphilic disorders b. erectile dysfunction c. arousal disorders in women d. gender dysphoria 110. What form of treatment teaches patients to recognize the early signs of temptation and institute a variety of selfcontrol procedures? a. covert sensitization b. cognitive-behavioural therapy c. relapse prevention treatment d. orgasmic reconditioning 111. Which of the following is NOT a strong predictor of treatment failure or recidivism with paraphilic disorders? a. history of unstable social relationships b. unstable employment history c. the severity of their paraphilia d. denial that a problem exists 112. How effective are the drugs currently available for the treatment of paraphilic disorders? a. The drugs reduce sex drive and continue to be effective for several years after the patient stops the medication. b. The drugs dramatically reduce sex drive but have side effects that make them harmful to many patients. c. The drugs produce a “chemical castration” that effectively eliminates all sex drive permanently so that the patient will never desire sex, even after discontinuing the medication. d. The drugs eliminate sex drive but are effective only while the drug is being taken.

113. Which individual could be diagnosed with gender dysphoria? a. Christian, who gets sexually aroused by wearing women’s bras b. Sid, who can only become sexually aroused while fantasizing that he is a woman c. Mark, who feels like a woman trapped in a man’s body d. Kersti, who is gay and has many traditionally masculine traits Powered by Cognero

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Chapter 11: Sex and Gender 114. Paul Vasey, from the University of Lethbridge, is one of many individuals who support which of the following positions? a. The dysphoria in gender dysphoria is mainly caused by lack of acceptance. b. Removing gender dysphoria from the DSM-5-TR is paramount. c. Removal of gender dysphoria from the DSM-5-TR will cause many issues, including lack of medical coverage for gender transitions. d. Gender identity issues are a major psychiatric problem.

115. How is an intersex condition distinct from gender dysphoria? a. Intersex individuals receive sexual pleasure from cross-dressing. b. Intersex individuals are born with ambiguous genitalia. c. Intersex individuals are born with the complete genitalia of both a male and a female. d. Intersex individuals are bisexual.

116. How can biological males with gender dysphoria be distinguished from biological males with transvestic fetishism (TF)? a. Those labelled male at birth with TF are not generally sexually aroused by wearing clothing associated with the other sex, and they do not feel as though they are a woman trapped in a man’s body. b. Those labelled male at birth with TF are sexually aroused by wearing clothing associated with the other sex and also feel as though they are a woman trapped in a man’s body. c. Those labelled male at birth with gender dysphoria are not generally sexually aroused by wearing clothing associated with the other sex. d. Those labelled male at birth with gender dysphoria are generally sexually aroused by wearing clothing associated with the other sex.

117. What is the relationship between culture and gender dysphoria? a. Some cultures accord respect to these individuals, while in Western cultures social tolerance remains low. b. In Western cultures there is more social tolerance than in other cultures. c. Social tolerance remains low across all cultures. d. In non-Western cultures individuals are still without a diagnostic label for different gender experiences.

118. In two twin studies cited in the text, it was found that the percentage of genetic influence ranged from about 62 to 70 percent. What does this pattern of findings suggest? a. The environment determines vulnerability to gender dysphoria. b. Genes are not an influence for gender dysphoria. c. Genes are only one influence for gender dysphoria. d. Gender dysphoria is determined solely by genetics.

119. What is the most likely adult outcome for a young boy who shows gender-nonconforming behaviours? a. a bisexual orientation b. an exclusively heterosexual orientation c. an exclusively gay orientation d. gender dysphoria 120. Andrew is just beginning to show signs of gender identity. How old is Andrew likely to be?

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Chapter 11: Sex and Gender a. between 18 months and 3 years b. between 3 years and 4 years c. between 4 years and 5 years d. between 5 years and 6 years 121. Who are the Fa’afafine? a. a Samoan group of individuals assigned male at birth attracted to masculine men b. a Samoan group of individuals assigned male at birth attracted to gender-nonconforming men c. a Samoan group of gendering-nonconforming males attracted to gender-nonconforming men d. a Samoan group of masculine males attracted to gender-nonconforming men 122. Which view does the American Psychological Association recommend regarding the treatment of gender nonconforming individuals? a. a biological focus b. an environmental focus c. a holistic view d. a psychological focus 123. Which of the following is NOT listed as a criterion that must be met for an individual to undergo gender-affirming surgery at a reputable clinic? a. live in the experienced gender for at least one to two years b. be stable psychologically, financially, and socially c. undergo a trial period d. be in a stable intimate relationship 124. Which statement best describes funding for gender-affirmation surgery in Canada? a. All gender-affirmation surgeries are publicly funded. b. Funding varies by province and territory. c. Gender-affirmation surgeries are funded up to $28 000. d. Gender-affirmation surgery is not publicly funded.

125. What is the best predictor of persistence of gender nonconformity and dysphoria among children? a. sexual orientation b. self-control c. strong negative feelings about one’s anatomy d. fluid gender expression 126. What is the common treatment for individuals with disorders of sex development (DSD)? a. surgery and hormonal replacement therapy b. treatment is not common for individuals with DSD c. psychological treatment d. a combination of pharmacological and psychological treatment

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Chapter 11: Sex and Gender 127. Describe the four types of sexual dysfunction disorders and the patterns of each type within males and females.

128. Outline the three major aspects in assessing sexual behaviour and provide examples of what to consider within each.

129. Describe the development of a typical sexual dysfunction. Explain how the various influences (genetic, psychosocial, or substance use) might interact in the following situation: An occasional dysfunction (e.g., first-time failure to maintain an erection) develops into a disorder that interferes with the individual’s ability to function sexually (e.g., erectile dysfunction).

130. Describe the symptoms of three different forms of paraphilic disorder. What do all paraphilic disorders have in common?

131. Describe two scenarios in which paraphilic disorders may develop.

132. Explain the treatment methods of covert sensitization and orgasmic reconditioning. What do these two methods have in common?

133. Explain the features of the treatment options (psychosocial and surgical gender-affirmation) for gender dysphoria.

Why is it so important for the patient to consider treatment options very carefully?

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Chapter 11: Sex and Gender Answer Key 1. a 2. d 3. c 4. d 5. a 6. c 7. d 8. b 9. d 10. c 11. b 12. b 13. c 14. d 15. a 16. c 17. c 18. d 19. a 20. b 21. b 22. a 23. a 24. a 25. c Powered by Cognero

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Chapter 11: Sex and Gender 26. a 27. b 28. a 29. c 30. c 31. a 32. d 33. c 34. a 35. d 36. c 37. a 38. a 39. d 40. c 41. a 42. b 43. c 44. c 45. b 46. d 47. a 48. a 49. a 50. a 51. b Powered by Cognero

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Chapter 11: Sex and Gender 52. c 53. b 54. a 55. b 56. c 57. c 58. d 59. a 60. d 61. d 62. a 63. c 64. b 65. d 66. d 67. b 68. d 69. c 70. a 71. c 72. c 73. a 74. d 75. b 76. a Powered by Cognero

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Chapter 11: Sex and Gender 77. a 78. a 79. a 80. b 81. b 82. c 83. d 84. d 85. a 86. d 87. d 88. b 89. c 90. d 91. c 92. a 93. c 94. d 95. c 96. c 97. a 98. d 99. b 100. a 101. d 102. c Powered by Cognero

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Chapter 11: Sex and Gender 103. c 104. c 105. a 106. a 107. c 108. d 109. a 110. c 111. c 112. d 113. c 114. a 115. b 116. c 117. a 118. c 119. c 120. a 121. a 122. c 123. d 124. b 125. c 126. a 127. Student responses will vary.

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Chapter 11: Sex and Gender 128. Student responses will vary.

129. Student responses will vary.

130. Student responses will vary.

131. Student responses will vary.

132. Student responses will vary.

133. Student responses will vary.

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Chapter 12: Substance Use and Impulse Control

Indicate the answer choice that best completes the statement or answers the question.

1. According to the 2012 Canadian Community Health Survey, how many Canadians had a substance use disorder in the previous year? a. 1.2 percent b. 3.8 percent c. 5.4 percent d. 8.3 percent 2. Statistics Canada estimates that First Nations people living on reserve have acute care hospitalization rates for substance-related disorders that are how many times the rate for non-Indigenous people? a. four times b. five times c. six times d. seven times 3. Which term refers to the disturbing but common habit of using multiple substances? a. comorbid substance use b. polysubstance use c. substance dependence d. multisubstance use 4. What does a psychoactive substance affect? a. mood b. behaviour c. mood, behaviour, or both d. emotion 5. A student consumes alcohol alone in their residence room when they have trouble sleeping. What level of involvement with alcohol would best apply? a. substance use b. substance use disorder c. substance dependence d. substance intoxication 6. Candace rarely drinks alcohol, but she became very intoxicated at the office party. That evening she was slurring her speech and did a striptease in front of her boss. Jason has had his driver’s licence suspended three times over the past two years for driving while intoxicated, yet he never drinks on the job. Which of the following levels of involvement with alcohol would best apply to Candace and Jason? a. Candace, substance use disorder; Jason, substance use b. Candace, substance use; Jason, substance intoxication c. Candace, substance use; Jason, substance use disorder d. Candace, substance intoxication; Jason, substance use disorder 7. What does the diagnosis of substance intoxication NOT depend on?

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Chapter 12: Substance Use and Impulse Control a. physiological dependence on the drug b. the specific drug that is used c. the drug user’s individual biological reaction d. how much of a drug is used or ingested 8. Junaid meets the criteria for five symptoms of substance use disorder. What range would he fall under for this disorder? a. mild b. moderate c. severe d. extreme 9. Cecilia has been using crack for about two months now. Although she knows it is destroying her job performance and she has been reprimanded for missing work, she refuses to give it up. She says she can quit whenever she wants to and just uses crack because she enjoys it. She tells others who question her drug use to mind their own business and leave her alone. What is Cecilia’s level of involvement with the drug? a. substance intoxication b. substance use c. substance use disorder d. substance misuse 10. Mark has been using crack for two years. Although he has tried repeatedly to give it up, the crash is so intense and his cravings for the rush are so strong he just can’t quit. What is Mark demonstrating? a. substance use b. physiological dependence c. psychological dependence d. substance intoxication 11. Shania has been using heroin for two years. Lately, she has found she must inject higher and higher dosages of the drug to get the same high she has come to expect from her drug use. What is the term for this need for higher dosages? a. dependence b. intoxication c. addiction d. tolerance 12. Shira has used marijuana to the point where she has impaired control over her use of it. While she experiences no withdrawal symptoms when she stops using it, she wants it so badly she cannot stop herself from taking it. What does Shira’s reliance on marijuana illustrate? a. substance use b. psychological dependence c. physiological dependence d. tolerance 13. When a person is physiologically dependent on a drug, what will they most likely experience? a. an increased likelihood that use will resume after a period of abstinence b. both tolerance and withdrawal Powered by Cognero

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Chapter 12: Substance Use and Impulse Control c. withdrawal symptoms if the drug is withdrawn d. tolerance to the effects of the drug 14. A patient decided to abruptly quit using alcohol. They are now experiencing sweating, mental confusion, incoherent speech, disorientation, terrifying hallucinations, and extreme restlessness. What are these symptoms typical of? a. alcohol poisoning b. hypnagogic shock c. delirium tremens d. drug tolerance 15. Substance dependence often involves drug-seeking behaviours. Which of the following is NOT one of these behaviours? a. resuming drug use after a period of abstinence b. physical symptoms when the drug is no longer used c. repeated use of the drug d. a desperate need to ingest more of the drug 16. A 46-year-old man has terminal cancer and has been receiving fairly high doses of morphine for pain relief around the clock for several months. What level of substance involvement would best apply to this individual? a. disordered use b. dependence c. use d. tolerance 17. Why did early editions of the DSM classify alcohol and drug misuse as sociopathic personality disorders? a. They were considered signs of mental illness. b. They were considered signs of moral weakness. c. They were considered criminal behaviours. d. They were considered symptoms of psychosis.

18. In which edition of the DSM were substance use disorders acknowledged as a complex biological and psychological problem? a. DSM-III b. DSM-IV c. DSM-5 d. DSM-5-TR 19. Max runs a group therapy session for people with alcohol disorders. What else do some members of the group likely have? a. schizophrenia b. a mood disorder c. a sociopathic personality disturbance d. misuse of marijuana 20. Approximately what percentage of individuals with alcohol use disorders also have an additional psychiatric disorder?

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Chapter 12: Substance Use and Impulse Control a. 10 b. 25 c. 50 d. 99 21. Ellery and colleagues (2005) showed that ingestion of alcohol led to increased risk-taking tendencies among regular gamblers when they were using a video lottery terminal, relative to gamblers ingesting a non-alcoholic control beverage.

What does this finding suggest? a. People addicted to alcohol may also be prone to engage in other risk-taking behaviours. b. Gamblers addicted to alcohol may be more likely to engage in aggressive behaviours when they are drinking. c. Risk-taking tendencies may contribute to alcohol addiction. d. Alcohol may contribute to the high co-occurrence of alcohol and gambling disorders.

22. What are alcohol and the drugs Seconal, Halcion, and Valium classified as? a. intoxicants b. stimulants c. depressants d. opioids 23. Depressants decrease central nervous system activity and help us relax. Which of the following substances is classified as a depressant? a. heroin b. cigarettes c. marijuana d. alcohol 24. What was the Temperance Movement? a. It allowed for the benefits of moderate drinking while morally condemning the heavy use of spirits. b. It advocated for the increase of alcohol education in schools. c. It increased organized crime and bootlegging because of prohibition. d. It was the repeal of prohibition near the beginning of the Depression era.

25. When someone drinks alcohol, they initially experience a feeling of well-being and more outgoing behaviour. Why is this? a. Alcohol stimulates the autonomic nervous system. b. Alcohol activates the inhibitory centres in the brain. c. Alcohol depresses the inhibitory centres in the brain. d. Alcohol depresses the autonomic nervous system.

26. How much alcohol can an average-size person metabolize per hour? a. 3 to 5 grams b. 7 to 10 grams c. 10 to 13 grams d. 15 to 18 grams Powered by Cognero

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Chapter 12: Substance Use and Impulse Control 27. Although most psychoactive substances interact with specific substances in the brain cells, the effects of some substances are much more complex because several different neurotransmitter systems are affected. What substance affects several neurotransmitter systems? a. alcohol b. marijuana c. opiates d. tranquilizers 28. Which of the following does NOT correctly identify the specific effect of alcohol on a particular neurotransmitter system? a. dopamine system—slurred speech b. glutamate system—alcohol use disorder blackouts c. serotonin system—alcoholic cravings d. GABA system—antianxiety effect 29. Which the following is NOT a symptom of withdrawal from alcohol? a. delirium tremens b. hallucinations c. hypersomnia d. nausea and/or vomiting 30. In some individuals, chronic alcohol use causes physical damage to the body. Whether this occurs depends on several factors. Which of the following is NOT one of these factors? a. type of alcohol consumed b. whether the body is given time to recover between binges c. genetic vulnerability d. blood alcohol levels during drinking periods 31. Which of the following statements is NOT accurate regarding alcohol use? a. Alcohol permanently kills brain cells. b. Organic brain syndromes may result from long-term heavy alcohol use. c. Mild to moderate alcohol use may negatively impact the brain. d. Alcohol affects many neurotransmitter systems.

32. Which of the following pairs an organic brain syndrome associated with long-term alcohol misuse and its symptoms and causes? a. dementia—loss of intellectual abilities caused by a deficiency of the vitamin called thiamine b. Wernicke-Korsakoff syndrome—loss of intellectual abilities caused by the toxic effects of alcohol on the brain c. dementia—confusion, loss of muscle coordination, and unintelligible speech caused by the toxic effects of alcohol on the brain d. Wernicke-Korsakoff syndrome—confusion, loss of muscle coordination, and unintelligible speech caused by a deficiency of the vitamin called thiamine 33. Fetal alcohol spectrum syndrome (FASS) is a combination of problems that can occur in a child whose mother drank alcohol while pregnant. Which of the following is a symptom of FASS? Powered by Cognero

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Chapter 12: Substance Use and Impulse Control a. autism spectrum disorder b. congenital deafness c. cognitive deficits and behaviour problems d. excessive fetal growth 34. How many drinks does the Canadian Centre on Substance Use and Addiction recommended for low-risk drinking per week? a. 0 to 2 drinks for everyone b. 3 to 4 drinks for everyone c. 2 drinks for women, 4 for men d. 5 drinks for women, 10 drinks for men 35. You are sitting on an airplane with 100 adult men and 100 adult women. About how many of the men are likely to be classified as heavy drinkers? a. 4 b. 12 c. 17 d. 23 36. In a 2019 survey of postsecondary students, how many students reported engaging in binge drinking? a. 33 percent of male students; 28 percent of female students b. 17 percent of male students; 12 percent of female students c. 54 percent of male students; 37 percent of female students d. 72 percent of male students; 13 percent of female students 37. According to data from the 2019 Canadian Community Health Survey, how many Canadians over the age of 12 engage in heavy drinking? a. 3 percent b. 9 percent c. 14 percent d. 18 percent 38. Approximately how many individuals with severe alcohol dependence have a spontaneous remission and do not reexperience problems with drinking? a. 5 percent b. 10 percent c. 15 percent d. 20 percent 39. What did DeWit and colleagues (2000) find to be predictive of later alcohol disorders? a. being in the presence of adults who drink a lot b. aggressive behaviour in early adolescence c. drinking at an early age (from ages 11 to 14) d. extreme shyness and social anxiety in childhood Powered by Cognero

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Chapter 12: Substance Use and Impulse Control 40. What did DeWit and colleagues (2000) find regarding their study of 6000 lifetime drinkers who drank at an early age (ages 11 to 14)? a. Drinking at an early age resulted in more severe withdrawal symptoms than drinking at later ages. b. Drinking at an early age seemed to lead to more responsible drinking habits at later ages. c. Drinking at an early age caused more frequent blackouts than drinking at later ages. d. Drinking at an early age was predictive of later alcohol-related disorders.

41. Research on the mechanism responsible for the differences in early alcohol use suggest which of the following is related to later use? a. the person’s response to the sedative effects of the substance b. the level of intoxication the alcohol causes c. pre-existing psychological conditions d. the person’s expectations about drinking 42. Alcohol use and aggression are positively correlated. Which of the following is NOT a factor that determines aggressive behaviour? a. the person’s previous history of violence b. the person’s IQ (measured intelligence) c. the quantity and timing of alcohol consumed d. the person’s expectations about drinking 43. You have just heard about a situation in which someone who was drunk vandalized a building and assaulted a security guard. You are aware that although alcohol does not cause aggressive behaviour, it can increase the likelihood of engaging in violent behaviour. For whom is this most likely so? a. people who have Wernicke-Korsakoff’s disease, caused by long-term chronic alcohol misuse b. people who have fetal alcohol syndrome c. people who have poor executive functions, such as planning and organizing abilities d. people who possess a combination of low IQ and poor impulse control 44. What does the term anxiolytic mean? a. anti-seizure b. anxiety-reducing c. calming d. sleep-inducing 45. What does the term sedative mean? a. anti-seizure b. anxiety-reducing c. calming d. sleep-inducing 46. What does the term hypnotic mean? a. sleep-inducing b. calming c. anxiety-reducing Powered by Cognero

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Chapter 12: Substance Use and Impulse Control d. anti-seizure 47. Which of the following is classified as a barbiturate? a. Xanax b. Nembutal c. Rohypnol d. alcohol 48. Which of the following is classified as a benzodiazepine? a. Valium b. Seconal c. Amytal d. Nembutal 49. At low doses, barbiturates relax the muscles and can produce feelings of well-being. However, large doses can have results similar to which of the following? a. heavy drinking b. opiates c. stimulants d. hallucinogens 50. Dr. Gomez is concerned with a recent report showing high rates of benzodiazepine use in his community. Why might Dr. Gomez find this problematic? a. Their use is positively correlated with violent behaviour. b. It has long been known that they are not appropriate for reducing tension and anxiety from everyday stresses and strains. c. They are more dangerous than barbiturates. d. They are largely ineffective at relieving symptoms of anxiety.

51. Why was the use of Rohypnol popular among adolescents in the 1990s? a. It has the same effect as alcohol without the tell-tale odour. b. It is a sexual stimulant. c. It can be taken in fairly high doses without any withdrawal symptoms. d. It produces a longer and more intense high than marijuana.

52. What drug is often known as “roofies”? a. Valium b. Xanax c. Ativan d. Rohypnol 53. Sedative, hypnotic, and anxiolytic drugs affect the brain by acting on one of the neurotransmitter systems. Which neurotransmitter system is it? a. serotonin system b. GABA system Powered by Cognero

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Chapter 12: Substance Use and Impulse Control c. dopamine system d. norepinephrine system 54. At extremely high doses barbiturates can cause overdose. What is the common mechanism behind this? a. The heart goes into arrhythmia and stops. b. The diaphragm muscles relax so much they cause suffocation. c. A GABA surge occurs in the brain, causing coma and death. d. It creates insomnia and the individual eventually passes away from lack of sleep.

55. Approximately how many Canadians report using sedatives? a. 10 percent b. 12 percent c. 15 percent d. 17 percent 56. Which psychoactive drug is the most commonly consumed in Canada? a. depressants b. stimulants c. opioids d. hallucinogens 57. The amphetamine compound used for centuries by Chinese physicians called Ma-huang was marketed in North America to help with which of the following? a. weight loss b. asthma c. nasal congestion d. irregular heart rhythms 58. What were amphetamines originally used to treat? a. anxiety b. irregular heart rhythms c. hysteria d. asthma and as a nasal decongestant 59. What drug was implicated in the friendly fire death of four Canadian soldiers by two U.S. pilots in Afghanistan in 2002? a. alcohol b. sedatives c. opioids d. amphetamines 60. Amphetamines have been prescribed to treat numerous conditions and disorders. Which of the following is NOT one of these conditions? a. narcolepsy b. attention-deficit/hyperactivity disorder Powered by Cognero

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Chapter 12: Substance Use and Impulse Control c. nasal congestion d. depression 61. When were amphetamines first manufactured? a. 1887 b. 1899 c. 1912 d. 1938 62. Jack has been experiencing hallucinations, panic, and paranoid delusions. What type of substance has he most likely taken too much of? a. amphetamine b. alcohol c. Seconal d. Xanax 63. MDMA was originally created to be used as which of the following? a. a sleep aid b. an asthma treatment c. a nasal decongestant d. an appetite suppressor 64. “Ice” is a particularly dangerous drug for several reasons. Which of the following is NOT one of those reasons? a. Extremely high doses can result in death by suffocation. b. It causes marked aggressive tendencies. c. It stays in the system longer than cocaine. d. It has an extremely high risk of physiological dependence.

65. What can repeated use of MDMA cause? a. marked aggressive tendencies b. lasting memory problems c. substantial mood changes d. insomnia and loss of appetite 66. Lev has just taken an amphetamine. His entire central nervous system is stimulated because of increased activity of which of the following? a. norepinephrine and dopamine b. dopamine and GABA c. serotonin and dopamine d. GABA 67. When did cocaine replace amphetamines as the stimulant of choice? a. the 1960s b. the 1970s c. the 1980s Powered by Cognero

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Chapter 12: Substance Use and Impulse Control d. the 1990s 68. Which neurotransmitter is stimulated in the pleasure pathway, thus causing the high associated with cocaine use? a. adrenaline b. serotonin and dopamine c. dopamine d. endorphin 69. In their controlled study of the effects of cocaine exposure on the developing fetus, what did Potter and colleagues (2000) find in the cocaine-exposed infants? a. subtle deficits in cardiac regulatory processes b. subtle deficits in reflexive responding c. subtle deficits in visual information processing d. subtle deficits in auditory information processing 70. Which symptom has been found to occur in two-thirds of cocaine users? a. hallucinations b. delusions c. paranoia d. seizures 71. Your shy and introverted friend tells you that she has discovered a wonder drug that produces feelings of euphoria and it is not addictive. When you realize that she is talking about cocaine, what should you tell her? a. In the long term, she will want to be reclusive and antisocial. b. If she continues to use it, she will exhibit extreme symptoms of depression, which are common to two-thirds or more of cocaine users. c. If she continues to use it, she will gradually develop an inability to resist taking more over time. d. Unlike other recreational drugs, the mellowing and calming effect she achieves will not last over repeated use.

72. Why is the withdrawal pattern from cocaine considered to be atypical? a. The pattern of withdrawal is the opposite of all other psychoactive drugs. b. Withdrawal causes extreme phases of depression. c. Withdrawal causes apathy and boredom, leading to more use. d. During withdrawal individuals feel mellow and calm.

73. According to the 2017 Canadian Tobacco, Alcohol and Drugs Survey, how much has the prevalence of smoking decreased from 1965? a. 20 percent b. 25 percent c. 30 percent d. 35 percent 74. From a physiological perspective, a person who is dependent on nicotine smokes cigarettes frequently throughout the day to prevent withdrawal symptoms. Which of the following is one of these symptoms? a. difficulty concentrating Powered by Cognero

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Chapter 12: Substance Use and Impulse Control b. nausea c. headache d. tiredness 75. In small doses, what are the effects of nicotine? a. It relieves stress and improves mood. b. It decreases blood pressure. c. It decreases nervous system activation. d. It blurs vision and causes confusion.

76. Nicotine appears to stimulate which receptors in the midbrain reticular formation and the limbic system? a. nicotinic acetylcholine receptors b. serotonergic receptors c. norepinephrine receptors d. GABA receptors 77. The most common of the psychoactive substances is used by 90 percent of North Americans. What is it? a. nicotine b. caffeine c. alcohol d. marijuana 78. Caffeine’s effect on the brain seems to be related to the involvement of which of the following? a. serotonin b. norepinephrine c. adenosine d. GABA 79. How long does it take caffeine to leave our bodies? a. one hour b. three hours c. four hours d. six hours 80. In which version of the DSM was caffeine use disorder included? a. the DSM-III b. the DSM-IV c. the DSM-5 d. caffeine use disorder was included as a condition for further study in the DSM-5-TR 81. Which of the following analgesic substances is NOT classified as an opiate? a. fentanyl b. cocaine c. heroin Powered by Cognero

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Chapter 12: Substance Use and Impulse Control d. oxycodone 82. Why are opioids considered analgesics? a. They have a sedative effect. b. They relieve pain. c. They cause hallucinations and dissociative experiences. d. They activate the central nervous system.

83. What is the primary use for legally available narcotic medications, such as morphine? a. as antagonists b. as antidotes c. as antibiotics d. as analgesics 84. Which substance was attributed to almost three-quarters of the accidental opioid-related deaths in 2018? a. heroin b. fentanyl c. OxyContin d. codeine 85. Which statement best describes the risks associated with opioid withdrawal? a. No one should stop taking any opioid suddenly. b. Opioid withdrawal is only dangerous if a person has been taking the substance for more than six months. c. Opioid withdrawal is unpleasant, so people continue to use the drugs. d. Opioid withdrawal is more dangerous than alcohol withdrawal.

86. A newer prescription drug for pain is oxycodone. Why has it been featured prominently in the news? a. because of its potential for the treatment for cancer b. because of its potential for the treatment of AIDS c. because of its potential for the treatment of withdrawal symptoms of heroin d. because of its potential for misuse and lethal overdose 87. Yara has been dependent on narcotics for many years. Recently, she has been trying to quit and has not used any drugs for the last week. As part of her withdrawal from narcotics, which of the following is Yara unlikely to experience? a. fever and chills b. nausea, vomiting, and diarrhea c. aches and pains d. increase in blood pressure 88. What is the mortality rate in a population that is dependent on opioids compared with the general population? a. 1 to 2 times as high b. 3 to 5 times as high c. 6 to 20 times as high d. 21 to 25 times as high Powered by Cognero

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Chapter 12: Substance Use and Impulse Control 89. Where are the natural opioids, enkephalins, and endorphins, found? a. in DNA b. in the adrenal glands c. in the pituitary gland d. in the brain 90. Which substance distorts sensory experiences, feelings, and perceptions? a. “benzos” b. opiates c. “roofies” d. hallucinogens 91. The hallucinogenic drug LSD is produced synthetically in laboratories. However, a naturally occurring derivative has caused outbreaks of illness throughout history. What is this naturally occurring derivative? a. lysergic acid amide b. ergot c. psilocybin d. mescaline 92. What is the scientist Albert Hoffmann famous for? a. discovering the naturally occurring endorphins in the brain b. experiencing the first recorded “trip” on LSD c. creation of the drug MDMA d. treating alcoholism with LSD 93. Which hallucinogen was used by the CIA as a “truth serum” during interrogations with limited efficacy? a. LSD b. cannabis c. psilocybin d. mescaline 94. In the 1950s, Dr. Humphrey Osmond experimented with the hallucinogenic drug LSD as a treatment for which of the following? a. sleep disorders b. pain c. anxiety disorders d. alcohol use disorder 95. Which of the following is NOT a hallucinogen? a. psilocybin b. dimethyltryptamine c. opium d. mescaline 96. Hallucinogenic symptoms are caused by the effect on which receptors?

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Chapter 12: Substance Use and Impulse Control a. GABA and glutamate b. norepinephrine and serotonin c. multiple receptors at one time in opposing ways d. the dopaminergic pathway 97. Luca uses mescaline repeatedly over several days. What is the most likely outcome? a. He will overdose and may die. b. The drug will completely lose its effectiveness. c. He will experience severe withdrawal symptoms when he stops. d. He will experience at least one bad trip.

98. Which of the following is NOT one of the categories that includes the effects of cannabis? a. depressant b. stimulant c. opioid d. hallucinogen 99. According to Health Canada (2019), how many Canadians used cannabis in the previous year? a. 10 percent b. 15 percent c. 20 percent d. 25 percent 100. Dylan has been using and misusing marijuana for more than 10 years. He is considering quitting because he has begun to experience which of the following? a. psychological dependence even with occasional use b. rapid development of tolerance c. physiological addiction to tobacco smoke d. impairments of memory, concentration, and motivation 101. What has been documented in cannabis users when large doses are taken? a. physiological dependence b. paranoia and hallucinations c. psychological dependence d. tolerance 102. Which of the following was NOT listed in the text as a medical purpose that cannabis-derived products are prescribed for? a. diabetes-induced nausea b. neuropathic pain in MS c. cancer pain d. HIV-associated anorexia 103. What is the reverse tolerance phenomenon reported by some regular users of marijuana? a. wanting to use the drug less often after repeated use Powered by Cognero

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Chapter 12: Substance Use and Impulse Control b. experiencing more pleasure from the same amount of the drug after repeated use c. experiencing less pleasure from smaller amounts of the drug after repeated use d. experiencing more pleasure from greater amounts of the drug after repeated use 104. Marijuana contains more than how many varieties of cannabinoids that alter mood and behaviour? a. 50 b. 60 c. 70 d. 80 105. The brain makes its own version of THC, a neurochemical called which of the following? a. dopamine b. adenosine c. anandamide d. glutamate 106. What do inhalants cause? a. symptoms of withdrawal that can last up to two or more weeks b. antisocial and aggressive behaviour c. heightened auditory and visual perception d. damage to bone marrow, kidneys, liver, and brain 107. Which of the following is NOT related to higher rates of inhalant use? a. a disadvantaged background b. higher levels of anxiety and depression c. living in large urban centres d. impulsivity and fearlessness 108. Although the media reports on inhalant use by Indigenous youth, how many First Nation youth reported using inhalants in 2018? a. 0.08 percent b. 2.0 percent c. 3.6 percent d. 4.2 percent 109. How does the use of testosterone-derived anabolic-androgenic steroids differ from the use of other illicit drugs? a. There is no desirable high with steroid use. b. Steroids can be taken orally or by injection. c. Twice as many young males use steroids for body size and performance as those who use drugs that produce a high. d. The high produced from steroid use is more intense than that experienced with other drugs.

110. Which of the following is NOT a common long-term effect of steroid use? a. depression b. anxiety Powered by Cognero

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Chapter 12: Substance Use and Impulse Control c. panic attacks d. dissociation 111. Karrie uses an illicit designer drug that is a dissociative anaesthetic. It produces in her a sense of detachment along with a reduced awareness of pain. What drug is it? a. ketamine (K or Special K) b. Ecstasy (MDMA) c. Eve (MDEA) d. Nexus (BDMPEA) 112. What was gamma hydroxybutyrate (GHB) previously marketed for? a. weight loss b. appetite suppressant c. muscle growth d. tranquilizer 113. Which term refers to the study of how genes work to influence addiction? a. psychopathology b. functional genomics c. molecular genetics d. genetic variation 114. One genetic factor that appears to be a part of alcohol use disorder is the body’s ability to metabolize alcohol. What enzyme is produced by the liver to break down acetaldehyde, an alcohol by-product? a. alcohol dehydrogenase (ADH) b. amylase c. lipase d. protease 115. Thirty to 50 percent of individuals of which ethnic descent are thought to be missing the alcohol dehydrogenase enzyme making it difficult to metabolize alcohol? a. Indigenous b. Asian c. African d. Latin American 116. What physiological reaction appears to prevent some people from becoming alcohol dependent? a. ADA response b. skin-flushing response c. red cell syndrome d. meta-alcohol syndrome 117. What does research data show is the relationship between gene(s) and substance misuse? a. No one gene causes substance misuse or dependence. b. One dominant gene is found in 90 percent of people with substance use disorders.

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Chapter 12: Substance Use and Impulse Control c. One recessive gene is found in 90 percent of people with alcohol or nicotine dependency. d. No genes have been found to be linked to substance misuse.

118. Barrett and colleagues (2006) found that tobacco use increased when an individual was using alcohol and other drugs. According to the researchers, which of the following reasons may explain these patterns? a. Combining drugs maximizes the effects of the serotonin system. b. Smoking becomes a conditioned stimulus for alcohol and other drugs and increases cravings. c. Nicotine maximizes the pleasurable effects of all drugs on the dopamine reward system. d. Using two substances may enhance the pleasurable experience with one drug by simultaneously using another.

119. What might be the common factor among misused psychoactive drugs? a. their identical effect on neurotransmitters at the synapse b. the suppression of the nervous system c. the similar way in which they are metabolized in the body d. their ability to activate the pleasure pathways of the brain 120. In the 1950s, Olds and Milner used electrical stimulation on the brains of rats. What did they discover? a. that rats lost memory of previously learned skills b. that rats have completely different neurotransmitter systems from humans c. the aggressive centre of the brain d. the pleasure centre of the brain 121. What are the pleasure pathways, or internal reward centres, in the human brain primarily composed of? a. both dopamine-sensitive and serotonin-sensitive neurons b. serotonin-sensitive neurons c. dopamine-sensitive neurons d. GABA-sensitive neurons 122. Which drugs act directly on the dopamine system? a. cocaine and alcohol b. LSD and alcohol c. inhalants and benzodiazepines d. amphetamines and cocaine 123. How do both amphetamines and cocaine produce their desired effects? a. by indirectly acting on the internal reward centre or pleasure pathway of the brain b. by directly acting on the internal reward centre or pleasure pathway of the brain c. by enhancing the activity of GABA in the septal-hippocampal system d. by increasing beta-endorphin release 124. What does the term sensitization mean? a. an increased high when taking the drug b. an increased dopamine release when taking the drug c. a decreased dopamine release when taking the drug Powered by Cognero

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Chapter 12: Substance Use and Impulse Control d. a decreased high when taking the drug 125. Yesterday, you took a couple of Aspirin tablets for a headache. In behaviourist terms, what is Aspirin? a. a positive reinforcer b. a neutral reinforcer c. a negative reinforcer d. a variable reinforcer 126. In behaviourist terms, when is a drug considered a negative reinforcer? a. when it “punishes” the user with aversive withdrawal symptoms b. when it stops a person from feeling bad c. when it makes a person feel good d. when it has a high risk of physiological dependency 127. In trying to understand why some individuals become addicted to drugs and others do not, it is important to consider the negative reinforcement that is associated with the anxiolytic effect. What is the anxiolytic effect? a. a drug’s ability to metabolize slowly, extending its effects b. a drug’s ability to reduce anxiety c. a drug’s ability to relieve pain d. a drug’s ability to produce a high 128. Why do some drugs produce an anxiolytic (anxiety-relieving) effect? a. They act directly on the dopamine system. b. They increase the activity of GABA in the septal-hippocampal region. c. They stimulate the pleasure pathways of the brain. d. They negatively reinforce drug-taking behaviour.

129. What did Pihl, Peterson, and colleagues (1996) discover about individuals at high familial genetic risk for alcoholism? a. They may be more sensitive to the positive effects of alcohol when it is first ingested. b. They may be less sensitive to the positive effects of alcohol when it is first ingested. c. They may be more sensitive to the negative effects of alcohol after a few hours. d. They may be more sensitive to the positive effects of alcohol and less sensitive to the negative effects of alcohol after a few hours.

130. What did laboratory research involving drug addiction in animals demonstrate about the positive reinforcing effect of drugs? a. It occurs regardless of biological influences. b. It occurs with fewer social and cultural influences than humans. c. It occurs independently of social and cultural influences. d. It occurs with as much social influence as with humans.

131. Which of the following theories uses both positive reinforcement and negative reinforcement to explain why the crash that follows the initial euphoria of drug use is not a deterrent to further drug use? a. amotivational theory Powered by Cognero

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Chapter 12: Substance Use and Impulse Control b. substance-related self-schema theory c. opponent-process theory d. expectancy theory 132. How is the opponent-process explanation of drug addiction best explained? a. An increase in negative feelings will be followed by further negative feelings, and this mechanism is both strengthened with use and weakened by disuse. b. An increase in positive feelings will be followed by an increase in negative feelings, and this mechanism is strengthened with disuse. c. An increase in positive feelings will be followed by an increase in negative feelings, and this mechanism is strengthened with use. d. An increase in negative feelings will be followed by an increase in positive feelings, and this mechanism is weakened by use.

133. Which of the following describes the influence of how we think about drug use on our reactions to drugs? a. availability heuristic b. expectancy effect c. positive reinforcement d. cravings 134. Which of the following is NOT a factor that may trigger urges and cravings for a drug? a. availability of the drug b. contact with things associated with drug taking c. attempts to avoid the drug at all costs d. having a small dose of the drug 135. Which of the following was added to the DSM-5-TR as one of the criteria for diagnosing a substance-related disorder? a. tolerance b. expectancy c. cravings d. reinforcement 136. Which of the following describes the common observation that heroin users are more likely to overdose when injecting in an unfamiliar environment? a. tolerance b. expectancy c. conditioned compensatory response d. environmental unfamiliarity 137. Which statement best explains the cognitive phenomenon called alcohol myopia? a. An individual continues to drink and denies that there are any negative consequences associated with alcohol. b. An individual properly evaluates the risks associated with continued misuse of alcohol and decides to enter a treatment program. c. An individual finally sees that drinking alcohol has only negative consequences and stops drinking.

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Chapter 12: Substance Use and Impulse Control d. An individual continues to drink even when they know that excessive drinking has severe negative consequences.

138. Why do children of parents who misuse drugs have a higher likelihood of engaging in substance use in adolescence? a. There are genetic contributions from these parents to these children. b. These parents spend less time monitoring their children. c. Negative role-modelling leads to repeated behaviours. d. It shows moral weakness.

139. What factor appears in part to account for the relatively low prevalence of substance misuse in parts of the world like Mexico and Brazil? a. poor economic conditions b. genetic predispositions c. cultural viewpoints d. religious frame of reference 140. The integrative approach to substance misuse reflects the concept of equifinality. Which statement best explains this concept? a. Neurobiological factors determine whether substance misuse will develop. b. A genetic factor alone is the cause of substance misuse. c. For any particular individual, substance misuse may arise from multiple and different causes. d. Psychological factors are the primary determinants of whether or not a person develops a substance use disorder.

141. Steven is undergoing therapy for his substance use disorder. The goal of the therapy is to increase his motivation to change and move toward a stage where he is ready to work on modifying his problematic substance use. Which technique is this therapeutic process? a. mindfulness-based cognitive therapy b. motivational enhancement therapy c. cognitive-behavioural therapy d. contingency management 142. Treatment for substance-related disorders focuses on several areas. The National Institute on Drug Abuse (NIDA) recommends how many principles for effective treatment based on this concept? a. 4 principles b. 8 principles c. 13 principles d. 17 principles 143. Which of the following is an example of agonist types of treatment for substance misuse? a. the use of methadone to treat heroin addiction b. moral condemnation of the behaviours as sins c. encouraging users to focus on the pain and suffering their substance use inflicts on themselves and others d. the use of naltrexone to treat heroin addiction

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Chapter 12: Substance Use and Impulse Control 144. Heroin and methadone are cross-tolerant. What does this mean? a. They act on the same neurotransmitter receptors and, thus, a person addicted to one drug may become addicted to the other. b. They each produce the same level of high in users. c. They each produce a significantly different type and level of high in users. d. They do not act on the same neurotransmitter receptors; however, the level of tolerance developed will automatically cause a generalization to the other drug.

145. What is the most commonly prescribed opioid-antagonist drug? a. methadone b. naltrexone c. bupropion d. Antabuse 146. The drug opiate-antagonist naltrexone is a treatment for substance misuse. How does it work? a. It substitutes a chemically similar drug for the addictive drug. b. It produces a cross-tolerance effect in a drug user. c. It produces only a temporary euphoric effect if opiates continue to be used. d. It both cancels the effects of opiates and produces withdrawal symptoms.

147. If a patient has just been prescribed acamprosate, what are they likely dependent on? a. opioids b. alcohol c. nicotine d. cannabis 148. A person with alcohol use disorder who is highly motivated to stop drinking and who understands the possible consequences of treatment may be prescribed the medication Antabuse. What is this medication an example of? a. an abstinent b. an antagonist c. an agonist d. an aversive 149. In some cases individuals with substance use disorder may be prescribed drugs that make ingesting the misused substance extremely unpleasant. Which term refers to this type of treatment condition? a. agonist treatment b. antagonist treatment c. aversive treatment d. negative reinforcement 150. Clonidine, although developed to treat hypertension, has also been given to people withdrawing from which substance? a. barbiturates b. alcohol c. cocaine Powered by Cognero

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Chapter 12: Substance Use and Impulse Control d. opioids 151. When comparing outpatient therapy and inpatient facilities to treat substance use disorders, what does the research suggest? a. They are equally effective, but inpatient facilities cost substantially more. b. They are equally effective, so whichever is less of a wait is recommended. c. Outpatient therapy is more effective long-term compared to inpatient facilities. d. Inpatient facilities show more efficacy than outpatient therapy.

152. What percentage of the adult U.S. population has attended an Alcoholics Anonymous meeting at one time or another? a. 1 percent b. 3 percent c. 5 percent d. 9 percent 153. Which of the following is NOT accurate concerning how effective controlled drinking approaches are to alcohol misuse? a. It works long term for about 30 percent of people with alcohol use disorder. b. People using this method stick to treatment at higher rates than those who attempt to abstain from alcohol entirely. c. The program does not work long term. d. The program is effective if run in conjunction with Alcoholics Anonymous.

154. It seems that a valuable part of therapy for substance use may be contingency management. In contingency management, what do the clinician and the client do together? a. They develop a skills-training program to resist social, media, and peer pressure to use drugs. b. They identify and correct aspects of the client’s life that might contribute to substance use or interfere with efforts to abstain. c. They focus on the learned aspects of dependence—that is, the failure of cognitive and behavioural coping skills. d. They select specific behaviours for change and reinforcers that will reward success.

155. In the community reinforcement approach to substance use treatment, which facet is NOT targeted? a. All individuals in relationships with the individual are recruited for relationship therapy. b. Clients are taught how to identify the antecedents and consequences that influence their drug taking. c. Clients are given assistance with employment, education, and finances to help reduce stress. d. New recreational opportunities help the person replace substance use with activities.

156. Marlatt and Gordon (1985) believed that relapse occurs because of which of the following? a. inadequate interpersonal relationships b. a failure of cognitive and behavioural coping skills c. lack of motivation d. lack of self-control

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Chapter 12: Substance Use and Impulse Control 157. Safe injection sites are an example of which type of treatment approach? a. contingency management b. relapse prevention c. antagonist treatment d. harm reduction 158. What is the purpose of abstinence in a harm reduction approach to substance misuse? a. Abstinence is assumed to be the natural result of improved cognitive and behavioural coping skills after therapy. b. Abstinence can be the final goal, but it does not have to be. c. Abstinence is an unrealistic goal for a person with a history of dependence problems. d. Abstinence is a key requirement for the user.

159. Which prevention approach appears to be the least promising for prevention approaches? a. limiting access to alcohol b. completing skills training to avoid or resist social pressure c. decreasing the impact of media portrayal of drug use d. attending programs with a “no drug use” message 160. New research suggests the possibility of creating vaccines that would use the immune system to fight drugs by taking away the pleasurable aspects of the drug. What is another name for these vaccines? a. vice vaccines b. reward response suppressants c. desensitizers d. dopamine blockers 161. Jean-Pierre has gambling disorder. Which of the following has Jean-Pierre most likely experienced? a. job loss b. bankruptcy c. incarceration d. arrest 162. Linea has gambling disorder. When she undergoes an fMRI as part of a research study, what parts of her brain are most likely to be functioning atypically? a. ventromedial prefrontal cortex and orbitofrontal cortex b. orbitofrontal cortex and medial temporal cortex c. medial temporal cortex and parahippocampal gyrus d. parahippocampal gyrus and ventromedial prefrontal cortex 163. Manuel has gambling disorder. Tests have shown he has poor impulse control. What impact will this have on the course of Manuel’s disorder? a. better response to treatment and a lower chance of relapse b. better response to treatment and a higher chance of relapse c. worse response to treatment and a lower chance of relapse d. worse response to treatment and a higher chance of relapse Powered by Cognero

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Chapter 12: Substance Use and Impulse Control 164. Dr. Reid is studying the efficacy of Gamblers Anonymous. What has she likely found? a. To be effective, the group leader must be a former gambler. b. The program is not very effective as typically 70 to 90 percent drop out. c. The gambler must have social support for the program to work. d. The program must occur in a psychiatric facility.

165. Which approach is most likely to help people with gambling disorder? a. a brief treatment program b. an inexpensive treatment c. a psychodynamic treatment d. Gamblers Anonymous 166. Occasionally Jared acts on aggressive impulses by assaulting others or destroying property. Jared likely meets the criteria for which disorder? a. kleptomania b. gambling disorder c. intermittent explosive disorder d. pyromania 167. Suganthy has intermittent explosive disorder. Which treatment option will most likely help Suganthy? a. cognitive behavioural therapy b. psychoanalysis c. systematic desensitization d. a token economy 168. Yan has kleptomania. She feels a sense of tension before she shoplifts. After she shoplifts, what does she feel? a. paranoia b. relief c. more tension d. anger 169. Dr. Palmer is developing a treatment program for people with kleptomania. To best serve his patient population, he is planning a treatment program that will help with the impulse-control component of kleptomania. What else could it potentially help treat? a. mood disorders b. personality disorders c. cognitive disorders d. substance use disorders 170. How many arsonists have pyromania? a. 3 percent b. 8 percent c. 12 percent d. 15 percent Powered by Cognero

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Chapter 12: Substance Use and Impulse Control

171. Define psychoactive substance and give examples of the categories of psychoactive drugs. Discuss whether these drugs are psychologically or physiologically addictive.

172. Compare and contrast the levels of involvement in substance-related disorders: use, intoxication, use disorder, and dependence. Define the meaning of the word addiction.

173. Discuss the current research and theories regarding the progression of alcohol-use disorders. How do current ideas compare to previous theories?

174. Describe the psychological and behavioural effects of alcohol. Discuss both the short-term and long-term consequences of alcohol misuse.

175. Compare and contrast the depressant drugs, including benzodiazepines, barbiturates, and anxiolytics. Discuss medical uses for these substances and the potential for misuse and/or addiction.

176. Compare and contrast the stimulant drugs. Discuss the history of cocaine, as well as its atypical type of withdrawal.

177. Describe the impacts of cannabis. Discuss how cannabis has been used for medicinal purposes, provide some examples, and highlight the controversy surrounding cannabis use for this purpose.

178. Describe opioid-based drugs and provide several examples. Discuss how these drugs interact with the body’s natural opioid system. Provide an overview of the main concerns surrounding these drugs today.

179. Discuss the problems of both steroid and inhalant use, noting psychological and physical effects. How do steroid and inhalant use differ from misuse of other substances?

180. Discuss current research on the genetic/biological, social, and cultural factors related to alcohol use disorder. Which factors appear most strongly related to the development and progression of the disorder?

181. Explain the basic assumptions and tenets of the Alcoholics Anonymous model of treatment for alcoholism versus the controlled drinking approach. Referring to recent research into long-term relapse prevention, what conclusions can be drawn about both approaches?

182. Explain the basic assumptions and examples of the harm reduction approach to drug misuse. Discuss fully the controversy surrounding this approach, explaining the positions of both its proponents and critics.

183. Provide an overview of gambling disorder, characteristics often associated with gamblers, the areas of the brain tied to gambling, and treatment suggestions.

184. Describe the three impulse-control disorders discussed in the text and a treatment approach suggested for each.

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Chapter 12: Substance Use and Impulse Control Answer Key 1. b 2. d 3. b 4. c 5. a 6. d 7. a 8. b 9. c 10. b 11. d 12. b 13. b 14. c 15. b 16. b 17. b 18. a 19. b 20. c 21. d 22. c 23. d 24. a 25. c Powered by Cognero

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Chapter 12: Substance Use and Impulse Control 26. b 27. a 28. a 29. c 30. a 31. a 32. d 33. c 34. a 35. d 36. a 37. d 38. d 39. c 40. d 41. a 42. b 43. c 44. b 45. c 46. a 47. b 48. a 49. a 50. b 51. a Powered by Cognero

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Chapter 12: Substance Use and Impulse Control 52. d 53. b 54. b 55. b 56. b 57. a 58. d 59. d 60. d 61. a 62. a 63. d 64. a 65. b 66. a 67. b 68. c 69. d 70. c 71. c 72. c 73. d 74. a 75. a 76. a Powered by Cognero

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Chapter 12: Substance Use and Impulse Control 77. b 78. c 79. d 80. d 81. b 82. b 83. d 84. b 85. c 86. d 87. d 88. c 89. d 90. d 91. b 92. b 93. a 94. d 95. c 96. c 97. b 98. c 99. b 100. d 101. b 102. a Powered by Cognero

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Chapter 12: Substance Use and Impulse Control 103. b 104. d 105. c 106. d 107. c 108. a 109. a 110. d 111. a 112. c 113. b 114. a 115. b 116. b 117. a 118. d 119. d 120. d 121. c 122. d 123. b 124. b 125. c 126. b 127. b Powered by Cognero

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Chapter 12: Substance Use and Impulse Control 128. b 129. a 130. c 131. c 132. c 133. b 134. c 135. c 136. c 137. d 138. b 139. a 140. c 141. b 142. c 143. a 144. a 145. b 146. d 147. b 148. d 149. c 150. d 151. a 152. d 153. d Powered by Cognero

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Chapter 12: Substance Use and Impulse Control 154. d 155. a 156. b 157. d 158. b 159. d 160. a 161. d 162. a 163. d 164. b 165. a 166. c 167. a 168. b 169. a 170. a 171. Student responses will vary.

172. Student responses will vary.

173. Student responses will vary.

174. Student responses will vary.

175. Student responses will vary.

176. Student responses will vary.

177. Student responses will vary.

178. Student responses will vary.

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Chapter 12: Substance Use and Impulse Control 179. Student responses will vary.

180. Student responses will vary.

181. Student responses will vary.

182. Student responses will vary.

183. Student responses will vary.

184. Student responses will vary.

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Chapter 13: Personality

Indicate the answer choice that best completes the statement or answers the question.

1. According to the definition of a personality disorder, what kind of pattern of maladaptive behaviour must an individual show to be diagnosed with a personality disorder? a. a persistent pattern b. a highly variable pattern c. an unpopular pattern d. a very severe pattern 2. Which of the following is NOT a necessary condition for the diagnosis of a personality disorder? a. maladaptive functioning b. pervasive pattern of behaviour c. subjective feelings of distress d. chronic pattern 3. Based on the argument that the problems of people with personality disorders may just be extreme versions of the problems many of us experience, how can personality disorders be viewed? a. as disorders of functioning rather than disease b. as disorders of learning rather than disease c. as disorders of biology rather than learning d. as disorders of degree rather than kind 4. Clinicians who have criticized the way DSM-5-TR classifies personality disorders view personality disorders as extremes of typical personality rather than as which of the following? a. impaired functioning b. medical conditions c. biologically based traits d. separate categories of disorders 5. Some researchers believe that personality disorders are extreme versions of otherwise typical personality variations.

Through which model do these people view personality disorders? a. functioning model b. dimensional model c. biological model d. categorical model 6. Widiger and colleagues have argued for decades that a dimensional model is more advantageous than a categorical model. Which of the following was NOT one of their listed advantages? a. It would retain more information about each individual. b. It would be more flexible because it would permit both categorical and dimensional differentiations. c. It would avoid the often arbitrary decisions involved in assigning a person to a diagnostic category. d. It would allow us to view disorders as real things, comparable to the realness of an infection or a broken arm.

7. The alternative model of personality disorders that is included in the emerging measures and models section of the DSM-5-TR focuses on which of the following?

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Chapter 13: Personality a. a continuum of disturbances of the self and interpersonal functioning b. both categorical and dimensional differentiations c. a fourth cluster of personality disorders d. a medicalized version of personality disorders 8. Dr. Gall is studying a personality characteristic that is NOT a dimension in the five-factor model of personality. What is it? a. extraversion b. neuroticism c. conscientiousness d. expressiveness 9. What does the cross-cultural research on the five-factor model of personality suggest? a. Only two dimensions are universal. b. Western-type personality structure differs from the non-Western type. c. There is no such thing as a universal human personality structure. d. The five dimensions are fairly universal.

10. Ming has narcissistic personality disorder and Ian has borderline personality disorder. Although they are quite different, which of the Big Five personality traits do they most likely share? a. agreeableness b. openness to experience c. extroversion d. conscientiousness 11. Which of the following is NOT a personality disorder cluster? a. odd or eccentric b. dramatic, emotional, or erratic c. avoidant and paranoid d. anxious or fearful 12. Jane and Katelyn both have personality disorders that are part of the DSM-5-TR Cluster B. Although the women have been diagnosed with different personality disorders, what characteristics do they most likely have in common? a. elevated levels of impulsivity b. elevated levels of anxiety c. elevated levels of eccentricity d. elevated levels of extraversion 13. Diego has a personality disorder. When their family is asked about it, what are they likely to say? a. It developed in childhood. b. It developed in adulthood. c. It developed in late adolescence. d. It developed gradually across their lifespan.

14. Of the DSM-5-TR personality disorders, which disorders are relatively rare, occurring in less than 1 percent of the Powered by Cognero

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Chapter 13: Personality general population? a. histrionic, avoidant, and schizoid personality disorders b. schizoid, schizotypal, dependent, and histrionic personality disorders c. schizoid, narcissistic, and avoidant personality disorders d. paranoid, schizotypal, histrionic, dependent, and obsessive-compulsive personality disorders 15. What is the main reason we do NOT have sufficient research examining the development of personality disorders? a. There is insufficient research funding for these disorders because of relative lack of public awareness. b. Many individuals do not seek treatment in the early phases of these disorders. c. There are many other disorders involving far greater impairment, and these tend to receive the most research funding. d. Sophisticated research methods are necessary to study disorders that are so ingrained in personality.

16. Dr. Eso specializes in treating histrionic personality disorder and dependent personality disorder. Which statement most likely describes their patient population? a. There will be more women with both histrionic personality disorder and dependent personality disorder. b. There will be similar numbers of men and women with histrionic personality disorder and dependent personality disorder. c. There will be more women with histrionic personality disorder and more men with dependent personality disorder. d. There will be more men with histrionic personality disorder and more women with dependent personality disorder.

17. According to a study by Ford and Widiger (1989), what is most likely the cause of gender differences observed in the prevalence of many personality disorders? a. cultural scripts that dictate the type of disordered behaviour appropriate for each gender b. genetic differences c. gender-specific, learned behaviour patterns d. gender bias on the part of the diagnosing clinician 18. A man demonstrating irresponsible and reckless behaviour would likely be diagnosed with antisocial personality disorder. What would most likely occur if a woman demonstrated these identical traits? a. She would not be diagnosed with a personality disorder. b. She would be given a diagnosis of histrionic personality disorder. c. She would be given a diagnosis of narcissistic personality disorder. d. She would be given a diagnosis of antisocial personality disorder.

19. Gary’s parents are furious at the psychiatrist for diagnosing him with a second personality disorder.They feel that the psychiatrist is incompetent, so they seek a second opinion. What will the second psychiatrist most likely tell them? a. You are right; it’s impossible to have more than one disorder unless the person has dissociative identity disorder. b. Multiple diagnoses are common. c. It is possible but only for personality disorders in the same DSM-5-TR cluster. d. It is rare but possible.

20. An individual presents for treatment and keeps talking about how gangsters are “out to get” him. Before diagnosing Powered by Cognero

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Chapter 13: Personality paranoid personality disorder, what must we determine? a. whether he is overly sensitive to criticism b. whether his fears are justified c. whether he has any meaningful relationships d. whether he has symptoms of any other personality disorder 21. You are waiting to board a plane when you hear that the flight has been delayed because of a passing thunderstorm.

The man sitting next to you says, “Passing thunderstorm, sure! That’s Jim again; he’s been doing everything to make me miss this meeting because he’s trying to get me fired!” Which personality disorder are his remarks most consistent with? a. paranoid personality disorder b. schizotypal personality disorder c. psychotic personality disorder d. borderline personality disorder 22. It is possible that teaching children to “trust nobody” and to “be careful all of the time because people want to hurt you” may contribute to the development of a personality disorder. Which personality disorder would it be? a. schizoid personality disorder b. paranoid personality disorder c. schizotypal personality disorder d. socially anxious personality disorder 23. Amaya is overly sensitive to criticism. She takes offence at the most trivial, real, or imagined slight. She’s distrustful, easily angers, and holds grudges. She has few friends and is extremely jealous and possessive of her one boyfriend, whom she is always accusing of “playing around” on her. Which personality disorder does Amaya most likely have? a. antisocial personality disorder b. schizoid personality disorder c. paranoid personality disorder d. narcissistic personality disorder 24. Certain groups of people such as prisoners, refugees, people with hearing impairments, and older adults are thought to be susceptible to which of the following? a. antisocial personality disorder b. schizoid personality disorder c. paranoid personality disorder d. narcissistic personality disorder 25. Dr. Angleman is having a hard time treating Craig, who has paranoid personality disorder. What problem is Dr. Angleman most likely encountering with Craig? a. Craig won’t follow treatment recommendations. b. Craig doesn’t trust him. c. He can’t understand Craig’s belief system. d. He can’t convince Craig to talk about his beliefs.

26. Elin’s brother Isak has paranoid personality disorder. She is considering seeking treatment for Isak. What do you tell her based on your knowledge of research on the effects of treatment on paranoid personality disorder?

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Chapter 13: Personality a. Cognitive restructuring therapy is effective in most cases. b. Treatment can be successful only if the patient remains in therapy for a minimum of one year. c. Strict behavioural approaches, which do not require that the patient become attached to the therapist, are most effective. d. To date, there are no forms of treatments that can significantly improve the lives of those with paranoid personality disorder.

27. Theo is a loner. He walks to class by himself, does not talk to anyone, and appears indifferent to other people. It is clear that Theo neither desires nor enjoys closeness with others. He does not act in any obviously unusual ways nor does he appear to possess strange beliefs about the world. Which personality disorder does Theo most likely have? a. schizotypal personality disorder b. schizoid personality disorder c. avoidant personality disorder d. antisocial personality disorder 28. Aidan has little interest in social relationships and appears distant and aloof. He seldom shows emotion and seems indifferent to praise and criticism. He is usually wrapped up in abstract ideas and has little time for, or interest in, people.

Which personality disorder does Aidan most likely have? a. schizotypal personality disorder b. avoidant personality disorder c. schizoid personality disorder d. antisocial personality disorder 29. Florian has paranoid personality disorder, and Arthur has schizoid personality disorder. What trait do the two most likely share? a. a dislike of other people b. extreme irritability c. a sense of being someone special d. social deficiencies 30. Taylor has autism spectrum disorder and has also been diagnosed with a Cluster A personality disorder. What personality disorder has Taylor most likely been diagnosed with? a. paranoid personality disorder b. schizoid personality disorder c. avoidant personality disorder d. schizotypal personality disorder 31. Beck has just been diagnosed with a personality disorder. Beck considers herself to be an observer rather than a participant in the world around her. Which personality disorder is Beck most likely to be diagnosed with? a. schizotypal personality disorder b. schizoid personality disorder c. avoidant personality disorder d. paranoid personality disorder 32. Sam goes through life as a loner and is not motivated to interact with others, but he has relatively typical behaviour and beliefs. Which personality disorder is Sam most likely to be diagnosed with?

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Chapter 13: Personality a. schizoid personality disorder b. paranoid personality disorder c. avoidant personality disorder d. narcissistic personality disorder 33. Anton’s father asks Anton’s psychiatrist what has caused Anton’s schizoid personality disorder. What is the psychiatrist most likely to say? a. The cause is social. b. The cause is unknown. c. It is learned in genetically predisposed individuals. d. It is genetic.

34. Which of the following has been reported to be a potential precursor to schizoid personality disorder? a. childhood shyness b. childhood abuse c. anxiety d. depression 35. Which neurotransmitter has been implicated in the social aloofness of people with schizoid personality disorder? a. serotonin b. dopamine c. GABA d. glutamate 36. Which statement best describes patients diagnosed with schizoid personality disorder? a. They are usually indifferent to the idea of changing their behaviour but make more progress once they become invested in the therapeutic relationship. b. They are usually highly resistant to begin therapy at first but become more motivated if they have a trusting relationship with the therapist. c. They are usually indifferent to the idea of changing their behaviour until they are convinced of the potential benefits to themselves. d. They usually request treatment only in situations of crisis such as the loss of a job.

37. Which type of treatment has shown some effect on patients diagnosed with schizoid personality disorder? a. social skills training b. mindfulness c. interpersonal therapy d. cognitive behavioural therapy 38. Mohamed is socially isolated, behaves in ways that seem unusual, tends to be suspicious, and has odd beliefs. Which personality disorder is Mohamed likely to be diagnosed with? a. schizoid personality disorder b. schizotypal personality disorder c. paranoid personality disorder d. narcissistic personality disorder Powered by Cognero

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Chapter 13: Personality 39. Martin believes he can read people’s minds and foretell the future. He often feels as if deceased relatives are in the room with him. He talks to himself frequently and often speaks to others in a meandering, vague, although not incoherent manner. He is often unkempt, he believes people are talking about him, and he tends to be socially aloof. Which personality disorder does Martin most likely have? a. schizoid personality disorder b. schizotypal personality disorder c. paranoid personality disorder d. multiple personality disorder 40. When Emily first started showing signs of mental illness, her family thought she had developed schizophrenia.

However, Emily has since received a diagnosis of a personality disorder that shares many symptoms with schizophrenia.

Which disorder is this most likely to be? a. paranoid personality disorder b. schizoid personality disorder c. borderline personality disorder d. schizotypal personality disorder 41. Maxime has ideas of reference, but senses that these beliefs are probably unrealistic. Which personality disorder is Maxime most likely to be diagnosed with? a. histrionic personality disorder b. paranoid personality disorder c. schizoid personality disorder d. schizotypal personality disorder 42. What is the most likely cause of schizotypal personality disorder? a. poor parenting b. isolation during childhood c. social modelling d. biological factors 43. In which of the following examples is a subtle but important difference between the unusual perceptual experiences associated with schizotypal personality disorder versus schizophrenia apparent? a. People with schizotypal personality disorder may have the feeling that someone else is in the room (when there isn’t), whereas people with schizophrenia may strongly believe others are trying to hurt them. b. People with schizotypal personality disorder may have the feeling that someone else is in the room (when there isn’t), whereas people with schizophrenia report there is someone else in the room (when there isn’t). c. People with schizotypal personality disorder are very emotional, whereas people with schizophrenia express little emotion. d. People with schizotypal personality disorder may think they have a “sixth sense,” whereas people with schizophrenia may strongly believe they have superhuman powers.

44. A client has schizotypal personality disorder and also meets the criteria for another psychological disorder. What is that other disorder most likely to be? a. schizoid personality disorder b. major depressive disorder Powered by Cognero

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Chapter 13: Personality c. schizophrenia d. paranoia 45. According to research, what is the best treatment to reduce symptoms or postpone the onset of later schizophrenia in individuals with schizotypal personality disorder? a. anti-psychotic medication and social skills training b. community treatment and social skills training c. anti-psychotic medication and community treatment d. anti-psychotic medication, community treatment, and social skills training 46. To people who know her casually, Liz is charming. But underneath her superficial charm is an impulsive, self-centred, insensitive, irresponsible person who has little anxiety and feels no guilt or remorse when she hurts someone else. She blames others for her problems. While she can appear to be the nicest person in the world, if you get in her way—watch out! Which personality disorder does Liz most likely have? a. paranoid personality disorder b. antisocial personality disorder c. schizotypal personality disorder d. narcissistic personality disorder 47. What is the key characteristic of antisocial personality disorder? a. criminal behaviour at a very young age b. impulsivity c. failure to comply with social norms d. selfishness 48. Phillipe Pinel used the term manie sans délire to describe roughly the same symptoms as a disorder in the DSM-5-TR. What is that disorder? a. schizotypal personality disorder b. bipolar disorder c. schizophrenia d. antisocial personality disorder 49. Which of the following has NOT been another label for what the DSM-5-TR calls antisocial personality disorder? a. egopathy b. sociopathy c. idiopathy d. moral insanity 50. Dr. Fries specializes in treating antisocial personality disorder. What percentage of Dr. Fries’s patients are likely to also have a substance use problem? a. 50 percent b. 60 percent c. 70 percent d. 90 percent Powered by Cognero

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Chapter 13: Personality 51. According to Ogloff and colleagues, which trait is important in predicting the amount of effort and likelihood of improvement of criminals in therapy programs? a. egocentrism b. neuroticism c. psychopathy d. impulsivity 52. Dave and Mike both have antisocial personality disorder. Dave has gotten in trouble with the law whereas Mike has not. If you had to guess what differs between the two men, what would you say? a. Mike has the capacity for empathy and Dave does not. b. Mike received early intervention and Dave did not. c. Mike probably has more supportive parents than Dave. d. Dave probably has a lower IQ than Mike.

53. Data from long-term follow-up research indicates that many adults with antisocial personality disorder or psychopathy had another condition as children. What is that condition? a. learning disability b. attention-deficit/hyperactivity disorder c. conduct disorder d. autism 54. What is the relationship between psychopathy and antisocial personality disorder? a. Antisocial personality disorder predicts future psychopathic behaviour. b. Antisocial personality disorder and psychopathy are the same concept. c. The diagnostic criteria for antisocial personality disorder are more liberal than those for psychopathy. d. Antisocial personality disorder is diagnosed before the age of 18, and if the behaviour persists, the individual will be diagnosed as a psychopath.

55. Aleksi is a 15-year-old boy who has been repeatedly arrested for theft and assault. In addition to shoplifting and other theft, he has been caught stealing money from his parents’ wallets and his young sister’s piggy bank. Aleksi demonstrates no guilt or remorse when he harms others. What is Aleksi’s most likely diagnosis? a. conduct disorder b. antisocial personality disorder c. narcissistic personality disorder d. attention deficit hyperactivity disorder 56. According to Carrasco and colleagues (2006), what personality characteristics are most important in distinguishing between boys who showed a stable pattern of antisocial behaviour over time and those who eventually outgrew the behaviour? a. high impulsivity and high empathy b. low impulsivity and low empathy c. high impulsivity and low empathy d. low impulsivity and high empathy 57. Dr. Hamid studies antisocial personality disorder. Which group most likely makes up the basis for much of Dr. Hamid’s research?

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Chapter 13: Personality a. hospital inpatients b. outpatient volunteers c. college and university students d. offenders 58. According to research, what role does genetics play in the cause of antisocial personality disorder? a. Genetic factors account for at least 90 percent of criminal behaviour. b. Genetic factors may cause criminal behaviour even in the absence of negative environmental influences. c. There is no evidence of a genetic cause. d. Genetic factors may contribute to criminal behaviour only in the presence of certain environmental factors.

59. Which of the following pairs includes the two major neurobiological theories that have received a great deal of attention in psychopathy? a. Yerkes-Dodson and lack of shame b. underarousal and fearlessness c. underarousal and lack of shame d. cortical immaturity and underarousal 60. What does the presence of excessive low-frequency theta waves in the brains of psychopaths lead to? a. underarousal b. cortical immaturity c. shamelessness d. fearlessness 61. According to the underarousal hypothesis, why do psychopaths engage in their characteristic behaviours? a. to provide a sense of relief from the feelings of depression that they experience when they are not highly aroused b. to reduce the generally high level of arousal that they feel c. to deal with their anger d. to provide a level of stimulation that most of us receive from more typical behaviours 62. What is the basic assumption of the fearlessness hypothesis of psychopathy? a. Individuals with this disorder have an underactive cortex. b. Individuals with this disorder learn to avoid punishment. c. Individuals with this disorder have a higher threshold for experiencing fear. d. Individuals with this disorder have brain damage that inhibits their ability to understand the implications of their actions.

63. An integrative model to explain antisocial personality disorder discusses that genetic inheritance may influence which two systems? a. the inhibition and reward systems b. the fight/flight and reward systems c. the cortical stimulation and reward systems d. the inhibition and fight/flight systems Powered by Cognero

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Chapter 13: Personality 64. What does research indicate regarding psychopaths and their goal setting patterns? a. Individuals with this disorder are less likely to be motivated toward a goal. b. Individuals with this disorder are more likely to keep trying even though the goal is no longer achievable. c. Individuals with this disorder are less likely to attempt difficult goals. d. Individuals with this disorder are more likely to quit trying as soon as failure appears imminent.

65. One of the contributing factors in the developmental history of individuals with antisocial personality disorder or psychopathy appears to involve parenting. Which behaviour were their parents more likely than other parents to have used? a. an overly permissive parenting style b. overly firm discipline c. physical discipline d. inconsistent discipline 66. What is involved in the most common treatment strategy for children at risk for antisocial personality disorder? a. medication and intensive psychotherapy b. placement in supervised foster homes c. behavioural modification d. parent training 67. What is an obstacle to the prevention efforts for antisocial behaviours? a. We have relatively poor methods for identifying which children will grow up to have antisocial personality disorder. b. Parents refuse to seek treatment for their children because of stigma. c. The children often refuse to participate in treatment. d. The cost of this treatment is too high.

68. Which type of personality disorder most often leads to self-mutilation? a. schizoid personality disorder b. schizotypal personality disorder c. antisocial personality disorder d. borderline personality disorder 69. Lauri has extremely unstable behaviour and emotion; they are impulsive, depressed, and often injures themself. What personality disorder does Lauri most likely have? a. schizotypal personality disorder b. borderline personality disorder c. dependent personality disorder d. histrionic personality disorder 70. Nick has difficulty maintaining relationships because he goes back and forth from being a best friend to hating people in his life quite often. His romantic relationships are always characterized by incredible loving passion, alternating with episodes of horrible fighting. Sometimes he becomes violent. At times, Nick becomes so upset that he cuts himself and reports that this makes him feel better emotionally. Which personality disorder does he most likely have? a. histrionic personality disorder Powered by Cognero

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Chapter 13: Personality b. dependent personality disorder c. narcissistic personality disorder d. borderline personality disorder 71. Which of the following disorders is NOT likely to coexist with borderline personality disorder? a. substance use disorder b. depression c. panic disorder d. an eating disorder 72. Approximately 65 percent of individuals diagnosed with borderline personality disorder also have another disorder.

What is the other disorder? a. bipolar disorder b. a substance use disorder c. antisocial personality disorder d. ADHD 73. Borderline personality disorder compares to antisocial personality disorder in which way? a. The disorder occurs in males more frequently than females do. b. Many individuals tend to show improvement with age. c. Both seem to have dopamine dysfunction underlying the etiology. d. Both are completely biological in nature.

74. Which of the following have Links and Stockwell (2001) NOT identified as a subtype of borderline personality patients? a. impulsive subtype b. identity disturbance subtype c. affective cluster d. self-harming subtype 75. Dr. Dawson is studying possible causes of borderline personality disorder. What is she NOT interested in researching? a. parental neglect b. interpersonal relationships c. child physical abuse d. child sexual abuse 76. Your friend’s therapist said that her borderline personality disorder may actually be another disorder. Which disorder was the therapist most likely to be referring to? a. histrionic personality disorder b. post-traumatic stress disorder c. dependent personality disorder d. bipolar disorder 77. Why might labelling childhood trauma as a cause of borderline personality disorder be too simplistic an explanation? a. People with borderline personality disorder frequently lie about childhood trauma.

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Chapter 13: Personality b. Childhood trauma histories occur in a number of other disorders as well. c. Individuals with borderline personality disorder tend to respond to SSRI medications. d. There are too many neurological deficits that are noted in people with borderline personality disorder.

78. What is the relationship between childhood sexual and physical abuse and borderline personality disorder? a. Although early trauma may play a small role in the development of borderline personality disorder, it is likely that biological factors play the major role. b. Neither sexual nor physical abuse appears to be necessary or sufficient to produce the disorder. c. Early trauma is indirectly related to the disorder in that all cases of borderline personality disorder resemble post-traumatic stress disorder. d. Because early abuse is linked to a number of disorders in addition to borderline personality disorder, it is unlikely that it is causally related to any specific disorder.

79. Recently, Janice was diagnosed with borderline personality disorder. Her therapist told her that many people with this disorder respond well to a variety of medications, including which of the following? a. antidepressants and anti-anxiety drugs b. anti-anxiety drugs c. antipsychotics and lithium d. anti-anxiety drugs and lithium 80. What does the psychological treatment that has been found to be most effective in helping patients with borderline personality disorder involve? a. learning to cope with stressors that seem to trigger maladaptive responses b. regressing patients to the time in their lives when they experienced trauma c. removing the reinforcing attention that they have received for their disordered behaviour in the past d. changing maladaptive attitudes about the patients themselves and others 81. Which psychotherapy has a growing body of evidence to support its effectiveness in treating borderline personality disorder? a. cognitive therapy b. dialectical behaviour therapy c. exposure and ritual prevention d. interpersonal therapy 82. Which treatment is described as “east meeting west”? a. dialectical behaviour therapy b. interpersonal therapy c. exposure and ritual prevention d. cognitive therapy 83. According to Links and Stockwell (2001), couples therapy can be very beneficial for those borderline personality patients who are in a relationship, but there is an exception. Which of the following would NOT benefit from couples therapy? a. those with the identity disturbance subtype of the disorder b. those with the impulsive subtype of the disorder Powered by Cognero

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Chapter 13: Personality c. those who have comorbid substance use disorders d. those who have a history of violent interpersonal behaviour 84. Avery overreacts to everything, is overly dramatic and vain, and seeks reassurance and approval constantly. Which personality disorder is Avery most likely to be diagnosed with? a. narcissistic personality disorder b. histrionic personality disorder c. antisocial personality disorder d. borderline personality disorder 85. Amy quickly becomes the centre of attention when she enters a room. She is a tall and attractive young woman who generally wears something striking. Amy is known as a flirt and acts in a seductive manner around men. When Amy speaks, she uses exaggerated terms, even when describing relatively ordinary situations. What is Amy’s most likely diagnosis? a. histrionic personality disorder b. dependent personality disorder c. borderline personality disorder d. narcissistic personality disorder 86. Rija shows excessive emotionality; has an excessive need for praise, reassurance, and approval; and constantly needs to be the centre of attention. Which personality disorder does Rija most likely have? a. narcissistic personality disorder b. dependent personality disorder c. histrionic personality disorder d. borderline personality disorder 87. Kelly is a born actor. She is always the centre of attention. She is highly dramatic, overemotional, self-centred, spoiled, and inconsiderate of her friends. While she can appear charming and is often flirtatious and seductive, she has never had a truly intimate relationship. She has poor self-esteem and tries to impress others as a means of improving her own self-worth. Which personality disorder does Kelly most likely have? a. histrionic personality disorder b. narcissistic personality disorder c. dependent personality disorder d. borderline personality disorder 88. There appears to be a relationship between two personality disorders, with some evidence that each may be sex-typed alternative ways of expressing the same underlying condition. What are these two disorders? a. histrionic and antisocial personality disorders b. borderline and histrionic personality disorders c. antisocial and borderline personality disorders d. histrionic and narcissistic personality disorders 89. Histrionic personality disorder has been suggested to be a sex-typed alternative expression of which of the following? a. dependent personality disorder b. borderline personality disorder Powered by Cognero

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Chapter 13: Personality c. antisocial personality disorder d. narcissistic personality disorder 90. Marielle has histrionic personality disorder. Her family has asked Marielle’s psychiatrist whether there is any treatment that can help reduce her problematic behaviours. What is the psychiatrist most likely to say? a. “Strict behavioural programs have been shown to be effective in controlled research.” b. “There are no well-controlled studies demonstrating success.” c. “Cognitive therapy is most effective.” d. “Patients who voluntarily attend therapy tend to get better.”

91. What is one of the problems encountered when trying to change the behaviour of an individual with histrionic personality disorder? a. Patients with this disorder generally do not have the intellectual abilities to change despite their desire to do so. b. The patient does not want to change. c. The maladaptive behaviour generally results in short-term benefits despite long-term costs. d. The maladaptive behaviour is genetically determined.

92. What is the primary characteristic of narcissistic personality disorder? a. thinking of oneself as deserving of special treatment b. exaggerated emotions and seductive behaviour c. a constant need for reassurance and approval d. impulsivity 93. Why are individuals with narcissistic personality disorder most likely to become depressed? a. They seldom live up to their unrealistic expectations of themselves. b. They are involved in an endless search for the ideal person who will meet their unfulfilled empathic needs. c. They feel that others don’t understand and appreciate them. d. They become upset when their intimate relationships fail.

94. Steven loves to brag. While he is not overly dramatic or flirtatious, he enjoys being the centre of attention. He is selfabsorbed and lacks empathy for others. He is successful in his career and very proud of his accomplishments. Steven just wishes others would appreciate how wonderful he thinks he is. He is preoccupied with fantasies of future success and power. Which personality disorder does Steven most likely have? a. antisocial personality disorder b. histrionic personality disorder c. narcissistic personality disorder d. borderline personality disorder 95. According to Lasch (1978), which of the following disorders has been increasing in frequency because of significant cultural changes? a. narcissistic personality disorder b. antisocial personality disorder c. histrionic personality disorder d. dependent personality disorder Powered by Cognero

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Chapter 13: Personality 96. Some writers, including Heinz Kohut, believe that narcissistic personality disorder arises largely from which of the following? a. a shift in the cultural beliefs to focus on the “me generation” b. an increase in competitiveness in individualistic cultures c. a failure of empathic mirroring by parents early in development d. an elevated personality trait of disagreeableness 97. Using the five-factor model of personality, Paulhus and Williams (2002) administered measures of psychopathy and narcissism to university students. What did they find? a. The two disorders are virtually identical constructs. b. The two disorders are overlapping but distinct constructs. c. Both disorders share a hypersensitivity to criticism. d. Both disorders were associated with elevated scores on the neuroticism scale.

98. Which of the following is NOT a typical treatment strategy for narcissistic personality disorder? a. coping strategies to help accept criticism b. cognitive therapy to replace fantasies with a focus on the day-to-day c. help to focus on the feelings of others d. coping strategies for the stressful life events that seem to trigger insecurity in the patient 99. Adam has always chosen to spend his time alone for fear of rejection. As a result, he feels detached from his family and the people he works with. His brothers report that Adam’s social skills are very poor. What personality disorder would best describe Adam? a. narcissistic personality disorder b. schizoid personality disorder c. avoidant personality disorder d. dependent personality disorder 100. Why do individuals with avoidant personality disorder avoid most relationships? a. They are simply not interested in social interaction. b. They are extremely sensitive to the opinions of others and fear rejection. c. They lack typical social skills and are generally rejected by others. d. They experience debilitating anxiety at the thought of embarrassing themselves in front of others.

101. Sho keeps to himself because he is anxious and fearful of rejection. Which personality disorder is he most likely to be diagnosed with? a. avoidant personality disorder b. antisocial personality disorder c. schizoid personality disorder d. dependent personality disorder 102. Lida wants to be involved with people. She loves people and has strong needs for affection and acceptance. But her fears of rejection and public embarrassment prevent her from reaching out to those around her. Instead, she sticks to her routine and refuses to take any risks or try anything new. Which personality disorder does Lida most likely have? a. histrionic personality disorder Powered by Cognero

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Chapter 13: Personality b. dependent personality disorder c. avoidant personality disorder d. paranoid personality disorder 103. When asked about their childhood, how do individuals diagnosed with avoidant personality disorder tend to remember their parents? a. as warm and loving b. as depressed c. as rejecting d. as harsh and physically abusive 104. Which temperamental factor links social anxiety and avoidant personality disorder? a. behavioural inhibition b. anxiety sensitivity c. fear d. suggestibility 105. How effective is the treatment for avoidant personality disorder? a. Individuals with this disorder are seldom sufficiently motivated to succeed in treatment. b. There are well-controlled studies, though none show any treatment success. c. No well-controlled studies of treatment outcomes have been conducted. d. Behavioural intervention programs for anxiety and social skills have had some success.

106. In Rowena’s psychotherapy sessions, her therapist has been using graduated exposure to slowly make her more comfortable with social situations. Which personality disorder is Rowena most likely being treated for? a. schizoid personality disorder b. schizotypal personality disorder c. avoidant personality disorder d. dependent personality disorder 107. Medical interventions for avoidant personality disorder often resemble the treatments for which other disorder? a. depression b. schizophrenia c. anxiety d. post-traumatic stress disorder 108. In terms of symptoms of feelings of inadequacy, sensitivity to criticism, and need for reassurance, which of the following personality disorders are quite similar? a. narcissistic and paranoid personality disorders b. dependent and schizoid personality disorders c. dependent and avoidant personality disorders d. schizoid and avoidant personality disorders 109. Clark and colleagues (1997) found that patients with one personality disorder also tend to obtain high scores on measures of sociotropy. What was the personality disorder?

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Chapter 13: Personality a. borderline personality disorder b. dependent personality disorder c. histrionic personality disorder d. narcissistic personality disorder 110. Individuals with avoidant personality disorder usually respond to certain feelings by avoiding relationships; those with dependent personality disorder respond to the same feelings by clinging to relationships. Which of the following best characterizes those feelings? a. depression b. self-consciousness c. anxiety d. inadequacy 111. How effective is the treatment for dependent personality disorder? a. It is generally successful with a cognitive-behavioural approach. b. It is successful when based on systematic desensitization and social-skills training. c. It is well researched, though no effective treatments have been established. d. It is not well researched.

112. How do individuals with dependent personality disorder respond to therapy? a. They are flirtatious and seductive. b. They are too unstable to do the intellectual work that therapy requires. c. They are seemingly ideal patients. d. They are resistant to the therapeutic process.

113. When working with a patient diagnosed with dependent personality disorder, what must the therapist be particularly careful about? a. that the patient does not behave seductively toward the therapist b. that the patient does not avoid attending sessions c. that the patient does not rely on the therapist for decision making d. that the patient does not manipulate the therapist with flattery 114. Terrance is very work oriented, spends little time going to movies or parties, is rigid in his thinking, and has generally poor interpersonal relationships. Which personality disorder does Terrance most likely have? a. antisocial personality disorder b. avoidant personality disorder c. obsessive-compulsive personality disorder d. narcissistic personality disorder 115. What distinguishes individuals with obsessive-compulsive personality disorder from those with obsessivecompulsive disorder? a. Patients with obsessive-compulsive personality disorder generally do not have obsessive thoughts and compulsive behaviours. b. Patients with obsessive-compulsive personality disorder generally show more compulsive and ritualistic behaviours.

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Chapter 13: Personality c. Patients with obsessive-compulsive personality disorder generally have more obsessive thoughts. d. Patients with obsessive-compulsive personality disorder generally have multiple diagnoses.

116. Which personality trait is an important aspect of obsessive-compulsive personality disorder? a. compulsions b. perfectionism c. anxiety d. achievement-related fears 117. Research by Ferguson and Rodway (1994) indicates that a certain therapy can be effective in treating one important aspect of obsessive-compulsive personality disorder. What is the therapy and what aspect of the disorder is it for? a. interpersonal therapy for dysfunctional relationships b. humanistic therapy for underlying feelings of inadequacy c. psychoanalytic therapy for an obsessive need for cleanliness d. cognitive-behavioural therapy for perfectionism 118. What role do genetics play in the development of obsessive-compulsive personality disorder? a. The role of genetics is non-existent. b. The role of genetics is dependent upon the specific pattern of symptoms displayed. c. The role of genetics is moderate. d. The role of genetics is strong.

119. Why were passive-aggressive personality disorder and sadistic personality disorder NOT included in the DSM-5-TR? a. These disorders are categorical and not dimensional. b. The existence of these disorders as distinct personality disorders remains controversial. c. Treatment plans need to be determined prior to their inclusion. d. There are already too many personality disorders listed in the current edition of the DSM.

120. Identify the three clusters of DSM-5-TR personality disorders and provide an example of one personality disorder that belongs to each cluster. How would you characterize each cluster?

121. Explain the reasons that the prognosis for patients treated for personality disorders is generally less optimistic than the prognosis for patients treated for many other disorders. Select any personality disorder and describe a treatment strategy that has had some evidence of success.

122. Explain what differentiates individuals with schizotypal personality disorder from those with schizophrenia. What are the similarities observed for individuals diagnosed with schizotypal personality disorder and those with schizophrenia?

123. Compare and contrast the behaviours, thoughts, and motivations of an individual with avoidant personality disorder versus someone with schizoid personality disorder. Make sure to note similarities and differences.

124. Describe the basic features of antisocial personality disorder. Why is psychotherapy with this population so likely to fail?

125. Describe some factors that might influence the development of antisocial personality disorder. What childhood Powered by Cognero

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Chapter 13: Personality behaviours/diagnoses have been observed in the histories of individuals who later developed antisocial personality disorder? Describe a typical intervention strategy designed to prevent at-risk youth from developing antisocial personality disorder.

126. One might say that the thoughts of those with avoidant and dependent personality disorders are similar, but the behaviours are not. We could further note that the behaviours of those with avoidant and schizoid personality disorders are similar, but the thoughts are not. Explain these two statements.

127. Describe the similarities and differences between individuals with obsessive-compulsive personality disorder and individuals diagnosed with obsessive-compulsive disorder. How would a clinician treat obsessive-compulsive personality disorder?

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Chapter 13: Personality Answer Key 1. a 2. c 3. d 4. d 5. b 6. d 7. a 8. d 9. d 10. a 11. c 12. a 13. a 14. b 15. b 16. a 17. d 18. b 19. b 20. b 21. a 22. b 23. c 24. c 25. b Powered by Cognero

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Chapter 13: Personality 26. d 27. b 28. c 29. d 30. b 31. b 32. a 33. b 34. a 35. b 36. d 37. a 38. b 39. b 40. d 41. d 42. d 43. b 44. b 45. d 46. b 47. c 48. d 49. c 50. b 51. c Powered by Cognero

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Chapter 13: Personality 52. d 53. c 54. c 55. a 56. c 57. d 58. d 59. b 60. b 61. d 62. c 63. a 64. b 65. d 66. d 67. a 68. d 69. b 70. d 71. c 72. b 73. b 74. d 75. b 76. b Powered by Cognero

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Chapter 13: Personality 77. b 78. b 79. c 80. a 81. b 82. a 83. b 84. b 85. a 86. c 87. a 88. a 89. c 90. b 91. c 92. a 93. a 94. c 95. a 96. c 97. b 98. d 99. c 100. b 101. a 102. c Powered by Cognero

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Chapter 13: Personality 103. c 104. a 105. d 106. c 107. c 108. c 109. b 110. d 111. d 112. c 113. c 114. c 115. a 116. b 117. d 118. c 119. b 120. Student responses will vary.

121. Student responses will vary.

122. Student responses will vary.

123. Student responses will vary.

124. Student responses will vary.

125. Student responses will vary.

126. Student responses will vary.

127. Student responses will vary.

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Chapter 13: Personality

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Chapter 14: Psychosis

Indicate the answer choice that best completes the statement or answers the question.

1. What percentage of people are affected by schizophrenia at some point in their lives? a. 1 percent b. 2 percent c. 5 percent d. 10 percent 2. You are the mayor of a city with 100 000 people in it. About how many people with schizophrenia can you estimate live in your city? a. 50 b. 100 c. 250 d. 1000 3. Toward the end of the 19th century, the German psychiatrist Emil Kraepelin used a term to refer to an onset of symptoms that often occurs before adulthood, and what we now call schizophrenia. What was that term? a. folie à deux b. dementia praecox c. adolescent insanity d. hebephrenia 4. Who first used the term dementia praecox? a. Eugen Bleuler b. Walter Heinrichs c. Heinz Lehmann d. Emil Kraepelin 5. Which symptom was NOT combined to form the term dementia praecox? a. paranoia b. hebephrenia c. mania d. catatonia 6. According to the terminology relating to dementia praecox, which symptom would Susanna demonstrate if she was showing silly and immature emotionality? a. paranoia b. hebephrenia c. mania d. catatonia 7. Who renamed dementia praecox as schizophrenia? a. Heinz Lehmann b. Eugen Bleuler c. Walter Heinrichs Powered by Cognero

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Chapter 14: Psychosis d. Emil Kraepelin 8. In 1908, Swiss psychiatrist Eugen Bleuler introduced the term schizophrenia, which comes from the combination of the Greek words for “split” and “mind.” What does the term refer to? a. an associative splitting of the basic functions of personality b. a malfunction of the left and right hemispheres of the brain c. a splitting of one personality into several distinct personalities d. a dualistic view of the mind, as consisting of both body and soul 9. Who introduced the term schizophrenia in 1908? a. Emil Kraepelin b. Heinz Lehmann c. Phillipe Pinel d. Eugen Bleuler 10. Eugen Bleuler’s concept of schizophrenia as an “associative splitting” of the basic functions of personality led to an incorrect use of the term. What is this incorrect meaning? a. manic-depressive disorder b. multiple personality c. a fugue state d. folie à deux 11. Veronica is hospitalized after a suicide attempt. In the hospital, she spends all her time drawing sketches of monsters that she calls “hell’s keepers.” She claims that these “hell’s keepers” talk to her and ordered her to plan her suicide. She talks to invisible people in her room. What disorder does Veronica most likely have? a. dissociative identity disorder b. paranoid personality disorder c. schizophrenia d. schizoid personality disorder 12. Marlon believes that he was sent to earth to save humankind. He says that he regularly hears the voice of God describing his mission. His appearance is dishevelled, and he often speaks incoherently. He has experienced these symptoms for the past seven months. Based on this information, what disorder does Marlon most likely have? a. delusional disorder b. schizophrenia c. brief psychotic disorder d. schizophreniform disorder 13. Which statement best characterizes an individual who is diagnosed with psychosis? a. The person has delusions. b. The person has hallucinations and delusions. c. The person has hallucinations. d. The person has hallucinations and delusions but in a less serious form than in the diagnosis of schizophrenia.

14. Jess tells her friend Martina that her brother is psychotic. What does Jess likely mean?

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Chapter 14: Psychosis a. He has disorders of thought. b. He has disorganized speech and disorganized behaviour. c. He has paranoia. d. He has lost contact with reality.

15. Although media portrayals continue to depict people with schizophrenia as violent, traits such as anger and which of the following are better predictors of violence? a. paranoia b. antisocial personality c. narcissism d. mania 16. Which of the following is NOT a type of symptom in schizophrenia? a. positive b. negative c. manic d. disorganized 17. What was also included in the DSM-5-TR diagnostic criteria for schizophrenia? a. cognitive symptoms b. subtypes of schizophrenia c. risk of violence assessment d. dimensional assessment of the symptoms 18. How long do symptoms need to be present in order to diagnose schizophrenia? a. two weeks of consistent symptoms over one month b. one month of consistent symptoms over six months c. two months of consistent symptoms over six months d. one year of consistent symptoms with no gaps 19. Alberto believes that his computer comes to life at night and transmits messages about humans to Pluto. Assuming Alberto’s computer does not do this, what is Alberto’s belief an example of? a. negative symptoms b. disorganization c. a delusion d. hallucination 20. Janet has been diagnosed with schizophrenia. What is the likelihood Janet will have delusions? a. 20 percent b. 40 percent c. 70 percent d. 100 percent 21. In working with patients with schizophrenia, mental health professionals typically distinguish between two types of symptoms—an excess or distortion of typical behaviour and deficits in typical behaviour. What are these symptoms Powered by Cognero

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Chapter 14: Psychosis called, respectively? a. dysmorphic and dysfunctional symptoms b. acute and passive symptoms c. manic and depressive symptoms d. positive and negative symptoms 22. Which symptom of schizophrenia has been referred to as “the basic characteristic of madness”? a. delusion b. hallucination c. Cotard’s syndrome d. disorganized thought 23. Which of the following would be considered a delusion? a. clearly seeing a vision of an object that is not physically present b. having to wash one’s hands thoroughly every time one touches something c. feeling pain in one’s back even though there is no physical sign of injury d. being convinced that one’s neighbours are aliens from another planet 24. Which of the following is an example of a delusion of persecution? a. the belief that people are out to get you b. the belief that a body part has changed in some impossible way c. the belief that a familiar person is actually a double d. the belief that you are a famous or important person 25. Your neighbour believes that people are spying on him. He claims that the RCMP has put a microphone in his dog’s stomach so that they can listen to his private conversations. What kind of delusions do his beliefs illustrate? a. delusions of being controlled b. delusions of reference c. delusions of persecution d. delusions of grandeur 26. Leo believes he is Jesus Christ. He is convinced he has returned to pass judgment on the world and offer salvation to true Christians. Despite a complete lack of evidence to support his beliefs, he remains convinced that he is Christ and that he is all-powerful. What kind of delusions do Leo’s beliefs illustrate? a. delusions of being controlled b. delusions of reference c. delusions of grandeur d. delusions of persecution 27. Shayna has schizophrenia and announces that the Pope has given her secret instructions. She plans to end world poverty and homelessness. What kind of delusions does Shayna’s thinking illustrate? a. delusions of grandeur b. delusions of reference c. delusions of thought insertion d. delusions of persecution Powered by Cognero

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Chapter 14: Psychosis 28. What is Cotard’s syndrome? a. the belief that people are out to get you b. the belief that a body part has changed in some impossible way c. the belief that you are a famous or important person d. the belief that a familiar person is actually a double 29. Allen is convinced that his brother has been replaced by an imposter. What aspect of schizophrenia is Allen displaying? a. delusional disorder b. Capgras syndrome c. Cotard’s syndrome d. folie à deux 30. What is one reason that schizophrenic delusions persist in the face of contradictory information? a. One of the symptoms of schizophrenia is perseverative thinking. b. The ventricles are enlarged. c. The delusions may provide the affected individual with a sense of purpose and meaning in life. d. The individual cannot recognize the difference between the voices in their head and voices of other people who are providing the information.

31. Roberts (1991) studied 17 people who had elaborate delusions about themselves and the world and compared them with a matched group of people who previously had delusions but were now improving. Compared to those who previously suffered delusions, what did Roberts discover about people with current delusions? a. Those with current delusions expressed a lack of purpose and meaning in life and greater depression. b. Those with current delusions were more motivated to undergo therapy. c. Those with current delusions expressed a stronger sense of purpose and meaning in life and less depression. d. Those with current delusions were functioning at a higher level in their everyday life.

32. Ivan just had a hallucination due to schizophrenia. What type of hallucination did they most likely experience? a. tactile b. olfactory c. auditory d. visual 33. James has schizophrenia. His parents can always tell when he is hallucinating. Consistent with research, James sits there and smiles as if he is listening to someone next to him. What is he usually doing while hallucinating? a. talking b. just waking up in the morning c. being unoccupied d. watching television 34. A woman with schizophrenia has a vision of St. Paul hovering in mid-air at the foot of her bed. What is this vision an example of? a. an apparition Powered by Cognero

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Chapter 14: Psychosis b. a hallucination c. an avolition d. a delusion 35. Which statement does NOT accurately describe the theories of auditory verbal hallucinations? a. Individuals may be misinterpreting their inner speech as other’s voices. b. Auditory verbal hallucinations may arise from atypical activation of the primary auditory cortex. c. There is increased metabolic activity in the left primary auditory cortex. d. Individuals with schizophrenia have been found to be missing the Wernicke’s area in the brain, the area responsible for speech comprehension.

36. What percentage of individuals with schizophrenia display negative symptoms? a. 25 percent b. 60 percent c. 70 percent d. 100 percent 37. What is the negative symptom of schizophrenia known as avolition? a. an inability to initiate and persist in activities b. a lack of speech content and/or slowed speech response c. a lack of emotional response and a blank facial expression d. an inability to experience pleasure 38. Aarav is experiencing alogia. What would someone spending time with Aarav notice about him? a. He would seem to have an inability to experience pleasure. b. He would seem to have an inability to initiate and persist in activities. c. He would show a lack of speech content and/or slowed speech response. d. He would show a lack of emotional response and a blank facial expression.

39. Sorin is experiencing anhedonia. What does this mean for Sorin? a. He lacks emotional responses and exhibits a blank facial expression. b. His speech lacks content or is slowed. c. He has an inability to initiate and persist in activities. d. He has an inability to experience pleasure.

40. How does anhedonia relate to schizophrenia? a. Anhedonia will result in avolition and alogia. b. Anhedonia will result in treatment resistant schizophrenia. c. Anhedonia will result in a delay of seeking treatment for schizophrenia. d. Anhedonia will result in an increase of delusional thinking.

41. Peter Liddle (2000), from the University of British Columbia, found that the best predictor of asociality in people with schizophrenia is which of the following? a. lack of emotional responses b. chronic cognitive impairment Powered by Cognero

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Chapter 14: Psychosis c. inability to experience pleasure d. delusional thoughts 42. What is the negative symptom of schizophrenia known as flat affect? a. an inability to initiate and persist in activities b. a lack of emotional response and a blank facial expression c. an inability to experience pleasure d. a lack of speech content and/or slowed speech response 43. Consider the following statement: “The time is 9:30. Ten is my favourite number. I also like to listen to music and paint pictures.” What kind of disorganized speech does the statement illustrate? a. catatonic slippage b. tangentiality c. word salad d. derailment 44. What is the disorganized symptom of schizophrenia known as tangentiality? a. incomprehensible speech b. abruptly changing the topic of conversation to unrelated or only peripherally related areas c. drawing illogical conclusions in one’s speech d. going off topic when answering a question 45. Tomas has schizophrenia. He frequently giggles childishly to himself on the subway and cries when he watches cartoons on television. What symptom is he exhibiting? a. flat affect b. cognitive slippage c. anhedonia d. inappropriate affect 46. Mark was diagnosed with schizophrenia. Recently, he has been standing for hours in unusual postures. What is this symptom called? a. cognitive slippage b. inappropriate affect c. hebephrenia d. catatonic immobility 47. Diagnosed with schizophrenia, Marta shows an unusual form of catatonia. If someone moves one of her arms or legs into a different position, it just stays that way. What is this symptom called? a. waxy flexibility b. catatonic cooperation c. schizophrenic movement disorder d. postural dysfunction 48. A patient has been showing signs of schizophrenia for a couple of months. At this point, which disorder can they be diagnosed with?

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Chapter 14: Psychosis a. schizoaffective disorder b. schizophreniform disorder c. delusional disorder d. schizophrenia 49. Callie has been diagnosed with schizoaffective disorder. This means that, in addition to schizophrenic symptoms, she also has another condition. What is the other condition? a. an anxiety disorder b. a split personality c. obsessive-compulsive disorder d. a mood disorder 50. Jack was recently arrested, for the fifth time, for stalking a local media celebrity who he believes is in love with him.

This is a persistent and strongly held belief of Jack’s, but it is his only symptom. What disorder does Jack most likely have? a. brief psychotic disorder b. delusional disorder c. schizophreniform disorder d. schizoaffective disorder 51. Many celebrity stalkers likely have which form of delusional disorder? a. erotomanic type b. jealous type c. grandiose type d. persecutory type 52. How are schizophrenia and delusional disorder different? a. In schizophrenic delusions, the imagined events could be happening but they’re not; in delusional disorder, the imagined events aren’t possible. b. Delusional disorder usually lasts only a few days; schizophrenia is long lasting and chronic. c. Delusional disorder is often triggered by stressful events; schizophrenia is never precipitated by stressful events. d. Schizophrenia usually begins in adolescence or early adulthood; delusional disorder often has an age of onset in the 40s.

53. You read a story about a couple who was arrested because they abducted their children from their previous marriages.

The wife believed that government agencies and others were plotting to sell children to childless parents, and the husband started to believe the same. Which disorder best characterizes the husband? a. brief psychotic disorder b. folie à deux c. dual schizophrenia d. schizophreniform disorder 54. Arthur, who is described in the text, suddenly experienced the delusion that he could save all the starving children in the world with a “secret plan.” Because his symptoms lasted only a few days, what was his diagnosis?

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Chapter 14: Psychosis a. schizotypal personality disorder b. schizoaffective disorder c. brief psychotic disorder d. folie à deux 55. After Martha’s last final examination, she began experiencing auditory hallucinations and told her friends about her plans to reunite all missing children from around the world with their parents. Martha’s friends were relieved two weeks later when Martha reported that she was not hearing any voices and did not have any plans for reuniting missing children.

What had Martha most likely experienced? a. an undiagnosable event b. schizophreniform disorder c. brief psychotic disorder d. delusional disorder 56. Several other disorders or diseases can cause delusions. Which of the following was NOT discussed in the text as one of these disorders/diseases? a. brain tumour b. Alzheimer’s disease c. alcohol use disorder d. diabetes 57. What is the defining feature of attenuated psychosis syndrome? a. psychosis lasting less than a week b. an awareness of the troubling nature of the symptoms c. experiencing only hallucinations or delusions, but not both d. chronic psychotic symptoms 58. What is the main difference between schizophrenia and schizotypal personality disorder? a. The onset—schizotypal personality disorder begins in childhood. b. The duration—schizotypal personality disorder is a more chronic disorder. c. The characteristics are similar but less severe in schizotypal personality disorder. d. The etiology of the two disorders is different.

59. Which statement best describes the onset of schizophrenia? a. Most people with schizophrenia develop symptoms in their teen years. b. Most people with schizophrenia develop symptoms in their 40s. c. The probability of developing schizophrenia is greater for males than for females until age 36. d. The probability of developing schizophrenia is greater for females than for males until age 36.

60. On average, how many years less do people with schizophrenia live? a. 1 to 2 years b. 5 to 10 years c. 10 to 15 years d. 20 to 25 years Powered by Cognero

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Chapter 14: Psychosis 61. According to Statistics Canada, how does the rate of acute care hospitalizations differ for Indigenous individuals with schizophrenic/psychotic disorders compared with non-Indigenous individuals with the same disorders? a. Indigenous individuals living on and off the reserve have almost double the hospitalizations. b. Indigenous individuals living on the reserve have almost triple the hospitalizations. c. Indigenous individuals living off the reserve have almost half the hospitalizations. d. Indigenous individuals have similar amounts of hospitalizations, regardless of residence.

62. Which of the following is NOT a typical clinical feature seen in children who go on to develop schizophrenia? a. poor motor coordination b. psychosis c. mild cognitive and social problems d. mild physical anomalies 63. Which term refers to the one- to two-year period when less severe yet unusual behaviours start to show themselves? a. a prodromal stage b. the attenuated period c. an episodic stage d. the evidentiary period 64. What are the chances that a patient with schizophrenia went through a prodromal stage? a. 50 percent b. 65 percent c. 85 percent d. 90 percent 65. According to a study on the relapse rates of schizophrenia, as described in the textbook, approximately what percentage of people who have one episode of schizophrenia will have no lasting impairments or further episodes? a. 22 percent b. 48 percent c. 74 percent d. 100 percent 66. What do cross-cultural studies of schizophrenia suggest? a. Schizophrenia is universal in its prevalence, course, and outcome. b. Schizophrenia is more prevalent in developing countries. c. Schizophrenia is largely a Western phenomenon. d. Schizophrenia is universal, but it may vary in its course and outcome across cultures.

67. How is the genetic basis of schizophrenia best understood? a. Schizophrenia is primarily genetically caused. b. Researchers have discovered the gene responsible for causing schizophrenia. c. Genes are responsible for making some individuals vulnerable to schizophrenia. d. Some forms of schizophrenia are influenced by genes; others are not.

68. If one identical twin has schizophrenia, what is the approximate probability that the other identical twin also has the Powered by Cognero

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Chapter 14: Psychosis disorder? a. 10 percent b. 25 percent c. 50 percent d. 100 percent 69. Which concept supports the outcome of the Genain sisters (the identical quadruplets all diagnosed with schizophrenia)? a. an unshared environment b. a unique perceptive interpretation c. an environmental phenomenon d. a variable home structure 70. In which situation would the risk of developing schizophrenia be the lowest for a child? a. The child’s parent with schizophrenia has a fraternal twin without schizophrenia. b. The child’s parent without schizophrenia has a fraternal twin with schizophrenia. c. The child’s parent without schizophrenia has a identical twin with schizophrenia. d. The child’s parent with schizophrenia has an identical twin without schizophrenia.

71. What has research on the relationship between schizophrenia and cannabis demonstrated? a. Certain genes may act as vulnerability factors that interact with specific environmental pathogens and can lead to the development of schizophrenia. b. Cannabis use in youth is an established but weak risk factor for developing schizophrenia. c. If predisposed to psychosis, using cannabis can decrease symptoms. d. If using cannabis induces psychosis, we can use this as proof a marker for schizophrenia.

72. In genetic linkage studies what is the name for the location of genes responsible for traits? a. marker genes b. chromosome association c. genome d. association genes 73. Of the various genetic linkage and association studies, which one seems to be a possible “marker” for schizophrenia? a. unusual facial features b. eye-tracking c. scores on various cognitive tests d. blood type 74. Several studies have shown a link between eye-tracking deficits and schizophrenic symptoms. Which of the following symptoms are these? a. negative symptoms b. both positive and negative symptoms c. both positive and negative symptoms, but mostly positive symptoms d. positive symptoms Powered by Cognero

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Chapter 14: Psychosis 75. Which of the following explains gradations of severity in people with schizophrenia (from mild to severe) and explains that the risk of having schizophrenia increases with the number of affected relatives in the family? a. the neurological damage theory of schizophrenia b. the quantitative trait loci model of schizophrenia c. the hypofrontality theory of schizophrenia d. the dopamine theory of schizophrenia 76. When looking for malfunctions in the brain as clues to the influences of schizophrenia, it is important to keep certain questions in mind when doing correlational research. For example, if a person with schizophrenia were found to have an excess of dopamine, a researcher would need to ask certain questions. Which of the following is NOT one of these questions? a. Why is the dopamine system active in the brain of a person with schizophrenia? b. Is there some factor that causes both schizophrenia and an excess of dopamine? c. Does too much dopamine cause schizophrenia? d. Does having schizophrenia cause an excess of dopamine?

77. Which statement best reflects “circumstantial evidence” for the dopamine theory of schizophrenia? a. Amphetamines, which activate dopamine, can lessen psychotic symptoms in persons with schizophrenia. b. The drug L-dopa, a dopamine agonist, is used to treat schizophrenic symptoms in patients with Parkinson’s disease. c. Antipsychotic drugs (neuroleptics) can produce side effects similar to those of Parkinson’s disease (a disorder caused by insufficient dopamine). d. Antipsychotic drugs (neuroleptics) act as dopamine agonists, increasing the amount of dopamine in the brain.

78. Which of the following has been proven regarding neurotransmitters and schizophrenia? a. The drug L-dopa has been very effective in stabilizing dopamine in the brain of a person with schizophrenia. b. Two dopamine sites are of particular interest in the brain of a person with schizophrenia—D5 and D6. c. The neurotransmitter dopamine is too active in a person with schizophrenia. d. The neurotransmitter dopamine is underactive in a person with schizophrenia.

79. Which of the following statements is accurate concerning drugs and patients with schizophrenia? a. Drugs that destroy dopamine cause an increase in schizophrenic behaviour. b. Drugs that increase dopamine cause an increase in schizophrenic behaviour. c. Drugs that decrease dopamine cause an increase in schizophrenic behaviour. d. Drugs that increase dopamine decrease schizophrenic behaviour.

80. Current research suggests that at least three specific neurochemical irregularities are involved in the development of schizophrenic symptoms. What are they? a. overactive striatal dopamine receptors; underactive prefrontal dopamine receptors; alterations in glutamate transmission b. underactive striatal dopamine receptors; underactive prefrontal glutamate receptors; alterations in serotonin transmission c. underactive striatal dopamine receptors; overactive prefrontal dopamine receptors; underactive glutamate transmission d. overactive striatal dopamine receptors; underactive prefrontal serotonin receptors; underactive glutamate Powered by Cognero

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Chapter 14: Psychosis transmission 81. When did researchers observe that the ventricles of the brain of people with schizophrenia where enlarged? a. 1907 b. 1927 c. 1947 d. 1967 82. Which statement best provides evidence for structural difference in the brains of patients with schizophrenia? a. In some patients with schizophrenia, there is an excess amount of “gray matter” in the cerebral cortex. b. Patients with schizophrenia have smaller ventricles in their brains. c. The majority of patients with schizophrenia have enlarged ventricles in their brains. d. Many patients with schizophrenia have increased activity in the frontal lobes of the brain.

83. Which factor is NOT associated with a likelihood of enlarged ventricles in patients with schizophrenia? a. being female b. age of the schizophrenia c. duration of the schizophrenia d. being exposed to influenza 84. What type of symptoms are associated with the phenomenon of hypofrontality? a. positive symptoms b. negative symptoms c. disorganized symptoms d. psychosis symptoms 85. Historic records and ancient literature contain descriptions of symptoms in people who today would be diagnosed with various disorders. Which of the following is NOT one of these disorders? a. mood disorders (depression and mania) b. schizophrenia c. intellectual developmental disorder d. dementia 86. What hypothesis has the fact that nothing that resembles our current image of schizophrenia exists in historic records or ancient literature given rise to? a. Schizophrenia is a recent phenomenon and, like AIDS, may involve some newly introduced virus. b. Schizophrenia is a social and cultural construct. c. There may have been effective treatments for the symptoms of schizophrenia in some ancient societies. d. Schizophrenia was frequently confused with bipolar illness.

87. There is some evidence to suggest that fingerprint ridges may be a marker for schizophrenia that result from prenatal exposure to which of the following? a. alcohol b. rubella c. a virus Powered by Cognero

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Chapter 14: Psychosis d. cocaine 88. Toxoplasma gondii is a parasite implicated in the etiology of schizophrenia. In which species is the parasite most often found? a. cats b. dogs c. birds d. bats 89. Which stressor did Boydell and Allardyce (2011) suggest was associated with an increased risk of developing schizophrenia? a. living in a large city b. going to university c. smoking cannabis d. being diagnosed with a medical condition 90. In contrast to retrospective research, which is based on after-the-fact reports, what is the purpose of prospective research studies of patients with schizophrenia? a. They look at brain-imaging diagnostic tests to determine whether patients with schizophrenia have structural neurological defects. b. They examine factors that predict the relapse of schizophrenic symptoms in the future. c. They assess recovery rates in patients with schizophrenia who have taken different medications. d. They compare genetic, biological, and social etiological factors to try to determine inheritance patterns in offspring of parents with schizophrenia.

91. Which term refers to the argument that life in a lower socioeconomic status is stressful, thus predisposing those with lower socioeconomic statuses to an increased likelihood of schizophrenia? a. societal hypothesis b. sociogenic hypothesis c. socioeconomic explanation d. social selection hypothesis 92. The hypothesis that individuals with schizophrenia may experience a downward social drift into a lower socioeconomic status is referred to as which of the following? a. sociogenic hypothesis b. social selection hypothesis c. socioeconomic explanation d. sociocultural hypothesis 93. What role does social support play in individuals who live with schizophrenia? a. Social support has no impact on outcomes of individuals living with schizophrenia. b. Social support has no impact on outcomes if the individual is experiencing psychosis. c. Social support from non-family members predicted better outcomes five years later. d. Social support from family impacted outcomes, but social support from non-family members had no impact.

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Chapter 14: Psychosis 94. Regarding the family interactions of patients with schizophrenia, for a certain time period, what was the word schizophrenogenic used to describe? a. a mother whose cold, dominant, and rejecting nature was thought to cause schizophrenia in her children b. a family in which relatives on both sides were psychotic c. a highly dysfunctional family environment, associated with divorce or extreme marital discord, which was thought to foster psychotic symptoms in children d. a physically and emotionally abusive father with alcohol use disorder whose children developed schizophrenia 95. A mother who responds coolly to her child’s embrace but says, “Don’t you love me anymore?” when the child withdraws is said to be engaging in which type of communication style? a. conflicting b. contradictory c. double bind d. abusive 96. Brown and colleagues (1959) followed a sample of people who had been discharged from the hospital after an episode of schizophrenic symptoms. What did the researchers find? a. Those who had limited contact with their relatives did worse than patients who spent longer periods with their families. b. If the mothers of the patients had schizophrenia, the patients did better. c. If the mothers of the patients did not have schizophrenia, the patients did better. d. Those who had limited contact with their relatives did better than patients who spent longer periods with their families.

97. Which of the following is NOT considered a part of the expressed emotion (EE) communication style? a. avoidance of the individual b. unrealistic expectations c. negative attitude toward the illness d. low tolerance 98. If expressed emotion is a cause of schizophrenia, we would expect to see a positive correlation between the rates of schizophrenia and the rates of expressed emotions across cultural groups. What does the research on this subject show? a. There is no correlation; levels of expressed emotion do not vary by cultural group, but rates of schizophrenia do. b. There is a positive correlation; most cultural groups with higher levels of expressed emotion show higher rates of schizophrenia. c. There is no correlation; levels of expressed emotion vary by cultural group, but rates of schizophrenia do not. d. There is a negative correlation; most cultural groups with higher levels of expressed emotion show lower rates of schizophrenia.

99. If you have schizophrenia and live in a family with high levels of expressed emotion, how much more likely are you to experience relapse? a. 1.8 times b. 2.4 times c. 3.7 times d. 4.6 times Powered by Cognero

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Chapter 14: Psychosis 100. If a patient had surgery to treat schizophrenia in 1947, what type of surgery would they have had? a. electroconvulsive therapy b. prefrontal lobotomy c. cingulotomy d. insulin coma therapy 101. Which treatment was first used in the 1930s to treat schizophrenia but is now used primarily to treat severe depression? a. insulin coma therapy b. prefrontal lobotomy c. psychosurgery d. electroconvulsive therapy 102. In the 1950s, what medications provided the first real hope for people with schizophrenia? a. insulin b. neuroleptics c. antagonists d. antidepressants 103. What is Heinz Lehmann credited with? a. developing insulin therapy b. performing the first prefrontal lobotomy on a patient with schizophrenia c. introducing neuroleptic mediations as a treatment method in North America d. discovering the role of dopamine in schizophrenia 104. The neuroleptic drugs, which were introduced in the 1950s, primarily treat the positive symptoms of schizophrenia.

Which of the following is NOT a positive symptom? a. alogia b. delusions c. agitation d. hallucinations 105. What were neuroleptics most beneficial in treating? a. positive symptoms b. negative symptoms c. disorganized symptoms d. social deficits 106. What is the mechanism of action of neuroleptics? a. They are dopamine agonists. b. They are glutamate agonists. c. They are glutamate antagonists. d. They are dopamine antagonists.

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Chapter 14: Psychosis 107. Which of the following is NOT a typical, minor side effect of antipsychotic medications? a. blurred vision b. grogginess c. headaches d. dry mouth 108. Research on the prevalence of occasional noncompliance suggests that over a two-year period, how many individuals refused to take their antipsychotic medication for at least one week? a. 25 percent b. 50 percent c. 75 percent d. 100 percent 109. What is tardive dyskinesia? a. a side effect of some antipsychotic drugs b. a neuroleptic drug c. a brain site affected by schizophrenia d. a side effect of schizophrenia 110. Tardive dyskinesia-induced motor disruptions in schizophrenia are similar to motor disruptions with which other disease? a. Parkinson’s disease b. ALS c. Huntington’s disease d. multiple sclerosis (MS) 111. Extrapyramidal symptoms, which are serious side effects of antipsychotic medications, occur in some patients with schizophrenia. These are similar to the symptoms of another condition. What is that condition? a. Alzheimer’s disease b. cerebral palsy c. Parkinson’s disease d. multiple sclerosis (MS) 112. Tardive dyskinesia, a severe side effect of antipsychotic medications, includes several involuntary movements.

Which of the following is NOT one of these movements? a. involuntary chewing b. tongue protrusion c. puffing of the cheeks d. tooth grinding 113. A patient’s family is concerned about the side effect of tardive dyskinesia with the use of antipsychotics. What are the chances that their family member will develop this side effect? a. 10 to 15 percent b. 20 to 50 percent c. 40 to 60 percent Powered by Cognero

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Chapter 14: Psychosis d. 60 to 90 percent 114. A patient taking antipsychotic medications has developed akinesia. What will the patient be exhibiting? a. excited speech b. an expressionless face c. jerky limb movements d. hand tremors 115. Use of antipsychotic medications can cause tardive dyskinesia. When they have been used long-term, what is the possible outcome on these symptoms? a. The symptoms are often irreversible. b. When the drugs are discontinued, the symptoms will take months to disappear. c. If the dosages of these medications are reduced, the symptoms can disappear within months. d. The symptoms can disappear within weeks when these drugs are discontinued.

116. Which factor is NOT related to patients’ noncompliance with a medication regimen for treatment of schizophrenia? a. poor social support b. cognitive impairments causing the individual to forget c. negative doctor–patient relationships d. cost of the medication 117. What kind of treatment did researchers hope would improve patient compliance in taking antipsychotic medication? a. skin patches worn for several months b. pills taken once a week instead of daily c. liquids instead of pills d. injections every few weeks 118. An experimental technique called transcranial magnetic stimulation has been used in some patients with schizophrenia. What is the purpose of this treatment? a. to reduce symptoms of thought disorder b. to reduce the negative side effects of antipsychotic medications c. to improve auditory hallucinations d. to modulate negative symptoms such as social withdrawal 119. Which position regarding the treatment approaches available for schizophrenia do most mental health professionals take today? a. Most mental health professionals do not believe that psychological factors cause people to have schizophrenia or that traditional psychotherapeutic approaches will cure them. b. Most mental health professionals do not believe that psychological factors cause people to have schizophrenia but do believe that traditional psychotherapeutic approaches may help to cure them. c. Most mental health professionals believe that psychological factors cause some people to have schizophrenia and traditional psychotherapeutic approaches may help to cure them. d. Most mental health professionals believe that psychological factors cause some people to have schizophrenia but do not believe that traditional psychotherapeutic approaches will cure them.

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Chapter 14: Psychosis 120. In the 1970s, researchers set up a treatment system called a “token economy” in a mental health centre. What is the focus of this type of treatment for patients with schizophrenia? a. language and speech b. routines for self-control c. socialization and self-care skills d. the self-monitoring of hallucinations 121. What is a token economy? a. a system in which hospitalized patients with schizophrenia “save up” or “bank” privileges for tasks performed on the hospital ward b. a system in which hospitalized patients with schizophrenia are praised for appropriate behaviour and given “time outs” for disruptive behaviour c. a system in which hospitalized patients with schizophrenia learn appropriate behaviours through social modelling by staff d. a system in which hospitalized patients with schizophrenia earn tokens for appropriate behaviour and lose tokens for disruptive behaviour 122. In the 1970s, Paul and Lentz applied behavioural principles in the form of a token economy to a traditional inpatient environment. What was the result? a. Fewer patients recovered from severe schizophrenic symptoms. b. Fewer patients were able to be discharged. c. More patients were able to be discharged. d. More patients recovered from severe schizophrenic symptoms.

123. In the latter half of the 20th century, which factor did NOT reduce the rate at which persons with schizophrenia were institutionalized? a. patient advocacy groups b. court rulings c. cutbacks in health care funding d. increased use of antipsychotic medications 124. Since the latter half of the 20th century, what has been the outcome of the deinstitutionalization policy? a. a worsening of symptoms in many patients b. former patients becoming more independent and productive members of the community c. greater patient compliance regarding medication d. many former patients becoming homeless 125. Which of the following may be the most visible impairment displayed by people with schizophrenia? a. hallucinations b. social skills c. delusions d. negative affect 126. How successful have social skills training programs been for patients with schizophrenia? a. They have not been successful at all.

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Chapter 14: Psychosis b. They have been somewhat successful during the first year. c. They have been successful, but only when the patient is on medication. d. They have been very successful.

127. How is behavioural family therapy used to treat schizophrenia? a. It awards tokens for appropriate behaviour and takes away tokens for disruptive behaviour. b. It provides education about schizophrenia and its treatment, and communication and problem-solving skills. c. It provides positive reinforcement of appropriate family interactions by therapists. d. It establishes guidelines for identifying and reducing expressed emotion.

128. Which of the following is NOT discussed in the text as a helpful addition to biological treatment for schizophrenia? a. family intervention b. social skills training c. psychoanalysis d. programs in vocational rehabilitation 129. What is the general trend in the treatment of schizophrenia today? a. The trend is toward the use of fewer biological therapies and more psychosocial interventions. b. The trend is toward early intervention. c. The trend is toward new psychosurgery techniques. d. The trend is toward the use of more biological therapies and fewer psychosocial interventions.

130. Who is the main target of early psychosis clinical programs? a. Those experiencing a first episode of psychosis. b. Children of individuals with schizophrenia. c. Adolescents who are demonstrating negative symptoms. d. Any individual who is experiencing psychosis.

131. As a relatively new approach to schizophrenia, what has cognitive-behavioural therapy been used to treat? a. negative attitudes toward medications b. primarily positive symptoms c. both positive and negative symptoms d. the low self-esteem that often accompanies chronic mental illness 132. A patient with schizophrenia has been receiving cognitive-behavioural therapy. What does the patient most likely have now? a. better self-esteem b. fewer visual and auditory hallucinations c. reduced negative symptoms d. better social skills 133. What is a common treatment, alongside antipsychotics, for schizophrenia in China? a. cognitive-behavioural therapy b. yoga Powered by Cognero

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Chapter 14: Psychosis c. meditation d. acupuncture 134. As a prevention method, researchers have looked at the classic at-risk study from the 1960s by Mednick and Schulsinger. In this study, which of the following factors is an environmental influence that may trigger the onset of schizophrenia? a. self-esteem b. drug use c. social skills d. instability of the family

135. Define what is meant by schizophrenia. Using concepts from the history of schizophrenia, explain how the common misconception that schizophrenia means “split personality” developed and why it is incorrect.

136. Compare schizophrenia to three other psychotic disorders in terms of symptoms, duration, and outcome.

137. Describe the three kinds of research studies (twin, adoptee, and family) that focus on the etiological factors in schizophrenia. How do these studies help to separate genetic from environmental influences? Explain what is meant by a marker for schizophrenia. Describe the evidence for one such marker.

138. Describe the current theories and evidence for the biological causative factors of schizophrenia, including neurotransmitter imbalances, brain structure, and viral infection.

139. Describe the evolution of treatment of schizophrenia from a historical perspective, including the use of electroshock therapy and psychosurgery in the 1930s through to the development of antipsychotic medications in the 1950s. Compare the new antipsychotics with conventional neuroleptics, in terms of effectiveness and side effects.

140. Describe unpleasant side effects associated with both traditional and atypical antipsychotic medications. Explain the issue of noncompliance with drug regimens, the problems caused by noncompliance, and how this situation has been addressed in treatment settings.

141. Describe the various goals, methods, and effectiveness associated with psychosocial interventions for schizophrenia, including a token economy, behavioural family therapy, and social skills training.

142. Describe the goals, methods, and effectiveness of cognitive-behavioural therapy (CBT) for schizophrenia. Explain how CBT may be integrated effectively with antipsychotic medications and more traditional psychosocial interventions.

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Chapter 14: Psychosis Answer Key 1. a 2. d 3. b 4. d 5. c 6. b 7. b 8. a 9. d 10. b 11. c 12. b 13. b 14. d 15. b 16. c 17. d 18. b 19. c 20. c 21. d 22. a 23. d 24. a 25. c Powered by Cognero

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Chapter 14: Psychosis 26. c 27. a 28. b 29. b 30. c 31. c 32. c 33. c 34. b 35. d 36. b 37. a 38. c 39. d 40. c 41. b 42. b 43. d 44. d 45. d 46. d 47. a 48. b 49. d 50. b 51. a Powered by Cognero

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Chapter 14: Psychosis 52. d 53. b 54. c 55. c 56. d 57. b 58. c 59. c 60. c 61. a 62. b 63. a 64. c 65. a 66. d 67. c 68. c 69. a 70. b 71. a 72. a 73. b 74. c 75. b 76. a Powered by Cognero

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Chapter 14: Psychosis 77. c 78. c 79. b 80. a 81. b 82. c 83. a 84. b 85. b 86. a 87. c 88. a 89. a 90. b 91. b 92. b 93. c 94. a 95. c 96. d 97. a 98. c 99. c 100. b 101. d 102. b Powered by Cognero

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Chapter 14: Psychosis 103. c 104. a 105. a 106. d 107. c 108. c 109. a 110. a 111. c 112. d 113. b 114. b 115. a 116. b 117. d 118. c 119. a 120. c 121. d 122. c 123. a 124. d 125. b 126. b 127. b Powered by Cognero

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Chapter 14: Psychosis 128. c 129. b 130. a 131. c 132. c 133. d 134. d 135. Student responses will vary.

136. Student responses will vary.

137. Student responses will vary.

138. Student responses will vary.

139. Student responses will vary.

140. Student responses will vary.

141. Student responses will vary.

142. Student responses will vary.

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Chapter 15: Neurodevelopment

Indicate the answer choice that best completes the statement or answers the question.

1. Although psychological disorders are not classified as developmental disorders, why can many—if not most— psychological disorders be considered developmental? a. because they lack biological causes and are influenced by learning b. because they have a genetic component c. because they change over time d. because they are first diagnosed in childhood 2. Why is accurately identifying a developmental disorder at an early stage so important? a. It is important so that specific deficits can be addressed before they affect the subsequent development of other skill domains. b. It is important because family functioning often declines as the disorder progresses and may cause further impairment. c. It is important because medications are most effective when administered at an early stage of the disorder. d. It is important because children are more receptive to therapy when they are young.

3. Sam has ADHD and he isn’t popular with his Grade 4 classmates. What is the most probable reason that Sam is NOT popular? a. Sam’s impulsivity interferes with his ability to create and maintain friendships. b. Sam’s ADHD involves social communication deficits. c. Sam has no desire to socialize because of his ADHD. d. Sam has been stigmatized by his teachers due to his ADHD. 4. It was once thought that echolalia was a sign of autism. What is the current belief about echolalia? a. Echolalia is a symptom of expressive language disorder, which often co-occurs with autism. b. Echolalia is a sign the child also may have schizophrenia. c. Echolalia in children with autism spectrum disorder is just a sign of delayed language skills, not a symptom of their disorder. d. Echolalia is frequently associated with mild intellectual developmental disorder (intellectual disability).

5. Enzo is a two-year-old boy who is not motivated to interact with other people. His absence of interest in people may also lead to severe deficits in certain abilities. Which of the following is one such ability? a. amusing himself b. thinking c. communicating d. learning 6. How does an individual diagnosed with attention-deficit/hyperactivity disorder present? a. with both patterns of inattention and hyperactivity/impulsivity b. with hyperactive behaviour that alternates with periods of distraction c. with patterns of inattention or hyperactivity/impulsivity d. with periods of distraction that lead to hyperactive/impulsive behaviour 7. Ronny is six years old. His behaviour is characterized by inattention, bullying, temper tantrums, stubbornness, and fidgeting. He is easily distracted, fails to finish anything he starts, often acts impulsively, and requires constant Powered by Cognero

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Chapter 15: Neurodevelopment supervision. He is constantly on the go, running and climbing on things, and he cannot wait his turn in games or lines.

What disorder does Ronny most likely have? a. oppositional defiant disorder b. attention-deficit/hyperactivity disorder c. conduct disorder d. obsessive-compulsive disorder 8. Manon shows hyperactivity but not inattention. What will a psychiatrist say when Manon is assessed for attentiondeficit/hyperactivity disorder (ADHD)? a. Symptoms must be present in both symptom subtypes. b. Symptoms must be present in the area of impulsivity. c. Symptoms can be present in either of the symptom subtypes. d. Symptoms must be present in the hyperactivity subtype.

9. Alexa has been diagnosed with attention-deficit/hyperactivity disorder combined presentation. She showed six different indicators of hyperactivity/impulsivity. What must she also have demonstrated for this diagnosis? a. four behaviours from the compulsivity cluster b. four behaviours from the distractibility cluster c. six behaviours from the inattention cluster d. six behaviours from the distractibility cluster 10. Mrs. Farthington is starting as a principal at a new school with 1000 students. About how many children with ADHD can she expect to be students at her school? a. 10 b. 50 c. 80 d. 100 11. You know that there are eight boys with ADHD at a given school. How many girls with ADHD would you expect at that same school? a. one or two b. two or three c. three or four d. four or five 12. At what age are children with ADHD often first identified as being different from their peers? a. around one to two years of age b. around three to four years of age c. around six to seven years of age d. around eight to nine years of age 13. Which of the following poses the largest barrier to attending postsecondary education? a. trauma b. anxiety c. ADHD Powered by Cognero

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Chapter 15: Neurodevelopment d. learning disabilities 14. What did Klein and colleagues (2012) find in their longitudinal study of boys diagnosed with ADHD and a comparison group without ADHD? a. They found that 74 percent of the ADHD group were employed, compared to 80 percent in the comparison group. b. Males in the ADHD group were employed at jobs with lower status than those in the comparison group. c. Most boys in the comparison group did not complete high school. d. There were no differences in employment level or employment status between the ADHD group and the comparison group.

15. Adil has been diagnosed with ADHD and a second disorder. What is that second disorder most likely to be? a. autism spectrum disorder b. conduct disorder c. a learning disorder d. anorexia 16. How does attention deficit/hyperactivity disorder (ADHD) develop as children grow into adulthood? a. Manifestations of ADHD tend to change over time, but many problems often persist. b. Specific symptoms remain relatively stable throughout the lifespan for most individuals. c. ADHD tends to evolve into more severe forms of pathology. d. Children tend to outgrow ADHD. 17. Which symptom of ADHD seems to decrease as children age? a. inattention b. impulsivity c. hyperactivity d. opposition 18. How many children with ADHD have ongoing difficulties through adulthood? a. one-quarter b. two-thirds c. one-half d. three-quarters 19. What is known regarding the role genetics plays in influencing attention-deficit/hyperactivity disorder? a. There appear to be multiple genetic influences. b. There are no known genetic influences. c. There appears to be a single gene of influence. d. Defects on the Y chromosome are the major influence.

20. Research on the development of ADHD is finding that in many cases, mutations may occur that either create extra copies of a gene or result in the deletion of genes. Which term refers to these mutations? a. neurochemicals b. proteins Powered by Cognero

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Chapter 15: Neurodevelopment c. copy number variants d. endophenotypes 21. There is strong evidence to suggest that methylphenidate (Ritalin) inhibits which gene to increase the amount of dopamine available? a. dopamine D4 receptor gene b. dopamine transporter gene DAT1 c. dopamine D5 receptor gene d. dopamine transporter gene DAT4 22. Which neurotransmitter is most often associated with ADHD? a. serotonin b. GABA c. norepinephrine d. dopamine 23. Ian has ADHD. When neurologists image his brain, what are they most likely to find? a. Ian shows overactivity in the frontal cortex and basal ganglia. b. Ian’s brain is larger than is typical. c. Ian’s brain is smaller than is typical. d. Ian shows underactivity in the left hemisphere and brain stem.

24. Researchers have found that children with a specific mutation involving the dopamine system (the DAT1 genotype) were more likely to exhibit the symptoms of ADHD if they were exposed to which of the following during pregnancy? a. cigarette smoke b. influenza c. amphetamines d. sugar 25. What has research suggested regarding stimulant medication and brain development? a. Several studies point to a growth-enhancing effect in which brain development progresses in a more typical fashion in children receiving medication for ADHD versus those who do not. b. Several studies point to a growth-deficit effect in which brain development is delayed in children with ADHD regardless of whether they take medication or not. c. Several studies point to a growth-deficit effect in which brain development is delayed in children taking medication for ADHD more so than those who do not. d. Several studies point to a growth-enhancing effect in which brain development can progress typically once medication is stopped.

26. What is the current consensus on the role of artificial food colours and additives on the behaviour of young kids? a. These are responsible for the symptoms of ADHD. b. Eliminating these substances can eliminate the symptoms of ADHD. c. These substances have very little impact on behaviour. d. There is no evidence to suggest these substances have an impact on behaviour.

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Chapter 15: Neurodevelopment 27. What is the relationship between sleep and ADHD? a. Children with ADHD sleep longer than children without ADHD. b. Children with ADHD sleep less than children without ADHD. c. There are no changes to sleep in children with ADHD. d. Children with ADHD spend more time in REM sleep.

28. Ritalin, Metadate, and Concerta are medications generally used to treat attention-deficit/hyperactivity disorder. How are these medications classified? a. as antidepressants b. as minor sedatives c. as stimulants d. as cognitive moderators 29. Antidepressants may improve some symptoms of ADHD but do not appear to produce substantial improvement in which of the following? a. learning and academic performance b. negative symptoms c. hyperactivity d. compliance 30. Controversy exists about the use of stimulant medications to treat attention-deficit/hyperactivity disorder. Which of the following is a concern? a. the use of medications to control what are essentially problems of parental discipline b. the potential that they might not work c. the long-term effects of these drugs on the developing brain d. stimulant drugs’ potential for misuse 31. A longitudinal study by Charach and colleagues (2006) found that stimulants will have a measurable long-term effect on school-age children on which of the following? a. growth b. intelligence c. sleep d. appetite 32. Lena’s son Jonas has ADHD, but she doesn’t want to give him medication. What alternative treatment could Lena choose? a. brief, inpatient treatment at a specialty hospital b. individual cognitive-behavioural therapy c. specialized psychological supports for communication d. behavioural programs and parent training 33. What do most clinicians recommend to treat those with ADHD? a. medication alone b. behavioural therapy alone c. parenting interventions Powered by Cognero

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Chapter 15: Neurodevelopment d. the combination of approaches to treat short-term and long-term concerns 34. What is the term for the study of how your genetic makeup influences your response to certain drugs? a. psychopharmacology b. psychogenetics c. psychopharmacogenetics d. behavioural genetics 35. What is a specific learning disorder? a. achievement in reading, written expression, or mathematics below the level predicted by the individual's age, IQ, and education b. the existence of a neurological deficit that interferes with the individual’s ability to assimilate new information c. achievement in any academic subject below the level predicted by the individual’s age, IQ, and education d. a substandard IQ score in comparison to the individual’s family and educational background 36. Which of the following is NOT a factor that informs the criteria for specific learning disorder? a. IQ b. education c. age d. cultural background 37. Which of the following is NOT a specifier for specific learning disorder? a. reading b. written expression c. mathematics d. oral expression 38. Approximately what percentage of Canadians between the ages of 5 and 17 have a learning disorder? a. 1 percent b. 3 percent c. 5 percent d. 8 percent 39. Of the population of Canadian school-age children who were recorded has having some form of disability, approximately what percentage of these children had a learning disability? a. 15 percent b. 25 percent c. 50 percent d. 70 percent 40. Pierce is a 12-year-old boy whose IQ score indicates he is of average intelligence. He loves school and works hard on his homework. Pierce has A’s in all his subjects, except for a C in math. Given this information does Pierce have a learning disorder and, if so, which one? a. Pierce does not appear to have a learning disorder because his achievement is consistent with expectations based on his intelligence.

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Chapter 15: Neurodevelopment b. Pierce does not appear to have a learning disorder because he has shown that he can achieve when he wants to. c. Pierce appears to have a math disorder because there is a discrepancy between his intelligence and his achievement in many subjects. d. Pierce appears to have a math disorder because his math grade is so far below his other grades.

41. What is the most prevalent type of learning disorder? a. oral communication disorders b. mathematics disorders c. disorders of written expression d. reading disorders 42. What is the employment rate for students with learning disorders? a. 30 to 40 percent b. 40 to 50 percent c. 60 to 70 percent d. 70 to 80 percent 43. In a school with 100 children, how many would have a mathematics learning disorder? a. 1 b. 3 c. 6 d. 12 44. Kathy has deficient writing skills. Her writing is characterized by numerous errors in spelling, punctuation, and grammar, and she has difficulty composing sentences and paragraphs. Although she is only eight years old, she lags behind her classmates in writing skills. Which disorder does Kathy likely have? a. articulation disorder b. mathematics disorder c. oral communication disorder d. disorder of written expression 45. Tiara is an adolescent with a learning disorder. Tiara may be particularly vulnerable to which of the following? a. substance use disorders b. obesity c. low self-esteem d. committing sexual assault 46. Childhood-onset fluency disorder falls under which group of disorders that seem closely related to specific learning disorder? a. articulation disorders b. communication and motor disorders c. fluency disorders d. stuttering disorders 47. Which treatment is considered promising for the treatment of childhood-onset fluency disorder?

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Chapter 15: Neurodevelopment a. interpersonal therapy b. mindfulness-based cognitive therapy c. exposure therapy d. regulated-breathing method 48. Cruz is 2 years old, and his expressive language is significantly below his receptive language, which is approximately average. What is Cruz likely to be diagnosed with? a. language disorder b. specific learning disorder c. childhood-onset fluency disorder d. social communication disorder 49. A middle ear infection may be a contributory cause to which of the following disorders? a. childhood-onset fluency disorder b. social communication disorder c. specific learning disorder d. language disorder 50. How does social (pragmatic) communication disorder differ from autism spectrum disorder? a. Those with social (pragmatic) communication disorder do not have the restricted and repetitive behaviours found in autism spectrum disorder. b. Those with social (pragmatic) communication disorder do not have the social difficulties found in autism spectrum disorder. c. Those with social (pragmatic) communication disorder do not have the difficulties in communication found in autism spectrum disorder. d. Those with social (pragmatic) communication disorder do not have the same prosody difficulties found in autism spectrum disorder.

51. Which of the following is characterized by involuntary motor movements called tics? a. autistic disorder b. selective mutism c. Tourette’s disorder d. coprolalia 52. Rod and Todd are identical twins. Rod has a reading disorder. What is the probability that Todd also has a reading disorder? a. about 30 percent b. about 40 percent c. about 60 percent d. about 100 percent 53. Research John Connolly and colleagues put forth provides evidence for a neurobiological cause of dyslexia. What did their research show? a. weaker or delayed neural responses during reading in people with dyslexia b. right hemisphere language processing for people with dyslexia, left hemisphere for controls Powered by Cognero

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Chapter 15: Neurodevelopment c. fewer neural connections in the left hemisphere of people with dyslexia compared with controls d. a 50 percent concordance rate in dyslexia between identical twins 54. Gina is in Grade 6 and has difficulty in school. She pays attention and works hard but appears to have trouble remembering facts and concepts that she has read about. An assessment of Gina’s learning disorder could involve administering intelligence and achievement tests. In which scenario would Gina most likely be diagnosed as having a reading learning disorder? a. if her intelligence test scores were significantly higher than her school grades in reading b. if she scored one standard deviation above average on an intelligence test but one standard deviation below average on an achievement test tapping reading skills c. if her scores on a reading test were significantly lower than her scores on a mathematics test d. if her scores on both kinds of tests were significantly higher than her school grades 55. Which treatment is primarily suggested for learning disorders? a. biological treatment b. cognitive-behavioural therapy c. parenting training d. educational intervention 56. When may biological treatment be given to an individual with a learning disorder? a. if they have comorbid autism spectrum disorder b. if they have comorbid ADHD c. if they have a comorbid intellectual developmental disorder (intellectual disability) d. if they have comorbid language disorders 57. Alvin is a ten-year-old boy diagnosed with a mathematics disorder. What will his treatment plan most likely involve? a. teaching him different strategies to strengthen areas where he has difficulty b. helping him to excel in other areas to compensate for his deficits in mathematics c. teaching him relaxation skills to reduce his math anxiety d. giving him exercises to help develop the behavioural skill of reading aloud 58. Luca is a nine-year-old boy diagnosed with a language-processing learning disorder. What has research shown that might help Luca distinguish among sounds? a. relaxation prior to reading b. specially designed computer programs c. medication d. exercise 59. Which intervention strategy is the most effective treatment for reading disorders? a. a phonology training program b. a strategy training program c. a goal-setting program d. a combined phonology and strategy training program 60. The DSM-5 category of autism spectrum disorder (ASD) combined the disorders from which group of disorders?

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Chapter 15: Neurodevelopment a. pervasive developmental disorders b. conduct disorders c. social functioning disorders d. language processing disorders 61. Which of the following was NOT listed as a pervasive developmental disorder that was combined in the DSM-5 as autism spectrum disorder? a. autistic disorder b. Asperger’s disorder c. childhood disintegrative disorder d. social (pragmatic) communication disorder 62. A child diagnosed with Asperger’s disorder using the DSM-IV-TR would receive which diagnosis using the DSM-5TR? a. pervasive developmental disorder b. social functioning disorder c. autism spectrum disorder d. childhood disintegrative disorder 63. Which disorder, which falls under the umbrella of autism spectrum disorder, is found almost exclusively in females? a. Asperger’s disorder b. Rett disorder c. childhood disintegrative disorder d. autistic disorder 64. What did the DSM-5 introduce to accommodate the range of difficulties in the two symptom clusters in autism spectrum disorder? a. levels of severity b. additional categories c. additional specifiers d. quantitative dimensions for assessment 65. Which of the following is most problematic for a child with autism spectrum disorder? a. impairment in social interactions b. hyperactivity c. significant intellectual impairment d. tics and movement disorders 66. Which of the following is NOT one of the major characteristics of autism spectrum disorder? a. impairments of social communication b. restricted, repetitive patterns of behaviour, interests, or activities c. impairments present in early childhood that limit daily functioning d. basic processing difficulties 67. When sitting with a parent in front of a favourite toy, young children will typically look back and forth between the Powered by Cognero

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Chapter 15: Neurodevelopment parent and toy, smiling, in an attempt to engage the parent with the toy. What would a child with autism spectrum disorder most likely do in this situation? a. The child would not display this behaviour at all with the parent. b. The child would engage in this behaviour only after watching another child do so. c. The child would typically talk to the toy but not to the parent. d. The child would show little or no interest in the toy.

68. Individuals with more severe symptoms of autism spectrum disorder often lack social reciprocity and the ability to engage in which of the following? a. games b. reciprocal play c. imaginative play d. joint attention 69. Marcus is unresponsive to most social stimuli. He rarely smiles, talks, or makes eye contact with others. He seems indifferent to everyone, including his parents. He engages in solitary, ritualistic behaviours. He sometimes goes into sudden tantrums or panics. He also insists on the same familiar food each day. What condition does Marcus appear to have? a. childhood schizophrenia b. autism spectrum disorder c. impulsivity d. avoidant disorder 70. Theo has autism spectrum disorder. Which characteristic does Theo most likely exhibit? a. a lack of interest in people b. clumsiness and poor coordination c. hyperactivity d. impulsivity 71. What technology has been used to show how social deficits in autism spectrum disorder develop? a. PET scan b. eye-tracking c. fMRI d. EEG 72. Which term refers to the lack of appropriate facial expressions or tone of voice seen in individuals with a less severe form of autism spectrum disorder? a. echolalia b. prosody c. joint attention d. social reciprocity 73. Four-year-old Ava has just been diagnosed with autism spectrum disorder (ASD). Her parents ask a specialist how likely it is that Ava will develop speech. What does the specialist tell them? a. Approximately 10 to 30 percent of children with ASD develop speech proficiency.

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Chapter 15: Neurodevelopment b. Approximately 30 to 50 percent of children with ASD develop speech proficiency. c. Approximately 50 to 70 percent of children with ASD develop speech proficiency. d. Approximately 70 to 90 percent of children with ASD develop speech proficiency.

74. One view of the social deficits of people with autism spectrum disorder is that they lack a theory of mind. Other researchers have argued that problems on theory-of-mind tasks may have another cause. What might that cause be? a. an unwillingness to carry on conversations with others b. an inability to pretend c. attention deficits d. more general difficulties with executive functioning 75. Caleb has the restricted pattern of behaviour observed in children with autism spectrum disorder. What does Caleb have trouble with? a. communication b. recognition c. change d. movement 76. Jeanne is a 14-year-old girl with autism spectrum disorder who seems compelled to run around touching each door every time she comes home. Which characteristic of her autism will cause Jeanne to have a tantrum if she is prevented from touching each door? a. maintenance of sameness b. obsessive-compulsive disorder c. ritualistic behaviour d. restricted behaviour pattern 77. Gabriel, a ten-year-old boy with autism spectrum disorder, likes to walk through the halls of his home touching all the doorknobs. One day, a visiting relative is standing in front of one of the doors, preventing Gabriel from touching the doorknob. What will most likely occur? a. Gabriel will ignore the relative and carry on to the next door. b. Gabriel will use echolalia speech to inform the relative that he needs that person to move. c. Gabriel will have a tantrum. d. Gabriel will stop and participate in a different activity.

78. Which term refers to the intense preference for the status quo in individuals with autism spectrum disorder? a. ritualism b. maintenance of sameness c. prosody d. social reciprocity 79. According to recent estimates, approximately how common is autism spectrum disorder? a. about one case in every 110 births b. about one case in every 100 births c. about one case in every 80 births d. about one case in every 70 births Powered by Cognero

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Chapter 15: Neurodevelopment 80. In terms of the level of support that will be necessary for a child with autism spectrum disorder, what factor is used as a predictor to determine the prognosis? a. severity of initial symptoms b. rate of symptom progression c. IQ d. age of onset 81. Approximately how many individuals with ASD have intellectual disabilities? a. one in three b. one in four c. one in five d. one in ten 82. Gender differences are apparent in autism. What is the average reported male-to-female estimate? a. 2 to 1 b. 3.5 to 1 c. 4.5 to 1 d. 6 to 1 83. What has cross-cultural research indicated about autism spectrum disorder? a. It is more common in wealthy countries. b. It is predominantly found in Western cultures and countries. c. It is predominantly found in North America. d. It is universal across cultures and countries.

84. Monty is a three-year-old boy who has recently been diagnosed with autism spectrum disorder. He appears completely unresponsive to his parents and shows no indication of any language development. Monty seems uninterested in communication of any kind, and he has rituals—such as lining up his toys and realigning them every few minutes. If interrupted, he becomes hysterical. Monty’s IQ score was extremely low. Why can we expect his prognosis to be poor? a. primarily because of his ritualistic behaviour and disinterest in his parents b. primarily because of his early age of onset and lack of language acquisition c. primarily because of his low IQ and early age of onset d. primarily because of his lack of language acquisition and low IQ 85. What is the relationship between autism and medical conditions such as German measles, tuberous sclerosis, and difficulties during pregnancy and labour? a. Most cases of autism are directly caused by some form of early infection or disease. b. Certain medical conditions, such as those mentioned above, result in autism in some cases, but not always. c. There is no empirical evidence that suggests a relationship exists between autism and any known medical disorder. d. Certain medical conditions are known to interact with a particular parenting style to produce autism in a vulnerable child.

86. The risk of having a child with autism spectrum disorder is approximately 0.0002 to 0.0005 percent for the general population. For parents who already have a child with autism spectrum disorder, what is their risk of having another child Powered by Cognero

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Chapter 15: Neurodevelopment with autism spectrum disorder? a. 1 percent b. 5 percent c. 10 percent d. 20 percent 87. Which brain chemical has been implicated in the etiology of autism spectrum disorder? a. oxytocin b. dopamine c. serotonin d. endorphins 88. Which term refers to the mutations that may occur in the sperm of fathers or the eggs of the mothers that may influence the development of autism spectrum disorder? a. X mutations b. de novo c. hypsarrhythmia d. cytomegalovirus 89. What convincing evidence is there that autism spectrum disorder involves some form of brain damage? a. Most children with autism spectrum disorder suffered some form of brain trauma at birth. b. Autism runs in families. c. A large percentage of people with autism spectrum disorder also have some level of intellectual developmental disorder (intellectual disability). d. Autism develops fairly quickly and at a young age.

90. According to research on the brains of individuals with autism spectrum disorder, which area of the brain may be involved with the disorder? a. the brain stem b. the hypothalamus c. the reticular formation d. the amygdala 91. As discussed in the textbook, which controversial theory has no evidence in regard to the etiology of autism spectrum disorder? a. vaccinations b. maternal alcohol consumption c. in utero exposure to nicotine d. food colouring and additives 92. It was once believed that the unusual speech patterns of some individuals with autism spectrum disorder were due to a characteristic lack of self-awareness. Later research showed that a lack of self-concept in some individuals with autism spectrum disorder is probably due to another factor. What is that factor? a. dysfunctional patterns of communication with the parents b. being treated by others as a baby because of the autism Powered by Cognero

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Chapter 15: Neurodevelopment c. cognitive disabilities or delays instead of autism itself d. an abnormally small amygdala 93. What does research regarding the behaviour of the parents of children with autism spectrum disorder suggest? a. Autism is the result of cold and aloof parenting. b. Autism is not the result of parenting behaviours. c. Autism is the result of a complex interaction of genetics and parenting style. d. Autism is the result of an overindulgent parenting style.

94. Persons with more severe autism spectrum disorder are NOT likely to present with which of the following? a. echolalia b. savant skills c. prosody d. maintenance of sameness 95. In the early days of therapy for autism, the psychodynamic approach focused on encouraging ego support. Why is this so? a. because psychodynamic theorists believed one of the primary causes was physical anomalies b. because psychodynamic theorists believed one of the primary causes was improper parenting c. because psychodynamic theorists believed one of the primary causes was bullying by siblings d. because psychodynamic theorists believed one of the primary causes was poor or negative bonding 96. Treatment for autism is most similar to the treatment for which of the following? a. learning disorders b. attention-deficit/hyperactivity disorder c. intellectual development disorder d. personality disorders 97. Which of the following has produced some success in the development of communication skills for children with autism spectrum disorder? a. the use of modelling appropriate communication styles b. the use of intensive therapy in which the patient is placed in many social situations c. the use of stimulant medications d. the use of behavioural procedures involving shaping and discrimination teaching 98. What have the results of behavioural treatment targeting the socialization deficits of individuals with autism spectrum disorder shown? a. minor improvement in socialization b. improvement in a variety of social communication skills c. no improvement d. improvement in skills but only in those with mild autism spectrum disorder 99. Lana is a 14-year-old girl with autism spectrum disorder. She is currently participating in a behavioural social skills teaching program for adolescents with autism spectrum disorder. What is Lana’s most likely outcome? a. an improvement in joint attention only Powered by Cognero

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Chapter 15: Neurodevelopment b. no progress at all c. relatively normal socialization for her age d. an increase in a variety of social communication skills 100. Sophie has autism spectrum disorder and is not responding to the speech-teaching technique known as shaping and discrimination teaching. What other form of treatment might her therapist choose? a. They can use children’s music videos that have simple, repetitive lyrics. b. They can use imitation techniques. c. They can place the children in settings with other children with autism spectrum disorder without speech so these children can develop their own methods of communication. d. They can use devices with vocal output.

101. According to research by Lovaas (1987), which type of intervention programs have shown improvements in the intellectual and educational functioning of children with autism spectrum disorder? a. programs that use a group therapy model b. programs that are school based c. programs that provide multiple therapists d. programs that meet 40 hours per week 102. What has research on using virtual reality (VR) to teach social skills in children with autism spectrum disorder (ASD) shown? a. It only works with less severe forms of ASD. b. There are preliminary findings that it may increase the level of social skills. c. The therapy must be intensive to work. d. There is no evidence that VR can aid in teaching social skills at this time.

103. A couple have recently discovered that their three-year-old daughter has autism spectrum disorder. They are both nutrition fanatics and are convinced that they can cure their daughter with vitamins and diet. What would you tell them? a. Vitamins and diet are currently being investigated as a promising treatment for autism, but the results are too preliminary to draw any conclusions. b. Vitamins and diet have been shown to be effective, but the gains are not sufficient to be considered a cure. c. Vitamins and diet do not appear to be an effective treatment for autism. d. Vitamins and diet may improve their daughter’s symptoms, but it is necessary to consult a professional to determine exactly which dietary deficiencies may be involved.

104. What has research examining the impact of medical treatments for autism spectrum disorder (ASD) revealed? a. Medical intervention has had little success. b. Medical treatments can have great impacts on all behaviours of ASD. c. There is promise that one drug may work for everyone with ASD. d. sychotropic drugs may cure ASD. 105. Generally speaking, what should the treatment for a child with autism spectrum disorder involve? a. early intervention, behavioural therapy, and home schooling b. cognitive therapy and school-based education c. early intervention, behavioural therapy, and school-based education Powered by Cognero

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Chapter 15: Neurodevelopment d. behavioural therapy and a focus on provisions for long-term custodial care 106. As children with autism spectrum disorder grow older, what should the intervention focus on? a. immersing children with autism spectrum disorder in intensive therapy for as long as possible before attempting to introduce them into the larger world b. having the child with autism spectrum disorder and their family accept the inherent limitations of the disorder c. providing a separate, but safe and secure, environment for the individual with autism spectrum disorder d. integrating the child with autism spectrum disorder into the community as much as possible 107. How do Black and Andreasen (2021) define intellectual developmental disorder (intellectual disability)? a. significantly below-average intellectual and adaptive functioning b. significantly below-average intellectual ability c. significant impairment in self-care abilities d. low IQ 108. Which of the following is NOT considered a domain of intellectual development disorder in the DSM-5-TR? a. conceptual b. social c. analytic d. practical 109. For which disorder has the historical treatment for it been described as shameful? a. depression b. schizophrenia c. autism d. intellectual developmental disorder (intellectual disability) 110. What do individuals with intellectual developmental disorder (intellectual disability) show? a. similar types of deficits in areas of functioning, although the degree of deficit varies greatly b. similar types and degree of deficits in areas of functioning c. varied types and degree of deficits in areas of functioning d. varied types of deficits in areas of functioning, although the degree of deficit tends to be quite similar 111. What are the DSM-5-TR criteria for intellectual developmental disorder (intellectual disability)? a. significant atypical intellectual functioning, deficits in communication, and onset before age 18 b. significant atypical intellectual functioning, deficits in adaptive functioning and communication, with onset at any age c. significant atypical intellectual functioning and onset before age 18 d. significant atypical intellectual functioning, deficits in adaptive functioning, and onset before age 18 112. What are the four levels of intellectual developmental disorder (intellectual disability) identified in the DSM-5-TR? a. mild, moderate, severe, profound b. educable, trainable, severe, profound c. slight, moderate, profound, intensive d. borderline, custodial care, intermittent care, pervasive care Powered by Cognero

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Chapter 15: Neurodevelopment 113. Joe is 24 years old, lives in a rural area, and works as a helper/stockperson in a small local store. Joe’s IQ was tested in elementary school and again in high school. His IQ score was about 71 and he did not finish high school. Joe lives in a guesthouse on his parents’ farm and, although he spends lots of time with his family, he takes care of himself. Based on this information, what diagnosis should Joe receive? a. intellectual developmental disorder (intellectual disability) b. mild intellectual developmental disorder (intellectual disability) c. no diagnosis d. borderline intellectual developmental disorder (intellectual disability) 114. Why do the diagnostic criteria for intellectual developmental disorder (intellectual disability) include an assessment of adaptive functioning? a. An IQ score is not a measure of intelligence. b. An IQ score is not adjusted statistically for people of different ages. c. An IQ score is an insufficient measure of impairment. d. An IQ score is culturally biased.

115. Mario has an IQ score of 30. How would he therefore be classified? a. as having mild intellectual developmental disorder (intellectual disability) b. as having moderate intellectual developmental disorder (intellectual disability) c. as having severe intellectual developmental disorder (intellectual disability) d. as having profound intellectual developmental disorder (intellectual disability) 116. What is the prognosis for living independently if a person has been diagnosed with a mild intellectual developmental disorder (intellectual disability)? a. No form of help will allow the person to live independently. b. It is difficult to state because there are so many variables given a mild intellectual diagnosis. c. If the person had good education and has good community support, they are likely to live independently but may still require minimal supervision. d. They will be able to live independently without requiring support.

117. What is the major difference between the DSM-5-TR system of classification of levels of intellectual developmental disorder (intellectual disability) and the American Association on Intellectual and Developmental Disabilities (AAIDD) system? a. The AAIDD system is based on disabilities. b. The AAIDD system is based on abilities. c. The AAIDD system is based on IQ. d. The AAIDD system is based on the level of support required.

118. What percentage of people with an intellectual developmental disorder (intellectual disability) fall under the mild intellectual developmental disorder category? a. 20 percent b. 40 percent c. 70 percent d. 90 percent Powered by Cognero

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Chapter 15: Neurodevelopment 119. What is the most accurate way to describe the cause of an intellectual developmental disorder (intellectual disability)? a. They are caused by either prenatal anomalies or difficulties in the birth process. b. Most cases of intellectual developmental disorder (intellectual disability) are caused by strictly biological factors. c. They are caused by genetics. d. There are hundreds of known causes.

120. Which term refers to difficulties during labour and delivery that lead to intellectual disabilities? a. environmental influences b. postnatal influences c. prenatal influences d. perinatal influences 121. Approximately how many cases of intellectual developmental disorder (intellectual disability) have no identified etiology? a. 20 percent b. 30 percent c. 40 percent d. 50 percent 122. What is one rare example of the successful prevention of one form of intellectual developmental disorder (intellectual disability)? a. to screen all infants for signs of fetal alcohol spectrum syndrome b. to give early behavioural skills training at the first signs of cognitive impairment c. to ensure that all infants have good nutrition starting from birth d. to screen all infants at birth for phenylketonuria (PKU) 123. What is Lesch-Nyhan syndrome? a. a form of cerebral palsy b. a viral infection that causes intellectual developmental disorder (intellectual disability) c. a cluster of symptoms displayed by some individuals with intellectual developmental disorder (intellectual disability) d. a genetic disorder that causes intellectual developmental disorder (intellectual disability) 124. Who will be impacted by the X-linked intellectual developmental disorder Lesch-Nyhan syndrome? a. males who receive a recessive gene on the X chromosome b. males and females if the gene is recessive c. females if the gene is recessive on an X chromosome d. males if they also have the gene on the Y chromosome 125. Lester has a round face; a broad, flat nose; small, downward-sloping folds of skin at the inside corners of his eyes; a protruding tongue; small, squarish hands; and short arms and legs in relation to his body. He also suffers from heart and respiratory problems. What disorder does Lester most likely have? a. phenylketonuria Powered by Cognero

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Chapter 15: Neurodevelopment b. Down syndrome c. fragile X syndrome d. Klinefelter’s syndrome 126. Nearly all adults with Down syndrome past the age of 40 will show signs of which disorder? a. schizophrenia b. bipolar disorder c. depression d. Alzheimer’s disease 127. What is the incidence of children being born with Down syndrome to a mother at age 35? a. 1 in 800 births b. 1 in 500 births c. 1 in 300 births d. 1 in 100 births 128. What is the incidence of children being born with Down syndrome to a mother at age 45? a. 1 in 120 births b. 1 in 90 births c. 1 in 60 births d. 1 in 30 births 129. A mother has learned through amniocentesis that her unborn child has a disorder. Which of the following could that disorder be? a. ADHD b. autism spectrum disorder c. Down syndrome d. Tourette’s syndrome 130. Which of the following procedures involves the removal of a small piece of placenta tissue to be tested for the presence of Down syndrome? a. amniocentesis b. chorionic villus sampling c. task analysis d. augmentative sampling 131. Fragile X syndrome is caused by a change on the X chromosome. Which of the following groups does it affect? a. only females b. only males c. males and females d. primarily males but female carriers may display disabilities also 132. Individuals who have cognitive impairments that result from a combination of psychosocial and biological influences are sometimes referred to as having which of the following? a. a cultural-familial intellectual development disorder Powered by Cognero

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Chapter 15: Neurodevelopment b. Down syndrome c. Fragile X syndrome d. Lesch-Nyhan syndrome 133. Treatment for mild intellectual developmental disorder (intellectual disability) is similar to intervention for which of the following disorders? a. learning disorders b. mild autism spectrum disorder c. ADHD d. conduct disorder 134. Soren has an intellectual developmental disorder (intellectual disability). What would be the best form of treatment for him to acquire skills? a. a cognitive approach b. interpersonal therapy c. medication d. a behavioural approach 135. Which form of intervention may be effective for individuals with intellectual developmental disorder (intellectual disability) who are experiencing severe communication difficulties? a. augmentative communication strategies b. interpersonal therapy c. medication d. task analysis 136. Which of the following was NOT identified as a lingering concern with the prevention of neurodevelopmental disorders? a. how to best identify children and families who will benefit from programs b. how early in the child’s development programs should begin c. how long to continue early intervention programs to produce desirable outcomes d. how to determine the cost of early intervention programs and who will be responsible for this cost 137. What is the current research position regarding the technology of gene therapy for intellectual developmental disorders (intellectual disabilities)? a. It is a viable treatment for only a small number of cases. b. It is a potentially effective treatment, but the risks must be evaluated carefully. c. It is considered unethical. d. It is in the research stage only.

138. Explain the developmental pattern of change that can be set into motion by early deficits in one area influencing the acquisition of skills in another, using one illustrative disorder from the following: attention-deficit/hyperactivity disorder, learning disorders, or autism spectrum disorder. Discuss the basic features of the disorder and how it can prevent the individual from developing in other important ways throughout their lifetime.

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Chapter 15: Neurodevelopment 139. Explain why it is completely incorrect to state that a specific learning disorder is just another way of saying “not bright.” Ensure that your explanation includes the procedures to diagnose a learning disorder and a description of the categories of learning disorders.

140. Describe the medications and therapy procedures used in the treatment of attention-deficit/hyperactivity disorder (ADHD). Explain the controversy regarding the use of medication treatment for ADHD. Within this context, discuss the benefits and disadvantages of medication treatment versus nonmedication treatments.

141. Describe the diagnostic criteria, clinical description, and prevalence of autism spectrum disorder.

142. Describe the impairments in social interaction, communication, and activities typically experienced by individuals with autism spectrum disorder.

143. Discuss the genetic and neurobiological causes of autism spectrum disorder. Explain the historical view that poor parenting causes autism and why that is now considered inaccurate.

144. Describe a typical treatment plan for a newly diagnosed, four-year-old boy with autism spectrum disorder. What are realistic short-term and long-term treatment goals? Assuming that this boy makes some progress in initial therapy, what would you suggest for his school education? Explain the rationale for your recommendations.

145. Describe a typical treatment plan for a 10-year-old girl with a mild intellectual development disorder. What are appropriate treatment goals? What treatment methods have been found to be successful to meet these goals?

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Chapter 15: Neurodevelopment Answer Key 1. c 2. a 3. a 4. c 5. c 6. c 7. b 8. c 9. c 10. b 11. b 12. b 13. c 14. b 15. b 16. a 17. b 18. b 19. a 20. c 21. b 22. d 23. c 24. a 25. a Powered by Cognero

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Chapter 15: Neurodevelopment 26. c 27. b 28. c 29. a 30. d 31. a 32. d 33. d 34. c 35. a 36. d 37. d 38. d 39. d 40. a 41. d 42. c 43. c 44. d 45. a 46. b 47. d 48. a 49. d 50. a 51. c Powered by Cognero

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Chapter 15: Neurodevelopment 52. d 53. a 54. b 55. d 56. b 57. a 58. b 59. d 60. a 61. d 62. c 63. b 64. a 65. a 66. d 67. a 68. d 69. b 70. a 71. b 72. b 73. d 74. d 75. c 76. c Powered by Cognero

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Chapter 15: Neurodevelopment 77. c 78. b 79. d 80. c 81. a 82. c 83. d 84. d 85. b 86. d 87. a 88. b 89. c 90. d 91. a 92. c 93. b 94. b 95. b 96. c 97. d 98. b 99. d 100. d 101. d 102. b Powered by Cognero

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Chapter 15: Neurodevelopment 103. c 104. a 105. c 106. d 107. a 108. c 109. d 110. c 111. d 112. a 113. c 114. c 115. c 116. c 117. d 118. d 119. d 120. d 121. b 122. d 123. d 124. a 125. b 126. d 127. b Powered by Cognero

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Chapter 15: Neurodevelopment 128. d 129. c 130. b 131. d 132. a 133. a 134. d 135. a 136. d 137. d 138. Student responses will vary.

139. Student responses will vary.

140. Student responses will vary.

141. Student responses will vary.

142. Student responses will vary.

143. Student responses will vary.

144. Student responses will vary.

145. Student responses will vary.

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Chapter 16: Neurocognition and Aging

Indicate the answer choice that best completes the statement or answers the question.

1. When do most instances of delirium and neurocognitive disorder develop? a. following complications at birth b. in late adulthood c. in early childhood d. following brainstem injuries that occur with equal frequency at all ages 2. Why is the term organic mental disorder no longer used to describe cognitive disorders? a. because the term implies that there is no effective treatment b. because cognitive disorders are actually thought disorders c. because research has found that most psychological disorders have an organic component, thus making the distinction meaningless d. because the term implies that there are no psychosocial influences on their onset and course 3. What is one of the distinguishing characteristics between disability due to cognitive functions and disability due to mental health? a. There is a much greater genetic contribution to disability due to cognitive functions than there is for disability due to mental health. b. Disability due to cognitive functions is more frequent after age 65; disability due to mental health is less frequent after age 65. c. Disability due to mental health is more frequent after age 65; disability due to cognitive functions is less frequent after age 65. d. Disability due to cognitive functions is mostly organic in origin; disability due to mental health is mostly psychosocial in origin.

4. What causes most neurocognitive disorders? a. prescription drug interactions b. organic brain dysfunction c. a frontal lobe head injury d. the normal process of aging 5. Why are neurocognitive disorders included in a textbook on psychopathology? a. They are statistically rare. b. They all represent some form of brain dysfunction. c. They often include profound changes in behaviour and personality. d. They used to be considered forms of insanity.

6. Helen has had impaired consciousness and cognition over the last two days. She had not had symptoms of illness before this. What condition does Helen most likely have? a. neurocognitive disorder b. Alzheimer’s disease c. delirium d. amnestic disorder 7. Mr. Garcia (age 72) is brought to the hospital emergency room. His son explains that his father woke up this morning Powered by Cognero

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Chapter 16: Neurocognition and Aging and was “not himself.” Mr. Garcia was confused, agitated, and a bit frightened. He did not know his own name and could not recognize his son. His son reports that he had been completely fine, with no symptoms, prior to that morning. What does Mr. Garcia appear to have? a. amnestic disorder b. delirium c. neurocognitive disorder d. Alzheimer’s disease 8. Archer is being treated for delirium in the hospital. The doctor asks Archer’s son how the symptoms developed. What will Archer’s son say? a. The symptoms came on gradually over the past two weeks. b. The symptoms came on gradually over the last two months. c. The symptoms came on quickly over the last few days. d. The symptoms came on very slowly, over the course of several years.

9. Aisha is being discharged from the hospital after being treated for delirium. How long did it likely take to treat her symptoms? a. probably about a few days b. probably about a month c. probably about six weeks d. probably about six months 10. If an emergency room has admitted 10 individuals over the last hour, how many of these individuals are likely to be presenting with delirium? a. one b. three c. four d. six 11. Although delirium usually subsides quickly, more recent work indicates which of the following? a. Delirium is the precursor for other neurocognitive disorders. b. As many as 50 percent of persons with delirium die within one year. c. Delirium can become chronic. d. Delirium can interfere with medication.

12. Which of following is NOT a common cause of delirium? a. dietary factors b. improper use of medication c. intoxication by drugs d. brain trauma 13. Tai has been admitted to the hospital with delirium. Tai’s doctor thinks the delirium was caused by a medication they take. Tai takes several medications. Which medications is the doctor most concerned about? a. those with neuroleptic effects b. those with cholinergic effects Powered by Cognero

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Chapter 16: Neurocognition and Aging c. those with extra-pyramidal effects d. those with anticholinergic effects 14. Which factor can trigger delirium? a. food deprivation b. excessive stress c. cardiovascular difficulties d. isolation 15. Which environmental factor has NOT been linked to delirium in hospitalized seniors? a. room changes b. absence of a clock c. staffing changes d. missing their glasses 16. Although fMRI research is important for efforts to both prevent and treat delirium, there are potential ethical concerns, including which of the following? a. A person experiencing delirium is not capable of providing informed consent. b. These tests can be costly for the individual and family experiencing delirium. c. These tests are very invasive. d. The delirium can get worse with the medication required for the procedure.

17. Serge has been admitted to the hospital with delirium brought on by withdrawal from alcohol. What medication will his doctor likely prescribe to help treat the delirium? a. an antibiotic medication b. an antidepressant medication c. a benzodiazepine medication d. an antipsychotic medication 18. Karl is in the hospital for delirium. What can Karl’s family do to help his recovery? a. exclude Karl from any medical decision to avoid increased anxiety b. reassure Karl and surround him with familiar belongings c. move Karl to a new hospital room to increase cognitive activity d. restrain Karl to prevent self-harm and allow the delirium to wear off 19. Ms. Martin, an 89-year-old hospital inpatient, has had six room changes in the last two weeks. Considering the results of research into the effects of environmental factors on the cognitive functioning of hospitalized older adults, what disorder would Ms. Martin likely begin to demonstrate? a. delirium b. amnestic disorder c. neurocognitive disorder d. Alzheimer’s disease 20. Which of the following is suggested as a preventative effort in assisting people who are susceptible to delirium? a. proper diet Powered by Cognero

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Chapter 16: Neurocognition and Aging b. exercise c. therapeutic drug monitoring d. yoga 21. How does delirium differ from neurocognitive disorder? a. People with delirium are not disoriented or confused in the early stages; people with neurocognitive disorder are. b. Neurocognitive disorder comes on more suddenly than does delirium. c. Delirium is not reversible, whereas neurocognitive disorder often is. d. People with neurocognitive disorder are not disoriented or confused in the early stages; people with delirium are.

22. How do the symptoms of neurocognitive disorder differ from those of delirium? a. The initial symptoms of neurocognitive disorder are generally more severe than the symptoms of delirium. b. The symptoms of neurocognitive disorder involve memory, while the symptoms of delirium are more likely to involve expressive language. c. Neurocognitive disorder symptoms develop from underlying medical conditions, while delirium symptoms are a result of other factors. d. Neurocognitive disorder symptoms develop slowly over time, while delirium symptoms develop acutely.

23. After turning 50, Sabrina began to be teased a lot by her family about being absentminded. In truth, she has been hiding the fact that she is seeing impairments in her cognitive abilities but, with some accommodations, is able to still function. What disorder does Sabrina appear to be developing? a. major neurocognitive disorder b. delirium c. mild neurocognitive disorder d. Alzheimer’s disease 24. Ivan is experiencing agnosia. What task will Ivan NOT be able to do? a. recognize and name objects b. process incoming sensory information c. produce or understand language d. find his way around in familiar surroundings 25. What causes the delusions, depression, agitation, aggression, and apathy that often occur with neurocognitive disorder? a. the frustration and fear experienced by patients as they lose their cognitive abilities b. the progressive deterioration of brain functioning c. medication side effects d. either the progressive brain deterioration of the disorder or the frustration experienced by patients 26. What was major neurocognitive disorder previously called? a. Alzheimer’s disease b. delirium c. cognitive dysfunction Powered by Cognero

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Chapter 16: Neurocognition and Aging d. dementia 27. How does death ultimately occur in people with neurocognitive disorder? a. as the result of inactivity combined with the onset of other illnesses such as pneumonia b. as the result of interactions between and complications from medications used to treat the disorder c. as the result of ever-decreasing levels of neurotransmitter activity d. as the result of an ever-increasing loss of brain mass 28. As the prevalence of major neurocognitive disorder increases with age, we see the highest rates of the disorder in individuals 65+. Approximately how many of these individuals are living with major neurocognitive disorder? a. 7 percent b. 13 percent c. 18 percent d. 25 percent 29. The prevalence of Alzheimer’s disease and other major neurocognitive disorders increase at what rate every five years, once individuals reach age 70? a. they double b. they increase by half c. they triple d. they show no increase in prevalence rate 30. If you had 100 Canadians over the age of 65 in a group, approximately how many would have major neurocognitive disorder? a. 3 b. 7 c. 10 d. 20 31. If you had 100 Canadians over the age of 85 in a group, how many would have neurocognitive disorder? a. 5 b. 10 c. 20 d. 25 32. Barrie has neurocognitive disorder. What is the most likely cause of this disorder? a. Alzheimer’s disease b. traumatic brain injury c. Parkinson’s disease d. a history of substance misuse 33. What is one major difference between neurocognitive disorder caused by Alzheimer’s disease and neurocognitive impairment caused by depression? a. Neurocognitive disorder due to Alzheimer’s disease is generally reversible. b. Neurocognitive disorder due to Alzheimer’s disease leads to a rapid decline in abilities.

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Chapter 16: Neurocognition and Aging c. Neurocognitive disorder due to Alzheimer’s disease involves a slow increase in symptoms. d. Neurocognitive disorder due to Alzheimer’s disease is not reversible.

34. A program coordinator has 10 neurocognitive patients in her day group. How many can she estimate will be found to have Alzheimer’s disease? a. 1 b. 3 c. 5 d. 7 35. How is neurocognitive disorder due to Alzheimer’s disease best characterized? a. by a few severe cognitive deficits that develop quickly b. by a few severe cognitive deficits that develop gradually and steadily c. by multiple cognitive deficits that develop gradually and steadily d. by multiple cognitive deficits that develop quickly 36. Shizana is showing early signs of neurocognitive disorder due to Alzheimer’s disease. Her family asks her doctor how the disease will likely progress. What will the doctor say about the typical progression of the disease? a. It is rapid during the early and late stages and slow during the middle stages. b. It is slow during the early stages and late stages and rapid during the middle stages. c. It is slow and progressive throughout the individual’s life. d. It is slow in the early stages and rapid during the late stages.

37. Marta is caring for her father who has advanced Alzheimer’s disease. While chatting on the phone with her sister, Marta says she has to go because it’s “that time of day,” implying that her father’s cognitive disturbance is particularly severe at the moment. What time of day is it most likely to be? a. morning b. early afternoon c. evening d. the middle of the night 38. Tam notes that his mother’s Alzheimer’s disease symptoms seem to become more pronounced later in the day. What is this phenomenon often referred to as? a. circadian shifting b. sundowner syndrome c. biological clock syndrome d. night-time deficit 39. Which term refers to the cognitive disturbance in which people with Alzheimer’s disease have difficulty with language? a. agnosia b. apraxia c. aphasia d. anomia Powered by Cognero

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Chapter 16: Neurocognition and Aging 40. What is the predominant cognitive deficit displayed by individuals with Alzheimer’s disease? a. facial agnosia b. memory impairment c. aphasia d. apraxia 41. Dr. Thomas tells Gary’s family he is fairly certain that Gary has neurocognitive disorder. Gary’s family asks Dr. Thomas how he came to his conclusion. What does Dr. Thomas say? a. Gary’s results on the neuropsychological assessments indicate the presence of a disorder. b. I looked at the results of a functional brain scan. c. Based on my experience I am quite certain he has the symptoms of the disorder. d. I looked at the results from an MRI. 42. Which of the following is one way in which a definitive diagnosis of neurocognitive disorder due to Alzheimer’s disease could be made? a. The patient’s family members report all the symptoms. b. A mental status exam indicates Alzheimer’s disease. c. Psychological testing indicates Alzheimer’s disease. d. An autopsy indicating Alzheimer’s disease.

43. Which marker for Alzheimer’s can be found in the spinal fluid of patients with the disease? a. beta-amyloid b. vascular markers c. Lewy bodies d. dopamine 44. Currently, to make a diagnosis without direct examination of the brain, the course and presence of the symptoms are observed as a slow, progressive decline, typically in which order? a. visuospatial function, language, executive function, and memory b. memory, language, visuospatial function, and executive function c. executive function, memory, visuospatial function, and language d. language, memory, executive function, and visuospatial function 45. Which test is often used to supplement the mental status exam for detecting neurocognitive disorders? a. the Clock Test b. the Wechsler Adult Intelligence Scale c. word games d. tests of memory of famous and familiar faces 46. One test that is often used to help detect neurocognitive disorder and Alzheimer’s disease asks the patient to complete a test involving a clock. What might a patient be asked to do? a. Tell the time, as well as the date and year. b. Explain the difference between 8:30 a.m. and 8:30 p.m. c. Make up a story about the clock being in someone’s home. d. Put the numbers on the clock and place the clock’s hands in the position to show the time as 11:10.

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Chapter 16: Neurocognition and Aging 47. In addition to its use in detecting neurocognitive disorder and Alzheimer’s disease, what can the Clock Test be useful for? a. identifying the specific form of neurocognitive disorder due to Alzheimer’s disease b. identifying which elderly individuals will develop neurocognitive disorder in the future c. identifying family members who may be carrying the gene for Alzheimer’s disease d. assessing the levels of cognitive functioning associated with various areas of the brain 48. What is the approximate average survival time of a patient diagnosed with neurocognitive disorder due to Alzheimer’s disease? a. 1 to 2 years b. 4 to 8 years c. 11 to 15 years d. 16 to 20 years 49. When do symptoms of neurocognitive disorder due to Alzheimer’s disease typically appear? a. when a person is in their 40s or 50s b. when a person is in their 50s or 60s c. when a person is in their 60s or 70s d. when a person is in their 70s or 80s 50. Which individual has the greatest risk of developing neurocognitive disorder due to Alzheimer’s disease? a. Rena, who completed university, although she has an average IQ b. Paul, who is wealthy and well educated c. Carrie, who dropped out of school when she was very young d. Jack, who is extremely bright but never finished university 51. Which hypothesis explains the observed differences in the rate of neurocognitive disorder due to Alzheimer’s disease for individuals of varying educational levels? a. The abilities acquired through formal education help compensate for some of the deficits of the disorder for a longer period. b. Higher levels of formal education are associated with higher levels of income and better access to quality health care. c. Higher levels of formal education are associated with lifestyles that include improved diet and higher levels of regular exercise. d. Occupations associated with lower as compared to higher levels of formal education expose individuals to a greater range of environmental toxins and physical stressors.

52. What is the biological version of the theory that states that formal education helps insulate people from the effects of neurocognitive disorder due to Alzheimer’s disease? a. cortical activity theory b. cerebral reserve hypothesis c. neuronal network theory d. mind-body hypothesis 53. What is one tentative explanation for why women have a higher prevalence rate for Alzheimer’s disease than men?

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Chapter 16: Neurocognition and Aging a. Women lack amyloid proteins. b. Women lack testosterone. c. The way estrogen and progestin interact. d. Women do not seek treatment.

54. How does the rate of neurocognitive disorder due to Alzheimer’s disease differ when comparing different demographic groups? a. No differences in the rate of the disorder by race or gender have been noted. b. Males and certain racial groups appear to have lower rates of the disorder. c. No differences are found in the rate of neurocognitive disorder due to Alzheimer’s disease by race, but women appear to have a slightly higher rate of the disorder than men. d. No differences are found in the rate of neurocognitive disorder due to Alzheimer’s disease by gender, but some racial differences have been noted.

55. Why are the prevalence rates of Alzheimer’s disease reportedly lower in low- and middle-income countries? a. genetic differences b. criterion bias c. lower numbers of those seeking assistance d. a greater likelihood there of being diagnosed with vascular neurocognitive disorder 56. What are the two most frequent causes of neurocognitive disorder? a. biochemical processes and head trauma b. Alzheimer’s disease and vascular neurocognitive disorder c. Alzheimer’s disease and biochemical processes d. head trauma and vascular neurocognitive disorder 57. Why are the symptoms of vascular neurocognitive disorder so different in each patient? a. The symptoms relate to the patient’s individual biochemical processes. b. The symptoms relate to the area of the brain damaged. c. The symptoms relate to vascular health. d. The symptoms depend upon the person’s other medical conditions.

58. Sixty-year-old Bo has the typical early symptoms of neurocognitive disorder. What does the fact that he has declines in speed of information processing and executive functioning suggest? a. His neurocognitive disorder is caused by a vascular neurocognitive disorder. b. His neurocognitive disorder is influenced by a medication. c. His neurocognitive disorder is due to multiple influences. d. His neurocognitive disorder is caused by Alzheimer’s disease.

59. In contrast to patients with neurocognitive disorder due to Alzheimer’s disease, what symptoms are patients with vascular neurocognitive disorder more likely to have? a. memory impairment during the late stages b. declines in speed of information processing and executive functioning in the early stages c. memory impairment during the early stages d. declines in speed of information processing and executive functioning in the late stages Powered by Cognero

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Chapter 16: Neurocognition and Aging 60. What gender is at greater risk of developing vascular neurocognitive disorder? a. It is greater for women than men. b. It is equal for men and women. c. It is greater for men in Western cultures, but equal for men and women in other cultures. d. It is greater for men than women.

61. How are Alzheimer’s disease and vascular neurocognitive disorder identified? a. Vascular neurocognitive disorder has a more rapid onset and patients have a much more rapid demise than with the other forms of neurocognitive disorder. b. Vascular neurocognitive disorder has a more rapid onset than neurocognitive disorder due to Alzheimer’s disease, although the course and outcome are similar. c. Vascular neurocognitive disorder has a much slower onset than neurocognitive disorder due to Alzheimer’s disease, but patients have a much more rapid demise than with the other forms of neurocognitive disorder. d. Vascular neurocognitive disorder has a more rapid onset and results in fewer deficits than neurocognitive disorder due to Alzheimer’s disease.

62. Dementia pugilistica, which is now referred to as chronic traumatic encephalopathy, originally was believed to be restricted to which type of individuals? a. wrestlers b. boxers c. football players d. soldiers 63. Which environmental stressor appears to be a significant factor in the later development of neurocognitive disorder with distinctive neurodegeneration? a. smoking b. repeated head trauma c. poverty d. exposure to high levels of aluminum 64. What would you expect to see in an individual with frontotemporal neurocognitive disorder? a. memory impairment b. declines in appropriate behaviour c. motor impairments d. speed of processing deficits 65. Pick’s disease falls under which category of neurocognitive disorders? a. Alzheimer’s disease b. vascular neurocognitive disorder c. frontotemporal neurocognitive disorder d. Parkinson’s disease 66. When do symptoms of Pick’s disease typically appear? a. when a person is in their 40s or 50s Powered by Cognero

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Chapter 16: Neurocognition and Aging b. when a person is in their 50s or 60s c. when a person is in their 60s or 70s d. when a person is in their 70s or 80s 67. Who is at greatest risk for traumatic brain injury? a. children b. teens and young adults c. adults d. older adults 68. Which term refers to the neurocognitive disorder resulting from the microscopic deposits of a protein that damage brain cells over time causing impairment in alertness and attention? a. neurocognitive disorder due to Lewy body disease b. Pick’s disease c. neurocognitive disorder due to Huntington’s disease d. vascular neurocognitive disorder 69. If neurocognitive disorder is caused by a process that has damaged the dopamine pathways in a patient’s brain, what can we assume is the cause of their neurocognitive disorder? a. head trauma b. Parkinson’s disease c. Huntington’s disease d. Alzheimer’s disease 70. Motor problems are characteristic of which neurocognitive disease? a. Huntington’s disease b. Alzheimer’s disease c. Parkinson’s disease d. Pick’s disease 71. Which of the following is NOT a known cause of neurocognitive disorder? a. HIV b. diabetes c. vitamin B12 deficiency d. head trauma 72. What appears to be the cause of HIV-related neurocognitive disorder? a. side effects of medications used to treat HIV b. opportunistic infections that impact people with HIV c. chemical imbalances in the brain d. the HIV infection itself 73. A patient has HIV and has developed a neurocognitive disorder. What part of their brain is likely the source of their neurocognitive problems? a. the cortex Powered by Cognero

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Chapter 16: Neurocognition and Aging b. the hindbrain c. the brain stem d. subcortical structures 74. What causes the differing patterns of impairment associated with neurocognitive disorder due to Alzheimer’s disease and HIV-caused neurocognitive disorder? a. the viral origins of HIV b. unexplained causes c. the different areas of the brain affected d. the immune response to the virus in people with HIV 75. Which of the following is more likely to be caused by neurocognitive disorder due to HIV than neurocognitive disorder due to Alzheimer’s disease? a. short-term memory loss b. death c. severe depression d. long-term memory loss 76. Only some patients go on to develop neurocognitive disorder after being diagnosed with which of the following diseases? a. Parkinson’s disease and Pick’s disease b. Pick’s disease and Huntington’s disease c. Alzheimer’s disease and Huntington’s disease d. Huntington’s disease and Parkinson’s disease 77. Compared with most disorders, what is so unusual about Huntington’s disease? a. It is the result of one gene. b. It is associated with subcortical impairment. c. It is a cause of neurocognitive disorder. d. It is influenced by many genes.

78. Which disorder begins with involuntary movements referred to as chorea? a. Alzheimer’s disease b. Huntington’s disease c. Parkinson’s disease d. Monger-Rolland syndrome 79. What of the following is NOT accurate concerning neurocognitive disorder due to prion disease? a. It is a rare progressive neurodegenerative disorder. b. Prions have DNA and RNA that can be destroyed by chemicals or radiation. c. Neurocognitive disorder due to prion disease is always fatal. d. Prions are not contagious in humans and can only be contracted through cannibalism or accidental. inoculations 80. The disorder that causes a form of neurocognitive disorder called bovine spongiform encephalopathy (BSE) or “mad Powered by Cognero

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Chapter 16: Neurocognition and Aging cow disease” is a variant of a specific illness. What is the illness? a. Creutzfeldt-Jakob disease b. Pick’s disease c. Huntington’s disease d. neurocognitive disorder due to Alzheimer’s disease 81. How many chronic heavy alcohol users show cognitive impairment? a. 20 to 30 percent b. 40 to 50 percent c. 50 to 70 percent d. 70 to 90 percent 82. The symptoms of neurocognitive disorder associated with substance dependence are similar to the symptoms observed in a specific illness. What is the illness? a. Huntington’s disease b. neurocognitive disorder due to Alzheimer’s disease c. vascular neurocognitive disorder d. HIV-induced neurocognitive disorder 83. The symptoms of neurocognitive disorder associated with substance dependence are generally caused by the prolonged drug use itself, especially in combination with another factor. What is the other factor? a. poor diet b. an inactive lifestyle c. cigarette smoking d. a family history of neurocognitive disorder 84. How is recent research regarding the biological processes and genetic factors associated with neurocognitive disorder due to Alzheimer’s disease best viewed? a. as significant findings that build upon an already extensive body of research b. as preliminary findings that need to be replicated before being accepted as truths c. as interesting theories regarding influences, though of little potential use for finding a way to predict and treat neurocognitive disorder d. as hypotheses that have yet to be tested 85. What disorder is associated with the formation of neurofibrillary tangles and amyloid plaques? a. Pick’s disease b. neurocognitive disorder due to Alzheimer’s disease c. Huntington’s disease d. Creutzfeldt-Jakob disease 86. How are the amyloid plaques that accumulate in the brains of Alzheimer’s patients best described? a. as gummy protein deposits b. as plaques of dead nerve cells c. as tangled, strand-like filaments d. as mineral deposits Powered by Cognero

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Chapter 16: Neurocognition and Aging 87. One theory about the development of neurocognitive disorder due to Alzheimer’s disease suggests that the disorder is caused by the formation of solid waxy proteins in the brain. What is this process similar to? a. the formation of scar tissue following an injury b. vascular spasms causing migraines c. cholesterol build up in blood vessels causing cardiovascular disease d. head trauma causing neuronal death 88. How are the neurofibrillary tangles and amyloid plaques associated with neurocognitive disorder due to Alzheimer’s disease observed? a. only during an EEG examination b. only during an autopsy c. only on functional brain scans (fMRI) d. only on MRI or CT brain scans 89. What do autopsies performed on the brains of deceased persons both with and without Alzheimer’s disease show regarding amyloid plaques? a. They are present only in the brains of people who died of Alzheimer’s disease. b. Those in patients with Alzheimer’s disease are of a different type from those in patients without Alzheimer’s. c. They accumulate in aging brains over time, regardless of whether symptoms of neurocognitive disorder are apparent, but to a much greater degree in the brains of patients with Alzheimer’s disease. d. They accumulate in aging brains over time, regardless of whether symptoms of neurocognitive disorder are apparent, but are located in different parts of the brain in patients with and without Alzheimer’s disease.

90. According to genetic research, how is neurocognitive disorder due to Alzheimer’s disease caused? a. There are many forms of neurocognitive disorder due to Alzheimer’s disease and each form may have somewhat different features and different genetic influences. b. There are too many complex interactions to ever understand the causes of neurocognitive disorder due to Alzheimer’s disease. c. There are one or two forms of neurocognitive disorder due to Alzheimer’s disease, and each form may have a different genetic cause. d. There are three identifiable forms of neurocognitive disorder due to Alzheimer’s disease, each with its own specific genetic influences.

91. Which chromosome was first linked to the onset of Alzheimer’s disease? a. 2 b. 14 c. 19 d. 21 92. Based on known facts about the genetic influences on Alzheimer’s disease, it appears that there may be several genetic causes, which may influence the course and age of onset for the disorder. For example, genetic research has found an association between chromosome 14 and chromosome 19 and specific types of Alzheimer’s disease. What are these types, respectively? a. late onset and early onset b. early onset and late onset Powered by Cognero

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Chapter 16: Neurocognition and Aging c. irreversible and reversible d. reversible and irreversible 93. Which term refers to the apolipoprotein E4 (apo E4) gene, which will slightly increase the risk of developing Alzheimer’s disease? a. recessive gene b. dominant gene c. deterministic gene d. susceptibility gene 94. What type of genes are Presenilin 1 and Presenilin 2 in relation to Alzheimer’s disease? a. recessive gene b. dominant gene c. deterministic gene d. susceptibility gene 95. Individuals who have late-onset Alzheimer’s disease, the most common form, are likely to carry which gene? a. apo E4, located on chromosome 19 b. apo E3, located on chromosome 19 c. apo E2, located on chromosome 21 d. apo E4, located on chromosome 21 96. What is the best way to think about the psychological and social influences involved in neurocognitive disorder? a. They can help compare and contrast cultural influences. b. They help determine the onset and course. c. They are direct causes. d. They have a minimal impact.

97. Which of the following is NOT a psychological or social factor influencing the risk for developing neurocognitive disorder? a. level of formal education b. diet c. personality traits, such as hostility d. participation in sports such as boxing 98. Black individuals without the apo E4 gene may have a protective factor to reduce the risk of Alzheimer’s. What is this protective factor? a. formal education b. diet c. low levels of cholesterol d. social support 99. Which of the following may reduce the likelihood of developing Alzheimer’s disease among those without the apo E4 gene? a. formal education Powered by Cognero

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Chapter 16: Neurocognition and Aging b. medication c. exercise d. social support 100. Because older adults in a given cultural group are relieved of the demands of work and care after a certain age, which of the following is most likely to happen? a. The early stages of confusion and memory loss may go undetected for years. b. They may be less vulnerable to developing neurocognitive disorder because of the lessened stress. c. The early stages of confusion and memory loss may be detected because they are more frequently engaged with family. d. They may be more vulnerable to developing neurocognitive disorder because of physical and mental inactivity.

101. Which Papua New Guinea ritual has been linked to neurocognitive disorder? a. neck extensions b. spitting c. scarification d. cannibalism 102. Which of the following neurocognitive disorders can be treated if caught early? a. stroke b. Parkinson’s disease c. Alzheimer’s disease d. infectious disease 103. What effect have today’s neurocognitive disorder treatments had on this disease? a. They have reversed neurocognitive disorder. b. They have cured neurocognitive disorder. c. Neurocognitive disorder can’t be stopped from progressing. d. Neurocognitive disorder has been controlled but not cured.

104. What is the main reason we do NOT have an effective treatment for neurocognitive disorder? a. The disorder mostly affects older adults who generally have many other health problems. b. There is a limit to how many neurons can be destroyed through neurocognitive disorder and be compensated for by other neurons. c. The cause is genetic. d. By the time neurocognitive disorder is accurately diagnosed, the damage is too widespread.

105. Why are treatments for major neurocognitive disorder usually ineffective? a. The damage is too extensive. b. Medications that improve cognitive functioning have unpleasant physical side effects, so patients refuse to take them. c. Medications to treat major neurocognitive disorder work on only a small segment of sufferers with a very specific type of tissue damage. d. Treatments are very expensive, and thousands of treatments are needed for any effect to be seen.

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Chapter 16: Neurocognition and Aging 106. Which of the following is a known characteristic of many caregivers of people with major neurocognitive disorder? a. They become clinically depressed. b. They develop substance use problems as a result of the caregiving responsibilities. c. They develop the same neurocognitive disorder as the person they are caring for. d. They are physically abusive.

107. How do many Indigenous Peoples view major neurocognitive disorder? a. as a genetic disorder b. as a part of the circle of life c. as a sociocultural phenomenon d. as a breakdown in connection from the Creator 108. What does glial cell-derived neurotrophic factor (GDNF) do? a. It preserves and possibly restores neurons. b. It breaks down amyloid plaques. c. It regulates dopamine production. d. It cures hypothyroidism.

109. William has Alzheimer’s disease and is receiving a medication regimen. What is that medication regimen most likely to be? a. an antidepressant and antipsychotic medications b. Exelon or Aricept c. vitamin B12 supplements d. benzodiazepines with antidepressants 110. Patients with neurocognitive disorder due to Alzheimer’s disease benefit from certain medications. What do these medications do? a. prevent the breakdown of acetylcholine b. repair neuronal damage c. enhance the level of dopamine d. prevent the reuptake of serotonin 111. What is the typical outcome of medication that can be expected for a person with neurocognitive disorder due to Alzheimer’s disease? a. relief of physical but not cognitive symptoms b. about one year without symptoms c. temporary improvement in abilities d. increased life expectancy 112. Which medical approach to treating Alzheimer’s disease is no longer recommended because it may actually increase mortality? a. ginkgo biloba b. vitamin E c. GDNF Powered by Cognero

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Chapter 16: Neurocognition and Aging d. antidepressants 113. What is a recommended treatment for individuals with neurocognitive disorder who become agitated? a. antidepressants b. acetylcholinase boosters c. exercise d. antipsychotics 114. What is targeted by research on vaccines that would potentially treat and prevent Alzheimer’s disease? a. the loss of acetylcholine b. the small proteins that lead to cell death c. dopamine receptors d. chromosome 21 115. What is the primary goal of most psychosocial treatments for neurocognitive disorder? a. to help the patient compensate for lost abilities b. to treat the anxiety associated with knowing that the disorder is progressive c. to enhance family functioning d. to relieve depression 116. Which of the following is a psychosocial treatment strategy for people with neurocognitive disorder? a. weekly family story time (narratives) b. combining storytelling and photo album viewing c. frequently reviewing family photo albums d. creating memory wallets 117. What is NOT one of the benefits of the process of cognitive stimulation through word games, tests of memory, and practice with numbers? a. It delays the onset of the more severe cognitive effects. b. It improves quality of life. c. It decreases the need for medical intervention. d. It maintains cognitive activity.

118. What is the typical outcome of combining medical and nonmedical treatments on those with Alzheimer’s disease? a. It compresses the time when the person is most impaired. b. It increases their lifespan. c. It decreases the need for hospitalization. d. It maintains cognitive activity.

119. What is the general finding on research aimed at supporting caregivers? a. The results remain weak and additional work is needed. b. Supporting caregivers increases life expectancy of the family member with Alzheimer’s disease. c. They have a great deal of promise in decreasing the likelihood of depression and anxiety. d. They decrease the frequency of elder abuse.

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Chapter 16: Neurocognition and Aging 120. The addition of mild neurocognitive disorder has raised some concerns, including which of the following? a. The number of individuals with mild neurocognitive disorder is rare. b. Many individuals are unaware of the progression from normal aging to mild neurocognitive disorder. c. The distinction between major and mild neurocognitive disorder is a difficult one to make. d. All older adults meet the criteria for mild neurocognitive disorder by the age of 70.

121. How can you accurately assess a decline in cognitive function? a. through brain scanning b. by having a picture of function before the decline c. by tying performance to one or two standard deviations below what would be expected d. there is no way to accurately assess a decline 122. A major study in Sweden was conducted to consider possible preventative strategies for neurocognitive disorder. It included 1810 participants who were older than 65 at the time and followed them for about 13 years. Through medical histories and interviews, what did the study conclude? a. You should lean toward a vegetarian diet and maintain a life of physical activity. b. Earlier genetic counselling is critical. c. It is important to control your blood pressure, not smoke, and lead a physical and social life. d. It is important to eat well and stay engaged in academically stimulating activities.

123. Describe the symptoms of neurocognitive disorder and delirium, noting similarities and differences. What do the symptoms of each of these disorders have in common? What features are unique to each disorder?

124. Describe the typical causes of delirium and how it is treated.

125. Describe the differences and similarities of neurocognitive disorder due to Alzheimer’s disease and vascular neurocognitive disorder. Explain ways of determining if neurocognitive disorder is due to Alzheimer’s disease or vascular problems. Why is it not always possible to determine the actual cause of neurocognitive disorder while the patient is alive?

126. Explain the relationship that has been observed between formal education and the development of neurocognitive disorder due to Alzheimer’s disease. What psychosocial and neurological explanations have been offered for this observation?

127. Describe some research findings regarding the possible influences on the development of neurocognitive disorder due to Alzheimer’s disease. Make sure that your description covers genetic findings, as well as information regarding the degenerative process that occurs in the brain.

128. Based on our current understanding of the biological, psychological, and social influences on the development of neurocognitive disorder, provide two examples of how the prevalence of some forms of neurocognitive disorder might be expected to differ between preindustrial rural societies and industrial urban societies. As well, provide a cross-cultural example in an explanation of how neurocognitive disorder might be less likely to be diagnosed in a society very different from mainstream Canadian society.

129. Describe three neurocognitive disorders other than due to Alzheimer’s disease and vascular damage and what we know about the causes of each.

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Chapter 16: Neurocognition and Aging 130. Explain how neurocognitive disorder due to Alzheimer’s disease is usually treated. Include information about medication and psychosocial therapies. How would you characterize the success of the currently available treatment options for neurocognitive disorder due to Alzheimer’s disease?

131. What are some of the issues that caregivers must face when dealing with a patient with neurocognitive disorder due to Alzheimer’s disease?

132. Assume that you had a relative who was beginning to develop significant deficits associated with early neurocognitive disorder due to Alzheimer’s disease. Describe several compensating strategies that you could help develop to aid the individual’s functioning. What kinds of tools could the patient use to keep from getting lost, to remember important information, and to stay safe? Be creative!

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Chapter 16: Neurocognition and Aging Answer Key 1. b 2. c 3. b 4. b 5. c 6. c 7. b 8. c 9. a 10. a 11. b 12. a 13. d 14. b 15. c 16. a 17. d 18. b 19. a 20. c 21. d 22. d 23. c 24. a 25. d Powered by Cognero

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Chapter 16: Neurocognition and Aging 26. d 27. a 28. a 29. a 30. b 31. d 32. a 33. d 34. c 35. c 36. b 37. c 38. b 39. c 40. b 41. a 42. d 43. a 44. b 45. a 46. d 47. b 48. b 49. c 50. c 51. a Powered by Cognero

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Chapter 16: Neurocognition and Aging 52. b 53. c 54. b 55. c 56. b 57. b 58. a 59. b 60. d 61. b 62. b 63. b 64. b 65. c 66. a 67. b 68. a 69. b 70. c 71. b 72. d 73. d 74. c 75. c 76. d Powered by Cognero

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Chapter 16: Neurocognition and Aging 77. a 78. b 79. b 80. a 81. c 82. b 83. a 84. b 85. b 86. a 87. c 88. b 89. c 90. a 91. d 92. b 93. d 94. c 95. a 96. b 97. c 98. c 99. d 100. a 101. d 102. d Powered by Cognero

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Chapter 16: Neurocognition and Aging 103. c 104. b 105. a 106. a 107. b 108. a 109. b 110. a 111. c 112. b 113. d 114. b 115. a 116. d 117. c 118. a 119. a 120. c 121. b 122. c 123. Student responses will vary.

124. Student responses will vary.

125. Student responses will vary.

126. Student responses will vary.

127. Student responses will vary.

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Chapter 16: Neurocognition and Aging 128. Student responses will vary.

129. Student responses will vary.

130. Student responses will vary.

131. Student responses will vary.

132. Student responses will vary.

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Chapter 17: Mental Health and the Law

Indicate the answer choice that best completes the statement or answers the question.

1. Civil commitment laws vary by province and territory and are set by which of the following? a. federal government b. municipal governments c. mental health acts d. Tri-Council policies 2. Which of the following is NOT a criterion for involuntary civil commitment? a. a lawyer’s request that their client be admitted b. a person is deemed dangerous to themselves or others c. a person has a mental disorder d. a person needs treatment 3. What is a general requirement for civil commitment in all provinces in Canada? a. presence of a mental disorder b. dangerousness to self or others c. a crime having been committed d. a need for treatment 4. Which jurisdiction does NOT require that a person have a mental illness before they can be detained under civil commitment legislation? a. British Columbia b. Alberta c. Quebec d. Ontario 5. In British Columbia, a psychiatrist can commit a patient with schizophrenia if they refuse to take their medications.

This provincial difference is due to which of the following? a. It is the result of broader definitions of competence. b. It is the result of broader definitions of safety and protection. c. It is the result of restricting patients’ right to refuse treatment. d. It is the result of more narrow definitions of safety and protection.

6. The government justifies its right to commit someone to a mental health facility under two types of authority. One is police power. What is the second type? a. legal power b. the protection of people with mental illness c. parens patriae (state as the parent) d. the will of the people 7. The government justifies its right to commit someone to a mental health facility under two types of authority: police power and parens patriae. Which of the following describes what happens under police power? a. The government allows for the arrest of people who commit criminal offences whether they have a mental illness or not.

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Chapter 17: Mental Health and the Law b. The government acts on behalf of a citizen who is not likely to act in their own best interest. c. The government takes responsibility for protecting public health, safety, and welfare. d. The government temporarily suspends the rights of a person who is harming or may harm others.

8. The government justifies its right to commit someone to a mental health facility under two types of authority: police power and parens patriae. What happens under parens patriae? a. The government becomes the legal guardian for an individual who is incompetent. b. The government acts on behalf of a citizen who is not likely to act in their own best interest. c. The government takes responsibility for protecting public health, safety, and welfare. d. The government temporarily suspends the rights of a person who is harming or may harm others.

9. Gavin was taken into custody under the principle of parens patriae. What does this mean? a. The state is acting as a legal advisor. b. The state is acting as a social worker. c. The state is acting as a legal guardian. d. The state is acting as a surrogate parent.

10. When can parens patriae power be used to commit individuals with severe mental illness to mental health facilities? a. when it is believed that they might be harmed because they are unable to secure the basic necessities of life, such as food and shelter b. when it is believed that they might be harmed because they are not taking their medications c. when it is believed that they might be harmed because they are vulnerable to attack by other inmates in jail d. when it is believed that they might be harmed because they are being abused in their family situation 11. Jade’s family has just begun the process of civil commitment. Although the specifics of this process differ across jurisdictions, typically all will include which of the following? a. a petition to the court, submitted by the Crown attorney’s office b. a report by police or emergency medical workers c. an assessment by one or two physicians or psychiatrists d. an individual voluntarily requesting admission to a mental health facility 12. Joe is being treated in a closed psychiatric ward for his panic disorder with agoraphobia. Which of the following civil commitment issues arises here? a. The staff–patient ratio is insufficient. b. Less restrictive treatments are available. c. The patient has a right to treatment. d. The patient has a right to refuse treatment.

13. In Canadian jurisdictions, the patient must satisfy one of two necessary criteria for compulsory community treatment (CCT). One is that they possibly pose harm to themselves or others. What is the other? a. There is some risk of increased mental deterioration. b. They will not voluntarily seek help. c. They are unable to be hospitalized due to lack of space. d. They are refusing treatment.

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Chapter 17: Mental Health and the Law 14. The two main goals for compulsory community treatments (CCT) are providing care in a less restrictive environment and which of the following? a. increasing rate of treatment b. increasing compliance c. preventing relapse d. decreasing risk 15. Each Canadian jurisdiction has its own definition of mental illness. Saskatchewan uses what Robertson (1994) calls a functional definition. What does that mean? a. It is practical and easy to understand and apply. b. It emphasizes behaviour over emotions and thoughts. c. It specifies the effect of the illness on the patient’s thoughts and behaviour. d. It serves the function of allowing for civil commitment.

16. Which statement best explains the definition of mental illness in Canada? a. It is defined differently among provinces and territories. b. It is defined similarly across Canada. c. It is defined by the hospital where the patient is being committed. d. It is determined by the federal government.

17. What is the connection between mental illness from a legal standpoint and mental illness based on the criteria in the DSM-5-TR? a. Not everyone who is considered to have a mental illness from a legal standpoint would meet the criteria for a DSM-5-TR diagnosis. b. It is a legal term used when the courts are describing dangerousness. c. Not everyone who receives a DSM-5-TR diagnosis is considered to have a mental illness from a legal standpoint. d. Mental illness has the same definition as psychological disorder.

18. Professor Dietrich is giving a lecture about stigmas concerning people who have a mental illness. What will Professor Dietrich most likely claim is the reason for the popular opinion that people who have a mental illness are more dangerous than those who do not? a. public knowledge of DSM-5-TR diagnostic criteria b. data from medical records c. media reports d. statistics on homicide and other violent crimes 19. What do statistics say about the relationship between dangerousness and mental illness? a. Statistics point to a small increased rate of violence among people with mental illness. b. Statistics suggest that there is an overwhelming increase in the rate of violence among people with mental illness. c. Statistics suggest that there is a significant increase in the rate of violence among those with mental illness and that the violent acts are more severe. d. Statistics overwhelmingly prove that there is no evidence to suggest that a higher rate of violence exists among people with mental illness.

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Chapter 17: Mental Health and the Law 20. What has research determined regarding the accurate predictions of the risk for violence in people with mental illness persons? a. They can be made in over 90 percent of the cases. b. They are rare but any prediction, even if inaccurate, is worth the risk to public safety. c. They are impossible. d. They are possible.

21. According to the research by Ogloff and his colleagues on nearly 300 psychiatric patients, which of the following individuals would NOT likely be at risk for self-injury? a. those who engaged in self-injurious behaviour within the two weeks before being committed to hospital b. those who have a history of self-harm c. those who showed verbal and physical aggression toward others in the hospital d. those who were recently victimized by a physical assault 22. James Ogloff and his colleagues studied nearly 300 psychiatric patients who had been involuntarily committed to a psychiatric hospital. Which of the following factors was NOT found to be predictive of risk for suicidal behaviour? a. reporting suicidal thoughts while in hospital b. showing verbal and physical aggression toward others in hospital c. having a history of self-harm d. having delusions 23. Which of the following is NOT a trend that has influenced the number of people in Canada who are involuntarily committed each year? a. the increase in the number of people who are homeless b. the inability to create the necessary network of community mental health services c. the movement of people with severe mental illness out of institutions d. the growing size of urban centres 24. As a result of the deinstitutionalization movement, which of the following has been a goal in mental health care? a. increasing institutional beds b. increasing hospital beds in psychiatric wards c. increasing community integration d. increasing homelessness of people with mental illness who cannot receive mental health services 25. What does research suggest is the relationship between mental health treatment and homelessness in Canada? a. Deinstitutionalization increased homelessness. b. More than 90 percent of people who are unhoused in Canada have a mental health disorder. c. Symptoms of mental health disorders make living on the streets easier than living elsewhere for many people with mental illnesses. d. Homelessness has increased because of an increase in unemployment and a shortage of low-income housing, which affects many people with mental illness indirectly.

26. According to estimates from the 2016 census, how many people in Canada are homeless in a given year? a. 50 000 b. 110 000 Powered by Cognero

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Chapter 17: Mental Health and the Law c. 235 000 d. 320 000 27. University of Lethbridge researchers have noted that which of the following groups are overrepresented among people who are homeless? a. Indigenous peoples, refugees, and ethnic minorities b. senior citizens who are unable to survive on fixed incomes c. women, and young children who have been abandoned by their families d. couples and single women 28. Which group does NOT appear to be overrepresented among people who are homeless in Canada? a. Indigenous people b. refugees c. ethnic minorities d. women 29. What has been the result of the trend toward deinstitutionalization? a. decreased numbers of people who are homeless and have a mental illness b. an increased number of patients in psychiatric institutions c. a decreased number of patients in psychiatric institutions d. better treatment of patients with mental illness in the community 30. What were the two goals of the deinstitutionalization movement? a. to downsize or close the large mental hospitals and create a network of community mental health services b. to close psychiatric hospitals and give the responsibility of caring for the people with mental illnesses back to their families c. to improve treatment for patients with mental illnesses and save money d. to eliminate the construct of mental illness and improve social conditions for economically marginalized people and vulnerable members of society 31. Which of the goals of deinstitutionalization has been accomplished? a. the creation of innovative outpatient mental health and recreational services b. the reduction of the societal stigma that once harmed those suffering from a mental illness c. the closing of large psychiatric hospitals d. the creation of a network of community mental health centres 32. In a pan-Canadian study on women’s housing and homelessness, how many of these individuals were survivors of abuse or trauma? a. 25 percent b. 50 percent c. 75 percent d. 100 percent 33. A cohort study conducted in Ontario revealed that those with a recent history of homelessness in relation to COVID19 were NOT which of the following?

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Chapter 17: Mental Health and the Law a. more likely to have been tested for coronavirus b. more likely to have received intensive care c. more likely to have been vaccinated for COVID-19 d. more likely to have died of COVID-19 34. The term transinstitutionalization refers to the movement of people with severe mental illness out of psychiatric hospitals. Which of the following is NOT a place where these people are to move to? a. jails and prisons b. group residences c. nursing homes d. community health centres 35. Although battered woman syndrome is not recognized in the DSM-5-TR, the Supreme Court of Canada has acknowledged that it may, in some cases, be used as a valid form of the self-defence legal defence. Why is this so? a. because a woman who has been severely battered may not possess reasonable control over her behaviour b. because an accused may reasonably believe that her life is in danger even though it may not be imminent or immediate c. because a person has the right to protect themselves d. because the battering may have resulted in brain damage, rendering the woman incapable of knowing right from wrong 36. Based on data from Crawford and Gartner (1992), how many female murder victims are killed by their spouses or intimate partners? a. 50 percent b. 60 percent c. 70 percent d. 80 percent 37. What does the criminal commitment process refer to? a. People are not held because they have only been accused of a crime and are instructed to be treated by their own psychiatrists because they have already been previously diagnosed. b. People are held because they have been accused of a crime and are detained in a mental health facility until they can be assessed as fit or unfit to stand trial or they have been found not criminally responsible on account of a mental disorder. c. People are held because they have been found not criminally responsible on account of a mental disorder and have been convicted of a crime. d. People are held because they have been convicted of a crime but are considered to have a mental illness and to be dangerous.

38. Since the 19th century, the method of determining responsibility when a person’s mental state is in question has been based on the M’Naghten rule. Where did this rule originate? a. England b. Ireland c. Australia d. Canada Powered by Cognero

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Chapter 17: Mental Health and the Law 39. Which case is the M’Naghten rule based on? a. A man attempted to kill former Canadian Prime Minister Jean Chrétien. b. A man in Ireland shot and killed his wife while in a dissociative state. c. An Australian woman killed her husband after many years of severe abuse. d. A man killed the British prime minister’s secretary, thinking it was the prime minister.

40. Danny murdered his brother, Wayne, in 1930. If Danny’s lawyers recommended the most commonly used insanity defence at the time, what defence would Danny be using? a. the M’Naghten rule b. the American Law Institute rule 1962 c. the Mental Disease rule d. the Durham rule 41. The M’Naghten rule (the insanity defence), which is still being used by numerous countries worldwide, holds that individuals are not responsible for their criminal behaviour if a certain condition applies. What is this condition? a. They don’t know what they are doing, or they don’t know that what they are doing is wrong. b. They don’t know that what they are doing is illegal. c. They know that what they’re doing is wrong, but they are unable to control their behaviour. d. They are unable to appreciate the legal consequences of their act.

42. In which of the following cases would someone most likely use the insanity defence? a. The person knew what they were doing was wrong but was compelled to do it because of a compulsion. b. The person was not aware of the law that they were breaking. c. The person had been committed to a psychiatric institution within 12 months of committing the offence. d. It was a charge of murder and the accused did not know they had killed someone.

43. Under the 1985 Canadian Criminal Code, what would happen to a person found not guilty by reason of insanity? a. The person would be automatically detained until their mental disorder improved sufficiently to justify release. b. The person would be released back into the community in the care of their family. c. The person would be automatically detained until they could appreciate the quality of their act. d. The person would be incarcerated for the same number of years in a psychiatric institution as they would have been sentenced to jail for the same offence.

44. What is recognized by the fact that the not criminally responsible on account of mental disorder defence used since 1991 has replaced “not guilty” with “not criminally responsible”? a. The act is not really a crime because it was committed without sufficient intent. b. The person feels remorse for the behaviour. c. The person did commit the crime. d. The act may be morally wrong but not legally wrong.

45. What did the court find in the 1995 case (described in the text) of André Dallaire, who tried to kill former Prime Minister Jean Chrétien? a. André Dallaire was not guilty of the crime and not criminally responsible for his actions. b. André Dallaire was guilty of the crime but not criminally responsible for his actions. c. André Dallaire was guilty of the crime but insane.

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Chapter 17: Mental Health and the Law d. André Dallaire was not guilty of the crime by reason of insanity.

46. The examination of long-term criminal outcomes of people found not guilty by reason of insanity or not criminally responsible on account of mental disorder between 1941 and 2015 revealed which of the following? a. Only 8 percent committed a new violent crime. b. Only 13 percent committed a new violent crime. c. Only 18 percent committed a new violent crime. d. Only 24 percent committed a new violent crime.

47. According to Ogloff and Whittemore’s (2001) research on public opinions, what happens when someone is found not criminally responsible on account of a mental disorder? a. The public often protests that the person “got off” too easily. b. The public expresses more negative views of the people with mental illness than before. c. The public becomes a little more educated about the nature of mental illness. d. The public mistakenly believes the person will be hospitalized for the rest of their life.

48. According to Hans (1986), what percentage of people who responded to a survey agreed with the statement that the “insanity plea is a loophole that allows too many guilty people to go free”? a. 23 b. 44 c. 77 d. 90 49. In a more recent Canadian survey (Fraser & Desjardins, 2009), how many respondents disagreed with the availability of the not criminally responsible on account of mental disorder defence? a. one-quarter b. one-third c. one-half d. three-quarters 50. A TV reporter is interviewing students about the insanity plea in 1986. If these students are similar to about 90 percent of the population, which of the following statements will they agree with? a. If someone successfully pleads insanity, they will spend more time in a mental hospital than in a jail. b. There are more people with mental illness in prisons than in mental hospitals. c. The insanity defence is not used in enough cases. Too many people with mental illness are in jail instead of in hospitals. d. Too many people escape responsibility for their crimes by pleading insanity.

51. According to Ogloff and Whittemore (2001), what do negative public perceptions of the not criminally responsible on account of mental disorder (NCRMD) defence reflect? a. an underestimate by the public of how often the NCRMD defence is used in criminal cases b. a lack of understanding by the public about the nature and prevalence of mental illness c. a lack of understanding by the public about criminal law d. a lack of appreciation by the public about how serious the consequences are of using this defence

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Chapter 17: Mental Health and the Law 52. Since 1991, when the not criminally responsible on account of mental disorder (NCRMD) defence was introduced in Canada, which of the following has occurred? a. The number of people recommended for NCRMD has remained constant. b. There have been fewer cases recommended for NCRMD each successive year since 1991. c. It is still fairly uncommon. d. There has been a steady and substantial increase each year in the number of people recommended for NCRMD and it is becoming the most common defence used in Canadian criminal cases.

53. In British Columbia, during the two years following the legal change to the not criminally responsible on account of mental disorder (NCRMD) defence, what percentage of cases remanded for assessment of criminal responsibility led to psychiatrists’ recommendations favouring an NCRMD defence? a. 1 percent b. 29 percent c. 57 percent d. 71 percent 54. Which statement best describes the public perception that people with mental illness have “beat the system” by being judged not criminally responsible on account of mental disorder? a. It is an incorrect perception. b. It is considered a factual perception in murder cases. c. It is true for males who commit crimes but not for females who commit crimes. d. It is a correct perception.

55. If a person succeeds at using the not criminally responsible on account of mental disorder defence, which of the following is most likely to occur? a. The person would express regret for having done so because of the stigma associated with mental illness. b. The person would automatically be kept in a psychiatric institution for exactly the same length of time as they would have been sentenced to prison if they had not used this defence. c. The person may end up spending only a fraction of the time in a psychiatric institution that they would have been sentenced to prison if they had not used this defence. d. The person may end up being kept in a psychiatric institution for much longer periods than they would have been sentenced to prison if they had not used this defence.

56. Andrea is currently being held in a psychiatric hospital after being tried for a criminal offence. Why may she be in this facility instead of in jail? a. She was found not criminally responsible on account of mental disorder. b. She was found criminally responsible because of her particular mental health diagnoses. c. She was found not guilty by reason of insanity. d. She was found to be unable to participate in legal proceedings against her.

57. The outcome of Avery’s trial resulted in a finding of not criminally responsible on account of mental disorder.

According to Canadian law, where will Avery now be sent? a. a psychiatric hospital b. a prison c. a community mental health centre d. a prison with 24-hour psychiatric treatment Powered by Cognero

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Chapter 17: Mental Health and the Law 58. In a Canadian review, Woodworth and colleagues (2003) suggested that forensic community programs are one of the best settings for helping people who are judged to be not criminally responsible on account of mental disorder. Which of the following is NOT a recommendation made by the authors to ensure a successful implementation of such communitybased programs? a. Routine use must be made of validated risk assessment tools. b. There must be unanimous acceptance of the program by people in the community. c. People in the community must be aware of the program and educated about the risk that these individuals pose. d. There must be high levels of monitoring of these individuals.

59. The court has found that Mounir is currently unable to participate in their own defence. What does this mean? a. The court found Mounir not guilty by reason of insanity. b. The court found Mounir not criminally responsible on account of mental disorder. c. The court found Mounir unfit to stand trial. d. Mounir was conditionally charged.

60. Andrew has been accused of committing a crime and is currently in a mental health facility. He will stay there until it is determined that he is fit to participate in legal proceedings against him. What does it mean if Andrew is found unfit to stand trial? a. He will be convicted of the crime but sent to a psychiatric hospital instead of prison. b. He will have a better chance of success with a not criminally responsible on account of mental disorder defence. c. He will be conditionally discharged, detained in hospital, or ordered to receive treatment. d. He will be acquitted of the crime.

61. According to the Canadian Criminal Code, which of the following is NOT a requirement for a person assessed as being fit to stand trial? a. They must understand the nature and object of the proceedings. b. They must understand the nature and moral quality of the act of which they stand accused. c. They must understand the possible consequences of the proceedings. d. They must communicate with counsel.

62. Cora was diagnosed with schizophrenia ten years ago and has been hospitalized several times. She has paranoid delusions and hallucinations. Her speech is rambling and incoherent. Recently, Cora got hold of a gun and shot several people, believing that they were her enemies. Following her arrest, what is the most likely scenario for Cora? a. Her case will never go to trial. b. She will be found fit to stand trial. c. If convicted, she will go to prison. d. Following a trial, she will be hospitalized again.

63. Since Diego’s arrest, a decision was made to have him undergo the Fitness Interview Test—Revised, a three-part instrument developed by Webster and colleagues (1999). What is the purpose of this test? a. to assess a person’s mental state at the time a crime was committed b. to determine a person’s physical and intellectual status as part of a standard pretrial assessment c. to assess a criminal defendant’s ability to appreciate the quality and moral nature of the act of which they are Powered by Cognero

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Chapter 17: Mental Health and the Law accused d. to assess a criminal defendant’s fitness to stand trial 64. What has research shown regarding the Fitness Interview Test—Revised, which was developed by Webster and colleagues (1999)? a. It reliably screens out those individuals who are unable to appreciate the quality and moral nature of the act of which they are accused. b. It is a reliable assessment of a person’s mental state at the time a crime was committed. c. It reliably screens out those individuals who are clearly fit to stand trial. d. It is considered an unreliable assessment tool.

65. In the 1970s U.S. case Tarasoff v. Regents of the University of California, a student killed a fellow student who had rejected his romantic advances. What important issue did this case involve? a. competency b. duty to warn c. restrictive environment d. patients’ rights 66. Dr. Bell works in the United States. Dr. Bell has a patient who has made threats against someone.What is Dr. Bell’s legal obligation? a. to warn a patient’s potential victim(s) b. to advise a patient of their rights c. to file a police report d. to involuntarily commit the patient 67. Although Canada has not had a legal precedent like the ruling in the Tarasoff case in the United States, what did the Alberta Court of Queen’s Bench state in Wenden v. Trikha (1991)? a. Psychologists must never violate patient–therapist confidentiality. b. Canadian psychologists must abide by U.S. laws regarding a duty to warn. c. A duty to warn might be imposed for psychologists under some circumstances. d. Psychologists will not be held responsible for not warning a patient’s potential victim(s).

68. Which scenario does NOT fall under limits to confidentiality? a. if there is suspected child abuse b. if there is a third party at risk for harm c. if there is risk to themselves d. if they identify that they have abused their spouse in the past 69. Why is the public sometimes ambivalent about testimony from expert witnesses? a. Expert witnesses are biased and want their testimony in court to be consistent with what they have concluded in research they have published. b. Expert witnesses generally are concerned about being sued if they give testimony that frees a person who goes on to commit a violent crime. c. The public suspects that the side paying the expert witness determines the expert’s opinion. d. The public often does not fully understand the scope and breadth of expertise within academic fields.

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Chapter 17: Mental Health and the Law 70. Which of the following is NOT an area in which expert witnesses assist courts or juries in making decisions? a. identifying malingering (faking symptoms) b. assessing the accused’s potential for future violence c. determining whether someone has a mental illness d. assessing someone’s fitness to stand trial 71. Which psychological test has been used to accurately identify malingering in almost 90 percent of people claiming to have post-traumatic stress disorder? a. Minnesota Multiphasic Personality Inventory (MMPI) b. Thematic Apperception Test (TAT) c. Rorschach Inkblot Test d. Wechsler Adult Scale of Intelligence (WAIS) 72. Gerri was found to be malingering. How was Gerri’s malingering most likely detected? a. through a polygraph b. through a validated instrument, such as the Minnesota Multiphasic Personality Inventory (MMPI) c. through the clinical experience of expert witnesses d. through an fMRI 73. What does malingering mean? a. warning potential victims of people with mental illness b. hanging around on street corners c. faking or grossly exaggerating symptoms d. reporting child abuse 74. In the 1980s, psychologist David Garner lost his licence to practise psychology in Ontario after he engaged in sexual relations with two clients he was treating. Which ethical principle for psychologists did Garner breach? a. boundary issues b. do no harm c. not engaging in sexual relationships with clients under the age of 21 d. recognizing limits of competence 75. Which of the following is NOT included in the boundary issues principle in the Canadian Code of Ethics for Psychologists? a. Give reasonable assistance to help a person secure needed services if the therapist is unable to treat the person themselves. b. Do not exploit any relationship established with a client to further one’s own personal, business, or political interests at the expense of the best interests of the client. c. Avoid dual relationships (e.g., acting as therapist to someone the therapist has interactions with in another context). d. Do not take advantage of a client’s trust or dependency to encourage or engage in sexual relations with clients or with a client’s partner or relatives.

76. Dr. Beck is a psychologist who risked having his psychologist’s licence revoked after he was ordered by the provincial court to surrender his records on a client who was involved in a criminal proceeding. Dr. Beck had recorded information about his client that was so carelessly and ambiguously worded that it was clinically inaccurate and was misinterpreted by Powered by Cognero

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Chapter 17: Mental Health and the Law the jury, to the detriment of his client. Which principle in the Canadian Code of Ethics for Psychologists did Dr. Beck appear to violate? a. recognizing limits of competence b. incompetence case recording c. boundary issues d. do no harm 77. A neuropsychologist is treating a client who has substance use disorder. He recognizes that he is not adequately trained in the area of addictions and makes a referral to another colleague. What principle of the Canadian Code of Ethics is he operating under? a. boundary issues b. do no harm c. patient’s rights d. recognizing limits of competence 78. Which subject is NOT included in the Canadian Code of Ethics for Psychologists published by the Canadian Psychological Association? a. the requirement that psychologists do no harm b. boundary issues c. the need for psychologists to practise within their area of expertise d. total confidentiality 79. According to the text, what is one of the most fundamental rights of people in mental health facilities? a. the right to treatment b. the right to legal counsel c. the right to refuse treatment d. the right to not participate in research 80. Fatima has a mental illness and the legal right to treatment. What else do they have a legal right to? a. hospital treatment for as long as it takes to stabilize b. treatment in the least restrictive setting possible c. to refuse treatment even if they are at risk for harming themselves or others d. to choose the facility where they will receive treatment 81. As specified by the U.S. case of Wyatt v. Stickney (1972), the least restrictive conditions for people with intellectual developmental disorder (intellectual disability) included several issues. Which of the following is NOT one of these issues? a. integration into the community b. more structured living c. smaller facilities d. independent living 82. The rights of people with mental illness in Canada are protected by advocacy efforts and constitutional provisions.

One of these rights is the right to treatment in the least restrictive environment possible. What is the other? a. the right to refuse treatment Powered by Cognero

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Chapter 17: Mental Health and the Law b. the right to choose their own medial practitioner c. the right to legal counsel d. the right to treatment in a supportive manner 83. According to the text, which of the following is one of the most controversial issues in mental health today? a. the not criminally responsible on account of mental disorder defence b. the misuse of expert witnesses in criminal trials c. the right of people, even those with severe mental disorders, to refuse treatment d. sexual relations between therapists and clients 84. What percentage of involuntary patients persist in refusing treatment? a. fewer than 2 percent b. fewer than10 percent c. fewer than 20 percent d. fewer than 30 percent 85. Some provinces, such as British Columbia, do not recognize the right of involuntary but competent patients to refuse treatment. What is this inconsistent with? a. the Criminal Code of Canada b. the Ethical Code of the Canadian Psychological Association c. the clinical practice guidelines of the American Psychological Association d. the Canadian Charter of Rights and Freedoms 86. An important legal question was raised to determine whether a person had the right to refuse psychiatric treatment in advance and when competent. The Ontario Appeals Court determined that to ignore this previously stated position was a violation of section 7 of the Canadian Charter of Rights and Freedoms. Who challenged the constitutionality of forced treatment? a. Ewan Cameron b. Russell Fleming c. Wayne Sullivan d. George Reid 87. What is the main argument used by some mental health professionals against the unlimited right of all patients to refuse treatment? a. Mental health professionals are in the best position to know what is in patients’ best interests by virtue of their clinical training and experience. b. The public has a stronger right to be protected against violent people with mental illness. c. Under certain circumstances, people with severe mental illness are not capable of deciding in their own best interest. d. Rights must be earned, not automatically granted.

88. What is the main argument used by patients and their advocates in favour of the unlimited right of all patients to refuse treatment? a. Most treatments are not proven to be 100 percent effective. b. Many medications, especially antipsychotic medications, have side effects that seriously compromise Powered by Cognero

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Chapter 17: Mental Health and the Law everyday functioning and quality of life. c. Without that right, patients are vulnerable to abuse or dangerous experimental procedures, such as those that occurred with the indiscriminate use of prefrontal lobotomies in the 1930s. d. All people have a fundamental right to make decisions about their own treatment, even if doing so is not in their own best interest.

89. In Canada, which of the following establishes the rights of human research participants? a. provincial mental health acts b. the Tri-Council policy statement c. the Canadian Criminal Code d. provincial human rights codes 90. Arden has agreed to be part of a research study examining the effectiveness of cognitive-behavioural therapy in treating schizophrenia. As a research participant, which of the following rights does Arden have? a. the right to demand compensation for participation b. the right to know the risks and benefits of the research c. the right to see the data from other participants in the study d. the right to modify any research condition 91. There is a description in the text of the “psychic driving” brainwashing research of Dr. Ewan Cameron in Montreal in the 1950s and 1960s. This case exemplifies the violation of several ethical principles for conducting research on human participants. Which of the following is NOT one of these principles? a. free and informed consent b. respect for vulnerable persons c. consent from family d. maximization of benefits 92. What do we call the situation in which a person has formally agreed to be a research participant after being apprised of all aspects of the study? a. minimization of harm b. participant consensus c. informed consent d. applied understanding 93. What question was the clinical efficacy axis of the APA clinical practice guidelines designed to answer? a. What is the most efficient way of admitting patients to clinics or hospitals? b. Is the treatment effective when compared with an alternative treatment or to no treatment in a controlled clinical research setting? c. What kind of research should be done to determine the type of clinician best suited for particular patients in terms of their diagnosis and chronicity? d. How long should the treatment be continued if there is no improvement in the patient’s condition or if the patient has serious side effects?

94. The clinical efficacy axis of the APA clinical practice guidelines is concerned with effective interventions. What is the clinical utility axis concerned with? a. feasibility and cost-effectiveness Powered by Cognero

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Chapter 17: Mental Health and the Law b. internal validity c. efficacious treatments d. ineffectiveness of the intervention in clinical practice 95. The first major consideration of the clinical utility axis of the APA clinical practice guidelines is feasibility, which asks several questions. Which of the following is NOT one of these questions? a. Has research shown the treatment to be effective? b. Will patients accept the intervention? c. Is the treatment relatively easy to administer? d. Will patients comply with the requirements?

96. Dr. Papadopolous has found that a certain type of therapy is effective with different patients, in different settings, and with different therapists. In other words, what is Dr. Papadopolous claiming the therapy has? a. internal validity b. generalizability c. clinical replication d. feasibility 97. Although electroconvulsive therapy (ECT) is an effective treatment for some, it is extremely frightening to patients, many of whom refuse it. The treatment also requires sophisticated procedures and close supervision by medical personnel, usually in a hospital setting. According to the APA clinical practice guidelines, what would this procedure be considered low in? a. generalizability b. feasibility c. ethicality d. utility 98. According to the APA clinical practice guidelines, what does the feasibility issue on the clinical utility axis refer to? a. the extent to which an intervention is effective with patients of differing backgrounds b. generalizability c. whether patients accept the intervention and comply with its requirements, and whether it is easy to administer d. the effectiveness of the intervention in the practice setting in which it is to be applied 99. Dr. McKenzie has developed a new cognitive therapy for the treatment of severe depression. Over the years, he found it to be highly effective on many inpatients in the hospital where he works. However, when a colleague agreed to conduct an outcome assessment of Dr. McKenzie’s treatment in a highly ethnically diverse community, she found the effectiveness of the treatment to be highly variable according to ethnicity and whether patients are inpatients or outpatients. According to the APA clinical practice guidelines, what would this procedure be considered low in? a. feasibility b. generalizability c. internal validity d. clinical efficacy 100. According to the APA clinical practice guidelines, what does the generalizability issue on the clinical utility axis refer to? a. the extent to which an intervention is effective with patients of differing backgrounds Powered by Cognero

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Chapter 17: Mental Health and the Law b. the effectiveness of the intervention in the practice setting in which it is to be applied c. whether patients accept the intervention and comply with its requirements, and whether it is easy to administer d. external validity 101. What does the clinical utility axis of the APA clinical practice guidelines refer to? a. internal validity b. external validity c. systematic data d. efficacy

102. Explain the term civil commitment. Describe the criteria for civil commitment, noting the similarities and differences among various Canadian jurisdictions. Identify and describe the two types of authority used by the government to justify it. What is the first step in the process of civil commitment?

103. Discuss research studies on the relationship between mental illness, dangerousness, and self-harm. Describe symptoms that correlate with an increased risk of violence and self-harm among people with mental illness.

104. Explore the consequences of the policy known as deinstitutionalization, noting specifically the effect on homelessness. Compare the intended outcome of this policy with the actual outcome.

105. Explain the use of and controversy surrounding the battered woman syndrome defence in criminal cases.

106. Discuss the historical development of the not guilty by reason of insanity (NGRI) defence, beginning with the M’Naghten Rule in England and how and when it was modified in the Canadian Criminal Code as the not criminally responsible on account of mental disorder (NCRMD) defence. Be sure to explain the critical differences between the NGRI and the NCRMD defences.

107. Discuss public perceptions of the insanity defence and how they contrast with factual information regarding the frequency of its use and its implications.

108. Discuss the concept of fitness to stand trial, including its definition according to the Canadian Criminal Code.

Describe the Fitness Interview Test and how it is used to determine fitness to stand trial.

109. Discuss both the legal and ethical responsibilities of Canadian psychologists to warn the potential victim(s) of their clients. Explain how these responsibilities shape the limits to confidentiality.

110. Discuss the role and responsibilities of the expert witness in criminal court cases. Explain how the Minnesota Multiphasic Personality Inventory (MMPI) is used to assess the possibility of malingering. Describe its effectiveness, as well as one caution provided by recent research.

111. Identify and discuss the three ethical principles for treating people with mental illness that are contained in the Canadian Code of Ethics for Psychologists and are described in the text. Give an illustrative example of a violation of each of those three principles (either an actual case described in the text or a hypothetical one).

112. Discuss the issue of patient rights and how the concept arose from the 1972 U.S. case of Wyatt v. Stickney. Explain what is meant by the right to refuse treatment and the implications of this right for the patient, as well as for their family and community.

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Chapter 17: Mental Health and the Law 113. Describe the purpose of developing clinical practice guidelines. Describe the two axes and the questions they aim to address.

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Chapter 17: Mental Health and the Law Answer Key 1. c 2. a 3. b 4. c 5. b 6. c 7. c 8. b 9. d 10. a 11. c 12. b 13. a 14. c 15. c 16. a 17. c 18. c 19. a 20. d 21. d 22. d 23. d 24. c 25. a Powered by Cognero

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Chapter 17: Mental Health and the Law 26. c 27. a 28. d 29. c 30. a 31. c 32. c 33. c 34. d 35. b 36. d 37. b 38. a 39. d 40. a 41. a 42. a 43. a 44. c 45. b 46. b 47. a 48. d 49. b 50. d 51. d Powered by Cognero

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Chapter 17: Mental Health and the Law 52. c 53. b 54. a 55. d 56. a 57. a 58. b 59. c 60. c 61. b 62. a 63. d 64. c 65. b 66. a 67. c 68. d 69. c 70. c 71. a 72. b 73. c 74. a 75. a 76. d Powered by Cognero

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Chapter 17: Mental Health and the Law 77. d 78. d 79. a 80. b 81. b 82. a 83. c 84. b 85. d 86. d 87. c 88. d 89. b 90. b 91. c 92. c 93. b 94. a 95. a 96. b 97. b 98. c 99. b 100. a 101. b 102. Student responses will vary.

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Chapter 17: Mental Health and the Law 103. Student responses will vary.

104. Student responses will vary.

105. Student responses will vary.

106. Student responses will vary.

107. Student responses will vary.

108. Student responses will vary.

109. Student responses will vary.

110. Student responses will vary.

111. Student responses will vary.

112. Student responses will vary.

113. Student responses will vary.

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Chapter 18: Stress, Pain, and Health

Indicate the answer choice that best completes the statement or answers the question.

1. Which term suggests that psychological factors affect physical functioning? a. psychobiological b. somatoform c. psychosomatic d. psychosocial 2. Using the word psychosomatic to describe a disorder that has an obvious physical component is considered misleading.

Why is this so? a. It gives the impression that biological disorders are not influenced by psychological factors. b. It emphasizes the physical symptoms of a disorder instead of the psychological symptoms. c. It gives the impression that psychological disorders like anxiety or depression do not have a biological component. d. It emphasizes the psychological symptoms of a disorder instead of the physical symptoms.

3. In 2020, where did COVID-19 rank as a cause of death in Canada? a. first b. second c. third d. fourth 4. What new field of study takes knowledge derived from behavioural science and applies it to the prevention, diagnosis, and treatment of medical problems? a. behavioural medicine b. medical psychology c. epidemiology d. health psychology 5. How does health psychology differ from behavioural medicine? a. Health psychology is less interdisciplinary. b. Health psychology focuses on work with psychologists, physicians, and other health professionals. c. Epidemiology is the main focus of health psychology. d. Behavioural medicine forms health policy whereas health psychology does not.

6. According to the principles of health psychology, what is the best protection against acquiring AIDS? a. choosing sexual abstinence even after years of being sexually active b. being treated for HIV before it develops into AIDS c. learning behaviour modification to prevent acquisition d. getting an injection of the AIDS vaccine 7. What does research suggest is a common characteristic of both mental disorders and physical disorders? a. Both types of disorders are primarily biological in nature. b. Most mental and physical disorders involve the perception of pain. c. Psychological, biological, and social factors can play a role in both types of disorders.

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Chapter 18: Stress, Pain, and Health d. Both types of disorders are best treated with biological interventions.

8. In 1936, Canadian researcher Hans Selye discovered that giving injections to laboratory rats caused them to develop ulcers. His finding led to a new area of study. What is it called? a. psychosomatic pathology b. stress physiology c. animal psychology d. stress psychology 9. Hans Selye described the sequence of stages the body goes through in response to sustained stress. What is this sequence called? a. the fight-or-flight syndrome b. the general adaptation syndrome c. the feedback loop syndrome d. the mobilized coping syndrome 10. Hans Selye described the sequence of stages the body goes through in response to sustained stress called the general adaptation syndrome. Which of the following is NOT one of these stages? a. alarm b. resistance c. exhaustion d. mobilization 11. What do we call the physiological response of an individual to a stressor? a. stress b. fight-or-flight reaction c. resistance d. adaptation 12. Your friend has a very stressful job. What part of their body may be damaged by increased cortisol released because of the stress? a. lungs b. stomach c. brain d. intestines 13. What happens when the HPA axis is activated? a. The adrenal glands secrete the stress hormone cortisol. b. The hippocampus secretes corticotropin releasing factor (CRF). c. The pituitary gland (via the parasympathetic nervous system) activates the adrenal glands. d. CRF stimulates the thyroid gland.

14. Which of the following may occur because of increased cortisol levels in response to chronic stress? a. liver damage b. decreased susceptibility to infectious disease Powered by Cognero

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Chapter 18: Stress, Pain, and Health c. compromised hippocampal activity d. a rise in humoral levels 15. If the HPA axis is activated, which chemical will be secreted by the hypothalamus and stimulate the pituitary gland? a. corticotropin releasing factor (CRF) b. high-density lipoprotein (HDL) c. adrenal cortisol hormone (ACH) d. cortisol 16. What is the final process in the activation of the HPA axis? a. stimulation of the pituitary gland by corticotropin releasing factor (CRF) b. secretion of corticotropin releasing factor (CRF) by the hypothalamus c. secretion of cortisol by the adrenal gland d. activation of the adrenal gland by the pituitary gland 17. Dr. Sapolsky is observing a troop of baboons and taking regular blood samples from them. The dominant male baboon Dr. Sapolsky calls “Rafiki” has just shown a much greater increase in cortisol than any of the other males in the troop. Dr. Sapolsky is not surprised because of something that happened about half an hour earlier. What might Dr. Sapolsky have seen? a. Rafiki was challenged. b. The troop was given less food at their regular feeding than usual. c. Lightning struck a tree in the habitat and one baboon was injured. d. Rafiki was bullied by a group of subordinate males.

18. Researchers studying baboons found that subordinate animals, unlike dominant animals, continually secrete cortisol, probably because their lives are so stressful. What did the researchers discover about the subordinate males’ HPA axis? a. It is less sensitive to the effects of cortisol and therefore less efficient in turning off the stress response. b. It is more sensitive to the effects of cortisol and therefore less efficient in turning off the stress response. c. It is associated with an increased sensitivity of the pituitary gland. d. It is associated with a decreased sensitivity of the pituitary gland.

19. After research on dominant and subordinate animals, Sapolsky concluded that it is the psychological benefits of which of the following that produces positive stress effects? a. having decreased sensitivity to situations b. having predictability and controllability in one’s life c. being unable to recognize stressful situations d. having dominance, which leads to a greater psychological coping mechanism 20. What did a longitudinal research study of 200 male undergraduate students (Vaillant, 1979) discover about individuals who developed psychological disorders or who were highly stressed? a. They suffered a significantly higher incidence of strokes than those who remained relatively well adjusted. b. They did not become chronically ill, despite their psychological disorder, if they had a sense of control in their life. c. They suffered a significantly higher incidence of heart attacks than those who remained relatively well adjusted.

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Chapter 18: Stress, Pain, and Health d. They became chronically ill at a higher rate than those who remained relatively well adjusted.

21. According to the text, stressful events can make us feel irritable, excited, anxious, or depressed. Why are so many different reactions possible? a. Responses to cortisol vary from person to person. b. They are associated with distinct physiological characteristics. c. They share a similar underlying physiology. d. The response to stress depends on the emotional state before the stressful event.

22. Which term did Bandura use to describe the confidence we have to cope with stress or challenges? a. self-efficacy b. sense of control c. depressive sensitivity d. emotionality 23. Jayden has been under a lot of stress. His body is beginning to show signs of having too much cortisol. Which of the following symptoms is Jayden most likely showing? a. impaired immune system functioning b. muscle tension c. damage to the amygdala d. low blood pressure in the cardiovascular system 24. Every year during the week of final exams in December, Judy came down with a severe cold. It was the only cold she would get each year. What is the most likely explanation for this pattern of colds? a. Cold viruses are most prevalent in December. b. The stress of final exams left Judy more susceptible to colds. c. Judy’s roommate caught a cold every December and gave it to Judy. d. It is just a random pattern of colds.

25. Which of the following students is most likely to have a suppressed immune system? a. Kaya, who has many friends and is returning from a relaxing vacation b. Karen, who has few friends and is returning from a relaxing vacation c. Alison, who has few friends and is finishing final exams d. Hana, who has many friends and is finishing final exams 26. What type of stress may be more problematic for the immune system than acute stress, because the effects are longer lasting? a. chronic stress b. work-related stress c. sudden stress d. relationship stress 27. Which of the following is a known connection between emotion and health? a. People who are depressed have increased immune system functioning. b. The evidence suggests that depression lowers immune system functioning.

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Chapter 18: Stress, Pain, and Health c. People who are anxious have reduced immune system function. d. Anger is associated with reduced immune system function.

28. Which term refers to the foreign materials that are identified and eliminated by the immune system? a. antigens b. suppressor cells c. killer T cells d. helper T cells 29. What are the two branches of the immune system? a. suppressing and producing b. macrophage and immunoglobual c. cellular and humoral d. antibody and trigger 30. What happens when the presence of too many helper T cells results in the immune system attacking the body’s normal cells rather than the antigens? a. stress b. an autoimmune disease c. production of antibodies d. regulation of the immune system 31. One of the ways in which the immune system is weakened in people with AIDS is that the human immunodeficiency virus (HIV) directly attacks certain lymphocytes. Which lymphocytes are these? a. helper T cells b. killer T cells c. suppressor T cells d. B cells 32. Dr. Frode is studying how nerve endings may be involved in the immune system. What type of tissue is Dr. Frode most likely studying? a. blood vessels b. mucous membranes c. hair follicles d. bone marrow 33. Which of the following relationships is NOT reflected in the new medical specialty called psychoneuroimmunology? a. the cardiovascular system b. the nervous system c. psychological influences d. the immune system 34. What is the focus of psychoneuroimmunology? a. the study of methods in which damaged or severed neurons can be stimulated to regrow b. the study of psychological influences on the neurological responding implicated in our immune response Powered by Cognero

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Chapter 18: Stress, Pain, and Health c. the study of various biochemical approaches to protecting the central nervous system from the ravages of deterioration disorders d. the study of the psychological side effects of physical illnesses 35. When is a person who has HIV most likely to receive an AIDS diagnosis? a. after the infection is discovered b. upon the development of AIDS-related complex c. only after the development of one of several serious diseases (e.g., wasting syndrome) d. when the physician decides that they are psychologically prepared for the diagnosis 36. What would be a symptom that develops in the AIDS-related complex (ARC)? a. night sweats b. pneumonia c. weight gain d. nausea 37. What is the closest estimate of the total number of people worldwide with HIV in 2020? a. 18 million b. 28 million c. 38 million d. 48 million 38. Approximately what percentage of individuals are transmitting HIV but are unaware of their infection? a. 13 percent b. 23 percent c. 33 percent d. 43 percent 39. Garrett has HIV and participated in a study of highly active antiretroviral therapy (HAART) but dropped out of the program. What is the most likely reason he dropped out of the study? a. because of the expense of the medications b. because improvement in symptoms was minimal, so he lost interest c. because of the side effects of the medications d. because he lacked adequate social support 40. What did a review of the literature on the effectiveness of group therapy for people who are HIV positive conclude? a. Although further study is needed, psychosocial interventions are helpful for enhancing psychosocial functioning but have no effect on physical functioning such as immune system activity. b. Although further study is needed, there seem to be positive effects in patients with advanced disease, but no effects have been observed in those in a very early, asymptomatic stage of the disease. c. Although further study is needed, group interventions have produced no noticeable improvements in either physical or psychological functioning of these patients. d. Although further study is needed, there seem to be positive changes in immune and endocrine activity associated with structured group interventions.

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Chapter 18: Stress, Pain, and Health 41. According to Antoni and colleagues (1991), when men who thought they might be HIV positive became involved in a stress-reduction program, what was the result? a. no change in the progression of the disease b. a significantly lower death rate as compared to those in the control group c. an increase in immune system functioning d. an increase in antibodies to herpes viruses 42. Dr. Beilfus is a researcher specializing in psycho-oncology. What is their area of interest? a. the psychosocial causes of cancer b. the psychosocial characteristics of cancer patients c. the psychosocial treatments for cancer d. the psychosocial influences on different varieties of cancer 43. Carlson and colleagues (2004) conducted research on the use of mindfulness-based therapy with early-stage breast and prostate cancer patients. They found post-intervention improvements in several areas. Which of the following is NOT one of these areas? a. beneficial changes in biological indices of immune system function b. increases in problem-solving skills c. increases in quality of life d. decreases in stress 44. Von Bayer and colleagues (2006) compared the effectiveness of two different strategies to help children manage pain.

They found that for younger children, a strategy in which children were prompted to direct their attention toward their internal sensations was less effective than another strategy. What was this other strategy? a. being directed to engage in progressive relaxation exercises b. being directed to talk about their pain to a supportive adult c. being directed to distract themselves and focus their attention externally d. being directed to engage in slow, deep breathing 45. How often are the nonpharmacological strategies for managing pain in cancer patients used? a. with every patient b. most of the time c. rarely d. only if the patient requests them 46. You and your friend are both in your late 30s. Your friend informs you that they have been diagnosed with the silent killer. What health-related issue do they have? a. HIV b. lung cancer c. diabetes d. hypertension 47. The overwhelming majority of cases of hypertension have no specific verifiable physical cause and are considered to be which of the following? a. essential hypertension Powered by Cognero

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Chapter 18: Stress, Pain, and Health b. prehypertension c. stage 1 hypertension d. stage 2 hypertension 48. Which of the following is NOT considered a risk factor for hypertension? a. age b. race c. genetics d. socioeconomic status 49. Marek’s parents have high blood pressure. How does Marek’s risk of developing high blood pressure compare with that of people whose parents don’t have high blood pressure? a. His risk is marginally higher b. He has twice the risk c. He has three times the risk d. He has four times the risk 50. Studies that have examined neurobiological causes of hypertension have focused on two factors that are central to the regulation of blood pressure. What are these factors? a. autonomic nervous system activity and the cardiovascular response to stress b. the cerebellum and the flight-or-flight response of the sympathetic nervous system c. the limbic system and the fight-or-flight response of the sympathetic nervous system d. autonomic nervous system activity and mechanisms regulating sodium in the kidneys 51. Married couples found that practising “warm touch” as a way of communicating decreased which of the following? a. autonomic nervous system activity b. blood pressure c. HPA activation d. colds 52. Which is NOT a psychological factor that contributes to coronary heart disease (CHD)? a. stress b. anxiety c. anger d. depression 53. Research by Campbell and colleagues (2012) demonstrated that which two components can provide health benefits to patients in cardiac rehabilitation? a. stress management and exercise b. anxiety-reduction and CBT c. anger management and CBT d. coping skills and exercise 54. Paul is worried about cardiovascular disease because of a strong family history of heart problems. Paul is already trying a stress-reduction intervention. His friend Mike, a doctor, suggests that something else may be beneficial if added.

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Chapter 18: Stress, Pain, and Health What does Mike recommend? a. a cognitive-behavioural intervention b. a mindfulness-based intervention c. a dietary intervention d. an exercise intervention 55. In trying to determine if the type A/type B classifications are reliable and valid as predictors of heart disease, which of the following becomes apparent? a. Interviews to assess people’s personality characteristics are more reliable than questionnaires. b. Medical tests remain the most valid predictors of heart disease. c. Not every individual shows distinctively type A or type B characteristics. d. Women are usually type A, and men are usually type B. 56. Joben is asked to volunteer for a study to determine whether he is has type A personality. He is a keen academic.

Based on his knowledge regarding personality types, he already knows he is the least likely man to be classified as type A. Which of the following profiles most likely describes Joben? a. He is a European man living in North America and practising the profession he has academically pursued for seven years. b. He is a North American Japanese man, who speaks Japanese at home and retains traditional Japanese values and behaviours. c. He is a North American man, well established in his professional job and university education. d. He is a married North American man, well established in his professional job and university education.

57. Which aspect of type A personality is the factor responsible for much of the relationship between personality and coronary heart disease? a. anger b. anxiety c. depression d. panic 58. Psychologist Kim Lavoie and her colleagues (2004) noted that coronary heart disease (CHD) and another disorder often co-occur, and patients with CHD and this additional disorder suffer greater morbidity and mortality rates than do patients with CHD but without the additional disorder. What is the other disorder? a. obsessive-compulsive personality disorder b. generalized anxiety disorder c. paranoid delusional disorder d. panic disorder 59. According to the 2019 Canadian Community Health Survey, how many Canadians are living with chronic pain? a. 10 percent b. 25 percent c. 35 percent d. 50 percent 60. A physician saw 100 patients in a week. How many of these patients were likely there for pain-related concerns?

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Chapter 18: Stress, Pain, and Health a. 30 b. 40 c. 60 d. 80 61. What are the two types of clinical pain? a. medical, psychological b. acute, chronic c. vascular, cardiac d. real, perceived 62. What is the emotional component of pain? a. psychological pain b. subjective pain c. suffering d. pain behaviours 63. What is the determining factor that predicts reaction to pain? a. severity b. general sense of control c. suffering d. anxiety 64. Mr. Tam is a pain catastrophizer. Which of the following would he NOT likely report when he is experiencing pain? a. There’s nothing I can do to stop this pain. b. I can’t stop thinking of how much it hurts. c. I’m worried that something serious might happen. d. If I can’t deal with this, I’m not strong enough to deal with anything else in my life either.

65. Changes to which area of the brain is believed to contribute to phantom limb pain? a. sensory cortex b. amygdala c. prefrontal cortex d. hippocampus 66. Changes in the sensory cortex of the brain are thought to contribute to phantom limb pain, in which people who have lost an arm or leg feel excruciating pain in the limb that is no longer there. Which of the following is most likely an additional factor in the intensity of pain and distress experienced? a. the avoidance of activity that leads to muscular atrophy b. the chronic experience of negative emotions c. the belief that pain is disastrous, uncontrollable, or reflective of personal failure d. the fear of additional injury or disease 67. Which of the following is an example of the phenomenon known as operant control of pain behaviour? a. Kim is recovering from a broken leg. Although she is walking on crutches, she has been trying to be as Powered by Cognero

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Chapter 18: Stress, Pain, and Health independent as possible. b. Divya had to have a finger amputated after it was partially severed in a slicing accident. Since she feels discomfort in the missing finger, she has been diagnosed with phantom limb pain. c. Kate’s family has always been critical and demanding. However, since her accident, family members have become caring and sympathetic. d. Maga suffers from chronic back pain. However, she rarely complains to others about the pain and tries to keep her facial expressions from showing that she is in pain. Recently, her doctor reduced her pain medication.

68. In the phenomenon known as operant control of pain, what determines the pain behaviours manifested by an individual? a. the patient’s reaction to treatment b. the association of pain with a conditioned stimulus c. social consequences d. a sense of uncontrollability 69. Which area of the spinal column is NOT related to the gate control theory of pain? a. dorsal horns b. small fibres c. large fibres d. ventral horns 70. Which of the following factors would make a person feel more pain according to the gate control theory of pain? a. anxiety b. drug use c. relaxation d. a type A personality 71. Hannah just had a rush of endorphins. What are the endorphins doing in her body? a. They are shutting down the sensation of pain. b. They are closing the gate of the spinal column, inhibiting the transmission of painful stimuli to the brain. c. They are increasing positive feelings that make the pain seem less important. d. They are causing a “natural” addiction to pain.

72. The “runners high” is related to the release of which substance? a. cortisol b. endorphins c. dopamine d. epinephrine 73. What theory of pain accommodates both psychological and physical factors? a. gate control theory of pain b. psychophysiological pain theory c. behavioural medicine theory d. operant maintenance theory Powered by Cognero

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Chapter 18: Stress, Pain, and Health 74. Endogenous opioids have been implicated in a variety of psychopathological conditions. Which of the following is one of these conditions? a. eating disorders b. personality disorders c. obsessive-compulsive disorder d. phobias 75. Dr. Kwok runs a pain clinic. He notes that men are much more likely than women to visit his clinic because of which condition? a. arthritis b. backache c. migraine headaches d. carpal-tunnel syndrome 76. Women may have an “extra” pain-regulating pathway focused on relieving pain associated with the reproductive system. What is one implication of this sex difference? a. The psychological experience of pain is different for men and women. b. Men need more pain relief than women following surgical procedures. c. Men and women may benefit from different kinds of medications and psychosocial interventions. d. Men experience more generalized pain than women do.

77. Which type of pain is more common in men? a. migraine headaches b. arthritic pain c. wrist and hand pain d. cardiac pain 78. What occurrence suggests that the placebo effect is not all in our heads? a. decreased autonomic activation b. activation of the endogenous opioid system c. distraction tasks decrease pain d. the same brain circuits are activated 79. What is the relationship between physical pain and social pain (e.g., rejection)? a. Decreased autonomic activation occurs in both. b. Similar neural mechanisms may be underlying both. c. Social pain can be treated by placebos, whereas physical pain cannot. d. There is no relationship between the two.

80. In the mid-19th century, which disorder was thought to cause symptoms of fatigue, vague aches and pains, low-grade fever, and lack of energy? a. somatic syndrome b. neurasthenia c. neurosis d. hysteria Powered by Cognero

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Chapter 18: Stress, Pain, and Health 81. What is another name for chronic fatigue syndrome? a. somatic syndrome b. myalgic encephalomyelitis c. neurosis d. hysteria 82. In Sharpe’s (1997) model of the causes of CFS/ME, key lifestyle attributes were identified. Which of the following was an identified lifestyle? a. asks for help b. is achievement oriented c. puts on a brave face d. has a poor work ethic 83. Various psychological factors have been implicated in CFS/ME. For example, in examining the role of cognitive factors in the psychological adjustment to the illness of patients with CFS/ME, White and colleagues found that feelings of helplessness and depression were associated with another factor. What is this other factor? a. perceiving the cause of CFS/ME as external and believing that there is no cure for CFS/ME b. believing that CFS/ME is just “in one’s head” and believing that there is no cure for CFS/ME c. perceiving the cause of CFS/ME as external and believing that one has no control over the disorder d. perceiving the cause of CFS/ME as internal and believing that one has no control over the illness 84. Which treatment has shown the greatest efficacy in treating CFS/ME? a. pharmacological b. cognitive-behavioural therapy c. relaxation training d. cortisol supplements 85. What did some experiments with rats reveal about postsurgical pain in rats? a. It actually kills certain cancer cells. b. It causes stress but is unrelated to the subsequent progress of the disease. c. It doubles the rate at which a certain cancer spreads to the lungs. d. It speeds recovery.

86. Alan is undergoing cancer treatment and is experiencing pain. Which treatment is Alan likely receiving? a. more painkillers than can be safely taken b. the safe dose of painkillers c. insufficient amounts of painkillers to eliminate the pain d. the safe dose of painkillers and mindfulness training 87. What is biofeedback? a. a process by which a person is helped to become aware of their negative thoughts b. a process by which a person is helped to become aware of their physiological functions c. a process by which a person is helped to become aware of their physiological and psychological states d. a process by which a person is helped to become aware of their psychological states Powered by Cognero

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Chapter 18: Stress, Pain, and Health 88. In the 1960s, Neal Miller produced the first experimental evidence suggesting physiological functions were subject to voluntary control. What did he use? a. obedience training with animals b. operant conditioning with animals c. physical retraining with animals d. classical conditioning with animals 89. Why do clinicians use physiological monitoring equipment in biofeedback procedures? a. to help the clinicians track changes in muscular tension b. to make the responses visible and/or audible to the patient c. to make the responses tactile to the patient d. to ensure patients properly interpret the clinician’s instructions 90. Jamal is receiving biofeedback. Which of the following physiological functions will biofeedback enable him to monitor? a. digestion b. EEG rhythms (“brain waves”) c. sweating of the hands d. anxiety 91. It has been suggested that biofeedback relieves the pain of tension headaches because it teaches people to relax. What is the more likely reason? a. The apparent relief of the patient’s pain is the result of the sensory adaptation process occurring in the therapeutic session. b. The biofeedback training gives patients a sense of control over their headache pain. c. Biofeedback has a numbing effect because it affects the nerve endings in the somatic nervous system. d. Patients experience a placebo effect because the headache pain returns once the biofeedback sessions are completed.

92. Pali has chronic pain and does not want to rely on analgesics. Based on current research, what can Pali attempt that has modest impacts on pain? a. medication b. psychotherapy c. a placebo d. relaxation response 93. How does the original progressive muscle relaxation technique devised by Edmund Jacobson in 1938 differ from the way the procedure is usually taught in clinics today? a. The procedure is now used in conjunction with muscle relaxant drugs. b. The person is now taught to monitor their stressful thoughts before, during, and after the relaxation procedure. c. The focus is now on exercising and thus stimulating the muscles, instead of simply relaxing them. d. The procedure is usually taught in a much shorter period now and is rarely the sole treatment.

94. Jacobson developed the procedure of progressive muscle relaxation in 1938. Compared with today, what is the difference in the time frame for a patient to acquire the skills to master the art of relaxation?

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Chapter 18: Stress, Pain, and Health a. Jacobson’s original procedure took weeks; today the procedure is taught in a matter of days. b. Jacobson’s original procedure took a matter of weeks; today the procedure takes months or even years. c. Jacobson’s original procedure took months or even years; today the procedure is taught in a matter of weeks. d. Jacobson’s original procedure took months or even years; today the procedure is taught in roughly the same time frame.

95. In transcendental meditation, what is attention focused on? a. the breath b. muscle tension c. the mantra d. external stimuli 96. Zara is sitting quietly. They are focused on a mantra and softly repeat the sound “om” as their breathing slows and their body relaxes. What is Zara engaging in? a. progressive muscle relaxation b. biofeedback c. transcendental meditation d. personal progressive relaxation 97. In the 1970s, Herbert Benson developed the relaxation response. What did this procedure involve? a. focusing on a word b. focusing on an image of a face c. focusing on a musical note d. focusing on an image of nature 98. Which of the following is one of the important items in a stress management program’s daily record? a. parasympathetic reactions b. empathetic reactions c. angry reactions d. triggers 99. In keeping daily records of the events in their lives, patients in stress management programs are taught to be very specific about certain issues. Which of the following is one of these issues? a. how they attempted to control the stress b. how others reacted to the stress c. body temperature changes as a result of the stress d. what seems to trigger the stress 100. Cognitive therapy is used in stress management programs to help clients learn several techniques. Which of the following is one of these techniques? a. developing realistic appraisals and attitudes b. developing subjective descriptions of experiences c. recording nonstressful situations d. identifying unrealistic positive thoughts Powered by Cognero

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Chapter 18: Stress, Pain, and Health 101. Jane is a frequent user of pain-relieving medications. Jila uses pain-relieving medications less frequently. How will the two women respond to pain-management programs? a. Both are equally likely to benefit. b. Jane will be unable to benefit. c. Jane is more likely to benefit. d. Jane is less likely to benefit.

102. According to Scheier and colleagues (1989), how can a person who undergoes coronary artery bypass surgery recover more quickly and achieve a stronger quality of life six months after surgery? a. by denying the severe pain connected with the condition and the surgery b. by playing a more aggressive role in the management of the illness c. by being optimistic d. by avoiding traditional treatment regimens or rehabilitation programs 103. Some studies indicate that the value of denial as a coping mechanism for illness may depend on one thing more than anything else. What is it? a. the gender of the patient b. the type of illness c. the severity of the illness d. timing 104. What is the long-term impact of denying an illness when you are first diagnosed? a. It results in higher levels of corticosteroids (stress hormones) in the long term. b. It results in higher levels of opioids in the long term. c. It enables the development of better coping mechanisms later. d. It has a negative long-term impact on prognosis.

105. A patient has a stress-related physical disorder. How should a health psychologist who uses behaviour modification procedures begin when treating the patient? a. by helping the patient enhance motivation to change unhealthy behaviours b. by relieving the patient’s depression enough that the patient can fully attend to the therapy c. by medicating the patient to relieve immediate symptoms d. by educating the patient about the causes of the disorder and the factors that maintain it 106. What is the fourth-leading cause of death in Canada? a. accidents b. diseases of the heart c. malignant neoplasms d. cerebrovascular diseases 107. According to Spielberger and Frank (1992), what is the crucial criterion in mediating virtually all factors that lead to injury? a. making the home environment safer b. making the workplace safer c. acknowledging and limiting risky activities Powered by Cognero

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Chapter 18: Stress, Pain, and Health d. addressing psychological variables 108. In which of the following cases is six-year-old Madison most likely to maintain the safety skills she learned for riding her bicycle? a. if assessments of her safety skills are continued b. if the bicycle is equipped with the latest safety technology c. if she rides her bicycle every day instead of just occasionally d. if she is warned repeatedly by parents and teachers 109. Jess is working hard on educating at-risk individuals about the risk of acquiring HIV. What impact will her efforts likely have? a. They will not cause a reduction in high-risk behaviours. b. They will cause her target audience to abstain from unprotected sex. c. They will cause a change in high-risk behaviours. d. They will make it more likely for people who are HIV positive to notify previous sex partners of their HIV condition.

110. Which of the following is NOT likely to bring about changes in risky behaviours for individuals who are at risk for HIV/AIDS? a. education about the disease b. cognitive-behavioural self-management training c. the development of an effective social support network d. a comprehensive behaviour change program 111. Fisher and colleagues (2002) conducted and assessed three school-based HIV prevention interventions with high school students, which focused on knowledge, motivation, behavioural skills, and actual behaviour. What did they determine to be of great importance in preventing HIV in youth? a. having positive role models b. using interventions that emphasized total abstention from sex c. using purely educational interventions as opposed to psychologically oriented interventions d. adding psychological techniques (e.g., motivational enhancement) to educational efforts 112. Which of the following was NOT a feature of the HIV prevention intervention program implemented by Fisher and colleagues (2002) for high school students? a. recommending sexual abstinence as the only way to prevent HIV transmission b. changing students’ attitudes and social norms about HIV risk and prevention c. giving factual information about HIV transmission and prevention d. training in effectively communicating about safer sex 113. In the behavioural change program to address the high rate of smoking in China, what was the most innovative aspect of that program? a. It was the parents of smokers who intervened with their children to stop smoking. b. It was the spouses of smokers who intervened with their partners to stop smoking. c. It was the children of smokers who intervened with their fathers to stop smoking. d. The government paid people to stop smoking.

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Chapter 18: Stress, Pain, and Health 114. Jun lives in China and recently helped with a massive antismoking campaign. What did she likely do? a. Threatened to divorce her husband if he didn’t stop smoking. b. Made an agreement with her spouse to stop smoking. c. Received a bonus at work because she quit smoking. d. Reported her father’s smoking habits to her school.

115. In 1989, health professionals in China began a massive antismoking effort in several cities, which involved children whose fathers smoked. Which of the following did NOT occur as part of this effort? a. Children wrote letters to their fathers asking them to quit smoking. b. Children submitted monthly reports on their fathers’ smoking habits to their schools. c. Photos of the fathers who continued smoking were published in the school newspapers. d. Schoolchildren were given antismoking literature and questionnaires to take home to their fathers.

116. In the 1989 massive antismoking campaign in China, the results indicated that 12 percent of the 10 000 fathers in the intervention group quit smoking for at least six months. In a control group of 10 000, how many quit smoking? a. 0.1 percent b. 0.2 percent c. 2.2 percent d. 4.0 percent 117. One of the most successful efforts to reduce risk factors for a medical condition involved three entire communities in California, in which residents received one of three different types of interventions or no intervention at all. What was the targeted condition of this effort? a. coronary heart disease b. cancer c. obesity d. diabetes 118. Meyer and colleagues (1980) conducted a community study in California to reduce the risk factors for coronary heart disease. What did the results indicate as the most effective aspect of intervention? a. hiring research assistants to monitor each participant’s daily behaviours b. launching a media education campaign aimed at the children of parents at risk for heart disease c. paying individuals to change their risky behaviours d. undertaking individual counselling in addition to a media campaign about heart disease

119. Define and describe the new fields of behavioural medicine and health psychology. What are the differences between them?

120. The field of stress physiology began with the research of Hans Selye. Explain how his findings developed into an understanding of the physical impact of stress.

121. Explore the relationship between stress and the immune system. What is the HPA axis? What are stress hormones?

122. Discuss how psychological factors, including negative cognitions, affect immune system functioning. Give examples of physical conditions that are considered stress related.

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Chapter 18: Stress, Pain, and Health 123. Discuss the role that stress plays in the progression of AIDS and cancer. Give examples of research studies that demonstrate the positive impact of reduced stress levels on these very serious conditions.

124. Discuss why stress is often implicated as a factor in cardiovascular disease. Define type A personality; discuss research regarding its validity.

125. Discuss chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and chronic pain. Relate CFS/ME to the condition known as neurasthenia. What psychological factors are thought to maintain chronic pain?

126. Describe the use of biofeedback, meditation, and relaxation techniques in the management of stress-related disorders.

Discuss the relative effectiveness of these treatments for stress management and pain relief.

127. Discuss prevention and intervention programs related to medical conditions. What medical conditions and/or behaviours are targeted? Compare injury prevention programs with the more typical information and warnings.

128. Explore how changes in attitudes and lifestyle behaviours contribute to illness and death. Give examples of behaviours that are known to have a negative impact on health. Why are individuals resistant to behavioural change?

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Chapter 18: Stress, Pain, and Health Answer Key 1. c 2. c 3. c 4. a 5. a 6. c 7. c 8. b 9. b 10. d 11. a 12. c 13. a 14. c 15. a 16. c 17. c 18. a 19. b 20. d 21. c 22. a 23. a 24. b 25. c Powered by Cognero

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Chapter 18: Stress, Pain, and Health 26. a 27. b 28. a 29. c 30. b 31. a 32. d 33. a 34. b 35. c 36. a 37. c 38. b 39. c 40. d 41. c 42. d 43. b 44. c 45. c 46. d 47. a 48. d 49. b 50. d 51. b Powered by Cognero

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Chapter 18: Stress, Pain, and Health 52. d 53. a 54. d 55. c 56. b 57. a 58. d 59. b 60. d 61. b 62. c 63. b 64. d 65. a 66. c 67. c 68. c 69. d 70. a 71. a 72. b 73. a 74. a 75. b 76. c Powered by Cognero

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Chapter 18: Stress, Pain, and Health 77. d 78. b 79. b 80. b 81. b 82. b 83. d 84. b 85. c 86. c 87. b 88. b 89. b 90. b 91. b 92. d 93. d 94. c 95. c 96. c 97. a 98. d 99. d 100. a 101. d 102. c Powered by Cognero

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Chapter 18: Stress, Pain, and Health 103. d 104. c 105. a 106. a 107. d 108. a 109. a 110. a 111. d 112. a 113. c 114. d 115. c 116. b 117. a 118. d 119. Student responses will vary.

120. Student responses will vary.

121. Student responses will vary.

122. Student responses will vary.

123. Student responses will vary.

124. Student responses will vary.

125. Student responses will vary.

126. Student responses will vary.

127. Student responses will vary.

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Chapter 18: Stress, Pain, and Health 128. Student responses will vary.

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