Abnormal Psychology, 7E Thomas F Oltmanns Test Bank by Ace Test Banks

Abnormal Psychology, 7E

Thomas F. Oltmanns

Email: richard@qwconsultancy.com

Chapter 1 Examples and Definitions of Abnormal Behavior Total Assessment Guide (T.A.G.) Topic Overview pp. 2-4

Recognizing the Presence of a Disorder pp.4-5 Defining Abnormal Behavior pp.5-9

Who Experiences Abnormal Behavior? pp. 9-12

The Mental Health Professions pp. 12-14 Psychopathology in Historical Context pp. 14-17

Methods for the Scientific Study of Mental Disorders pp. 17-20

Question Type Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay

Factual 1, 2, 3, 5, 6, 7

9, 10, 12

124 15, 17, 23, 24, 28, 31

Short Answer Essay Multiple Choice

114, 115, 116

Short Answer Essay Multiple Choice Short Answer Essay

Applied

112, 113

Multiple Choice

Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice

Conceptual

32, 33, 34, 38, 41, 42, 44, 45, 46, 47, 48, 49, 50, 53, 54, 55, 57, 58, 59, 60, 61, 64 117, 118, 119, 120

67, 68, 69, 70, 71, 72, 73, 75, 77, 81, 82 121

86, 88, 89, 92, 95, 97

128 108, 109, 110

16, 18, 21, 22, 26, 29, 31

13, 14, 19, 20, 25, 27, 30

125 37, 39, 40, 56 62, 65, 66

126 35, 36, 43, 51, 52, 63

74, 76, 78, 79, 80

127 83, 84, 85, 87, 90, 91, 96, 98, 100, 101, 102

93, 94, 99

129 103, 105, 106, 107, 111

104

130

131

122, 123

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Chapter 1: Examples and Definitions of Abnormal Behavior Multiple Choice

1.1.1. A magazine reporter wants to write a story describing the occurrence of mental disorders in the United States. She needs a title that captures the findings of a national survey completed several years ago. Which of the following would be the best title? a. "Rate of mental disorders considered low" b. "Almost everyone will be diagnosed with a mental disorder at some point in their life." c. "Rate of mental disorders overestimated in the past" d. "At least two out of every four Americans will experience a serious form of abnormal behavior at some point in their life." Difficulty: 1 Question ID: 1.1.1 Page Reference: 2 Topic: Overview Skill: Factual Answer: d. "At least two out of every four Americans will experience a serious form of abnormal behavior at some point in their life." 1.1.2. In the United States and other developed countries, mental disorders are the ___leading cause of disease burden. a. b. c. d.

2nd 5th 10th 30th Difficulty: 2 Question ID: 1.1.2 Page Reference: 1 Topic: Overview Skill: Factual Answer: a. 2nd

1.1.3.

The symptoms and signs of mental illness are known as

a. b. c. d.

the analysis of the mind. the treatment of mental disorders. psychopathology. the ancient philosophy of the interaction of mind and body.

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Difficulty: 1 Question ID: 1.1.3 Page Reference: 2 Topic: Overview Skill: Factual Answer: c. psychopathology. 1.1.4.

The point of view of this textbook is that

very few people will ever come into contact with the problems that are associated with mental illness. isolation between people with mental illness and people without mental illness benefits both groups. it is likely that everyone will be touched by the problems associated with mental illness at some point in their life. mental illness is almost a thing of the past due to modern treatments.

b. c. d.

Difficulty: 1 Question ID: 1.1.4 Page Reference: 2 Topic: Overview Skill: Conceptual Answer: c. it is likely that everyone will be touched by the problems associated with mental illness at some point in their life. 1.1.5.

Which is the best description of abnormal psychology?

a. b. c. d.

a deviant personality trait analysis of the childhood roots of pathology study of unconscious influences on mental disorders application of psychological science to the study of mental disorders

Difficulty: 1 Question ID: 1.1.5 Page Reference: 2 Topic: Overview Skill: Factual Answer: d. application of psychological science to the study of mental disorders 1.1.6.

What is the literal meaning of the word psychopathology?

a. b. c. d.

demons within deviant behavior brain dysfunction pathology of the mind

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Difficulty: 1 Question ID: 1.1.6 Page Reference: 2 Topic: Overview Skill: Factual Answer: d. pathology of the mind

1.1.7.

According to the textbook the line dividing normal from abnormal is

a. b. c. d.

always clear. often one of degree. based on the exact form or content of behavior. not a very important issue.

Difficulty: 1 Question ID: 1.1.7 Page Reference: 2 Topic: Overview Skill: Factual Answer: b. often one of degree.

1.1.8. The case of Kevin Warner was presented in the text as an example of the diagnosis of schizophrenia. Which of Kevin's symptoms strongly suggested that he had lost touch with reality, which is the defining feature of schizophrenia? a. b. c. d.

social withdrawal difficulty in communicating inability to succeed at work belief that people were poisoning him Difficulty: 2 Question ID: 1.1.8 Page Reference: 2-3 Topic: Recognizing the Presence of a Disorder Skill: Conceptual

Answer: d. belief that people were poisoning him

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1.1.9. Why did the staff at the psychiatric hospital give Kevin Warner injections of antipsychotic medication? a. b. c. d.

People with Kevin's blood type do not respond to medication in pill form. A high level of gastric juices in his digestive system destroyed the medication. He only pretended to take the pills because he believed people were trying to poison him. Antipsychotic drugs given by injection do not have the same serious side effects as those in pill form. Difficulty: 3 Question ID: 1.1.9 Page Reference: 3 Topic: Recognizing the Presence of a Disorder Skill: Applied Answer: c. He only pretended to take the pills because he believed people were trying to poison him.

1.1.10. Determining the presence of disorder is based on all but which one of the following? a. b. c. d.

duration of a person's symptoms the presence of a specific symptom in isolation impairment of the ability to perform occupational roles impairment of the ability to perform social roles Difficulty: 3 Question ID: 1.1.10 Page Reference: 4 Topic: Recognizing the Presence of a Disorder Skill: Applied Answer: b. the presence of a specific symptom in isolation

1.1.11. A group of symptoms that appear together and are assumed to represent a specific type of disorder is referred to as a a. b. c. d.

syndrome. sign. psychosis. disease.

Difficulty: 1 Question ID: 1.1.11 Page Reference: 4 Topic: Recognizing the Presence of a Disorder Skill: Factual

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Answer: a. syndrome.

1.1.12. Specific laboratory tests to confirm the presence of psychopathology a. b. c. d.

do not at present exist. are used by psychologists but not by psychiatrists. are used by psychiatrists but not by psychologists. are used to test for the presence of some viral infection or brain lesion to confirm a diagnosis. Difficulty: 3 Question ID: 1.1.12 Page Reference: 4 Topic: Recognizing the Presence of a Disorder Skill: Applied Answer: a. do not at present exist.

1.1.13. While you and your friends are watching a movie, one of the characters says, "That's an example of insanity" in reference to another character. Because you are taking a course in abnormal psychology, everyone turns to you. What do you say about the term insanity? a. b. c. d.

"The key to identifying insanity is the presence of delusions." "In order to be insane, a person must show evidence of some biological cause of the symptoms." "Insanity is a general term that refers to the presence of severe signs of mental deterioration." "Insanity is a legal term that refers to judgments about whether a person should be held responsible for criminal behavior." Difficulty: 2 Question ID: 1.1.13 Page Reference: 4-5 Topic: Defining Abnormal Behavior Skill: Applied Answer: d. "Insanity is a legal term that refers to judgments about whether a person should be held responsible for criminal behavior."

1.1.14. A problem with defining abnormal behavior in terms of deviation from statistical norms is that this definition a. b. c. d.

focuses only on very rare conditions. focuses only on conditions that are actually relatively common. does not specify how unusual the behavior must be to be considered abnormal. only considers deviations that are harmful. Difficulty: 3 Question ID: 1.1.14 Page Reference: 5 Topic: Defining Abnormal Behavior Skill: Applied

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Answer: c. does not specify how unusual the behavior must be to be considered abnormal. 1.1.15. Which of the following is a rare form of psychopathology? a. b. c. d.

schizophrenia panic disorder major depression gender identity disorder Difficulty: 3 Question ID: 1.1.15 Page Reference: 5 Topic: Defining Abnormal Behavior Skill: Factual Answer: d. gender identity disorder

1.1.16. According to Jerome Wakefield, one essential component of the definition of a mental disorder is a. b. c. d.

statistical rarity. one distinguishing symptom. an individual's subjective distress. tissue damage revealed by medical tests. Difficulty: 2 Question ID: 1.1.16 Page Reference: 5-6 Topic: Defining Abnormal Behavior Skill: Conceptual Answer: c. an individual's subjective distress

1.1.17. In the term "harmful dysfunction," the word dysfunction refers to a. b. c. d.

a mental disorder. a set of distinguishing symptoms. a disruption of thought, feeling, or perception. the inability of the person to function at work or school. Difficulty: 2 Question ID: 1.1.17 Page Reference: 5-6 Topic: Defining Abnormal Behavior Skill: Factual Answer: c. a disruption of thought, feeling, or perception.

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1.1.18. Applying the concept of harmful dysfunction to the case of Kevin Warner, we can emphasize Kevin's failures of which of the following mental mechanisms? a. b. c. d.

perception thinking communication all of the above Difficulty: 2 Question ID: 1.1.18 Page Reference: 5-6 Topic: Defining Abnormal Behavior Skill: Conceptual Answer: d. all of the above

1.1.19. What problem in defining abnormal behavior is evident in the case of Kevin Warner described in the text? a. b. c. d.

Some statistically rare forms of behavior are desirable. Some mental disorders have symptoms that are not harmful. A behavior is not dysfunctional unless it is statistically unusual. Some people do not perceive their abnormal behavior as personally stressful. Difficulty: 3 Question ID: 1.1.19 Page Reference: 6 Topic: Defining Abnormal Behavior Skill: Applied Answer: d. Some people do not perceive their abnormal behavior as personally stressful.

1.1.20. What is one of the advantages of Jerome Wakefield's harmful dysfunction approach to defining mental disorders? a. b. c. d.

Cultural factors do not affect the definition. The definition is based on established humanistic criteria. The meaning of harmful is limited to life threatening conditions. As much as possible objective evaluation is used to define the dysfunction. Difficulty: 3 Question ID: 1.1.20 Page Reference: 6 Topic: Defining Abnormal Behavior Skill: Applied Answer: d. as much as possible objective evaluation is used to define the dysfunction

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1.1.21. Behaviors of entertainers like the stars of the movie Jackass, in which individuals are shown taking reckless risks of their own devising, can be bizarre and outrageous without being viewed as evidence of a mental disorder because such behaviors a. b. c. d.

are voluntary and serve a useful function. are rare and unusual. can cause harm. deviate from society's standards of proper behavior. Difficulty: 2 Question ID: 1.1.21 Page Reference: 6 Topic: Defining Abnormal Behavior Skill: Conceptual Answer: a. are voluntary and serve a useful function.

1.1.22. Conditions like albinism or fused toes are physical dysfunctions but would not be regarded as disorders because they a. b. c. d.

are physical. do not cause any harm. are rare. are not easily diagnosed. Difficulty: 1 Question ID: 1.1.22 Page Reference: 6 Topic: Defining Abnormal Behavior Skill: Conceptual Answer: b. do not cause any harm.

1.1.23. Which organization publishes the Diagnostic and Statistical Manual of Mental Disorders, text revision 4th Edition (DSM-IV-TR)? a. b. c. d.

World Health Organization American Psychiatric Association American Psychological Association National Institute of Mental Health Difficulty: 1 Question ID: 1.1.23 Page Reference: 6 Topic: Defining Abnormal Behavior Skill: Factual

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Answer: b. American Psychiatric Association

1.1.24. Which publication contains the official criteria for diagnosing mental disorders? a. b. c. d.

Physicians' Desk Reference Syndromes of Mental Disorders Diagnostic and Statistical Manual of Mental Disorders American Psychiatric Association Guidelines for Diagnosis Difficulty: 1 Question ID: 1.1.24 Page Reference: 6 Topic: Defining Abnormal Behavior Skill: Factual Answer: c. Diagnostic and Statistical Manual of Mental Disorders

1.1.25. What is the emphasis of the definition of abnormal behavior in the DSM IV-TR? a. b. c. d.

statistical rarity biological etiology biological disadvantage in terms of reproduction personal distress or impairment in social functioning Difficulty: 2 Question ID: 1.1.25 Page Reference: 6 Topic: Defining Abnormal Behavior Skill: Applied Answer: d. personal distress or impairment in social functioning

1.1.26. What principle guided developers of the DSM-IV-TR as they wrote definitions of mental disorders? a. b. c. d.

Definitions should consider political factors. Disorders should be associated with distress or disability. Deviant behaviors that are encouraged by certain religions should be included. Abnormal behaviors should have a biological basis to be considered mental disorders. Difficulty: 2 Question ID: 1.1.26 Page Reference: 6 Topic: Defining Abnormal Behavior Skill: Conceptual Answer: b. Disorders should be associated with distress or disability.

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1.1.27. The DSM definition of mental disorder excludes all of the following EXCEPT a. b. c. d.

a culturally sanctioned response to a particular event. beliefs and actions shared by a religious group. sexual behavior of sexual minority groups such as gays or lesbians. behavior of which the individual is unaware. Difficulty: 2 Question ID: 1.1.27 Page Reference: 7 Topic: Defining Abnormal Behavior Skill: Applied Answer: d. behavior of which the individual is unaware

1.1.28. Culture is defined in terms of a. b. c. d.

the level of education attained by most people in a specific group. the degree of emphasis a community places on art and literature. the values, beliefs, and practices shared by a specific group of people. the similarity of people within a group. Difficulty: 1 Question ID: 1.1.28 Page Reference: 7 Topic: Defining Abnormal Behavior Skill: Factual Answer: c. the values, beliefs, and practices shared by a specific group of people.

1.1.29. Olivia grew up in a society where mourners pull out their hair, go into an emotional frenzy, and speak in tongues. On a visit to the U.S., she did these things in public when she heard that a relative had died. According to DSM-IV-TR, her behavior would be considered a. b. c. d.

psychopathological, because of her personal distress. not psychopathological, because it is part of her culture. psychopathological, because it disrupted her social functioning. not psychopathological, because it caused no disruption in social functioning. Difficulty: 2 Question ID: 1.1.29 Page Reference: 7 Topic: Defining Abnormal Behavior Skill: Conceptual Answer: b. not psychopathological, because it is part of her culture.

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1.1.30. A woman who is unable to achieve orgasm and who lives in a society that discourages female sexuality would probably not be given the DSM diagnosis of female orgasmic disorder because a. b. c. d.

she probably would not experience any distress or impairment. she would be distressed but not impaired. she would be impaired but not distressed. she would probably be both distressed and impaired. Difficulty: 2 Question ID: 1.1.30 Page Reference: 7 Topic: Defining Abnormal Behavior Skill: Applied Answer: a. she probably would not experience any distress or impairment.

1.1.31. What is the history of the "diagnosis" homosexuality in the DSM? a. b. c. d.

Homosexuality was never a diagnosis in the DSM. Homosexuality was, and is, a possible diagnosis in the DSM. Homosexuality was a diagnosis in the first two editions of the DSM, taken out for the third edition, and then reintroduced in the 4th. Homosexuality was a diagnosis in the first two editions of the DSM, taken out for the third edition, and has never been reintroduced. Difficulty: 2 Question ID: 1.1.31 Page Reference: 7-9 Topic: Defining Abnormal Behavior Skill: Conceptual Answer: d. Homosexuality was a diagnosis in the first two editions of the DSM, taken out for the third edition, and has never been reintroduced.

1.1.32. What was one of the factors that seems to have played a role in Mary's development of an eating disorder? (This is from one of the case studies.) a. b. c. d.

sexual abuse throughout childhood She was prone to sleepwalking episodes. a genetic predisposition to high levels of anxiety She was determined that she would never gain as much weight as her mother had. Difficulty: 2 Question ID: 1.1.32 Page Reference: 9 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: d. She was determined that she would never gain as much weight as her mother had.

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1.1.33. Two terms are particularly important in epidemiological research, incidence and __________. a. b. c. d.

statistical validity correlation prevalence N Difficulty: 2 Question ID: 1.1.33 Page Reference: 10 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: c. prevalence

1.1.34. What is one of the signs of the possible presence of bingeing and purging that was noticed in the case of Mary? a. b. c. d.

loss of hearing teeth/gum problems frequent bone fractures fluctuating dopamine levels Difficulty: 2 Question ID: 1.1.34 Page Reference: 9 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: b. teeth/gum problems

1.1.35. What was the focus of the underlying dysfunction in the case of Mary's bingeing-purging eating disorder? a. b. c. d.

loss of neurons mechanisms that regulate appetite failure to process dream memories poor motor skills resulting from lack of oxygen at birth Difficulty: 2 Question ID: 1.1.35 Page Reference: 9 Topic: Who Experiences Abnormal Behavior? Skill: Applied Answer: b. mechanisms that regulate appetite

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1.1.36. Compared to Kevin Warner, Mary Childress was much more acutely aware of her disorder; this tells us that a. b. c. d.

Mary has a disorder while Kevin doesn't. Kevin has a disorder while Mary doesn't. Mary probably experiences more distress than Kevin. Mary is probably more impaired than Kevin. Difficulty: 3 Question ID: 1.1.36 Page Reference: 10 Topic: Who Experiences Abnormal Behavior Skill: Applied Answer: c. Mary probably experiences more distress than Kevin.

1.1.37. Which of these is an example of something an epidemiologist would do? a. b. c. d.

encourage people with the flu to avoid alcohol study rates of alcoholism in urban versus rural areas investigate the effects of clothing preference on social communication study chromosomes to find abnormal genes associated with various diseases Difficulty: 2 Question ID: 1.1.37 Page Reference: 10 Topic: Who Experiences Abnormal Behavior? Skill: Conceptual Answer: b. study rates of alcoholism in urban versus rural areas

1.1.38. Epidemiology is the scientific study of the a. b. c. d.

effects of diets. biological treatment of diseases. frequency and distribution of disorders. classification systems for mental disorders. Difficulty: 1 Question ID: 1.1.38 Page Reference: 10 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: c. frequency and distribution of disorders.

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1.1.39. An epidemiologist studies rates of depression in a community over a one-year period. Her calculation of incidence will be based on the a. b. c. d.

average time between diagnosis and cure. proportion of people who had ever been depressed. number of new cases that developed during that year. total number of active cases on the day of calculation. Difficulty: 3 Question ID: 1.1.39 Page Reference: 10 Topic: Who Experiences Abnormal Behavior? Skill: Conceptual Answer: c. number of new cases that developed during that year.

1.1.40. In a nearby town, two people had anxiety disorders in the past but not now. Three people developed anxiety disorders four or five years ago, and continue to have an anxiety disorder now. Six people developed anxiety disorders this year and continue to be so diagnosed. Which of the following might an epidemiologist write in her report concerning the rate of mental disorders in this community? a. b. c. d.

incidence (this year) = 5; lifetime prevalence = 6 incidence (this year) = 6; lifetime prevalence = 11 lifetime prevalence = 5; lifetime prevalence = 3 lifetime prevalence = 5; incidence (this year) = 11 Difficulty: 3 Question ID: 1.1.40 Page Reference: 10 Topic: Who Experiences Abnormal Behavior? Skill: Conceptual Answer: b. incidence (this year) = 6; lifetime prevalence = 11

1.1.41. Which is the most accurate statement about the lifetime prevalence rates for bipolar disorder in the United States? a. b. c. d.

More men than women will be diagnosed with bipolar disorder. More women than men will be diagnosed with bipolar disorder. Almost twice as many women will receive this diagnosis. The rates for this disorder are the same for men and women. Difficulty: 2 Question ID: 1.1.41 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: d. The rates for this disorder are the same for men and women.

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1.1.42. All of the following are disorders that are more common in women than men except a. b. c. d.

eating disorders. anxiety disorders. major depression. alcoholism. Difficulty: 1 Question ID: 1.1.42 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: d. alcoholism

1.1.43. If a disorder is short-term and typically has a high rate of recovery, then lifetime prevalence rates for that disorder will be ____________ one-year prevalence rates. a. b. c. d.

somewhat lower than much higher than equal to much lower than Difficulty: 2 Question ID: 1.1.43 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Applied Answer: b. much higher than

1.1.44. Based on the results of the National Comorbidity Survey Replication (NDR-R) Study, which disorder has the highest lifetime prevalence in the United States? a. b. c. d.

schizophrenia major depression bipolar mood disorder obsessive-compulsive disorder Difficulty: 2 Question ID: 1.1.44 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: b. major depression

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1.1.45. Which disorder is about equally common in men and women in the United States? a. b. c. d.

depression bipolar mood disorder alcohol abuse/dependence antisocial personality disorder Difficulty: 2 Question ID: 1.1.45 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: b. bipolar mood disorder

1.1.46. Which disorder is more common in men than women? a. b. c. d.

depression schizophrenia bipolar disorder alcohol abuse/dependence Difficulty: 1 Question ID: 1.1.46 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: d. alcohol abuse/dependence

1.1.47. The presence of more than one condition within the same time period is known as a. b. c. d.

twin diagnosis. double diagnosis. comorbidity. confounded morbidity. Difficulty: 1 Question ID: 1.1.47 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: c. comorbidity.

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1.1.48. According to the textbook some disorders, such as __________, are found in virtually every culture social scientists have studied. a. b. c. d.

sleep apnea alcoholism schizophrenia bulimia Difficulty: 2 Question ID: 1.1.48 Page Reference: 12 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: c. schizophrenia

1.1.49. The only medical condition with a higher incidence than mental disorders is a. b. c. d.

closed head injury. alcohol addiction. cancer. cardiovascular disease. Difficulty: 2 Question ID: 1.1.49 Page Reference: 12 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: d. cardiovascular disease

1.1.50. Comorbidity exists when a. b. c. d.

two people have the same disorder. one person has first one disorder, then later develops another. one person has more than one condition within the same period of time. a health professional cannot distinguish between two different conditions. Difficulty: 1 Question ID: 1.1.50 Page Reference: 12 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: c. one person has more than one condition within the same period of time.

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1.1.51. How has research on comorbidity changed the focus of epidemiological research? a. b. c. d.

shifted the focus from the psychotic disorders to milder disorders that affect more people higher than expected prevalence of mental retardation led to more emphasis on intellectual ability shifted the focus from counting the number of people with a disorder to measuring the functional impairment associated with the problems evidence for the biological etiology of more mental disorders has switched the focus to identifying the genes responsible for particular disorders Difficulty: 3 Question ID: 1.1.51 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Applied Answer: c. shifted the focus from counting the number of people with a disorder to measuring the functional impairment associated with the problems

1.1.52. An epidemiologist is about to testify to Congress on the findings of comorbidity. Which of the following points will she want to make after reviewing research on comorbidity? a. b. c. d.

Most mental disorders have a biological basis. Those with severe impairment often have more than one disorder. We have underestimated the role of toxins as the cause of disorders. The majority of mental disorders tend to "run in families" as a result of genetic anomalies. Difficulty: 3 Question ID: 1.1.52 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Applied Answer: b. Those with severe impairment often have more than one disorder.

1.1.53. What two factors are combined to measure disease burden? a. b. c. d.

mortality and disability infection rates and poverty levels physician visits and pollution levels daily caloric intake and hospitalization rates Difficulty: 2 Question ID: 1.1.53 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: a. mortality and disability

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1.1.54. In research on disease burden, the disability associated with schizophrenia is considered to be comparable to that associated with a. b. c. d.

diabetes. hypertension. quadriplegia. Alzheimer's disease. Difficulty: 1 Question ID: 1.1.54 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: c. quadriplegia.

1.1.55. In order to compare the disability associated with different conditions, epidemiologists had to assume that the burden associated with certain mental disorders was equivalent to that associated with diseases and injuries. Which of the following is a correct association of a mental disorder with a medical condition? a. b. c. d.

mania : heart disease panic disorder : cancer depression : blindness schizophrenia : diabetes Difficulty: 2 Question ID: 1.1.55 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: c. depression: blindness

1.1.56. What has research on disease burden found concerning the relative impact of medical illnesses and mental disorders? a. b. c. d.

Medical illnesses and mental disorders are associated with equal levels of disease burden. Although quite prevalent, mental disorders account for insignificant levels of disease burden. Mental disorders are responsible for more disease burden than all of the medical illnesses combined. Although mental disorders account for a small number of deaths, they are a significant cause of disease burden.

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Difficulty: 3 Question ID: 1.1.56 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Conceptual Answer: d. Although mental disorders account for a small number of deaths, they are a significant cause of disease burden.

1.1.57. The World Health Organization estimates that all mental disorders combined account for _____ percent of all disability worldwide. a. b. c. d.

less than 1 11 28 52 Difficulty: 2 Question ID: 1.1.57 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: c. 28

1.1.58. Which of the following is the correct listing of the disease burden associated with the top three illness categories? a. b. c. d.

cardiovascular conditions, all drug use, all mental disorders cardiovascular conditions, all mental disorders, all malignant diseases (cancer) all drug use, all infectious and parasitic diseases, all respiratory diseases all mental disorders, all respiratory conditions, all cardiovascular conditions Difficulty: 2 Question ID: 1.1.58 Page Reference: 12 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: b. cardiovascular conditions, all mental disorders, all malignant diseases (cancer)

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1.1.59. Investigators in the World Health Organization (WHO) predict that, relative to other types of health problems, the burden of mental health disorders will _________________by 2020. a. b. c. d.

increase decrease stay about the same increase in developing countries and decrease in developed countries Difficulty: 2 Question ID: 1.1.59 Page Reference: 12 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: a. increase

1.1.60. Which of the following is most accurate for the situation in the United States? a. b. c. d.

Bulimia is higher among university women and more common in older women. Bulimia is higher in working women and more common in younger women. Bulimia is higher among university women and more common in younger women. Bulimia is higher in working women and more common in younger women. Difficulty: 2 Question ID: 1.1.60 Page Reference: 12 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: c. Bulimia is higher among university women and more common in younger women.

1.1.61. Which of the following is most true regarding bulimia? a. b. c. d.

The prevalence is higher in Western nations than other parts of the world, and the number of cases increased during the later part of the 20th century. The prevalence is lower in Western nations than other parts of the world, and the number of cases increased during the later part of the 20th century. The prevalence is higher in Western nations than other parts of the world, and the number of cases decreased during the later part of the 20th century. The prevalence is higher in developing nations than other parts of the world, and the number of cases increased during the later part of the 20th century. Difficulty: 2 Question ID: 1.1.61 Page Reference: 12 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: a. The prevalence is higher in Western nations than other parts of the world, and the number of cases increased during the later part of the 20th century.

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1.1.62. All of the following can be concluded from cross-cultural studies except: a. b. c. d.

All mental disorders are shaped, to some extent, by cultural factors. No mental disorders are due entirely to cultural or social factors. Psychotic disorders are more influenced by culture than other disorders. The symptoms of certain disorders are more likely to vary across cultures than are the disorders themselves. Difficulty: 3 Question ID: 1.1.62 Page Reference: 12 Topic: Who Experiences Abnormal Behavior? Skill: Conceptual Answer: c. Psychotic disorders are more influenced by culture than other disorders.

1.1.63. Which individual is most likely to suffer bulimia nervosa? a. b. c. d.

Amy, a 19-year-old college student Michael, a 30-year-old auto mechanic Joe, a 45-year-old air traffic controller Isabel, a 10-year-old grade-school student Difficulty: 3 Question ID: 1.1.63 Page Reference: 12 Topic: Who Experiences Abnormal Behavior? Skill: Applied Answer: a. Amy, a 19-year-old college student

1.1.64. Which category of disorders seems less affected by culture? a. b. c. d.

anxiety neurotic psychotic personality Difficulty: 2 Question ID: 1.1.64 Page Reference: 12 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: c. psychotic

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1.1.65. An epidemiologist conducts a comparison of the incidence of bulimia nervosa in various groups. The data can be categorized in many ways. After analyzing the data, what is the epidemiologist likely to say her findings reveal? a. b. c. d.

The incidence is declining among all groups. The rate is relatively even across socioeconomic and age groups. The incidence is much higher among university women than among working women. The incidence is high among older women who have recently entered the workforce. Difficulty: 3 Question ID: 1.1.65 Page Reference: 12 Topic: Who Experiences Abnormal Behavior? Skill: Conceptual Answer: c. The incidence is much higher among university women than among working women.

1.1.66. Epidemiological evidence suggests that which of the following factors is an important ingredient in establishing risk for developing an eating disorder? a. b. c. d.

comorbidity genetics holding particular sets of values related to women’s appearance early family relations Difficulty: 1 Question ID: 1.1.66 Page Reference: 12 Topic: Who Experiences Abnormal Behavior? Skill: Conceptual Answer: c. holding particular sets of values related to women’s appearance

1.1.67. Specialized mental health professionals treat _____ percent of those who seek help for mental disorders. a. b. c. d.

10 20 40 60 Difficulty: 1 Question ID: 1.1.67 Page Reference: 13 Topic: The Mental Health Professions Skill: Factual Answer: c. 40

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1.1.68. From which of the following are people who seek help for mental disorders most likely to receive help? a. b. c. d.

primary care physicians social workers psychiatrists psychologists Difficulty: 2 Question ID: 1.1.68 Page Reference: 13 Topic: The Mental Health Professions Skill: Factual Answer: a. primary care physicians

1.1.69. The largest group of clinically trained professionals providing mental health services in the United States are a. b. c. d.

psychiatrists. clinical psychologists. social workers. psychiatric nurses. Difficulty: 2 Question ID: 1.1.69 Page Reference: 13 Topic: The Mental Health Professions Skill: Factual Answer: c. social workers.

1.1.70. Which of the following statements most accurately describes the specialized training needed to prepare people to provide professional assistance to those who suffer from mental disorders? a. b. c. d.

It is necessary to pursue a degree in medicine. It is desirable to pursue a degree in medicine. It is necessary to pursue an advanced degree in psychology. There are many forms of appropriate specialized training available. Difficulty: 1 Question ID: 1.1.70 Page Reference: 13 Topic: The Mental Health Professions Skill: Factual Answer: d. There are many forms of appropriate specialized training available.

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1.1.71. One specific difference between psychiatrists and psychologists is that the psychiatrist a. b. c. d.

is able to provide psychotherapy. can prescribe medication. uses the DSM to diagnose mental disorders. has had supervised clinical experience. Difficulty: 1 Question ID: 1.1.71 Page Reference: 13 Topic: The Mental Health Professions Skill: Factual Answer: b. can prescribe medication.

1.1.72. Which physician has received specialized training in the diagnosis and treatment of mental disorders? a. b. c. d.

neurologist psychiatrist dermatologist clinical physician Difficulty: 1 Question ID: 1.1.72 Page Reference: 13 Topic: The Mental Health Professions Skill: Factual Answer: b. psychiatrist

1.1.73. You were asked to find the number of various professionals providing mental health services in the United States. Which group will top the list? a. b. c. d.

psychiatrists family physician clinical psychologists marriage and family therapists Difficulty: 1 Question ID: 1.1.73 Page Reference: 13 Topic: The Mental Health Professions Skill: Factual Answer: b. family physician

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1.1.74. On a talk show last night Don described some symptoms of anxiety he has experienced during the past year. He said his therapist prescribed an anti-anxiety medication, which seems to be effective. Based on Don's description, you conclude that the therapist is a a. b. c. d.

podiatrist. psychiatrist. social worker. clinical psychologist. Difficulty: 3 Question ID: 1.1.74 Page Reference: 13 Topic: The Mental Health Professions Skill: Conceptual Answer: b. psychiatrist.

1.1.75. What is the best description of clinical psychology? a. b. c. d.

a branch of medicine concerned with the treatment of mental disorders a legal term used to identify practitioners who use various forms of psychotherapy the application of psychological science to the assessment and treatment of mental disorders a newly established branch of medicine that has connections to both psychiatry and psychology Difficulty: 1 Question ID: 1.1.75 Page Reference: 13 Topic: The Mental Health Professions Skill: Factual Answer: c. the application of psychological science to the assessment and treatment of mental disorders

1.1.76. Which approach to providing services for those with mental disorders is represented by this description: Will work in crisis and case management programs for people with severe disorders. Will teach practical day-to-day skills to clients. High school education or bachelor's degree needed. a. b. c. d.

counseling social work social management psychosocial rehabilitation Difficulty: 3 Question ID: 1.1.76 Page Reference: 14 Topic: The Mental Health Professions Skill: Conceptual Answer: d. psychosocial rehabilitation

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1.1.77. The major difference between Ph.D. and Psy.D. degrees in psychology involves the degree of emphasis on training in a. b. c. d.

treatment methods. assessment methods. research methods. the uses of medications. Difficulty: 1 Question ID: 1.1.77 Page Reference: 13 Topic: The Mental Health Professions Skill: Factual Answer: c. research methods.

1.1.78. George completed five years of graduate school that led to a Psy.D. degree. He is now completing a one-year internship at a mental health clinic. What type of mental health professional is George? a. b. c. d.

psychiatrist social worker medical therapist clinical psychologist Difficulty: 2 Question ID: 1.1.78 Page Reference: 13 Topic: The Mental Health Professions Skill: Conceptual Answer: d. clinical psychologist

1.1.79. Some professionals work in crisis, residential, and case management programs for people with severe forms of disorder, such as schizophrenia. They teach people practical, day-to-day skills that are necessary for living in the community. This field is known as a. b. c. d.

clinical co-worker. psychosocial rehabilitation. marriage and family therapy. psychiatric nursing. Difficulty: 2 Question ID: 1.1.79 Page Reference: 14 Topic: The Mental Health Professions Skill: Conceptual

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Answer: b. psychosocial rehabilitation.

1.1.80. The textbook suggests that one likely change in the future in the mental health professions is a. b. c. d.

boundaries between professions will become less rigid. boundaries between professions will become more rigid. restricting the rights of non-psychologists to administer tests will increase. legislation restricting the use of psychological terminology to licensed personnel will be adopted. Difficulty: 2 Question ID: 1.1.80 Page Reference: 14 Topic: The Mental Health Professions Skill: Conceptual Answer: a. boundaries between professions will become less rigid.

1.1.81. According to your text, managed care in the United States puts a high premium on a. psychiatric care. b. evaluation of treatment compatibility. c. cost containment. d. volunteers as treatment assistants. Difficulty: 1 Question ID: 1.1.81 Page Reference: 14 Topic: The Mental Health Professions Skill: Factual Answer: c. cost containment.

1.1.82. Many psychologists in the United States are pursuing the right to a. b. c. d.

finance their own services. prescribe medications. perform brain surgery. practice in hospitals. Difficulty: 1 Question ID: 1.1.82 Page Reference: 14 Topic: The Mental Health Professions Skill: Factual Answer: b. prescribe medications.

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1.1.83. When we adopt an historical perspective to study how other societies have viewed the problems that we consider to be mental disorders, we find that they have a. b. c. d.

held quite different views. held very similar views. almost always emphasized natural explanations. almost always emphasized supernatural explanations. Difficulty: 1 Question ID: 1.1.83 Page Reference: 14 Topic: Psychopathology in Historical Context Skill: Conceptual Answer: a. held quite different views.

1.1.84. Your instructor has invited to today's class an actor who plays the role of famous historical figures. This actor is going to portray Hippocrates. What would be a good title for today's presentation? a. b. c. d.

"How demons cause deviant behavior" "The humors that control our behavior" "Severe disorders require radical treatments" "Rely on authority when searching for answers" Difficulty: 2 Question ID: 1.1.84 Page Reference: 14 Topic: Psychopathology in Historical Context Skill: Conceptual Answer: b. "The humors that control our behavior"

1.1.85. Hippocrates is viewed as one of the first figures in history to emphasize that psychopathology can be attributed to a. b. c. d.

supernatural causes. the influence of culture. natural causes. unconscious mental processes.

Difficulty: 1 Question ID: 1.1.85 Page Reference: 14 Topic: Psychopathology in Historical Context Skill: Conceptual Answer: c. natural causes.

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1.1.86. Which of the following is one of the bodily fluids that Hippocrates included in his explanation of abnormal behavior? a. b. c. d.

urine plasma yellow bile cerebrospinal fluid Difficulty: 1 Question ID: 1.1.86 Page Reference: 14 Topic: Psychopathology in Historical Context Skill: Factual Answer: c. yellow bile

1.1.87. Which of the following treatments is most consistent with the view that bodily fluids cause mental disorders? a. b. c. d.

purging exorcism fever therapy electroconvulsive therapy Difficulty: 1 Question ID: 1.1.87 Page Reference: 14 Topic: Psychopathology in Historical Context Skill: Conceptual Answer: a. purging

1.1.88. In Europe during the Middle Ages, the mentally ill and mentally retarded were often a. b. c. d.

confined to large mental institutions or asylums. imprisoned or placed in almshouses for the poor. treated with respect and even worship. viewed as pretty much the same as everybody else. Difficulty: 1 Question ID: 1.1.88 Page Reference: 14 Topic: Psychopathology in Historical Context Skill: Factual Answer: b. imprisoned or placed in almshouses for the poor.

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1.1.89. What was one reason for the growth of large mental institutions during the 1800s? a. b. c. d.

urbanization widespread famines spread of viral diseases rapid development of surgical techniques Difficulty: 1 Question ID: 1.1.89 Page Reference: 15 Topic: Psychopathology in Historical Context Skill: Factual Answer: a. urbanization

1.1.90. The improvement in conditions of mental hospitals in the 1800s was based in part on the belief that a. b. c. d.

humanistic care would help to relieve mental illness. patients, though incurable, deserved compassionate care. patients with mental disorders were not really dangerous. patients had the right to sue to gain better treatment. Difficulty: 2 Question ID: 1.1.90 Page Reference: 15 Topic: Psychopathology in Historical Context Skill: Conceptual Answer: a. humanistic care would help to relieve mental illness.

1.1.91. How might a practitioner of moral treatment describe this approach? a. b. c. d. ones."

"Restraints force patients to recognize the need for morality." "Until patients face their moral shortcomings, there is no hope for recovery." "Providing a humane and relaxed environment would bring about positive changes." "Patients have no right to special treatment because of the havoc they cause in the lives of loved

Difficulty: 2 Question ID: 1.1.91 Page Reference: 15 Topic: Psychopathology in Historical Context Skill: Conceptual Answer: c. "Providing a humane and relaxed environment would bring about positive changes."

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1.1.92. Over the course of the 1800s the number of mental hospitals in the United States and the number of patients in those hospitals a. b. c. d.

decreased dramatically. increased dramatically. remained mostly constant. cannot be determined because no statistics were collected. Difficulty: 1 Question ID: 1.1.92 Page Reference: 15 Topic: Psychopathology in Historical Context Skill: Factual Answer: b. increased dramatically.

1.1.93. The large patient populations placed in mental hospitals in the 1800s are important in the history of abnormal psychology because they a. b. c. d.

provided physicians with an opportunity to observe and treat various types of psychopathology. created growing awareness of the need for psychological rather than medical interventions. gave public officials a new way to deal with dangerous criminals. led to a steady reduction in the number of people with mental illness. Difficulty: 3 Question ID: 1.1.93 Page Reference: 15 Topic: Psychopathology in Historical Context Skill: Applied Answer: a. provided physicians with an opportunity to observe and treat various types of psychopathology.

1.1.94. A patient at the Worcester Lunatic Hospital in the mid-1800s has been excited, agitated, and even violent at times. Which of the following would Samuel Woodward most likely prescribe in this case? a. b. c. d.

opium or morphine alcohol or marijuana yellow bile or black bile saltpeter or cod liver oil

Difficulty: 2 Question ID: 1.1.94 Page Reference: 16 Topic: Psychopathology in Historical Context Skill: Applied Answer: a. opium or morphine

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1.1.95. To Samuel Woodward, superintendent of Worcester Lunatic Hospital in the 1800s, heavy drinking, masturbation, overwork, faulty education, and excessive ambitions were viewed as a. b. c. d.

common symptoms of mental disorders. frequent causes of mental disorders. problems resulting from overcrowding of mental hospitals. irrelevant to an understanding of mental disorders. Difficulty: 1 Question ID: 1.1.95 Page Reference: 16 Topic: Psychopathology in Historical Context Skill: Factual Answer: b. frequent causes of mental disorders.

1.1.96. Samuel Woodward of the Worcester Lunatic Hospital is getting ready to write his annual report on the hospital and its patients. Which of the following titles would most accurately reflect the body of that report? a. b. c. d.

"No Cure, Little Hope" "Exorcism Instead of Exercise" "The Need for Greater Restraints is Evident" "High Rates of Successful Treatment of Insanity" Difficulty: 2 Question ID: 1.1.96 Page Reference: 16 Topic: Psychopathology in Historical Context Skill: Conceptual Answer: d. "High Rates of Successful Treatment of Insanity"

1.1.97. What were the two categories of the causes of mental disorders described by Samuel Woodward? a. b. c. d.

moral and physical viral and bacteria conscious and unconscious poverty and lack of will power Difficulty: 2 Question ID: 1.1.97 Page Reference: 16 Topic: Psychopathology in Historical Context Skill: Factual Answer: a. moral and physical

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1.1.98. Samuel Woodward's claim of a 90 percent success rate in treating the seriously disturbed patients at Worcester Lunatic Hospital a. b. c. d.

was backed by rigorous scientific evidence. reflects his lack of training in scientific research. was a tactic he used to increase state funding for his hospital. was based on the value of such treatments as bleeding and purging. Difficulty: 2 Question ID: 1.1.98 Page Reference: 16 Topic: Psychopathology in Historical Context Skill: Conceptual Answer: b. reflects his lack of training in scientific research.

1.1.99. An emphasis on masturbation as a cause of mental disorder, or the deliberate injection of mentally ill patients with malaria, can be viewed as examples of a. b. c. d.

excessive emphasis on biological explanations. a willingness to accept ideas that are not backed by scientific proof. how little psychiatry has changed in the past 100 years. the contempt with which most medical professionals viewed their patients. Difficulty: 2 Question ID: 1.1.99 Page Reference: 16 Topic: Psychopathology in Historical Context Skill: Applied Answer: b. a willingness to accept ideas that are not backed by scientific proof.

1.1.100. What was the rationale for deliberately injecting mentally ill patients with malaria? a. b. c. d.

The patients' immoral behaviors had to be punished with illness. The high fever would divert patients' attention from the symptoms of mental disorders. It was a desperate attempt to shock the afflicted individual's system back to normality. The malaria would bring about a high fever that in some cases had been associated with a reduction in symptoms. Difficulty: 1 Question ID: 1.1.100 Page Reference: 17 Topic: Psychopathology in Historical Context Skill: Conceptual Answer: d. The malaria would bring about a high fever that in some cases had been associated with a reduction in symptoms.

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1.1.101. While searching through old records of patients at the mental hospital you come across one with a notation "Lobotomy performed on 2/3/52." Because you are not sure what this means, you ask the staff. What are they likely to tell you? a. b. c. d.

The patient had to be tied to the bed to reduce violent outbursts. Repeated electroconvulsive treatments were required to reduce the patient's stupor. A surgical procedure cut nerve tracts between the frontal lobes and the rest of the brain. As a last resort, the patient's stomach was pumped and his blood was purified in order to remove potentially harmful substances. Difficulty: 1 Question ID: 1.1.101 Page Reference: 17 Topic: Psychopathology in Historical Context Skill: Conceptual Answer: c. A surgical procedure cut nerve tracts between the frontal lobes and the rest of the brain.

1.1.102. You are a member of a research team that is about to begin research on the effectiveness of a drug called Relax on the symptoms of anxiety. One of the researchers asks you to describe the null hypothesis for this study. What will you say? a. b. c. d.

The null hypothesis states that the drug's effect will not differ from no treatment. The null hypothesis states that the dependent variable in this experiment must be objectively measured. The null hypothesis means the researchers must be blind to the identity of the individuals that are receiving the drug. The null hypothesis means there are no differences in demographic characteristics between the control and the experimental groups. Difficulty: 2 Question ID: 1.1.102 Page Reference: 18 Topic: Methods for the Scientific Study of Mental Disorders Skill: Conceptual Answer: a. The null hypothesis states that the drug's effect will not differ from no treatment.

1.1.103. Which of the following provides the best analogy for the null hypothesis? a. b. c. d.

typical cutoffs for passing academic exams the assumption of innocence in the legal system a round robin tournament to find the best golfer ratings of multiple judges during the Olympics ice skating competition

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Difficulty: 2 Question ID: 1.1.103 Page Reference: 18 Topic: Methods for the Scientific Study of Mental Disorders Skill: Conceptual Answer: b. the assumption of innocence in the legal system

1.1.104. If the null hypothesis had influenced how psychiatrists thought about inducing fevers and carrying out lobotomies in the 1920s and 1930s, they would have a. b. c. d.

moved even more quickly to accept these new treatments. been even more likely to emphasize underlying biological causes of disorder. dismissed the need for more research. been skeptical of these treatments unless more scientific proofs of their value were established. Difficulty: 2 Question ID: 1.1.104 Page Reference: 18 Topic: Methods for the Scientific Study of Mental Disorders Skill: Applied Answer: d. been skeptical of these treatments unless more scientific proofs of their value were established.

1.1.105. Which of the following is the equivalent in the legal system of failing to reject the null hypothesis? a. b. c. d.

the defendant is guilty and sentenced to prison the judge calls a mistrial after unreliable evidence is introduced the defendant is not guilty although he is not necessarily innocent the defendant is found not guilty by reason of insanity and sent to a mental hospital Difficulty: 2 Question ID: 1.1.105 Page Reference: 18 Topic: Methods for the Scientific Study of Mental Disorders Skill: Conceptual Answer: c. the defendant is not guilty although he is not necessarily innocent

1.1.106. What is the best definition of a case study? a. b. c. d.

a detailed description of one person a psychological evaluation for legal purposes an analysis of the daydreams of college students a large scale study of the rates of a disorder

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Difficulty: 2 Question ID: 1.1.106 Page Reference: 17 Topic: Methods for the Scientific Study of Mental Disorders Skill: Conceptual Answer: a. a detailed description of one person

1.1.107. What is one of the major uses of case studies? a. b. c. d.

studying unusual conditions verifying the effectiveness of therapies validating correlations established in the laboratory establishing the borderline between normal and abnormal behaviors Difficulty: 2 Question ID: 1.1.107 Page Reference: 17 Topic: Methods for the Scientific Study of Mental Disorders Skill: Conceptual Answer: a. studying unusual conditions

1.1.108. Jane Addams was an influential social activist. Which of the following does not apply to her? a. b. c. d.

She founded a program to serve poor people in Chicago. She won a Nobel Peace Prize. She was a psychiatrist. She suffered bouts of depression. Difficulty: 1 Question ID: 1.1.108 Page Reference: 17-19 Topic: Methods for the Scientific Study of Mental Disorders Skill: Factual Answer: c. She was a psychiatrist.

1.1.109. It is likely that ________ played a role in the recurring depression of Jane Addams. a. b. c. d.

heredity lack of sleep and drugs early childhood sexual abuse social isolation

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Difficulty: 1 Question ID: 1.1.109 Page Reference: 19 Topic: Methods for the Scientific Study of Mental Disorders Skill: Factual Answer: a. heredity

1.1.110. What is one of the primary limitations of case studies? a. b. c. d.

focused on childhood useful only for rare disorders requires breaking confidentiality can be viewed from many different perspectives Difficulty: 1 Question ID: 1.1.110 Page Reference: 19 Topic: Methods for the Scientific Study of Mental Disorders Skill: Factual Answer: d. can be viewed from many different perspectives

1.1.111. After reading a case study like that of Jane Addams, we must remember that a. b. c. d.

case studies are not conclusive. heredity and loss of a parent are rarely causes of depression. her case is very typical and thus very informative. severe childhood punishment almost always leads to depression. Difficulty: 2 Question ID: 1.1.111 Page Reference: 19 Topic: Methods for the Scientific Study of Mental Disorders Skill: Conceptual Answer: a. case studies are not conclusive.

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Short Answer 1.2.112. A general term that refers to several types of severe mental disorder in which the person is considered to be out of contact with reality is __________ . Difficulty: 1 Question ID: 1.2.112 Page Reference: 4 Topic: Recognizing the Presence of a Disorder Skill: Factual Answer: psychosis

1.2.113. A group of symptoms that appear together and are assumed to represent a specific type of disorder is referred to as a __________ . Difficulty: 1 Question ID: 1.2.113 Page Reference: 4 Topic: Recognizing the Presence of a Disorder Skill: Factual Answer: syndrome

1.2.114. In the United States the definition of abnormal behavior is presented in the official Diagnostic and Statistical Manual of Mental Disorders, published by the American __________ Association. Difficulty: 1 Question ID: 1.2.114 Page Reference: 6 Topic: Defining Abnormal Behavior Skill: Factual Answer: Psychiatric

1.2.115. In the realm of psychological functioning, people who function at the highest levels can be described as __________ . Difficulty: 1 Question ID: 1.2.115 Page Reference: 7 Topic: Defining Abnormal Behavior Skill: Factual Answer: flourishing

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1.2.116. __________________ is defined in terms of the values, beliefs, and practices that are shared by a specific community or group of people. Difficulty: 1 Question ID: 1.2.116 Page Reference: 9 Topic: Defining Abnormal Behavior Skill: Factual Answer: Culture

1.2.117. The scientific study of the frequency and distribution of disorders within a population is defined as __________ .

Difficulty: 2 Question ID: 1.2.117 Page Reference: 7 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: epidemiology

1.2.118. ______________ refers to the number of new cases of a disorder that appear in the population during a specific period of time. Difficulty: 2 Question ID: 1.2.118 Page Reference: 9 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: Incidence

1.2.119. ________________ refers to the total number of active cases, both old and new, of a disorder that are present in a population during a specific period of time. Difficulty: 2 Question ID: 1.2.119 Page Reference: 9 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: Prevalence

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1.2.120. The presence of more than one condition within the same period of time in an individual is known as __________ .

Difficulty: 2 Question ID: 1.2.120 Page Reference: 11 Topic: Who Experiences Abnormal Behavior? Skill: Factual Answer: comorbidity

1.2.121. _______________ psychology is concerned with the application of psychological science to the assessment and treatment of mental disorders.

Difficulty: 1 Question ID: 1.2.121 Page Reference: 13 Topic: The Mental Health Professions Skill: Factual Answer: Clinical

1.2.122. An in-depth look at the symptoms and circumstances surrounding one person's mental disturbance is called a __________ __________ .

Difficulty: 1 Question ID: 1.2.122 Page Reference: 17 Topic: Methods for the Scientific Study of Mental Disorders Skill: Factual Answer: case study

1.2.123. In scientific research the alternative to the experimental hypothesis is known as the __________ hypothesis. Difficulty: 1 Question ID: 1.2.123 Page Reference: 18 Topic: Methods for the Scientific Study of Mental Disorders Skill: Factual Answer: null

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Essay 1.3.124. Describe the problems that are associated with attempts to define abnormal behavior in terms of (a) personal distress and (b) statistical rarity. Difficulty: 2 Question ID: 1.3.124 Page Reference: 5 Topic: Recognizing the Presence of a Disorder Skill: Applied Answer: (a) The individual may not demonstrate insight into the condition, and the behaviors may bother others but not the individual. (b) The cutoff for statistical rarity might be arbitrary, and would be different for different disorders. Statistical rarity doesn't address the issue of whether the behavior is harmful or not harmful. Moreover, some mental disorders are actually quite common.

1.3.125. Describe the categories of behavior that are excluded from categorization as mental illness in the DSM-IV-TR, and give an example of each.

Difficulty: 3 Question ID: 1.3.125 Page Reference: 7 Topic: Defining Abnormal Behavior Skill: Conceptual Answer: (1) Expected or culturally sanctioned response to a particular event (such as the death of a loved one), (2) deviant behaviors (such as the actions of political, religious, or sexual minorities), (3) conflicts that are between the individual and society (voluntary efforts to express individuality such as political protest or controversial art work).

1.3.126. How do epidemiologists measure disease burden and what have their results revealed? Difficulty: 3 Question ID: 1.3.126 Page Reference: 11 Topic: Defining Abnormal Behavior? Skill: Applied Answer: Disease burden is a combination of measures of mortality and disability. By equating certain medical diseases and injuries with specific mental disorders, epidemiologists estimate the disease burden due to various conditions. Their results indicate that the top three conditions in terms of disease burden are: all cardiovascular conditions; all mental disorders, including suicide; and all malignant disease (cancer). The specific mental disorder that accounts for the greatest disease burden is unipolar major depression.

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1.3.127. Discuss the different types of specialized mental health professionals, their role in the treatment of people with mental disorders, and how people are most likely to receive mental health care. Difficulty: 3 Question ID: 1.3.127 Page Reference: 12-14 Topic: The Mental Health Professions Skill: Conceptual Answer: There are three general sources of mental health care. Fewer than half of those who seek help for mental disorders receive help from specialized mental health professionals. Roughly one-third are treated by primary care physicians and roughly one-quarter receive help from social agencies and self-help groups. Among the specialized providers, there are various kinds. Psychiatrists are specialists in medicine and can prescribe medications. Clinical psychologists typically have completed five years of graduate study to earn a Ph.D. or Psy.D. Social workers are the most numerous of the specialized mental health providers in the U.S., and they usually have a master's degree in social work. There are also other types of specialized providers, including professional counselors, marriage and family therapists, and psychosocial rehabilitation professionals, most of whom are also trained at the master's level.

1.3.128. Trace the development of the Greek tradition in medicine on the causes and treatments of mental disorders. Trace the development of asylums from the Middle Ages to the 1800s in the United States. Difficulty: 3 Question ID: 1.3.128 Page Reference: 14-16 Topic: Psychopathology in Historical Context Skill: Factual

Answer: In contrast to earlier times, the Greek philosopher, Hippocrates, proposed natural explanations for mental disorders. He suggested that a balance among four humors was necessary for health. An excess or deficiency in one of the humors could result in a disorder. His attempts to uncover natural, biological explanations dominated medical thought in Western countries until the middle of the nineteenth century. During the Middle Ages, "lunatics" or "idiots" (terms used for the mentally ill and mentally retarded) aroused little interest. Their disturbed behavior was considered to be the responsibility of the family rather than the community or the state. In the 1600s and 1700s "insane asylums" were established to house the mentally disturbed. However, changes in economic, demographic, and social conditions brought a different perspective to the care of the mentally ill. For example, there was rapid population growth and the rise of large cities between 1790 and 1850 in the United States. This increased urbanization led to a shift from an agricultural to an industrial economy. Lunatic asylums were created to serve the needs of heavily populated cities and to assume responsibilities that had been performed by families. Although the early asylums were little more than warehouses, the moral treatment movement led to improved conditions in at some of these hospitals. This approach offered support, care and some degree of freedom rather than just confinement. This treatment approach coupled with Dorothea Dix's advocacy led to expansion of the number of mental institutions in the United States.

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1.3.129. During the 1920s and 1930s several somatic treatments were widely used to treat mental disorders. Give a brief description of the procedure and the rationale for the following: fever therapy, insulin coma therapy, and lobotomy.

Difficulty: 2 Question ID: 1.3.129 Page Reference: 16 Topic: Psychopathology in Historical Context Skill: Conceptual

Answer: (1) Fever therapy involved taking blood from people with malaria and injecting it into people with psychiatric disorders so they would develop a fever. This method was used because the symptoms of some people with mental disorders had disappeared after they became ill with typhoid fever. (2) Insulin coma therapy involved injecting insulin into psychiatric patients. These injections lower the sugar content of the blood and induce a hypoglycemic state and a deep coma. The method was used because mental changes had been noted in some diabetic drug addicts who were treated with insulin. (3) A lobotomy involves inserting a sharp knife through a hole bored in a patient's skull. Nerve fibers between the frontal lobes and the rest of the brain were cut. This surgical procedure had led to a reduction of negative emotions in chimpanzees.

1.3.130. Describe the benefits and drawbacks of the use of case studies in research on psychopathology. Difficulty: 2 Question ID: 1.3.130 Page Reference: 17 Topic: Methods for the Scientific Study of Mental Disorders Skill: Conceptual Answer: (1) Benefits: rich clinical descriptions (symptoms displayed, manner in which symptoms emerged, developmental and family history, response to any treatment efforts), especially important if the disorder is rare (e.g., multiple personality disorder and transsexualism); can be used to generate hypotheses; associated details can give clues about the nature of mental illness. (2) Drawbacks: can be viewed from many different perspectives and competing explanations may be equally plausible; risky to draw general conclusions from a single case.

1.3.131. A pharmaceutical company has asked you to design a study to evaluate the effectiveness of a new drug for treating bulimia. They have asked you specifically to do case studies. You are writing a memo in reply to this request in which you explain what case studies can do for the project, but also what they can not do. Include a brief description of the components you would add to the study to make it more useful in testing a theory. Difficulty: 3 Question ID: 1.3.131 Page Reference: 17 Topic: Methods for the Scientific Study of Mental Disorders Skill: Applied

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Answer: (1) Case studies can suggest a research direction and give hints about theory, but they can’t actually tell much about cause and effect. A hypothesis can be derived from a case study and a few case studies can suggest that a more experimental project would be worthwhile. It would be valuable to follow several cases to see if the new drug does in fact reduce their symptoms. (2) In order to actually know something about cause and effect, however, it is necessary to conduct a controlled experiment. For this you would need a larger group of subjects, 1/3 of whom were given the drug, 1/3 of whom were given a placebo, and 1/3 of whom were provided with the current standard treatment. This study would have to follow the rules of science. From this study you could tell something about which condition is more effective in treating this disorder.

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Test Bank for

Oltmanns and Emery

Abnormal Psychology Seventh Edition

prepared by

John S. Conklin Camosun College Victoria . BC Canada

ISBN 10: 0-205-03747-X ISBN 13: 978-0-205-03747-6 Printed in the United States of America

TABLE OF CONTENTS

Chapter 1

Examples and Definitions of Abnormal Behavior

Chapter 2

Causes of Abnormal Behavior

Chapter 3

Treatment of Psychological Disorders

104

Chapter 4

Classification and Assessment of Abnormal Behavior

150

Chapter 5

Mood Disorders and Suicide

189

Chapter 6

Anxiety Disorders

235

Chapter 7

Acute and Posttraumatic Stress Disorders, Dissociative Disorders, and Somatoform Disorders

277

Chapter 8

Stress and Physical Health

324

Chapter 9

Personality Disorders

365

Chapter 10

Eating Disorders

408

Chapter 11

Substance Use Disorders

445

Chapter 12

Sexual and Gender Identity Disorders

488

Chapter 13

Schizophrenic Disorders

529

Chapter 14

Dementia, Delirium, and Amnestic Disorders

573

Chapter 15

Intellectual Disabilities and Autistic Spectrum Disorders

612

Chapter 16

Psychological Disorders of Childhood

657

Chapter 17

Adjustment Disorders and Life-Cycle Transitions

703

Chapter 18

Mental Health and the Law

741

iii

Chapter 2 Causes of Abnormal Behavior Total Assessment Guide (T.A.G.) Topic Overview p. 24

Brief Historical Perspective pp. 25-29

Systems Theory pp. 29-32

Biological Factors pp. 32-43

Question Type Multiple Choice Short Answer Essay Multiple Choice

Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice

Short Answer

Psychological Factors pp. 43-47

Essay Multiple Choice Short Answer

Social Factors pp. 47-49

Essay Multiple Choice Short Answer Essay

Factual 1, 2, 3, 4

Conceptual

Applied

5, 6, 7

132 8, 9, 11, 13, 14, 16, 18, 19, 21, 24, 25, 27, 29, 30, 33, 36, 37 133, 134, 135, 136 42, 43, 51, 52, 53, 55, 56, 57 137, 138, 139 58, 59, 60, 61, 63, 64, 66, 67, 68, 71, 72, 73, 74, 78, 79, 82, 83, 84, 85, 86, 89, 90, 91, 94, 97, 105 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155 167 106, 111, 112, 113, 115, 117, 118, 120, 121, 123 156, 157, 158, 159, 160 168 126, 127, 130

162 12, 15, 17, 20, 22, 23, 31, 38, 39, 40, 41

10, 26, 28, 32, 34, 35

45, 46, 48, 49, 54

44, 47, 50

163, 164, 165 62, 65, 77, 87, 88, 93, 95, 96, 98, 99, 100, 101, 102, 103, 104

69, 70, 75, 76, 80, 81, 92

166 107, 108, 109, 110, 119, 122

114, 116

169 124, 128, 129, 131

125

161 170, 171, 172

Chapter 2: Causes of Abnormal Behavior

Multiple Choice 2.1.1.

The etiology of a problem behavior is its

a. b. c. d.

cause. paradigm. treatment. classification.

Difficulty: 1 Question ID: 2.1.1 Page Reference: 24 Topic: Overview Skill: Factual Answer: a. cause.

2.1.2. Which term is used for a set of shared assumptions that includes both the substance of a theory and beliefs about how scientists should collect data and test a theory? a. b. c. d.

etiology paradigm diagnosis prognosis Difficulty: 2 Question ID: 2.1.2 Page Reference: 24 Topic: Overview Skill: Factual Answer: b. paradigm

2.1.3.

Most forms of abnormal behavior are thought to be caused by

a. b. c. d.

genetics. learning. a single cause. multiple factors.

Difficulty: 1 Question ID: 2.1.3 Page Reference: 24 Topic: Overview Skill: Factual Answer: d. multiple factors.

2.1.4.

What approach do the authors use when considering the etiology of various mental disorders?

a. b. c. d.

systems confluence reductionism biopsychosocial Difficulty: 1 Question ID: 2.1.4 Page Reference: 24 Topic: Overview Skill: Factual Answer: d. biopsychosocial

2.1.5. A researcher described her approach to understanding mental disorders as biopsychosocial. When you ask her to explain what she means, what is she likely to say? a. b. c. d.

Biological abnormalities give rise to psychological disturbances that have social consequences. Biological, psychological, and social factors are just as likely to be the cause of these disorders. The integration of biological, psychological, and social factors provides the most fruitful avenue for discovering the cause of most mental disorders. The search for etiologies is best accomplished by viewing the evidence through the lens provided by one of the major paradigms. Difficulty: 1 Question ID: 2.1.5 Page Reference: 24 Topic: Overview Skill: Conceptual Answer: c. The integration of biological, psychological, and social factors provides the most fruitful avenue for discovering the cause of most mental disorders.

2.1.6. A distinguished researcher reviewed the current findings on the etiology of mental disorders. Which of the following is the best summary of the consensus of opinion? a. b. c. d.

Most mental disorders are the result of genetic abnormalities. We do not currently know all of the specific causes of most mental disorders. Unconscious factors have been overlooked as the root cause of mental disorders. Environmental factors have been overlooked in the wake of recent findings on biological etiologies. Difficulty: 2 Question ID: 2.1.6 Page Reference: 24 Topic: Overview Skill: Conceptual Answer: b. We do not currently know all of the specific causes of most mental disorders.

2.1.7.

The case of Meghan B. in your text illustrates

a. b. c. d.

many plausible alternative causes. that disorders can often have a single cause. the importance of genetic factors. how objective tools can be used to pinpoint causation. Difficulty: 1 Question ID: 2.1.7 Page Reference: 25 Topic: Overview Skill: Conceptual Answer: a. many plausible alternative causes.

2.1.8. The search for explanations of the etiology of abnormal behavior dates to ancient times. It was not until the 19th and 20th centuries that three major advances occurred. Which of the following is NOT one of these advances? a. b. c. d.

The discovery of the cause of general paresis. The work of Sigmund Freud. The development of the germ theory. The development of academic psychology. Difficulty: 1 Question ID: 2.1.8 Page Reference: 25 Topic: Brief Historical Perspective Skill: Factual Answer: c. The development of the germ theory.

2.1.9. The discovery of the etiology of which disorder was an important scientific advance for the biological paradigm? a. b. c. d.

general paresis Alzheimer's disease bipolar mood disorder dissociative identity disorder Difficulty: 1 Question ID: 2.1.9 Page Reference: 25 Topic: Brief Historical Perspective Skill: Factual Answer: a. general paresis

2.1.10. A physician at a hospital in the late 1800s has read about the disease called general paresis. Which of the following patients is most likely to receive such a diagnosis? a. b. c. d.

Alice, whose symptoms include restlessness and agitation Brenda, whose symptoms include insomnia and obsessiveness Bob, whose symptoms include lack of appetite and thoughts of suicide Al, whose symptoms include delusions of grandeur and progressive paralysis Difficulty: 2 Question ID: 2.1.10 Page Reference: 25 Topic: Brief Historical Perspective Skill: Applied Answer: d. Al, whose symptoms include delusions of grandeur and progressive paralysis

2.1.11. The correct biological explanation for general paresis a. b. c. d.

was discovered very quickly. is still a mystery to scientists. will never be discovered. was only discovered after more than 100 years of study. Difficulty: 1 Question ID: 2.1.11 Page Reference: 25 Topic: Brief Historical Perspective Skill: Factual Answer: d. was only discovered after more than 100 years of study.

2.1.12. Confirming a specific biological cause of general paresis was greatly aided by eventually discovering that a. b. c. d.

all such patients had a history of syphilis. most such patients developed syphilis later in life. very few such patients had ever been treated with penicillin. most such patients had lied about their sexual history. Difficulty: 2 Question ID: 2.1.12 Page Reference: 25-26 Topic: Brief Historical Perspective Skill: Conceptual Answer: a. all such patients had a history of syphilis.

2.1.13. General paresis was virtually eliminated because a. b. c. d.

the patients died before they could have children. antibiotics were developed to treat syphilis. most older patients now develop Alzheimer's disease. psychiatrists developed the tools to diagnose it. Difficulty: 1 Question ID: 2.1.13 Page Reference: 26 Topic: Brief Historical Perspective Skill: Factual Answer: b. antibiotics were developed to treat syphilis.

2.1.14. You are reading a biography of Sigmund Freud and find that he was trained as a a. b. c. d.

neurologist. psychiatrist. clinical psychologist. counseling psychologist. Difficulty: 1 Question ID: 2.1.14 Page Reference: 26 Topic: Brief Historical Perspective Skill: Factual Answer: a. neurologist.

2.1.15. Both Jean Charcot and Sigmund Freud focused on a disorder called hysteria. Which of the following patients is most likely to have received this diagnosis from these two well-known clinicians? a. b. c. d.

Hazel, who experiences delusions Amy, who screams during bouts of "night terrors" Laura, whose "blindness" has no organic explanation Zelda, who cannot sit still for more than 5 seconds Difficulty: 1 Question ID: 2.1.15 Page Reference: 26 Topic: Brief Historical Perspective Skill: Conceptual Answer: c. Laura whose "blindness" has no organic explanation

2.1.16. According to Sigmund Freud, what are the three parts of the mind? a. b. c. d.

id, ego, superego oral, anal, phallic reality, pleasure, spiritual conscious, preconscious, unconscious Difficulty: 1 Question ID: 2.1.16 Page Reference: 26 Topic: Brief Historical Perspective Skill: Factual Answer: a. id, ego, superego

2.1.17. In psychoanalytic theory, sexual and aggressive drives are part of the a. b. c. d.

id. ego. superego. conscience. Difficulty: 2 Question ID: 2.1.17 Page Reference: 26 Topic: Brief Historical Perspective Skill: Conceptual Answer: a. id.

2.1.18. According to Freudian theory, what part of the mind is roughly equivalent to the conscience? a. b. c. d.

id ego libido superego Difficulty: 1 Question ID: 2.1.18 Page Reference: 27 Topic: Brief Historical Perspective Skill: Factual Answer: d. superego

2.1.19. According to Freudian theory, the reality principle is the framework of operation for the a. b. c. d.

id. ego. superego. conscience. Difficulty: 1 Question ID: 2.1.19 Page Reference: 26 Topic: Brief Historical Perspective Skill: Factual Answer: b. ego.

2.1.20. According to Sigmund Freud, what is the purpose of defense mechanisms? a. b. c. d.

to reduce anxiety to establish reality contact to develop self actualization to reduce reliance on social support Difficulty: 1 Question ID: 2.1.20 Page Reference: 27 Topic: Brief Historical Perspective Skill: Conceptual Answer: a. to reduce anxiety

2.1.21. According to Sigmund Freud, how does a boy resolve forbidden sexual desire for his mother? a. b. c. d.

by becoming attracted to girls by identifying with his father by developing an Electra complex by developing aggressive urges toward his mother Difficulty: 1 Question ID: 2.1.21 Page Reference: 27 Topic: Brief Historical Perspective Skill: Factual Answer: b. by identifying with his father

2.1.22. When we are around someone we dislike intensely we often "bend over backward" to be nice to this individual. Which defense mechanism is illustrated here? a. b. c. d.

denial projection sublimation reaction formation Difficulty: 1 Question ID: 2.1.22 Page Reference: 27 Topic: Brief Historical Perspective Skill: Conceptual Answer: d. reaction formation

2.1.23. You get a paper back and briefly feel angry at the low grade you received, but this feeling is upsetting because you like the professor so much. You quickly turn your attention to other matters. Later that day you pick a fight with your roommate because of the unfair manner in which the week's chores were divided. This fight could be an example of a defense mechanism called a. b. c. d.

projection. sublimation. displacement. rationalization. Difficulty: 1 Question ID: 2.1.23 Page Reference: 27 Topic: Brief Historical Perspective Skill: Conceptual Answer: c. displacement.

2.1.24. Who is credited with beginning the modern science of psychology at the University of Leipzig? a. b. c. d.

Ivan Pavlov Wilhelm Wundt B. F. Skinner Sigmund Freud Difficulty: 1 Question ID: 2.1.24 Page Reference: 27-28 Topic: Brief Historical Perspective Skill: Factual Answer: b. Wilhelm Wundt

2.1.25. The textbook suggests that Freud’s ideas were a. b. c. d.

scientifically valid. metaphors. of little value. dangerous. Difficulty: 1 Question ID: 2.1.25 Page Reference: 27 Topic: Brief Historical Perspective Skill: Factual Answer: b. metaphors.

2.1.26. The cognitive-behavioral paradigm views all of the following as the product of learning except a. b. c. d.

abnormal behavior. normal behavior. unconscious processes. mental disorders. Difficulty: 3 Question ID: 2.1.26 Page Reference: 27-28 Topic: Brief Historical Perspective Skill: Applied Answer: c. unconscious processes

2.1.27. Ivan Pavlov rang a bell every time he fed meat powder to dogs. After repeated trials, the dogs began to salivate when they heard the bell, even if there was no food in sight. According to Pavlov, the dogs' salivation in the absence of food, following the ringing of the bell, is called the a. b. c. d.

conditioned stimulus. conditioned response. unconditioned stimulus. unconditioned response. Difficulty: 2 Question ID: 2.1.27 Page Reference: 28 Topic: Brief Historical Perspective Skill: Factual Answer: b. conditioned response.

2.1.28. Beth received a painful shock while turning on her television. Now she reacts with fear whenever she sees a television. What is the television in this example? a. b. c. d.

neutral stimulus reinforced stimulus conditioned stimulus unconditioned stimulus Difficulty: 2 Question ID: 2.1.28 Page Reference: 28 Topic: Brief Historical Perspective Skill: Applied Answer: c. conditioned stimulus

2.1.29. According to Ivan Pavlov's ideas on classical conditioning, extinction occurs when a conditioned stimulus is no longer presented along with a. b. c. d.

a negative reinforcer. a conditioned response. an unconditioned response. an unconditioned stimulus. Difficulty: 1 Question ID: 2.1.29 Page Reference: 28 Topic: Brief Historical Perspective Skill: Factual Answer: d. an unconditioned stimulus.

2.1.30. What is the primary concept in operant conditioning? a. b. c. d.

a conditioned stimulus is neutral conditioned response leads to extinction behavior is determined by its consequences negative reinforcement is the same as punishment Difficulty: 2 Question ID: 2.1.30 Page Reference: 28 Topic: Brief Historical Perspective Skill: Factual Answer: c. behavior is determined by its consequences

2.1.31. According to the principles of operant conditioning, what happens when negative reinforcement is applied? a. b. c. d.

behavior increases behavior decreases behavior is punished behavior remains at the same level Difficulty: 3 Question ID: 2.1.31 Page Reference: 28 Topic: Brief Historical Perspective Skill: Conceptual Answer: a. behavior increases

2.1.32. Your neighbors are playing loud music late at night and it annoys you. You ask them to turn down the music and they do. The next time they play loud music, you call them even sooner. B. F. Skinner would say this happens because a. b. c. d.

your assertiveness is like a punishment. the noise was an unconditioned stimulus. the decreased noise negatively reinforced your assertiveness. the decreased noise positively reinforced your assertiveness. Difficulty: 2 Question ID: 2.1.32 Page Reference: 28 Topic: Brief Historical Perspective Skill: Applied Answer: c. the decreased noise negatively reinforced your assertiveness.

2.1.33. John B. Watson was best known for a. b. c. d.

founding humanism. promoting behaviorism. developing the theory of modeling. developing the theory of operant conditioning. Difficulty: 1 Question ID: 2.1.33 Page Reference: 28 Topic: Brief Historical Perspective Skill: Factual Answer: b. promoting behaviorism.

2.1.34. Mary and Jim took their two-year-old to the supermarket this past week. For more than an hour all Little Jimmy did was yell and scream because in the past this would have obtained him an ice cream cone. Jim managed to ignore him. Finally, Little Jimmy stopped yelling and screaming. What operant conditioning concept is illustrated by this story? a. b. c. d.

shaping extinction punishment token economy Difficulty: 2 Question ID: 2.1.34 Page Reference: 28 Topic: Brief Historical Perspective Skill: Applied Answer: b. extinction

2.1.35. Though easily confused, negative reinforcement and punishment are quite different; with negative reinforcement, behavior __________ when the aversive stimulus is ____________, and with punishment, behavior __________ when the aversive stimulus is ____________. a. b. c. d.

increases; removed; increases; introduced increases; removed; decreases; introduced decreases; removed; increases; introduced decreases; introduced; increases; removed Difficulty: 2 Question ID: 2.1.35 Page Reference: 28 Topic: Brief Historical Perspective Skill: Applied

Answer: b. increases; removed; decreases; introduced

2.1.36. Watson made the very important assumption that all behavior is a. b. c. d.

under the control of free will. inborn rather than learned. the result of hidden desires and unconscious conflicts. a result of learning. Difficulty: 1 Question ID: 2.1.36 Page Reference: 28 Topic: Brief Historical Perspective Skill: Factual Answer: d. a result of learning.

2.1.37. Humanistic psychologists objected to the biological, psychoanalytic, and behavioral theories of abnormal behavior because these other approaches assume that a. b. c. d.

free will exists. behavior is a paradigm. human nature is inherently good. behavior is predictably determined. Difficulty: 1 Question ID: 2.1.37 Page Reference: 28 Topic: Brief Historical Perspective Skill: Factual Answer: d. behavior is predictably determined.

2.1.38. Which paradigm views human nature as basically good, attributes abnormal behavior to frustrations of society, and uses nondirective therapy to treat abnormal behavior? a. b. c. d.

biomedical humanistic psychoanalytic cognitive behavioral Difficulty: 1 Question ID: 2.1.38 Page Reference: 28 Topic: Brief Historical Perspective Skill: Conceptual Answer: b. humanistic

2.1.39. Who is the historian and philosopher who has written about the nature of paradigms? a. b. c. d.

Sigmund Freud Karl Byron Thomas Kuhn John Watson Difficulty: 1 Question ID: 2.1.39 Page Reference: 28 Topic: Brief Historical Perspective Skill: Conceptual Answer: c. Thomas Kuhn.

2.1.40. What is the purpose of the enigma written by Lord Byron that was included in the text? a. b. c. d.

to show how writing can reveal one's unconscious memories to provide an example of the integration of different etiologies to reveal how paradigms can either help or hinder our search for answers to demonstrate that a psychotic process can often be uncovered in the words of even greater writers Difficulty: 2 Question ID: 2.1.40 Page Reference: 29 Topic: Brief Historical Perspective Skill: Conceptual Answer: c. to reveal how paradigms can either help or hinder our search for answers

2.1.41. All four of the paradigms presented in your text make assumptions about the causes of abnormal behavior that can be too a. b. c. d.

broad. narrow. untestable. vague. Difficulty: 1 Question ID: 2.1.41 Page Reference: 29 Topic: Brief Historical Perspective Skill: Conceptual Answer: b. narrow.

2.1.42. Holism is the idea that a. b. c. d.

humans have free will. behavior is determined. human nature is basically good. the whole is more than the sum of its parts. Difficulty: 1 Question ID: 2.1.42 Page Reference: 29 Topic: Systems Theory Skill: Factual Answer: d. the whole is more than the sum of its parts.

2.1.43. The idea that ultimate explanations for abnormal behavior are found when problems are analyzed in terms of their smallest components is known as a. b. c. d.

deduction. paradigms. determinism. reductionism. Difficulty: 3 Question ID: 2.1.43 Page Reference: 29 Topic: Systems Theory Skill: Factual Answer: d. reductionism.

2.1.44. Thinking of the different academic disciplines as representing different levels of analysis in trying to understand the causes of abnormal behavior, systems theory asserts that a. b. c. d.

no single academic discipline has a corner on the truth. the molar level is more helpful than the molecular level. the molecular level is more helpful than the molar level. only the molar level lends itself to rigorous research. Difficulty: 1 Question ID: 2.1.44 Page Reference: 29 Topic: Systems Theory Skill: Applied Answer: a. no single academic discipline has a corner on the truth.

2.1.45. A newspaper headline heralds a finding that an excess of a particular brain chemical is the cause of a certain mental disorder. The article is not convincing to you. What potential flaw do you note in the report? a. b. c. d.

The chemical change could be due to other variables. Chemical changes cannot bring about changes in behavior. The genetic code associated with the chemical has not been identified. Such findings are very difficult to generalize to the entire population. Difficulty: 1 Question ID: 2.1.45 Page Reference: 30 Topic: Systems Theory Skill: Conceptual Answer: a. The chemical change could be due to other variables.

2.1.46. Which of the following correlation coefficients indicates the strongest association between two variables? a. b. c. d.

-0.74 -0.15 +0.26 +0.62 Difficulty: 2 Question ID: 2.1.46 Page Reference: 30 Topic: Systems Theory Skill: Conceptual Answer: a. -0.74

2.1.47. The correlation between scores on a measure of hostility and age at death is -.64. We could conclude from this correlation coefficient that people a. b. c. d.

with high hostility scores tend to live longer. who have low hostility scores tend to die younger. who have high hostility scores tend to die younger. who have low hostility scores die 64 percent sooner than those with high hostility scores. Difficulty: 3 Question ID: 2.1.47 Page Reference: 30 Topic: Systems Theory Skill: Applied Answer: c. who have high hostility scores tend to die younger.

2.1.48. Assume that variables X and Y are significantly correlated; the concept of reverse causality tells us that a. b. c. d.

X causes Y but not the reverse. Y causes X but not the reverse. X might cause Y or Y might cause X. X causes Y and Y causes X. Difficulty: 3 Question ID: 2.1.48 Page Reference: 30 Topic: Systems Theory Skill: Conceptual Answer: c. X might cause Y or Y might cause X.

2.1.49. Assume that variables X and Y are significantly correlated; the third variable problem means that a. b. c. d.

the correlation could be explained by their joint relation with some other factor. another variable must correlate with X but not Y. another variable must correlate with Y but not X. X causes Y and Y causes X. Difficulty: 2 Question ID: 2.1.49 Page Reference: 30 Topic: Systems Theory Skill: Conceptual Answer: a. the correlation could be explained by their joint relation with some other factor.

2.1.50. A study has found a positive correlation between smoking cigarettes and schizophrenia. Which is/are possible explanations for this finding? a. b. c. d.

A third variable could be causing both. Some property of nicotine could be part of the cause of schizophrenia. Something about the nature of schizophrenia could be a factor in the cause of smoking. All of the above are possible explanations for this finding. Difficulty: 3 Question ID: 2.1.50 Page Reference: 30 Topic: Systems Theory Skill: Applied Answer: d. All of the above are possible explanations for this finding.

2.1.51. The principle of equifinality, or the concept of multiple pathways, means that a. b. c. d.

many risk factors might be involved in a disorder's etiology. disorders must always be explained in terms of many different risk factors. a diathesis must always be combined with some form of stress. the same risk factors can produce many different disorders. Difficulty: 2 Question ID: 2.1.51 Page Reference: 31 Topic: Systems Theory Skill: Factual Answer: a. many risk factors might be involved in a disorder's etiology.

2.1.52. Which of the following best illustrates reciprocal causality? a. b. c. d.

Parents influence their children and are also influenced by their own parents. Parents influence their children both through heredity and through socialization. Parents influence their children and children influence their parents. Children are influenced both by their parents and by their peers. Difficulty: 2 Question ID: 2.1.52 Page Reference: 32 Topic: Systems Theory Skill: Factual Answer: c. Parents influence their children and children influence their parents.

2.1.53. What is a diathesis? a. b. c. d.

a form of stress a predisposition a biological cause of mental illness an observable symptom of mental illness Difficulty: 1 Question ID: 2.1.53 Page Reference: 31 Topic: Systems Theory Skill: Factual Answer: b. a predisposition

2.1.54. Some researchers view alcoholism as the result of a genetic predisposition to be addicted to alcohol plus life experiences that drive a person to drink more and more. This type of analysis is an example of a. b. c. d.

circular thinking. biological etiology. the diathesis-stress model. the nature-nurture controversy. Difficulty: 2 Question ID: 2.1.54 Page Reference: 31 Topic: Systems Theory Skill: Conceptual Answer: c. the diathesis-stress model.

2.1.55. Developmental psychopathology is a new approach to abnormal psychology that emphasizes the importance of analyzing behavior in terms of a. b. c. d.

cybernetics. early childhood trauma. learned patterns that are ingrained over time. comparisons of individual behavior to age-based norms. Difficulty: 2 Question ID: 2.1.55 Page Reference: 32 Topic: Systems Theory Skill: Factual Answer: d. comparisons of individual behavior to age-based norms.

2.1.56. What term is used to describe the pattern of behavior that is apparent before a disorder develops? a. b. c. d.

premorbid history prognosis homeostasis developmental history Difficulty: 2 Question ID: 2.1.56 Page Reference: 32 Topic: Systems Theory Skill: Factual Answer: a. premorbid history

2.1.57. You are watching a movie about a mental hospital. In one scene two mental health professionals are talking about a patient. One of them asks about the patient's prognosis. The response to this question will deal with the patient's a. b. c. d.

diagnosis. predicted course. premorbid history. developmental norm. Difficulty: 1 Question ID: 2.1.57 Page Reference: 32 Topic: Systems Theory Skill: Factual Answer: b. predicted course.

2.1.58. Neuroanatomy focuses on brain _________ while neurophysiology focuses on brain __________. a. b. c. d.

functions; structures structures; functions dendrites; axons axons; dendrites Difficulty: 1 Question ID: 2.1.58 Page Reference: 32 Topic: Biological Factors Skill: Factual Answer: b. structures; functions

2.1.59. Which of the following is NOT a part of a neuron? a. b. c. d.

dendrite nerve axon soma Difficulty: 1 Question ID: 2.1.59 Page Reference: 32 Topic: Biological Factors Skill: Factual Answer: b. nerve

2.1.60. A synapse is a a. b. c. d.

cell body. nerve cell. chemical substance in the brain. fluid-filled gap between neurons. Difficulty: 2 Question ID: 2.1.60 Page Reference: 32 Topic: Biological Factors Skill: Factual Answer: d. fluid-filled gap between neurons.

2.1.61. How is information transmitted between nerve cells? a. b. c. d.

by release of neurotransmitters at the synapse by release of neurotransmitters along the axon by changes in electrical potential along the axon by changes in electrical potential in the synapse Difficulty: 1 Question ID: 2.1.61 Page Reference: 32-33 Topic: Biological Factors Skill: Factual Answer: a. by release of neurotransmitters at the synapse

2.1.62. A report of research on physiological psychology contains a description of a substance that can influence communication among neurons and can act some distance from where the substance was released. What is the topic of this report? a. b. c. d.

axons humors neuromodulators neurotransmitters Difficulty: 2 Question ID: 2.1.62 Page Reference: 33 Topic: Biological Factors Skill: Conceptual Answer: c. neuromodulators

2.1.63. What is the process by which some neurotransmitters in the synapse return to the axon terminals of the neuron that released them? a. b. c. d.

reuptake regeneration neuromodulation neuroregeneration Difficulty: 1 Question ID: 2.1.63 Page Reference: 33 Topic: Biological Factors Skill: Factual Answer: a. reuptake

2.1.64. Chemicals that may be released from neurons or from endocrine glands and that affect the functioning of neurotransmitters are known as a. b. c. d.

adrenotransmitters. neuromodulators. reuptake inhibitors. reuptake facilitators. Difficulty: 2 Question ID: 2.1.64 Page Reference: 33 Topic: Biological Factors Skill: Factual Answer: b. neuromodulators.

2.1.65. All of the following have been suggested as a way that neurotransmitters could play a role in abnormal behavior except a. b. c. d.

an oversupply of a certain neurotransmitter. an undersupply of a neurotransmitter. faulty genes that misfold the proteins that make up a given neurotransmitter. a disturbance in the reuptake mechanism for a given neurotransmitter. Difficulty: 1 Question ID: 2.1.65 Page Reference: 33 Topic: Biological Factors Skill: Conceptual Answer: c. faulty genes that misfold the proteins that make up a given neurotransmitter.

2.1.66. Dualism refers to the out-of-date idea that a. b. c. d.

mind and body are separate. the whole is more than the sum of its parts. the brain is made up of structures and functions. behavior is influenced by free will and determinism. Difficulty: 2 Question ID: 2.1.66 Page Reference: 34 Topic: Biological Factors Skill: Factual Answer: a. mind and body are separate.

2.1.67. Which of the following neurotransmitters was first implicated in the development of schizophrenia? a. b. c. d.

GABA dopamine serotonin norepinephrine Difficulty: 1 Question ID: 2.1.67 Page Reference: 33 Topic: Biological Factors Skill: Factual Answer: b. dopamine

2.1.68. Basic bodily functions such as heart rate, blood pressure, and respiration are regulated by which region of the brain? a. b. c. d.

pons medulla midbrain corpus callosum Difficulty: 1 Question ID: 2.1.68 Page Reference: 34 Topic: Biological Factors Skill: Factual Answer: b. medulla

2.1.69. A police officer pulls over a driver suspected of driving under the influence of alcohol. The driver is asked to exit the car and walk a straight line. This test is designed to detect the effects of alcohol on the a. b. c. d.

cerebellum. hypothalamus. temporal lobe. limbic system. Difficulty: 1 Question ID: 2.1.69 Page Reference: 34 Topic: Biological Factors Skill: Applied Answer: a. cerebellum.

2.1.70. Evidence that effective treatments for depression inhibit the reuptake of a neurotransmitter links a depletion of that neurotransmitter to mood disorders. That neurotransmitter is a. b. c. d.

dopamine. GABA. serotonin. Prozac. Difficulty: 2 Question ID: 2.1.70 Page Reference: 33 Topic: Biological Factors Skill: Applied Answer: c. serotonin

2.1.71. The ________ is involved with some motor activities associated with fighting and sexual behavior. a. b. c. d.

midbrain forebrain hindbrain corpus callosum Difficulty: 1 Question ID: 2.1.71 Page Reference: 34 Topic: Biological Factors Skill: Factual Answer: a. midbrain

2.1.72. Changes in the brains of individuals with Alzheimer's disease have been found, but they are of limited value because a. b. c. d.

they are too similar to the changes seen in Parkinson's disease. they can only be seen by very expensive imaging techniques. they appear in women, but not men. they are only seen during autopsy. Difficulty: 2 Question ID: 2.1.72 Page Reference: 37 Topic: Biological Factors Skill: Factual Answer: d. they are only seen during autopsy.

2.1.73. The reticular activating system regulates a. b. c. d.

eating and drinking. sleeping and waking. sex drive and eating. aggression and emotions. Difficulty: 2 Question ID: 2.1.73 Page Reference: 34 Topic: Biological Factors Skill: Factual Answer: b. sleeping and waking.

2.1.74. Which region of the brain plays a key role in regulating emotion? a. b. c. d.

cerebellum limbic system corpus callosum reticular activating system Difficulty: 1 Question ID: 2.1.74 Page Reference: 34 Topic: Biological Factors Skill: Factual Answer: b. limbic system

2.1.75. Which of the following is most likely to be affected by a tumor on the hypothalamus? a. b. c. d.

creativity long-term memory motor coordination basic biological urges Difficulty: 2 Question ID: 2.1.75 Page Reference: 34 Topic: Biological Factors Skill: Applied Answer: d. basic biological urges

2.1.76. Your patient shows signs of restlessness, agitation, and anxiety. One of the first disorders to test for would be Graves’ disease, so you order tests of a. b. c. d.

dopamine levels. blood sugar levels. thyroid function. cerebral blood flow. Difficulty: 3 Question ID: 2.1.76 Page Reference: 37 Topic: Biological Factors Skill: Applied Answer: c. thyroid function.

2.1.77. Researchers are interested in the ventricles in the brain because a. b. c. d.

they become enlarged in some disorders. they fill with cerebrospinal fluid. they are often found to be absent in people with severe mental disorders. they connect the forebrain, midbrain, hindbrain, and cerebellum. Difficulty: 2 Question ID: 2.1.77 Page Reference: 37 Topic: Biological Factors Skill: Conceptual Answer: a. they become enlarged in some disorders.

2.1.78. The region of the brain responsible for the regulation of emotion and some aspects of learning, memory, and language reception is called the a. b. c. d.

occipital love. cerebellum. corpus callosum. temporal lobe. Difficulty: 3 Question ID: 2.1.78 Page Reference: 35 Topic: Biological Factors Skill: Factual

Answer: d. temporal lobe

2.1.79. If blood vessels in the brain rupture, cutting off the supply of oxygen to parts of the brain and thereby killing surrounding brain tissue, the person is said to have suffered a a. b. c. d.

stroke. broken ventricle. tangle of neurons. nervous breakdown. Difficulty: 1 Question ID: 2.1.79 Page Reference: 36 Topic: Biological Factors Skill: Factual Answer: a. stroke.

2.1.80. A patient has just undergone a complete examination of the brain using the most sophisticated imaging tools available. The neurosurgeon found a tumor in the frontal lobe. Which of the following is most likely to be affected by this tumor? a. b. c. d.

sleep biological urges reasoning and planning hearing and vision Difficulty: 2 Question ID: 2.1.80 Page Reference: 36 Topic: Biological Factors Skill: Applied

Answer: c. reasoning and planning

2.1.81. If you focused your research efforts on problems associated with psychophysiological arousal, you would be interested in activity in the a. b. c. d.

endocrine system. brain stem and temporal lobes. the early signs of Alzheimer's disease and Korsakoff's syndrome. hormone levels and corpus callosum. Difficulty: 3 Question ID: 2.1.81 Page Reference: 37 Topic: Biological Factors Skill: Applied Answer: a. nervous and endocrine systems.

2.1.82. The endocrine system is a collection of a. b. c. d.

glands. neurons. ventricles. brain structures. Difficulty: 2 Question ID: 2.1.82 Page Reference: 37 Topic: Biological Factors Skill: Factual Answer: a. glands.

2.1.83. Chemical substances that affect the functioning of distant body systems and sometimes act as neuromodulators are known as a. b. c. d.

glands. ventricles. hormones. endocrines. Difficulty: 2 Question ID: 2.1.83 Page Reference: 37 Topic: Biological Factors Skill: Factual Answer: c. hormones.

2.1.84. Which of the following would be most likely to be observed in a patient whose thyroid gland is secreting too much of the hormone thyroxin? a. b. c. d.

Alzheimer's disease schizophrenia agitation and anxiety low levels of motivation and sexual desire Difficulty: 2 Question ID: 2.1.84 Page Reference: 37 Topic: Biological Factors Skill: Factual Answer: c. agitation and anxiety

2.1.85. What are the two components of the central nervous system? a. b. c. d.

brain and spinal cord somatic and autonomic systems corpus callosum and cerebellum sympathetic and parasympathetic systems Difficulty: 1 Question ID: 2.1.85 Page Reference: 37-38 Topic: Biological Factors Skill: Factual Answer: a. brain and spinal cord

2.1.86. In the autonomic nervous system, increased arousal and energy expenditure are associated with activation of the a. b. c. d.

somatic nervous system. central nervous system. sympathetic nervous system. parasympathetic nervous system. Difficulty: 3 Question ID: 2.1.86 Page Reference: 38 Topic: Biological Factors Skill: Factual Answer: c. sympathetic nervous system.

2.1.87. Theories that attempt to link psychophysiology to the etiology of psychopathology have implicated a. b. c. d.

both overarousal and underarousal. only overarousal. both overmodulation and undermodulation. only overmodulation. Difficulty: 2 Question ID: 2.1.87 Page Reference: 38 Topic: Biological Factors Skill: Conceptual Answer: a. both overarousal and underarousal.

2.1.88. Your neighbor is a behavior geneticist. When you ask her to describe her discipline, what is she likely to say? a. b. c. d.

the computer driven study of genotypes a search for various biochemical abnormalities investigation of the hereditary functions of specific genes a broad approach that studies genetic influences on behavior Difficulty: 3 Question ID: 2.1.88 Page Reference: 38 Topic: Biological Factors Skill: Conceptual Answer: d. a broad approach that studies genetic influences on behavior

2.1.89. Genes are all of the following EXCEPT a. b. c. d.

small units of DNA. composed of proteins. carriers of genetic information. located on chromosomes. Difficulty: 1 Question ID: 2.1.89 Page Reference: 38 Topic: Biological Factors Skill: Factual Answer: b. composed of proteins.

2.1.90. What is a phenotype? a. b. c. d.

a genetic structure a set of observable traits a pattern of dominant and recessive genes a description of a chromosomal abnormality Difficulty: 2 Question ID: 2.1.90 Page Reference: 39 Topic: Biological Factors Skill: Factual Answer: b. a set of observable traits

2.1.91. Genes have alternative forms known as a. b. c. d.

phenotypes. genotypes. alleles. genosomes. Difficulty: 3 Question ID: 2.1.91 Page Reference: 39 Topic: Biological Factors Skill: Factual Answer: c. alleles.

2.1.92. Suppose that researchers discover the gene responsible for manic behavior. Assume that the alleles of the gene are represented by M and m and the gene is dominant/recessive. Which of the following represents the phenotype? a. b. c. d.

the M allele the m allele manic behavior the combination of the M and m alleles Difficulty: 3 Question ID: 2.1.92 Page Reference: 39 Topic: Biological Factors Skill: Applied Answer: c. manic behavior

2.1.93. Most theories developed by behavior geneticists to pin down genetic explanations for abnormal behavior assume that mental disorders are most likely a. b. c. d.

polygenic; that is, caused by a single gene. polygenic; that is, caused by multiple genes. autosomal; that is, caused by a single gene. autosomal; that is, caused by multiple genes. Difficulty: 2 Question ID: 2.1.93 Page Reference: 39 Topic: Biological Factors Skill: Conceptual Answer: b. polygenic; that is, caused by multiple genes.

2.1.94. What is another name for a proband? a. b. c. d.

carrier index case identical twin fraternal twin Difficulty: 3 Question ID: 2.1.94 Page Reference: 39 Topic: Biological Factors Skill: Factual Answer: b. index case

2.1.95. The major problem with family incidence studies that ask whether diseases "run in families" is that even when they find a higher prevalence of a certain illness in families with one ill proband a. b. c. d.

they cannot determine if a single gene or multiple genes are involved. they cannot determine if dominant genes or recessive genes are involved. the finding is consistent with both genetic and environmental causation. they can only study families where there are identical twins. Difficulty: 3 Question ID: 2.1.95 Page Reference: 39 Topic: Biological Factors Skill: Conceptual Answer: c. the finding is consistent with both genetic and environmental causation.

2.1.96. As more genes are involved in determining a trait, what happens to the distribution of the trait in the general population? a. b. c. d.

It occurs more often in each generation. It occurs less frequently with each generation. The trait tends to be distributed in a bimodal manner. The trait tends to be distributed as a normal distribution. Difficulty: 3 Question ID: 2.1.96 Page Reference: 39 Topic: Biological Factors Skill: Conceptual Answer: d. The trait tends to be distributed as a normal distribution.

2.1.97. In twin studies the key comparison involves determining how many pairs of twins either have the same disorder or are free of the disorder; this involves the calculation of a. b. c. d.

discordance rates. concordance rates. shared environment rates. nonshared environment rates. Difficulty: 2 Question ID: 2.1.97 Page Reference: 39 Topic: Biological Factors Skill: Factual Answer: b. concordance rates.

2.1.98. Similar concordance rates for a given trait in monozygotic (MZ) and dizygotic (DZ) twins suggests that the trait may be due to a. b. c. d.

genetic causes. endocrine causes. environmental causes. phonotypical causes. Difficulty: 3 Question ID: 2.1.98 Page Reference: 40 Topic: Biological Factors Skill: Conceptual Answer: c. environmental causes.

2.1.99. In a study of twins, a researcher finds that 40 percent of dizygotic (DZ) twins and 40 percent of monozygotic (MZ) twins share a trait. What is the researcher most likely to conclude about the trait? a. b. c. d.

It is 40 percent concordant. It is 60 percent concordant. It is genetically determined. It is not genetically determined. Difficulty: 3 Question ID: 2.1.99 Page Reference: 40 Topic: Biological Factors Skill: Conceptual Answer: d. It is not genetically determined.

2.1.100. What is the most likely cause of a disorder if both monozygotic and dizygotic twins show a high concordance rate? a. b. c. d.

recessive genes dominant genes different environmental experiences shared environmental experiences Difficulty: 2 Question ID: 2.1.100 Page Reference: 40 Topic: Biological Factors Skill: Conceptual Answer: d. shared environmental experiences

2.1.101. Even when twin studies find that monzygotic twins have higher concordance rates than dizygotic twins, it is possible these results are not due to genetics but to the possibility that a. b. c. d.

DZ twins are usually treated very similarly. MZ twins may be treated more similarly than DZ twins. MZ twins are easier to locate and study. DZ twins are more likely to live in similar environments. Difficulty: 2 Question ID: 2.1.101 Page Reference: 40 Topic: Biological Factors Skill: Conceptual Answer: b. MZ twins may be treated more similarly than DZ twins.

2.1.102. Adoption studies are important in behavior genetics because they help to a. b. c. d.

investigate the effects of adoption. provide evidence on genetic versus environmental contributions. separate the MZ twins from the DZ twins. determine whether adoption can influence genetic makeup. Difficulty: 2 Question ID: 2.1.102 Page Reference: 40 Topic: Biological Factors Skill: Conceptual Answer: b. provide evidence on genetic versus environmental contributions.

2.1.103. A strong piece of evidence that genes alone do not cause the vast majority of mental disorders is that genetic studies a. b. c. d.

rely too much on twin studies and not enough on adoption studies. rely too much on adoption studies and not enough on twin studies. typically find concordance rates for DZ twins far below 100 percent. typically find concordance rates for MZ twins far below 100 percent. Difficulty: 2 Question ID: 2.1.103 Page Reference: 40 Topic: Biological Factors Skill: Conceptual Answer: d. typically find concordance rates for MZ twins far below 100 percent.

2.1.104. Which of the following would be a legitimate summary of the role of genes in causing abnormal behavior? a. b. c. d.

Single genes have been found for many mental disorders. Scientists have found the gene or genes responsible for only a few, rare forms of mental disorder. Scientists have not yet been able to locate any gene responsible for a mental disorder. The influence of genes is almost always greater than the influence of environment. Difficulty: 2 Question ID: 2.1.104 Page Reference: 40 Topic: Biological Factors Skill: Conceptual Answer: b. Scientists have found the gene or genes responsible for only a few, rare forms of mental disorder.

2.1.105. Dr. Andrew Wakefield has speculated that the measles/mumps/rubella vaccination may be responsible for 12 cases of autism. A Danish study of half a million children found a. b. c. d.

weak evidence to support this theory. strong evidence to support this theory. no evidence to support this theory. evidence that rubella itself is part of the cause of autism. Difficulty: 2 Question ID: 2.1.105 Page Reference: 41 Topic: Biological Factors Skill: Factual Answer: c. no evidence to support this theory.

2.1.106. In evolutionary psychology, which of the following would be a good description of natural selection? a. b. c. d.

Successful genetically determined adaptations become more common over successive generations. Successful genetically determined adaptations become less common over successive generations. Unsuccessful genetically determined adaptations become more common over successive generations. Successful genetically determined adaptations become more common in many other species. Difficulty: 3 Question ID: 2.1.106 Page Reference: 43 Topic: Psychological Factors Skill: Factual Answer: a. Successful genetically determined adaptations become more common over successive generations.

2.1.107. According to the concept of sexual selection, those characteristics that give males greater access to mates a. b. c. d.

are likely to become less common over successive generations. are likely to become more common over successive generations. lead to the development of similar characteristics in females. are also likely to make males less aggressive and less able to survive and reproduce. Difficulty: 2 Question ID: 2.1.107 Page Reference: 43 Topic: Psychological Factors Skill: Conceptual

Answer: b. are likely to become more common over successive generations.

2.1.108. You are watching a videotape of John Bowlby in which he discusses his views on attachment. Later you are to write a summary of Bowlby's comments and include the major reason why he believes that attachments form. What will you write? a. b. c. d.

They are reinforcing. They have survival value. They fulfill sexual and aggressive drives. They are a component of self actualization. Difficulty: 2 Question ID: 2.1.108 Page Reference: 43 Topic: Psychological Factors Skill: Conceptual Answer: b. They have survival value.

2.1.109. According to attachment theorists, why do anxious attachments develop during the first year of life? a. b. c. d.

modeling low self-actualization inconsistent and unresponsive parenting temperament differences Difficulty: 2 Question ID: 2.1.109 Page Reference: 44 Topic: Psychological Factors Skill: Conceptual Answer: c. inconsistent and unresponsive parenting

2.1.110. The observations of attachment theory and ethology suggest that ______________ has survival value. a. b. c. d.

proximity imitation affiliation social support Difficulty: 2 Question ID: 2.1.110 Page Reference: 43 Topic: Psychological Factors Skill: Conceptual

Answer: a. proximity

2.1.111. The two broad categories of social behaviors studied by ethologists are a. b. c. d.

imprinting and attachment. temperament and social learning. affiliation and dominance. extraversion and agreeableness. Difficulty: 1 Question ID: 2.1.111 Page Reference: 44 Topic: Psychological Factors Skill: Factual Answer: c. affiliation and dominance

2.1.112. While visiting your niece in the hospital, you see several other very young children. You observe one young child who is placid and smiles often, whereas another child seems to be very active and fussy. Such differences in style are often described as reflections of a. b. c. d.

imprinting. motivation. affiliation. temperament. Difficulty: 2 Question ID: 2.1.112 Page Reference: 44 Topic: Psychological Factors Skill: Factual Answer: d. temperament.

2.1.113. Which of the following is one of the five major personality traits that have been the focus of recent research? a. b. c. d.

dominance achievement extraversion responsibility Difficulty: 2 Question ID: 2.1.113 Page Reference: 44 Topic: Psychological Factors Skill: Factual

Answer: c. extraversion

2.1.114. Which of the following is NOT one of the “big five” dimensions of temperament? a. b. c. d.

agressiveness conscientiousness extraversion neuroticism Difficulty: 2 Question ID: 2.1.114 Page Reference: 44 Topic: Psychological Factors Skill: Applied Answer: a. agressiveness

2.1.115. Researchers have taken the hundreds of words for different feelings in the English language and have used statistical analysis to discover that a. b. c. d.

no two feelings are alike. they can reduce the list to six basic emotions. they can reduce the list to two basic emotions. anger is the strongest emotion. Difficulty: 1 Question ID: 2.1.115 Page Reference: 44 Topic: Psychological Factors Skill: Factual Answer: b. they can reduce the list to six basic emotions.

2.1.116. What conclusion follows from the finding that emotions are controlled primarily by subcortical brain structures? a. b. c. d.

Emotional responding may be more basic than cognition. In terms of evolution, emotions are a rather new development. Emotional responding requires the input of the cerebral cortex. Reduced memory capacity has led to expression of a limited number of emotions. Difficulty: 3 Question ID: 2.1.116 Page Reference: 44 Topic: Psychological Factors Skill: Applied Answer: a. Emotional responding may be more basic than cognition.

2.1.117. a. b. c. d.

Modeling is learning based on imitation. self actualization. operant conditioning. classical conditioning. Difficulty: 1 Question ID: 2.1.117 Page Reference: 45 Topic: Psychological Factors Skill: Factual Answer: a. imitation.

2.1.118. Some forms of psychopathology are associated with errors in attribution. Such errors involve a. b. c. d.

modeling. perceived causes. attachment processes. the identification process. Difficulty: 3 Question ID: 2.1.118 Page Reference: 45 Topic: Psychological Factors Skill: Factual Answer: b. perceived causes.

2.1.119. psychology. a. b. c. d.

People's beliefs about cause-effect relations are called ___________ in cognitive

causal beliefs attributions hallucinations cognitions Difficulty: 2 Question ID: 2.1.119 Page Reference: 45 Topic: Psychological Factors Skill: Conceptual Answer: b. attributions

2.1.120. Erikson's concept of _________ is an integrated sense of individuality, wholeness, and continuity. a. b. c. d.

ego self identity schema Difficulty: 1 Question ID: 2.1.120 Page Reference: 45 Topic: Psychological Factors Skill: Factual Answer: c. identity

2.1.121. Socialization is a process that leads a child to develop a. b. c. d.

identity. self-schema. self-concept. self-control.

Difficulty: 2 Question ID: 2.1.121 Page Reference: 46 Topic: Psychological Factors Skill: Factual Answer: d. self-control.

2.1.122. In their stage theories, Sigmund Freud focused on ________ stages while Erik Erikson focused on _________ stages. a. b. c. d.

psychological; biological unlearned; learned conscious; unconscious psychosexual; psychosocial Difficulty: 3 Question ID: 2.1.122 Page Reference: 46 Topic: Psychological Factors Skill: Conceptual Answer: d. psychosexual; psychosocial

2.1.123. What is an important characteristic of Erik Erikson's theory of psychosocial development? a. b. c. d.

There are no stages in development. Development does not end in adolescence. Children ages 5-12 are in a period of latency. Developmental changes are quantitative, not qualitative. Difficulty: 2 Question ID: 2.1.123 Page Reference: 46 Topic: Psychological Factors Skill: Factual Answer: b. Development does not end in adolescence.

2.1.124. What do proponents of labeling theory view as the cause of emotional disorders and abnormal behavior? a. b. c. d.

social expectations inadequate attachment irrational self schemas developmental transitions Difficulty: 2 Question ID: 2.1.124 Page Reference: 47 Topic: Social Factors Skill: Conceptual Answer: a. social expectations

2.1.125. A child overhears her teacher call her a "troublemaker." The child then stops trying to please the teacher, and actually gets in more trouble. The child's behavior is an example of a. b. c. d.

fixation. regression. a developmental transition. a self-fulfilling prophesy. Difficulty: 2 Question ID: 2.1.125 Page Reference: 47 Topic: Social Factors Skill: Applied Answer: d. a self-fulfilling prophesy.

2.1.126. What is the general finding concerning the relationship of marital status and psychopathology? a. b. c. d.

Marital status and psychopathology are not related. Marriage tends to increase the rate of psychopathology among both men and women. Marital status has an influence on the children of a marriage but not on the spouses. There is more psychopathology among divorced and never married people than among those who are married. Difficulty: 2 Question ID: 2.1.126 Page Reference: 47 Topic: Social Factors Skill: Factual Answer: d. There is more psychopathology among divorced and never married people than among those who are married.

2.1.127. Research suggests that one reason why many children facing troubled family circumstances are protected against the development of psychopathology is a. b. c. d.

social support from adults outside the family. that their parents still love them. their ability to learn to repress negative feelings. their agreeable temperament. Difficulty: 1 Question ID: 2.1.127 Page Reference: 47 Topic: Social Factors Skill: Factual Answer: a. social support from adults outside the family.

2.1.128. The higher rates of psychopathology among African Americans compared to whites that have been reported in many studies can probably be attributed to a. b. c. d.

cultural differences between groups. genetic factors. different experiences of poverty and prejudice. statistical miscalculations. Difficulty: 1 Question ID: 2.1.128 Page Reference: 48 Topic: Social Factors Skill: Conceptual Answer: c. different experiences of poverty and prejudice.

2.1.129. Which of the following is an example of how gender roles may influence psychopathology? a. b. c. d.

Mike cannot remember any of the details of an accident that killed two of his friends. Alice has developed a form of schizophrenia involving delusions related to television shows. Carol has been dependent on others for most of her life and has recently developed depression. Andy fears water as an adult after falling into a pool at the age of four. Difficulty: 1 Question ID: 2.1.129 Page Reference: 48 Topic: Social Factors Skill: Conceptual Answer: c. Carol has been dependent on others for most of her life and has recently developed depression.

2.1.130. The possession of both female and male gender role characteristics in one person is known as a. b. c. d.

hermaphrodism. androgyny. bisexuality. heterosexuality. Difficulty: 1 Question ID: 2.1.130 Page Reference: 48 Topic: Social Factors Skill: Factual Answer: b. androgyny

2.1.131. All of the following have been suggested as ways in which poverty could add to the rate of mental disorders except a. b. c. d.

living a life of poverty is inherently stressful. living in a poor section of a U.S. city can expose children to the stress of high crime rates. people with mental disorders gravitate to poorer areas of cities. poor areas of most U.S. cities have higher rates of toxins like lead. Difficulty: 2 Question ID: 2.1.131 Page Reference: 48 Topic: Social Factors Skill: Conceptual Answer: c. People with mental disorders gravitate to poorer areas of cities.

Short Answer 2.2.132. Many contemporary psychological scientists are guided by the __________ model, an effort to integrate research on various contributions to the causes of mental disorders. Difficulty: 2 Question ID: 2.2.132 Page Reference: 24 Topic: Overview Skill: Factual Answer: biopsychosocial

2.2.133. According to Freud the ego protects itself from anxiety by utilizing various __________ __________ that he saw as unconscious self-deceptions. Difficulty: 1 Question ID: 2.2.133 Page Reference: 27 Topic: Brief Historical Perspective: Twentieth Century Paradigms Skill: Factual Answer: defense mechanisms

2.2.134. In Freudian theory the part of the psyche that is present at birth and houses biological drives, such as hunger, as well as two key psychological drives, sex and aggression, is known as the __________. Difficulty: 1 Question ID: 2.2.134 Page Reference: 26 Topic: Brief Historical Perspective: Twentieth Century Paradigms Skill: Factual Answer: id

2.2.135. _____________ conditioning involves learning through association. Difficulty: 1 Question ID: 2.2.135 Page Reference: 28 Topic: Brief Historical Perspective: Twentieth Century Paradigms Skill: Factual Answer: Classical

2.2.136. ____________________ reinforcement is when the cessation of a stimulus increases the frequency of a behavior. Difficulty: 2 Question ID: 2.2.136 Page Reference: 28 Topic: Brief Historical Perspective: Twentieth Century Paradigms Skill: Factual Answer: Negative

2.2.137. Equifinality has a mirror concept, the principle of __________ which says that the same event can lead to different outcomes. Difficulty: 2 Question ID: 2.2.137 Page Reference: 31 Topic: Systems Theory Skill: Factual Answer: multifinality

2.2.138. A __________ is a predisposition toward developing a disorder, for example, an inherited tendency toward alcoholism. Difficulty: 1 Question ID: 2.2.138 Page Reference: 31 Topic: Systems Theory Skill: Factual Answer: diathesis

2.2.139. The __________ - __________ model suggests that mental disorders develop only when a stress is added on top of a predisposition. Difficulty: 1 Question ID: 2.2.139 Page Reference: 31 Topic: Systems Theory Skill: Factual

Answer: diathesis-stress

2.2.140. The basic building block of the brain, the cells that are most active are known as __________ . Difficulty: 1 Question ID: 2.2.140 Page Reference: 32 Topic: Biological Factors Skill: Factual Answer: neurons

2.2.141. Neurotransmitters are released into the synaptic gap and eventually come into contact with sites called __________ at the surface of the receiving neuron. Difficulty: 1 Question ID: 2.2.141 Page Reference: 32 Topic: Biological Factors Skill: Factual Answer: receptors

2.2.142. The __________ controls basic biological urges, such as eating, drinking, and sexual activity. Difficulty: 2 Question ID: 2.2.142 Page Reference: 34 Topic: Biologcial Factors Skill: Factual Answer: hypothalamus

2.2.143. Often one hemisphere of the brain serves a specialized role as the site of specific cognitive and emotional activities. The brain is said to be __________ . Difficulty: 2 Question ID: 2.2.143 Page Reference: 35 Topic: Biological Factors Skill: Factual Answer: lateralized

2.2.144. Endocrine glands produce psychophysiological responses by releasing __________ . Difficulty: 1 Question ID: 2.2.144 Page Reference: 37 Topic: Biological Factors Skill: Factual Answer: hormones

2.2.145. An individual's actual genetic makeup is known as her/his __________ . Difficulty: 2 Question ID: 2.2.145 Page Reference: 39 Topic: Biological Factors Skill: Factual Answer: genotype

2.2.146. _____________ have alternative forms known as alleles. Difficulty: 2 Question ID: 2.2.146 Page Reference: 39 Topic: Biological Factors Skill: Factual Answer: Genes

2.2.147. The textbook uses the example of “anxious” parents giving their children “anxiety” promoting genes and raising them in an environment of anxiety as an example of gene-environment ____________. Difficulty: 1 Question ID: 2.2.147 Page Reference: 42 Topic: Biological Factors Skill: Factual Answer: correlation

2.2.148. If a mental disorder has a genetic component to its cause, it is rarely caused by a single gene. Instead, it is said to be __________ . Difficulty: 2 Question ID: 2.2.148 Page Reference: 39 Topic: Biological Factors Skill: Factual Answer: polygenic

2.2.149. Genes are located on chainlike structures found in the nucleus of cells known as __________ Difficulty: 2 Question ID: 2.2.149 Page Reference: 38 Topic: Biological Factors Skill: Factual Answer: chromosomes

2.2.150. Family incidence studies ask whether diseases “run in families.” Investigators identify normal and ill __________ , or index cases, and tabulate the frequency with which other members of their families suffer from the same disorder. Difficulty: 2 Question ID: 2.2.150 Page Reference: 39 Topic: Biological Factors Skill: Factual Answer: probands

2.2.151. __________________ twins start when one sperm fertilizes one egg. They start off being genetically identical, having identical genotypes. Difficulty: 1 Question ID: 2.2.151 Page Reference: 39 Topic: Biological Factors Skill: Factual Answer: Monozygotic

2.2.152. Genetic influences on abnormal behavior are __________ (that is, increased risks), not predestinations or inevitabilities. Difficulty: 1 Question ID: 2.2.152 Page Reference: 42 Topic: Biological Factors Skill: Factual Answer: predispositions

2.2.153. The widely accepted idea that a combination of a genetic risk and an environmental stress causes emotional disorders is known as gene-environment __________ . Difficulty: 2 Question ID: 2.1.153 Page Reference: 42 Topic: Biological Factors Skill: Factual Answer: interaction

2.2.154. The application of the principles of evolution to understanding animal and human mind is at the heart of a new field known as evolutionary __________ . Difficulty: 1 Question ID: 2.2.154 Page Reference: 43 Topic: Biological Factors Skill: Factual Answer: psychology

2.2.155. Attachment theory is know mainly through the writing of John __________ . Difficulty: 1 Question ID: 2.2.155 Page Reference: 43 Topic: Psychological Factors Skill: Factual Answer: Bowlby

2.2.156. From the perspective of evolutionary psychology, __________ selection improves inclusive fitness through increased access to mates and mating. Difficulty: 2 Question ID: 2.2.156 Page Reference: 43 Topic: Psychological Factors Skill: Factual Answer: sexual

2.2.157. John Bowlby based his approach known as __________ theory on ethology, the study of animals in their natural habitat. Difficulty: 1 Question ID: 2.2.157 Page Reference: 43 Topic: Psychological Factors Skill: Factual Answer: attachment

2.2.158. One of the most important areas of study in individual differences is called __________ or characteristic styles of relating to the world. Difficulty: 1 Question ID: 2.2.158 Page Reference: 44 Topic: Psychological Factors Skill: Factual Answer: temperament

2.2.159. Having internal rules for guiding appropriate behavior is an important concept in research on abnormal behavior and is known as __________ __________ . Difficulty: 3 Question ID: 2.2.159 Page Reference: 46 Topic: Psychological Factors Skill: Factual Answer: self control

2.2.160. An important concept in cognitive psychology is that of perceived causes, or people's beliefs about cause-effect relations know as __________ . Difficulty: 2 Question ID: 2.2.160 Page Reference: 45 Topic: Psychological Factors Skill: Factual Answer: attributions

2.2.161. Labeling theory suggests that people’s actions conform to the expectations created by the label, a process known as __________ - __________ __________ . Difficulty: 2 Question ID: 2.2.161 Page Reference: 47 Topic: Social Factors Skill: Factual Answer: self-fulfilling prophecy

Essay 2.3.162. Describe how a paradigm can both direct and misdirect scientists. Difficulty: 2 Question ID: 2.3.162 Page Reference: 24 - 29 Topic: Overview Skill: Conceptual

Answer: A paradigm can suggest ways to look for answers to questions and the methodology to test ideas. On the other hand, a paradigm works under assumptions that may be appropriate for one theory but may hinder the discovery of solutions to other problems because of a limiting mindset.

2.3.163. Define reductionism. Discuss the limitations of the reductionistic idea that if a depletion of certain chemicals in the brain accompanies depression, then the depletion must be the cause of the depression. Difficulty: 2 Question ID: 2.3.163 Page Reference: 29 Topic: Systems Theory Skill: Conceptual

Answer: Reductionism is the belief that ultimate causes rest in the smallest unit of analysis. However, in the case of depression, just because chemicals are a small unit of analysis does not mean that they are a more likely causal element. Broader elements such as behavior, relationships, and negative cognitions associated with depression could also cause chemical changes in the brain.

2.3.164. Explain why it is not possible to assume that a correlation must indicate causation. Relate this to the correlation of depression with the depletion of neurotransmitters. Difficulty: 2 Question ID: 2.1.164 Page Reference: 30 Topic: Systems Theory Skill: Conceptual Answer: In interpreting any correlation, there are always two alternative explanations. Reverse causality means that if X and Y are correlated, X could cause Y but Y might also cause X. The third variable problem means that the correlation between X and Y could be explained by their joint relation with some unmeasured factor. Thus, even if there is a correlation between depression and the depletion of neurotransmitters, it's possible that the depletion causes the depression, but it's also possible that the depression causes the depletion. Moreover, both the depression and the depletion could come about as the result of stress.

2.3.165. Discuss the implications of the idea that most forms of psychopathology are polygenic. Difficulty: 3 Question ID: 2.3.165 Page Reference: 38-39 Topic: Systems Theory Skill: Conceptual Answer: Phenotypes produced by a single gene produce characteristics that are categorically different. Polygenic traits (caused by more than one gene) are continuously distributed, and thus polygenic abnormal traits are on a continuum with normal traits. This may make it difficult to determine the threshold of abnormality, which may be a question of degree rather than qualitative differences. What's more, when behavior geneticists find that a given mental disorder is "genetic," our interpretation must be cautious. This finding does not mean the disorder is caused by the presence or absence of one or two genes, nor does it confirm that the abnormal behavior is in a different category from normal behavior. 2.3.166. The assumption that the environment affects dizygotic (DZ) twins in the same way it influences monozygotic (MZ) twins has been criticized. Describe this criticism and the research methodology used to address it. Difficulty: 1 Question ID: 2.3.166 Page Reference: 39-40 Topic: Biological Factors Skill: Conceptual

Answer: The criticism is that there may be greater concordance among MZ twins in part because they are treated more similarity than are DZ twins. To address this concern, adoption studies have been conducted. If the concordance rate is higher for biological relatives than for adoptive relatives, this points to genetic involvement in the trait.

2.3.167. Summarize the evidence in the matter of the hypothesis that vaccinations contribute to the cause of autism. Difficulty: 1 Question ID: 2.3.167 Page Reference: 41 Topic: Biological Factors Skill: Factual Answer: In 1998 Andrew Wakefield and several other authors speculated that it was likely that MMR vaccinations were responsible for 12 cases of autism. They did not however base this on any empirical evidence. Since then several very large, empirical studies have looked for epidemiological evidence of a link between vaccinations and the rate of autism. For example a Danish study of one half million children found no statistical difference in the rate of autism between children who had received the suspect vaccination and children who hadn’t. The same conclusion was published by studies in the UK and Japan which also found no evidence of a link between vaccinations and autism.

2.3.168. Researchers have identified the five basic dimensions of personality (temperament). List them. Difficulty: 1 Question ID: 2.3.168 Page Reference: 44 Topic: Psychological Factors Skill: Factual Answer: (1) extraversion (active and talkative vs. passive and reserved); (2) agreeableness (trusting and kind vs. hostile and selfish); (3) conscientiousness (organized and reliable vs. careless and negligent); (4) neuroticism (nervous and moody vs. calm and pleasant); (5) openness to experience (imaginative and curious vs. shallow and imperceptive).

2.3.169. What are attributions? Why are psychologists interested in them? Explain how attributions can be used to explain depression, with a specific example. Difficulty: 2 Question ID: 2.3.169 Page Reference: 45 Topic: Psychological Factors Skill: Conceptual

Answer: Attributions involve how people perceive causes, their beliefs about cause-effect relations. Attribution errors can play a prominent role in the development of psychopathology. For example, a person who attributes a bad event to internal, stable, and global causes is more at risk for depression. So a student getting a bad grade who says "I'm stupid" will feel more helpless and ultimately more depressed.

2.3.170. What has research revealed concerning the relationship between marital status and mental health? What particular problems of interpretation occur when trying to reach valid conclusions on this relationship? Difficulty: 2 Question ID: 2.3.170 Page Reference: 47-48 Topic: Social Factors Skill: Applied Answer: Data from the Epidemiological Catchment Area study provided valuable data in assessing the relationship between marriage and mental health. Researchers found consistent relationships between marital status and mental health. For example, depression occurred in 1.5 percent of people still in their first marriage. The rate for those who were never married (1-year prevalence) was 2.4 percent. Among those who had been divorced, the rate was 4.1 in the past year. Finally, 5.8 percent of people who had been divorced more than once had experienced depression in the previous 12 months. Similar findings were found for alcoholism and schizophrenia as well as virtually every disorder diagnosed in the study. How do we interpret these results? The usual interpretation is that not being married causes emotional problems. The absence of a supportive mate makes one more susceptible to psychological problems. However, reverse causality needs to be considered as an alternative explanation. Specifically, emotional problems may be the cause of marital status. Psychologically disturbed people may have more trouble dating and forming permanent relationships. If they get married, their emotional struggles may make them or their spouses unhappier in their marriages and more prone to divorce. What's more, third variable interpretations could create spurious relationships, and poverty has been suggested as one possible third variable. Researches have concluded that although the relationship between marriage and mental health may be partly explained by third variables, much of it is real. The correlation is still found when the effects of poverty are excluded. For severe psychological disorders like schizophrenia, it seems clear that being single or getting divorced is a reaction to, not a cause of, the emotional problems.

2.3.171. Discuss how gender roles affect the development, expression, and consequences of psychopathology. Difficulty: 1 Question ID: 2.3.171 Page Reference: 48 Topic: Social Factors Skill: Applied

Answer: Gender roles may cause problems (e.g., women are raised to show dependency and helplessness, which may cause depression). Gender roles may affect the expression of problems (e.g., it is socially acceptable for women to show depression, and for men to show physical illness). Gender roles can affect the consequences of problems (e.g., once a phobia develops, it is socially acceptable for women, but not men, to continue to avoid the feared object, and this may exacerbate the problem for women).

2.3.172. Compare and contrast the concepts of “gene-environment interaction” and “gene-environment correlation.” Difficulty: 3 Question ID: 2.3.172 Page Reference: 42 Topic: Social Factors Skill: Applied Answer: Many contemporary models of the etiology of mental disorders suggest that genetic factors or diatheses interact with environmental factors in complex ways to cause mental disorders. One may have a genetic risk of developing schizophrenia, for example, but not develop it in the absence of environmental stress. This is an example of gene-environment interaction. An example of gene-environment correlation would be if an individual inherited a predisposition to respond to stressful situations with anxiety and was raised in a way that encouraged or rewarded anxious behavior.

Chapter 3 Treatment of Psychological Disorders Total Assessment Guide (T.A.G.) Topic Overview pp. 51-55

Biological Treatments pp. 55-58 Psychodynamic Psychotherapies pp. 58-60 CognitiveBehavior Therapy pp. 60-63

Humanistic Therapies pp. 63-64 Research on Psychotherapy pp. 64-70

Couples, Family, and Group Therapy pp. 70-73 Specific Treatments for Specific Disorders p. 73

Question Type Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice

Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice

Short Answer Essay Multiple Choice

Short Answer Essay Multiple Choice Short Answer Essay

Factual 1, 2, 3, 4, 7, 8, 15, 16, 17

Conceptual 9, 12, 13, 14

Applied 5, 6, 10, 11

114 20, 21, 24, 25, 27, 28, 30, 32, 34 115 35, 36, 38, 40, 43, 45, 47 116 48, 49, 55, 58, 62, 63, 65, 66, 67

18, 19, 33

128 37, 41, 42, 44, 46

50, 51, 52, 53, 54, 56, 57, 59, 60, 64, 68, 70, 71

22, 23, 26, 29, 31

130* 61, 69

117, 118, 119, 120, 121, 122 129 74, 75 124

72, 73 123 76, 80, 84, 87, 89, 90, 97

103, 107, 108, 112

77, 81, 82, 83, 88, 93, 94, 95, 96, 98, 99, 100 126, 127, 131, 132, 134 101, 102, 104, 105, 106, 110, 111 125 135

113

*This question covers two topics

130* 78, 79, 85, 86, 91, 92

133 109

Chapter 3: Treatment of Psychological Disorders Multiple Choice

3.1.1.

Most mental health professionals today identify themselves with

a. b. c. d.

the psychodynamic paradigm. the cognitive-behavioral paradigm. the humanistic paradigm. no single paradigm. Difficulty: 1 Question ID: 3.1.1 Page Reference: 52 Topic: Overview Skill: Factual Answer: d. no single paradigm.

3.1.2.

Trying to determine whether and to what extent psychotherapy is effective requires

a. b. c. d.

psychotherapy process research. psychotherapy outcome research. eclectic psychotherapy research. epidemiological research. Difficulty: 1 Question ID: 3.1.2 Page Reference: 52 Topic: Overview Skill: Factual Answer: b. psychotherapy outcome research.

3.1.3. A clinician who uses research to select the most effective form of treatment is practicing _________________ psychotherapy. a. b. c. d.

eclectic outcome based evidence-based epidemiological

Difficulty: 1

Question ID: 3.1.3 Page Reference: 52 Topic: Overview Skill: Factual Answer: c. evidence-based

3.1.4. Which of the following best describes the evidence for how many people receive psychological help of all those who need it? a. b. c. d.

Most people will receive help. Only people with severe disturbances will receive help. Most people will not receive help. Only people with the most common disturbances will receive help. Difficulty: 1 Question ID: 3.1.4 Page Reference: 52 Topic: Overview Skill: Factual Answer: c. Most people will not receive help.

3.1.5. Therapists representing the biological, psychodynamic, behavioral, and humanistic orientations are discussing the case of Frances from the text. What common feature will these therapists see in this case of depression? a. All focus on her use of defense mechanisms. b. All note her tendency to blame herself for troubles in her relationships. c. All see how the basic cause of the depression can be traced to early childhood experiences. d. All focus on the influence of her family as a causative agent in the development of her depression. Difficulty: 1 Question ID: 3.1.5 Page Reference: 53 Topic: Overview Skill: Applied Answer: b. All note her tendency to blame herself for troubles in her relationships. 3.1.6. In viewing the case of Frances presented in your text, a biologically oriented therapist would view her interpersonal problems as a. b. c. d.

the cause of her depression. the result of her depression. irrelevant to her condition. a separate problem requiring another diagnosis.

Difficulty: 2 Question ID: 3.1.6 Page Reference: 53 Topic: Overview Skill: Applied Answer: b. the result of her depression. 3.1.7. What is the primary goal of psychodynamic therapy as presented in the case of Frances in the textbook? a. b. c. d.

gaining insight into unconscious motivations encouraging acceptance of individual responsibility changing psychological experience with the use of medication applying psychological research to foster learning of new behaviors Difficulty: 1 Question ID: 3.1.7 Page Reference: 53 Topic: Overview Skill: Factual Answer: a. gaining insight into unconscious motivations

3.1.8. Which form of treatment aims to gain insight into defenses and unconscious motivations and relies on the interpretation of defenses? a. b. c. d.

behavioral humanistic biological psychodynamic Difficulty: 1 Question ID: 3.1.8 Page Reference: 53 Topic: Overview Skill: Factual Answer: d. psychodynamic

3.1.9. What is a cognitive behavior therapist likely to do in treating Frances, whose battle with depression was described in the text? a. b. c. d.

be very directive in getting her to look at her distorted thinking reward her each time she gets through the day without feeling depressed teach her a relaxation technique and slow breathing to help her deal with stress use role-playing to demonstrate healthy and unhealthy interactions

Difficulty: 1

Question ID: 3.1.9 Page Reference: 54 Topic: Overview Skill: Conceptual Answer: a. be very directive in getting her to look at her distorted thinking 3.1.10. These are the notes of a therapist who is treating Frances whose case of depression was described in the text: "Client assigned homework to monitor conflict with family and to try out new ways of relating to them." The orientation of this therapist is probably a. b. c. d.

humanistic. cognitive behavioral. biological. psychodynamic. Difficulty: 2 Question ID: 3.1.10 Page Reference: 54 Topic: Overview Skill: Applied Answer: b. cognitive behavioral.

3.1.11. At a retreat for therapists, the group leader decides to use a few warm-up exercises to help everyone get to know each other. She says, "I want all of the therapists who view their role as active and directive in the back of the room." When she looks at the back of the room she finds that most of the people back there follow which treatment approaches? a. b. c. d.

behavioral and humanistic behavioral and biological psychodynamic and behavioral psychodynamic and biological Difficulty: 3 Question ID: 3.1.11 Page Reference: 54 Topic: Overview Skill: Applied Answer: b. behavioral and biological

3.1.12. A therapist tells a patient that he is "not being genuine, not being himself." The therapist encourages the patient to make life choices based on his true feelings. What is the therapist's most likely theoretical framework? a. b. c. d.

behavioral humanistic biological psychodynamic

Difficulty: 1 Question ID: 3.1.12 Page Reference: 54 Topic: Overview Skill: Conceptual Answer: b. humanistic 3.1.13. During therapy to treat the depression experienced by Frances as described in your text, which type of therapist would be nondirective but would focus the sessions on emotional issues? a. b. c. d.

behavioral biological humanistic psychodynamic Difficulty: 1 Question ID: 3.1.13 Page Reference: 54 Topic: Overview Skill: Conceptual Answer: c. humanistic

3.1.14. A straightforward example of an eclectic approach to the case Frances presented in your text would be to a. b. c. d.

combine psychotherapy with medication. conduct outcome research. conduct process research. follow one specific paradigm of treatment. Difficulty: 2 Question ID: 3.1.14 Page Reference: 54 Topic: Overview Skill: Conceptual Answer: a. combine psychotherapy with medication.

3.1.15. According to the textbook, how did the ancient practice of trephining seek to treat mental illness? a. b. c. d.

by performing sacrifices to appease the gods by dunking the person in water to "cleanse the soul" by chipping a hole in the skull to allow evil spirits to escape by confining patients in "insane asylums" as a form of punishment

Difficulty: 1

Question ID: 3.1.15 Page Reference: 54 Topic: Overview Skill: Factual Answer: c. by chipping a hole in the skull to allow evil spirits to escape

3.1.16. Which of the following did Hippocrates recommend as treatments for mental illness? a. b. c. d.

exorcism, trephining, and wine rest, exercise, and healthy diet dunking in water, massage, and sleep trephining, opium, and dream analysis Difficulty: 1 Question ID: 3.1.16 Page Reference: 54 Topic: Overview Skill: Factual Answer: b. rest, exercise, and healthy diet

3.1.17. Mental health professionals who strive to meet the mental health needs of members of various ethnic minority groups need to be sensitive to the challenge of acculturation, which refers to a. b. c. d.

the preservation of each group's unique customs and values. how members of each group understand themselves in terms of their own culture. the process of learning and adopting the cultural patterns of the majority group. depreciating of the customs and values of the majority group. Difficulty: 1 Question ID: 3.1.17 Page Reference: 55 Topic: Overview Skill: Factual Answer: c. the process of learning and adopting the cultural patterns of the majority group.

3.1.18. The discovery of both a specific biological cause and an effective cure for general paresis a. b. c. d.

has been followed by many more similar successes. has not been followed by similar success stories. was never achieved despite decades of scientific study. was finally achieved just within the past few years.

Difficulty: 1

Question ID: 3.1.18 Page Reference: 55 Topic: Biological Treatments Skill: Conceptual Answer: b. has not been followed by similar success stories.

3.1.19. When biological treatments are used for various mental disorders without knowing the specific cause of the problem, such treatments focus on a. b. c. d.

prevention. discovering the cause. establishing the correct diagnosis. symptom alleviation. Difficulty: 1 Question ID: 3.1.19 Page Reference: 55 Topic: Biological Treatments Skill: Conceptual Answer: d. symptom alleviation.

3.1.20. Which form of treatment for certain mental disorders produces retrograde amnesia? a. b. c. d.

Free association Bilateral Electro Convulsive Therapy Unilateral Electro Convulsive Therapy Forced cold baths Difficulty: 2 Question ID: 3.1.20 Page Reference: 56 Topic: Biological Treatments Skill: Factual Answer: c. Unilateral Electro Convulsive Therapy

3.1.21. What erroneous assumption led to the development of electroconvulsive therapy (ECT)? a. b. c. d.

Schizophrenia prevented epileptic seizures. Epileptic seizures prevented schizophrenia. Schizophrenia resulted from failure to use both hemispheres. ECT would result in memory loss that would cure schizophrenia. Difficulty: 1 Question ID: 3.1.21 Page Reference: 56

Topic: Biological Treatments Skill: Factual Answer: b. Epileptic seizures prevented schizophrenia.

3.1.22. Agnes has been recently diagnosed as suffering a particularly severe form of depression. She was admitted to the hospital and given the typical recommended electroconvulsive therapy (ECT) treatment. What will her medical chart reveal about her treatment? a. b. c. d.

She was given one major unilateral treatment. She was given mild shocks throughout two days of treatment. A series of 6 to 12 ECT sessions was given over a few weeks. A series of 15 to 25 sessions was given in a week followed by psychosurgery. Difficulty: 2 Question ID: 3.1.22 Page Reference: 56 Topic: Biological Treatments Skill: Applied Answer: c. A series of 6 to 12 ECT sessions was given over a few weeks.

3.1.23. What is the major consideration in deciding whether to use unilateral versus bilateral electroconvulsive therapy (ECT) for a patient suffering from severe depression? a. b. c. d.

patient's age reducing memory loss patient's family history of mental illness reduction in patient's white cell blood count Difficulty: 1 Question ID: 3.1.23 Page Reference: 56 Topic: Biological Treatments Skill: Applied Answer: b. reducing memory loss

3.1.24. Compared to its use in the middle of the last century, today electroconvulsive therapy (ECT) is a. b. c. d.

used far less frequently. used far more frequently. never used because of its severe side effects. only used to treat schizophrenia. Difficulty: 2 Question ID: 3.1.24 Page Reference: 56

Topic: Biological Treatments Skill: Factual Answer: a. used far less frequently.

3.1.25. What was one of the severe side effects of prefrontal lobotomies? a. b. c. d.

epilepsy manic behavior increased anxiety absence of emotional responsiveness Difficulty: 1 Question ID: 3.1.25 Page Reference: 56 Topic: Biological Treatments Skill: Factual Answer: d. absence of emotional responsiveness

3.1.26. A medical records clerk was reviewing patient files when he came across one that had the name of a procedure he did not recognize: cingulotomy. When he looked up the procedure he found that it is a surgical procedure used in cases in which the diagnosis is a. b. c. d.

schizophrenia. major depression. obsessive-compulsive disorder. antisocial personality disorder. Difficulty: 2 Question ID: 3.1.26 Page Reference: 56 Topic: Biological Treatments Skill: Applied Answer: c. obsessive-compulsive disorder.

3.1.27. What is the major effect of antipsychotic medications given to people that do not suffer from schizophrenia? a. b. c. d.

The drugs have no effect. The people become addicted. The drugs send them into a long, groggy sleep. The drugs cause delusions and hallucinations. Difficulty: 1 Question ID: 3.1.27 Page Reference: 56

Topic: Biological Treatments Skill: Factual Answer: c. The drugs send them into a long, groggy sleep.

3.1.28. When you walk into your next class you see the term “psychotropic medications” written on the blackboard. You never know when such information might come in handy, so you look it up and find that it refers to a. b. c. d.

special placebo pills used in drug research. chemical substances that affect our psychological state. chemical substances that cause a psychedelic experiences. special drugs designed to "turn off" genes thought to cause mental disorders. Difficulty: 1 Question ID: 3.1.28 Page Reference: 57 Topic: Biological Treatments Skill: Factual Answer: b. chemical substances that affect our psychological state.

3.1.29. While reading a medical article you come across the category of minor tranquilizers. The writer then gives the term benzodiazepines as an example of the chemical group of drugs. What type of drugs are being described? a. b. c. d.

antimanic antianxiety antipsychotic antidepressants Difficulty: 2 Question ID: 3.1.29 Page Reference: 57 Topic: Biological Treatments Skill: Applied Answer: b. antianxiety

3.1.30. For an assignment you are asked to look up a group of drugs known as major tranquilizers. You consult a drug handbook and find that another term for these drugs is a. b. c. d.

antianxiety. antipsychotic. antidepressant. sedative hypnotic. Difficulty: 2

Question ID: 3.1.30 Page Reference: 57 Topic: Biological Treatments Skill: Factual Answer: b. antipsychotic.

3.1.31. You are reading a case study of a patient who has been prescribed the following: Haldol, Clozaril, and Thorazine. You recognize these drugs as belonging to the category called a. b. c. d.

antimanic. antianxiety. antipsychotic. antidepressant. Difficulty: 2 Question ID: 3.1.31 Page Reference: 57 Topic: Biological Treatments Skill: Applied Answer: c. antipsychotic.

3.1.32. Ted wants to learn about the effects of the drug Prozac. Under what heading would he find the drug listed? a. b. c. d.

antimanic medications antianxiety medications antipsychotic medications antidepressant medications Difficulty: 1 Question ID: 3.1.32 Page Reference: 57 Topic: Biological Treatments Skill: Factual Answer: d. antidepressant medications

3.1.33. Current evidence on the effects of psychotropic medications indicate that they a. b. c. d.

are effective cures for many disorders. are effective cures only for mild disorders. offer symptom relief but not a cure. are not very effective and usually cause serious side effects. Difficulty: 1 Question ID: 3.1.33

Page Reference: 58 Topic: Biological Treatments Skill: Conceptual Answer: c. offer symptom relief but not a cure.

3.1.34. Joseph Breuer's method of catharsis provided relief for psychological symptoms by helping patients to a. b. c. d.

release previously unexpressed feelings. overcome their anxiety through using systematic desensitization. open up under the influence of "truth serum." assess the irrational basis of their beliefs. Difficulty: 1 Question ID: 3.1.34 Page Reference: 58 Topic: Psychodynamic Psychotherapies Skill: Factual Answer: a. release previously unexpressed feelings.

3.1.35. Free association refers to a. b. c. d.

the effectiveness of psychoactive medications. a defense mechanism seen in personality disorders. talking freely about whatever thoughts cross the mind. the right of patients to associate with other patients. Difficulty: 1 Question ID: 3.1.35 Page Reference: 58 Topic: Psychodynamic Psychotherapies Skill: Factual Answer: c. talking freely about whatever thoughts cross the mind.

3.1.36. What did Sigmund Freud believe was the "true benefit" of free association? a. b. c. d.

induces hypnosis increases drive levels reveals aspects of the unconscious mind encourages conversations concerning taboo topics Difficulty: 2 Question ID: 3.1.36 Page Reference: 58 Topic: Psychodynamic Psychotherapies

Skill: Factual Answer: c. reveals aspects of the unconscious mind

3.1.37. According to Freudian psychoanalysis it is sufficient to cure mental illness if the therapist were to a. b. c. d.

break down a person's defenses. bring unconscious material into conscious awareness. train patients to become more hypnotizable. help patients accept themselves. Difficulty: 2 Question ID: 3.1.37 Page Reference: 58 Topic: Psychodynamic Psychotherapies Skill: Conceptual Answer: b. bring unconscious material into conscious awareness.

3.1.38. What is the meaning of the term interpretation from psychoanalysis? a. b. c. d.

a method used to induce catharsis in difficult cases a general guideline for the therapist that is not shared with the patient material the therapist shares with patients to help them understand their own behavior statements the patient shares with the therapist that explain the troubling behavior Difficulty: 2 Question ID: 3.1.38 Page Reference: 58 Topic: Psychodynamic Psychotherapies Skill: Factual Answer: c. material the therapist shares with patients to help them understand their own behavior

3.1.39. A psychoanalyst might suggest that Frances, whose case was presented in the text, is demonstrating ______________ if she begins to treat the analyst in ways that suggest she feels about him the way she felt about her father. a. b. c. d.

free association transference counter transference resistance Difficulty: 2 Question ID: 3.1.39 Page Reference: 59 Topic: Psychodynamic Psychotherapies Skill: Applied

Answer: b. transference

3.1.40. Therapeutic neutrality is viewed as a key component of a. b. c. d.

psychoanalysis. client-centered therapy. in vivo desensitization. rational-emotive therapy. Difficulty: 1 Question ID: 3.1.40 Page Reference: 59 Topic: Psychodynamic Psychotherapies Skill: Factual Answer: a. psychoanalysis.

3.1.41. Which of the following best exemplifies the psychoanalytic idea of countertransference? a. b. c. d.

catharsis brings emotional healing a patient begins to use healthier defenses a therapist begins to feel angry with the patient a patient who is angry at his mother becomes angry at the therapist Difficulty: 3 Question ID: 3.1.41 Page Reference: 59 Topic: Psychodynamic Psychotherapies Skill: Conceptual Answer: c. a therapist begins to feel angry with the patient

3.1.42. In psychoanalytic therapy, what is supposed to happen to a patient's defenses? a. b. c. d.

They should be eliminated. They should be left alone. The healthier ones should be strengthened. They should be replaced with resistance. Difficulty: 2 Question ID: 3.1.42 Page Reference: 59 Topic: Psychodynamic Psychotherapies Skill: Conceptual Answer: c. The healthier ones should be strengthened.

3.1.43. Which of the following is most accurate with regard to the outcome research on psychoanalysis? a. b. c. d.

Most outcome research has demonstrated the effectiveness of this form of therapy. Very little research has been conducted looking at the outcome of this therapy. When compared to other forms of therapy this one is usually found to be more effective. The most effective form of therapy has been found to be psychoanalysis with drug therapy. Difficulty: 2 Question ID: 3.1.43 Page Reference: 59 Topic: Psychodynamic Psychotherapies Skill: Factual Answer: b. Very little research has been conducted looking at the effectiveness of this therapy.

3.1.44. For an assignment you are asked to create a poster that shows the similarities and differences between psychoanalysis and psychodynamic therapy. When you are finished, your poster shows that psychodynamic therapy is a. b. c. d.

more directive. more focused on the id. likely to take longer to complete treatment. likely to focus on original Freudian theory. Difficulty: 2 Question ID: 3.1.44 Page Reference: 59 Topic: Psychodynamic Psychotherapies Skill: Conceptual Answer: a. more directive.

3.1.45. The innovation in Freudian theory that emphasizes the person's way of dealing with reality is known as a. b. c. d.

ego analysis. transference therapy. counter-transference therapy. behavior therapy. Difficulty: 1 Question ID: 3.1.45 Page Reference: 59 Topic: Psychodynamic Psychotherapies Skill: Factual Answer: a. ego analysis.

3.1.46. If Harry Stack Sullivan could comment on the case of Frances presented in your text, he would probably focus on a. b. c. d.

both her relationship with her mother and her feelings about her mother. her relationship with her mother, but not her feelings about her mother. her feelings about her mother, but not her relationship with her mother. her sexual feelings for her father. Difficulty: 1 Question ID: 3.1.46 Page Reference: 59 Topic: Psychodynamic Psychotherapies Skill: Conceptual Answer: a. both her relationship with her mother and her feelings about her mother.

3.1.47. The theorist who elevated the need for warm, close relationships to the status of a basic human need was a. b. c. d.

Sigmund Freud. Erik Erikson. Karen Horney. John Bowlby. Difficulty: 1 Question ID: 3.1.47 Page Reference: 59 Topic: Psychodynamic Psychotherapies Skill: Factual Answer: d. John Bowlby.

3.1.48. Which of the following is NOT an essential feature of the experimental method? a. b. c. d.

hypothesis independent variable correlation random assignment Difficulty: 2 Question ID: 3.1.48 Page Reference: 61 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: c. correlation

3.1.49. John B. Watson's behaviorism can be seen as the forerunner of modern a. b. c. d.

classical conditioning therapy. cognitive-behavior therapy. new psycodynamic therapy. attatchment therapy. Difficulty: 1 Question ID: 3.1.49 Page Reference: 60 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: b. cognitive-behavior therapy.

3.1.50. What is a major difference between a psychoanalytic approach and a cognitive behavioral approach to therapy? a. Psychoanalytic approaches have been better researched. b. Psychoanalytic therapy focuses on direct education of the patient. c. Cognitive-Behavior Therapy focuses on change without offering a theory of human personality. d. The course of Cognitive-Behavior Therapy depends on theoretical assumptions about the nature of the pathology. Difficulty: 2 Question ID: 3.1.50 Page Reference: 60 Topic: Cognitive-Behavior Therapy Skill: Conceptual Answer: c. Cognitive-Behavior Therapy focuses on change without offering a theory of human personality. 3.1.51. Which therapy emphasizes empirical evaluation and the application of psychological science to treating clinical problems? a. b. c. d.

ego analysis cognitive-behavior therapy humanistic therapy psychoanalytic therapy Difficulty: 1 Question ID: 3.1.51 Page Reference: 60 Topic: Cognitive-Behavior Therapy Skill: Conceptual Answer: b. cognitive-behavior therapy

3.1.52. In an experiment, a researcher gives some patients psychotherapy, gives others medication, and puts others on a waiting list. The researcher then measures how depressed the patients are feeling after six months. What is the independent variable in this experiment? a. b. c. d.

number of patients time span of six months improvement in depression kind of treatment received Difficulty: 1 Question ID: 3.1.52 Page Reference: 61 Topic: Cognitive-Behavior Therapy Skill: Conceptual Answer: d. kind of treatment received

3.1.53. In an experiment, a researcher gives some patients psychotherapy, gives others medication, and puts others on a waiting list. The researcher then measures how depressed the patients are feeling after six months. What is the dependent variable in this experiment? a. b. c. d.

number of patients time span of six months improvement in depression kind of treatment received Difficulty: 1 Question ID: 3.1.53 Page Reference: 61 Topic: Cognitive-Behavior Therapy Skill: Conceptual Answer: c. improvement in depression

3.1.54. Random assignment is important to an experiment to ensure that a. b. c. d.

any differences found between the groups are caused by the independent variable. any differences found between the groups are caused by the dependent variable. the subjects in a study are a good representation of the larger population. experimenter bias does not contaminate the results. Difficulty: 2 Question ID: 3.1.54 Page Reference: 61 Topic: Cognitive-Behavior Therapy Skill: Conceptual Answer: a. any differences found between the groups are caused by the independent variable.

3.1.55. In most psychology experiments a research finding is considered to be statistically significant if the a. b. c. d.

hypothesis was supported. participants were randomly assigned. result would occur no more than 5% of the time by chance. independent variable changed substantially during the experiment. Difficulty: 1 Question ID: 3.1.55 Page Reference: 61 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: c. result would occur no more than 5% of the time by chance.

3.1.56. A research finding that does not generalize to circumstance different from those of the experiment is lacking a. b. c. d.

internal validity. external validity. random assignment. statistical significance. Difficulty: 3 Question ID: 3.1.56 Page Reference: 61 Topic: Cognitive-Behavior Therapy Skill: Conceptual Answer: b. external validity.

3.1.57. Under which of the following circumstances would a study of the effectiveness of different forms of psychotherapy have high internal validity? a. b. c. d.

The results are statistically significant. The independent variable is confounded with other factors. The findings can be generalized to other types of patients. Patient improvement can be attributed to the psychotherapy, and not to other factors. Difficulty: 3 Question ID: 3.1.57 Page Reference: 61 Topic: Cognitive-Behavior Therapy Skill: Conceptual Answer: d. Patient improvement can be attributed to the psychotherapy, and not to other factors.

3.1.58. All of the following are one of the three key elements of systematic desensitization EXCEPT a. b. c. d.

progressive muscle relaxation constructing a hierarchy of fears operant conditioning in the presence of the object of fear learning to relax while confronting the feared stimulus Difficulty: 2 Question ID: 3.1.58 Page Reference: 60 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: c. operant conditioning in the presence of the object of fear

3.1.59. Systematic desensitization is based on the principles of a. b. c. d.

operant conditioning. classical conditioning. imitation learning. cathartic learning. Difficulty: 1 Question ID: 3.1.59 Page Reference: 60 Topic: Cognitive-Behavior Therapy Skill: Conceptual Answer: b. classical conditioning.

3.1.60. The technique of flooding in the treatment of phobia utilizes what learning principle? a. b. c. d.

gradual exposure extinction contingency management relaxation Difficulty: 2 Question ID: 3.1.60 Page Reference: 60 Topic: Cognitive-Behavior Therapy Skill: Conceptual Answer: b. extinction

3.1.61. Sid wants to end his habit of smoking three packs of cigarettes a day; Ted wants to stop his serious drinking problem. Which treatment might be used for both individuals? a. b. c. d.

aversion therapy flooding in vivo desensitization systematic desensitization Difficulty: 1 Question ID: 3.1.61 Page Reference: 62 Topic: Cognitive-Behavior Therapy Skill: Applied Answer: a. aversion therapy

3.1.62. A token economy system in a psychiatric hospital is an example of the application of a. b. c. d.

contingency management. survival of the fittest. dependency among patients. supply and demand to therapy activities. Difficulty: 1 Question ID: 3.1.62 Page Reference: 62 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: a. contingency management.

3.1.63. Contingency management involves changing the relationship between a. b. c. d.

one behavior and another. a behavior and the stimulus that triggers it. a behavior and its consequences. what one thinks and how one acts. Difficulty: 1 Question ID: 3.1.63 Page Reference: 62 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: c. a behavior and its consequences.

3.1.64. Assertiveness training and social problem solving are examples of a. b. c. d.

teaching clients new ways of behaving that are likely to be rewarded. teaching clients new ways of thinking that are likely to be more rational. short-term psychodynamic psychotherapy. in vivo desensitization. Difficulty: 2 Question ID: 3.1.64 Page Reference: 62 Topic: Cognitive-Behavior Therapy Skill: Conceptual Answer: a. teaching clients new ways of behaving that are likely to be rewarded.

3.1.65. What is an attribution? a. b. c. d.

a personality trait a defense mechanism the perceived cause of something a change that occurs over the course of psychotherapy Difficulty: 1 Question ID: 3.1.65 Page Reference: 62 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: c. the perceived cause of something

3.1.66. What is the major purpose of Meichenbaum's self-instruction training? a. b. c. d.

to help adults become more assertive to teach depressed persons to change their attributions to encourage patients to engage in collaborative empiricism to assist children in learning to internalize rules of appropriate behavior Difficulty: 1 Question ID: 3.1.66 Page Reference: 63 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: d. to assist children in learning to internalize rules of appropriate behavior

3.1.67. Aaron Beck's cognitive therapy was developed specifically as a treatment for a. b. c. d.

anxiety. depression. impulsivity. schizophrenia. Difficulty: 1 Question ID: 3.1.67 Page Reference: 63 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: b. depression.

3.1.68. If a cognitive therapist trained by Beck were treating Frances, whose depression was presented in your text, the therapist would probably a. b. c. d.

use role-playing to help her acquire some new behaviors. challenge her tendency to blame herself. teach her deep breathing and how to relax. try to uncover her hidden motivations. Difficulty: 2 Question ID: 3.1.68 Page Reference: 63 Topic: Cognitive-Behavior Therapy Skill: Conceptual Answer: b. challenge her tendency to blame herself.

3.1.69. You are asked to compare Ellis's rational-emotive therapy (RET) and Aaron Beck's cognitive therapy. After comparing the two you note that one difference is that the therapist in RET is likely to a. b. c. d.

use operant conditioning techniques. require the client to keep a dream log. directly challenge the rationality of the client's beliefs. accept the client's irrationality. Difficulty: 2 Question ID: 3.1.69 Page Reference: 63 Topic: Cognitive-Behavior Therapy Skill: Applied Answer: c. directly challenge the rationality of the client's beliefs.

3.1.70. Which is a treatment for borderline personality disorder that includes an emphasis on “mindfulness,” increased awareness of your feelings, thoughts, and motivations? a. b. c. d.

dialectical behavior therapy cognitive-behavior therapy neo-psychodynamic therapy focused humanistic therapy Difficulty: 2 Question ID: 3.1.70 Page Reference: 63 Topic: Cognitive-Behavior Therapy Skill: Conceptual Answer: a. dialectical behavior therapy

3.1.71. An argument that humanists have against psychodynamic, cognitive behavioral, and biological therapists is that these other therapists a. b. c. d.

overlook the individual's ability to make choices. place too much emphasis on free will. do not put the needs of their clients first. are too cold and judgmental in their dealings with their clients. Difficulty: 1 Question ID: 3.1.71 Page Reference: 63-64 Topic: Humanistic Therapies Skill: Conceptual Answer: a. overlook the individual's ability to make choices.

3.1.72. Rogers viewed three qualities as essential in a therapist. Which of the following is NOT one of those qualities? a. b. c. d.

warmth emotional understanding intelligence empathy

Difficulty: 2 Question ID: 3.1.72 Page Reference: 64 Topic: Humanistic Therapies Skill: Factual Answer: c. intelligence

3.1.73. A unique technique that Carl Roger's suggested for humanistic psychotherapists was a. b. c. d.

therapist self-disclosure. client self-disclosure. the use of positive reinforcement. the use of thought analysis. Difficulty: 2 Question ID: 3.1.73 Page Reference: 64 Topic: Humanistic Therapies Skill: Factual Answer: a. therapist self-disclosure

3.1.74. Client-centered therapy is closely associated with the concept of a. b. c. d.

empathy. interpretation. countertransference. operant conditioning. Difficulty: 1 Question ID: 3.1.74 Page Reference: 64 Topic: Humanistic Therapies Skill: Conceptual Answer: a. empathy.

3.1.75. In client-centered therapy the bond between therapist and client that is seen as central to the process of therapy is known as the a. b. c. d.

therapy relationship. transference relationship. therapeutic bond. therapeutic alliance. Difficulty: 2 Question ID: 3.1.75 Page Reference: 64 Topic: Humanistic Therapies Skill: Conceptual Answer: d. therapeutic alliance.

3.1.76. What is a meta-analysis?

a. b. c. d.

a case study a form of psychoanalysis a way of measuring changes in observable behaviors a statistical technique for combining the results of many studies Difficulty: 2 Question ID: 3.1.76 Page Reference: 64 Topic: Research on Psychotherapy Skill: Factual Answer: d. a statistical technique for combining the results of many studies

3.1.77. Which of the following most accurately summarizes the results of outcome research on different forms of psychotherapy? a. Despite decades of research there is little evidence that psychotherapy is effective. b. Psychotherapy is effective, and many types of psychotherapy share key 'active ingredients.’ c. Psychoanalytic treatment tends to be superior to other treatments because it is the only one that seeks to uncover underlying causes of disorders. d. Various forms of psychotherapy are so radically different that it is not possible to offer definitive conclusions concerning their effectiveness. Difficulty: 2 Question ID: 3.1.77 Page Reference: 64 Topic: Research on Psychotherapy Skill: Conceptual Answer: b. Psychotherapy is effective, and many types of psychotherapy share key 'active ingredients.’ 3.1.78. The textbook lists several ways in which different forms of psychotherapy can harm clients that includes all of the following EXCEPT a. b. c. d.

false accusations of child abuse. creation of false memories. increased substance abuse. increased criminal recidivism. Difficulty: 1 Question ID: 3.1.78 Page Reference: 66 Topic: Research on Psychotherapy Skill: Applied Answer: d. increased criminal recidivism.

3.1.79. How does the effect size of psychotherapy compare to the effect size of the use of chemotherapy in reducing the mortality associated with breast cancer? a. b. c. d.

The effect sizes are similar and small. The effect sizes are similar and large. The effect size for chemotherapy is larger. The effect size for psychotherapy is larger. Difficulty: 2 Question ID: 3.1.79 Page Reference: 64 Topic: Research on Psychotherapy Skill: Applied Answer: d. The effect size for psychotherapy is larger.

3.1.80. Spontaneous remission refers to a patient getting a. b. c. d.

worse with therapy. better with therapy. worse without therapy. better without therapy. Difficulty: 1 Question ID: 3.1.80 Page Reference: 65 Topic: Research on Psychotherapy Skill: Factual Answer: d. better without therapy.

3.1.81. Therapy outcome studies typically have a no-treatment control group, but results from such studies can be difficult to interpret because a. b. c. d.

people waiting for therapy often seek counseling and advice from others. it is not possible to randomly assign people to that group. the control group patients usually improve more than the treated patients. nobody wants to wait for therapy. Difficulty: 1 Question ID: 3.1.81 Page Reference: 65-66 Topic: Research on Psychotherapy Skill: Conceptual Answer: a. people waiting for therapy often seek counseling and advice from others.

3.1.82. Which of these is an example of a placebo in medicine?

a. b. c. d.

a test to diagnose a disorder a pill with inactive ingredients the beneficial effects of treatment a medication designed to treat a disease Difficulty: 1 Question ID: 3.1.82 Page Reference: 66 Topic: Research on Psychotherapy Skill: Conceptual Answer: b. a pill with inactive ingredients

3.1.83. Which best summarizes the views of the authors of the text about the placebo effect? a. b. c. d.

The placebo effect is itself a treatment—one that heals psychologically. Using the placebo effect in psychotherapy would be considered unethical. The placebo effect is benign, but never effective. The placebo effect is a dangerous interference with the process of psychotherapy. Difficulty: 1 Question ID: 3.1.83 Page Reference: 66-67 Topic: Research on Psychotherapy Skill: Conceptual Answer: a. The placebo effect is itself a treatment—one that heals psychologically.

3.1.84. Why are double-blind studies of medication effectiveness necessary? a. b. c. d.

A placebo is not a treatment. If expectancies are too high, treatment might fail. Physicians' expectations can influence patients' expectations. Patients can't tell if a medication is real. Difficulty: 1 Question ID: 3.1.84 Page Reference: 67 Topic: Research on Psychotherapy Skill: Factual Answer: c Physicians' expectations can influence patients' expectations.

3.1.85. Your friend told you that she was a member of the placebo group in a recently completed study of a new drug. What is your friend likely to have experienced? a.

She showed no improvement.

b. c. d.

She received no treatment, or was put on a waiting list. She received a treatment specifically designed for her disorder. She received a treatment not thought to be specifically effective in treating her disorder. Difficulty: 1 Question ID: 3.1.85 Page Reference: 67 Topic: Research on Psychotherapy Skill: Applied

Answer: d. She received a treatment not thought to be specifically effective in treating her disorder.

3.1.86. What occurs in a double-blind study of medication? a. b. c. d.

Any placebo effect can be seen as a hoax. There is a higher risk of expectation effects. The doctor, but not the patient knows if the medication is a placebo. Neither the patient nor the doctor knows if the medication is a placebo. Difficulty: 1 Question ID: 3.1.86 Page Reference: 67 Topic: Research on Psychotherapy Skill: Applied Answer: d. Neither the patient nor the doctor knows if the medication is a placebo.

3.1.87. According to the text, what is the best estimate of the number of people with a mental disorder who improve without any professional treatment? a. b. c. d.

one-tenth one-third one-half three-quarters Difficulty: 1 Question ID: 3.1.87 Page Reference: 67 Topic: Research on Psychotherapy Skill: Factual Answer: b. one-third

3.1.88. When we ask whether the results of therapy outcome research under carefully controlled conditions will be the same as the results that people experience in the real world, we are taking into account the difference between

a. b. c. d.

success and failure. experimental groups and control groups. treated and untreated groups. efficacy and effectiveness. Difficulty: 2 Question ID: 3.1.88 Page Reference: 67 Topic: Research on Psychotherapy Skill: Conceptual Answer: d. efficacy and effectiveness.

3.1.89. Which of the following describes allegiance effects in psychotherapy? a. Psychotherapists tend to use the form of therapy they encountered first in training. b. Psychotherapists tend to use the forms of therapy they are reimbursed by insurance companies. c. Patients tend to seek out those therapists who will give them "a break" when they bill for their time. d. Psychotherapy researchers tend to find evidence that their preferred form of therapy is more effective than other forms. Difficulty: 1 Question ID: 3.1.89 Page Reference: 67 Topic: Research on Psychotherapy Skill: Factual Answer: d. Psychotherapy researchers tend to find evidence that their preferred form of therapy is more effective than other forms.

3.1.90. A reporter for the local newspaper is deciding on a headline for an article describing the Consumer Reports study of psychotherapy. Which of the following titles would most effectively capture the findings? a. b. c. d.

"Psychotherapy: Consumer Rip-off" "Psychotherapy: Consumers Generally Satisfied" "The Success of Psychotherapy: It Takes Years" "Consumers Pay for Friendship in Psychotherapy" Difficulty: 1 Question ID: 3.1.90 Page Reference: 67-68 Topic: Research on Psychotherapy Skill: Factual Answer: b. "Psychotherapy: Consumers Generally Satisfied"

3.1.91. Your friend is considering seeking psychotherapy and asks your advice on the type of therapist she should consider. Based on the results of the Consumer Reports survey, what would you tell her? a. b. c. d.

Clinical psychologists were viewed as most effective because of their broad training. Consumer satisfaction was equal with the three major types of mental health professionals. Psychiatrists were viewed as most effective due to their ability to prescribe medication. Social workers who emphasize family dynamics were generally viewed as the most effective. Difficulty: 1 Question ID: 3.1.91 Page Reference: 68 Topic: Research on Psychotherapy Skill: Applied

Answer: b. Consumer satisfaction was equal with the three major types of mental health professionals. 3.1.92. What were the findings of the Consumers Reports survey of psychotherapy effectiveness concerning medications in treatment? a. b. c. d.

Medication adds little to psychotherapy. Medication was superior to psychotherapy in treating clients. Medication added significantly to the effectiveness of psychotherapy. The use of medication detracted from the overall effectiveness of the psychotherapy. Difficulty: 2 Question ID: 3.1.92 Page Reference: 68 Topic: Research on Psychotherapy Skill: Applied Answer: a. Medication adds little to psychotherapy.

3.1.93. What factor best predicts when treatment is more or less likely to be effective? a. b. c. d.

the experience of the therapist the orientation of the therapist the nature of the client's problems how much therapy the client can afford Difficulty: 1 Question ID: 3.1.93 Page Reference: 68 Topic: Research on Psychotherapy Skill: Conceptual Answer: c. the nature of the client's problems

3.1.94. According to research, what types of clients are most likely to improve?

a. b. c. d.

the most disturbed clients, after several years the most disturbed clients, in the first few months intelligent, successful people, after several years intelligent, successful people, in the first few months Difficulty: 1 Question ID: 3.1.94 Page Reference: 68 Topic: Research on Psychotherapy Skill: Conceptual Answer: d. intelligent, successful people, in the first few months

3.1.95. The fact that many studies show that different forms of treatment often appear to work equally well can be attributed to the fact that a. b. c. d.

most people want to get better. most people get better with or without treatment. different treatments still share many common factors. the research studies are very poorly done. Difficulty: 2 Question ID: 3.1.94 Page Reference: 68-69 Topic: Research on Psychotherapy Skill: Conceptual Answer: c. different treatments still share many common factors.

3.1.96. Research comparing behavioral and psychoanalytic therapies has found that a. b. c. d.

behavior therapists offer fewer interpretations. therapists' empathy only matters in psychoanalytic therapy. psychodynamic therapy is more effective with severe cases. clients see the therapist-client relationship as most important to outcome in both types of therapy. Difficulty: 2 Question ID: 3.1.96 Page Reference: 69 Topic: Research on Psychotherapy Skill: Conceptual

Answer: d. clients see the therapist-client relationship as most important to outcome in both types of therapy.

3.1.97. Which of the following is related to positive outcomes across different approaches to therapy?

a. b. c. d.

therapist supportiveness not limiting goals to just a few areas a well developed theoretical perspective discouragement of the therapeutic alliance Difficulty: 1 Question ID: 3.1.97 Page Reference: 69 Topic: Research on Psychotherapy Skill: Factual Answer: a. therapist supportiveness

3.1.98. Which of the following did Jerome Frank see as essential to the process of the persuasion that he suggested was an essential part of therapy? a. b. c. d.

listening instilling hope making a diagnosis involving family members Difficulty: 2 Question ID: 3.1.98 Page Reference: 70 Topic: Research on Psychotherapy Skill: Conceptual Answer: b. instilling hope

3.1.99. What interesting finding has emerged from the analysis of tapes of therapy sessions conducted by Carl Rogers? a. Much of the session focused on early childhood experiences. b. Several specific behavioral procedures were used during the sessions. c. Despite his opposition to psychoanalytic techniques he used dream analysis extensively. d. Although he advocated a nondirective approach, he was subtly directive by empathizing with some client statements but not others. Difficulty: 1 Question ID: 3.1.99 Page Reference: 70 Topic: Research on Psychotherapy Skill: Conceptual Answer: d. Although he advocated a nondirective approach, he was subtly directive by empathizing with some client statements but not others.

3.1.100. The fact that researchers have found that clients tend to adopt beliefs similar to those of their therapists is evidence that psychotherapy is a form of a. b. c. d.

social influence. brain-washing. faith healing. collaborative enterprise. Difficulty: 1 Question ID: 3.1.100 Page Reference: 70 Topic: Research on Psychotherapy Skill: Conceptual Answer: a. social influence.

3.1.101. You are attending a convention of therapists and hear one of them talking about "improving communication and negotiation skills." What is the most likely form of therapy this person practices? a. b. c. d.

couples therapy Gestalt therapy a token economy stress reduction training Difficulty: 1 Question ID: 3.1.101 Page Reference: 71 Topic: Couples, Family, and Group Therapy Skill: Conceptual Answer: a. couples therapy

3.1.102. During a couples therapy session with Frances and her husband, the therapist suggests that she has been using "mind reading" again and that is not helping her in improving communication. Which of the following is an example of what the therapist thinks needs work? a. b. c. d.

She has a tendency to put words in the mouths of others. She fails to tell her husband of her wants in the hope that he will just know. She uses too many non-verbal gestures when she speaks, which is distracting to listeners. She often offers interpretations of her own behavior before the therapist has a chance to speak. Difficulty: 2 Question ID: 3.1.102 Page Reference: 71 Topic: Couples, Family, and Group Therapy Skill: Conceptual Answer: b. She fails to tell her husband of her wants in the hope that he will just know.

3.1.103. Parent management training is designed to a. b. c. d.

provide support for teen mothers. provide child care for mentally ill parents. teach parents new skills for rearing troubled children. educate professionals about the demands of parenting. Difficulty: 1 Question ID: 3.1.103 Page Reference: 71 Topic: Couples, Family, and Group Therapy Skill: Factual Answer: c. teach parents new skills for rearing troubled children.

3.1.104. What is a common goal in systems approaches to family therapy? a. b. c. d.

to train parents in behavior management to strengthen the alliance between parents to encourage family members to express emotion to point out how family behavior can cause psychopathology Difficulty: 1 Question ID: 3.1.104 Page Reference: 71 Topic: Couples, Family, and Group Therapy Skill: Conceptual Answer: b. to strengthen the alliance between parents

3.1.105. What is a widely held view among current theorists of family therapy? a. b. c. d.

Family relationships cause mental disorders. Altering family functioning can improve the mental health of family members. The child has to be a major focus of treatment. Family therapy should not be used in conjunction with individual therapy. Difficulty: 2 Question ID: 3.1.105 Page Reference: 71 Topic: Couples, Family, and Group Therapy Skill: Conceptual Answer: b. Altering family functioning can improve the mental health of family members.

3.1.106. Jason is attending a group in which he is learning specific information and skills that are designed to improve his psychological well-being. Jason is probably attending

a. b. c. d.

a Gestalt therapy group. a psychoeducational group. an encounter group. a self-help group. Difficulty: 1 Question ID: 3.1.106 Page Reference: 72 Topic: Couples, Family, and Group Therapy Skill: Conceptual Answer: b. a psychoeducational group.

3.1.107. Which term describes efforts to improve the environment in order prevent new cases of mental illness from developing? a. b. c. d.

social ecology primary prevention tertiary prevention secondary prevention Difficulty: 1 Question ID: 3.1.107 Page Reference: 72 Topic: Couples, Family, and Group Therapy Skill: Factual Answer: b. primary prevention

3.1.108. Programs that focus on the early detection of emotional problems so programs can be designed to keep them from becoming more serious is a form of a. b. c. d.

primary prevention. secondary prevention. tertiary prevention. wholistic prevention. Difficulty: 1 Question ID: 3.1.108 Page Reference: 72 Topic: Couples, Family, and Group Therapy Skill: Factual Answer: b. secondary prevention

3.1.109. As a community psychologist you have been hired to design a violence prevention program for a local school district. Your target population includes teenagers who have been convicted of violent crimes. Therefore your program will, by necessity, involve

a. b. c. d.

primary prevention. secondary prevention. tertiary prevention. forensic prevention. Difficulty: 1 Question ID: 3.1.109 Page Reference: 73 Topic: Couples, Family, and Group Therapy Skill: Applied Answer: c. tertiary prevention.

3.1.110. Many prevention programs in the field of mental health face an insurmountable obstacle in the field's a. b. c. d.

unwillingness to spend money on prevention programs. lack of a specific understanding of the cause of most mental disorders. control by one group of theorists who do not believe in prevention. inability to make a decision as to which mental illness to target first. Difficulty: 2 Question ID: 3.1.110 Page Reference: 73 Topic: Couples, Family, and Group Therapy Skill: Conceptual Answer: b. lack of a specific understanding of the cause of most mental disorders.

3.1.111. Several women who have been victims of rape establish a crisis line for rape victims. What type of prevention program does this crisis line represent? a. b. c. d.

primary reactive secondary fundamental Difficulty: 1 Question ID: 3.1.111 Page Reference: 72 Topic: Couples, Family and Group Therapy Skill: Conceptual Answer: c. secondary

3.1.112. What term is used to describe programs intended to reduce the adverse, indirect consequences of mental illness?

a. b. c. d.

primary prevention tertiary prevention quartile prevention secondary prevention Difficulty: 1 Question ID: 3.1.112 Page Reference: 73 Topic: Couples, Family and Group Therapy Skill: Factual Answer: b. tertiary prevention

3.1.113. The authors of your text express their strong belief that the choice of treatment should a. b. c. d.

be based on the therapist's years of experience. be determined by the client's problems. favor new experimental approaches. not be an issue, since almost anything works. Difficulty: 1 Question ID: 3.1.113 Page Reference: 73 Topic: Specific Treatments for Specific Disorders Skill: Factual Answer: b. be determined by the client's problems.

Short Answer 3.2.114. With regard to psychotherapy, all ethnic minorities face the challenge of __________ , the process of learning or adopting the cultural patterns of the majority group. Difficulty: 1 Question ID: 3.2.114 Page Reference: 55 Topic: Overview Skill: Conceptual Answer: acculturation

3.2.115. The most promising form of biological treatment in use today is __________, the use of medications to treat mental disorders. Difficulty: 2 Question ID: 3.2.115 Page Reference: 56 Topic: Biological Treatments Skill: Factual Answer: psychopharmacology

3.2.116. The form of psychotherapy used by Sigmund Freud himself was called __________ . Difficulty: 1 Question ID: 3.2.116 Page Reference: 58 Topic: Psychodynamic Psychotherapies Skill: Factual Answer: psychoanalysis 3.2.117. The experimenter's prediction about the outcome of a given experiment is known as the __________ .

Difficulty: 1 Question ID: 3.2.117 Page Reference: 61 Topic: Cognitive Behvior Therapy Skill: Factial Answer: hypothesis

3.2.118. In an experiment to compare the effects of a treatment to no treatment, the group receiving the treatment is known as the __________ group. Difficulty: 1 Question ID: 3.2.118 Page Reference: 61 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: experimental

3.2.119. Joseph Wolpe developed an effective form of treatment for phobias designed to break the link between object of fear and the experience of fear. His therapy is known as systematic __________. Difficulty: 2 Question ID: 3.2.119 Page Reference: 60 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: desensitization

3.2.120. The main goal of __________ __________ training is to teach clients new ways of behaving that are both desirable and likely to be rewarded in everyday life. Difficulty: 2 Question ID: 3.2.120 Page Reference: 62 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: social skills

3.2.121. According to Albert Ellis emotional disorders are caused by __________ beliefs.

Difficulty: 1 Question ID: 3.2.121 Page Reference: 63 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: irrational

3.2.122. According to the text recent years have witnessed the development of a __________ wave of CBT based on broad principles such as acceptance and mindfulness.

Difficulty: 1 Question ID: 3.2.122 Page Reference: 63 Topic: Cognitive-Behavior Therapy Skill: Factual Answer: third

3.2.123. Humanistic psychotherapy was conceived of as a __________ force to counter act flaws in psychodynamic and cognitive behavior therapies. Difficulty: 1 Question ID: 3.2.123 Page Reference: 63 Topic: Humanistic Therapies Skill: Factual Answer: third

3.2.124. Carl Rogers suggested that three qualities made for a good therapist: warmth, genuineness and particularly __________ . Difficulty: 1 Question ID: 3.2.124 Page Reference: 64 Topic: Humanistic Therapies Skill: Conceptual Answer: empathy

3.2.125. __________ prevention tries to improve the environment or social situation so fewer new cases of a mental problem get started.

Difficulty: 1 Question ID: 3.2.125 Page Reference: 72 Topic: Couples, Family, and Group Therapy Skill: Factual Answer: Primary

3.2.126. A statistical procedure that allows researchers to combine the results from several studies on a similar topic in a standardized way is known as __________ - __________ . Difficulty: 2 Question ID: 3.2.126

Page Reference: 64 Topic: Research on Psychotherapy Skill: Conceptual Answer: meta analysis

3.2.127. Prevention efforts that aim to improve the overall environment in order to reduce the incidence of new cases of mental disorders in called what type of prevention? __________ Difficulty: 1 Question ID: 3.2.127 Page Reference: 72 Topic: Couples, Family, and Group Therapy Skill: Conceptual Answer: primary

Essay 3.3.128. Discuss some of the major issues in the use of psychotropic drugs to treat mental disorders. Difficulty: 2 Question ID: 3.3.128 Page Reference: 57-58 Topic: Biological Treatments Skill: Conceptual Answer: (1) There is considerable evidence that indicates that various drugs are safe and effective treatments for particular mental disorders. (2) These drugs offer symptom relief, but they do not offer a cure for the underlying pathology. (3) All drugs have side effects, which is one of the major reasons that many patients do not take their medications. (4) Many drugs must be taken for long periods of time. It may be necessary to take the drugs for months, years, or sometimes for a lifetime.

3.3.129. Describe the technique of systematic desensitization. Difficulty: 2 Question ID: 3.3.129 Page Reference: 60 Topic: Cognitive-Behavior Therapy Skill: Conceptual Answer: Systematic desensitization, developed by Joseph Wolpe, has three key elements. The first is relaxation training (usually progressive muscle relaxation) is used to induce a calm state through the contraction and relaxation of all of the major muscle groups. The second component is the construction of a hierarchy of fears ranging from very mild to very frightening stimuli. The third part is the learning process, namely, the pairing of the feared stimulus with the relaxation response. Wolpe had his clients carry out the pairing in their imagination. Evidence supports the effectiveness of this treatment for fears and phobias, although the specific mechanism that leads to the fear reduction is not clear.

3.3.130. In what ways is humanistic therapy different from psychodynamic and behavioral therapies? In what ways is humanistic therapy similar to psychodynamic and behavioral therapies? Difficulty: 3 Question ID: 3.3.130 Page Reference: 58-63 Topic: Humanistic Therapies Skill: Applied Answer: Humanistic therapy was promoted originally to counteract what were seen as overly mechanistic and deterministic views of psychodynamic and behavioral approaches. Different: humanistic therapy focuses on a genuine, reciprocal relationship as the treatment, not as the means for delivering therapy. Similar to psychoanalytic: focus on uncovering hidden emotions. Similar to behavioral: focus on the present.

3.3.131. Discuss the problems associated with using no-treatment control groups in experimental research on treatment effectiveness. Difficulty: 2 Question ID: 3.3.131 Page Reference: 65-66 Topic: Research on Psychotherapy Skill: Conceptual Answer: In experimental research on psychotherapy, some clients are assigned to a no-treatment control group. These people are part of a waiting list, so they will receive psychotherapy at some future time. While waiting for therapy, people in no-treatment control groups often seek counseling and advice from family members, friends, or religious leaders. Thus, any improvement in their condition may not be due to spontaneous remission, but may be due to receiving informal psychological help.

3.3.132. What is the placebo effect, why is it important, and how do researchers deal with it in outcome research? Difficulty: 2 Question ID: 3.3.132 Page Reference: 66 Topic: Research on Psychotherapy Skill: Conceptual Answer: The placebo effect refers to the powerful healing that can be produced by apparently inert treatment. It is important because it has been repeatedly shown to be a factor that can produce many of the benefits associated with physical and psychological treatments, thus making it difficult to determine if an active ingredient in the treatments was effective. Researchers have to isolate these active ingredients to determine whether they have effects beyond what the placebo effect alone could account for. Researchers do this by including a placebo control group in their outcome studies, and then they use double-blind procedures so that neither the patient nor the person treating the patient knows whether the patient received the active ingredient or the placebo.

3.3.133. Describe the procedures used in the Consumer Reports study of psychotherapy. What are some of the major findings of this study? Difficulty: 2 Question ID: 3.3.133 Page Reference: 67 Topic: Research on Psychotherapy Skill: Applied Answer: Consumer Reports surveyed nearly 3,000 respondents who had seen a mental health professional in the past three years. These respondents were generally satisfied with the treatment. For example, of those who were feeling "very poorly" at the beginning of treatment, 87 percent were feeling "very good," "good," or at least "so-so" when they were surveyed. The survey found that psychologists, psychiatrists, and social workers were essentially equal in treatment effectiveness. People who had received psychotherapy along reported similar outcomes as those who had received psychotherapy plus medication.

3.3.134. What are possible common factors in psychotherapy that might account for its effectiveness, and why is it important to know about them? Difficulty: 2 Question ID: 3.3.134 Page Reference: 68-70 Topic: Research on Psychotherapy Skill: Conceptual Answer: Studies indicate that clients' ratings of therapist warmth, empathy, and supportiveness predicted successful outcomes. Several studies have found that the actual therapeutic procedures differ during therapy, but the outcomes do not. One possible explanation for this is that while it may appear that psychotherapies are different, the most significant therapeutic factors may be the same. Clients rate their personal relationship with their therapists as the single most important aspect of both behavior therapy and psychodynamic psychotherapy. A therapist's supportiveness is related to positive outcomes across various approaches to treatment. It could be that not matter what the actual therapeutic procedures, the heart of the therapeutic endeavor is the relationship between client and therapist. Another possible common factor is that therapies all involve an element of social persuasion. No matter what the procedures, it is implied, by the therapist, that the client should behave and feel differently. Frank has defined psychotherapy as involving (1) a trained, socially sanctioned healer, whose healing powers are accepted by the sufferer and by his social group or an important segment of it, (2) a sufferer who seeks relief from the healer, (3) a circumscribed, more-or-less structured series of contacts between the healer and the sufferer, through which the healer, often with the aid of a group, tries to produce certain changes in the sufferer's emotional state, attitudes, and behavior. There is research evidence that the attitudes and beliefs of the client do begin to match those of the therapist as the therapy progresses. Knowing about common factors is important to help us to understand why many studies, like the Consumer Reports study, often do not show much difference in effectiveness between various treatment approaches. These common factors can also help us to understand why psychotherapy usually works.

3.3.135. Discuss the overall aims and strategies of community psychology.

Difficulty: 3 Question ID: 3.3.135 Page Reference: 72 Topic: Couples, Family, and Group Therapy Skill: Conceptual Answer: Community psychology is a branch of psychology that aims to reduce the incidence and severity of mental health problems by improving social conditions. This field believes that many social factors play a role in the cause of mental illness. Examples include poverty, the stress of prejudice both racial and sexual, and social stress. Primary prevention programs, such a Head Start, aim at a wide social group before any problems are specifically identified. Secondary programs aim at target groups where emerging social problems have been identified. Tertiary programs identify individuals who have already developed problems, but attempts to provide supports and social improvements that will likely reduce repeat problems.

Chapter 4 Classification and Assessment of Abnormal Behavior Total Assessment Guide (T.A.G.) Topic Overview pp. 75-78

Basic Issues in Classification pp. 78-80 Classifying Abnormal Behavior pp. 80-83 Evaluating Classification Systems pp. 83-86 Basic Issues in Assessment pp. 86-88 Psychological Assessment Procedures pp. 88-96

Biological Assessment Procedures pp. 96-99

Question Type Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice

Factual

Conceptual

1, 2, 3

Applied 4

107 5, 10

6, 7, 8, 11

97, 98, 99 12, 13, 14, 15, 16, 19, 20, 23, 24, 25, 32, 33, 35 100 36, 37, 38, 39, 48

108 17, 18, 21, 22, 27, 29, 31, 34

26, 28, 30

109, 110, 111* 41, 42, 43, 45, 46, 47

40, 44, 49

101 111*, 114 51

50, 53, 54

102 55, 57, 59, 61, 62, 66, 67, 68, 69, 70, 74, 75, 76, 78, 80, 81, 84, 85 103, 104, 105

112 56, 58, 60, 63, 64, 72, 77, 79, 82, 83

Short Answer Essay Multiple 86, 89, 91, 92, 95, 87, 88, 90 Choice 96 Short Answer 106 Essay *This question covers two topics

65, 71, 73

93, 94

113

Chapter 4: Classification and Assessment of Abnormal Behavior Multiple Choice 4.1.1. A psychologist conducts an interview and administers several psychological tests in order to evaluate the nature of a person's problem and to formulate a treatment plan. What term is used to describe this process? a. b. c. d.

diagnosis assessment validation ego analysis Difficulty: 1 Question ID: 4.1.1 Page Reference: 75 Topic: Overview Skill: Factual Answer: b. assessment

4.1.2. In the field of mental health, a clinician's decision to assign a diagnosis when a person's behavior meets the specific criteria for a particular type of disorder is important because it tells the clinician a. b. c. d.

that the person's problems are similar to those experienced by others. what caused the person's problems. exactly how the problems can best be treated. that the person's problems are unique. Difficulty: 1 Question ID: 4.1.2 Page Reference: 76 Topic: Overview Skill: Factual Answer: a. that the person's problems are similar to those experienced by others.

4.1.3.

What is a diagnosis?

a. b. c. d.

an explanation of the etiology of a problem an estimate of the chances of a full recovery a description of behavior as fitting the criteria for a particular type of disorder a mental health professional's estimate of the impact of family conflict on a disorder

Difficulty: 1

Question ID: 4.1.3 Page Reference: 76 Topic: Overview Skill: Factual Answer: c. a description of behavior as fitting the criteria for a particular type of disorder

4.1.4. In the case of Michael presented in your text, which of these is one of the keys that should lead a mental health professional to suspect that Michael suffers from obsessive-compulsive disorder? a. b. c. d.

Michael's symptoms fall into a recognized pattern. There is a significant family history of conflict. Michael expresses a need to be alone. Michael has trouble communicating his thoughts. Difficulty: 2 Question ID: 4.1.4 Page Reference: 77 Topic: Overview Skill: Applied Answer: a. Michael's symptoms fall into a recognized pattern.

4.1.5.

One advantage of a dimensional system of classification is that it allows scientists to

a. b. c. d.

make all-or-none decisions. arrive at a specific diagnosis. record subtle distinctions. go beyond what people say. Difficulty: 2 Question ID: 4.1.5 Page Reference: 78 Topic: Basic Issues in Classification Skill: Conceptual Answer: c. record subtle distinctions.

4.1.6.

A system that classifies mental disorders on the basis their qualitative differences is known as a

a. b. c. d.

class approach. dimensional approach. categorical approach. measurement approach.

Difficulty: 2

Question ID: 4.1.6 Page Reference: 78 Topic: Basic Issues in Classification Skill: Factual Answer: c. categorical approach

4.1.7. In the classification of intellectual ability, psychologists determine how much intelligence a person has on a particular set of tasks; such a classification system is known as a. b. c. d.

archetypal. dimensional. categorical. diagnostic. Difficulty: 2 Question ID: 4.1.7 Page Reference: 78 Topic: Basic Issues in Classification Skill: Factual Answer: b. dimensional.

4.1.8. A classification system that focuses on how much of a given characteristic an individual exhibits is called a. b. c. d.

categorical. measurement based. classificatory. dimensional. Difficulty: 2 Question ID: 4.1.8 Page Reference: 78 Topic: Basic Issues in Classification Skill: Factual Answer: d. dimensional.

4.1.9. The development of scientific classification system proceeds in an orderly fashion over several years from the first steps involving description to later stages involving a. b. c. d.

diagnosis. theory. dimensions. categories. Difficulty: 1

Question ID: 4.1.9 Page Reference: 78 Topic: Basic Issues in Classification Skill: Applied Answer: b. theory.

4.1.10. The most likely theories for the cause of mental disorders involve a. b. c. d.

biological systems. psychological systems. social systems. interactions involving all three of the above. Difficulty: 1 Question ID: 4.1.10 Page Reference: 80 Topic: Basic Issues in Classification Skill: Conceptual Answer: d. interactions involving all three of the above.

4.1.11. Mental disorders are currently classified on the basis of a. b. c. d.

causal mechanisms. biological features. descriptive features. theoretical relatedness. Difficulty: 1 Question ID: 4.1.11 Page Reference: 78 Topic: Basic Issues in Classification Skill: Factual Answer: c. descriptive features.

4.1.12. Currently there are two classification systems for mental disorders used in the world; the DSM, used mostly in North America, and in most of the rest of world the a. b. c. d.

WHO. ICD. DSM-TR. PCL.

Difficulty: 1

Question ID: 4.1.12 Page Reference: 80 Topic: Classifying Abnormal Behavior Skill: Factual Answer: b. ICD.

4.1.13. The Diagnostic and Statistical Manual of the American Psychiatric Association is also called the DSM-IV-TR. The IV refers to the 4th edition. What does the TR stand for? a. b. c. d.

Text Replacements Tertiary Revision Text Revision Tertiary Replacements Difficulty: 1 Question ID: 4.1.13 Page Reference: 80 Topic: Classifying Abnormal Behavior Skill: Factual Answer: c. Text Revision

4.1.14. Which organizations publish the two most widely recognized diagnostic systems for mental disorder? a. b. c. d.

American Psychiatric Association and World Health Organization American Psychiatric Association and American Psychological Association National Institute of Mental Health and the American Medical Association American Medical Association and the National Association for the Mentally Ill Difficulty: 1 Question ID: 4.1.14 Page Reference: 80 Topic: Classifying Abnormal Behavior Skill: Factual Answer: a. American Psychiatric Association and World Health Organization

4.1.15. In the 1950s and 1960s, mental health clinicians using DSM-I and DSM-II who independently evaluated the same client a. b. c. d.

usually arrived at the same diagnosis. frequently disagreed with one another. relied heavily on psychological tests. tended to prefer the term "problems in living." Difficulty: 1

Question ID: 4.1.15 Page Reference: 80 Topic: Classifying Abnormal Behavior Skill: Factual Answer: b. frequently disagreed with one another.

4.1.16. Labeling theory is a perspective on mental disorders that focuses on a. b. c. d.

interrater reliability in diagnosis. identification of biological causes of mental disorders. social factors that influence the assignment of a diagnosis. validity of including certain symptoms in criteria for diagnosis. Difficulty: 1 Question ID: 4.1.16 Page Reference: 79 Topic: Classifying Abnormal Behavior Skill: Factual Answer: c. social factors that influence the assignment of a diagnosis.

4.1.17. According to labeling theory, a psychiatric diagnosis serves to a. b. c. d.

identify etiological factors. eliminate bias due to social factors. clarify the nature of a psychiatric disorder. create a social role that perpetuates abnormal behavior. Difficulty: 2 Question ID: 4.1.17 Page Reference: 79 Topic: Classifying Abnormal Behavior Skill: Conceptual Answer: d. create a social role that perpetuates abnormal behavior.

4.1.18. A patient was just released from a psychiatric hospital where he has spent the last five years. A social worker spends some time trying to help him prepare for what she calls stigma. What was the focus of these sessions? a. b. c. d.

negative attitudes that result in various forms of discrimination the tendency for most mental patients to cease taking their medications the tendency for the public to provide too much assistance to former mental patients a government effort to assist former mental patients by providing group living arrangements

Difficulty: 1

Question ID: 4.1.18 Page Reference: 79 Topic: Classifying Abnormal Behavior Skill: Conceptual Answer: a. negative attitudes that result in various forms of discrimination

4.1.19. DSM-IV diagnoses are grouped under 18 general categories based on a. b. c. d.

presumed causes. biological factors. descriptive similarity. theoretical assumptions. Difficulty: 1 Question ID: 4.1.19 Page Reference: 80 Topic: Classifying Abnormal Behavior Skill: Factual Answer: c. descriptive similarity.

4.1.20. Modern classification systems in psychiatry were introduced a. b. c. d.

by biologists and then adapted by psychiatrists. by clinical psychologists working for the World Health Organization. by Freud before WWII. shortly after WWII. Difficulty: 1 Question ID: 4.1.20 Page Reference: 980 Topic: Classifying Abnormal Behavior Skill: Factual Answer: d. shortly after WWII.

4.1.21. A clinician is using DSM-IV-TR to arrive at a diagnosis for Michael, the case presented in your text; to justify a diagnosis of obsessive-compulsive disorder, the clinician will have to a. b. c. d.

conduct extensive psychological tests. refer Michael to a physician. compare Michael to a specific set of criteria. arrange for Michael to undergo a brain scan.

Difficulty: 2 Question ID: 4.1.21

Page Reference: 80-81 Topic: Classifying Abnormal Behavior Skill: Conceptual Answer: c. compare Michael to a specific set of criteria.

4.1.22. The DSM-IV-TR uses a multiaxial system; each person is rated on five separate axes. Which of the following is NOT a concern of one of these axes? a. b. c. d.

diagnostic categories. general medical conditions. a description of the individual’s psychosexual history. a global assessment of the person’s overall level of functioning. Difficulty: 1 Question ID: 4.1.22 Page Reference: 80-81 Topic: Classifying Abnormal Behavior Skill: Conceptual Answer: c. a description of the individual’s psychosexual history..

4.1.23. Which of the following describes the multiaxial approach of DSM-IV? a. b. c. d.

five axes, two of which list specific mental disorders five axes, one of which lists specific mental disorders three axes, two of which list specific mental disorders three axes, one of which lists specific mental disorders Difficulty: 2 Question ID: 4.1.23 Page Reference: 80 Topic: Classifying Abnormal Behavior Skill: Factual Answer: a. five axes, two of which list specific mental disorders

4.1.24. In order to meet the criteria for schizotypal personality disorder, a person must have five of the listed symptoms. Moreover, the symptoms cannot be due to disorders such as schizophrenia. What aspects of the DSM system are illustrated by these diagnostic criteria? a. b. c. d.

reliable and valid criteria primary and secondary criteria inclusion and exclusion criteria etiological diagnosis and assessment Difficulty: 2 Question ID: 4.1.24

Page Reference: 80 Topic: Classifying Abnormal Behavior Skill: Factual Answer: c. inclusion and exclusion criteria

4.1.25. In DSM, clinical disorders can be classified on either Axis I or Axis II; which of the following statements is true? a. b. c. d.

Most disorders are classified on Axis II. Only disorders with episodes of psychological turmoil are classified on Axis II. Axis II is concerned with stable, long-standing problems. Mild disorders are classified on Axis I, and more severe disorders are classified on Axis II. Difficulty: 2 Question ID: 4.1.25 Page Reference: 80 Topic: Classifying Abnormal Behavior Skill: Factual Answer: c. Axis II is concerned with stable, long-standing problems.

4.1.26. In the case of Michael, from the text, he received an Axis I diagnosis of obsessive-compulsive disorder and an Axis II diagnosis of schizotypal personality disorder. The Axis II diagnosis was based on a. b. c. d.

his inability to adjust to changing requirements of different people and situations. his reports of hallucinations and delusions. long standing depression. his almost constant fear of being contaminated by anything associated with school. Difficulty: 2 Question ID: 4.1.26 Page Reference: 80 Topic: Classifying Abnormal Behavior Skill: Applied Answer: a. his inability to adjust to changing requirements of different people and situations.

4.1.27. In the example in the textbook of Michael he met the criteria for diagnosis for obsessivecompulsive disorder (OCD). Which of the following did not point toward that diagnosis? a. b. c. d.

He performed repetitive hand-washing rituals in response to obsessive thoughts. He considered his obsessive concerns to be logical. His relationships with his friends were limited due to his fear of contamination. His rituals interfered with his family’s income. Difficulty: 1 Question ID: 4.1.27

Page Reference: 80 Topic: Classifying Abnormal Behavior Skill: Conceptual Answer: b. He considered his obsessive concerns to be logical. 4.1.28. Work on DSM-V a. b. c. d.

will begin in 2012. will be finished by 2013. is. progressing, but is being done in secret. it is being done by mostly lay people with experience with mental disorders. Difficulty: 2 Question ID: 4.1.28 Page Reference: 82 Topic: Classifying Abnormal Behavior Skill: Applied Answer: b. will be finished by 2013.

4.1.29. One pervasive issue for almost all DSM-V working groups is a. b. c. d.

the question of whether mental disorders are real or culturally constructed. the integration of dimensional and categorical assessment procedures. the validity of the classification of homosexuality as a mental disorder. the cost of various models of mental health care. Difficulty: 2 Question ID: 4.1.29 Page Reference: 82 Topic: Classifying Abnormal Behavior Skill: Conceptual Answer: b. the integration of dimensional and categorical assessment procedures.

4.1.30. Oscar has recently lost a loved one; a mental health professional who is trying to be sensitive to the cultural context of Oscar's problem will want to know a. b. c. d.

what Oscar has learned about how grief should be displayed. how depressed Oscar is. whether Oscar suffers from some chemical imbalance. whether Oscar's family has a history of depression. Difficulty: 1 Question ID: 4.1.30 Page Reference: 81 Topic: Classifying Abnormal Behavior Skill: Applied

Answer: a. what Oscar has learned about how grief should be displayed.

4.1.31. In the DSM, the behavior referred to as ataques de nervios is viewed as an example of a. b. c. d.

paranoid schizophrenia. panic disorder. a culture-free syndrome. a culture-bound syndrome. Difficulty: 1 Question ID: 4.1.31 Page Reference: 82 Topic: Classifying Abnormal Behavior Skill: Conceptual Answer: d. a culture-bound syndrome.

4.1.32. Culture-bound syndromes in DSM are also known as idioms of distress because they represent a. b. c. d.

different forms of speech. a unique manner of expressing emotion. the non-professional term for mental disorders. non-existent or imagined forms of psychopathology. Difficulty: 1 Question ID: 4.1.32 Page Reference: 82 Topic: Classifying Abnormal Behavior Skill: Factual Answer: b. a unique manner of expressing emotion.

4.1.33. Which of the following seems to be a key feature of ataques de nervios? a. b. c. d.

delusions hallucinations loss of control a need to sleep for long periods

Difficulty: 1 Question ID: 4.1.33 Page Reference: 82 Topic: Classifying Abnormal Behavior Skill: Factual

Answer: c. loss of control

4.1.34. One theory to explain ataques de nervios is that it may be a culturally sanctioned way of expressing a. b. c. d.

fear of darkness. disagreement with the cultural group. distress in response to a threat to the family. fear of death. Difficulty: 2 Question ID: 4.1.34 Page Reference: 82 Topic: Classifying Abnormal Behavior Skill: Conceptual Answer: c. distress in response to a threat to the family.

4.1.35. Your text suggests the possibility that the eating disorder known as bulimia could be listed as a culture-bound syndrome; what fact best supports this view? a. b. c. d.

Eating rituals vary between cultures. Bulimia is found primarily in developed Western cultures. Bulimia is a rare condition. The prevalence of eating disorders does not vary between countries. Difficulty: 2 Question ID: 4.1.35 Page Reference: 82 Topic: Classifying Abnormal Behavior Skill: Factual Answer: b. Bulimia is found primarily in developed Western cultures.

4.1.36. The two principal criteria used to evaluate a classification system like DSM-IV-TR are a. b. c. d.

reactivity and sensitivity. reliability and validity. inclusiveness and exclusiveness. cultural specificity and cultural universality.

Difficulty: 1 Question ID: 4.1.36 Page Reference: 83 Topic: Evaluating Classification Systems Skill: Factual

Answer: b. reliability and validity.

4.1.37. Two clinical psychologists each interview and diagnose a group of patients. The extent to which they agree on the diagnosis of each patient is called a. b. c. d.

utility. validity. coverage. reliability. Difficulty: 1 Question ID: 4.1.37 Page Reference: 83 Topic: Evaluating Classification Systems Skill: Factual Answer: d. reliability.

4.1.38. When we ask whether a category or diagnosis is useful, we are asking about its a. b. c. d.

kappa. coverage. validity. reliability. Difficulty: 1 Question ID: 4.1.38 Page Reference: 83 Topic: Evaluating Classification Systems Skill: Factual Answer: c. validity.

4.1.39. "Kappa" is a measure of interrater reliability that describes a. b. c. d.

the proportion of time raters agree exactly. proportion of agreement beyond chance agreement. whether certain diagnoses are used disproportionately. whether a clinician is equally accurate with all diagnoses.

Difficulty: 1 Question ID: 4.1.39 Page Reference: 84 Topic: Evaluating Classification Systems Skill: Factual

Answer: b. proportion of agreement beyond chance agreement.

4.1.40. A team of researchers has developed a structured interview to diagnose a new type of personality disorder. A series of trials to check the reliability of the structured interview yields a kappa of .75. How should the researchers view this result? a. The kappa is so low they decide to abandon the project. b. The kappa is not at an acceptable level but encouraging for a new instrument that can be improved. c. Kappa is not the appropriate measure to be used when evaluating the reliability of a new diagnostic category. d. The kappa is at an acceptable level for well-established diagnostic instruments, so the interview is ready to be used in clinical settings. Difficulty: 2 Question ID: 4.1.40 Page Reference: 84 Topic: Evaluating Classification Systems Skill: Applied Answer: d. The kappa is at an acceptable level for well-established diagnostic instruments, so the interview is ready to be used in clinical settings.

4.1.41. If you had to briefly summarize the results of research on diagnostic reliability of mental disorders, which of the following sentences would do the job? a. b. c. d.

"The reliability has increased with few exceptions." "Reliability for major categories is higher than for specific subtypes." "The highest reliability is found for the specific examples of each of the major categories." "There is good reliability for personality disorders but lower reliability for other disorders." Difficulty: 1 Question ID: 4.1.41 Page Reference: 84 Topic: Evaluating Classification Systems Skill: Conceptual Answer: b. "Reliability for major categories is higher than for specific subtypes."

4.1.42. Your text describes a study of the reliability of diagnoses for several types of mental disorders which concludes a. b. c. d.

clinicians do not use psychological testing. more categories of mental disorder should be introduced. the diagnostic categories of the DSM are not always used reliably by clinicians. psychiatrists and psychologists fail to cooperate.

Difficulty: 2 Question ID: 4.1.42 Page Reference: 85 Topic: Evaluating Classification Systems Skill: Conceptual Answer: c. the diagnostic categories of the DSM are not always used reliably by clinicians.

4.1.43. Which of the following disorders have especially low diagnostic reliability? a. b. c. d.

anxiety disorders, substance use disorders, mood disorders schizophrenic disorders, mood disorders, personality disorders substance use disorders, obsessive-compulsive disorder, manic episodes schizotypal personality disorder, histrionic personality, dependent personality disorder Difficulty: 2 Question ID: 4.1.43 Page Reference: 85 Topic: Evaluating Classification Systems Skill: Factual Answer: d. schizotypal personality disorder, histrionic personality, dependent personality disorder

4.1.44. You are part of a team designing a study to see if a given DSM category tends to run in families. With regards to validity your team is looking for evidence of a. b. c. d.

genetic validity. test-retest validity. reliable validity. etiological validity. Difficulty: 1 Question ID: 4.1.44 Page Reference: 83 Topic: Evaluating Classification Systems Skill: Applied Answer: d. etiological validity.

4.1.45. Videotapes of 10-year-old children are being used to determine if their social interactions are related to the development of schizophrenia in adulthood. What type of validity is the focus of interest here? a. b. c. d.

prognostic validity predictive validity concurrent validity test-retest validity

Difficulty: 1 Question ID: 4.1.45 Page Reference: 83 Topic: Evaluating Classification Systems Skill: Conceptual Answer: b. predictive validity

4.1.46. The case of Michael presented in your text illustrates comorbidity because a. b. c. d.

Michael suffers from more than one disorder. Michael suffers from a life-threatening disorder. Michael's disorder resulted from family conflict. Michael shares the disorder with other members of his family. Difficulty: 1 Question ID: 4.1.46 Page Reference: 86 Topic: Evaluating Classification Systems Skill: Conceptual Answer: a. Michael suffers from more than one disorder.

4.1.47. In DSM, many disorders are defined in terms of cutoff point for the number of features required for a diagnosis; such cutoff points a. b. c. d.

are based on extensive empirical justification. are often chosen with little empirical justification. are usually set at a low threshold to increase the number of diagnosed cases. are usually set at a high threshold to decrease the number of diagnosed cases. Difficulty: 2 Question ID: 4.1.47 Page Reference: 85 Topic: Evaluating Classification Systems Skill: Conceptual Answer: b. are often chosen with little empirical justification.

4.1.48. According to the National Comorbidity Survey, what percentage of people who qualify for a diagnosis of one mental disorder in their lifetime are likely to meet the criteria for two or more disorders? a. b. c. d.

less than 5 percent almost 100 percent a little more than 50 percent no more than 20 percent Difficulty: 2

Question ID: 4.1.48 Page Reference: 86 Topic: Evaluating Classification Systems Skill: Factual Answer: c. a little more than 50 percent

4.1.49. A clinician has met with a client who presents symptoms that would meet the criteria for several disorders; according to DSM, the clinician would a. b. c. d.

pick the most severe disorder to diagnose. pick the disorder that appeared first to diagnose. diagnose each disorder that fits the client's symptoms. have to decide which disorder was the most treatable. Difficulty: 1 Question ID: 4.1.49 Page Reference: 86 Topic: Evaluating Classification Systems Skill: Applied Answer: c. diagnose each disorder that fits the client's symptoms.

4.1.50. The three primary goals that guide most assessment procedures are a. b. c. d.

making predictions, planning treatments, evaluating treatments. pinpointing etiology, testing etiology, and planning treatments pinpointing etiology, evaluating etiology, and making predictions. deciding on a diagnosis, testing the diagnosis, and pinpointing etiology. Difficulty: 2 Question ID: 4.1.50 Page Reference: 86 Topic: Basic Issues in Assessment Skill: Factual Answer: a. making predictions, planning treatments, evaluating treatments.

4.1.51. Based on their assessment, clinicians want to generalize, or draw inferences about the person's behavior in the natural environment, but a. b. c. d.

clinicians are unable to generalize accurately. clinicians must rely on specific samples of a person's behavior. only psychophysiological tests allow for such generalizations. only objective tests allow for such generalizations. Difficulty: 2 Question ID: 4.1.51

Page Reference: 87 Topic: Basic Issues in Assessment Skill: Conceptual Answer: b. clinicians must rely on specific samples of a person's behavior.

4.1.52. A psychologist wants to obtain a measure of children's attention spans under quiet conditions. She arranges for a group of children to meet individually with a research assistant who reads each child a list of numbers and then asks the child to repeat the numbers in reverse order. A week later the children repeat this task. The psychologist finds that the scores that each child received at week one and at week two tend to be very similar. She concludes that this test has high a. b. c. d.

validity. split-half reliability. interrater reliability. test-retest reliability. Difficulty: 2 Question ID: 4.1.52 Page Reference: 87 Topic: Basic Issues in Assessment Skill: Applied Answer: d. test-retest reliability.

4.1.53. Split-half reliability is a measure of a test's a. b. c. d.

validity. internal consistency. interrater consistency. test-retest consistency. Difficulty: 1 Question ID: 4.1.53 Page Reference: 87 Topic: Basic Issues in Assessment Skill: Factual Answer: b. internal consistency.

4.1.54. Which of the following is the best word or phrase to explain the meaning of validity of an assessment procedure? a. b. c. d.

meaning consistency reliability predictability

Difficulty: 1 Question ID: 4.1.54 Page Reference: 88 Topic: Basic Issues in Assessment Skill: Factual Answer: a. meaning

4.1.55. What are the most commonly used psychological assessment procedures? a. b. c. d.

IQ tests interviews rating scales personality tests Difficulty: 1 Question ID: 4.1.55 Page Reference: 89 Topic: Psychological Assessment Procedures Skill: Factual Answer: b. interviews

4.1.56. Paul Meehl has suggested that when clinicians mistakenly pay attention to vague, superficial, or stereotyped statements by clients, and fail to pay to attention to subtler but more important evidence, they are victims of the cognitive error he has labeled the a. b. c. d.

cognitive dissonance effect. unreliability bias. Barnum effect. diagnostic fallibility crisis. Difficulty: 2 Question ID: 4.1.56 Page Reference: 89 Topic: Psychological Assessment Procedures Skill: Conceptual Answer: c. Barnum effect.

4.1.57. Why are interviews with psychiatric patients important? a. b. c. d.

They incorporate talk therapy. Diagnoses cannot be made without them. The therapist can explain the diagnosis. Many psychiatric symptoms are subjective. Difficulty: 1

Question ID: 4.1.57 Page Reference: 89 Topic: Psychological Assessment Procedures Skill: Factual Answer: d. Many psychiatric symptoms are subjective.

4.1.58. A clinical psychologist is interviewing a client and asks a series of questions. Later the same psychologist interviews another client and asks the same series of questions in the same order. What type of interview is the psychologist using? a. b. c. d.

primary interview objective interview projective interview structured interview Difficulty: 1 Question ID: 4.1.58 Page Reference: 90 Topic: Psychological Assessment Procedures Skill: Conceptual Answer: d. structured interview

4.1.59. Why do researchers conducting epidemiological studies often employ structured interviews? a. b. c. d.

to reduce the need for value judgments to reduce the need to establish rapport to increase the validity of diagnostic decisions to increase the reliability of diagnostic decisions Difficulty: 1 Question ID: 4.1.59 Page Reference: 90 Topic: Psychological Assessment Procedures Skill: Factual Answer: d. to increase the reliability of diagnostic decisions

4.1.60. What is one of the advantages of structured interviews in assessing clients? a. b. c. d.

Scoring is based on empirical research. Structured interviews do not require training. The interviewer can probe further when necessary. The structured interview has a strict time limit that provides more time for other diagnostic tests. Difficulty: 1 Question ID: 4.1.60

Page Reference: 90 Topic: Psychological Assessment Procedures Skill: Conceptual Answer: c. The interviewer can probe further when necessary.

4.1.61. What is one of the limitations of structured interviews? a. b. c. d.

There is no room for clinical judgment. They are based only on open-ended questions. Information provided by the client can be distorted. The interviewer cannot control the course of the interview. Difficulty: 1 Question ID: 4.1.61 Page Reference: 90 Topic: Psychological Assessment Procedures Skill: Factual Answer: c. Information provided by the client can be distorted.

4.1.62. Using observation as part of a clinical interview can help the interviewer to a. b. c. d.

confirm the person's self-report. question the person's self-report. both confirm and question the person's self-report. neither confirm nor question, because observation is a different assessment procedure. Difficulty: 1 Question ID: 4.1.62 Page Reference: 91 Topic: Psychological Assessment Procedures Skill: Factual Answer: c. both confirm and question the person's self-report.

4.1.63. A client is asked to respond to items such as "How much distress do your obsessive thoughts cause you?" by using numbers from 0 to 4. What type of assessment is being used? a. b. c. d.

rating scale behavioral coding projective testing self-report inventory Difficulty: 1 Question ID: 4.1.63 Page Reference: 92 Topic: Psychological Assessment Procedures

Skill: Conceptual Answer: a. rating scale 4.1.64. A researcher wants to compare the use of rating scales to behavioral coding systems. After making the comparison, he concludes that behavioral coding systems tend to a. b. c. d.

be less reliable. be more qualitative. require more subjective judgment. require less inference by the observer. Difficulty: 1 Question ID: 4.1.64 Page Reference: 92 Topic: Psychological Assessment Procedures Skill: Conceptual Answer: d. require less inference by the observer.

4.1.65. Alice has been experiencing a number of symptoms of anxiety for several months. A psychologist decides to assess her symptoms by using a behavioral coding system. What is Alice likely to be asked to do? a. evaluate the symbolism of each of her symptoms b. record the presence of specific symptoms during 30-minute segments throughout the day c. rate the level of anxiety she feels on a scale ranging from very anxious to not anxious d. discuss her symptoms while a psychologist checks instruments designed to measure her pulse and breathing Difficulty: 2 Question ID: 4.1.65 Page Reference: 92 Topic: Psychological Assessment Procedures Skill: Applied Answer: b. record the presence of specific symptoms during 30-minute segments throughout the day

4.1.66. Self-monitoring refers to a. b. c. d.

clinicians looking out for their own biases. children learning to regulate their own behavior. adult clients keeping records of their own behavior. the importance of the clinician's presence in formal observation. Difficulty: 1 Question ID: 4.1.66 Page Reference: 93 Topic: Psychological Assessment Procedures

Skill: Factual Answer: c. adult clients keeping records of their own behavior.

4.1.67. Reactivity refers to the a. b. c. d.

effects of personal judgment on observers' ratings. tendency for observers to rate less severity over time. tendency for a person to change her behavior when she knows she is being observed. tendency for a person to reveal less in a structured interview than on a questionnaire. Difficulty: 1 Question ID: 4.1.67 Page Reference: 93 Topic: Psychological Assessment Procedures Skill: Factual Answer: c. tendency for a person to change her behavior when she knows she is being observed.

4.1.68. What is the benefit of personality tests in psychological assessment? a. b. c. d.

the same stimuli are used every time the test is given it is more useful to assess personality than specific behaviors people are generally unable to describe their own personalities they don't have to be administered and interpreted by trained clinicians Difficulty: 1 Question ID: 4.1.68 Page Reference: 94 Topic: Psychological Assessment Procedures Skill: Factual Answer: a. the same stimuli are used every time the test is given

4.1.69. Carol is asked to complete a questionnaire made up of more than 500 true-false items. What test is she taking? a. b. c. d.

Visual Analogue Test Thematic Apperception Test Wechsler Adult Intelligence Test Minnesota Multiphasic Personality Inventory Difficulty: 1 Question ID: 4.1.69 Page Reference: 93 Topic: Psychological Assessment Procedures Skill: Factual

Answer: d. Minnesota Multiphasic Personality Inventory

4.1.70. After reviewing the manual for scoring the MMPI-2, Elizabeth decides that the scoring can best be described as a. b. c. d.

reactive. objective. subjective. projective. Difficulty: 1 Question ID: 4.1.70 Page Reference: 93 Topic: Psychological Assessment Procedures Skill: Factual Answer: b. objective.

4.1.71. A psychologist is reviewing results of the MMPI-2 test administered to a client who was mandated by a judge to seek therapy. The psychologist is concerned that the client may not have answered the questions consistently and honestly. Which part of the MMPI-2 will be of special interest to this psychologist? a. b. c. d.

validity scales actuarial scales projective scales reliability scales Difficulty: 1 Question ID: 4.1.71 Page Reference: 94 Topic: Psychological Assessment Procedures Skill: Applied Answer: a. validity scales

4.1.72. Several questions on the MMPI-2 contain questions that almost everyone is likely to answer in the same way; these questions are included to catch unsophisticated attempts to avoid answering honestly and are scored on the a. b. c. d.

D or Deception Scale L or Lie Scale T or Truth Scale O or Obfuscation Scale Difficulty: 1 Question ID: 4.1.72 Page Reference: 93-94

Topic: Psychological Assessment Procedures Skill: Conceptual Answer: b. L or Lie Scale

4.1.73. Ray is suspicious and has the unrelenting delusion that agents of a foreign government are following him with the intention of killing him. If administered the MMPI-2 you expect that Ray would have a high score on the scale measuring a. b. c. d.

Hysteria. Paranoia. Ego Identity. Narrow-mindedness. Difficulty: 1 Question ID: 4.1.73 Page Reference: 94 Topic: Psychological Assessment Procedures Skill: Applied Answer: b. Paranoia.

4.1.74. An actuarial procedure of interpretation of psychological tests relies on a. b. c. d.

subjective ratings of clinical interviews. current behavior rather than past behavior. psychoanalytic interpretation of test results. probability statements derived from empirical research. Difficulty: 2 Question ID: 4.1.74 Page Reference: 94 Topic: Psychological Assessment Procedures Skill: Factual Answer: d. probability statements derived from empirical research.

4.1.75. An advantage of the MMPI-2 in clinical assessment is that it a. b. c. d.

provides an in-depth measure of a small number of critical dimensions. gives the clinician ample opportunity to ask additional questions. covers a wide range of problems in an efficient manner. allows clinicians to include their own professional judgments. Difficulty: 2 Question ID: 4.1.75 Page Reference: 95 Topic: Psychological Assessment Procedures Skill: Factual

Answer: c. covers a wide range of problems in an efficient manner.

4.1.76. What is one of the limitations of the MMPI-2 as a personality measure? a. b. c. d.

It relies on subjective scoring. It is limited to use with the normal personality. There is little research on its reliability or validity. People who are acutely psychotic often have difficulty reading and comprehending. Difficulty: 1 Question ID: 4.1.76 Page Reference: 95 Topic: Psychological Assessment Procedures Skill: Factual Answer: d. People who are acutely psychotic often have difficulty reading and comprehending.

4.1.77. One empirical finding about the MMPI-2 scales is that an individual's scores change over time. This could be an indication a. b. c. d.

of the scales’ lack of reliability. of the scales’ sensitivity to changes in personality. both a and b none of the above are correct. Difficulty: 2 Question ID: 4.1.77 Page Reference: 95 Topic: Psychological Assessment Procedures Skill: Conceptual Answer: c. both a and b

4.1.78. Projective tests a. b. c. d.

are objectively scored. are used mostly by cognitive behavioral therapists. involve the presentation of stimuli that elicit standardized responses. involve the presentation of ambiguous stimuli. Difficulty: 1 Question ID: 4.1.78 Page Reference: 95 Topic: Psychological Assessment Procedures Skill: Factual Answer: d. involve the presentation of ambiguous stimuli.

4.1.79. A psychologist administers a series of projective tests to a client. Which major theoretical orientation is most consistent with this psychologist's preference in assessment methods? a. b. c. d.

behavioral biological humanistic psychodynamic Difficulty: 1 Question ID: 4.1.79 Page Reference: 95 Topic: Psychological Assessment Procedures Skill: Conceptual Answer: d. psychodynamic

4.1.80. What is the primary assumption of projective personality tests? a. b. c. d.

Self-report checklists are more efficient than interviews. Visual processing errors often indicate a schizophrenic process. Individuals would project unconscious feelings onto ambiguous stimuli. A person's future goals reveal a lot about motivation, emotion, and personality. Difficulty: 1 Question ID: 4.1.80 Page Reference: 95 Topic: Psychological Assessment Procedures Skill: Factual Answer: c. individuals would project unconscious feelings onto ambiguous stimuli

4.1.81. As originally designed, the Rorschach was scored based on the a. b. c. d.

client's verbal expressiveness. way descriptions take into account shapes and colors. emotions expressed by patients while looking at the cards. clinician's interpretations of the content of responses. Difficulty: 2 Question ID: 4.1.81 Page Reference: 95 Topic: Psychological Assessment Procedures Skill: Factual Answer: d. clinician's interpretations of the content of responses.

4.1.82. Recent advances in the scoring of projective tests focus on a. b. c. d.

the clinical experience of the clinician scoring the test. the form of the client's answers rather than the content. the content of the client's answers rather than the form. an objective score of the frequency of categories of responses. Difficulty: 2 Question ID: 4.1.82 Page Reference: 96 Topic: Psychological Assessment Procedures Skill: Conceptual Answer: b. the form of the client's answers rather than the content.

4.1.83. The textbook suggests that each of the following are potential advantages of a projective test EXCEPT? a. Some people feel more comfortable talking with someone rather than completing a lengthy questionnaire such as the MMPI. b. Whether or not they are subject to interpretation, a projective test can elicit interesting information about the person taking the test. c. While there are problems with both the reliability and validity of projective tests, they are still slightly better on both of these measures than tests such as the MMPI. d. If a person’s relationships with others has some unconscious cognitive or emotional component, this information may be obtained during the interview that is involved in a projective test. Difficulty: 1 Question ID: 4.1.83 Page Reference: 96 Topic: Psychological Assessment Procedures Skill: Conceptual Answer: c. While there are problems with both the reliability and validity of projective tests, they are still slightly better on both of these measures than tests such as the MMPI.

4.1.84. What is the main advantage of projective personality tests over other forms of personality tests? a. b. c. d.

objective scoring based on extensive research efficient self-administration can provide a view of a patient's unique view of the world Difficulty: 1 Question ID: 4.1.84 Page Reference: 96 Topic: Psychological Assessment Procedures Skill: Factual

Answer: d. can provide a view of a patient's unique view of the world

4.1.85. What is one of the limitations of projective personality testing? a. b. c. d.

little information on normal individuals or children focus on unconscious factors clients easily see through the testing standardized procedures leave little room for clinical judgment Difficulty: 1 Question ID: 4.1.85 Page Reference: 96 Topic: Psychological Assessment Procedures Skill: Factual Answer: a. little information on normal individuals or children

4.1.86. Recent advances in brain imaging have allowed clinicians to make scientifically useful comparisons in the relative size of the chambers in the brain that are filled with cerebrospinal fluid. These chambers are called a. b. c. d.

lobes. ventricles. cerebrospinal spaces. meninges. Difficulty: 1 Question ID: 4.1.86 Page Reference: 97 Topic: Biological Assessment Procedures Skill: Factual Answer: b. ventricles.

4.1.87. You are attempting to diagnosis a patient and you would like a view of her brain. You are interested in static structures, not function, so your two choices of scanning techniques are CT scans and a. b. c. d.

MRI. fMRI. EEG. TAT. Difficulty: 1 Question ID: 4.1.87 Page Reference: 97 Topic: Biological Assessment Procedures Skill: Conceptual

Answer: a. MRI.

4.1.88. fMRI is a new and exciting method of imaging brains that is based on the physiological observation that a. b. c. d. blood.

the magnetic properties of neurons change as they release neurotransmitters. the magnetic properties of blood changes as a function of the level of oxygen it is carrying. the magnetic resonance of brain regions changes with age and experience. blood flow can be measured directly by the magnetic properties of the vessels containing the

Difficulty: 2 Question ID: 4.1.88 Page Reference: 97 Topic: Biological Assessment Procedures Skill: Conceptual Answer: b. the magnetic properties of blood changes as a function of the level of oxygen it is carrying.

4.1.89. Pet and fMRI scans have found valuable information about the biological components of OCD including over activity in all of the following EXCEPT a. b. c. d.

Occipital Lobe. Orbital Prefontal Cortex. Head of the Caudate Nucleus. Anterior Cingulate Cortex. Difficulty: 3 Question ID: 4.1.89 Page Reference: 97 Topic: Biological Assessment Procedures Skill: Factual Answer: a. Occipital Lobe.

4.1.90. One of the main advantages of modern brain imaging techniques is that they can a. b. c. d.

illuminate the relationship between brain activity and mental problems. reduce the cost of clinical assessments. be used to validate the diagnostic information derived from projective techniques. eliminate the need for costly interview techniques in the diagnostic process. Difficulty: 2 Question ID: 4.1.90 Page Reference: 98 Topic: Biological Assessment Procedures Skill: Conceptual

Answer: a. illuminate the relationship between brain activity and mental problems.

4.1.91. One of the main limitations of modern brain imaging techniques in the field of abnormal psychology is that a. b. c. d.

very few hospitals in the United States have access to these tools. they are quite unreliable in their measures. the images are not of sufficient quality to allow for diagnostic use. they lack the normative information that would allow them to be used for diagnosis. Difficulty: 1 Question ID: 4.1.91 Page Reference: 98 Topic: Biological Assessment Procedures Skill: Factual Answer: d. they lack the normative information that would allow them to be used for diagnosis.

4.1.92. Which biological system is highly reactive to environmental events and can provide useful information regarding a person's emotional states? a. b. c. d.

central nervous system somatic nervous system parietal nervous system autonomic nervous system Difficulty: 1 Question ID: 4.1.92 Page Reference: 98 Topic: Biological Assessment Procedures Skill: Factual Answer: d. autonomic nervous system

4.1.93. How could psychophysiological measurements be used to help us with the case of Michael presented in your text? a. b. c. d.

to identify structural abnormalities in Michael's brain to monitor his heart rate when he touched a contaminated object to confirm the presence of REM activity while he was sleeping to verify that his problems were both psychological and physical Difficulty: 2 Question ID: 4.1.93 Page Reference: 99 Topic: Biological Assessment Procedures Skill: Applied

Answer: b. to monitor his heart rate when he touched a contaminated object

4.1.94. What is an advantage of the use of physiological measures in studying mental disorders? a. b. c. d.

they provide inexpensive methods of gathering information they provide objective information that is difficult to fake they are less intimidating than more traditional methods they fit more closely with the theoretical assumptions of the DSM Difficulty: 1 Question ID: 4.1.94 Page Reference: 99 Topic: Biological Assessment Procedures Skill: Applied Answer: b. they provide objective information that is difficult to fake

4.1.95. What is a limitation of the use of physiological assessment? a. b. c. d.

There is little variability in people's physiological reactions. There is a high correlation among different autonomic response systems. Physiological reactivity and stability vary from person to person. They provide little information beyond what patients can report themselves. Difficulty: 1 Question ID: 4.1.95 Page Reference: 99 Topic: Physiological reactivity and the stability of Skill: Factual Answer: c. Physiological reactivity and stability vary from person to person.

4.1.96. One advantage of psychophysiological tests is that a. b. c. d.

they can pinpoint the underlying causes of a mental disorders. they can not only diagnose but also treat several mental disorders. they do not depend on self-report and may be less subject to faking. they can usually be administered to patients in their homes. Difficulty: 1 Question ID: 4.1.96 Page Reference: 99 Topic: Physiological reactivity and the stability of Skill: Factual Answer: c. they do not depend on self-report and may be less subject to faking.

Short Answer 4.2.97. A __________ approach to classification assumes that distinctions among members of different categories are qualitative. Difficulty: 1 Question ID: 4.2.97 Page Reference: 78 Topic: Basic Issues in Classification Skill: Factual Answer: categorical

4.2.98. A __________ approach focuses on how much of a diagnostic characteristic an individual exhibits. Difficulty: 1 Question ID: 4.2.98 Page Reference: 78 Topic: Basic Issues in Classification Skill: Factual Answer: dimensional 4.2.99. ___________ refers to rejection or isolation of an individual resulting from a stamp or label. Difficulty: 1 Question ID: 4.2.99 Page Reference: 79 Topic: Basic Issues in Classification Skill: Factual Answer: Stigma

4.2.100. Recurrent and persistent thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause marked anxiety or distress are called __________ . Difficulty: 2 Question ID: 4.2.100 Page Reference: 81 Topic: Classifying Abnormal Behavior Skill: Factual Answer: obsessions

4.2.101. In reliability research the statistic that is used to measure agreement between clinicians is known as __________.

Difficulty: 1 Question ID: 4.2.101 Page Reference: 84 Topic: Evaluating Classification Systems Skill: Factual Answer: kappa

4.2.102. Psychological __________ is the process of gathering information in an attempt to understand a patient. Difficulty: 1 Question ID: 4.2.102 Page Reference: 86 Topic: Basic Issues in Assessment Skill: Factual Answer: assessment

4.2.103. In Michael's intake interview, the clinician reads him a set of questions about his symptoms in a particular order. He is being given a __________ interview. Difficulty: 1 Question ID: 4.2.103 Page Reference: 90 Topic: Psychological Assessment Procedures Skill: Factual Answer: structured

4.2.104. Behavioral __________ systems focus on the frequency of specific behavioral events during assessment. Difficulty: 1 Question ID: 4.2.104 Page Reference: 92 Topic: Psychological Assessment Procedures Skill: Factual Answer: coding

4.2.105. The scale on the MMPI-2 that measures physical symptoms that cannot be traced to a medical illness is called the __________ scale. Difficulty: 2 Question ID: 4.2.105

Page Reference: 94 Topic: Psychological Assessment Scale Skill: Factual Answer: hysteria

4.2.106. A recent advance in brain imaging allows details of both structure and function of the brain to be seem. This method is _________ . Difficulty: 1 Question ID: 4.2.106 Page Reference: 97 Topic: Biological Assessment Procedures Skill: Factual Answer: fMRI

Essay 4.3.107. Explain how the term "diagnosis" in psychopathology does not have the same meaning that it has in other fields, and explain this significance of this difference. Difficulty: 2 Question ID: 4.3.107 Page Reference: 76 Topic: Overview Skill: Conceptual

Answer: In many fields, diagnosis refers to causal analysis. It means that one can look underneath to pinpoint the origins of the problem. In this way, the diagnosis leads directly to the problem's solution. In the field of psychopathology, assigning a diagnosis does not mean that we understand the etiology of the person's problem. Assigning a diagnosis of a mental disorder simply identifies the nature of the problem without implying exactly how the problem came into existence. A diagnostic label does not provide an explanation and thus does not lead directly to a specific solution.

4.3.108. Compare and contrast a dimensional classification system with a categorical classification system, such as the current DSM-IV. Difficulty: 2 Question ID: 4.3.108 Page Reference: 78 Topic: Basic Issues in Classification Skill: Conceptual Answer: The current DSM-IV-TR is based on a categorical system. It attempts to treat mental disorders as physical disorders. It assumes that there are discrete disease entities, such as schizophrenia,

unipolar depression, OCD, etc. that are discrete, caused by a specific etiological process, and that they are qualitatively different from each other. The DSM lays out the behaviors and signs to look for and then spells out when to assign an individual to a discrete category. If the DSM were a dimensional system, such as “intelligence,” it would assume that an individual was possessed of various properties and assign each individual an estimate of how much of a given property they demonstrate. An individual may demonstrate a significant level of delusional thinking, somewhat less intellectual impairment, varying degrees of unhappiness, etc. This system may or may not result in a definitive or categorical diagnosis.

4.3.109. During the 1950s and 1960s, psychiatric classification systems were widely criticized. Discuss some of the reasons for this criticism. Difficulty: 1 Question ID: 4.3.109 Page Reference: 80 Topic: Classifying Abnormal Behavior Skill: Conceptual Answer: (1) low reliability and interrater consistency; (2) the ideas that people who are diagnosed as mentally ill actually are having "problems in living" and are not "sick"; (3) the problems of selffulfilling prophecies: those who are diagnosed live up to the expectations of the "sick" role. Patients may be stigmatized by being labeled.

4.3.110. What are two major uses of a classification system for abnormal behavior? Difficulty: 1 Question ID: 4.3.110 Page Reference: 80 Topic: Classifying Abnormal Behavior Skill: Conceptual Answer: (1) matching clients' problems with the most effective treatment; (2) searching for knowledge, and the possibility of identifying unique disorders and their causes so that treatments can later be developed.

4.3.111. Describe the different ways in which diagnosis can be useful (valid). Mention two types of validity. Difficulty: 2 Question ID: 4.3.111 Page Reference: 83-84 Topic: Classifying Abnormal Behavior Skill: Conceptual Answer: (1) meaningful or important: provides information and communication value; can provide evidence that leads to a theory of the cause of a disorder; (2) etiological validity: provides information on cause; (3) concurrent validity: agrees with information about behavior in other situations and from other sources; (4) predictive: provides information about the predictable course of the disorder, and later status and behavior.

4.3.112. Describe the three primary goals of clinical assessment, and give an example of each. Difficulty: 2 Question ID: 4.3.112 Page Reference: 86-87 Topic: Basic Issues in Assessment Skill: Conceptual Answer: (1) making predictions: will this person engage in violence if he or she is released from jail? (2) plan interventions: does this person have the intelligence level necessary to benefit from insightoriented therapy? (3) evaluate treatment effectiveness: has this person's depression decreased over the course of therapy?

4.3.113. A psychologist is treating a patient with an anxiety disorder and wants to measure the patient's anxiety while discussing upcoming feared events as a way of assessing the patient's progress in therapy. The psychologist measures heart rate before, during, and after her patient's discussion. She finds that discussion of the upcoming feared event is associated with increased heart rate, and concludes that her patient has not yet made enough progress in treatment. Discuss the grounds on which such a conclusion would be criticized, and describe what else the psychologist might do to measure her patient's progress. Difficulty: 2 Question ID: 4.3.113 Page Reference: 98-99 Topic: Biological Assessment Procedures Skill: Applied

Answer: Physiological assessment is not sufficient because (1) any individual autonomic response has a low correlation with other autonomic responses; (2) individuals vary in their reactivity, and for some, anxiety may be associated with great increases in heart rate while for others, anxiety may be associated with small increases in heart rate; and (3) the increased heart rate could be due to her patient's condition but it could also be related to situational variables, such as having to discuss anything in front of a psychologist. The psychologist's assessment of her patient's anxiety could include (1) other physiological measures; (2) the psychologist's observations of her patient; (3) measures from some form of rating scale or self-report inventory.

4.3.114. Describe some disadvantages of the current DSM-IV-TR classification system. Difficulty: 2 Question ID: 4.3.114 Page Reference: 83-86 Topic: Evaluating Classification Systems Skill: Conceptual

Answer: The current DSM is widely used and recognized, but that very acceptance may mean that new ways of looking at and conceptualizing mental illness may be overlooked. Most patients don’t fit neatly into one category; they exhibit a variety of symptoms that vary over time and with changing circumstances. If we categorize them are we overlooking other, possibly more important aspects of their problem? The problem of comorbidity is identified by many clinicians and researchers. The National Comorbidity Study suggests that a small subgroup of individuals exhibit three or more diagnoses and that this group accounts for a significant percentage of serious diagnoses. In addition, the DSM has difficulty handling change over time. There is a tendency to label individuals and fail to notice that the nature of their disorder changes over the years and sometimes over a matter of weeks. It is not unusual for an individual to be mainly anxious one day and mainly unhappy a few days later.

Chapter 5 Mood Disorders and Suicide Total Assessment Guide (T.A.G.) Topic Overview pp. 102-106

Symptoms pp. 106-108

Diagnosis pp. 108-111

Course and Outcome pp. 111-112 Frequency pp. 112-115

Causes pp. 115-124

Short Answer Essay 7. Treatment pp. 124-129

8. Suicide pp. 129-135

Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay

Factual

Conceptual

Applied

2, 3, 7, 8

1, 4

5, 6, 9

112, 113

111

10, 12, 15, 16

11, 14, 17

13, 18

20, 23, 25, 26, 31, 32

21, 22, 24, 30

114 19, 28, 27, 28, 29, 33, 34 116 35, 37

115 124 38

41, 42, 45

40, 44

125 48, 50, 51, 54, 55, 60, 61, 63, 65, 68, 73, 80, 83

49, 59, 69, 76, 81, 82

117 39, 43, 46, 47 118 52, 53, 56, 57, 58, 62, 64, 66, 67, 70, 71, 72, 74, 75, 77, 78, 79 120

86, 87, 88, 89, 91, 94, 95, 99

119, 121 126, 127, 128, 130 84, 90, 93, 96, 97

129, 134 85, 92, 98 122

101, 103, 104, 105, 107 123

131 100, 106, 108, 110

102, 109

132

133

Chapter 5: Mood Disorders and Suicide

Multiple Choice 5.1.1. You were asked to give a talk to illustrate the problems caused by depression for youth as compared to their parents' generation. Which of the following could be an accurate way to start your talk? a. b. c. d.

The younger generation is experiencing rates of depression higher than previous generations. The younger generation is experiencing rates of depression lower than previous generations. The younger generation is experiencing depression at a later age than previous generations. None of the above are correct. Difficulty: 1 Question ID: 5.1.1 Page Reference: 103 Topic: Overview Skill: Conceptual

Answer : a. The younger generation is experiencing rates of depression higher than previous generations.

5.1.2.

Which of the following describes the term affect?

a. b. c. d.

a state of arousal subjective feelings observable behaviors associated with subjective feelings physiological changes associated with subjective feelings Difficulty: 1 Question ID: 5.1.2 Page Reference: 103 Topic: Overview Skill: Factual Answer : c. observable behaviors associated with subjective feelings

5.1.3. Which of the following is the term that psychologists use for a pervasive and sustained emotional response that can color the person's perception of the world? a. b. c. d.

affect mania depression mood

Difficulty: 2 Question ID: 5.1.3 Page Reference: 103 Topic: Overview Skill: Factual Answer : d. mood

5.1.4.

Which of the following is a clinical feature of mania?

a. b. c. d.

elated mood criminality dissociation blunted affect Difficulty: 2 Question ID: 5.1.4 Page Reference: 104 Topic: Overview Skill: Conceptual Answer : a. elated mood

5.1.5. Mary has had two episodes of major depression with no other periods of psychological disturbance. What is the appropriate description of her symptoms? a. b. c. d.

dysthymia double depression bipolar mood disorder unipolar mood disorder Difficulty: 2 Question ID: 5.1.5 Page Reference: 104 Topic: Overview Skill: Applied Answer : d. unipolar mood disorder

5.1.6. Robert has just experienced an episode of mania. Which diagnostic label best describes his condition? a. b. c. d.

dysthymia bipolar mood disorder unipolar mood disorder dysphoric mood disorder

Difficulty: 2 Question ID: 5.1.6 Page Reference: 104 Topic: Overview Skill: Applied Answer : b. bipolar mood disorder

5.1.7.

Euphoria is characterized by

a. b. c. d.

elated mood. labile affect. depressed mood. inappropriate affect. Difficulty: 1 Question ID: 5.1.7 Page Reference: 104 Topic: Overview Skill: Factual Answer: a. elated mood.

5.1.8. Which of these is a characteristic of clinical depression that helps to distinguish it from normal sadness? a. b. c. d.

altered brain chemistry caused by an identifiable precipitant occurs only in people who suffered early losses accompanied by a cluster of signs and symptoms, including cognitive features Difficulty: 2 Question ID: 5.1.8 Page Reference: 103 Topic: Overview Skill: Factual Answer: d. accompanied by a cluster of signs and symptoms, including cognitive features

5.1.9. The case of Cathy presented in your text is an example of major depressive disorder. One of the aspects of her case that clearly tells us this is more than just normal sadness is that Cathy a. b. c. d.

had become impaired in her ability to work. did not have any manic or hypomanic symptoms. had been separated from her husband for five years. felt unworthy of her latest promotion at work.

Difficulty: 1 Question ID: 5.1.9 Page Reference: 104 Topic: Overview Skill: Applied Answer: a. had become impaired in her ability to work.

5.1.10. What is dysphoric mood? a. b. c. d.

elated mood labile mood depressed mood inappropriate mood Difficulty: 1 Question ID: 5.1.10 Page Reference: 106 Topic: Symptoms Skill: Factual Answer: c. depressed mood

5.1.11. As was the case of Debbie in the textbook, it is often the case that symptoms of mania are initially a. b. c. d.

very frightening. quite pleasant. triggered by some specific life stress. indistinguishable from depression. Difficulty: 1 Question ID: 5.1.11 Page Reference: 105 Topic: Symptoms Skill: Conceptual Answer: b. quite pleasant.

5.1.12. All of the following are important considerations in distinguishing clinical depression from normal sadness EXCEPT a. In clinical depression the mood change may occur in the absence of any precipitating event. b. A clinically depressed mood is often accompanied by an inability to function in usual social situations. c. A clinical mood change may feel different or “strange” to the person. d. A clinical mood change is generally all pervasive, and is usually the only symptom or sign to occur.

Difficulty: 1 Question ID: 5.1.12 Page Reference: 106 Topic: Symptoms Skill: Factual Answer: d. A clinical mood change is generally all pervasive, and is usually the only symptom or sign to occur.

5.1.13. Betty believes she is less capable than her coworkers, even though she has won many awards for her performance. She often feels lonely and believes no one wants to be her friend. Her future seems empty and meaningless. These traits characterize a. b. c. d.

cyclothymia. psychotic depression. the "depressive triad." somatic deficits in depression. Difficulty: 2 Question ID: 5.1.13 Page Reference: 107 Topic: Symptoms Skill: Applied Answer: c. the "depressive triad."

5.1.14. People who are clinically depressed frequently note that their thinking is __________ while manic patients commonly report that their thoughts are __________. a. b. c. d.

realistic; unrealistic easily distracted; very focused slowed down; speeded up focused on the past; focused on the future Difficulty: 2 Question ID: 5.1.14 Page Reference: 107 Topic: Symptoms Skill: Conceptual Answer: c. slowed down; speeded up

5.1.15. Which of the following is an example of a somatic symptom of depression? a. b. c.

suicidal thoughts sleeping problems feelings of low self-worth

pessimistic thoughts about the future Difficulty: 2 Question ID: 5.1.15 Page Reference: 107 Topic: Symptoms Skill: Factual Answer: b. sleeping problems

5.1.16. Depressed patients often walk and talk as though they are in slow motion; this quality is described by the term a. b. c. d.

hypomania. psychomotor retardation. dysphoria. morbid preoccupation. Difficulty: 1 Question ID: 5.1.16 Page Reference: 108 Topic: Symptoms Skill: Factual Answer: b. psychomotor retardation.

5.1.17. Harold has just been diagnosed as suffering from major depressive disorder. In planning his treatment, the mental health professionals will discover that he has a comorbid condition. Which of the following is the most likely comorbid condition? a. b. c. d.

alcoholism hypochondriasis paranoid schizophrenia histrionic personality disorder Difficulty: 2 Question ID: 5.1.17 Page Reference: 108 Topic: Symptoms Skill: Conceptual Answer: a. alcoholism

5.1.18. One of your patients has been diagnosed with unipolar depression and alcohol addiction. Which of the following do you need consider in this light? a. b.

For some people alcoholism develops first, for others it is the depression that comes first. Neither disorder tends to run in families.

c. d.

Alcohol is actually good for some schizophrenic patients as it dampens their hallucinations. Marijuana use is also correlated with alcoholism. Difficulty: 3 Question ID: 5.1.18 Page Reference: 108 Topic: Symptoms Skill: Applied Answer: a. For some people alcoholism develops first, for others it is the depression that comes

first.

5.1.19. In the DSM-IV-TR classification of mood disorders, an emphasis is placed on the distinction between a. b. c. d.

unipolar and bipolar disorders. disorders with and without psychotic features. conditions precipitated by an identifiable stressor and conditions without identifiable stressor. disorders with somatic symptoms and disorders without somatic symptoms. Difficulty: 1 Question ID: 5.1.19 Page Reference: 108 Topic: Diagnosis Skill: Factual Answer: a. unipolar and bipolar disorders.

5.1.20. Which of the following is the most typical course of unipolar mood disorder? a. b. c. d.

a single episode of mania repeated episodes of major depression a single episode of major depression cycling episodes of depression and mania Difficulty: 1 Question ID: 5.1.20 Page Reference: 109 Topic: Diagnosis Skill: Conceptual Answer: b. several episodes of major depression

5.1.21. For the past two years, Nick has experienced poor appetite, insomnia, fatigue, and several other symptoms. These symptoms have kept him from feeling happy although they do not indicate a major depressive episode. When assessing Nick, what disorder is the psychologist most likely to consider? a.

bipolar I disorder

b. c. d.

dysthymia cyclothymia seasonal affective disorder Difficulty: 1 Question ID: 5.1.21 Page Reference: 109 Topic: Diagnosis Skill: Applied Answer: b. dysthymia

5.1.22. Generally your patient of the past two years has exhibited depression. She did, however, have one quite dramatic symptom that rules out a diagnosis of both major depressive disorder and dysthymia. This symptom is a. b. c. d.

alcohol addiction. extreme sadness. mania. comorbidity. Difficulty: 3 Question ID: 5.1.22 Page Reference: 110 Topic: Diagnosis Skill: Applied Answer: c. mania

5.1.23. Henry has a serious episode of depression that is diagnosed as major depressive disorder. A year later he experiences an episode of mania. What is his diagnosis after this event? a. b. c. d.

cyclothymia bipolar I disorder dysthymic disorder cyclical major depressive disorder Difficulty: 1 Question ID: 5.1.23 Page Reference: 110 Topic: Diagnosis Skill: Conceptual Answer: b. bipolar I disorder

5.1.24. For several years, Greg has experienced alternating episodes of very severe depression and episodes of hypomania. What is the most appropriate DSM diagnosis?

a. b. c. d.

bipolar I disorder without psychotic features bipolar II disorder cyclothymic disorder mixed bipolar disorder Difficulty: 1 Question ID: 5.1.24 Page Reference: 110 Topic: Diagnosis Skill: Applied Answer: b. bipolar II disorder

5.1.25. What is one way that dysthymia differs from major depression? a. b. c. d.

Dysthymia is more severe. Dysthymia usually lasts longer. Dysthymia responds better to medication. Dysthymia usually has a precipitating event. Difficulty: 2 Question ID: 5.1.25 Page Reference: 109 Topic: Diagnosis Skill: Conceptual Answer: b. Dysthymia usually lasts longer.

5.1.26. For the past two weeks Barbara has experienced serious symptoms including weight loss, feelings of worthlessness, insomnia, and difficultly in concentrating. She is also experiencing depressed mood and loss of interest in doing much of anything. What is the DSM-IV-TR term for what Barbara is experiencing? a. b. c. d.

dysthymic disorder bipolar I disorder, mixed episode cyclothymic disorder major depressive episode Difficulty: 2 Question ID: 5.1.126 Page Reference: 109 Topic: Diagnosis Skill: Conceptual Answer: d. major depressive episode

5.1.27. Hypomania is an episode involving

a. b. c. d.

high energy, but less severe than mania. high energy, but more severe than mania. low energy, but less severe than depression. low energy, but more severe than depression. Difficulty: 1 Question ID: 5.1.27 Page Reference: 110 Topic: Diagnosis Skill: Factual Answer: a. high energy, but less severe than mania.

5.1.28. A chronic but less severe form of bipolar disorder is a. b. c. d.

dysthymia. dysphoria. cyclothymia. unipolar disorder. Difficulty: 1 Question ID: 5.1.28 Page Reference: 110 Topic: Diagnosis Skill: Factual Answer: c. cyclothymia.

5.1.29. Melancholia is a term for a. b. c. d.

dysthymia. neurotic depression. a severe type of depression. normal sadness unrelated to clinical depression. Difficulty: 2 Question ID: 5.1.29 Page Reference: 111 Topic: Diagnosis Skill: Factual Answer: c. a severe type of depression.

5.1.30. Which of the following individuals exhibits symptoms that suggest the presence of melancholia? a. b. c.

weight gain, dysphoria, and hallucinations anxiety, excessive guilt, and depression worse in the evening difficulty getting to sleep, psychomotor agitation, and significant weight gain

d. absence of any feelings of pleasure, early morning awakening, and marked psychomotor retardation

Difficulty: 2 Question ID: 5.1.30 Page Reference: 111 Topic: Diagnosis Skill: Applied Answer: d. absence of any feelings of pleasure, early morning awakening, and marked psychomotor retardation

5.1.31. Which of the following patients' depression most clearly exhibits psychotic features? a. b. c. d.

Ann, who wakes up early in the morning and cannot get back to sleep Kathy, who finds that food is unappealing and so she has been eating less Pete, who believes his digestive tract is dust and hears voices telling him he is evil Ted, who comes from a family with several depressed close relatives who committed suicide Difficulty: 2 Question ID: 5.1.31 Page Reference: 111 Topic: Diagnosis Skill: Conceptual Answer: c. Pete, who believes his digestive tract is dust and hears voices telling him he is evil

5.1.32. Jane has recently become very depressed, and her doctor is explaining to her that she has a mood disorder with postpartum onset. If her doctor is correct, what do we know about Jane? a. b. c. d.

Her depression will end very soon. She has given birth within the past four weeks. Her depression is linked to an identifiable environmental stressor. She has recently suffered the loss of someone she loves. Difficulty: 2 Question ID: 5.1.32 Page Reference: 111 Topic: Diagnosis Skill: Conceptual Answer: b. She has given birth within the past four weeks.

5.1.33. Rapid cycling bipolar disorder is characterized by a.

many mood shifts per day.

b. c. d.

a seasonal pattern of symptoms. at least four episodes of mania, hypomania, or major depression within a year. development of a manic episode in less than a week.

Difficulty: 1 Question ID: 5.1.33 Page Reference: 111 Topic: Diagnosis Skill: Factual Answer: c. at least four episodes of mania, hypomania, or major depression within a year.

5.1.34. What is the most typical seasonal pattern in mood disorders? a. b. c. d.

mania in summer, recovery in winter mania in winter, recovery in spring depression in winter, recovery in spring depression in summer, recovery in winter Difficulty: 1 Question ID: 5.1.34 Page Reference: 111 Topic: Diagnosis Skill: Factual Answer: c. depression in winter, recovery in spring

5.1.35. Which of these individuals is at the average age for the onset of unipolar mood disorder? a. b. c. d.

Al, who is 15 years old Sid, who is 21 years old Sally, who is 32 years old Veronica, who is 65 years old Difficulty: 1 Question ID: 5.1.35 Page Reference: 112 Topic: Course and Outcome Skill: Factual Answer: c. Sally, who is 32 years old

5.1.36. Andy has just experienced his first episode of major depression; if Andy is average for someone with unipolar depression, how many additional episodes is he likely to experience in his lifetime? a. b.

none; recurrence is uncommon one or two

c. d.

five or six none unless he also experiences a manic or hypomanic episode

Difficulty: 2 Question ID: 5.1.36 Page Reference: 112 Topic: Course and Outcome Skill: Applied Answer: c. five or six

5.1.37. The return of active symptoms in a person who has recovered from a previous episode of a disorder is known as a. b. c. d.

remission. relapse. refraction. rapid cycling. Difficulty: 1 Question ID: 5.1.37 Page Reference: 112 Topic: Course and Outcome Skill: Factual Answer: b. relapse.

5.1.38. Other than the presence of manic episodes in bipolar mood disorder, what is the main distinguishing factor between unipolar and bipolar mood disorders? a. b. c. d.

later onset and more episodes in bipolar mood disorder later onset and fewer episodes in bipolar mood disorder earlier onset and more episodes in bipolar mood disorder earlier onset and fewer episodes in bipolar mood disorder Difficulty: 2 Question ID: 5.1.38 Page Reference: 112 Topic: Course and Outcome Skill: Conceptual Answer: c. earlier onset and more episodes in bipolar mood disorder

5.1.39. Despite differences among epidemiological surveys in samples, methods, and definitions of mental disorders, what is one common finding concerning mood disorders? a.

Bipolar disorder occurs in fewer people than major depressive disorder.

b. c. d.

Dysthymic disorder is the most common form of mood disorder. Mood disorders are the most common form of mental disorders. Bipolar and unipolar disorders are equally common in the general population. Difficulty: 1 Question ID: 5.1.39 Page Reference: 112 Topic: Frequency Skill: Factual Answer: a. Bipolar disorder occurs in fewer people than major depressive disorder.

5.1.40. According to the National Comorbidity Survey Replication, the approximate percentage of individuals diagnosed with a major mood disorder in the past 12 months who received adequate treatment for that disorder was a. b. c. d.

10 percent. 20 percent. 40 percent. 60 percent. Difficulty: 2 Question ID: 5.1.40 Page Reference: 112 Topic: Frequency Skill: Applied Answer: b. 20 percent.

5.1.41. A report in the newspaper describes the common epidemiological finding that the rate of depression is higher among women than among men. How have researchers evaluated the validity of this finding? a. Men and women differ in their willingness to talk about their depressive symptoms. b. Mental health professionals are more prone to diagnose depression in women than in men. c. This gender difference is an artifact that occurs only in samples of patients that seek treatment. d. This gender difference is a real one that cannot be explained by methodological or sampling differences. Difficulty: 2 Question ID: 5.1.41 Page Reference: 114 Topic: Frequency Skill: Conceptual Answer: d. This gender difference is a real one that cannot be explained by methodological or sampling differences.

5.1.42. Comparisons of rates of emotional disorder across cultural boundaries encounter many problems. One such problem is that a. b. c. d.

each culture has different words and concepts for describing illness. emotional disorders don't exist in every culture. there is no agreement on which diagnostic criteria to use. it is not ethical to study people from cultures different from our own. Difficulty: 1 Question ID: 5.1.42 Page Reference: 114 Topic: Frequency Skill: Conceptual Answer: a. each culture has different words and concepts for describing illness.

5.1.43. What do cross cultural studies of psychopathology suggest concerning depression? a. DSM categories are culture-free. b. Chinese psychiatrists often mistake depression for a form of schizophrenia. c. There are very different rates of mood disorder in Western and non-Western countries. d. Depression is a universal phenomenon that may be expressed differently depending on cultural factors. Difficulty: 1 Question ID: 5.1.43 Page Reference: 114 Topic: Frequency Skill: Factual Answer: d. Depression is a universal phenomenon that may be expressed differently depending on cultural factors.

5.1.44. You are asked to consult about a patient who may be depressed. What you notice is that the focus of their symptoms is mostly somatic: on headaches, sleep disorder, and lack of energy. You ask if this patient happens to be from the country where these symptoms are more generally seen in depression, a. b. c. d.

the East Coast of the United States. Eastern Europe. Australia. China. Difficulty: 2 Question ID: 5.1.44 Page Reference: 114 Topic: Frequency Skill: Applied Answer: d. China.

5.1.45. You are given the topic of age and mood disorders for a term paper in abnormal psychology and instructed to write the paper in the format of a newspaper report for the general public. Which of the following titles would be the best choice? a. b. c. d.

"Mania Runs Wild in Older Generations" "Age and Mood Disorders: A Positive Correlation" "High Rates of Depression in the Elderly: Correcting a Myth" "Age Trends in Prevalence of Mood Disorders Obscured by Gender Effects" Difficulty: 1 Question ID: 5.1.45 Page Reference: 113 Topic: Frequency Skill: Conceptual Answer: c. "High Rates of Depression in the Elderly: Correcting a Myth"

5.1.46. What do the results of the epidemiological studies tell us about changes over time in the frequency of depression? a. b. c. d.

Rates of depression appear to be decreasing. Rates of bipolar disorder appear to be increasing. Rates of depression appear to be increasing and with earlier onset. Rates of depression appear to be increasing but with later onset. Difficulty: 1 Question ID: 5.1.46 Page Reference: 113 Topic: Frequency Skill: Factual Answer: c. Rates of depression appear to be increasing and with earlier onset.

5.1.47. The rate of depression in women is about what percentage of the rate for men? a. b. c. d.

10 percent 50 percent 100 percent 200 percent Difficulty: 2 Question ID: 5.1.47 Page Reference: 114 Topic: Frequency Skill: Factual Answer: d. 200 percent

5.1.48. A strong correlation exists between stressful life events and the onset of depression, but it is difficult to interpret this relationship because a. b. c. d.

there haven't been enough studies. stress can cause depression, but depression can cause stress. depression is a very subjective state and thus very difficult to measure. people are usually aware of any connection between their depression and stress in their lives. Difficulty: 2 Question ID: 5.1.48 Page Reference: 115-116 Topic: Causes Skill: Conceptual Answer: b. stress can cause depression, but depression can cause stress.

5.1.49. A researcher investigating the link between stressful life events and depression has decided to use a prospective research design. This means that the researcher will have to a. b. c. d.

select subjects with the prospect of becoming depressed. select subjects with the prospect of experiencing stress. follow subjects over time to see if stress predicts the onset of depression. question subjects carefully to see if their depression has always followed some identifiable stress. Difficulty: 2 Question ID: 5.1.49 Page Reference: 116 Topic: Causes Skill: Applied Answer: c. follow subjects over time to see if stress predicts the onset of depression.

5.1.50. The research by Brown and Harris on the cause of depression in women has suggested that types of events that have a greater likelihood of contributing to the cause of depression are a. b. c. d.

an accumulation of many small, daily hassles. severe events that are particularly threatening. family events such as the loss of a parent. none of the above are particularly related to the cause of depression. Difficulty: 2 Question ID: 5.1.50 Page Reference: 116 Topic: Causes Skill: Conceptual Answer: b. severe events that are particularly threatening.

5.1.51. What did George Brown and Tirril Harris find when they followed women over a one-year period to study the link between depression and stressful life events? a. None of those who experienced a severe life event became depressed. b. Most of those who experienced a severe life event became depressed. c. Although life events and depression were related, most people who experienced such events did not become depressed. d. Although life events and depression were related, the results suggested that depression actually caused the life events. Difficulty: 2 Question ID: 5.1.51 Page Reference: 116 Topic: Causes Skill: Conceptual Answer: c. Although life events and depression were related, most people who experienced such events did not become depressed.

5.1.52. Research shows that depression is often preceded by stressful life events, although not all such events lead to depression. What characteristics of a stressful life did George Brown and Tirril Harris identify as more likely to lead to depression? a. b. c. d.

devaluation and loss preexisting and dangerous biological and unpredictable feeling trapped and devaluation Difficulty: 1 Question ID: 5.1.52 Page Reference: 116 Topic: Causes Skill: Factual Answer: d. feeling trapped and devaluation

5.1.53. With respect to the link between stress and the onset of manic and depressive episodes, it appears that a. b. c. d.

the types of stress are very similar. the types of stress tend to be different. stress is linked to depressive episodes but not manic ones. stress is linked to manic episodes but not depressive ones.

Difficulty: 2 Question ID: 5.1.53

Page Reference: 116 Topic: Causes Skill: Factual Answer: b. the types of stress tend to be different.

5.1.54. Severe events are clearly related to the onset of depression, but they do not provide a complete account of who will become depressed. Studies that examine factors that might explain which people are most likely to become depressed are seeking evidence for what psychologists call a. b. c. d.

fragmentation. vulnerability. retrospective exposure. prospective exposure. Difficulty: 2 Question ID: 5.1.54 Page Reference: 117 Topic: Causes Skill: Conceptual Answer: b. vulnerability.

5.1.55. According to cognitive models of depression, various types of cognitive errors or distortions in thinking are partly responsible for the disorder. Which of the following is NOT one of these cognitive distortions mentioned in the book? a. b. c. d.

assigning global, personal meaning to an experience of failure a tendency to overgeneralize conclusions about the self based on negative experiences a tendency to turn anger at others toward the self a tendency to recall selectively events with negative consequences Difficulty: 1 Question ID: 5.1.55 Page Reference: 117 Topic: Causes Skill: Conceptual Answer: c. a tendency to turn anger at others toward the self

5.1.56. A good example of the type of cognitive distortions that lead to depression, according to the textbook, would include all of the following EXCEPT a. b. c. d.

over generalized conclusions about one's self based on negative experiences. drawing inferences about one's self without any evidence. exaggerating one’s estimates of their intellectual ability. exaggerating the importance of negative events over positive.

Difficulty: 3 Question ID: 5.1.56 Page Reference: 117 Topic: Causes Skill: Factual Answer: c. exaggerating one’s estimates of their intellectual ability.

5.1.57. What is a schema? a. b. c. d.

a role played in a relationship an example of a cognitive distortion a point of contention in a relationship an organized cognitive representation of prior experience Difficulty: 1 Question ID: 5.1.57 Page Reference: 118 Topic: Causes Skill: Factual Answer: d. an organized cognitive representation of prior experience

5.1.58. According to the hopelessness theory of depression, what are depressed persons likely to do? a. b. c. d.

make external causal attributions make unstable causal attributions believe that their fate is determined at birth believe that aversive events will occur regardless of what they do Difficulty: 1 Question ID: 5.1.58 Page Reference: 118 Topic: Causes Skill: Factual Answer: d. believe that aversive events will occur regardless of what they do

5.1.59. Mary fails a calculus exam. Although other students who failed the same exam complain that the exam was too hard and the professor has a reputation for tough grading, Mary is convinced that she failed because she is incapable of understanding the material. How might we characterize Mary's attribution style? a. b. c. d.

global stable primary internal

Difficulty: 2 Question ID: 5.1.59 Page Reference: 118 Topic: Causes Skill: Applied Answer: d. internal

5.1.60. Robert strikes out during a softball game, causing his team to lose the game. He begins to brood about his failure, and concludes that not only is he a failure in sports, but in all areas of his life. How might we describe Robert's attribution style? a. b. c. d.

stable global external magnified Difficulty: 2 Question ID: 5.1.60 Page Reference: 118 Topic: Causes Skill: Conceptual Answer: b. global

5.1.61. Meredith is depressed. According to the interpersonal view of depression, what is a likely description of Meredith? a. b. c. d.

She makes internal causal attributions. Her interpersonal style may alienate others. Her grief over early childhood losses was not resolved. She erroneously believes that her relationships are inadequate. Difficulty: 2 Question ID: 5.1.61 Page Reference: 118 Topic: Causes Skill: Conceptual Answer: b. Her interpersonal style may alienate others.

5.1.62. Some research evidence suggests that persons who show a ruminative style by writing in a diary or talking extensively with a friend about their depressed mood show a. b. c. d.

increased empathy. longer and more severe depressed moods shorter and less severe depressed moods. good ability to distract themselves from their bad moods.

Difficulty: 1 Question ID: 5.1.62 Page Reference: 118 Topic: Causes Skill: Factual Answer: b. longer and more severe depressed moods

5.1.63. A hypothesis with regard to the response style model that attempts to explain the difference in rates of depression between men and women is a. men are more likely to respond to depression with rumination which prolongs and intensifies the depression. b. women are more likely to respond to depression with rumination which prolongs and intensifies the depression. c. women are more likely to respond to depression with rumination which has the effect of reducing their level of depression. d. men are more likely to respond to depression with rumination which has the effect of reducing their level of depression. Difficulty: 2 Question ID: 5.1.63 Page Reference: 118 Topic: Causes Skill: Conceptual Answer: b. women are more likely to respond to depression with rumination which prolongs and intensifies the depression.

5.1.64. What two response styles are emphasized by Susan Nolen-Hoeksema in her research designed to understand the duration and severity of depression? a. b. c. d.

social and individual internal and external distracting and ruminative predictable and unpredictable Difficulty: 1 Question ID: 5.1.64 Page Reference: 118 Topic: Causes Skill: Factual Answer: c. distracting and ruminative

5.1.65. Genetic factors seem to

a. b. c. d.

play a stronger role in bipolar than unipolar mood disorders. play a stronger role in unipolar than bipolar mood disorders play an insignificant role in the cause of mood disorders. be almost impossible to conduct with current technology. Difficulty: 2 Question ID: 5.1.65 Page Reference: 119 Topic: Causes Skill: Conceptual Answer: a. play a stronger role in bipolar than unipolar mood disorders

5.1.66. Studies suggest that the heritability factor for bipolar disorder is approximately a. b. c. d.

20 percent. 40 percent. 60 percent. 80 percent. Difficulty: 1 Question ID: 5.1.66 Page Reference: 119 Topic: Causes Skill: Factual Answer: d. 80 percent.

5.1.67. Studies of the concordance rates for unipolar mood disorder and bipolar mood disorder in monozygotic (MZ) and dizygotic (DZ) twins suggest a. b. c. d.

a larger role of genetic factors in bipolar mood disorder. a larger role of genetic factors in unipolar mood disorder. similar concordance rates for bipolar mood disorder in MZ and DZ twins. similar concordance rates for unipolar mood disorder in MZ and DZ twins. Difficulty: 1 Question ID: 5.1.67 Page Reference: 119 Topic: Causes Skill: Factual Answer: a. a larger role of genetic factors in bipolar mood disorder.

5.1.68. The best evidence for the influence of nongenetic factors in the cause of mood disorder is in the a. b. c.

concordance rates for MZ twins which are less than 100 percent. concordance rates for DZ twins which are less than 100 percent. concordance rates for MZ twins which are less than for DZ twins.

concordance rates for DZ twins which are less than for MZ twins. Difficulty: 2 Question ID: 5.1.68 Page Reference: 119 Topic: Causes Skill: Conceptual Answer: a. concordance rates for MZ twins which are less than 100 percent.

5.1.69. A report in a research journal describes the symptoms of a mental disorder along with information on its etiology, including a heritability of 50%. How should this finding be interpreted? a. b. c. d.

Genetic factors and the environment contribute about equally to this disorder. Half of the people who suffer from the disorder have a genetically caused disorder. Half of the children of carriers of this disorder will actually develop the disorder. Geneticists have identified half of the genes thought to be responsible for this disorder. Difficulty: 3 Question ID: 5.1.69 Page Reference: 119 Topic: Causes Skill: Applied Answer: a. Genetic factors and the environment contribute about equally to this disorder.

5.1.70. What is the estimated heritability for unipolar mood disorder? a. b. c. d.

5 percent 25 percent 50 percent 75 percent Difficulty: 2 Question ID: 5.1.70 Page Reference: 119 Topic: Causes Skill: Factual Answer: c. 50 percent

5.1.71. Which of the following lists mood disorders from the one with highest heritability to the one with the smallest degree of heritability? a. b. c. d.

dysthymia, cyclothymia, major depressive disorder bipolar disorder, major depressive disorder, dysthymia major depressive disorder, bipolar disorder, dysthymia dysthymia, bipolar disorder, major depressive disorder

Difficulty: 1 Question ID: 5.1.71 Page Reference: 119 Topic: Causes Skill: Factual Answer: b. bipolar disorder, major depressive disorder, dysthymia

5.1.72. A study by Kendler and his colleagues involving twins was designed to investigate the etiology of depression. What was one of the major conclusions? a. Genetics plays a small role in depression. b. The environment plays a major role in depression. c. Genetic factors seem to influence the effect the environment may have on depression. d. Twins are relatively immune from depression as a result of the close bond that they form with each other. Difficulty: 2 Question ID: 5.1.72 Page Reference: 119 Topic: Causes Skill: Factual Answer: c. Genetic factors seem to influence the effect the environment may have on depression.

5.1.73. To conduct linkage studies, researchers attempt to find evidence for a. b. c. d.

an association between life events and specific disorders. similar rates of disorder in MZ and DZ twins. different rates of disorder in adopted children and their biological and their adopted parents. an association between a disorder and another trait within the same family. Difficulty: 1 Question ID: 5.1.73 Page Reference: 119 Topic: Causes Skill: Conceptual Answer: d. an association between a disorder and another trait within the same family.

5.1.74. Failure to suppress production of the hormone cortisol in response to the dexamethasone suppression test has implicated a dysfunction of which system in the etiology of depression? a. b. c. d.

genetics MAO inhibition neurotransmitter system hypothalamus—pituitary—adrenal axis

Difficulty: 2 Question ID: 5.1.74 Page Reference: 120 Topic: Causes Skill: Factual Answer: d. hypothalamus—pituitary—adrenal axis

5.1.75. The endocrine system and the central nervous system may be linked in the etiology of depression through which substance? a. b. c. d.

cortisol dopamine HPA Dexamethasone Difficulty: 2 Question ID: 5.1.75 Page Reference: 120 Topic: Causes Skill: Factual Answer: a. cortisol

5.1.76. You are running a clinical trial on a method of stimulating regions of the brain in order to relieve symptoms of depression. Given the evidence that underacting in this region is associated with depression you decide to start clinical trials in the a. b. c. d.

reticular activating system. dorsolateral prefrontal cortex. posterior occipital cortex. amygdala. Difficulty: 3 Question ID: 5.1.76 Page Reference: 121-122 Topic: Causes Skill: Applied Answer: b. dorsolateral prefrontal cortex.

5.1.77. Using brain imaging techniques to examine activity of the prefrontal cortex (PFC) in depressed patients, researchers have reported finding a. b. c.

decreased activity. increased activity. decreased activity in some PFC regions and increased activity in others.

d. decreased activity in patients with unipolar depression and increased activity in patients with bipolar depression. Difficulty: 1 Question ID: 5.1.77 Page Reference: 121-122 Topic: Causes Skill: Factual Answer: c. decreased activity in some PFC regions and increased activity in others.

5.1.78. Brain imaging studies have identified elevated levels of resting blood flow and glucose metabolism in which area of the brain of depressed patients? a. b. c. d.

amygdala cerebellum parietal lobes temporal lobes Difficulty: 1 Question ID: 5.1.78 Page Reference: 122 Topic: Causes Skill: Factual Answer: a. amygdala

5.1.79. Which of the following is not a neurotransmitter? a. b. c. d.

norepinephrine serotonin catecholamine dopamine Difficulty: 2 Question ID: 5.1.79 Page Reference: 122 Topic: Causes Skill: Factual Answer: c. catecholamine

5.1.80. The activity at the synapse of which of the following is most especially enhanced by medications like Prozac? a. b. c.

serotonin dopamine activity of the amygdala

activity of the cingulate gyrus Difficulty: 2 Question ID: 5.1.80 Page Reference: 122 Topic: Causes Skill: Conceptual Answer: a. serotonin

5.1.81. What is the primary advantage of analogue studies in research on mood disorders? a. b. c. d.

They can use animals rather than humans. They can employ an experimental procedure. They are not subject to Ethics Review Boards. They are highly generalizable to situations outside the laboratory. Difficulty: 2 Question ID: 5.1.81 Page Reference: 123 Topic: Causes Skill: Applied Answer: b. They can employ an experimental procedure.

5.1.82. Some clinicians have argued that mental disorders cannot be studied using laboratory animals as subjects, because a. b. c. d.

studies of depression should only be done in natural settings and very few of those exist. cognitive symptoms cannot be measured in animals. animals don't express emotions similar to depression. the brains of animals are too different from homo sapiens. Difficulty: 2 Question ID: 5.1.82 Page Reference: 123 Topic: Causes Skill: Applied Answer: b. cognitive symptoms cannot be measured in animals.

5.1.83. A group of rats was exposed to the uncontrollable stress associated with being forced to swim for 15 minutes in cold water from which they cannot escape. What did researchers notice when they observed these animals? a. b. c.

Most rats were immune to the effects of the stress. The rats' depression was reduced by the high level of physical activity. The stress caused a form of brain damage that first led to motor retardation and then death.

The rats that exhibited symptoms similar to depression had altered neurotransmitter levels. Difficulty: 1 Question ID: 5.1.83 Page Reference: 123 Topic: Causes Skill: Conceptual Answer: d. The rats that exhibited symptoms similar to depression had altered neurotransmitter

levels. 5.1.84. Which of the following characterizes a cognitive therapy approach to the treatment of depression? a. b. c. d.

probing for unconscious roots of anger focusing on early childhood experiences increasing internal causal attributions reducing patients' self-defeating thoughts Difficulty: 1 Question ID: 5.1.84 Page Reference: 124 Topic: Treatment Skill: Conceptual Answer: d. reducing patients' self-defeating thoughts

5.1.85. Your boss just praised you effusively for a superior job on a marketing report; he also said he liked the presentation you gave at the regional meeting. As you walk out the door, he says you might want to try another tie. You spend hours mulling over that last comment and find yourself becoming depressed. Your reaction to the comment was, "I am washed up as an employee; they want someone to replace me." Your conclusion is an example of a. b. c. d.

attribution. an inexact label. cognitive dissonance. selective abstraction. Difficulty: 3 Question ID: 5.1.85 Page Reference: 124 Topic: Treatment Skill: Applied Answer: d. selective abstraction.

5.1.86. What is the focus of interpersonal therapy for depression? a. b. c.

current relationship difficulties patterns learned in childhood relationships unconscious feelings for the attachment figure

close, dependent relationship with the therapist Difficulty: 1 Question ID: 5.1.86 Page Reference: 124 Topic: Treatment Skill: Factual Answer: a. current relationship difficulties

5.1.87. Among patients who respond positively to antidepressant medication, a. b. c. d.

improvement usually occurs within four to six weeks. side effects usually force them to terminate early. improvement usually occurs almost immediately. side effects are almost never a problem. Difficulty: 1 Question ID: 5.1.87 Page Reference: 125 Topic: Treatment Skill: Factual Answer: a. improvement usually occurs within four to six weeks.

5.1.88. How do SSRI drugs produce their antidepressant effect? a. b. c. d.

inhibiting reuptake of norepinephrine inhibiting reuptake of serotonin blocking production of norepinephrine blocking production of serotonin Difficulty: 1 Question ID: 5.1.88 Page Reference: 125 Topic: Treatment Skill: Factual Answer: b. inhibiting reuptake of serotonin

5.1.89. What are the most frequently prescribed antidepressant medications? a. b. c. d.

lithium tricyclics anticonvulsants selective serotonin reuptake inhibitors Difficulty: 1

Question ID: 5.1.89 Page Reference: 125 Topic: Treatment Skill: Factual Answer: d. selective serotonin reuptake inhibitors

5.1.90. Compared to tricyclics and MAO inhibitors, what is a major reason for the popularity of newer antidepressant drugs such as Prozac? a. b. c. d.

lower cost fewer side effects available over-the-counter more effective Difficulty: 1 Question ID: 5.1.90 Page Reference: 125 Topic: Treatment Skill: Conceptual Answer: b. fewer side effects

5.1.91. Which of the following are the most troublesome side effects of the use of selective serotonin reuptake inhibitors? a. b. c. d.

muscle pain and double visions insomnia and excessive sweating sexual dysfunction and weight gain heart palpitations and difficulty breathing Difficulty: 1 Question ID: 5.1.91 Page Reference: 125 Topic: Treatment Skill: Factual Answer: c. sexual dysfunction and weight gain

5.1.92. Sal's psychiatrist wrote a prescription for him and warned him not to eat a long list of foods, including cheese and chocolate. If Sal's diagnosis is depression, what type of drug is likely to have been prescribed? a. b. c. d.

tricyclics MAO inhibitors anticonvulsants selective serotonin reuptake inhibitors

Difficulty: 2 Question ID: 5.1.92 Page Reference: 126 Topic: Treatment Skill: Applied Answer: b. MAO inhibitors

5.1.93. The U.S. Food and Drug Administration has ruled that care should be taken when prescribing some SSRIs to children because of the possibility of the side effects of a. b. c. d.

catatonic, lethargic behavior. sever sleep disturbance. extreme weight loss. violent or suicidal thoughts or behavior. Difficulty: 2 Question ID: 5.1.93 Page Reference: 127 Topic: Treatment Skill: Conceptual Answer: d. violent or suicidal thoughts or behavior.

5.1.94. Which of the following summarizes the research evaluating psychological and pharmacological treatments for depression? a. Antidepressant medication is the most effective approach. b. Cognitive therapy is the most effective approach. c. Antidepressants and cognitive therapy are both effective forms of treatment. d. Antidepressants work better on more severe depression and cognitive therapy works better with milder depression. Difficulty: 2 Question ID: 5.1.94 Page Reference: 127 Topic: Treatment Skill: Factual Answer: c. Antidepressants and cognitive therapy are both effective forms of treatment.

5.1.95. The first choice for treating bipolar disorders is a. b. c. d.

an SSRI like Prozac. electroconvulsive therapy. lithium. cognitive therapy plus a self-help group.

Difficulty: 1 Question ID: 5.1.95 Page Reference: 126 Topic: Treatment Skill: Factual Answer: c. lithium.

5.1.96. Bonnie has been diagnosed with a mental disorder and is currently receiving medication. If the prescription is for anticonvulsant drugs, what is the most likely mental disorder? a. b. c. d.

dysthymic disorder cyclothymic disorder major depressive episode rapid cycling bipolar disorder Difficulty: 2 Question ID: 5.1.96 Page Reference: 126 Topic: Treatment Skill: Conceptual Answer: d. rapid cycling bipolar disorder

5.1.97. A bipolar patient in therapy is learning to lead a more orderly life and to resolve interpersonal problems more effectively. With this type of therapy, mood stabilizing medication will a. b. c. d.

still be very important. no longer be needed. only confuse the patient. be less likely to cause side-effects. Difficulty: 1 Question ID: 5.1.97 Page Reference: 126 Topic: Treatment Skill: Conceptual Answer: a. still be very important.

5.1.98. The family of a patient about to undergo electroconvulsive therapy (ECT) is concerned about how the treatment will affect their loved one's memory. They meet with the psychiatrist and ask questions. What is the psychiatrist likely to tell them? a. b. c.

“Memory problems are typically of short duration." "Although there will be some loss of memory, the patients rarely complain." "Although there are serious memory losses, the benefits of treatment outweigh these losses."

d. "The memory problems are actually a benefit because they keep negative memories out of consciousness." Difficulty: 2 Question ID: 5.1.98 Page Reference: 128 Topic: Treatment Skill: Applied Answer: a. “Memory problems are typically of short duration."

5.1.99. Based on outcome studies that have evaluated the effectiveness of light therapy for seasonal depressions, it appears that a. b. c. d.

many patients with seasonal affective disorders do respond well to light therapy. light therapy is an expensive but useless gimmick. no one knows the correct dosage of light. there is no theory to explain how light therapy could possibly work. Difficulty: 1 Question ID: 5.1.99 Page Reference: 128 Topic: Treatment Skill: Factual Answer: a. many patients with seasonal affective disorders do respond well to light therapy.

5.1.100. Durkheim's classification of suicides focused on a person's social circumstances in terms of high and low levels of social a. b. c. d.

apathy and altruism. egotism and fatalism. integration and regulation. anomie and bonhomie. Difficulty: 2 Question ID: 5.1.100 Page Reference: 129 Topic: Suicide Skill: Conceptual Answer: c. integration and regulation.

5.1.101. The highest suicide rate in the United States is among a. b. c. d.

White males under 40 years old. White males over 50 years old. Black females over 50 years old. teenage females.

Difficulty: 1 Question ID: 5.1.101 Page Reference: 129 Topic: Suicide Skill: Factual Answer: b. White males over 50 years old.

5.1.102. Which of the following individuals is most likely to die as a result of suicide? a. b. c. d.

Jim, a 60-year-old Zack, an 8-year-old Alice, a 23-year-old Laura, a 4-year-old Difficulty: 1 Question ID: 5.1.102 Page Reference: 129 Topic: Suicide Skill: Applied Answer: a. Jim, a 60-year-old

5.1.103. What percentage of patients with mood disorders will eventually kill themselves? a. b. c. d.

5-10% 15-20% 40-45% more than 50% Difficulty: 1 Question ID: 5.1.103 Page Reference: 129 Topic: Suicide Skill: Factual Answer: b.15-20%

5.1.104. Deliberate self harm is listed in the DSM-IV-TR as one of the symptoms of a. b. c. d.

schizophrenia. borderline personality disorder. psychopathy. self-injurious neuroses. Difficulty: 1 Question ID: 5.1.104

Page Reference: 130 Topic: Suicide Skill: Factual Answer: b. borderline personality disorder.

5.1.105. From rates of attempted and successful suicides, we can conclude that females more often ________ and males more often _________. a. b. c. d.

attempt; succeed succeed; attempt leave notes; do not leave notes use guns; use poisons Difficulty: 1 Question ID: 5.1.105 Page Reference: 131 Topic: Suicide Skill: Factual Answer: a. attempt; succeed

5.1.106. According to Edwin Schneidman, the most common stressor in suicide is a. b. c. d.

hostility. anger. frustration of psychological needs. the desire to make others suffer. Difficulty: 1 Question ID: 5.1.106 Page Reference: 132 Topic: Suicide Skill: Conceptual Answer: c. frustration of psychological needs.

5.1.107. Studies of the role of genetic factors in suicide indicate that a. b. c. d.

there is a genetic factor independent of the risk for depression. the only genetic factor is the genetic risk for depression. genetic factors do not play a role in suicide. genetic factors play a role in suicides by males but not suicides by females. Difficulty: 1 Question ID: 5.1.107 Page Reference: 133 Topic: Suicide

Skill: Factual Answer: a. there is a genetic factor independent of the risk for depression.

5.1.108. According to Edwin Schneidman, the most common emotion in suicide is a. b. c. d.

fear. anger. hopelessness. depression. Difficulty: 1 Question ID: 5.1.108 Page Reference: 132 Topic: Suicide Skill: Conceptual Answer: c. hopelessness.

5.1.109. The state legislature is considering enacting measures that will have an impact in reducing suicide rates. Which of the following individuals who are testifying before a legislative committee will be able to provide the most empirical support for his or her suggestion? a. b. c. d.

Al, who wants to reduce access to guns Jim, who wants to make suicide a criminal offence Stacey, who wants public service announcements focused on famous suicides Randy, who wants to establish crisis lines to handle calls from individuals contemplating suicide Difficulty: 1 Question ID: 5.1.109 Page Reference: 133 Topic: Suicide Skill: Applied Answer: a. Al, who wants to reduce access to guns

5.1.110. The city council is considering funding a suicide hot line and they ask you to review the literature on the topic. What will your report tell the council? a. b. c. d.

Special training for police officers is a better way to spend the money. A hot line phone service is the most economical way to reduce the rate of suicide. Suicide rates do not differ in communities with and without suicide prevention programs. Crisis hot lines must be connected with hospital emergency rooms in order to be effective. Difficulty: 2 Question ID: 5.1.110 Page Reference: 134 Topic: Suicide

Skill: Conceptual Answer: c. Suicide rates do not differ in communities with and without suicide prevention programs.

Short Answer 5.2.111. Depressed, or ____________(unpleasant), mood is the most common and obvious symptom of depression. Difficulty: 1 Question ID: 5.2.111 Page Reference: 106 Topic: Overview Skill: Conceptual Answer: dysphoric

5.2.112. The syndrome of depression is also called __________ depression. Difficulty: 2 Question ID: 5.2.112 Page Reference: 103 Topic: Overview Skill: Factual Answer: clinical

5.2.113. __________ or elated mood is the opposite emotional state from depressed mood.

Difficulty: 2 Question ID: 5.2.113 Page Reference: 106 Topic: Overview Skill: Factual Answer: a. Euphoria

5.2.114. Mood disorder symptoms that are related to basic bodily functions are known as __________ symptoms. Difficulty: 1 Question ID: 5.2.114 Page Reference: 107

Topic: Symptoms Skill: Factual Answer: a. somatic

5.2.115. If, during a period of mood disturbance, your patient experiences inflated self-esteem or grandiosity, you likely will diagnosis this as a(n) __________ episode.

Difficulty: 2 Question ID: 5.2.115 Page Reference: 107 Topic: Diagnosis Skill: Applied Answer: a. manic

5.2.116. A mood disorder that is regularly associated with changes in the seasons is called __________ __________ disorder.

Difficulty: 1 Question ID: 5.2.116 Page Reference: 111 Topic: Diagnosis Skill: Factual Answer: seasonal affective

5.2.117. When an individual's symptoms are improved for a period of time this is referred to as __________ .

Difficulty: 1 Question ID: 5.2.117 Page Reference: 112 Topic: Course and Outcome Skill: Factual Answer: a. remission

5.2.118. Gender differences are typically not reported for __________ mood disorders. Difficulty: 2 Question ID: 5.2.118 Page Reference: 112 Topic: Frequency

Skill: Factual Answer: bipolar

5.2.119. Brown and colleagues have found evidence that depression in women is more likely to occur when severe life events are associated with (provide one of the three terms suggested in the textbook) __________ .

Difficulty: 1 Question ID: 5.2.119 Page Reference: 116 Topic: Causes Skill: Conceptual Answer: humiliation and entrapment and defeat

5.2.120. The system in the body responsible for regulating a person's response to stress is known as the __________ system. Difficulty: 2 Question ID: 5.2.120 Page Reference: 120 Topic: Causes Skill: Factual Answer: endocrine

5.2.121. When rats are exposed to stress in the lab, they exhibit signs of depression and evidence that the concentration of chemicals in their brains have been changed. These chemicals are known collectively as _________.

Difficulty: 3 Question ID: 5.2.121 Page Reference: 122 Topic: Causes Skill: Conceptual Answer: neurotransmitters

5.2.122. In a case conference about a procedure you are about to perform on your depressed patient the main topic is the amount of amnesia or memory loss they will experience as a result of the therapy. Likely you are considering using [three letter acronym or initials] __________. Difficulty: 1 Question ID: 5.2.122

Page Reference: 128 Topic: Treatment Skill: Applied Answer: ECT

5.2.123. _____ suicide occurs when the rules of a society or social group dictate that an individual must sacrifice their life for the good of the group. Difficulty: 2 Question ID: 5.2.123 Page Reference: 130 Topic: Suicide Skill: Factual Answer: Altruistic

Essay 5.3.124. What are the two primary issues central to the debate regarding definitions of mood disorders? What are the five major considerations we can use in distinguishing clinical depression from normal sadness?

Difficulty: 2 Question ID: 5.3.124 Page Reference: 108-109 Topic: Diagnosis Skill: Conceptual Answer: (1) should these disorders be defined in a broad or narrow fashion? (2) the issue of heterogeneity. All depressed persons do not have the same set of symptoms, same pattern of onset, or the same course over time. Some patients have manic episodes, whereas others experience only depression. Some exhibit psychotic symptoms, such as delusions and hallucinations. The important considerations in distinguishing clinical depression from normal sadness are: (1) Intensity: The mood change pervades all aspects of the person and impairs social and occupational functions. (2) Absence of precipitants: The mood may arise in the absence of any discernible precipitant or may be grossly out of proportion to those precipitants. (3) Quality: The mood change is different from that experienced in normal sadness. (4) Associated features: The change in mood is accompanied by a cluster of signs and symptoms, including cognitive and somatic features. (5) History: The mood change may be preceded by a history of past episodes of elation and hyperactivity.

5.3.125. What has research revealed concerning the rate of depression among the elderly? Difficulty: 2 Question ID: 5.3.125 Page Reference: 113-114

Topic: Frequency Skill: Conceptual Answer: Although people mistakenly identify depression with the elderly, data from the NCS-R suggest that mood disorders actually are more frequent among young and middle-aged adults. The rates of both major depression and bipolar mood disorder are lowest among people over age 60. Several explanations have been offered for this pattern. It is possible that this finding is due to how the research was conducted, not actual differences in the rate of depression across age groups. One interpretation is that the elderly have greater difficulty remembering episodes of depression. In addition, mood disorders are associated with increased mortality; thus, some severely depressed people might not have survived into old age. However, the pattern observed in the NCS-R has been observed in several studies, and most investigators believe the effect (lower rates of depression among the elderly) is genuine.

5.3.126. Summarize the findings of research investigating the relationship between stressful life events and depression, and then explain why it is difficult to interpret what the relationship means.

Difficulty: 2 Question ID: 5.3.126 Page Reference: 115-116 Topic: Causes Skill: Conceptual Answer: People who become clinically depressed experience an increased number of stressful life events. Comparisons among different populations show that communities with the highest rates of severe events produced the highest prevalence of major depression. One troublesome problem involves the direction of the relationship. If depressed people experience more stressful events, what is the direction of effect? Does failure lead to depression, or does depression lead to failure? Another problem is that many people who experience stressful life events do not become depressed, and we don't always know who will become depressed. The research of Brown, Harris, and others points to "severe" events, ones that are particularly threatening, as factors in the cause of depression, especially in women. Events that lead to humiliation, entrapment or defeat seem to be particularly related to depression.

5.3.127. Discuss the concept of cognitive vulnerability as a model of the cause of depression. Difficulty: 2 Question ID: 5.3.127 Page Reference: 117-118 Topic: Causes Skill: Conceptual Answer: There are several cognitive models of the etiology of depression. One model is based on the work of Aaron Beck who suggests that people develop through the course of their lives habitual ways of looking at the world and themselves. These cognitive patterns determine how they interpret and react to life events. Some patterns, or habitual ways of thinking and perceiving, make an individual more vulnerable to depression. From this perspective persistent negative or pessimistic thoughts would be such a vulnerability. Various types of distortions, errors or biases in thinking or perceiving, such as a tendency to assign a global, personal meaning to negative experiences, would be conducive to depression. There

are several cognitive distortions that could be mentioned here including a tendency to over generalize negative conclusions from one negative experience, drawing arbitrary inferences about one’s self with out evidence, and a tendency to exaggerate any negative experience. Mention should be made of Beck’s concept of schema which is a cognitive term for the collection of assumptions, attributions, and ways of perceiving that guide ones cognitive habits or tendencies.

5.3.128. What are the two response styles described by Susan Nolen-Hoeksema? How are these response styles related to depression? Difficulty: 2 Question ID: 5.3.128 Page Reference: 118 Topic: Causes Skill: Conceptual Answer: Nolen-Hoeksema has proposed that the manner in which a person responds to the onset of depressed mood influences its duration and severity. Ruminative styles involve responding to feelings of depression by turning attention inward, contemplating causes and implications of sadness. Distracting style involves diverting oneself from unpleasant mood by working on hobbies, playing sports, etc. People with ruminative style experience longer and more severe episodes of depression than do people with distracting style. Women tend to use the ruminative style.

5.3.129. Describe the research results suggesting that there is a greater genetic influence on bipolar disorder than on unipolar disorder.

Difficulty: 3 Question ID: 5.3.129 Page Reference: 119 Topic: Causes Skill: Applied Answer: (1) There is a greater difference in the concordance rates for MZ and DZ twins in the case of bipolar disorder than in the case of unipolar disorder. (2) The rate of bipolar disorder in family members of unipolar patients is similar to the rate in the general population, but the rate of unipolar disorder in family members of bipolar patients is higher than the rate in the general population.

5.3.130. Brief describe the brain regions that have been associated with a biological model of the cause of depression. Difficulty: 3 Question ID: 5.3.130 Page Reference: 121-122 Topic: Causes Skill: Conceptual Answer: There are several brain regions currently associated with models of the cause of depression. Likely they interact in some complicated fashion, but we are still in the process of sorting out

their individual contributions. Mention could be made of the following: Hypothalamic–pituitary–adrenal (HPA) axis. When the CNS perceives a threat it signals the hypothalamus which intern signals the pituitary gland to secrete the hormone ACTH which modulates the secretion of, for example, cortisol from the adrenal cortex which helps the individual prepare for fight or flight in a number of ways. Depressed patients show a failure of suppression of the HPA axis after being given DST which suggests that they have, during depression, a hyperactive HPA axis. Stress causes the release of adrenal steroids, such as cortisol, which has been shown to cause structural and functional changes in the brain, including alterations in gene expression, that are associated with depression. Functional imaging of the brain suggests abnormal activation in several regions of the brain including: decreased activity in the regions of the prefrontal cortex (PFC) responsible for planning and the anticipation of emotion; increased activity in the region of the PFC responsible for the experience of reward and punishment; the anterior cingulate cortex (ACC) which is activated when a person’s goals are frustrated; increased activity in the amygdala which is the part of the limbic system responsible for emotional experiences. Individual who respond well to any form of therapy evidence reduce activity in the amygdala.

5.3.131. Summarize what is currently known about the effectiveness of psychotherapy and medication in the treatment of depression, and cite some of the research evidence. Difficulty: 2 Question ID: 5.3.131 Page Reference: 124-126 Topic: Treatment Skill: Conceptual Answer: There are several different kinds of antidepressant medications, but they are generally equal in terms of effectiveness, with positive responses being shown by 50 to 60 percent of depressed patients. Cognitive therapy and antidepressant medication appear to be equally effective for people who suffer from unipolar depression, including major depressive disorder and dysthymia. Medication and psychotherapy also appeared equally effective in randomized trials conducted in primary care settings, with 64 percent of patients recovering from an episode of depression after 11 weeks of treatment with either an SSRI or problem-solving therapy.

5.3.132. Discuss Joiner's (closely related to Schneidman's) model of the psychological factors that are involved in the cause of suicide. Mention the common elements of suicide. Difficulty: 2 Question ID: 5.3.132 Page Reference: 132 Topic: Suicide Skill: Conceptual Answer: For Joiner, social factors can set the stage for thoughts or motivations of suicide, but psychological events lie at the core of suicidal behavior. Emotional stress and hopelessness are central features of many individuals who actually attempt suicide. Joiner, and others, consider the common elements of suicidal psychology to focus on an attempt to escape from unbearable psychological pain, often the pain associated with prolonged frustration of basic psychological needs. Most important are the needs for affiliation and competence. People who view themselves as having failed in these domains— those who are low in belongingness or high in burdensomeness—will experience intense negative emotional states, such as shame, guilt, anger, and grief. Suicide then becomes a somewhat logical route to

escape this on-going pain caused by these psychological states. Of particular association with the act of suicide are the belief and experience of being socially isolated and being a burden to others.

5.3.133. What are some of the recommendations for dealing with individuals who have expressed a serious intent to harm themselves? Difficulty: 3 Question ID: 5.3.133 Page Reference: 134 Topic: Suicide Skill: Applied Answer: (1) reduce the lethality: reduce psychological pain and reduce access to means of committing suicide; (2) negotiate agreements: ask the client to sign a contract agreeing to postpone selfdestructive behavior for at least a short period of time, include an agreement that the client will contact the therapist directly before engaging in any lethal actions; (3) provide support: make concrete arrangements for social support, alert friends and family members to be available; (4) replace tunnel vision with a broader perspective: suicidal individuals are often unable to consider alternative solutions for their problems; help clients to use a more flexible and adaptive pattern of problem solving to replace death as the only solution.

5.3.134. Discuss the concept of genetic risk interacting with stress as demonstrated in the work of Caspi on the 5-HTT gene. Difficulty: 3 Question ID: 5.3.134 Page Reference: 120 Topic: Causes Skill: Applied Answer: Caspi’s work focused on the 5-HTT transporter gene which has been studied because several drugs that are used to treat depression have a direct impact on this particular neurotransmitter. There are two alleles or different versions of this gene one of which is shorter and is associated with reduced efficiency of neural transmission in serotonin pathways. Individuals who inherit this short allele or version of the gene are at particularly high risk for becoming clinically depressed if they experience stressful life events. In the absence of increased stress, the presence of this gene does not increase the person’s risk for depression. Both factors seem to be necessary.

Chapter 6 Anxiety Disorders Total Assessment Guide (T.A.G.) Topic Overview pp. 138-140

Symptoms pp. 140-144

Diagnosis pp. 144-147

Frequency pp. 147-149

Causes pp. 149-156

Treatment 156-160

Question Type Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice

Factual 1

Conceptual

Applied

2, 4

5, 7, 13, 17, 18, 28

6, 19, 20, 24, 27, 29, 30

117, 118* 32, 36, 41, 42, 46

35, 37, 38, 45

105 8, 9, 10, 11, 12, 14, 15, 16, 21, 22, 23, 25, 26 106, 107 31, 33, 34, 39, 40, 43, 44 108 47, 48, 49, 50, 51, 52

118*, 119 53, 54, 55

109 120 60, 61, 68, 70, 71, 56, 57, 62, 63, 65, 72, 74, 77, 79, 83 67, 69, 73, 76, 78, 80, 81, 82 Short Answer 114 110, 111, 112, 113 Essay 121, 122 Multiple 84, 86, 89, 93, 94, 90, 91, 99, 102, Choice 95, 96, 100, 101 103, 104 Short Answer 116 115 Essay 123 *This question covers two topics

58, 59, 64, 66, 75

85, 87, 88, 92, 97, 98

Chapter 6: Anxiety Disorders

Multiple Choice 6.1.1. The National Comorbidity Survey Replication (NCS-R) found the percent of adults who suffer from at least one type of anxiety disorder in a given year to be a. b. c. d.

6 percent. 18 percent. 24 percent. 36 percent. Difficulty: 1 Question ID: 6.1.1 Page Reference: 139 Topic: Overview Skill: Factual Answer: b. 18 percent.

6.1.2.

The close relationship between symptoms of anxiety and those for depression suggests that

a. b. c. d.

anxiety and depression are really the same emotion. these disorders may share common etiological features. psychological testing is needed to tell them apart. anxiety and depression are not true mental disorders. Difficulty: 1 Question ID: 6.1.2 Page Reference: 139 Topic: Overview Skill: Conceptual Answer: b. these disorders may share common etiological features.

6.1.3.

In which of these situations would an agoraphobic be most likely to exhibit avoidance or fear?

a. b. c. d.

touching an insect swimming in a backyard pool being at the top of a tall building sitting in the middle of a row in a crowded theater

Difficulty: 1 Question ID: 6.1.3 Page Reference: 139 Topic: Overview Skill: Applied Answer: d. sitting in the middle of a row in a crowded theater

6.1.4. According to the case study of the writer presented in the textbook why would individuals with agoraphobia feel terrified of crowds? a. b. c. d.

They fear people. They are paranoid. They have low self-esteem. They fear not being able to escape. Difficulty: 2 Question ID: 6.1.4 Page Reference: 139-140 Topic: Overview Skill: Conceptual Answer: d. They fear not being able to escape.

6.1.5.

Anxiety is a reaction to

a. b. c. d.

avoidance. impaired insight. anticipated future problems. an immediate threat from the environment. Difficulty: 1 Question ID: 6.1.5 Page Reference: 141 Topic: Symptoms Skill: Conceptual Answer: c. anticipated future problems.

6.1.6.

Which of the following statements about anxiety is true?

a. b. c. d.

Anxiety is a more severe emotion than depression. Anxiety is a less severe emotion than depression. Anxiety can be adaptive at low levels. Anxiety is always adaptive.

Difficulty: 1 Question ID: 6.1.6 Page Reference: 141 Topic: Symptoms Skill: Applied Answer: c. Anxiety can be adaptive at low levels.

6.1.7.

In what way is fear different from anxiety?

a. b. c. d.

Fear is more general. Fear occurs appropriately in the face of real danger. Fear is associated with anticipation of future problems. Fear is out of proportion to threats from the environment. Difficulty: 2 Question ID: 6.1.7 Page Reference: 141 Topic: Symptoms Skill: Conceptual Answer: b. Fear occurs appropriately in the face of real danger.

6.1.8.

Which of the following is typically associated with anxious mood?

a. b. c. d.

fainting and cramps preoccupation with other people pessimistic thoughts and feelings organization and rehearsal of adaptive responses Difficulty: 1 Question ID: 6.1.8 Page Reference: 141 Topic: Symptoms Skill: Factual Answer: c. pessimistic thoughts and feelings

6.1.9.

David Barlow suggests that anxious apprehension involves which of the following?

a. b. c. d.

immediate danger specific negative emotions a preoccupation with others a sense of uncontrollability

Difficulty: 2 Question ID: 6.1.9 Page Reference: 141 Topic: Symptoms Skill: Factual Answer: d. a sense of uncontrollability

6.1.10. Worry is a relatively uncontrollable sequence of negative emotional thoughts and images concerned with a. b. c. d.

immediate danger. physiological hypoarousal. absence of positive affect. possible future threats or dangers. Difficulty: 1 Question ID: 6.1.10 Page Reference: 141 Topic: Symptoms Skill: Factual Answer: d. possible future threats or dangers.

6.1.11. Worriers are preoccupied with _______ rather than unpleasant visual images. a. b. c. d.

fears fantasies affects “self talk” Difficulty: 1 Question ID: 6.1.11 Page Reference: 141 Topic: Symptoms Skill: Factual Answer: d. “self talk”

6.1.12. People who worry excessively usually report that their worries are not a. b. c. d.

realistic. distressing. excessive. hard to control.

Difficulty: 1 Question ID: 6.1.12 Page Reference: 141 Topic: Symptoms Skill: Factual Answer: a. realistic.

6.1.13. According to the DSM, which of the following questions would be most useful in distinguishing a panic attack from anxiety? a. b. c. d.

Do you experience a lot of nightmares? Would you describe your symptoms as distressing? Do your symptoms reach peak intensity within 10 minutes? Are your symptoms difficult for you to control? Difficulty: 1 Question ID: 6.1.13 Page Reference: 142 Topic: Symptoms Skill: Conceptual Answer: c. Do your symptoms reach peak intensity within 10 minutes?

6.1.14. To say that panic is like a "false alarm" means that panic is a. b. c. d.

a normal fear response triggered at an inappropriate time. a deliberate attempt to seek attention. very different from the normal fear response. easily dismissed as harmless. Difficulty: 1 Question ID: 6.1.14 Page Reference: 141 Topic: Symptoms Skill: Factual Answer: a. a normal fear response triggered at an inappropriate time.

6.1.15. Compared to anxiety, a panic attack tends to be a. b. c. d.

sudden. longer in duration. less intense. less like a normal fear response.

Difficulty: 1 Question ID: 6.1.15 Page Reference: 141 Topic: Symptoms Skill: Factual Answer: a. sudden.

6.1.16. Which of the following is one of the DSM-IV-TR criteria used to identify panic attack? a. b. c. d.

shows gradual build-up over several days reaches peak intensity within 10 minutes involves a blend of several negative emotions involves preoccupation with words rather than images Difficulty: 2 Question ID: 6.1.16 Page Reference: 142 Topic: Symptoms Skill: Factual Answer: b. reaches peak intensity within 10 minutes

6.1.17. Which of the following statements about panic attacks is true? a. b. c. d.

Panic attacks are always cued. Panic attacks are always unexpected. Panic attacks are sometimes cued, sometimes unexpected. Panic attacks that are cued are less severe than unexpected panic attacks. Difficulty: 2 Question ID: 6.1.17 Page Reference: 142 Topic: Symptoms Skill: Conceptual Answer: c. Panic attacks are sometimes cued, sometimes unexpected.

6.1.18. Under what circumstances is a panic attack said to be cued? a. b. c. d.

when it occurs only in predictable situations when it occurs without warning or "out of the blue" when it is triggered by real, not imagined, dangers when it is triggered by imagined, not real, dangers

Difficulty: 1 Question ID: 6.1.18 Page Reference: 142 Topic: Symptoms Skill: Conceptual Answer: a. when it occurs only in predictable situations

6.1.19. Which of the following situations is most likely to be associated with the development of a panic attack? a. b. c. d.

Al was out walking his dog when another dog barked loudly. When Al was four years old, he almost drowned at the beach. Al misinterpreted a sudden increase in his heart rate as evidence of a heart attack. Al feels constantly on edge as a result of a long list of worries at work and at home. Difficulty: 2 Question ID: 6.1.19 Page Reference: 142 Topic: Symptoms Skill: Applied Answer: c. Al misinterpreted a sudden increase in his heart rate as evidence of a heart attack.

6.1.20. Which of the following is NOT appropriately matched? a. b. c. d.

agoraphobia: fear of places from which escape may be difficult claustrophobia: fear of enclosed spaces altaphobia: fear of flying hemophobia: fear of blood Difficulty: 2 Question ID: 6.1.20 Page Reference: 142 Topic: Symptoms Skill: Applied Answer: c. altaphobia: fear of flying

6.1.21. Fear is not considered phobic unless the person a. avoids contact with the source of the fear or experiences intense anxiety in the presence of the feared stimulus. b. the fear is generalized to more than one stimulus. c. the person has a failed attempt to repress the fear. d. the person experiences a parasympathetic storm.

Difficulty: 1 Question ID: 6.1.21 Page Reference: 142 Topic: Symptoms Skill: Factual Answer: a. avoids contact with the source of the fear or experiences intense anxiety in the presence of the feared stimulus.

6.1.22. Repetitive, unwanted, intrusive cognitive events in the form of thoughts, images, or impulses that intrude suddenly into consciousness are called a. b. c. d.

phobias. disorders. obsessions. compulsions. Difficulty: 2 Question ID: 6.1.22 Page Reference: 142 Topic: Symptoms Skill: Factual Answer: c. obsessions.

6.1.23. What are compulsions? a. b. c. d.

a type of obsession normal feelings of drive intrusive, unwanted thoughts irrational, repetitive behaviors Difficulty: 1 Question ID: 6.1.23 Page Reference: 143 Topic: Symptoms Skill: Factual Answer: d. irrational, repetitive behaviors

6.1.24. How do patients typically view their compulsions? a. b. c. d.

as very pleasurable as making sense as senseless and irrational as necessary to their survival

Difficulty: 2 Question ID: 6.1.24 Page Reference: 143 Topic: Symptoms Skill: Applied Answer: c. as senseless and irrational

6.1.25. In the case of Ed presented in your text, what motivated him to rush to the mailbox and tear open an envelope containing a form that he had just completed? a. He decided that he had let down his company because his work was not perfect. b. He was afraid that his writing contained symbolic representations of hidden sexual desires. c. He thought his writing of a particular letter would be associated with the strangulation of his wife. d. He thought the evil voices he heard would punish him for his failure to follow their plan as they had instructed. Difficulty: 2 Question ID: 6.1.25 Page Reference: 143 Topic: Symptoms Skill: Factual Answer: c. He thought his writing of a particular letter would be associated with the strangulation of his wife.

6.1.26. How do clinical obsessions differ from normal obsessions? a. b. c. d.

They differ in degree rather than kind. Clinical obsessions are more visually oriented. The content of the reported images is different. Clinical obsessions are more likely to be acted upon. Difficulty: 1 Question ID: 6.1.26 Page Reference: 144 Topic: Symptoms Skill: Factual Answer: a. They differ in degree rather than kind.

6.1.27. After studying her patients' compulsions, a clinician is most likely to conclude about their effects? a. b. c.

reduce anxiety, increase pleasure increase anxiety, increase pleasure reduce anxiety, don't increase pleasure

increase anxiety, don't increase pleasure Difficulty: 2 Question ID: 6.1.27 Page Reference: 144 Topic: Symptoms Skill: Applied Answer: c. reduce anxiety, don't increase pleasure

6.1.28. Compulsives can sometimes resist their compulsions, but they usually return to their compulsive behavior because a. b. c. d.

not engaging in the compulsive behavior increases distress. they miss the pleasure produced by their compulsions. they do not view their compulsions as a problem. they need the attention that their compulsive behavior attracts. Difficulty: 1 Question ID: 6.1.28 Page Reference: 144 Topic: Symptoms Skill: Conceptual Answer: a. not engaging in the compulsive behavior increases distress.

6.1.29. You are starting a research project in which you wish to compare everyday compulsive behavior of individuals not diagnosed with a mental disorder with the most common forms of compulsive behavior found in those diagnosed with OCD. What are the two most common forms of compulsion found in those so diagnosed? a. b. c. d.

eating and dressing escape and avoidance checking and cleaning counting and collecting Difficulty: 1 Question ID: 6.1.29 Page Reference: 144 Topic: Symptoms Skill: Applied Answer: c. checking and cleaning

6.1.30. Amy loves collecting coffee mugs and has been collecting them for years. At the drop of a hat, she will launch into a discussion of her collection, the price of mugs, and her plans for purchasing more mugs. Her friends say she must have obsessive-compulsive disorder. You disagree. What do you say to her friends when they ask why you disagree?

a. Unlike an obsessive-compulsive, Amy derives pleasure from this activity. b. Although Amy experiences anxiety, it is the result of a deep-seated conflict. c. Amy is actually suffering from depression, which she hides by engaging in mug collecting. d. Obsessive-compulsive disorder is an inherited disorder and there is no evidence that other family members have the disorder. Difficulty: 2 Question ID: 6.1.30 Page Reference: 144 Topic: Symptoms Skill: Applied Answer: a. Unlike an obsessive-compulsive, Amy derives pleasure from this activity.

6.1.31. During the first half of the twentieth century, psychiatrists tended to adopt a generalized position with regard to anxiety disorder. In other words they a. b. c. d.

lumped together the various anxiety disorders. only defined “generalized anxiety disorder.” focused on an integrated and unified definition of anxiety. defined anxiety only in psychotic disorders. Difficulty: 2 Question ID: 6.1.31 Page Reference: 145 Topic: Diagnosis Skill: Factual Answer: a. lumped together the various anxiety disorders.

6.1.32. Why didn't anxiety disorders play a prominent role in psychiatric classification systems in the 1800s? a. b. c. d.

There were fewer cases then. They were seen as moral problems. They were seen as physiological, not psychological, problems. Few cases were treated in institutions where they would be seen by psychiatrists. Difficulty: 1 Question ID: 6.1.32 Page Reference: 144 Topic: Diagnosis Skill: Conceptual Answer: d. Few cases were treated in institutions where they would be seen by psychiatrists.

6.1.33. DSM-IV-TR approach to classifying anxiety disorders is based primarily on

a. b. c. d.

a psychodynamic model of the cause of each disorder. descriptive features of each disorder. specific scores on tests of anxiety. a dimensional approach. Difficulty: 1 Question ID: 6.1.33 Page Reference: 145 Topic: Diagnosis Skill: Factual Answer: b. descriptive features of each disorder

6.1.34. Which of the following are the current DSM categories of phobias? a. b. c. d.

linguistic, natural, and symbolic neurotic, physical, and psychotic agoraphobia, social, and specific generalized, social, and specific Difficulty: 1 Question ID: 6.1.34 Page Reference: 145 Topic: Diagnosis Skill: Factual Answer: c. agoraphobia, social, and specific

6.1.35. A differential diagnosis between social and specific phobia is a bit tricky. You need to look for the most important difference between social phobia and specific phobia which is that social phobia a. b. c. d.

does not involve avoidance. also involves the element of performance. is much less distressing. also involves the element of panic. Difficulty: 2 Question ID: 6.1.35 Page Reference: 145 Topic: Diagnosis Skill: Applied Answer: b. also involves the element of performance.

6.1.36. In which situation might a person exhibit a social phobia? a. b.

performing at a concert watching a concert on TV

c. d.

going for a walk having one's name called over the loudspeaker at a concert Difficulty: 2 Question ID: 6.1.36 Page Reference: 145 Topic: Diagnosis Skill: Conceptual Answer: a. performing at a concert

6.1.37. Bill worries about a long list of concerns. He finds himself constantly thinking about these topics at work, when he exercises, and as he tries to sleep. He is easily fatigued, can't concentrate, and is often restless. He has been worrying like this for the past year. Bill seems to meet the criteria for the diagnosis of a. b. c. d.

agoraphobia. social phobia. generalized anxiety disorder. obsessive-compulsive disorder. Difficulty: 3 Question ID: 6.1.37 Page Reference: 146 Topic: Diagnosis Skill: Applied Answer: c. generalized anxiety disorder.

6.1.38. Tim has been worried about his grades for more than three months. After hearing about the diagnosis of generalized anxiety disorder he becomes convinced that this is what he has. After seeing a mental health professional, what is he told? a. He is actually suffering from the early stages of panic disorder. b. His concern over grades is more indicative of obsessive-compulsive disorder. c. He does not meet the criteria for generalized anxiety disorder in terms of length of time and number of worries. d. The focus of his worry suggests that he is suffering from a phobic reaction rather than a generalized anxiety disorder.

Difficulty: 2 Question ID: 6.1.38 Page Reference: 146 Topic: Diagnosis Skill: Applied Answer: c. He does not meet the criteria for generalized anxiety disorder in terms of length of time and number of worries.

6.1.39. Generalized anxiety disorder (GAD) is one of the most controversial anxiety disorders because a. b. c. d.

the diagnostic reliability of GAD is lower than that of other anxiety disorders. the symptoms of GAD primarily involve depression. the criteria for GAD do not involve any reference to etiology. the symptoms of GAD are no different than normal worrying. Difficulty: 1 Question ID: 6.1.39 Page Reference: 146 Topic: Diagnosis Skill: Factual Answer: a. the diagnostic reliability of GAD is lower than that of other anxiety disorders.

6.1.40. What must a person demonstrate in order to be diagnosed with obsessive-compulsive disorder? a. b. c. d.

a history of phobias free-floating anxiety both obsessions and compulsions realization that the obsessions or compulsions are excessive or unreasonable Difficulty: 1 Question ID: 6.1.40 Page Reference: 146 Topic: Diagnosis Skill: Factual Answer: d. realization that the obsessions or compulsions are excessive or unreasonable

6.1.41. What is an essential element of the diagnosis of obsessive-compulsive disorder? a. b. c. d.

The obsessions develop in response to the compulsions. The person engages in compulsions, which increase anxiety. The person's sleep is disrupted by nightmares. The person tries to ignore, suppress, or neutralize the unwanted thoughts or impulses.

Difficulty: 1 Question ID: 6.1.41 Page Reference: 147 Topic: Diagnosis Skill: Conceptual Answer: d. The person tries to ignore, suppress, or neutralize the unwanted thoughts or impulses.

6.1.42. In the theoretical debate around the nature of anxiety disorders, those who suggest that all anxiety disorders should be seen as the same disorder are sometimes referred to as a. b. c. d.

splitters. lumpers. amalgamationists. anxiolytics. Difficulty: 1 Question ID: 6.1.42 Page Reference: 145 Topic: Diagnosis Skill: Conceptual Answer: b. lumpers.

6.1.43. In the debate between "lumpers" and "splitters" regarding anxiety disorders, the splitters argue that a. b. c. d.

people with anxiety disorders are split off from reality. people with anxiety disorders show signs of split personality. it is not possible to separate normal from pathological anxiety. there are a number of separate disorders. Difficulty: 1 Question ID: 6.1.43 Page Reference: 145 Topic: Diagnosis Skill: Factual Answer: d. there are a number of separate disorders.

6.1.44. Research on the long-term outcomes for people experiencing anxiety disorders indicates that a. b. c. d.

even with therapy, long-term outcomes are generally poor. long-term outcomes tend to be quite mixed and unpredictable. age of onset predicts long-term outcomes across all disorders. treatment response is primarily positive and long-lasting.

Difficulty: 1 Question ID: 6.1.44 Page Reference: 147 Topic: Diagnosis Skill: Factual Answer: b. long-term outcomes tend to be quite mixed and unpredictable.

6.1.45. All of the following are true as to the course of anxiety disorders except a. the long-term outcome of individuals with anxiety disorder is mixed and unpredictable. b. individuals with agoraphobia avoidance tend to get over their fears with age. c. the frequency and intensity of anxiety attacks to tends to lessen with age. d. patients with generalized anxiety disorder may find their worries replaced with physical symptoms. Difficulty: 2 Question ID: 6.1.45 Page Reference: 147 Topic: Diagnosis Skill: Applied Answer: b. Individuals with agoraphobia avoidance tend to get over their fears with age.

6.1.46. Studies of the long-term course of obsessive-compulsive disorder indicate that all of the following are true EXCEPT a. b. c. d.

less than 30 percent of patients demonstrate recovery after one year. at a 40-year follow-up approximately 80% show improvement. approximately 50 percent of patients still show symptoms after 30 years. a higher percentage of females than males had not relapsed after 30 years. Difficulty: 2 Question ID: 6.1.46 Page Reference: 147 Topic: Diagnosis Skill: Conceptual Answer: d. A higher percentage of females than males had not relapsed after 30 years.

6.1.47. Based on the National Comorbidity Survey Replication (NCS-R), which type of anxiety disorder is the most common? a. b. c. d.

specific phobias generalized anxiety disorder obsessive-compulsive disorder agoraphobia with panic attacks

Difficulty: 1 Question ID: 6.1.47 Page Reference: 148 Topic: Frequency Skill: Factual Answer: a. specific phobias

6.1.48. Prospective studies of the relationship between drinking problems and anxiety disorders suggest that a. b. c. d.

anxiety disorders lead to heavy drinking. heavy drinking increases the probability that an anxiety disorder will later develop. anxiety disorders can lead to heavy drinking, and heavy drinking can lead to anxiety disorders. the relationship exists for patterns of alcohol abuse but not for alcohol dependence. Difficulty: 1 Question ID: 6.1.48 Page Reference: 148 Topic: Frequency Skill: Factual

Answer: c. anxiety disorders can lead to heavy drinking, and heavy drinking can lead to anxiety disorders.

6.1.49. Among those diagnosed with an anxiety disorder a. b. c. d.

the relapse rates are higher for men than for women. the relapse rates are higher for women than for men. the comorbidity rates are higher for women than for men. the comorbidity rates are higher for men than for women. Difficulty: 1 Question ID: 6.1.49 Page Reference: 148 Topic: Frequency Skill: Factual Answer: b. the relapse rates are higher for women than for men.

6.1.50. One study found that ___ percent of people who met the criteria for one anxiety disorder also met the criteria for at least one other form of anxiety disorder or mood disorder. a. b. c. d.

10 25 50 75 Difficulty: 2 Question ID: 6.1.50 Page Reference: 148 Topic: Frequency Skill: Factual Answer: c. 50

6.1.51. What is the only anxiety disorder that does not exhibit a significant gender difference? a. b. c. d.

agoraphobia panic disorder generalized anxiety disorder obsessive-compulsive disorder Difficulty: 1 Question ID: 6.1.51 Page Reference: 148 Topic: Frequency Skill: Factual Answer: d. obsessive-compulsive disorder

6.1.52. How does the prevalence of anxiety disorders among the elderly compare to the prevalence among other age groups? a. b. c. d.

The prevalence rate is lower among the elderly. The highest prevalence rates are found among the elderly. The prevalence rates are virtually identical across the life span. Whether the rates are high or low depends on both age and gender. Difficulty: 1 Question ID: 6.1.52 Page Reference: 148 Topic: Frequency Skill: Factual Answer: a. The prevalence rate is lower among the elderly.

6.1.53. In Western societies anxiety is most frequently associated with work performance whereas in non-Western societies, anxiety is most frequently associated with a. b. c. d.

family or religious concerns. personal appearance. intimate relationships. educational achievement. Difficulty: 2 Question ID: 6.1.53 Page Reference: 149 Topic: Frequency Skill: Conceptual Answer: a. family or religious concerns.

6.1.54. Cultural anthropologists have recognized many different culture-bound syndromes that, in some cases,

a. b. c. d.

appear to be unique to specific cultures. appear to be caused by the presence of outsiders in the culture. look similar but have very different causes than Western disorders. resemble very closely disorders listed in the DSM-IV-TR. Difficulty: 2 Question ID: 6.1.54 Page Reference: 149 Topic: Frequency Skill: Conceptual Answer: d. resemble very closely disorders listed in the DSM-IV-TR.

6.1.55. What was the major result of the Cross-National Collaborative Panic Study? a. Panic disorder occurs in all countries studied. b. Panic disorder does not exist in some of the countries included in the study. c. Mental health professionals in some countries do not recognize the symptoms of panic disorder as serious problems. d. Differences in language and conceptualization of symptoms made it impossible to study similarities in the diagnosis of panic. Difficulty: 1 Question ID: 6.1.55 Page Reference: 149 Topic: Frequencies Skill: Conceptual Answer: a. Panic disorder occurs in all countries studied.

6.1.56. Current theories regarding the evolutionary significance of anxiety and fear suggest that a. b. c. d.

anxiety is viewed as often adaptive, but fear is not. fear is viewed as often adaptive, but anxiety is not. both emotional responses are adaptive in some circumstances. neither emotional response is considered to be adaptive under any circumstances. Difficulty: 2 Question ID: 6.1.56 Page Reference: 149 Topic: Causes Skill: Conceptual Answer: c. both emotional responses are adaptive in some circumstances.

6.1.57. What conclusion was reached by researchers studying the relationship between stressful life events and anxiety/depressive disorders?

a. Stressful life events are much more common precursors of depression. b. Stressful life events are much more common precursors of anxiety disorders. c. Stressful events frequently precede the development of both anxiety or depressive disorders. d. The reported association between life events and these disorders is the result of the tendency to expect such a relationship rather than a true association. Difficulty: 2 Question ID: 6.1.57 Page Reference: 150 Topic: Causes Skill: Conceptual Answer: c. Stressful events frequently precede the development of both anxiety and depressive disorders.

6.1.58. Based on research on the development of agoraphobia, which of the following individuals would be at greatest risk for the onset of this disorder? a. b. c. d.

Alice, who has just changed her college major Teresa, who is having difficulty finding a job Sara, who has just moved away from home for her first year in college Christine, who has had an increase in the number of serious arguments with her parents Difficulty: 2 Question ID: 6.1.58 Page Reference: 150 Topic: Causes Skill: Applied Answer: d. Christine, who has had an increase in the number of serious arguments with her

parents

6.1.59. Which of the following best describes the connection between particular forms of adverse environmental events and specific types of mental disorder? a. b. c. d.

Neglect is most closely linked to mood disorders. Abuse is most closely linked to anxiety disorders. There does not seem to be any direct connection. Direct connections have been found for women but not for men. Difficulty: 2 Question ID: 6.1.59 Page Reference: 150 Topic: Causes Skill: Applied Answer: c. There does not seem to be any direct connection.

6.1.60. What type of attachment has been reported to be associated with the development of agoraphobia? a. b. c. d.

secure insecure ambivalent regressive Difficulty: 1 Question ID: 6.1.60 Page Reference: 150 Topic: Causes Skill: Factual Answer: b. insecure

6.1.61. After Harriet was in a bicycle accident, she became fearful of riding bicycles. Which theory of the development of phobias would explain her fearing of riding bicycles? a. b. c. d.

preparedness psychoanalytic operant conditioning classical conditioning Difficulty: 1 Question ID: 6.1.61 Page Reference: 151 Topic: Causes Skill: Factual Answer: d. classical conditioning

6.1.62. While walking along the road, a car drives by and honks right next to you. The car hits your leg, and you are slightly injured. A few weeks later you hear a car horn and become very nervous. What is the horn honking in this scenario? a. b. c. d.

conditioned stimulus conditioned response unconditioned stimulus unconditioned response Difficulty: 1 Question ID: 6.1.62 Page Reference: 151 Topic: Causes Skill: Conceptual Answer: a. conditioned stimulus

6.1.63. The preparedness model of phobic acquisition holds that phobias develop in response to a. b. c. d.

stimuli to which the person has had little exposure. objects with symbolic associations to sex and aggression. any neutral stimulus paired with an unconditioned stimulus. objects and situations that humans are biologically "wired" to fear. Difficulty: 2 Question ID: 6.1.63 Page Reference: 151 Topic: Causes Skill: Conceptual Answer: d. objects and situations that humans are biologically "wired" to fear.

6.1.64. One important element in the development of social phobias may be a biologically-based preparedness to fear a. b. c. d.

large crowds. faces that appear angry or rejecting toward us. the body posture of people seen as important. unrelated persons more than biologically related persons. Difficulty: 2 Question ID: 6.1.64 Page Reference: 151 Topic: Causes Skill: Applied Answer: b. faces that appear angry or rejecting toward us.

6.1.65. Research has suggested that a factor contributing to the development of some anxiety reactions is a. operant conditioning and preparedness work against each other. b. people apparently learn to avoid certain stimuli if they observe other people showing a strong fear response to those stimuli. c. some people are more prepared than others for emotional events. d. people need to experience emotional events themselves in order for it to affect their lives in future. Difficulty: 2 Question ID: 6.1.65 Page Reference: 151 Topic: Causes Skill: Conceptual

Answer: b. people apparently learn to avoid certain stimuli if they observe other people showing a strong fear response to those stimuli.

6.1.66. As a cognitive psychologist you hypothesis that many factors can contribute to the cause of an anxiety disorder, but the following are especially important: a. b. c. d.

conditioned stimuli and responses. perceptions, memories and attention. negative reinforcement. neurotransmitter levels. Difficulty: 2 Question ID: 6.1.66 Page Reference: 151 Topic: Causes Skill: Applied Answer: b. perceptions, memories and attention

6.1.67. Research has consistently found evidence that problems with anxiety show up at high rates in people who believe a. b. c. d.

they are in control of a situation. that they are not in control of events. events are their fault. they have been treated badly by important people. Difficulty: 2 Question ID: 6.1.67 Page Reference: 151 Topic: Causes Skill: Conceptual Answer: b. that they are not in control of events.

6.1.68. According to D.M. Clark's research, people with anxiety sensitivity would likely be frightened most by a. b. c. d.

stomach discomfort. heart palpitations. foot pain. insomnia. Difficulty: 2 Question ID: 6.1.68 Page Reference: 152 Topic: Causes Skill: Factual

Answer: b. heart palpitations.

6.1.69. Several lines of research have clarified the basic cognitive mechanisms involved in generalized anxiety disorder as well as panic disorder. Experts now believe that a factor that plays a crucial role in the onset of this process is a. b. c. d.

depression. conditioned responses. the hypothalamus. attention. Difficulty: 1 Question ID: 6.1.69 Page Reference: 152 Topic: Causes Skill: Conceptual Answer: d. attention.

6.1.70. A patient with panic disorder tends to interpret the rapid beating of his heart as a heart attack; a cognitive psychologist would call this a. b. c. d.

automatic thinking. catastrophic misinterpretation. illusion of predictability. "what-if" thinking. Difficulty: 1 Question ID: 6.1.70 Page Reference: 152 Topic: Causes Skill: Factual Answer: b. catastrophic misinterpretation.

6.1.71. Cognitive psychologists believe that people whose threat schemas contain a high proportion of "what-if" questions a. b. c. d.

are more likely to suffer from a conviction that they will fail. usually experience depression along with anxiety. experience a dramatic increase in negative affect. are able to avoid the experience of anxiety by suppressing their anxious thoughts. Difficulty: 1 Question ID: 6.1.71 Page Reference: 152 Topic: Causes Skill: Factual

Answer: c. experience a dramatic increase in negative affect.

6.1.72. According to cognitive models of anxiety (such as Borkovec et al’s model), why do people continue to worry despite the fact that it is unproductive? a. b. c. d.

They have a superstition that worry will lead to symptom reduction. Classical conditioning has led to an association between worry and cognitive stability. The worry is reinforced by a temporary reduction in uncomfortable physiological sensations. The worry results from activation of the superego in order to punish oneself for past misdeeds. Difficulty: 2 Question ID: 6.1.72 Page Reference: 152 Topic: Causes Skill: Factual

Answer: c. The worry is reinforced by a temporary reduction in uncomfortable physiological sensations.

6.1.73. A person with social phobia can perform a particular task when alone but not in front of an audience; according to Barlow's model of anxious apprehension, this is due to a. b. c. d.

misinterpreting the audience as hostile. insufficient practice of the task. the distraction of self-focused attention. poor interpersonal skills. Difficulty: 3 Question ID: 6.1.73 Page Reference: 152 Topic: Causes Skill: Conceptual Answer: c. the distraction of self-focused attention.

6.1.74. What is thought suppression? a. b. c. d.

a symptom of panic attack an attention deficit caused by intrusive images an active attempt to stop thinking about something the absence of rational thinking Difficulty: 1 Question ID: 6.1.74 Page Reference: 153 Topic: Causes Skill: Factual

Answer: c. an active attempt to stop thinking about something

6.1.75. According to Wegner, what typically happens when people prone to anxiety disorders try to rid their mind of distressing or unwanted thoughts? a. b. c. d.

The thoughts actually become more associated with emotions. They relax because physiological cues are decreased. Physiological changes in the brain attempt to repress the unwanted thoughts. The thoughts are replaced with scenes related to images from previous dreams. Difficulty: 2 Question ID: 6.1.75 Page Reference: 153 Topic: Causes Skill: Applied Answer: a. The thoughts actually become more associated with emotions.

6.1.76. The episodic nature of obsessive-compulsive disorder symptoms is thought to be related to a. b. c. d.

cycles of activity in neurotransmitters. changing levels of environmental stress. changes in the ability to suppress thoughts. a rebound from attempts to suppress strong emotion. Difficulty: 2 Question ID: 6.1.76 Page Reference: 153 Topic: Causes Skill: Conceptual Answer: d. a rebound from attempts to suppress strong emotion.

6.1.77. What have studies of the genetics of panic disorder and generalized anxiety disorder found concerning the genetic component in a model of the cause of these disorders? a. both appear to be moderately heritable b. neither appears to have a significant heritable component c. both have a very high heritable component d. generalized anxiety disorder has a high heritable component, but panic disorders appears to be very low Difficulty: 1 Question ID: 6.1.77 Page Reference: 153 Topic: Causes Skill: Factual

Answer: a. both appear to be moderately heritable

6.1.78. Twin studies of anxiety disorders indicate that they have a heritability of a. b. c. d.

around 20 to 30 percent. less than 5 percent. over 50 percent. almost 100 percent. Difficulty: 2 Question ID: 6.1.78 Page Reference: 154 Topic: Causes Skill: Conceptual Answer: a. around 20 to 30 percent.

6.1.79. The brain pathway that operates as a "short cut" in the detection of danger a. b. c. d.

provides for quicker conscious processing of threat. is acquired through classical conditioning. interferes with the organism's ability to respond to threat. allows some threats to be responded to very quickly. Difficulty: 2 Question ID: 6.1.79 Page Reference: 154 Topic: Causes Skill: Factual Answer: d. allows some threats to be responded to very quickly.

6.1.80. The two different pathways in the brain involved in the detection of danger differ from one another with respect to a. b. c. d.

their roles in panic disorder versus specific phobia. the amount of conscious thinking and reasoning. the detection of reality-based versus unrealistic threats. their presence in humans versus lower animals. Difficulty: 3 Question ID: 6.1.80 Page Reference: 155 Topic: Causes Skill: Conceptual Answer: b. the amount of conscious thinking and reasoning.

6.1.81. Brain imaging studies of patients with obsessive-compulsive disorder (OCD) show that OCD a. b. c. d.

has neurological foundations similar to other anxiety disorders. has neurological foundations different from other anxiety disorders. has no neurological foundation. can be related to danger-detection pathways. Difficulty: 2 Question ID: 6.1.81 Page Reference: 156 Topic: Causes Skill: Conceptual Answer: b. has neurological foundations different from other anxiety disorders.

6.1.82. Research from the National Institute of Mental Health (NIMH) has suggested a model called the pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection, or PANDAS which a. b. c. d.

has been proven. has resulted in several law suits against hospitals. does not yet have strong evidence for or against it. is considered to be pseudoscience with no evidence to support it. Difficulty: 1 Question ID: 6.1.82 Page Reference: 155 Topic: Causes Skill: Conceptual Answer: c. does not yet have strong evidence for or against it.

6.1.83. An inhibitory neurotransmitter that functions to reduce levels of anxiety is called a. b. c. d.

MAO. dopamine. GABA. glutamate. Difficulty: 1 Question ID: 6.1.83 Page Reference: 156 Topic: Causes Skill: Factual Answer: c. GABA.

6.1.84. In the treatment of Ed, the case study from the textbook involving OCD, the first form of treatment used involved a. b. c. d.

sugar (placebo). an anticonvulsant. antidepressant medication. an antianxiety drug. Difficulty: 1 Question ID: 6.1.84 Page Reference: 156 Topic: Treatments Skill: Factual Answer: c. antidepressant medication.

6.1.85. Systematic desensitization involves a. b. c. d.

suppression of phobic thoughts. insight into unconscious motivations. exposure to the feared item while maintaining relaxation. dampening of physiological reactions with medication. Difficulty: 2 Question ID: 6.1.85 Page Reference: 157 Topic: Treatment Skill: Applied Answer: c. exposure to the feared item while maintaining relaxation.

6.1.86. Flooding refers to a. b. c. d.

recovery of repressed memories. exposure to highly feared objects. a rebound effect after thought suppression. the side effects of antianxiety medications. Difficulty: 1 Question ID: 6.1.86 Page Reference: 157 Topic: Treatment Skill: Factual Answer: b. exposure to highly feared objects.

6.1.87. Alex suffers from agoraphobia, and while in treatment he is asked to repeatedly confront places like crowded shopping malls and theaters that he has been avoiding. The treatment he is receiving is

a. b. c. d.

stimulus generalization. stimulus discrimination. situational exposure. avoidance reconditioning. Difficulty: 2 Question ID: 6.1.87 Page Reference: 157 Topic: Treatment Skill: Applied Answer: c. situational exposure.

6.1.88. Pamela experiences frequent unexpected panic attacks. A treatment that could help her to reduce her fear of bodily sensations that seem to trigger her panic attacks would be a. b. c. d.

situational exposure. interoceptive exposure. flooding. deep breathing. Difficulty: 2 Question ID: 6.1.88 Page Reference: 157 Topic: Treatment Skill: Applied Answer: b. interoceptive exposure.

6.1.89. Exposure and response prevention is most effective in the treatment of a. b. c. d.

panic attacks. social phobias. generalized anxiety disorder. obsessive-compulsive disorder. Difficulty: 1 Question ID: 6.1.89 Page Reference: 157 Topic: Treatment Skill: Factual Answer: d. obsessive-compulsive disorder.

6.1.90. Which of the following is one of the reasons why it is important to distinguish between statistical significance and clinical importance of treatment outcome studies?

a. Clinical importance is based on subjective judgment, not statistical procedures. b. Statistical significance could be based on relatively trivial changes in the patients' adjustment. c. Statistical significance can only be calculated in correlational designs. d. Clinical importance involves statements of certainty, whereas statistical significance involves statements of probability. Difficulty: 2 Question ID: 6.1.90 Page Reference: 159 Topic: Treatment Skill: Conceptual Answer: b. Statistical significance could be based on relatively trivial changes in the patients' adjustment.

6.1.91. A therapist asks a patient to describe what he assumes would happen if his worst case scenario actually happened. The patient says, "If I fail this test, I'll never get into graduate school." What cognitive aspect is the therapist working with? a. b. c. d.

self-fulfilling prophecy automatic thinking decatastrophizing all-or-nothing thinking Difficulty: 2 Question ID: 6.1.91 Page Reference: 158 Topic: Treatment Skill: Conceptual Answer: c. decatastrophizing

6.1.92. The technique of breathing retraining provides panic disorder patients with education about a. b. c. d.

the psychological effects of hyperventilation. the physiological effects of hyperventilation. the counter-productive effects of avoidance. the self-fulfilling nature of self-focused attention. Difficulty: 1 Question ID: 6.1.92 Page Reference: 158 Topic: Treatment Skill: Applied Answer: b. the physiological effects of hyperventilation.

6.1.93. A psychiatrist prescribes a benzodiazepine for a patient suffering from an anxiety disorder. Which of the following symptoms are most likely to respond to this treatment?

a. b. c. d.

worry and rumination palpitations and rumination rumination and muscle tension muscle tension and palpitations Difficulty: 1 Question ID: 6.1.93 Page Reference: 159 Topic: Treatment Skill: Factual Answer: d. muscle tension and palpitations

6.1.94. Which category contains the drugs known as benzodiazepines? a. b. c. d.

antimanic antipsychotics antidepressants minor tranquilizers Difficulty: 1 Question ID: 6.1.94 Page Reference: 158 Topic: Treatment Skill: Factual Answer: d. minor tranquilizers

6.1.95. Which of the following are examples of the benzodiazepine class of drugs? a. b. c. d.

Zoloft and Paxil Valium and Xanax Haldol and Thorazine Elavil and Stelazine Difficulty: 2 Question ID: 6.1.95 Page Reference: 158 Topic: Treatment Skill: Factual Answer: b. Valium and Xanax

6.1.96. Which neurotransmitter is affected by benzodiazepine drugs? a.

GABA

b. c. d.

dopamine acetylcholine norepinephrine Difficulty: 2 Question ID: 6.1.96 Page Reference: 159 Topic: Treatment Skill: Factual Answer: a. GABA

6.1.97. Benzodiazepines are most effective for treating a. b. c. d.

depression. agoraphobia. generalized anxiety disorder. obsessive-compulsive disorder. Difficulty: 2 Question ID: 6.1.97 Page Reference: 159 Topic: Treatment Skill: Applied Answer: c. generalized anxiety disorder.

6.1.98. Which of the following is considered a drug of choice for panic disorder because it produces clinical improvement more quickly than antidepressants? a. b. c. d.

Alprazolam (Xanax) Buspirone (BuSpar) Phenelzine (Nardil) Clonazepam (Klonopin) Difficulty: 2 Question ID: 6.1.98 Page Reference: 160 Topic: Treatment Skill: Applied Answer: a. Alprazolam (Xanax)

6.1.99. Another class of antianxiety medications are known as the azapirones which instead of working on GABA neurons work on __________ transmission. a. b.

dopamine serotonin

c. d.

amygdala sympathetic. Difficulty: 1 Question ID: 6.1.99 Page Reference: 160 Topic: Treatment Skill: Conceptual Answer: b. serotonin

6.1.100. Approximately what percentage of patients who have used a benzodiazepine for more than six months will experience withdrawal effects if they discontinue use of the drug? a. b. c. d.

10% 20% 40% 60% Difficulty: 2 Question ID: 6.1.100 Page Reference: 160 Topic: Treatment Skill: Factual Answer: c. 40%

6.1.101. Which of the following drugs is the first-line treatment for panic disorder and OCD? a. b. c. d.

anti-anxiety drugs anti-convulsants barbiturates SSRIs Difficulty: 2 Question ID: 6.1.101 Page Reference: 160 Topic: Treatment Skill: Factual Answer: d. SSRIs

6.1.102. Why do some psychiatrists prefer imipramine to antianxiety drugs for the treatment of panic disorder? a. b. c.

It is longer lasting. It is less expensive. It helps people get to sleep.

It is less likely to lead to dependence. Difficulty: 1 Question ID: 6.1.102 Page Reference: 160 Topic: Treatment Skill: Conceptual Answer: d. It is less likely to lead to dependence.

6.1.103. At a meeting of psychiatrists you see a sign for a session titled "Antidepressant drugs: Not just for depression." A summary of the session indicates that the speaker will outline how selective serotonin reuptake inhibitors can be used in treating anxiety disorders. What are some reasons for using these drugs instead of antianxiety drugs? a. b. c. d.

They are cheaper and act faster. The act naturally and do not affect appetite. They have fewer side effects and are safer to use. They are much more powerful and can be used in smaller doses. Difficulty: 1 Question ID: 6.1.103 Page Reference: 160 Topic: Treatment Skill: Conceptual Answer: c. They have fewer side effects and are safer to use.

6.1.104. A group of mental health professionals specialize in the treatment of anxiety disorders. Based on current empirical evidence, these professionals would be well advised to a. stick with one specific mode of treatment for all disorders. b. use medications with their more severe cases. c. use any combination of treatments, because they all appear equally effective with all anxiety disorders. d. select specific treatments according to specific symptoms exhibited by their patients. Difficulty: 1 Question ID: 6.1.104 Page Reference: 160 Topic: Treatment Skill: Conceptual Answer: d. select specific treatments according to specific symptoms exhibited by their patients.

Short Answer

6.2.105. __________ refers to an exaggerated fear of being in situations from which escape might be difficult, such as being caught in a traffic jam on a bridge or in a tunnel. Difficulty: 1 Question ID: 6.2.105 Page Reference: 139 Topic: Overview Skill: Factual Answer: Agoraphobia

6.2.106. __________ are persistent, irrational, narrowly defined fears that are associated with a specific object or situation. Difficulty: 1 Question ID: 6.2.106 Page Reference: 142 Topic: Symptoms Skill: Factual Answer: Phobias

6.2.107. In the case of an anxiety disorder, behavior that represents an attempt to ensure the person’s safety or the safety and health of a friend or family member is known as compulsive ___________ .

Difficulty: 1 Question ID: 6.2.107 Page Reference: 143 Topic: Symptoms Skill: Factual Answer: checking

6.2.108. Experts who classify mental disorders can be described informally as belonging to one of two groups. Those that argue that anxiety is a generalized condition or set of symptoms without any special subdivisions are referred to as _________ . Difficulty: 1 Question ID: 6.2.108 Page Reference: 145 Topic: Diagnosis Skill: Factual Answer: lumpers

6.2.109. The symptoms of various anxiety disorders overlap considerably. If one meets the diagnostic criteria for more than one disorder this is known as __________ .

Difficulty: 1 Question ID: 6.2.109 Page Reference: 148 Topic: Frequency Skill: Conceptual Answer: comorbidity

6.2.110. Following up on the work started by John Bowlby, several studies have found that people with a variety of anxiety disorders are more likely to have had what type of problems as children? __________

Difficulty: 2 Question ID: 6.2.110 Page Reference: 150 Topic: Causes Skill: Conceptual Answer: attachment

6.2.111. The observation that conditioned responses to fear-relevant stimuli (such as spiders and snakes) are more resistant to extinction than are those to fear-irrelevant stimuli (such as flowers) supports the __________ model. Difficulty: 1 Question ID: 6.2.111 Page Reference: 151 Topic: Causes Skill: Conceptual Answer: preparedness

6.2.112. Laboratory research indicates that feelings of lack of __________ contribute to the onset of panic attacks among patients with panic disorder. Difficulty: 1 Question ID: 6.2.112 Page Reference: 151 Topic: Causes Skill: Conceptual Answer: control

6.2.113. D.M. Clark, a psychologist, suggests that panic disorder may be caused by the catastrophic __________ of bodily sensations or perceived threat. Difficulty: 2 Question ID: 6.2.113 Page Reference: 152 Topic: Causes Skill: Conceptual Answer: misinterpretations

6.2.114. Work by LeDoux and others suggests that the __________ plays a central role in circuits in the brain designed to detect danger and organize a response to it. Difficulty: 1 Question ID: 6.2.114 Page Reference: 153-154 Topic: Causes Skill: Factual Answer: amygdala

6.2.115. In the years since systematic desensitization was originally proposed, many different variations on this procedure have been employed. The crucial feature of the treatment involves systematic maintained __________ to the feared stimulus.

Difficulty: 1 Question ID: 6.2.115 Page Reference: 157 Topic: Treatment Skill: Conceptual Answer: exposure

6.2.116. Current evidence suggests that patients who receive both medication and psychotherapy may do better in the short run, but patients who receive only __________ behavior therapy may do better in the long run because of difficulties that can be encountered when medication is discontinued. Difficulty: 1 Question ID: 6.2.116 Page Reference: 158 Topic: Treatment Skill: Factual Answer: cognitive

Essay 6.3.117. Define phobia. Describe the difference between a phobia and normal fear. Give an example of the difference between a phobia and normal fear. Difficulty: 2 Question ID: 6.3.117 Page Reference: 142 Topic: Symptoms Skill: Conceptual Answer: (1) A phobia is a persistent, irrational narrowly defined fear that is associated with a specific object or situation. (2) In contrast to a normal fear, phobia involves attempts to avoid an object that others do not find dangerous. (3) A person who fears cats may prefer not to be around them, and may show physiological arousal when close to a cat; a person who is phobic of cats would have an immediate fear reaction upon seeing a cat, and the person's attempts to avoid getting closer to the cat might interfere with whatever the person was doing at the time.

6.3.118. Describe the nature of obsessions and compulsions in obsessive-compulsive disorder, and explain how they differ from "normal" obsessions and compulsions. Do both have to be present for the diagnosis of OCD to be made? Which typically comes first? What is their functional relationship?

Difficulty: 2 Question ID: 6.3.118 Page Reference: 142-146 Topic: Symptoms and Diagnosis Skill: Conceptual Answer: Obsessions are repetitive, unwanted, intrusive thoughts or images or impulses that may seem silly or crazy, are anxiety-provoking, and are resisted strongly but unsuccessfully. Compulsions are repetitive behaviors or mental acts that are used to reduce anxiety, especially the anxiety associated with the obsessions, and that do not produce any pleasure. Most patients with OCD show both obsessions and compulsions, but this is not necessary for the diagnosis. The person must recognize that the obsessions or compulsions are excessive or unreasonable. What's more, the thoughts must not be simply excessive worries about real problems. Most normal people (80-90%) experience obsessive thoughts at times. Research suggests that the difference between normal obsessions and clinical obsessions is a matter of degree. In most cases it would appear the obsessive thoughts come first and compulsive behaviors are often an attempt to cope with the anxiety provoked by the obsessive thoughts.

6.3.119. Compare and contrast the theoretical position of "lumpers" with that of "splitters" with regard to anxiety disorders. Difficulty: 3 Question ID: 6.3.119 Page Reference: 145 Topic: Diagnosis

Skill: Conceptual Answer: Lumpers are theorists who suggest that the subdivisions of anxiety disorders should be done away with. For them anxiety is anxiety and the particular manner in which it manifests in individuals is not particularly relevant. Quite likely there is one etiological model that accounts for all forms of anxiety disorders and the variations are a matter of individual differences and life experiences. Splitters, on the other hand, suggest that we need different diagnostic categories for several variations of anxiety disorders. For them, the differences seen in anxiety disorder are due to different etiologies and, likely, different treatments. It is important to keep diagnostic distinctions to guide research and treatment of what are, for them, different diseases.

6.3.120. Discuss the epidemiology for varying rates of anxiety disorder across the life span, comparing adults with the elderly. Difficulty: 2 Question ID: 6.3.120 Page Reference: 148-149 Topic: Frequency Skill: Conceptual Answer: Prevalence rates for anxiety disorders are lower for individuals over 60 than under 60, though there is some evidence that this rate may go up as individuals reach ages of 70 or 80 and encounter the inevitable fears of old age, disease and death. In addition it is relatively uncommon for an individual to develop an anxiety disorder in later life. Individuals in this age group so diagnosed have generally had the disorder from a younger age. The diagnostic process is also complicated by age. Some physical disorder associated with age, such as cardiovascular problems, have symptoms similar to some anxiety disorders. Hearing loss can lead one to behave in a way that looks like social avoidance, and if an elderly person has a physical trauma such as a fall or a car accident that leads them to go out less, should this be seen as a symptom of agoraphobia or a sensible precaution due to failing abilities?

6.3.121. Describe the hypothesized role of thought suppression in the etiology of obsessive-compulsive disorder.

Difficulty: 2 Question ID: 6.3.121 Page Reference: 151-152 Topic: Causes Skill: Conceptual Answer: Attempts to disregard or forget a troubling thought may actually make the thought more intrusive, as the troubling thought becomes associated with the other thoughts meant to replace it. The troubling thought also becomes associated with negative feelings, so that afterwards the negative feelings can trigger the unwanted thought, and the unwanted thought can trigger negative feelings. As a result of the individual's attempt to suppress strong emotions, a rebound effect may occur, culminating in a vicious cycle, which may help to explain the episodic nature of obsessive-compulsive symptoms.

6.3.122. Discuss what is known about the role of genetics in anxiety disorders and whether evidence points toward specific genetic risks for specific disorders.

Difficulty: 3 Question ID: 6.3.122 Page Reference: 153-156 Topic: Causes Skill: Conceptual Answer: Genetic factors seem to be involved to a modest extent in all the anxiety disorders, with evidence for separate risks for panic disorder versus generalized anxiety disorder. However, although there is also a genetic risk for obsessive-compulsive disorder, it appears to be part of a more generalized increased risk for several types of anxiety disorder. The overall degree of heritability for anxiety disorders appears to be in the range of 20 to 30 percent.

6.3.123. Which anxiety disorders respond to treatment with antianxiety medications? What are the major drugs used and what are their side effects? Difficulty: 2 Question ID: 6.3.123 Page Reference: 158-159 Topic: Treatment Skill: Conceptual Answer: In the past, the major class of drugs used to treat anxiety disorders was the benzodiazepine class. Examples of these drugs are diazepam (Valium) and alprazolam (Xanax). These drugs tend to reduce symptoms of anxiety, especially vigilance and subjective somatic sensations. They reduce muscle tension, palpitations, perspiration, and gastrointestinal distress. They have been used to treat generalized anxiety disorder and social phobias. The side effects include sedation and cognitive impairments; the most serious adverse effect is the potential for addiction. More recently, the selective serotonin reuptake inhibitors (e.g. Luvox, Prozac, Paxil) have become the preferred drugs for treating almost all forms of anxiety disorders. These drugs have fewer unpleasant side effects and are safer to use.

Chapter 7 Acute and Posttraumatic Stress Disorders, Dissociative Disorders, and Somatoform Disorders Total Assessment Guide (T.A.G.) Topic Overview pp. 163-164

Acute and Posttraumatic Stress Disorders pp. 164-175 Dissociative Disorders pp. 175-184

Somatoform Disorders pp. 184-191

Question Type Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice

Short Answer Essay

Factual

Conceptual

Applied

2, 3, 7, 12, 15, 19, 20, 21, 22, 23, 26, 30, 35 115, 117, 118

6, 9, 11, 14, 16, 18, 24, 25, 27, 28, 29, 31, 32, 33, 34 116, 119 129, 130 42, 45, 47, 49, 50, 51, 52, 56, 58, 60, 62, 66, 67, 69 122 132, 136 71, 72, 74, 83, 85, 90, 91,92, 94, 97, 98, 101, 102, 104, 105, 107, 109 128 134, 135

4, 5, 8, 10, 13, 17, 36, 37

1 114

38, 40, 41, 46, 53, 54, 55, 57, 61, 64, 68, 70 120, 121, 123, 124 75, 76, 77, 81, 82, 86, 88, 93, 95, 99, 100, 110, 112, 113 125, 126, 127

131 39, 43, 44, 48, 59, 63, 65

133 73, 78, 79, 80, 84, 87, 89, 96, 103, 106, 108, 111

Chapter 7: Acute and Posttraumatic Stress Disorders, Dissociative Disorders, and Somatoform Disorders

Multiple Choice 7.1.1.

Which of the following is a good definition of the term dissociation?

a. b. c. d.

separation from loved ones withdrawal from intimate relationships and social isolation disruption of mental processes of memory, consciousness, identity, and perception the disengagement of physiological from psychological processes Difficulty: 1 Question ID: 7.1.1 Page Reference: 164 Topic: Overview Skill: Factual Answer: c. disruption of mental processes of memory, consciousness, identity, and perception

7.1.2. An event that involves actual or threatened death or serious injury to self or others and creates intense feelings of fear, helplessness, or horror is defined by the DSM-IV-TR as involving a. b. c. d.

feelings of numbness. stress. traumatic stress. eustress. Difficulty: 1 Question ID: 7.1.2 Page Reference: 164 Topic: Acute and Posttraumatic Stress Disorders Skill: Factual Answer: c. traumatic stress.

7.1.3. You are asked to review the DSM diagnostic criteria for traumatic stress disorders. Under which category will you find these disorders? a. b. c. d.

anxiety disorders psychotic disorders adjustment disorders psychophysiological disorders

Difficulty: 1 Question ID: 7.1.3 Page Reference: 164 Topic: Acute and Posttraumatic Stress Disorders Skill: Factual Answer: a. anxiety disorders

7.1.4. Which of the following events would fit the DSM description of situations that could lead to posttraumatic stress disorder? a. The car Ted was driving spun out of control and almost fell off a bridge as he waited helplessly to be rescued. b. While driving on the interstate, Kevin passes the site of a serious bus accident that is commemorated by a stone monument. c. The roller coaster ride was faster and had more turns than Alice had been told before she agreed to go with her friends. d. The newspaper account of a bank robbery and gun fight between the robbers and police contained more vivid details than Frank expected. Difficulty: 1 Question ID: 7.1.4 Page Reference: 164 Topic: Acute and Posttraumatic Stress Disorders Skill: Applied Answer: a. The car Ted was driving spun out of control and almost fell off a bridge as he waited helplessly to be rescued.

7.1.5. Ray has the diagnosis of acute stress disorder; Bob has been diagnosed as suffering from posttraumatic stress disorder. What is a major difference in their conditions? a. Bob has had the symptoms for longer than Ray. b. Ray's symptoms are the result of a social stressor, not a natural stressor. c. Bob's symptoms involve a greater level of autonomic nervous system activation. d. Ray is likely to have more trouble sleeping than Bob who is more likely to have appetite difficulties. Difficulty: 1 Question ID: 7.1.5 Page Reference: 164 Topic: Acute and Posttraumatic Stress Disorders Skill: Applied Answer: a. Bob has had the symptoms for longer than Ray.

7.1.6. In the case of Stephanie, the victim of rape discussed in the textbook, for months after her assault she was constantly on the lookout for new threats. This condition is called a. b. c. d.

hypersensitivity. hypovigilance. hypervigilance. Korsokov's syndrome. Difficulty: 2 Question ID: 7.1.6 Page Reference: 165 Topic: Acute and Posttraumatic Stress Disorders Skill: Conceptual Answer: c. hypervigilance.

7.1.7. Which cluster of symptoms most sharply differentiates acute stress disorder from posttraumatic stress disorder? a. b. c. d.

dissociative somatoform factitious reexperiencing Difficulty: 1 Question ID: 7.1.7 Page Reference: 166-167 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual Answer: a. dissociative

7.1.8. The medical records of a patient at the local mental health center indicate that she has experienced a general numbing of responsiveness or detachment from others. Based on this symptom, which of the following is the most likely diagnosis in this case? a. b. c. d.

pain disorder conversion disorder somatization disorder acute stress disorder Difficulty: 1 Question ID: 7.1.8 Page Reference: 166 Topic: Acute and Posttraumatic Stress Disorder Skill: Applied Answer: d. acute stress disorder

7.1.9. Which of the following is a common characteristic of acute stress disorder and posttraumatic stress disorder? a. b. c. d.

flashbacks sleepwalking multiple personalities increased parasympathetic nervous system arousal Difficulty: 1 Question ID: 7.1.9 Page Reference: 165 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: a. flashbacks

7.1.10. A psychologist wants to collect some information from individuals who have been diagnosed as suffering either acute stress disorder or posttraumatic stress disorder. Which of the following could provide the best indication of the presence of certain symptoms in these individuals? a. b. c. d.

They are asked to keep track of their calorie intake for a period of two months. They are asked to fill out a questionnaire asking for basic demographic information. They are videotaped as they wait to be interviewed and react to an expected loud noise. They are asked to proceed to another building on campus and their speed of walking is measured. Difficulty: 2 Question ID: 7.1.10 Page Reference: 166 Topic: Acute and Posttraumatic Stress Disorder Skill: Applied Answer: c. They are videotaped as they wait to be interviewed and react to an expected loud

noise.

7.1.11. Marjorie has just experienced a traumatic event, and she is feeling cut off from herself and her environment and reports feeling like a robot. A mental health professional would say that Marjorie is experiencing a. b. c. d.

derealization. depersonalization. amnesia. flashbacks. Difficulty: 1 Question ID: 7.1.11 Page Reference: 166 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: b. depersonalization.

7.1.12. What was the first focus of research on posttraumatic stress disorder as the aftermath of traumatic events? a. b. c. d.

rape victims Vietnam War veterans World War II veterans victims of natural disaster Difficulty: 1 Question ID: 7.1.12 Page Reference: 166 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual Answer: b. Vietnam War veterans

7.1.13. A psychologist is interviewing a client who reports having experienced a severe trauma; before making a diagnosis of posttraumatic stress disorder, the psychologist would want to find evidence that the client is experiencing a. b. c. d.

dissociative symptoms. persistent symptoms of increased arousal. depression. physical symptoms, such as headaches or stomach distress. Difficulty: 2 Question ID: 7.1.13 Page Reference: 167 Topic: Acute and Posttraumatic Stress Disorder Skill: Applied Answer: b. persistent symptoms of increased arousal.

7.1.14. Acute stress disorder (ASD) was not included in early editions of DSM. Its inclusion in DSM-IV was justified in part because ASD a. b. c. d.

is more severe than PTSD. lasts longer than PTSD. may predict future PTSD. is more treatable than PTSD. Difficulty: 2 Question ID: 7.1.14 Page Reference: 167 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: c. may predict future PTSD.

7.1.15. To meet the DSM-IV-TR definition of trauma, an event must involve not only actual or threatened death to self or others but also a. b. c. d.

a response of intense fear, helplessness, or horror. an inability to recall the event. depression and substance abuse. a belief that one was responsible for the event. Difficulty: 1 Question ID: 7.1.15 Page Reference: 167 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual Answer: a. a response of intense fear, helplessness, or horror.

7.1.16. Which of the following variables predicted lower rates of posttraumatic stress disorder after the attack on the World Trade Centre in New York? a. b. c. d.

hardiness extraversion responsibility sensation seeking Difficulty: 1 Question ID: 7.1.16 Page Reference: 168 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: a. hardiness

7.1.17. As a clinician you would be most concerned about the probability of posttraumatic stress disorder in a victim of which of the following? a. b. c. d.

rape natural disaster serious car crash sudden unexpected death Difficulty: 2 Question ID: 7.1.17 Page Reference: 169 Topic: Acute and Posttraumatic Stress Disorder Skill: Applied Answer: a. rape

7.1.18. Which of the following is a description of what has been termed secondary victimization in cases of rape? a. b. c. d.

Family members often ignore the victim. Multiple diagnoses are often made following a rape. Many cases of rape involve multiple crimes such as robbery. Various professionals exhibit a degree of insensitivity to rape victims. Difficulty: 1 Question ID: 7.1.18 Page Reference: 169 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: d. Various professionals exhibit a degree of insensitivity to rape victims.

7.1.19. A psychologist is talking about the self-blame that occurs in cases of rape. What factors tend to influence such reactions to rape? a. b. c. d.

cultural myths suggest that women provoke rape deep seated tendencies to punish oneself for past deeds a natural physiological reaction seeks to restore a sense of justice pre-existing disorders such as obsessive-compulsive disorder lead to self-blame Difficulty: 1 Question ID: 7.1.19 Page Reference: 169 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual Answer: a. cultural myths suggest that women provoke rape

7.1.20. A recent study found that ____ percent of rape survivors had thoughts of suicide? a. b. c. d.

5 10 33 66 Difficulty: 1 Question ID: 7.1.20 Page Reference: 169 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual Answer: b. 33

7.1.21. What accounts for the reports of higher incidence rates of posttraumatic stress disorder in recent research? a. b. c. d.

the inclusion of ASD along with PTSD recognition that traumatic stresses are common redefining "trauma" as involving more ordinary forms of stress the inclusion of adjustment disorders along with PTSD Difficulty: 1 Question ID: 7.1.21 Page Reference: 169 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual Answer: b. recognition that traumatic stresses are common

7.1.22. A national study found that approximately ___ percent of the people in the United States suffered from PTSD at some point. a. b. c. d.

2 7 12 15 Difficulty: 2 Question ID: 7.1.22 Page Reference: 169 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual Answer: b. 7

7.1.23. What is the single most common traumatic event that can lead to PTSD? a. b. c. d.

rape losing a job combat exposure sudden unexpected death of a loved one Difficulty: 2 Question ID: 7.1.23 Page Reference: 170 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual Answer: d. sudden unexpected death of a loved one

7.1.24. Which of the following is the best description of the development of posttraumatic stress disorder (PTSD)?

a. Some individuals are predisposed to develop PTSD and there is nothing they can do to stop its emergence. b. The severity of the traumatic event is the most important factor in the development of PTSD. c. PTSD develops in individuals who have inherited certain physiological patterns, regardless of their level of exposure to trauma. d. PTSD results from the interaction of a traumatic event occurring to individuals with certain risk factors such as a history of mental disorder or a susceptibility to PTSD. Difficulty: Question ID: 7.1.24 Page Reference: 170 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: d. PTSD results from the interaction of a traumatic event occurring to individuals with certain risk factors such as a history of mental disorder or a susceptibility to PTSD. 7.1.25. A person with acute stress disorder is most likely to develop posttraumatic stress disorder when a. b. c. d.

the trauma is especially severe. the trauma involves the possibility of death. symptoms of numbing, depersonalization, and reliving the trauma are present. the person develops a complete amnesia for the traumatic event. Difficulty: 2 Question ID: 7.1.25 Page Reference: 170 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: c. symptoms of numbing, depersonalization, and reliving the trauma are present.

7.1.26. The National Comorbidity Study found that the course of posttraumatic stress disorder is best described as follows: a. b. c. d.

The person fully recovers. Symptoms tend to diminish gradually. Most people with PTSD report symptoms of the disorder 10 years later. PTSD usually leads to severe alcohol and drug problems. Difficulty: 1 Question ID: 7.1.26 Page Reference: 171 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual Answer: b. Symptoms tend to diminish gradually.

7.1.27. Research on social factors and the risk of posttraumatic stress disorder suggests a role of social support in the etiology of posttraumatic stress disorder (PTSD). It was found that a. veterans who didn't face the embarrassment of being treated as heroes had lower rates of PTSD. b. veterans from units that encouraged independence had lower rates of PTSD. c. veterans who did not receive social support on their return had high rates of PTSD. d. veterans who had high social support through the Veterans Administration still had high rates of PTSD. Difficulty: 1 Question ID: 7.1.27 Page Reference: 171 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: c. veterans who did not receive social support on their return had high rates of PTSD.

7.1.28. If you were to summarize the main results with regard to the biological factors in the cause of PTSD from the study of twins who served in Vietnam, what would you say? a. b. c. d.

Genetic factors account for little in PTSD. Level of exposure did not predict PTSD symptoms. Genetic factors were most significant in accounting for arousal/anxiety symptoms. Whether individuals were exposed to trauma was not affected by genetic influences. Difficulty: 1 Question ID: 7.1.28 Page Reference: 171 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: c. Genetic factors were most significant in accounting for arousal/anxiety symptoms.

7.1.29. Evidence suggests that individuals diagnosed with posttraumatic stress disorder have regions of their brains that are structurally and functionally different than controls. All of the following are suggested in the textbook as an explanation of this observation EXCEPT a. b. c. d.

damage caused by trauma. damage caused by drug treatment of the PTSD. normal biological adaptations to stress. preexisting differences. Difficulty: 2 Question ID: 7.1.29 Page Reference:171-172 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: b. damage caused by drug treatment of the PTSD.

7.1.30. What are the elements of the two-factor theory explanation of the development and maintenance of posttraumatic stress disorder? a. b. c. d.

anxiety and phobias repression and withdrawal reinforcement and punishment classical and operant conditioning Difficulty: 1 Question ID: 7.1.30 Page Reference: 172 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual Answer: d. classical and operant conditioning

7.1.31. New York City college students had lower rates of PTSD following September 11 if they were better at enhancing and suppressing emotional expression. This is an example of what psychologist Edna Foa calls emotional processing, which involves three key stages. Each of the following is one of her stages EXCEPT a. b. c. d.

victims need to engage in a specialized counseling as soon as possible after the event. victims must engage emotionally with their traumatic memories. victims need to find a way to articulate and organize their chaotic experience. victims must come to believe that, despite the trauma, the world is not a terrible place. Difficulty: 2 Question ID: 7.1.31 Page Reference: 172 Topic: Skill: Conceptual Answer: a. victims need to engage in a specialized counseling as soon as possible after the event.

7.1.32. When people with PTSD are able to integrate the experience of trauma and find some broader reason or higher value for enduring it, they are engaging in the task of a. b. c. d.

emotional reintegration. meaning making. intellectualizing. denying the reality of their pain. Difficulty: 2 Question ID: 7.1.32 Page Reference: 172 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual

Answer: b. meaning making. 7.1.33. The term given to positive changes resulting from trauma is a. b. c. d.

posttraumatic growth. hardiness. integration. meaning making. Difficulty: 2 Question ID: 7.1.33 Page Reference: 172 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: a. posttraumatic growth.

7.1.34. With respect to the value of critical incident stress debriefing (CISD), a. b. c. d.

CISD almost always prevents future PTSD. there is no evidence that CISD prevents PTSD. CISD is never harmful to those who receive it. CISD should not be offered until several days after the trauma. Difficulty: 2 Question ID: 7.1.34 Page Reference: 173 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: b. there is no evidence that CISD prevents PTSD.

7.1.35. Which of the following types of medication is most often prescribed for PTSD? a. b. c. d.

anti-anxiety medications anti-hypertensive medications anti-depressant medications. stimulant medications. Difficulty: 1 Question ID: 7.1.35 Page Reference: 175 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual Answer: c. anti-depressant medications.

7.1.36. Jane has been diagnosed with PTSD and has begun seeing a psychotherapist. Which of the following will be the most important strategy for her therapist to employ to achieve long-term benefit? a. b. c. d.

reexposure to the traumatic event stress-inoculation training emotional distancing reactivation of defense mechanisms Difficulty: 1 Question ID: 7.1.36 Page Reference: 174 Topic: Acute and Posttraumatic Stress Disorder Skill: Applied Answer: a. reexposure to the traumatic event

7.1.37. Your friend has just come from a therapist who has recommended eye movement desensitization and reprocessing for posttraumatic stress disorder. Because you are taking a course in abnormal psychology, your friend asks what you think. Based on the literature, what would you say? a. This technique is based on operant conditioning principles and seems quite effective. b. This technique does not seem to have a theoretical basis and the limited effectiveness it does show may be due to the fact that it involves exposure. c. Classical conditioning provides the theoretical rationale for this technique that has had mixed results. d. Because the eyes are the "window on the mind," this technique explores hidden meanings related to traumatic events and has been extremely successful. Difficulty: 3 Question ID: 7.1.37 Page Reference: 174 Topic: Acute and Posttraumatic Stress Disorder Skill: Applied Answer: b. This technique does not seem to have a theoretical basis and the limited effectiveness it does show may be due to the fact that it involves exposure. 7.1.38. What event seemed to trigger Dallae's case of dissociative fugue reported in the text? a. b. c. d.

poor grades her parents' divorce recovered memories of sexual abuse breakup of a longstanding relationship Difficulty: 1 Question ID: 7.1.38 Page Reference: 175 Topic: Dissociative Disorders Skill: Factual

Answer: a. poor grades 7.1.39. Which symptom of dissociative fugue can be used to distinguish fugue from the other dissociative disorders? a. b. c. d.

malingering identity confusion purposeful, unplanned travel inability to remember details of the past Difficulty: 2 Question ID: 7.1.39 Page Reference: 176 Topic: Dissociative Disorders Skill: Applied Answer: c. purposeful, unplanned travel

7.1.40. The name "hysteria" (Greek for "uterus") reflects the erroneous idea that somatoform and dissociative disorders were caused by a. b. c. d.

confused sexual identity. women's frustrated desires to have children. gynecological dysfunctions that cause fevers. women misinterpreting mild symptoms as catastrophic. Difficulty: 1 Question ID: 7.1.40 Page Reference: 176 Topic: Dissociative Disorders Skill: Factual Answer: b. women's frustrated desires to have children.

7.1.41. Jean Charcot influenced the thinking of Sigmund Freud and Pierre Janet. Specifically, Freud and Janet were influenced by Charcot's a. b. c. d.

views on gynecology. integration of multiple personalities. use of hypnosis to treat and induce hysteria. discovery of biological causes of somatoform disorders. Difficulty: 1 Question ID: 7.1.41 Page Reference: 176 Topic: Dissociative Disorders Skill: Factual Answer: c. use of hypnosis to treat and induce hysteria.

7.1.42. What is the view of contemporary psychology regarding unconscious processes? a. b. c. d.

These processes do not exist. These processes only play a role in abnormal emotion and cognition. These processes only play a role in normal emotion and cognition. These processes play a role in both normal and abnormal emotion and cognition. Difficulty: 1 Question ID: 7.1.42 Page Reference: 176 Topic: Dissociative Disorders Skill: Conceptual Answer: d. These processes play a role in both normal and abnormal emotion and cognition.

7.1.43. Epstein has suggested that we have two systems of information processing, a rational system that uses abstract, logical knowledge and a(n) ________________ system that uses intuitive knowledge to respond more quickly. a. b. c. d.

illogical unconscious right brain experiential Difficulty: 3 Question ID: 07.1.43 Page Reference: 176 Topic: Dissociative Disorders Skill: Applied Answer: d. experiential.

7.1.44. Why are studies that seem to demonstrate the phenomenon of implicit memory important? a. b. c. d.

They indicate that memory can only affect behavior when there is conscious remembering. They show that unconscious mental processes really do not exist. They represent a research technique that enables scientists to study unconscious processes. They provide objective evidence for the existence of a dissociative disorder. Difficulty: 2 Question ID: 7.1.44 Page Reference: 176 Topic: Dissociative Disorders Skill: Applied

Answer: c. They represent a research technique that enables scientists to study unconscious processes.

7.1.45. Some psychologists do not see hypnosis as an altered state of consciousness. How are they likely to view being hypnotized? a. b. c. d.

a form of depersonalization a form of psychogenic amnesia a sign of predisposition to dissociation a response to suggestion and expectations Difficulty: 2 Question ID: 7.1.45 Page Reference: 177 Topic: Dissociative Disorders Skill: Conceptual Answer: d. a response to suggestion and expectations

7.1.46. What is the cause of psychogenic amnesia? a. b. c. d.

malingering brain injury emotional distress neurotransmitter imbalance Difficulty: 1 Question ID: 7.1.46 Page Reference: 178 Topic: Dissociative Disorders Skill: Factual Answer: c. emotional distress

7.1.47. After Linda witnessed a violent crime, she could not recall anything that happened before the trauma. Linda's experience is an example of a. b. c. d.

fugue. dementia. regressive amnesia. psychogenic amnesia. Difficulty: 1 Question ID: 7.1.47 Page Reference: 178 Topic: Dissociative Disorders Skill: Conceptual Answer: d. psychogenic amnesia.

7.1.48. While in his bedroom, Zack suddenly feels as if he in a strange and unfamiliar place. Later, he experiences the feeling that his body does not belong to him. What is Zack experiencing? a. b. c. d.

fugue deja vu depersonalization identity disorder Difficulty: 2 Question ID: 7.1.48 Page Reference: 178 Topic: Dissociative Disorders Skill: Applied Answer: c. depersonalization

7.1.49. In the DSM-IV-TR, fugue and psychogenic amnesia are in the category of dissociative disorders while the traumatic stress disorders are classified as anxiety disorders, but many psychologists believe there is an important link between them. Which of the following provides evidence of such a link? a. They are all closely tied to the phenomenon of recovered memories. b. They all usually involve a clear and sudden trauma that, for most people, would be followed by a rapid return to normal psychological functioning. c. They all involve some significant distortions of reality. d. They are all chronic disorders from which a return to normal psychological functioning is very unlikely. Difficulty: 2 Question ID: 7.1.49 Page Reference: 178 Topic: Dissociative Disorders Skill: Conceptual Answer: b. They all usually involve a clear and sudden trauma that, for most people, would be followed by a rapid return to normal psychological functioning.

7.1.50. One of the greatest controversies in psychology today is the issue of recovered memories. Some individuals argue that such memories reveal past sexual abuse; others disagree. What is one of the concerns of those that raise questions about recovered memories? a. Therapists may be suggesting the existence of such memories to their clients. b. Many people cannot tell the difference between what they have dreamed and reality. c. Some psychotic individuals are reporting their delusions as examples of claimed sexual abuse. d. Some clients are deliberately creating memories of sexual abuse in order to sue individuals against whom they have held grudges.

Difficulty: 1 Question ID: 7.1.50 Page Reference: 178 Topic: Dissociative Disorders Skill: Conceptual Answer: a. Therapists may be suggesting the existence of such memories to their clients.

7.1.51. George Franklin was convicted of the murder of an 8-year-old that occurred over 20 years earlier. What aspect of this case is of interest to psychologists? a. b. c. d. fugue.

Franklin claimed he committed the murder while in a dissociative state. His daughter's recovered memories were the basis for Franklin's conviction. A polygraph was used to identify those who were telling the truth about the murder. Franklin was covering up for a crime committed by his daughter who developed dissociative

Difficulty: 1 Question ID: 7.1.51 Page Reference: 179 Topic: Dissociative Disorders Skill: Conceptual Answer: b. His daughter's recovered memories were the basis for Franklin's conviction.

7.1.52. Neisser and Harsch interviewed people about how they learned about the explosion of the space shuttle Challenger, and what they were doing at the time. They interviewed people at the time of the explosion, and then three years later. What did they find at the three-year follow-up? a. b. c. d.

leading questions led to false memories hardly anyone remembered what they were doing about one-third had vivid but inaccurate memories nearly everyone showed accurate memories of where they were Difficulty: 1 Question ID: 7.1.52 Page Reference: 179 Topic: Dissociative Disorders Skill: Conceptual Answer: c. about one-third had vivid but inaccurate memories

7.1.53. The essential feature of behavior that will lead to diagnosis of dissociative fugue is a. b. c.

hearing voices outside of oneself. dissociative hallucinations. gradual dissociation.

sudden unexpected travel. Difficulty: 1 Question ID: 7.1.53 Page Reference: 178 Topic: Dissociative Disorders Skill: Factual Answer: d. sudden unexpected travel.

7.1.54. What is the most common form of dissociative amnesia? a. b. c. d.

selective amnesia regressive amnesia continuous amnesia generalized amnesia Difficulty: 1 Question ID: 7.1.54 Page Reference: 178 Topic: Dissociative Disorders Skill: Factual Answer: a. selective amnesia

7.1.55. The famous case study by Thigpen and Cleckley (1957) that started the public’s fascination with the idea of multiple personality disorder, now called dissociative identity disorder, became a book and movie called a. b. c. d.

Michelle Remembers. Eve Black and Eve White. The Three Faces of Eve. The Shinning. Difficulty: 1 Question ID: 7.1.55 Page Reference: 180 Topic: Dissociative Disorders Skill: Factual Answer: c. The Three Faces of Eve.

7.1.56. Which of the following individuals is going through a depersonalization experience? a. b. c. d.

Peter, who believes the world is out to get him Abigail, who has amnesia for her name and identity Ronald, who believes he has more than one personality Terry, who has the sensation of floating above her body

Difficulty: 2 Question ID: 7.1.56 Page Reference: 180 Topic: Dissociative Disorders Skill: Conceptual Answer: d. Terry, who has the sensation of floating above her body

7.1.57. Multiple personality disorder is now known as a. b. c. d.

depersonalization. selective amnesia. dissociative fugue. dissociative identity disorder. Difficulty: 1 Question ID: 7.1.57 Page Reference: 180 Topic: Dissociative Disorders Skill: Factual Answer: d. dissociative identity disorder.

7.1.58. For a class assignment, students are required to read the book The Three Faces of Eve. The professor says he will offer extra credit to any student who can point out one of the inaccuracies in the book. Which of these students is going to earn extra credit? a. b. c. d.

Melissa says Eve was suffering from schizophrenia. Andy says that Eve had more than three personalities. Bill says that Eve lied to become a celebrity. Zelda says Eve suffered from epileptic seizures that led her to engage in odd behaviors at times. Difficulty: 2 Question ID: 7.1.58 Page Reference: 180 Topic: Dissociative Disorders Skill: Conceptual Answer: b. Andy says that Eve had more than three personalities.

7.1.59. Research suggests many reasons to disbelieve claims that dissociative disorders are prevalent but overlooked. The following are all reasons presented in the textbook for this EXCEPT a. most cases of DID are diagnosed by a small group of advocates. b. the increase in the frequency of the diagnosis correlated with the release of a popular book and movie. c. DID is rarely diagnosed outside of Canada and the United States.

the diagnosis of DID has been associated with specific religious groups. Difficulty: 3 Question ID: 7.1.59 Page Reference: 180 Topic: Dissociative Disorders Skill: Applied Answer: d. the diagnosis of DID has been associated with specific religious groups.

7.1.60. Some psychologists believe the increase in the diagnosis of multiple personality disorder in recent years in the United States reflects a "fad" because a. b. c. d.

the diagnosis is made mostly by younger doctors. the diagnosis is extremely rare in Great Britain. insurance companies will now cover its treatment. the growing interest in psychic phenomena has stimulated belief in the disorder. Difficulty: 1 Question ID: 7.1.60 Page Reference: 181 Topic: Dissociative Disorders Skill: Conceptual Answer: b. the diagnosis is extremely rare in Great Britain.

7.1.61. Some epidemiological studies, using instruments like the Dissociative Experiences Questionnaire (DEQ), have reported high rates of dissociative symptoms, but these studies are viewed skeptically because a. dissociative symptoms cannot be measured based on self-reports. b. the symptoms measured by the DEQ are far less dramatic than those found in dissociative disorders. c. there is no agreement as to what dissociative symptoms should be measured. d. people with real dissociative disorders are not able to complete the DEQ. Difficulty: 1 Question ID: 7.1.61 Page Reference: 181 Topic: Dissociative Disorders Skill: Factual Answer: b. the symptoms measured by the DEQ are far less dramatic than those found in dissociative disorders.

7.1.62. Not all psychologists agree that multiple personality disorder is a psychological disorder. What is the most commonly asserted alternative hypothesis used to explain behavior described as "multiple personality disorder"? a. b. c. d.

The patient has an affective disorder. The patient has organic brain dysfunction. The patient responds to expectations by playing a role. The patient is under the influence of psychoactive drugs. Difficulty: 1 Question ID: 7.1.62 Page Reference: 181 Topic: Dissociative Disorders Skill: Conceptual Answer: c. The patient responds to expectations by playing a role.

7.1.63. Why did some experts doubt the claim that Kenneth Bianchi, the "Hillside Strangler," had multiple personality disorder? a. b. c. d.

An expert in hypnosis tricked Bianchi into feigning new symptoms. There was no known trauma during his childhood. Bianchi did not know the names of the personalities. Bianchi's poor verbal skills made his responses difficult to comprehend. Difficulty: 2 Question ID: 7.1.63 Page Reference: 181-182 Topic: Dissociative Disorders Skill: Applied Answer: a. An expert in hypnosis tricked Bianchi into feigning new symptoms.

7.1.64. What disorder did Kenneth Bianchi (the "Hillside Strangler") feign in his attempt to explain his participation in several murders? a. b. c. d.

depersonalization dissociative fugue dissociative amnesia dissociative identity disorder Difficulty: 1 Question ID: 7.1.64 Page Reference: 181 Topic: Dissociative Disorders Skill: Factual Answer: d. dissociative identity disorder

7.1.65. To test the role-playing hypothesis of multiple personality disorder (MPD), Nicholas Spanos and colleagues have conducted analogue experiments in which they asked college students to play the role of an accused murderer. What have these studies shown? a. b. c. d.

role playing causes multiple personality disorder the symptoms of MPD can be induced through hypnosis the ease of role-taking correlates with risk for MPD most individuals deny having a "hidden part," even under hypnosis Difficulty: 2 Question ID: 7.1.65 Page Reference: 181 Topic: Dissociative Disorders Skill: Applied Answer: b. the symptoms of MPD can be induced through hypnosis

7.1.66. There is dispute about the importance of trauma as a factor in the etiology of dissociative identity disorder (DID) because a. there is no agreement as to what actually constitutes trauma. b. studies of the long-term consequences of child physical or sexual abuse have found little evidence of dissociation. c. it is not possible to confirm whether a person has ever experienced any trauma. d. most people diagnosed with DID deny having ever experienced a trauma. Difficulty: 2 Question ID: 7.1.66 Page Reference: 183-184 Topic: Dissociative Disorders Skill: Conceptual Answer: b. studies of the long-term consequences of child physical or sexual abuse have found little evidence of dissociation. 7.1.67. What is the basis for the controversy about the role of trauma in the etiology of multiple personality disorder? a. b. c. d.

patients' reluctance to disclose trauma poor reliability of the definition of trauma concern about the validity of retrospective reports case histories that show few cases associated with trauma Difficulty: 1 Question ID: 7.1.67 Page Reference: 184 Topic: Dissociative Disorders Skill: Conceptual

Answer: c. concern about the validity of retrospective reports 7.1.68. Iatrogenesis refers to a. b. c. d.

state-dependent learning. inability to recognize faces. emotional reliving of past experiences. treatment that causes, not cures, a disorder. Difficulty: 2 Question ID: 7.1.68 Page Reference: 184 Topic: Dissociative Disorders Skill: Factual Answer: d. treatment that causes, not cures, a disorder.

7.1.69. What is the main objective in treating patients with dissociative identity disorder? a. b. c. d.

stop abreaction reduce depersonalization induce amnesia for all but one personality reintegrate the different personalities into a whole Difficulty: 1 Question ID: 7.1.69 Page Reference: 184 Topic: Dissociative Disorders Skill: Conceptual Answer: d. reintegrate the different personalities into a whole

7.1.70. What term is used to describe the emotional reliving of past traumatic experiences? a. b. c. d.

abreaction dissociation iatrogenesis prosopagnosia Difficulty: 1 Question ID: 7.1.70 Page Reference: 184 Topic: Dissociative Disorders Skill: Factual Answer: a. abreaction

7.1.71. Which of the following is characteristic of somatoform disorders? a. b. c. d.

They are the result of malingering. They have no clear biological cause. The symptoms are hypnotically induced. The disorders consist of the presentation of impossible symptoms. Difficulty: 1 Question ID: 7.1.71 Page Reference: 184 Topic: Somatoform Disorders Skill: Conceptual Answer: b. They have no clear biological cause.

7.1.72. What aspect of the somatoform disorders make them different from psychosomatic disorders? a. b. c. d.

They make sense neurologically. They are due to an actual physical illness. They are unrelated to psychological factors. They cannot be explained by an underlying organic impairment. Difficulty: 2 Question ID: 7.1.72 Page Reference: 185 Topic: Somatoform Disorders Skill: Conceptual Answer: d. They cannot be explained by an underlying organic impairment.

7.1.73. The sudden onset of paralysis or blindness without a clear biological cause is an example of a. b. c. d.

malingering. depersonalization. somatoform disorder. dissociative disorder. Difficulty: 1 Question ID: 7.1.73 Page Reference: 185 Topic: Somatoform Disorders Skill: Applied Answer: c. somatoform disorder.

7.1.74. What do dissociative and somatoform disorders have in common? a. b. c. d.

They both involve malingering. They have the same biological cause. They both involve a degree of dissociation. People with these disorders also have personality disorders. Difficulty: 2 Question ID: 7.1.74 Page Reference: 185 Topic: Somatoform Disorders Skill: Conceptual Answer: c. They both involve a degree of dissociation.

7.1.75. Which category of disorders is often associated with unnecessary medical treatment? a. b. c. d.

somatoform disorders adjustment disorders dissociative disorders schizophrenic disorders Difficulty: 1 Question ID: 7.1.75 Page Reference: 185 Topic: Somatoform Disorders Skill: Factual Answer: a. somatoform disorders

7.1.76. Which of the following is a problem associated with somatoform disorders? a. b. c. d.

unnecessary surgery stress-related illnesses amnesia due to organic brain dysfunction legal difficulties due to having more than one personality Difficulty: 1 Question ID: 7.1.76 Page Reference: 185 Topic: Somatoform Disorders Skill: Factual Answer: a. unnecessary surgery

7.1.77. The symptoms of conversion disorder often resemble

a. b. c. d.

flu-like symptoms. neurological diseases. gastrointestinal problems. dissociative identity disorder. Difficulty: 1 Question ID: 7.1.77 Page Reference: 185 Topic: Somatoform Disorders Skill: Factual Answer: b. neurological diseases.

7.1.78. Terry is unable to see, even though a medical examination reveals no physical problems with her eyes or brain. What is the most likely diagnosis? a. b. c. d.

hypochondriasis dissociative fugue conversion disorder psychosomatic disorder Difficulty: 2 Question ID: 7.1.78 Page Reference: 185 Topic: Somatoform Disorders Skill: Applied Answer: c. conversion disorder

7.1.79. Alice has lost any sensitivity to pain only on the left side of her face. Why is it reasonable to suspect that Alice suffers from a conversion disorder? a. b. c. d.

Conversion disorders often involve loss of sensitivity to pain. Conversion disorders do not usually involve bilateral symptoms. There is no possible organic explanation for why someone would lose pain sensation in the face. The nerves involved in pain sensation do not divide the face neatly in half. Difficulty: 2 Question ID: 7.1.79 Page Reference: 186 Topic: Somatoform Disorders Skill: Applied Answer: d. The nerves involved in pain sensation do not divide the face neatly in half.

7.1.80. If a patient with somatization disorder is described as presenting symptoms in a histrionic manner what has the clinician concluded?

a. b. c. d.

The physical symptoms do not make anatomical sense. The patient's report is filled with suspicious gaps of memory. The patient's symptoms are consistent with "la belle indifference." The symptoms were presented in a vague but seductive and dramatic manner. Difficulty: 1 Question ID: 7.1.80 Page Reference: 186 Topic: Somatoform Disorders Skill: Applied Answer: d. The symptoms were presented in a vague but seductive and dramatic manner.

7.1.81. A flippant lack of concern about symptoms, called "la belle indifference," is sometimes observed in patients with a. b. c. d.

pain disorder. schizophrenia. somatization disorder. psychosomatic illness. Difficulty: 1 Question ID: 7.1.81 Page Reference: 186 Topic: Somatoform Disorders Skill: Factual Answer: c. somatization disorder.

7.1.82. A history of multiple, somatic complaints in the absence of organic impairments is characteristic of a. b. c. d.

conversion disorder. psychosomatic illness. somatization disorder. body dysmorphic disorder. Difficulty: 1 Question ID: 7.1.82 Page Reference: 186 Topic: Somatoform Disorders Skill: Factual Answer: c. somatization disorder.

7.1.83. When Bob noticed a pain in his thigh he was convinced it was the first sign of bone cancer. Although X-rays revealed no sign of cancer, Bob sought the opinions of several other physicians who agreed with the original opinion. What mental disorder might Bob's behavior indicate? a. b. c. d.

a mood disorder hypochondriasis conversion disorder catatonic schizophrenia Difficulty: 1 Question ID: 7.1.83 Page Reference: 186 Topic: Somatoform Disorders Skill: Conceptual Answer: b. hypochondriasis

7.1.84. When faced with the results of medical tests which indicate that their symptoms have no medical cause, what is the typical response of someone with hypochondriasis? a. b. c. d.

They become delusional, believing that the physician is lying. They accept the results and then generally enter counseling. They accept the results, but worry that the test is wrong. They become extremely afraid and have a panic attack. Difficulty: 2 Question ID: 7.1.84 Page Reference: 186 Topic: Somatoform Disorders Skill: Applied Answer: c. They accept the results, but worry that the test is wrong.

7.1.85. Frank is experiencing a lot of pain. His condition would be classified as a somatoform disorder in DSM-IV-TR if a. b. c. d.

his pain is the expected result of a medical condition. his pain is chronic. his pain is faked or intentionally produced. psychological factors are judged to be significant. Difficulty: 1 Question ID: 7.1.85 Page Reference: 187 Topic: Somatoform Disorders Skill: Conceptual Answer: d. psychological factors are judged to be significant.

7.1.86. What part of the body is the most frequent preoccupation of individuals with body dysmorphic disorder? a. b. c. d.

brain sense organs facial features internal organs Difficulty: 1 Question ID: 7.1.86 Page Reference: 187 Topic: Somatoform Disorders Skill: Factual Answer: c. facial features

7.1.87. Which of these people is most likely to receive the diagnosis of body dysmorphic disorder? a. b. c. d.

Teresa, who is 25 pounds overweight Mike, whose blindness has no physical cause Amy, who experiences gastrointestinal problems when she is stressed Kevin, who imagines he has a serious defect in his physical appearance Difficulty: 1 Question ID: 7.1.87 Page Reference: 187 Topic: Somatoform Disorders Skill: Applied Answer: d. Kevin, who imagines he has a serious defect in his physical appearance

7.1.88. Which of these disorders is as much as 10 times more likely to occur in women than men? a. b. c. d.

pain disorder hypochondriasis conversion disorder somatization disorder Difficulty: 1 Question ID: 7.1.88 Page Reference: 188 Topic: Somatoform Disorders Skill: Factual Answer: d. somatization disorder

7.1.89. Rick walks into the emergency room and asks to see a doctor. He explains that he has a fever, but he does not report that he gave himself an injection of dirty water that is probably responsible for his fever. Without this information, the medical staff cannot determine the cause of for Rick's fever, so they admit him for observation. Rick is delighted because he enjoys the "sick role." After numerous tests are run, the staff is still puzzled, so they call for a psychiatric consult. The psychiatrist should consider the diagnosis of a. b. c. d.

factitious disorder. somatoform disorder. bipolar mood disorder. psychosomatic disorder. Difficulty: 1 Question ID: 7.1.89 Page Reference: 188 Topic: Somatoform Disorders Skill: Applied Answer: a. factitious disorder.

7.1.90. You overhear several students discussing a news report on Munchausen syndrome. Because you are taking a course in abnormal psychology, you recognize this syndrome to be an example of a(n) a. b. c. d.

anxiety disorder. psychotic disorder. traumatic disorder. factitious disorder. Difficulty: 2 Question ID: 7.1.90 Page Reference: 188 Topic: Somatoform Disorders Skill: Conceptual Answer: d. factitious disorder.

7.1.91. Hannah's doctors are convinced that her physical symptoms are not real, but they cannot decide whether this is an instance of malingering or factitious disorder. What factor will best help them to choose between these two possibilities? a. b. c. d.

the severity of her symptoms how long her symptoms have been affecting her whether she is achieving some specific external gain whether she seeks or refuses medical treatment

Difficulty: 2 Question ID: 7.1.91 Page Reference: 188

Topic: Somatoform Disorders Skill: Conceptual Answer: c. whether she is achieving some specific external gain 7.1.92. Which of these individuals is most likely to suffer from somatization disorder? a. b. c. d.

Eight-year-old Alice, who is from an upper socioeconomic background and is in grade-school at this time Sixty-five-year-old Harry, who is from a lower socioeconomic background and has two college degrees Fifty-year-old John, who is from an upper socioeconomic background and has a doctoral degree in education Twenty-two-year-old Mary, who is from a lower socioeconomic background and has eight years of education Difficulty: 2 Question ID: 7.1.92 Page Reference: 188-189 Topic: Somatoform Disorders Skill: Conceptual

Answer: d. Twenty-two-year-old Mary, who is from a lower socioeconomic background and has eight years of education

7.1.93. People who suffer from somatoform disorder also commonly suffer from a. b. c. d.

delusions. nightmares. depression. factitious disorder. Difficulty: 1 Question ID: 7.1.93 Page Reference: 189 Topic: Somatoform Disorders Skill: Factual Answer: c. depression.

7.1.94. In a family with somatization disorder, the male relatives are at increased risk for antisocial personality disorder. What are the underlying characteristics that tie these disorders together? a. b. c. d.

mania and psychasthenia extraversion and agreeableness sensation seeking and irresponsibility absence of inhibition and high negative emotion Difficulty: 2 Question ID: 7.1.94

Page Reference: 189 Topic: Somatoform Disorders Skill: Conceptual Answer: d. absence of inhibition and high negative emotion

7.1.95. Which disorder is related to antisocial personality disorder and is more common in women? a. b. c. d.

anorexia nervosa somatization disorder sadistic personality disorder dissociative identity disorder Difficulty: 1 Question ID: 7.1.95 Page Reference: 189 Topic: Somatoform Disorders Skill: Factual Answer: b. somatization disorder

7.1.96. The Williams family is sitting down for Thanksgiving dinner. Mary Williams starts describing her many different somatic complaints. Then, Aunt Helen adds her own long list of complaints. Somatization disorder seems to run in the female members of this family. The male relatives in this family may have an elevated risk for which disorder? a. b. c. d.

panic disorder bipolar disorder schizophreniform disorder antisocial personality disorder Difficulty: 2 Question ID: 7.1.96 Page Reference: 189 Topic: Somatoform Disorders Skill: Applied Answer: d. antisocial personality disorder

7.1.97. Under what circumstances is a physical complaint assumed to be part of a somatoform disorder? a. b. c. d.

There are gaps in memory. The symptoms are gastrointestinal in nature. Various known physical causes are ruled out. There is a history of other psychiatric problems. Difficulty: 2 Question ID: 7.1.97

Page Reference: 189 Topic: Somatoform Disorders Skill: Conceptual Answer: c. Various known physical causes are ruled out.

7.1.98. Which of the following is a significant problem in confirming a diagnosis of somatoform disorder? a. b. c. d.

Patients don't always tell the truth about symptoms. A true somatic illness will often be detected later on. There is no objective measure of a person's pain. Somatoform disorders overlap substantially with mood disorders. Difficulty: 2 Question ID: 7.1.98 Page Reference: 189 Topic: Somatoform Disorders Skill: Conceptual Answer: b. A true somatic illness will often be detected later on.

7.1.99. The diagnosis of somatoform disorder is sometimes mistakenly made in cases where there actually is an undetected physical illness, especially a. b. c. d.

sensory deficits. ulcer or colitis. cardiovascular diseases. neurological diseases. Difficulty: 1 Question ID: 7.1.99 Page Reference: 189 Topic: Somatoform Disorders Skill: Factual Answer: d. neurological diseases.

7.1.100. What was Sigmund Freud's original conclusion concerning reports of child sexual abuse by patients with conversion disorders? a. b. c. d.

The trauma causes conversion. The conversion precedes child abuse. Memories of sexual abuse are fantasies. Mental illness causes errors in memory. Difficulty: 1 Question ID: 7.1.100

Page Reference: 190 Topic: Somatoform Disorders Skill: Factual Answer: a. The trauma causes conversion.

7.1.101. In psychoanalytic theory, the symptoms of somatoform and dissociative disorders provide primary gain. This means that the symptoms a. b. c. d.

allow benefits such as missing work. help the patient learn the sick role. are more easily treated than other problems. protect the conscious mind from painful conflicts. Difficulty: 2 Question ID: 7.1.101 Page Reference: 190 Topic: Somatoform Disorders Skill: Conceptual Answer: d. protect the conscious mind from painful conflicts.

7.1.102. What is one of the major findings of research on memory and retrospective reports? a. b. c. d.

Parents report more negative memories than children do. Anxiety is associated with long-term memory impairments. Depressed people erroneously recall more negative events. Specific memories are more reliable than global memories. Difficulty: 2 Question ID: 7.1.102 Page Reference: 182-183 Topic: Dissociative Disorders Skill: Conceptual Answer: d. Specific memories are more reliable than global memories.

7.1.103. What element would make for an adequate test of the hypothesized relationship between child abuse and dissociative disorder? a. b. c. d.

retrospective analysis prospective research with objective measures accurate prevalence rates for child sexual abuse intensive case studies of patients with multiple personality disorder Difficulty: 2 Question ID: 7.1.103 Page Reference: 183

Topic: Dissociative Disorders Skill: Applied Answer: b. prospective research with objective measures

7.1.104. Which of the following is an example of a retrospective report? a. b. c. d.

a teen describing how he likes high school an adult describing what high school was like evaluation of high school students' work by several sources a child describing what she expects high school to be like Difficulty: 2 Question ID: 7.1.104 Page Reference: 183 Topic: Dissociative Disorders Skill: Conceptual Answer: b. an adult describing what high school was like

7.1.105. Donna has a somatoform disorder. According to a cognitive behavior therapist, how is her disorder likely to be perpetuated? a. b. c. d.

getting attention and getting to miss work stigma from a society that labels her mentally ill complications from associated anxiety or depression negative self-statements that reduce her self-esteem Difficulty: 2 Question ID: 7.1.105 Page Reference: 190 Topic: Somatoform Disorders Skill: Conceptual Answer: a. getting attention and getting to miss work

7.1.106. The medical records of a patient contain the word alexithymia. Assuming the word is accurate, what can we conclude about this patient? a. b. c. d.

He has difficulty recognizing and expressing emotions. He has been hostile and will not cooperate in his treatment. He is feigning an illness in order to take on the sick role. He does not take responsibility for his actions and constantly blames others.

Difficulty: 2 Question ID: 7.1.106 Page Reference: 190

Topic: Somatoform Disorders Skill: Applied Answer: a. He has difficulty recognizing and expressing emotions.

7.1.107. According to the sociocultural view of the etiology of somatoform disorders, these disorders are more common in nonindustrial societies and among the poorly educated in the United States. Why do people in these communities tend to develop these disorders? a. b. c. d.

They view therapists with great suspicion. They typically live in very crowded conditions. They learn to express emotions as physical symptoms. They are subjected to more pollution and discrimination. Difficulty: 2 Question ID: 7.1.107 Page Reference: 189 Topic: Somatoform Disorders Skill: Conceptual Answer: c. They learn to express emotions as physical symptoms.

7.1.108. Barbara suffers from a conversion disorder and has recently begun treatment with a Freudian therapist. What is this therapist most likely to emphasize in treating Barbara? a. b. c. d.

encouraging her to recall psychologically painful events teaching her how to put her feelings into words eliminating the reinforcers for her symptoms showing her how her symptoms do not make anatomical sense Difficulty: 2 Question ID: 7.1.108 Page Reference: 191 Topic: Somatoform Disorders Skill: Applied Answer: a. encouraging her to recall psychologically painful events

7.1.109. How would a therapist use operant behavioral approaches to treat chronic pain? a. b. c. d.

use pain as a punisher reward successful coping and life adaptation reduce reinforcement for the sick role induce relaxation by using biofeedback Difficulty: 2 Question ID: 7.1.109 Page Reference: 191

Topic: Somatoform Disorders Skill: Conceptual Answer: b. reward successful coping and life adaptation

7.1.110. Which group of medications has been found to produce more relief from the symptoms of body dysmorphic and pain disorders than placebo? a. b. c. d.

SSRIs anticonvulsants antianxiety drugs marijuana type drugs Difficulty: 1 Question ID: 7.1.110 Page Reference: 191 Topic: Somatoform Disorders Skill: Factual Answer: a. SSRIs

7.1.111. What is one reason for the limited research on the psychological treatment of somatoform disorders? a. b. c. d.

Most of these patients deny having any symptoms. These people tend to see physicians, not psychologists. The high rate of dissociation among these people makes assessment very difficult. Psychological treatment is usually seen as unnecessary. Difficulty: 1 Question ID: 7.1.111 Page Reference: 191 Topic: Somatoform Disorders Skill: Applied Answer: b. These people tend to see physicians, not psychologists.

7.1.112. What is the major recommendation for the medical management of patients with somatoform disorder? a. b. c. d.

use medication to reduce anxiety confront the patient's irrational thinking use repeated medical procedures to reassure the patient establish a strong and consistent physician-patient relationship

Difficulty: 1 Question ID: 7.1.112

Page Reference: 191 Topic: Somatoform Disorders Skill: Factual Answer: d. establish a strong and consistent physician-patient relationship

7.1.113. Norman's primary care physician is convinced that his symptoms are due to a somatoform disorder, and the physician is encouraging Norman to accept a referral to a mental health professional. Norman is likely to a. b. c. d.

accept the referral willingly. drop out of all forms of treatment. reject the referral because he feels belittled. reject the referral because he is faking and does not want to be found out. Difficulty: 1 Question ID: 7.1.113 Page Reference: 191 Topic: Somatoform Disorders Skill: Factual Answer: c. reject the referral because he feels belittled.

Short Answer 7.2.114. _________ stress is defined in DSM-IV-TR as an event that involves actual or threatened death or serious injury to self or others and creates intense feelings of fear, helplessness, or horror. Difficulty: 1 Question ID: 7.1.114 Page Reference: 164 Topic: Overview Skill: Factual Answer: Traumatic

7.2.115. Sudden memories during which a trauma is replayed in images or thoughts—often at full emotional intensity-- are known as __________ .

Difficulty: 1 Question ID: 7.2.115 Page Reference: 165 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual

Answer: flashbacks

7.2.116. __________ is a marked sense of unreality about yourself and the world around you that is considered a dissociative symptom. Difficulty: 2 Question ID: 7.2.116 Page Reference: 166 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: Derealization

7.2.117. Many people with PTSD also suffer from another mental disorder such as depression, anxiety, and/or drug abuse. This is known as __________ . Difficulty: 2 Question ID: 7.2.117 Page Reference: 169 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual Answer: comorbidity

7.2.118. Women are most likely to develop PTSD as a result of rape. For men the leading cause is a result of __________ . Difficulty: 1 Question ID: 7.2.118 Page Reference: 170 Topic: Acute and Posttraumatic Stress Disorder Skill: Factual Answer: combat and war

7.2.119. Some individuals experience positive changes as a result of living through a traumatic event. Psychologists label this __________ growth.

Difficulty: 2 Question ID: 7.2.119 Page Reference: 172 Topic: Acute and Posttraumatic Stress Disorder Skill: Conceptual Answer: posttraumatic

7.2.120. __________ disorders are characterized by persistent, maladaptive disruptions in the integration of memory, consciousness, or identity. Difficulty: 1 Question ID: 7.2.120 Page Reference: 175 Topic: Dissociative Disorders Skill: Factual Answer: Dissociative

7.2.121. The case study called "Dallae’s Journey" summarized in the textbook involved a dissociative __________ . Difficulty: 1 Question ID: 7.2.121 Page Reference: 175 Topic: Dissociative Disorders Skill: Factual Answer: fugue

7.2.122. Psychologist disagree as to the nature of hypnosis. Some see it as an altered state of consciousness while other see it as merely an example of a social _________ . Difficulty: 2 Question ID: 7.2.122 Page Reference: 181 Topic: Dissociative Disorders Skill: Conceptual Answer: role and roleplaying

7.2.123. ___________ amnesia involves a sudden inability to recall extensive and important personal information that exceeds normal forgetfulness.

Difficulty: 1 Question ID: 7.2.123 Page Reference: 182 Topic: Dissociative Disorders Skill: Factual Answer: Dissociative

7.2.124. ___________ disorders involve the creation of a disorder by its treatment. Difficulty: 2 Question ID: 7.2.124 Page Reference: 184 Topic: Dissociative Disorders Skill: Factual Answer: Iatrogenic

7.2.125. ____________ disorders are characterized by unusual physical symptoms that occur in the absence of a known physical illness. Difficulty: 1 Question ID: 7.2.125 Page Reference: 184 Topic: Somatoform Disorders Skill: Factual Answer: Somatoform

7.2.126. Today, a somatoform disorder that is much more common than the type seen by Freud or Charcot is __________ disorder, characterized by a history of multiple somatic complaints in the absence of organic impairments. Difficulty: 1 Question ID: 7.2.126 Page Reference: 190 Topic: Somatoform Disorders Skill: Factual Answer: somatization

7.2.127. Body __________ disorder is a different type of somatoform disorder in which the patient is preoccupied with some imagined defect in appearance.

Difficulty: 1 Question ID: 7.2.127 Page Reference: 185 Topic: Somatoform Disorders Skill: Factual Answer: dysmorphic

7.2.128. Freud recognized that individuals who exhibited various psychological symptoms could gain certain advantages such as sympathy or an excuse to avoid work. He labeled this "secondary gain." Cognitive behavioral psychologists would call this process positive __________ . Difficulty: 2 Question ID: 7.2.128 Page Reference: 190 Topic: Soamtoform Disorders Skill: Conceptual Answer: reinforcement

Essay 7.3.129. Identify the major clusters of symptoms used in diagnosing acute stress disorder and posttraumatic stress disorder. Give an example of each. Difficulty: 2 Question ID: 7.3.129 Page Reference: 164-166 Topic: Acute and Posttraumatic Stress Disorders Skill: Conceptual Answer: (1) Re-experiencing: visualizing the trauma over and over or in dreams or in flashbacks (sudden, repeated, intrusive memories during which the memory is replayed in thoughts or images; (2) avoidance: avoidance of stimuli associated with the trauma (including thoughts or feelings); (3) arousal or anxiety: increased arousal and anxiety evident in trouble falling or staying asleep or difficulty maintaining concentration; (4) dissociative symptoms (likely to occur in acute stress disorder): becoming less aware of surroundings following a traumatic event or depersonalization (feeling cut off from oneself) or derealization (a marked sense of unreality about oneself).

7.3.130. How and why has the definition of traumatic events changed from earlier versions of DSM to the current DSM? What have surveys revealed about traumatic events?

Difficulty: 2 Question ID: 7.3.130 Page Reference: 169-170 Topic: Acute and Posttraumatic Stress Disorders Skill: Conceptual Answer: Earlier versions of DSM defined trauma as an event "outside the range of usual human experience." Recent research has revealed that many traumatic events are common in the United States. Now, DSM defines traumatic events as (1) the experience of an event involving actual or threatened death or injury to self or others, and (2) a response of intense fear, helplessness, or horror in reaction to the event. A study of a random sample of over 2,000 adults living in the Detroit area found that almost 90%

of the participants reported having experienced at least one traumatic stressor in their lives. About 9% of the participants developed PTSD following the trauma.

7.3.131. Discuss cognitive behavior therapy methods used to treat posttraumatic stress disorder (PTSD). Difficulty: 2 Question ID: 7.3.131 Page Reference: 173-174 Topic: Acute and Posttraumatic Stress Disorders Skill: Applied Answer: The most effective types of treatments for PTSD involve a reexposure to the events or stimuli that caused the trauma in the first place. A study of prolonged exposure to traumatic stimuli found it to be more effective in relieving symptoms than relaxation and supportive counseling. Similarly, a method that involves imagining nightmares, while awake, called imagery rehearsal therapy was also found to relieve symptoms. Other cognitive techniques are also employed such a challenging faulty assumptions such as “no one cares,” but it is the exposure to the events that seem to have the most consistent therapeutic effect.

7.3.132. Recovered memories from early childhood have become an important and controversial issue. Discuss the reasons for this controversy and the research evidence that casts doubt on some reports of "recovered memories." Difficulty: 2 Question ID: 7.3.132 Page Reference: 178 Topic: Dissociative Disorders Skill: Conceptual Answer: (1) Memory research indicates that most memories from preschool are forgotten. (2) Therapists rarely doubt their patients' memories and may ask leading questions or set up expectations that induce false memories. (3) Research indicates high rates of erroneous memories for important events, such as where people were on the day the space shuttle Challenger blew up.

7.3.133. Explain why dissociative identity disorder (multiple personality disorder) is such a controversial diagnosis.

Difficulty: 2 Question ID: 7.3.133 Page Reference: 177-178 Topic: Dissociative Disorders Skill: Applied Answer: Dissociative identity disorder (DID) is being diagnosed with much greater frequency in recent years, with some studies suggesting unbelievably high prevalence rates. Most cases of DID are diagnosed by only a handful of clinicians, and the number of personalities claimed to exist has grown rapidly. Dissociative disorders are rarely diagnosed outside of the U.S. and Canada. It is even possible

that the disorder does not exist but is only created by the power of suggestion or that it represents a form of role enactment.

7.3.134. Describe the association between antisocial personality disorder and somatization disorder. Difficulty: 2 Question ID: 7.3.134 Page Reference: 189 Topic: Somatoform Disorders Skill: Conceptual Answer: The two disorders do not typically occur in the same individual, but they often are found in different members of the same family. Because antisocial personality is far more common among men, whereas somatoform disorders have the opposite pattern, some have speculated that the two problems are flip sides of the same coin. Antisocial personality disorder may be the male expression of high negative emotion and the absence of inhibition, whereas somatization disorder is the female expression of the same characteristics.

7.3.135. Explain the social learning perspective on the role of learning in the etiology of somatoform disorders. Difficulty: 2 Question ID: 7.3.135 Page Reference: 190 Topic: Somatoform Disorders Skill: Conceptual Answer: The social learning perspective would suggest that somatoform disorders are caused by learning. There is a concept called “learning the sick role” in which behaving as if sick is acquired through observation of others, some of whom are actually ill. Once the patient is in a sick role, operant conditioning may take over. People take care of you, do things for you and reduce demands made of you, all of which can act as either positvie or negative reinforcement and increase the behavior in question. Getting attention acts generally as positive reinforcement, reduced demands as negative reinforcement.

7.3.136. Discuss a "state dependent learning" model as a possible cause of a dissociative disorder. Difficulty: 2 Question ID: 7.2.136 Page Reference: 184 Topic: Dissociative Disorders Skill: Conceptual Answer: State dependent learning is a process where learning that takes place in one state of affect or consciousness is best recalled in the same state of affect or consciousness. Research has shown that if a memory is acquired in a state of fear, then in future it is sometimes the case that fear itself serves as a trigger for those memories that have become associated with that particular emotion. Perhaps what happens with someone who behaves in a certain way, under certain conditions, but then later forgets the

events is that they have formed an autonomous cluster of memories associated with a particular state or emotional set. It is then as if they have independent personalities that are themselves state dependent.

Chapter 8 Stress and Physical Health Total Assessment Guide (T.A.G.) Topic Overview pp. 195-196

Defining Stress pp. 196-198

Symptoms of Stress pp. 198-204

Diagnosis of Stress and Physical Illness pp. 204-204 Psychological Factors and Some Familiar Illnesses pp. 204-208 Cardiovascular Disease pp. 208-215

Question Type Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice

Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay

Factual

Conceptual

Applied

1, 2, 7, 8

3, 5, 6, 10

4, 9

11, 12

13, 14, 16

113 18, 22, 27, 29, 32, 33, 34, 35, 39, 48, 50, 53

19, 28, 36, 38, 40, 41, 43, 45, 46

102 17, 20, 21, 23, 24, 25, 26, 30, 31, 37, 42, 44, 47, 49, 51, 52, 54, 55, 56, 57 103, 104, 105

114, 115, 116 58, 60

106 61, 62, 64, 68, 70, 72, 75 107, 108

63, 65, 69, 71, 76, 77

66, 67, 73, 74, 78

117 79, 80, 81, 89, 94, 96, 100, 101 109, 110, 111, 112

82, 83, 84, 86, 88, 91, 92, 93, 97, 99 118, 119, 120

85, 87, 89, 90, 95, 98

Chapter 8: Stress and Physical Health

Multiple Choice 8.1.1.

What broad definition of stress has been offered by scientists?

a. b. c. d.

a subtype of mental disorder that emphasizes physiological symptoms a challenging event that requires behavioral, cognitive, and physiological adaptation a set of specific symptoms that are associated with increased risk for mental disorders an evolutionary development that has enabled humans to adapt to rapid technological changes Difficulty: 1 Question ID: 8.1.1 Page Reference: 195 Topic: Overview Skill: Factual Answer: b. a challenging event that requires behavioral, cognitive, and physiological adaptation

8.1.2.

Stress can include

a. b. c. d.

only minor hassles. only major events. both minor hassles and major events. only severe traumas. Difficulty: 1 Question ID: 8.1.2 Page-Reference: 195 Topic: Overview Skill: Factual Answer: c. both minor hassles and major events.

8.1.3. How do contemporary theories of the relationship of stress and illness view the influence of stress? a. b. c. d.

Stress affects physical not psychological health. Stress affects psychological but not physical health. Stress is influential in a limited number of diseases, such as ulcers. Stress plays a role in the onset or exacerbation of all physical illnesses, from a cold to AIDS.

Difficulty: 2 Question ID: 8.1.3 Page Reference: 195 Topic: Overview Skill: Conceptual Answer: d. Stress plays a role in the onset or exacerbation of all physical illnesses, from a cold to AIDS.

8.1.4. At work a group of coworkers is discussing psychosomatic disorders. Which of them has the best understanding of the term? a. Hank, who says, "These disorders are not as bad as real physical illnesses." b. Anna, who says, "The mind and the body sometimes work together to produce a disease." c. Sal, who says, "I don't know why anyone would want to consciously create the symptoms of a disease." d. Ann, who says, "If you have one of these disorders you have nothing to worry about, it is only in your head." Difficulty: 2 Question ID: 8.1.4 Page Reference: 195 Topic: Overview Skill: Applied Answer: b. Anna, who says, "The mind and the body sometimes work together to produce a disease."

8.1.5.

What is a psychosomatic illness?

a. b. c. d.

an imaginary physical disorder a fictitious psychological disorder a psychological, not physical illness a real physical illness involving both mind and body Difficulty: 2 Question ID: 8.1.5 Page Reference: 195 Topic: Overview Skill: Conceptual Answer: d. a real physical illness involving both mind and body

8.1.6. In what way do contemporary researchers' views on psychosomatic illness differ from views held earlier? a. b. c. d.

They now believe in the specificity hypothesis. They now believe that all physical illnesses can have psychological components. They now believe that only certain physical illnesses have psychological components. They now believe that depression is the primary cause of most of these types of illness. Difficulty: 1 Question ID: 8.1.6 Page Reference: 195 Topic: Overview Skill: Conceptual Answer: b. They now believe that all physical illnesses can have psychological components.

8.1.7. Evidence indicates that learning more adaptive ways of coping can limit the recurrence or improve the course of many physical illnesses by a. b. c. d.

changing the amount of stress we face. strengthening the body's immune system. diminishing the burden of stress. making it more likely that the illnesses will be correctly diagnosed. Difficulty: 1 Question ID: 8.1.7 Page Reference: 195 Topic: Overview Skill: Factual Answer: c. diminishing the burden of stress.

8.1.8. What multidisciplinary field includes both medical and mental health professionals who investigate psychological factors in the symptoms, etiology, and treatment of physical illness and chronic disease? a. b. c. d.

wellness psychophysiology behavioral medicine psychosomatic medicine Difficulty: 1 Question ID: 8.1.8 Page Reference: 195 Topic: Overview Skill: Factual Answer: c. behavioral medicine

8.1.9. Which of the following problems is LEAST likely to be addressed in a behavioral medicine clinic? a. b. c. d.

a man with diabetes has a poor diet an elderly woman mourns her husband a heart patient wants to stop smoking a child refuses to wear orthopaedic braces Difficulty: 1 Question ID: 8.1.9 Page Reference: 195 Topic: Overview Skill: Applied Answer: b. an elderly woman mourns her husband

8.1.10. The case of Bob Carter presented in your text is important because it shows a. that Bob's lifestyle was to blame for his heart attack. b. that stress and lifestyle are more important factors in heart attacks than genetic or physiological factors. c. the enormous advances in medical treatment for patients who have suffered heart attacks. d. that Bob would never have had a heart attack if he didn't smoke, eat a lot of red meat, and drink too much alcohol. Difficulty: 2 Question ID: 8.1.10 Page Reference: 196 Topic: Overview Skill: Conceptual Answer: c. the enormous advances in medical treatment for patients who have suffered heart attacks.

8.1.11. How did the developers of the Social Readjustment Rating Scale measure the amount of stress caused by each of the items on the scale? a. Each item was evaluated by a group of experts on stress and behavioral medicine. b. They used the judgments of a large group of normal people who assigned the items life change units. c. Scores were given to each item based on how much family members thought each event contributed to the death loved ones. d. The items were weighted according to estimates from epidemiological research of how much each contributes to mortality.

Difficulty: 2 Question ID: 8.1.11 Page Reference: 197 Topic: Defining Stress Skill: Conceptual Answer: b. They used the judgments of a large group of normal people who assigned the items life change units. 8.1.12. According to the conceptualization of stress used in the Social Readjustment Rating Scale, how would an outstanding personal achievement be viewed? a. b. c. d.

a stressful event a counterbalance for stress in other areas counted as stressful if it affects personal relationships counted as stressful if it is unexpected, but not if expected Difficulty: 2 Question ID: 8.1.12 Page Reference: 197 Topic: Defining Stress Skill: Conceptual Answer: a. a stressful event

8.1.13. Which of the following is an example of why some researchers object to instruments such as the Social Readjustment Rating Scale? a. b. c. d.

a stressor rarely has a physiological effects a stressor can have different meanings for different people a stressor doesn't necessarily cause immediate life changes a stressor doesn't necessarily affect social relationships Difficulty: 2 Question ID: 8.1.13 Page Reference: 197 Topic: Defining Stress Skill: Applied Answer: b. a stressor can have different meanings for different people

8.1.14. Your teacher describes the following incident to the class: His teen-age daughter called home and tearfully described how she received a speeding ticket on her way to an amusement park. Her father tells her not to worry, that it was not a big deal. What is he suggesting that she do? a. b. c. d.

change her primary appraisal of the event change her secondary appraisal of the event grow up and accept responsibility for what she has done recognize that her id has gotten the better of her at the moment

Difficulty: 2 Question ID: 8.1.14 Page Reference: 198 Topic: Defining Stress Skill: Applied Answer: a. change her primary appraisal of the event

8.1.15. According to Richard Lazarus, what is the role of cognition in stress? a. b. c. d.

life events are stressors only when perceived as distressing life events can be stressors even when not perceived as distressing distress is an automatic cognitive reaction, independent of physiological reactions distress is an automatic physiological reaction, independent of cognitive reactions Difficulty: 2 Question ID: 8.1.15 Page Reference: 198 Topic: Defining Stress Skill: Factual Answer: a. life events are stressors only when perceived as distressing

8.1.16. Imagine you have flunked a class. You have evaluated this situation and decided that flunking is stressful and important enough to be upset about, but you realize that you have the option to repeat the class in summer school. The realization is an example of a. b. c. d.

primary appraisal. primary prevention. secondary appraisal. secondary prevention. Difficulty: 2 Question ID: 8.1.16 Page Reference: 198 Topic: Defining Stress Skill: Applied Answer: c. secondary appraisal.

8.1.17. Walter Cannon believed that how we respond to stress has had obvious value for survival over the course of evolution, and with this in mind he emphasized the importance of the a. b. c. d.

appraisal or prevention response. activation or inhibition response. fight or flight response. primary or secondary response.

Difficulty: 1 Question ID: 08-1-17 Page Reference: 198 Topic: Symptoms of Stress Skill: Factual Answer: c. fight or flight response.

8.1.18. Which of the following characterizes one of the observations that Canon had about the fight or flight response? a. b. c. d.

seen in animals but not in humans maladaptive to modern day stress most adaptive in the face of social danger most adaptive in the face of psychological stressors Difficulty: 2 Question ID: 8.1.18 Page Reference: 198 Topic: Symptoms of Stress Skill: Conceptual Answer: b. maladaptive to modern day stress

8.1.19. An expert on human physiology and stress responses is giving a public lecture this evening. He intends to review the history of the fight or flight response and to describe its effectiveness in ancient and modern times. What is a good title for this presentation? a. b. c. d.

"When an Adaptive Response Becomes Maladaptive" "Fight or Flight: Major Physiological Changes Over Time" "Slowly Eroding: Elements of the Stress Response Lost to Evolution Over Time" "How Speed, Toxins, and Pollution are Destroying the Fight or Flight Response" Difficulty: 2 Question ID: 8.1.19 Page Reference: 198 Topic: Symptoms of Stress Skill: Applied Answer: a. "When an Adaptive Response Becomes Maladaptive"

8.1.20. Activation of which bodily system is responsible for the fight or flight response? a. b. c. d.

somatic system central nervous system sympathetic nervous system parasympathetic nervous system

Difficulty: 1 Question ID: 8.1.20 Page Reference: 198 Topic: Symptoms of Stress Skill: Factual Answer: c. sympathetic nervous system

8.1.21. Which of the following are likely to occur during the fight or flight response? a. b. c. d.

increased respiration, blood pressure rises, pupils dilate pupils constrict, blood pressure increases, heart rate increases blood sugar levels decrease, blood pressure rises, pupils dilate blood flow redirected for muscular activity, increased respiration, blood pressure decreases Difficulty: 1 Question ID: 8.1.21 Page Reference: 198 Topic: Symptoms of Stress Skill: Factual Answer: a. increased respiration, blood pressure rises, pupils dilate

8.1.22. When a perceived threat is registered in the brain's cortex, it sends a signal to the part of the brain responsible for activating the stress response known as the a. b. c. d.

cingulate. amygdala. hippocampus. CRF. Difficulty: 2 Question ID: 8.1.22 Page Reference: 199 Topic: Symptoms of Stress Skill: Conceptual Answer: b. amygdala

8.1.23. Which of the following is known as the "stress hormone"? a. b. c. d.

adrenalin epinephrine cortisol norepinephrine

Difficulty: 2 Question ID: 8.1.23 Page Reference: 199 Topic: Symptoms of Stress Skill: Factual Answer: c. cortisol

8.1.24. What is the body's major defense against "foreign invaders" such as bacteria or viruses? a. b. c. d.

immune system pituitary gland circulatory system central nervous system Difficulty: 1 Question ID: 8.1.24 Page Reference: 199 Topic: Symptoms of Stress Skill: Factual Answer: a. immune system

8.1.25. What do we call substances such as bacteria that invade the body? a. b. c. d.

antigens allergens immuno-agents anti-fectious agents Difficulty: 1 Question ID: 8.1.25 Page Reference: 199 Topic: Symptoms of Stress Skill: Factual Answer: a. antigens

8.1.26. What are lymphocytes? a. b. c. d.

a type of white blood cell that fights antigens a category of stress hormones that are released during the fight or flight response a type of neuromodulator released in response in high levels of chronic stress a category of bacteria that invades the body when we are under a great deal of stress

Difficulty: 1 Question ID: 8.1.26 Page Reference: 199 Topic: Symptoms of Stress Skill: Factual Answer: a. a type of white blood cell that fights antigens

8.1.27. Which of the following describes the process by which stress is thought to impair immune functioning? a. b. c. d.

adrenal hormones inhibit T-cells T-cells inhibit adrenal hormones T-cells increase adrenal hormones adrenal hormones increase T-cells Difficulty: 2 Question ID: 8.1.27 Page Reference: 199 Topic: Symptoms of Stress Skill: Conceptual Answer: a. adrenal hormones inhibit T-cells

8.1.28. Which of the following represents a project that a researcher in psychoneuroimmunology might undertake? a. b. c. d.

using brain scans to estimate brain dopamine levels measuring the number of T-cells in individuals exposed to loud noise counting the number of stressors that college students encounter during registration evaluating ways to reduce stress by training individuals to use the relaxation response Difficulty: 2 Question ID: 8.1.28 Page Reference: 199 Topic: Symptoms of Stress Skill: Applied Answer: b. measuring the number of T-cells in individuals exposed to loud noise

8.1.29. Which best describes the current thinking about the stress response and the immune system? a. Short term stressors enhance the immune responses that are quick, while chronic stressors create immunosuppression. b. Chronic stressors enhance the immune responses that are long term, but short term stressors crate immunosuppression. c. Neither chronic nor short term stressors impair the immune system. d. Both chronic and short term stressors impair the immune system.

Difficulty: 3 Question ID: 8.1.29 Page Reference: 199 Topic: Symptoms of Stress Skill: Conceptual Answer: a. Short term stressors enhance the immune responses that are quick, while chronic stressors create immunosuppression.

8.1.30. After reading Hans Selye's work on the concept of stress, you are required to summarize his general views. What did he call his concept of the physiological effects of stress over time? a. b. c. d.

stress syndrome general adaptation syndrome psychoneuroimmunology general distress response Difficulty: 1 Question ID: 8.1.30 Page Reference: 200 Topic: Symptoms of Stress Skill: Factual Answer: b. general adaptation syndrome

8.1.31. What are the stages of the general adaptation syndrome (GAS)? a. b. c. d.

alertness, fight, flight alarm, resistance, exhaustion general arousal, adaptation, homeostasis emergency response, general arousal, specific arousal Difficulty: 1 Question ID: 8.1.31 Page Reference: 200-201 Topic: Symptoms of Stress Skill: Factual Answer: b. alarm, resistance, exhaustion

8.1.32. How could we describe the resistance stage of the general adaptation syndrome? a. b. c. d.

a period of physiological activation a period of physiological replenishment the individual's active decision to combat stress a period when the individual is least susceptible to stress

Difficulty: 2 Question ID: 8.1.32 Page Reference: 200-201 Topic: Symptoms of Stress Skill: Conceptual Answer: a. a period of physiological activation

8.1.33. According to Hans Selye, what is the mechanism through which stress causes physical illness? a. b. c. d.

exhaustion alarm stage resistance stage emergency response Difficulty: 2 Question ID: 8.1.33 Page Reference: 201 Topic: Symptoms of Stress Skill: Conceptual Answer: a. exhaustion

8.1.34. Which of these is the best analogy of Walter Cannon's theory of chronic stress? a. b. c. d.

a car has run out of gas and is damaged because stress keeps turning the key a car in which the engine continues to race instead of idling down after running fast the car has enough gas but the fuel line is clogged and no fuel is getting to the engine there is an electrical short in the ignition system that is making it impossible to start the car Difficulty: 3 Question ID: 8.1.34 Page Reference: 201 Topic: Symptoms of Stress Skill: Conceptual Answer: b. a car in which the engine continues to race instead of idling down after running fast

8.1.35. Which of the following is the best analogy of Han Selye's theory of chronic stress? a. b. c. d.

Difficulty: 2 Question ID: 8.1.35 Page Reference: 201 Topic: Symptoms of Stress Skill: Conceptual Answer: a. a car has run out of gas and is damaged because stress keeps turning the key

8.1.36. Health psychologists had newly married couples engage in a 30-minute discussion of marital problems. What did they find when they compared couples who were more hostile and negative with those who had more positive conversations? a. b. c. d.

Hostile interactions were associated with immunosuppression. Hostile interactions led to a higher rate of colds over the next month. Although hostile interactions raised blood pressure, it quickly returned to normal. The type of interaction had no demonstrated effect on any aspect of immune system functioning. Difficulty: 2 Question ID: 8.1.36 Page Reference: 203 Topic: Symptoms of Stress Skill: Applied Answer: a. Hostile interactions were associated with immunosuppression.

8.1.37. What is the most important distinction in types of coping that Lazarus and Folkman identified? a. b. c. d.

nonspecific vs. specific emergency vs. resistance adaptive vs. maladaptive problem-focused vs. emotion-focused Difficulty: 1 Question ID: 8.1.37 Page Reference: 201 Topic: Symptoms of Stress Skill: Factual Answer: d. problem-focused vs. emotion-focused

8.1.38. Earl works in an office where his office mate smokes. This irritates and frustrates Earl. Which of the following behaviors is an example of problem-focused coping? a. b. c. d.

putting in a filter and opening a window trying to see the office mate's point of view using relaxation techniques to feel less frustrated thinking about the problem so much it interferes with work

Difficulty: 2 Question ID: 8.1.38 Page Reference: 201 Topic: Symptoms of Stress Skill: Applied Answer: a. putting in a filter and opening a window

8.1.39. What is emotion-focused coping? a. b. c. d.

an attempt to change a stressor an attempt to alter internal distress an attempt to cause others to change their emotional responses an attempt to change physiological responses directly in order to alter emotions indirectly Difficulty: 1 Question ID: 8.1.39 Page Reference: 201 Topic: Symptoms of Stress Skill: Conceptual Answer: b. an attempt to alter internal distress

8.1.40. Andy is dealing with a situation over which he really has no control and which has no real solution; nonetheless, he still insists on trying to solve it. In this instance, his problem-focused coping will probably a. b. c. d.

reduce his distress anyway. increase, not reduce, his distress. provide him with an outlet for his frustration. make him tougher and more able to deal with future problems. Difficulty: 3 Question ID: 8.1.40 Page Reference: 201 Topic: Symptoms of Stress Skill: Applied Answer: b. increase, not reduce, his distress.

8.1.41. Shana is under a lot of stress but she is not acknowledging any anxiety and seems to be repressing unpleasant emotions. Evidence suggests that as a result Shana will probably a. b. c. d.

develop a dissociative disorder. develop an anxiety disorder. experience heightened psychophysiological reactions to stress. strengthen her positive outlook and maintain good health.

Difficulty: 2 Question ID: 8.1.41 Page Reference: 201 Topic: Symptoms of Stress Skill: Applied Answer: c. experience heightened psychophysiological reactions to stress.

8.1.42. Research studies have shown that when people are encouraged to recount very stressful experiences, they show a. b. c. d.

increased physiological distress. increased psychological distress. reductions in psychophysiological stress indicators. increases in psychophysiological stress indicators. Difficulty: 1 Question ID: 8.1.42 Page Reference: 201 Topic: Symptoms of Stress Skill: Factual Answer: c. reductions in psychophysiological stress indicators.

8.1.43. In a study of stress, what is the effect of a signal given before a rat is shocked? a. b. c. d.

The anticipation leaves the rat in a chronically stressed state. The anticipation is more stressful than if there were no warning. The signal gives the rat a sense of a lack of control over the stressor. The anticipatory response is stressful, but weaker than if there were no warning. Difficulty: 2 Question ID: 8.1.43 Page Reference: 201 Topic: Symptoms of Stress Skill: Applied Answer: d. The anticipatory response is stressful, but weaker than if there were no warning.

8.1.44. What are the two critical issues in cognitive responses to stress? a. b. c. d.

alarm and exhaustion control and predictability disclosure and anticipation specificity and nonspecificity

Difficulty: 1 Question ID: 8.1.44 Page Reference: 201 Topic: Symptoms of Stress Skill: Factual Answer: b. control and predictability

8.1.45. Consider a study in which two different groups of rats are being exposed to exactly the same amount of painful shock. One group is able to stop the shock by pressing a bar, while the other group can do nothing to stop the shock. What would you expect to happen to their stress response? a. The rats that have control will have a larger stress response. b. The rats that have control will have a smaller stress response. c. There will be no difference in stress response because the shock is equally painful for both groups. d. The painful electric shock will prevent the rats from being able to learn to press the bar. Difficulty: 2 Question ID: 8.1.45 Page Reference: 201 Topic: Symptoms of Stress Skill: Applied Answer: b. The rats that have control will have a smaller stress response.

8.1.46. While walking through an abandoned area of town, you hear a deafening alarm sounding from an empty warehouse. Under which condition is this situation hypothesized to be most stressful? a. b. c. d.

you know there is nothing you can do to stop the alarm you use emotion-focused coping before problem-focused coping you use problem-focused coping before emotion-focused coping you think you could stop the alarm if you could reach it, but you can't reach it Difficulty: 2 Question ID: 8.1.46 Page Reference: 201 Topic: Symptoms of Stress Skill: Applied Answer: d. you think you could stop the alarm if you could reach it, but you can't reach it

8.1.47. Control can actually increase stress when it is a. b. c. d.

illusory. not predictable. perceived but attempts fail. perceived and can be exercised.

Difficulty: 1 Question ID: 8.1.47 Page Reference: 201 Topic: Symptoms of Stress Skill: Factual Answer: c. perceived but attempts fail.

8.1.48. Positive psychologists define the ability to cope well with life's challenges, even stressful ones, as a. b. c. d.

immunosupport. resilience. self actualization. very rare. Difficulty: 1 Question ID: 8.1.48 Page Reference: 202 Topic: Symptoms of Stress Skill: Conceptual Answer: b. resilience.

8.1.49. A study of Latinos with arthritis found that their religion a. b. c. d.

discouraged their use of medical treatments. had no benefit for their medical problems. encouraged passive coping. encouraged active coping. Difficulty: 1 Question ID: 8.1.49 Page Reference: 202 Topic: Symptoms of Stress Skill: Factual Answer: d. encouraged active coping.

8.1.50. Which of the following would be a good title for an article in a health journal that reviews the relationship between optimism and health? a. b. c. d.

"Optimism: Much Ado about Nothing" "Optimism: A Road to Good Health" "Unexpected Finding: Pessimists Outlive Optimists" "Optimism Can Cure Heart Disease"

Difficulty: 2 Question ID: 8.1.50 Page Reference: 201 Topic: Symptoms of Stress Skill: Conceptual Answer: b. "Optimism: A Road to Good Health"

8.1.51. Optimism can have an influence on health because optimists a. b. c. d.

experience less cardiovascular reactivity. are better able to deny their distress. experience fewer stressors. have a more effective coping style. Difficulty: 1 Question ID: 8.1.51 Page Reference: 201 Topic: Symptoms of Stress Skill: Factual Answer: d. have a more effective coping style.

8.1.52. Stress can indirectly affect our health and contribute to illness by leading people to a. b. c. d.

engage in more unhealthy activities. exercise in excessive and risky ways. seek out unnecessary medical treatment. engage in more primitive fight-flight responses. Difficulty: 1 Question ID: 8.1.52 Page Reference: 203 Topic: Symptoms of Stress Skill: Factual Answer: a. engage in more unhealthy activities.

8.1.53. Which of the following is an example of how stress may cause illness indirectly? a. Stress tends to lead to premature nerve cell death. b. The hormones released during stress are the actual cause of illness, not the stress itself. c. People under a great deal of stress are less likely to engage in actions that promote good health. d. The mind of a stressed person is racing so fast that it burns energy that could be used for other purposes.

Difficulty: 2 Question ID: 8.1.53 Page Reference: 203 Topic: Symptoms of Stress Skill: Conceptual Answer: c. People under a great deal of stress are less likely to engage in actions that promote good health.

8.1.54. What are the major reasons that account for improved health and increased life expectancy over the last two centuries? a. b. c. d.

improved personal hygiene and an adequate diet stress management programs and exercise programs Web-based medical information programs and social support networks discovery of antibiotics and development of new surgical techniques Difficulty: 1 Question ID: 8.1.54 Page Reference: 203 Topic: Symptoms of Stress Skill: Factual Answer: a. improved personal hygiene and an adequate diet

8.1.55. What percentage of patients fail to fully adhere to medical advice? a. b. c. d.

less than 10 percent 25 percent 50 percent over 90 percent Difficulty: 1 Question ID: 8.1.55 Page Reference: 203 Topic: Symptoms of Stress Skill: Factual Answer: d. over 90 percent

8.1.56. As an influence on health, social support a. b. c. d.

can encourage positive health behavior. can create more adaptive immune system functioning. can encourage positive health behavior and can create more adaptive immune system functioning. can encourage positive health behavior but will tend to weaken immune system functioning.

Difficulty: 1 Question ID: 8.1.56 Page Reference: 203 Topic: Symptoms of Stress Skill: Factual Answer: c. can encourage positive health behavior and can create more adaptive immune system functioning. 8.1.57. To understand the relationship between stress and health, it is important to realize that a. b. c. d.

only certain types of stress can affect health. only chronic stress can affect health. stress can affect health and health problems can create stress. DSM-IV-TR does not include any health-related factors in its classification system. Difficulty: 1 Question ID: 8.1.57 Page Reference: 204 Topic: Symptoms of Stress Skill: Factual Answer: c. stress can affect health and health problems can create stress.

8.1.58. The DSM-IV-TR does not distinguish “____________ disorders” from other physical illnesses. a. b. c. d.

personality stress psychosomatic hypochondriacally Difficulty: 1 Question ID: 8.1.58 Page Reference: 204 Topic: Diagnosis of Stress and Physical Illness Skill: Factual Answer: c. psychosomatic

8.1.59. In the past year, Alice's mother and two friends died. Because she has been laid off several times, Alice has moved and currently lives in an unsafe neighborhood. The medical clinic has diagnosed her as hypertensive. They have put her on medication and also referred her to a therapist at the mental health clinic. After an assessment at the clinic, the psychologist's diagnosis should contain entries on which DSM axes? a. b. c. d.

I and II I, IV and V III and IV II and III Difficulty: 2

Question ID: 8.1.59 Page Reference: 204 Topic: Diagnosis of Stress and Physical Illness Skill: Applied Answer: c. III and IV

8.1.60. Why were ratings of the amount of stress in earlier versions of DSM abandoned in DSM-IV? a. b. c. d.

The ratings were not reliable. The list of possible stressors was too long. The guidelines for ratings were too detailed. The number of stressors is more important than the severity. Difficulty: 2 Question ID: 8.1.60 Page Reference: 204 Topic: Diagnosis of Stress and Physical Illness Skill: Factual Answer: a. The ratings were not reliable.

8.1.61. In the United States in the early 20th century the most common forms of disease were a. b. c. d.

stress related diseases. life style related diseases. infectious diseases. cancers. Difficulty: 1 Question ID: 8.1.61 Page Reference: 204 Topic: Psychological Factors and Some Familiar Illnesses Skill: Factual Answer: c. infectious diseases.

8.1.62. At the start of the 21st century the most common forms of disease in the United States were a. b. c. d.

lifestyle diseases. infectious diseases. cancers. drug addiction diseases.

Difficulty: 1

Question ID: 8.1.62 Page Reference: 204 Topic: Psychological Factors and Some Familiar Illnesses Skill: Factual Answer: a. lifestyle diseases.

8.1.63. To a health psychologist, what interesting observation can be made when you compare the top 10 causes of death in the United States in 1900 and 2000? a. b. c. d.

The leading causes of death today are lifestyle diseases. Infectious diseases continue to be the major causes. There has been little change over almost 100 years. Homicide and suicide cause almost as many deaths as cancer. Difficulty: 2 Question ID: 8.1.63 Page Reference: 204 Topic: Psychological Factors and Some Familiar Illnesses Skill: Conceptual Answer: a. The leading causes of death today are lifestyle diseases.

8.1.64. What is the leading cause of death in the United States? a. b. c. d.

cancer violence accidents heart disease Difficulty: 1 Question ID: 8.1.64 Page Reference: 204 Topic: Psychological Factors and Some Familiar Illnesses Skill: Factual Answer: d. heart disease

8.1.65. Which types of laboratory rats are least likely to reject the start of cancerous tumors? a. b. c. d.

those exposed to shock that they have to figure out how to escape from those exposed to the stress of inescapable shock those who observe siblings exposed to shock those who have no experience of shock

Difficulty: 2

Question ID: 8.1.65 Page Reference: 205 Topic: Psychological Factors and Some Familiar Illnesses Skill: Conceptual Answer: b. those exposed to the stress of inescapable shock 8.1.66. Jane has been diagnosed as suffering from cancer; her prognosis is not good and she needs to decide about her treatment. One of the options that she is considering joining a support group. What does the evidence suggest about these groups? a. Cancer does not respond to such treatments. b. Although the mechanisms are not clear, such groups are associated with lower death rates. c. Such self-help groups have developed in order to prepare people to die with greater dignity. d. The social support that such groups provide has a positive effect on psychological well-being, but no documented effect on physical aspects of cancer. Difficulty: 2 Question ID: 8.1.66 Page Reference: 205 Topic: Psychological Factors and Some Familiar Illnesses Skill: Applied Answer: b. Although the mechanisms are not clear, such groups are associated with lower death rates. 8.1.67. Your instructor asks one of the students to look up AIDS in a medical textbook. What chapter should the student read to obtain the needed information? a. b. c. d.

immune system nervous system respiratory system circulatory system Difficulty: 1 Question ID: 8.1.67 Page Reference: 205 Topic: Psychological Factors and Some Familiar Illnesses Skill: Applied Answer: a. immune system

8.1.68. Which group has the highest rate of new cases of HIV infection in the United States? a. b. c. d.

individuals who participate in high-risk heterosexual sexual intercourse homosexual women who engage in high risk homosexual intercourse heterosexual males in general IV drug users

Difficulty: 1

Question ID: 8.1.68 Page Reference: 206 Topic: Psychological Factors and Some Familiar Illnesses Skill: Factual Answer: a. individuals who participate in high-risk heterosexual sexual intercourse

8.1.69. Which of the following has been linked directly to an increase in the rate of progression of HIV? a. b. c. d.

SES age of onset sexual preference of patient stress Difficulty: 1 Question ID: 8.1.69 Page Reference: 206 Topic: Psychological Factors and Some Familiar Illnesses Skill: Conceptual Answer: d. stress

8.1.70. Research indicates that psychological interventions, such as support groups for people with HIV/AIDS a. b. c. d.

have significantly lowered the death rate. do not necessarily have any physical benefit but can lower distress. have been effective only for some groups within the population. lead people to put less emphasis on taking appropriate preventive measures. Difficulty: 2 Question ID: 8.1.70 Page Reference: 206 Topic: Psychological Factors and Some Familiar Illnesses Skill: Factual Answer: b. do not necessarily have any physical benefit but can lower distress.

8.1.71. Transmission of HIV always involves contact with a. b. c. d.

bodily fluids. dirty needles. sexual secretions. sexual partners.

Difficulty: 1

Question ID: 8.1.71 Page Reference: 206 Topic: Psychological Factors and Some Familiar Illnesses Skill: Conceptual Answer: a. bodily fluids. 8.1.72. Researchers have discovered an association between depression/anxiety and pain. How do they explain this association? a. People who are prone to anxiety and depression have lower levels of endogenous opioids. b. Anxious and depressed people are more sensitive to pain and less able to cope with it. c. Anxious and depressed people are more likely to become involved in accidents as a result of high levels of distractibility. d. People who are anxious and/or depressed have learned that reporting pain symptoms is a prime means of gaining attention from friends and relatives. Difficulty: 1 Question ID: 8.1.72 Page Reference: 206 Topic: Psychological Factors and Some Familiar Illnesses Skill: Factual Answer: b. Anxious and depressed people are more sensitive to pain and less able to cope with it. 8.1.73. Psychologists have used a variety of techniques to treat pain; these techniques include hypnosis, biofeedback, relaxation training, and cognitive therapy. What has research demonstrated concerning the effectiveness of these treatments for pain? a. b. c. d.

None of the techniques has any notable effect. Cognitive therapy is the most effective treatment. All the techniques reduce pain, but only modestly. The combination of cognitive therapy and relaxation training has led to high rates of success. Difficulty: 2 Question ID: 8.1.73 Page Reference: 206 Topic: Psychological Factors and Some Familiar Illnesses Skill: Applied Answer: c. All the techniques reduce pain, but only modestly.

8.1.74. Rebecca is suffering from recurrent chronic pain; she is referred to a psychologist who talks in terms of pain management. What can Rebecca expect when the psychologist begins treatment? a. hypnosis will be used to help the client forget about the pain b. efforts to help her cope in ways that minimize the pain's impact on her life c. a psychoanalytic approach will delve into the unconscious roots of the pain d. a variety of drugs will be mixed to reduce the pain to the lowest level possible, without causing severe side effects

Difficulty: 1 Question ID: 8.1.74 Page Reference: 206 Topic: Psychological Factors and Some Familiar Illnesses Skill: Applied Answer: b. efforts to help her cope in ways that minimize the pain's impact on her life

8.1.75. What are the two major categories of sleep disorders in DSM? a. b. c. d.

dyssomnias and parasomnias hypersomnia and hyposomnia circadian rhythm disorders and REM disorders sleep onset disorders and sleep maintenance disorders Difficulty: 2 Question ID: 8.1.75 Page Reference: 207 Topic: Psychological Factors and Some Familiar Illnesses Skill: Factual Answer: a. dyssomnias and parasomnias

8.1.76. Your uncle returns home after visiting a sleep clinic. He says the sleep specialists diagnosed him as suffering from narcolepsy. Which of the following sets of symptoms probably led to his decision to seek an evaluation at the sleep clinic? a. b. c. d.

loud snoring and violent leg movements during sleep early morning waking and an inability to get back to sleep irresistible sleep attacks and sudden loss of muscle tone for brief period of time inability to breathe and sleep at the same time and difficulty getting to sleep Difficulty: 1 Question ID: 8.1.76 Page Reference: 207 Topic: Psychological Factors and Some Familiar Illnesses Skill: Conceptual Answer: c. irresistible sleep attacks and sudden loss of muscle tone for brief period of time

8.1.77. Mary just experienced a nightmare and Alice experienced a sleep terror. What is one way to distinguish what these two people experienced? a. b. c. d.

Alice had no memory of the events. Mary was sleepwalking during the episode. Mary had a higher rate of arousal during the nightmare. Alice experienced insomnia at the beginning of the night.

Difficulty: 2 Question ID: 8.1.77 Page Reference: 208 Topic: Psychological Factors and Some Familiar Illnesses Skill: Conceptual Answer: a. Alice had no memory of the events.

8.1.78. A patient being prepared to sleep in the sleep laboratory is believed to suffer from sleep apnea. You have been given permission to observe this evening. What do you expect to observe? a. b. c. d.

loud snoring, gasping, and body movements loud screams, heightened arousal, and violent outbursts difficulty getting to sleep, strong leg movements, and screaming rigid body posture during sleep, punctuated by episodes of heightened physiological arousal Difficulty: 2 Question ID: 8.1.78 Page Reference: 208 Topic: Psychological Factors and Some Familiar Illnesses Skill: Applied Answer: a. loud snoring, gasping, and body movements

8.1.79. Your text devotes considerable coverage to cardiovascular disease (CVD) because a. b. c. d.

it is the disease most subject to psychological influences. it is the number one killer in the United States today. it is more easily studied than other diseases. people are more willing to seek help for CVD than for other diseases. Difficulty: 1 Question ID: 8.1.79 Page Reference: 208 Topic: Cardiovascular Disease Skill: Factual Answer: b. it is the number one killer in the United States today.

8.1.80. Why is hypertension often called the silent killer? a. It has a strong genetic link. b. It produces no obvious symptoms. c. It is not currently a focus of research efforts. d. It results from the use of convenience foods and reliance on modern conveniences that reduce opportunities for exercise. Difficulty: 1

Question ID: 8.1.80 Page Reference: 208 Topic: Cardiovascular Disease Skill: Factual Answer: b. It produces no obvious symptoms.

8.1.81. Determining that someone suffers from hypertension depends on which of the following two measures? a. b. c. d.

systolic and diastolic blood pressure sympathetic and parasympathetic blood pressure self reports of tension and psychophysiological measures of heart rate self reports of tension and objective behavior ratings by skilled observers Difficulty: 1 Question ID: 8.1.81 Page Reference: 209 Topic: Cardiovascular Disease Skill: Factual Answer: a. systolic and diastolic blood pressure

8.1.82. Which of the following is a major concern of behavioral medicine and health psychology? a. b. c. d.

systolic hypertension secondary hypertension essential hypertension diastolic hypertension Difficulty: 2 Question ID: 8.1.82 Page Reference: 208-209 Topic: Cardiovascular Disease Skill: Conceptual Answer: c. essential hypertension

8.1.83. Which of these individuals is most likely to experience coronary heart disease? a. b. c. d.

a 40-year-old man from an upper socioeconomic group a 60-year-old man from a lower socioeconomic group a 45-year-old woman from a lower socioeconomic group a 50-year-old woman from an upper socioeconomic group

Difficulty: 2

Question ID: 8.1.83 Page Reference: 209 Topic: Cardiovascular Disease Skill: Conceptual Answer: b. a 60-year-old man from a lower socioeconomic group

8.1.84. Which of the following illustrates the relationship between stress and cardiovascular disease? a. b. c. d.

Stress is associated with thinned artery walls. Over the long run, stress can damage the heart. Type B personality is associated with higher blood pressure. Stress causes people to focus on the warning signs of heart attack. Difficulty: 1 Question ID: 8.1.84 Page Reference: 209 Topic: Cardiovascular Disease Skill: Conceptual Answer: b. Over the long run, stress can damage the heart.

8.1.85. An individual is connected to physiological measuring devices for blood pressure and heart rate. Which of the following circumstances would enable us to collect information that could reveal the individual's heightened risk for heart disease? a. b. c. d.

during REM sleep while watching television while watching a movie about war while trying to solve a difficult problem Difficulty: 3 Question ID: 8.1.85 Page Reference: 210 Topic: Cardiovascular Disease Skill: Applied Answer: d. while solving a difficult problem

8.1.86. Which of the following situations describes a job that is the most stressful? a. b. c. d.

low decisional control with low psychological demands low decisional control with high psychological demands high decisional control with low psychological demands high decisional control with high psychological demands

Difficulty: 2

Question ID: 8.1.86 Page Reference: 210-211 Topic: Cardiovascular Disease Skill: Conceptual Answer: b. low decisional control with high psychological demands

8.1.87. In developing prevention programs with the goal of reducing heart disease in women, which type of women should the health department target especially? a. b. c. d.

employed women homemakers employed women with children homemakers with children Difficulty: 2 Question ID: 8.1.87 Page Reference: 211 Topic: Cardiovascular Disease Skill: Applied Answer: c. employed women with children

8.1.88. A research design that involves studying people repeatedly over time is called a. b. c. d.

sagittal. horizontal. cross-sectional. longitudinal. Difficulty: 2 Question ID: 8.1.88 Page Reference: 212 Topic: Cardiovascular Disease Skill: Conceptual Answer: d. longitudinal.

8.1.89. In assessing your patients for risk of heart disease, which of these characteristics of Type A behavior would you be most concerned about should they be seen in your assessment? a. b. c. d.

anxiety hostility impatience achievement orientation

Difficulty: 1

Question ID: 8.1.89 Page Reference: 211 Topic: Cardiovascular Disease Skill: Applied Answer: b. hostility

8.1.90. The new boss is supposed to be on the job today. The word is that he is a "real Type A." Because you are not sure what this means, you ask a fellow worker. She tells you to expect the new boss to be a. b. c. d.

shy and anxious. sociable and responsible. humorless and unassertive. impatient and competitive. Difficulty: 2 Question ID: 8.1.90 Page Reference: 211 Topic: Cardiovascular Disease Skill: Applied Answer: d. impatient and competitive.

8.1.91. Marvin has answered "Yes" to the following question: "Have you felt so sad, discouraged, hopeless or had so many problems that you wondered if anything is worthwhile." What can we say about Marvin's risk for coronary heart disease (CHD)? a. b. c. d.

He is depressed but not more likely to suffer CHD. He is twice as likely to suffer CHD. He is no more likely to suffer CHD but more likely to die from it. He is five times more likely to suffer CHD. Difficulty: 2 Question ID: 8.1.91 Page Reference: 212 Topic: Cardiovascular Disease Skill: Conceptual Answer: b. He is twice as likely to suffer CHD.

8.1.92. Which of the following is a benefit of longitudinal research? a. b. c. d.

provides systematic control of stress costs less than cross-sectional research allows one to rule out reverse causality easier to conduct than cross-sectional research Difficulty: 2

Question ID: 8.1.92 Page Reference: 212 Topic: Cardiovascular Disease Skill: Conceptual Answer: c. allows one to rule out reverse causality

8.1.93. In longitudinal studies, prospective designs are preferred to retrospective designs because a. b. c. d.

it is easier to follow subjects forward in time than backward in time. retrospective studies are limited by distorted memories. only prospective designs can rule out reverse causality. prospective designs can be conducted more quickly. Difficulty: 1 Question ID: 8.1.93 Page Reference: 212 Topic: Cardiovascular Disease Skill: Conceptual Answer: b. retrospective studies are limited by distorted memories.

8.1.94. Social ecology refers to a. b. c. d.

teaching people about pollution in the environment. how behaviors such as smoking contribute to pollution. relationships between the individual and the social world. maintaining a group of close friends for social support. Difficulty: 1 Question ID: 8.1.94 Page Reference: 213 Topic: Cardiovascular Disease Skill: Factual Answer: c. relationships between the individual and the social world.

8.1.95. Which of the following is an example of a primary prevention effort to reduce cardiovascular disease? a. b. c. d.

biofeedback about blood pressure stress management for Type A behavior anti-smoking advertising for children smoking cessation programs for cardiac patients

Difficulty: 1

Question ID: 8.1.95 Page Reference: 213 Topic: Cardiovascular Disease Skill: Applied Answer: c. anti-smoking advertising for children

8.1.96. Biofeedback uses laboratory equipment to a. b. c. d.

lower blood pressure through relaxation training. provide relaxing stimuli to decrease blood pressure. help the patient focus less on physiological processes. provide information about physical processes that are usually outside of awareness. Difficulty: 1 Question ID: 8.1.96 Page Reference: 214 Topic: Cardiovascular Disease Skill: Factual Answer: d. provide information about physical processes that are usually outside of awareness.

8.1.97. Relaxation training for patients with high blood pressure is an example of a. b. c. d.

treatment of coronary heart disease. primary prevention of coronary heart disease. tertiary prevention of coronary heart disease. secondary prevention of coronary heart disease. Difficulty: 2 Question ID: 8.1.97 Page Reference: 214 Topic: Cardiovascular Disease Skill: Conceptual Answer: d. secondary prevention of coronary heart disease.

8.1.98. Carol suffers from coronary heart disease and is trying to decide between stress management and antihypertensive medication. Based on current research findings, how would you advise her? a. b. c. d.

Stress management will provide her with greater benefit. Stress management might be a useful adjunct to medication. There is no evidence that stress management works. Stress management is better because it has fewer side-effects.

Difficulty: 1

Question ID: 8.1.98 Page Reference: 214 Topic: Cardiovascular Disease Skill: Applied Answer: b. Stress management might be a useful adjunct to medication.

8.1.99. Findings from the Trials of Hypertension Prevention (TOHP) suggest that the most important factor in lowering high blood pressure is a. b. c. d.

anger management. stress management. weight loss. appropriate dietary supplements. Difficulty: 2 Question ID: 8.1.99 Page Reference: 215 Topic: Cardiovascular Disease Skill: Conceptual Answer: c. weight loss.

8.1.100. In designing a public health prevention program you are targeting a group that already has the problem you are aiming to prevent. Your program is called what type of prevention program? a. b. c. d.

primary secondary tertiary It is not a prevention program. Difficulty: 1 Question ID: 8.1.100 Page Reference: 215 Topic: Cardiovascular Disease Skill: Factual Answer: c. tertiary

8.1.101. In a prevention program aimed at Type-A behavior a therapist acts out less hostile responses to frustration in a procedure called a. b. c. d.

acting out group therapy acting intervention role playing

Difficulty: 1

Question ID: 8.1.101 Page Reference: 215 Topic: Cardiovascular Disease Skill: Factual Answer: d. role playing

Short Answer 8.2.102. Lazarus defines our assessment of our abilities and resources for coping with that event as __________ appraisal. Difficulty: 1 Question ID: 8.2.102 Page Reference: 198 Topic: Defining Stress Skill: Factual Answer: a. secondary

8.2.103. The region of the brain that is considered to be the principal mediator of the stress response is called the __________ . Difficulty: 2 Question ID: 8.2.103 Page Reference: 199-200 Topic: Symptoms of Stress Skill: Factual Answer: a. amygdala

8.2.104. Taylor has suggested that fight or flight may be a predominantly male response to stressful stimuli and that females may be more likely to __________ and _________ . Difficulty: 2 Question ID: 8.2.104 Page Reference: 199 Topic: Symptoms of Stress Skill: Factual Answer: tend; befriend

8.2.105. Canon proposed that the body has a natural tendency to return to a steady state of normal functioning that he termed _________ . Difficulty: 2 Question ID: 8.2.105 Page Reference: 199 Topic: Symptoms of Stress Skill: Factual Answer: a. homeostasis

8.2.106. The DSM-IV-TR has a separate axis for coding stressors, axis _________ . Difficulty: 2 Question ID: 8.2.106 Page Reference: 204 Topic: Diagnosis of Stress and Physical Illness Skill: Factual Answer: a. IV

8.2.107. Excessive sleepiness accompanied by prolonged daytime sleep is diagnosed as primary __________ . Difficulty: 2 Question ID: 8.2.107 Page Reference: 207 Topic: Psychological Factors and Some Familiar Illnesses Skill: Factual Answer: a. hypersomnia

8.2.108. A mismatch between an individual's 24-hour sleep cycle and their 24-hour life demands is known as __________ rhythm sleep disorder.

Difficulty: 2 Question ID: 8.2.108 Page Reference: 207 Topic: Psychological Factors and Some Familiar Illnesses Skill: Factual Answer: a. circadian

8.2.109. A more technical term for a heart attack is __________ __________ .

Difficulty: 3 Question ID: 8.2.109 Page Reference: 196, 208 Topic: Cardiovascular Disease Skill: Factual Answer: a. myocardial infarction

8.2.110. When high blood pressure is the principal or only disorder, the diagnosis is __________ hypertension. Difficulty: 1 Question ID: 8.2.110 Page Reference: 209 Topic: Cardiovascular Disease Skill: Factual Answer: a. essential

8.2.111. A study that looks at a group of people periodically over a period of time is known as a __________ study. Difficulty: 1 Question ID: 8.2.111 Page Reference: 212 Topic: Cardiovascular Disease Skill: Factual Answer: a. longitudinal

8.2.112. A study that looks at a group of people at one point in time is known as a __________ __________ study.

Difficulty: 1 Question ID: 8.2.112 Page Reference: 212 Topic: Cardiovascular Disease Skill: Factual Answer: cross sectional

Essay 8.3.113. What is the difference between primary appraisal and secondary appraisal? Difficulty: 2 Question ID: 8.3.113 Page Reference: 198 Topic: Defining Stress Skill: Conceptual Answer: Primary appraisal is the cognitive evaluation of the challenge, threat, or harm posed by a particular event. According to Richard Lazarus, any given life event is a stressor only when it is considered stressful by the individual. Secondary appraisal is the assessment of one's ability and resources for coping with a difficult event.

8.3.114. Explain the difference between Walter Cannon's idea of the link between stress and physical disease and Hans Selye's idea of the link between stress and physical disease. Difficulty: 2 Question ID: 8.3.114 Page Reference: 198-200 Topic: Symptoms of Stress Skill: Conceptual Answer: Selye saw exhaustion as the link: after prolonged stress, the body can no longer respond appropriately and is subsequently damaged. Cannon saw chronic arousal as the link: experiencing "fight or flight" arousal, without being able to fight or flee, causes prolonged arousal of the sympathetic nervous system, which in turn causes physical damage to the body.

8.3.115. Describe the difference between emotion-focused coping and problem-focused coping. Difficulty: 1 Question ID: 8.3.115 Page Reference: 201 Topic: Symptoms of Stress Skill: Conceptual Answer: Lazarus and Folkman suggested two general methods or strategies for coping with stress. Problem-focused coping involves attempts to change a stressor. If your living conditions are stressful, you look for new ones. Problem-focused methods involve trying to find ways to alter your external circumstances. Emotion-focused coping is an attempt to alter your own internal distress. Before taking a big exam, you sit quietly and breathe deeply to calm yourself. In general with an emotionfocused coping style you learn how to alter your own internal responses to the inevitable stressors involved in day to day living. Clearly if you had some facility with both methods you would have a better chance of coping.

8.3.116. What is health behavior and how are such behaviors related to illness? Difficulty: 2 Question ID: 8.3.116 Page Reference: 203-204 Topic: Symptoms of Stress Skill: Conceptual Answer: Health behavior involves activities that promote good health, and it includes both positive actions like eating, sleeping, and exercising adequately and the avoidance of unhealthy activities such as cigarette smoking, excessive alcohol consumption, and drug use. Stress can lead people to engage in less positive and more negative health behavior, and these poor health habits, and not stress, per se, may be responsible for much of the relationship between stress and illness.

8.3.117. Discuss the relationship between stress, health behavior, and cancer. Difficulty: 2 Question ID: 8.3.117 Page Reference: 204 Topic: Psychological Factors and Some Familiar Illnesses Skill: Conceptual Answer: While clearly cancer is a biological disorder with genetic and physiological causes, there are still links between this disease and behavior and stress. For starters, the major preventable cause of cancer in the United States is a voluntary behavior, smoking. Once someone has developed this disorder there are also emotional and behavioral components. Having cancer can be both anxiety provoking and depressing. Both of these mental disorders can lead to behavior that is unhealthy. Alcohol is used as a way of avoiding both of these mood disorders and alcohol can get in the way of health behavior such as exercise and diet. Social support can contribute to healthy behavior, medication and treatment compliance, and general reduced stress. We know from animal studies that mammals exposed to inescapable stress are less able to mount an immune system defense against cancer and that stress can be a direct cause of immunosuppression. In human studies participation in support groups has been shown to increase survival rates following cancer treatment.

8.3.118. What are the major demographic risk factors for the development of coronary heart disease (CHD)? Difficulty: 2 Question ID: 8.3.118 Page Reference: 207 Topic: Cardiovascular Disease Skill: Conceptual Answer: (1) gender: men are twice as likely to suffer from CHD as women; (2) age: for men, risk increases linearly with increasing age after 40; for women, risk accelerates more slowly until they reach menopause and increases sharply thereafter; (3) socioeconomic status: rates are higher for low-income groups; (4) family history: a positive family history is linked to CHD risk.

8.3.119. Describe the concept of Type A behavior and how it is measured. What does research show concerning the relationship between Type A and cardiovascular disease? Difficulty: 2 Question ID: 8.3.119 Page Reference: 209-210 Topic: Cardiovascular Disease Skill: Conceptual Answer: Type A behavior is characterized as an urgent, hostile, competitive, impatient, and achievement oriented style of responding to challenges. In contrast, the Type B individual is calm and content. Two cardiologists, Meyer Friedman and Ray Rosenman, developed a structured interview to measure Type A behavior. The interview asks about the individual's achievement striving, urgency, and hostility but also provokes those very behaviors in the context of a high-stress interview. The classification of Type A behavior has predicted CHD in several prospective studies; however, other studies have failed to support these findings. Researchers now suggest that only one certain element of Type A behavior increases risk for CHD, and that element is hostility.

8.3.120. Give examples of the primary, secondary, and tertiary prevention of cardiovascular disease. Difficulty: 2 Question ID: 8.3.120 Page Reference: 213-215 Topic: Cardiovascular Disease Skill: Conceptual Answer: Primary: public service programs that encourage people to quit smoking, eat well, exercise, monitor their blood pressure, and otherwise improve their health. Secondary: The treatment of hypertension is one of the most important attempts at the secondary prevention of CHD. These attempts fall into two categories: improving health behavior and stress management programs. Tertiary: These programs target those who have already had a cardiac event. Exercise programs are probably the most common treatment recommended for cardiac patients. Interventions aimed at reducing Type A behavior have also been used. These programs include role playing to teach patients how to respond to stressful interactions with reduced hostility.

Chapter 9 Personality Disorders Total Assessment Guide (T.A.G.)

Diagnosis pp. 224-230

Question Type Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice

Frequency pp. 230-232

Short Answer Essay Multiple Choice

Topic Overview pp. 218-221

Symptoms pp. 221-224

Schizotypal Personality pp. 232-236 Borderline Personality Disorder pp. 236-240 Antisocial Personality Disorder pp. 240-244

Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay

Factual 1, 2, 3

Conceptual

Applied

4, 5, 7, 8, 11

6, 9, 10, 12

116 13, 14, 16, 20

105, 115 15, 17, 19 106 21, 22, 26, 27, 32, 39, 41, 47, 48

117 23, 28, 30, 31, 33, 35, 37, 40, 43, 44, 46

24, 25, 29, 34, 36, 38, 42, 45

118 54, 56, 60, 61, 62, 63, 66, 71

58, 59, 67

107, 108 49, 50, 51, 52, 53, 55, 57, 64, 65, 68, 69, 70 110

109 119, 120

72, 73, 74, 75

111 77, 78, 83

79, 81, 84, 86

112

113 121 89, 90, 91, 93, 94, 97, 98, 100, 101

88, 95, 96, 103 114

122, 123

80, 82, 85, 87

92, 99, 102, 104

Chapter 9: Personality Disorders Multiple Choice 9.1.1.

In the DSM-IV-TR system of diagnosis, personality disorders are listed on Axis

a. b. c. d.

I. II. III. IV. Difficulty: 1 Question ID: 9.1.1 Page Reference: 219 Topic: Overview Skill: Factual Answer: b. II.

9.1.2.

To meet the definition of personality disorders in DSM-IV-TR, one must meet the criteria of

a. b. c. d.

personality traits never seen in normal people. an enduring pattern of behavior that differs considerably from one's culture. the presence of emotional symptoms that make one aggressive. the presence of psychotic symptoms. Difficulty: 2 Question ID: 9.1.2 Page Reference: 219 Topic: Overview Skill: Factual Answer: b. an enduring pattern of behavior that differs considerably from one's culture.

9.1.3.

People diagnosed with a personality disorder exhibit behavior that is described as

a. b. c. d.

clustered and psychotic. inflexible and pervasive. acutely, not chronically problematic. more impaired than that associated with most other mental disorders. Difficulty: 1 Question ID: 9.1.3 Page Reference: 219 Topic: Overview Skill: Factual Answer: b. inflexible and pervasive.

9.1.4. A large part of the justification for defining personality disorders as mental disorders is that they involve a. b. c. d.

social dysfunction. significant personal distress. loss of contact with reality. significant risk of suicide. Difficulty: 2 Question ID: 9.1.4 Page Reference: 219 Topic: Overview Skill: Conceptual Answer: a. social dysfunction.

9.1.5.

What is one of the reasons that the category of personality disorders is controversial?

a. b. c. d.

These disorders have poorly understood etiologies. These disorders were conceptualized for insurance purposes. These disorders are not associated with social or occupational impairment. These disorders are easily learned and unlearned, and so they don't require therapy. Difficulty: 2 Question ID: 9.1.5 Page Reference: 220 Topic: Overview Skill: Conceptual Answer: a. These disorders have poorly understood etiologies.

9.1.6. Which of the following plays an important role in justifying the inclusion of personality disorders in the DSM? a. All of these disorders have similar genetic etiologies. b. The presence of pathological personality traits in adolescence is associated with development of other mental disorders. c. All of these disorders are related to an early history of either sexual abuse or family problems. d. The personality characteristics are all reflections of either excesses or deficiencies in neurotransmitter levels. Difficulty: 2 Question ID: 9.1.6 Page Reference: 220 Topic: Overview Skill: Applied Answer: b. The presence of pathological personality traits in adolescence is associated with development of other mental disorders.

9.1.7. Mental health professionals who are actively involved in treating people with mental disorders view personality disorders as important because these disorders a. b. c. d.

are the most common mental disorders that they treat. make it easier to treat people with other mental disorders. can interfere with the treatment of disorders such as depression. are more easily defined and easier to diagnose. Difficulty: 2 Question ID: 9.1.7 Page Reference: 220 Topic: Overview Skill: Conceptual Answer: c. can interfere with the treatment of disorders such as depression.

9.1.8. What were some of the early indications that Tom (case described in the text) would one day grow up to exhibit behaviors that meet the criteria for antisocial personality disorder? a. He was often truant from school, stole items, and lied. b. He reported that he heard voices directing him to engage in actions that would cause trouble. c. His eating, sleeping, and motor behaviors were all sources of difficulty that required medical intervention. d. In order to prove that he was tough, he would deliberately engage in actions that would lead to serious physical punishment. Difficulty: 1 Question ID: 9.1.8 Page Reference: 220 Topic: Overview Skill: Conceptual Answer: a. He was often truant from school, stole items, and lied. 9.1.9. Tom's case, described in your text, illustrates which of the following characteristics of personality disorders that would allow a clinician to differentiate his disorder from other disorders that are more episodic in nature? a. b. c. d.

His problems were intense but very brief. He understood the nature for his problems and felt bad about them. His problems began early and were exhibited consistently over an extended period of time. He was able to recognize his need for help and participate actively in treatment. Difficulty: 2 Question ID: 9.1.9 Page Reference: 220 Topic: Overview Skill: Applied Answer: c. His problems began early and were exhibited consistently over an extended period of

time.

9.1.10. During a case conference, one of the staff describes a patient as experiencing an "ego-dystonic" disorder. What is the most likely description of this patient? a. b. c. d.

The client is distressed by his symptoms. The client views his symptoms as a moral failure. The client does not view himself as having a problem. The client believes he can solve his own problems without a therapist's help. Difficulty: 1 Question ID: 9.1.10 Page Reference: 221 Topic: Overview Skill: Applied Answer: a. The client is distressed by his symptoms.

9.1.11. Generally, personality disorders tend to be "ego-syntonic" in nature, which means that the patient a. b. c. d.

has other disorders as well. does not see the disorder as a problem. has tremendous insight into the problems. is distressed by and perhaps ashamed of the problem. Difficulty: 2 Question ID: 9.1.11 Page Reference: 221 Topic: Overview Skill: Conceptual Answer: b. does not see the disorder as a problem.

9.1.12. At a conference a researcher reports prevalence rates for personality disorders. Several audience members conclude that these figures are lower than those reported in the literature. During a questionand-answer period, which of the following is likely to be viewed as a reason for this discrepancy? a. The researcher relied on a psychodynamic model of the etiology of personality disorders. b. The researcher failed to consider the impact of mental retardation on the prevalence of these disorders. c. The researcher failed to obtain records of physiological functions that can often reveal otherwise hidden pathology. d. The researcher used self-report instruments to estimate prevalence of disorders seen in people with little awareness of their behavior. Difficulty: 2 Question ID: 9.1.12 Page Reference: 221 Topic: Overview Skill: Applied Answer: d. The researcher used self-report instruments to estimate prevalence of disorders seen in people with little awareness of their behavior.

9.1.13. Two of the most important motives for understanding human personality and personality disorders are a. b. c. d.

escape from reality and escape from pain. acceptance of reality and acceptance of self. affiliation and power. dependence and nurturance. Difficulty: 2 Question ID: 9.1.13 Page Reference: 221-222 Topic: Symptoms Skill: Conceptual Answer: c. affiliation and power.

9.1.14. In his perception of himself and others, Andy displays what a psychologist describes as paranoid beliefs. We can assume that Andy a. b. c. d.

is highly anxious and sees himself as weak. feels inferior and sees others as his protectors. is out of contact with reality and delusional. believes that others are trying to exploit or harm him. Difficulty: 2 Question ID: 9.1.14 Page Reference: 222 Topic: Symptoms Skill: Conceptual Answer: d. believes that others are trying to exploit or harm him.

9.1.15. Temperament refers to a. b. c. d.

anger over abandonment. insight into one's problems. remorse over doing something wrong. a characteristic style of relating to the world. Difficulty: 1 Question ID: 9.1.15 Page Reference: 222 Topic: Symptoms Skill: Factual Answer: d. a characteristic style of relating to the world.

9.1.16. Which of the following is part of the definition of a person's temperament? a. b. c. d.

emotional reactivity guilt feelings ego development personality development Difficulty: 1 Question ID: 9.1.16 Page Reference: 222 Topic: Symptoms Skill: Conceptual Answer: a. emotional reactivity

9.1.17. With regard to the number of basic dimensions of temperament and personality, experts a. b. c. d.

believe there are only four or five. believe there are at least 10. believe there are probably more than 30. disagree about how many there are. Difficulty: 1 Question ID: 9.1.17 Page Reference: 222 Topic: Symptoms Skill: Factual Answer: d. disagree about how many there are.

9.1.18. The plant manager needs to fill a newly created position. He tells the Director of Human Resources that he wants someone who is well organized, reliable, dependable, and punctual. The director intends to screen applicants using scores on the five-factor model of personality. High scores on which factor should mark applicants as having the desired characteristics? a. b. c. d.

openness neuroticism extraversion conscientiousness Difficulty: 1 Question ID: 9.1.18 Page Reference: 223 Topic: Symptoms Skill: Applied Answer: d. conscientiousness

9.1.19. In personality theory, neuroticism refers to a. b. c. d.

conscientiousness. bizarre and unusual thinking. expression of anxiety and depression. low interest in interacting with other people. Difficulty: 2 Question ID: 9.1.19 Page Reference: 223 Topic: Symptoms Skill: Factual Answer: c. expression of anxiety and depression.

9.1.20. A difficult temperament a. b. c. d.

will always be maladaptive. will always be adaptive. can be adaptive or maladaptive, depending on social circumstances. can be adaptive or maladaptive, depending on whether it is genetically determined. Difficulty: 1 Question ID: 9.1.20 Page Reference: 224 Topic: Symptoms Skill: Conceptual Answer: c. can be adaptive or maladaptive, depending on social circumstances.

9.1.21. Which of the following is not one of the clusters of personality disorders in the DSM? a. b. c. d.

anxious or fearful socially isolated, odd, or eccentric out of contact with reality and delusional excessively dramatic, emotional, or erratic Difficulty: 1 Question ID: 9.1.21 Page Reference: 224 Topic: Diagnosis Skill: Factual Answer: c. out of contact with reality and delusional

9.1.22. Which of these is one of the clusters of personality disorders in DSM-IV-TR? a. b. c. d.

dissociative odd or eccentric neurotic/mood-disordered psychotic/schizophreniform Difficulty: 1 Question ID: 9.1.22 Page Reference: 224 Topic: Diagnosis Skill: Factual Answer: b. odd or eccentric

9.1.23. What common thread runs through paranoid, schizoid, and schizotypal personality disorders? a. b. c. d.

They are commonly mistaken for schizophrenia. They typically follow a schizophrenic episode. They sometimes precede onset of full-blown schizophrenia. They are inherited disorders that often lead to dementia. Difficulty: 2 Question ID: 9.1.23 Page Reference: 224 Topic: Diagnosis Skill: Conceptual Answer: c. They sometimes precede onset of full-blown schizophrenia.

9.1.24. A patient at the mental health center talks in a vague and digressive manner. His behavior, perceptions, and dress are considered odd. However, he does not report any delusions or hallucinations. What is the most likely diagnosis? a. b. c. d.

schizoid personality disorder avoidant personality disorder borderline personality disorder schizotypal personality disorder Difficulty: 1 Question ID: 9.1.24 Page Reference: 225 Topic: Diagnosis Skill: Applied Answer: d. schizotypal personality disorder

9.1.25. A novelist wants to write a book centered on a character described as suspicious and on guard all of the time. He has difficult relationships with friends and relatives as a result of distrustful nature, overreacts to minor events that may lead to aggression, and is delusional. What advice would you give to the novelist? a. b. c. d.

The symptoms that you describe are rarely seen in adults in this country. You have captured the paranoid personality disorder except they do not have delusions. Your description does not seem to meet the criteria of any of the disorders found in the DSM. You have captured the essence of a series of disorders that tend to be comorbid and untreatable. Difficulty: 2 Question ID: 9.1.25 Page Reference: 224 Topic: Diagnosis Skill: Applied

Answer: b. You have captured the paranoid personality disorder except they do not have delusions.

9.1.26. Schizoid personality disorder is often characterized by a. b. c. d.

delirium. inappropriate suspiciousness. indifference to other people. unusual perceptual experiences. Difficulty: 1 Question ID: 9.1.26 Page Reference: 225 Topic: Diagnosis Skill: Factual Answer: c. indifference to other people.

9.1.27. Antisocial personality disorder is characterized by a. b. c. d.

psychosis. peculiar thinking. impulsive behavior. disinterest in human relationships. Difficulty: 1 Question ID: 9.1.27 Page Reference: 226 Topic: Diagnosis Skill: Factual Answer: c. impulsive behavior.

9.1.28. Instability in mood, unstable relationships, and difficulty being alone are all characteristics of a. b. c. d.

avoidant personality disorder. schizoid personality disorder. antisocial personality disorder. borderline personality disorder. Difficulty: 1 Question ID: 9.1.28 Page Reference: 226 Topic: Diagnosis Skill: Conceptual Answer: d. borderline personality disorder.

9.1.29. A movie producer wants to make a film about the life of a person with borderline personality disorder. She asks you for some suggestions concerning possible titles. Which of the following would fit the diagnostic hallmark of this disorder? a. b. c. d.

"An identity disturbance" "Overwhelmed by my superego" "Lost in my delusional world" "Only the lonely know how I feel" Difficulty: 2 Question ID: 9.1.29 Page Reference: 226 Topic: Diagnosis Skill: Applied Answer: a. "An identity disturbance"

9.1.30. Which personality disorder is characterized by excessive emotionality, attention-seeking behavior, and inappropriate seductiveness? a. b. c. d.

dependent histrionic schizotypal obsessive-compulsive Difficulty: 1 Question ID: 9.1.30 Page Reference: 227 Topic: Diagnosis Skill: Conceptual Answer: b. histrionic

9.1.31. What etiological link has been suggested between histrionic personality disorder and antisocial personality disorder? a. b. c. d.

lack of inhibition strong social ties tendency to commit suicide early parental abandonment Difficulty: 2 Question ID: 9.1.31 Page Reference: 227 Topic: Diagnosis Skill: Conceptual Answer: a. lack of inhibition

9.1.32. Narcissistic personality disorder is characterized by a a. b. c. d.

attachment to parents. need for admiration. feeling of social anxiety. intensity in close relationships. Difficulty: 2 Question ID: 9.1.32 Page Reference: 227 Topic: Diagnosis Skill: Factual Answer: b. need for admiration.

9.1.33. A film critic describes a character in a film in these words: a grandiose sense of self-importance, inability to empathize with others, a preoccupation with his own achievements and abilities. At the end of the description, the critic says the character needs therapy. If the character sought therapy, what diagnosis might be made? a. b. c. d.

dependent personality disorder borderline personality disorder schizotypal personality disorder narcissistic personality disorder Difficulty: 1 Question ID: 9.1.33 Page Reference: 227 Topic: Diagnosis Skill: Conceptual Answer: d. narcissistic personality disorder

9.1.34. At the drop of a hat, Pete will tell you in as many ways as one can imagine that he is the most talented salesperson in the company. He often boasts about his ability to "size up" customers and to close deals. He says he has not been promoted to manager because his work is not really appreciated. He resents those who have been promoted and views them as self-promoters. He expects others to meet his wishes but he is insensitive to their needs. What type of personality disorder does Pete's behavior represent? a. b. c. d.

schizoid personality disorder paranoid personality disorder borderline personality disorder narcissistic personality disorder Difficulty: 2 Question ID: 9.1.34 Page Reference: 227 Topic: Diagnosis Skill: Applied Answer: d. narcissistic personality disorder

9.1.35. Roberta has been diagnosed as having avoidant personality disorder. She is timid, does not like to go to parties, and is extremely anxious in most social situations. Why does Roberta feel this way? a. b. c. d.

She is actually disinterested in other people. She wants to be liked but is afraid of criticism. She is preoccupied with understanding social rules. She prefers to be the center of attention, and retreats from groups when that is not possible. Difficulty: 2 Question ID: 9.1.35 Page Reference: 227 Topic: Diagnosis Skill: Conceptual Answer: b. She wants to be liked but is afraid of criticism.

9.1.36. A psychologist is describing the different personality disorders. When she comes to avoidant and schizoid personality disorders, the students look puzzled. How will she distinguish these two personality disorders? a. Avoidant personality disorder has closer etiologicalties to mood disorders than schizoid personality disorder does. b. Those with schizoid personality disorder tend to become extremely dependent on others those with avoidant personality disorder manage to maintain their independence. c. Those with schizoid personality disorder prefer to be alone; those with avoidant personality want to be liked by others but are afraid of even minimal signs of disapproval. d. Those with avoidant personality disorder are not distressed by their self-induced social isolation; those with schizoid personality disorder are distressed by their lack of social skills.

Difficulty: 2 Question ID: 9.1.36 Page Reference: 227 Topic: Diagnosis Skill: Applied Answer: c. Those with schizoid personality disorder prefer to be alone; those with avoidant personality want to be liked by others but are afraid of even minimal signs of disapproval. 9.1.37. The personality disorder in which individuals are fearful of any involvement with other people and afraid of being publicly embarrassed is referred to as a. b. c. d.

paranoid personality disorder. avoidant personality disorder. borderline personality disorder. schizotypal personality disorder. Difficulty: 1 Question ID: 9.1.37 Page Reference: 227 Topic: Diagnosis Skill: Conceptual Answer: b. avoidant personality disorder.

9.1.38. Chris is a painfully shy 24-year-old woman who usually stays at home and rarely interacts with others outside of her immediate family. At work she stays away from other people, preferring to remain in the stock room as often as possible. She rarely initiates conversations at work or at home. What personality disorder does Chris seem to exhibit? a. b. c. d.

paranoid personality disorder avoidant personality disorder borderline personality disorder narcissistic personality disorder Difficulty: 2 Question ID: 9.1.38 Page Reference: 227 Topic: Diagnosis Skill: Applied Answer: b. avoidant personality disorder

9.1.39. Avoidant personality disorder overlaps most closely with a. b. c. d.

dependent personality disorder. social phobia. adaptive shyness. posttraumatic stress disorder.

Difficulty: 1 Question ID: 9.1.39 Page Reference: 227 Topic: Diagnosis Skill: Factual Answer: b. social phobia. 9.1.40. What similarity would you expect to find in the behavior of a person with dependent personality disorder and a person with avoidant personality disorder? a. b. c. d.

They avoid closeness. They are preoccupied with rules. They seek advice and reassurance. They are easily hurt by criticism. Difficulty: 2 Question ID: 9.1.40 Page Reference: 227-228 Topic: Diagnosis Skill: Conceptual Answer: d. They are easily hurt by criticism.

9.1.41. Which personality disorder is characterized by a fear of separation from others who are looked to for advice and reassurance? a. b. c. d.

paranoid dependent borderline schizotypal Difficulty: 1 Question ID: 9.1.41 Page Reference: 228 Topic: Diagnosis Skill: Factual Answer: b. dependent

9.1.42. A psychologist has developed a series of personality inventories and wants to determine if they are valid. One of the scales measures perfectionism, so he asks a colleague for advice on how to establish the validity of this scale. The colleague tells him that if he can find a sample of people with a certain personality disorder, they should obtain high scores on the scale. Which type of personality disorder should this psychologist recruit to evaluate this scale? a. b. c. d.

avoidant personality disorder histrionic personality disorder antisocial personality disorder obsessive-compulsive personality disorder

Difficulty: 2 Question ID: 9.1.42 Page Reference: 228 Topic: Diagnosis Skill: Applied Answer: d. obsessive-compulsive personality disorder

9.1.43. Unlike obsessive-compulsive personality disorder, obsessive-compulsive disorder involves a. b. c. d.

lack of guilt. excessive emotionality. dependency and advice seeking. intrusive thoughts and ritualistic behavior. Difficulty: 2 Question ID: 9.1.43 Page Reference: 228 Topic: Diagnosis Skill: Conceptual Answer: d. intrusive thoughts and ritualistic behavior.

9.1.44. Which personality disorder is most strongly related to the dimension of conscientiousness in the five-factor model of personality? a. b. c. d.

schizoid personality disorder histrionic personality disorder borderline personality disorder obsessive-compulsive personality disorder Difficulty: 1 Question ID: 9.1.44 Page Reference: 228 Topic: Diagnosis Skill: Conceptual Answer: d. obsessive-compulsive personality disorder

9.1.45. You have a client who is diagnosed with obsessive-compulsive personality disorder. As a result you would also be concerned because they are at risk of developing a. b. c. d.

schizophrenia. various mood disorders. various anxiety disorders. suicidal tendencies.

Difficulty: 2 Question ID: 9.1.45 Page Reference: 228 Topic: Diagnosis Skill: Applied Answer: c. various anxiety disorders. 9.1.46. Which of the following is a frequent complaint about the categorical approach to diagnosis in the DSM-IV-TR that could be addressed by a dimensional approach? a. b. c. d.

Many patients are misdiagnosed. The whole system is too psychoanalytic in nature. Many patients meet the criteria for more than one diagnosis. The diagnosis is confusing as they involve several axes. Difficulty: 2 Question ID: 9.1.46 Page Reference: 228-229 Topic: Diagnosis Skill: Conceptual Answer: c. Many patients meet the criteria for more than one diagnosis.

9.1.47. What is one criticism of the DSM classification of personality disorders as discrete categories rather than dimensional traits? a. Category names are arbitrary. b. A categorical approach does not explain etiology. c. The labels have created more problems than they solved. d. There are a lot of people with serious personality problems who do not fit the official DSM-IVTR subtypes. Difficulty: 1 Question ID: 9.1.47 Page Reference: 228-229 Topic: Diagnosis Skill: Factual Answer: d. There are a lot of people with serious personality problems who do not fit the official DSM-IV-TR subtypes. 9.1.48. Low levels of which two traits characterize someone like Patricia, the case of narcissistic personality disorder presented in your text? a. b. c. d.

extraversion and neuroticism openness and conscientiousness agreeableness and extraversion conscientiousness and openness

Difficulty: 1 Question ID: 9.1.48 Page Reference: 229 Topic: Diagnosis Skill: Factual Answer: c. agreeableness and extraversion

9.1.49. Epidemiologists have a difficult time pinning down the prevalence of personality disorders because a. b. c. d.

there is considerable overlap among categories in these disorders. there are too many dimensions to be measured. there is no agreement on the criteria for personality disorders. they are so rare. Difficulty: 1 Question ID: 9.1.49 Page Reference: 230 Topic: Frequency Skill: Factual Answer: a. there is considerable overlap among categories in these disorders.

9.1.50. In two large-scale epidemiological studies of mental disorders, the overall lifetime prevalence rate for antisocial personality disorder for men was a. b. c. d.

1 percent. 5 percent. 10 percent. 20 percent. Difficulty: 1 Question ID: 9.1.50 Page Reference: 230 Topic: Frequency Skill: Factual Answer: b. 5 percent

9.1.51. What percent of people who qualify for a diagnosis on Axis II also meet criteria for a syndrome such as major depression, substance dependence, or an anxiety disorder? a. b. c. d.

1 25 50 75

Difficulty: 2 Question ID: 9.1.51 Page Reference: 230 Topic: Frequency Skill: Factual Answer: d. 75

9.1.52. The personality disorder with the lowest prevalence rate is a. b. c. d.

antisocial. narcissistic. psychopathy. obsessive-compulsive. Difficulty: 2 Question ID: 9.1.52 Page Reference: 230 Topic: Frequency Skill: Factual Answer: b. narcissistic.

9.1.53. Comorbidity of personality disorders, where people meet the diagnostic criteria for more than one personality disorder, a. b. c. d.

is a rare occurrence. occurs at least half the time. occurs in almost every instance. occurs often because there is a common genetic basis. Difficulty: 2 Question ID: 9.1.53 Page Reference: 230 Topic: Frequency Skill: Factual Answer: b. occurs at least half the time.

9.1.54. Dr. Jones has just determined that his new client meets the criteria for an Axis II personality disorder. What would you tell Dr. Jones about the possibility that there is a comorbid Axis I disorder? a. Comorbid mood, anxiety, and substance use disorders are very common. b. She is only likely to find evidence of a mood disorder. c. It is unlikely that there will be an Axis I disorder. d. There might well be an Axis I disorder, but it would not have any connection to the personality disorder.

Difficulty: 2 Question ID: 9.1.54 Page Reference: 230 Topic: Frequency Skill: Conceptual Answer: a. Comorbid mood, anxiety, and substance use disorders are very common.

9.1.55. The rate of antisocial personality disorder in men and women is a. b. c. d.

equal. 5 percent for men; 2 percent for women. 5 percent for women; 1 percent for men. impossible to determine. Difficulty: 2 Question ID: 9.1.55 Page Reference: 230 Topic: Frequency Skill: Factual Answer: b. 5 percent for men; 2 percent for women.

9.1.56. In research both male and female clinicians are more likely to identify features of which personality disorder in women than in men? a. b. c. d.

schizotypal borderline antisocial psychopathic Difficulty: 2 Question ID: 9.1.56 Page Reference: 230 Topic: Frequency Skill: Conceptual Answer: b. borderline

9.1.57. What is the most common personality disorder found among persons in inpatient and outpatient treatment settings? a. b. c. d.

dependent personality disorder antisocial personality disorder borderline personality disorder schizotypal personality disorder

Difficulty: 1 Question ID: 9.1.57 Page Reference: 230 Topic: Frequency Skill: Factual Answer: c. borderline personality disorder

9.1.58. The class is reading a case history of an individual whose reaction to the death of a loved one is described. The individual writes that he hears the voice of a dead relative. The class is asked for a diagnosis and everyone agrees this is an example of dysfunctional behavior. However, when the instructor disagrees, everyone is puzzled. What aspect of this case history could have led the instructor to his opinion? a. Hearing the voices of a dead relative is a metaphor for the bereavement process. b. The experience was probably drug induced and thus would not meet the criteria for a mental disorder. c. The individual is a Native American and in their culture they expect to hear the spirit of dead relatives. d. The individual in question does not recognize that the symptoms are actually dysfunctional and thus would not seek therapy. Difficulty: 2 Question ID: 9.1.58 Page Reference: 233 Topic: Frequency Skill: Applied Answer: c. The individual is a Native American and in their culture they expect to hear the spirit of dead relatives.

9.1.59. You walk into your next class and see the following written on the board: "Differences are not disorders." You find out that the class that met in this classroom was a psychology class. What was the point of the class? a. b. c. d.

We should avoid culturally biased interpretations. The mentally ill deserve the same rights as the rest of the population. Laws restricting the ability of the mentally disabled to marry are misguided. We should not look down upon those whose level of intellectual functioning is below ours. Difficulty: 1 Question ID: 9.1.59 Page Reference: 233 Topic: Frequency Skill: Applied Answer: a. We should avoid culturally biased interpretations.

9.1.60. You are arguing with another student about whether personality disorders occur more frequently in women. What should your position be? a. b. c. d.

The overall prevalence is approximately equal. Cluster A personality disorders are more common in women. Cluster B personality disorders are more common in men. The overall prevalence is higher for men. Difficulty: 1 Question ID: 9.1.60 Page Reference: 230 Topic: Frequency Skill: Conceptual Answer: a. The overall prevalence is approximately equal.

9.1.61. One personality disorder that has a relatively high recover rate following early detection and therapy is a. b. c. d.

avoidant personality disorder. antisocial personality disorder. borderline personality disorder. schizotypal personality disorder. Difficulty: 2 Question ID: 9.1.61 Page Reference: 231 Topic: Frequency Skill: Conceptual Answer: c. borderline personality disorder.

9.1.62. Some critics contend that certain personality disorder diagnoses are sexist labels and propose that it is easier to diagnose women with personality disorders. What tentative conclusion has been reached in research on this issue? a. The DSM criteria do not make it easier to make such diagnoses of women. b. Although DSM is a non-sexist document, personality disorders are still diagnosed more frequently among women than among men. c. Although every effort was made to make DSM a non-sexist document, there is strong evidence of sexist bias in actual diagnoses. d. According to DSM criteria, it takes fewer criteria to diagnose females than males with the same personality disorder. Difficulty: 1 Question ID: 9.1.62 Page Reference: 231 Topic: Frequency Skill: Conceptual Answer: a. The DSM criteria do not make it easier to make such diagnoses of women.

9.1.63. What types of mental health workers are more likely to diagnose women with borderline personality disorder than men? a. b. c. d.

Men are more likely to diagnose BPD in women. Women are more likely to diagnose BPD in women. Men and women are both prone to this bias. Psychiatrists are more likely than psychologists to do this. Difficulty: 1 Question ID: 9.1.63 Page Reference: 231 Topic: Frequency Skill: Conceptual Answer: c. Men and women are both prone to this bias.

9.1.64. What personality disorder in adulthood is predicted by conduct disorder in childhood? a. b. c. d.

avoidant personality disorder antisocial personality disorder schizotypal personality disorder narcissistic personality disorder Difficulty: 1 Question ID: 9.1.64 Page Reference: 231 Topic: Frequency Skill: Factual Answer: b. antisocial personality disorder

9.1.65. Based on a longitudinal study conducted by Lee Robins, what was one factor that predicted which boys would receive a diagnosis of antisocial personality disorder in adulthood? a. b. c. d.

history of child abuse sibling with a criminal record extremely harsh punishment from parents history of theft or aggressive behavior Difficulty: 2 Question ID: 9.1.65 Page Reference: 231 Topic: Frequency Skill: Factual Answer: d. history of theft or aggressive behavior

9.1.66. What did Cohen and colleagues find when they surveyed adolescents to study the prevalence of personality disorders? a. b. c. later. d.

Personality disorders were almost non-existent. The most common personality disorder in the sample was antisocial personality disorder. Fewer than half the adolescents who originally met the diagnostic criteria still did so two years If strictly applied, the criteria would lead to a diagnosis for almost every adolescent in the sample. Difficulty: 2 Question ID: 9.1.66 Page Reference: 231 Topic: Frequency Skill: Conceptual

Answer: c. Fewer than half the adolescents who originally met the diagnostic criteria still did so two years later.

9.1.67. A newspaper reporter is given the job of reporting on the survey of adolescents designed to determine the prevalence and stability of personality disorders. Which of the following would be the best headline for the story? a. b. c. d.

Adolescents' Personality Disorders: Rare and Not Stable Adolescents' Personality Disorders: Not Rare and Not So Stable Do All Adolescents Meet the Criteria for Personality Disorders? Adolescence: A Period of Stress Causes A High Rate of Personality Disorders Difficulty: 1 Question ID: 9.1.67 Page Reference: 231 Topic: Frequency Skill: Applied Answer: b. Adolescents' Personality Disorders: Not Rare and Not So Stable

9.1.68. Which personality disorders are associated with the poorest long-term prognosis? a. b. c. d.

paranoid and antisocial schizotypal and borderline disorders borderline and histrionic antisocial and avoidant Difficulty: 1 Question ID: 9.1.68 Page Reference: 231 Topic: Frequency Skill: Factual Answer: b. schizotypal and borderline disorders

9.1.69. Minority groups and recent immigrants’ realistic concerns about oppression could be misinterpreted and lead clinicians to make an incorrect diagnosis of a. b. c. d.

paranoid personality disorder. schizoid personality disorder. borderline personality disorder. narcissistic personality disorder. Difficulty: 1 Question ID: 9.1.69 Page Reference: 232 Topic: Frequency Skill: Factual Answer: a. paranoid personality disorder.

9.1.70. What is DSM's position regarding the role of culture in the diagnosis of personality disorders? a. b. c. d.

Cultural standards for appropriate behavior are not taken into account. Cultural standards for appropriate behavior must be taken into account. The criteria for personality disorders are culturally universal. Cultural standards are only taken into account for Cluster C disorders. Difficulty: 1 Question ID: 9.1.70 Page Reference: 232 Topic: Frequency Skill: Factual Answer: b. Cultural standards for appropriate behavior must be taken into account.

9.1.71. Making cross-cultural comparisons to determine how rates of personality disorders might differ around the world is difficult because a. b. c. d.

personality disorders do not exist in most cultures. researchers from one culture might misinterpret the differences they find in other cultures. There is not enough variability between cultures to make valid comparisons. the rates do not vary very much. Difficulty: 2 Question ID: 9.1.71 Page Reference: 232 Topic: Frequency Skill: Conceptual

Answer: b. researchers from one culture might misinterpret the differences they find in other cultures.

9.1.72. What did the term schizotypal originally mean? a. b. c. d.

an abbreviation for schizophrenic phenotype an abbreviation for schizophrenic subtype that is not specified in the DSM a term coined to describe a form of schizophrenia that is induced by a virus a term coined to describe a set of symptoms that occur in reaction to environmental stress Difficulty: 1 Question ID: 9.1.72 Page Reference: 234 Topic: Schizotypal Personality Skill: Factual Answer: a. an abbreviation for schizophrenic phenotype

9.1.73. What have family studies of the first-degree relatives of schizophrenic patients revealed about these individuals? a. b. c. d.

They rarely show schizotypal personality disorder. They almost always show schizotypal personality disorder. They have higher than average rates of schizotypal personality disorder. They have lower than average rates of schizotypal personality disorder. Difficulty: 1 Question ID: 9.1.73 Page Reference: 234 Topic: Schizotypal Personality Skill: Factual Answer: c. They have higher than average rates of schizotypal personality disorder.

9.1.74. Which personality disorder is characterized by odd beliefs, thinking, behavior, and appearance? a. b. c. d.

schizoid paranoid borderline schizotypal Difficulty: 1 Question ID: 9.1.74 Page Reference: 234 Topic: Schizotypal Personality Skill: Factual Answer: d. schizotypal

9.1.75. What is one of the problems in treating patients with personality disorders? a. b. c. d.

high drop out rates low intellectual ability related physical problems high distress about problems Difficulty: 1 Question ID: 9.1.75 Page Reference: 235 Topic: Schizotypal Personality Skill: Factual Answer: a. high drop out rates

9.1.76. At a treatment planning conference, a psychologist is describing a new client who has been diagnosed with a personality disorder. The psychologist is emphasizing the ego-syntonic nature of the client's problems because a. b. c. d.

treatment will have to focus on the client's weak ego. the client might not be motivated for treatment. the client is an excellent candidate for treatment. the problems are psychotic in nature. Difficulty: 2 Question ID: 9.1.76 Page Reference: 235 Topic: Schizotypal Personality Skill: Applied Answer: b. the client might not be motivated for treatment.

9.1.77. What does Otto Kernberg view as the common characteristic of people with borderline personality disorder? a. b. c. d.

lack of guilt preoccupation with rules faulty development of ego structure impaired smooth pursuit eye movements Difficulty: 1 Question ID: 9.1.77 Page Reference: 236 Topic: Borderline Personality Disorder Skill: Factual Answer: c. faulty development of ego structure

9.1.78. "Splitting" by a borderline personality disorder patient refers to a. b. c. d.

lack of impulse control. seeing people as all good or all bad. brain dysfunction causing attention deficit. imagining that what one wants is actually true. Difficulty: 1 Question ID: 9.1.78 Page Reference: 236 Topic: Borderline Personality Disorder Skill: Factual Answer: b. seeing people as all good or all bad.

9.1.79. Which diagnostic category is heavily influenced by psychodynamic theories about the origins of personality traits? a. b. c. d.

borderline personality disorder antisocial personality disorder schizotypal personality disorder obsessive-compulsive personality disorder Difficulty: 1 Question ID: 9.1.79 Page Reference: 236 Topic: Borderline Personality Disorder Skill: Conceptual Answer: a. borderline personality disorder

9.1.80. Your local community is considering whether to adopt an ordinance that would allow riverboat gambling. This controversial issue has strong emotions on both sides. When you go to a meeting to hear both sides, what might you hear from the side making an argument against the boat? a. b. c. d.

Pathological gambling is listed as an impulse control disorder. Pathological gambling is a subtype of obsessive-compulsive disorder. A high rate of medical problems is associated with pathological gambling. Antisocial personality disorder is strongly associated with pathological gambling. Difficulty: 1 Question ID: 9.1.80 Page Reference: 237 Topic: Borderline Personality Disorder Skill: Applied Answer: a. Pathological gambling is listed as an impulse control disorder.

9.1.81. Repetitive behaviors can be described as either compulsive or impulsive according to whether the original goal was a. b. c. d.

to express anger or anxiety. rational or irrational. adaptive or maladaptive. to experience pleasure or avoid anxiety. Difficulty: 2 Question ID: 9.1.81 Page Reference: 237 Topic: Borderline Personality Disorder Skill: Conceptual Answer: d. to experience pleasure or avoid anxiety.

9.1.82. You are reading for a part in a play. The description of the part describes the character as exhibiting a pervasive pattern of intense and unstable interpersonal relationships, an unstable self-image, and repeated suicidal gestures. You conclude that this character would meet the criteria for a. b. c. d.

schizoid personality disorder. dependent personality disorder. borderline personality disorder. antisocial personality disorder. Difficulty: 2 Question ID: 9.1.82 Page Reference: 236 Topic: Borderline Personality Disorder Skill: Applied Answer: c. borderline personality disorder

9.1.83. Which disorder commonly occurs with borderline personality disorder? a. b. c. d.

phobia depression schizophrenia generalized anxiety disorder Difficulty: 1 Question ID: 9.1.83 Page Reference: 236 Topic: Borderline Personality Disorder Skill: Factual Answer: b. depression

9.1.84. Various forms of abuse and frequent witnessing of domestic violence have been reported by adolescent girls diagnosed with a. b. c. d.

schizophrenia. hypochondriasis. borderline personality disorder. obsessive compulsive personality disorder. Difficulty: 2 Question ID: 9.1.84 Page Reference: 239 Topic: Borderline Personality Disorder Skill: Conceptual Answer: c. borderline personality disorder.

9.1.85. What characteristics of patients with borderline personality disorder make it especially difficult to treat them with psychotherapy? a. b. c. d.

They are indifferent to others. They are psychotic and need medication. They are generally of very low intelligence. They don't easily form a relationship with the therapist. Difficulty: 2 Question ID: 9.1.85 Page Reference: 239 Topic: Borderline Personality Disorder Skill: Applied Answer: d. They don't easily form a relationship with the therapist.

9.1.86. Dialectical behavior therapy with borderline personality disorder patients is called dialectical because it a. b. c. d.

makes use of philosophical arguments. helps the client seek a balance between the client's contradictory needs. helps the client use confrontation as its major technique. isn't a true form of behavior therapy. Difficulty: 2 Question ID: 9.1.86 Page Reference: 239 Topic: Borderline Personality Disorder Skill: Conceptual Answer: b. helps the client seek a balance between the client's contradictory needs.

9.1.87. At a conference on the treatment of borderline personality disorder, a group of psychiatrists is discussing their drug treatment options. What is the consensus on drug treatment of this disorder? a. The entire spectrum of psychoactive medications has been used, but none are specifically recommended. b. Antidepressants seem to be the preferred choice. c. Because of the wide variety of symptoms, the powerful antipsychotics seem to be the wisest treatment choice. d. These patients are not likely to agree to take any medications that could alter their behavior. Difficulty: 1 Question ID: 9.1.87 Page Reference: 240 Topic: Borderline Personality Disorder Skill: Applied Answer: a. The entire spectrum of psychoactive medications has been used, but none are specifically recommended.

9.1.88. Which personality disorder has been studied the most thoroughly and for the longest period of time? a. b. c. d.

paranoid personality disorder histrionic personality disorder borderline personality disorder antisocial personality disorder Difficulty: 1 Question ID: 9.1.88 Page Reference: 240 Topic: Antisocial Personality Disorder Skill: Factual Answer: d. antisocial personality disorder

9.1.89. Which of the following is part of H. Cleckley's description of the psychopath? a. b. c. d.

dependent, anxious, unstable psychotic, delusional, schizoid deceitful, intelligent, unreliable confused sexual identity, guilt-ridden, impotent Difficulty: 1 Question ID: 9.1.89 Page Reference: 241 Topic: Antisocial Personality Disorder Skill: Conceptual Answer: c. deceitful, intelligent, unreliable

9.1.90. The description of antisocial personality disorder (ASPD) in DSM III was made more reliable by focusing on tangible consequences of antisocial personality traits, such as failure to conform to social norms. What aspect of this change was criticized and led to a change in DSM-IV? a. b. c. d.

It focused too much on the lack of remorse. It did not take into account substance abuse. It blurred the distinction between criminality and ASPD. It relied too much on the presence of childhood conduct disorder. Difficulty: 2 Question ID: 9.1.90 Page Reference: 241 Topic: Antisocial Personality Disorder Skill: Conceptual Answer: c. It blurred the distinction between criminality and ASPD.

9.1.91. You are reading the records of Paul, a 28-year-old who has been diagnosed as exhibiting ASPD. The records describe his background, history, and treatments since age 8. According to the research of Lee Robins and her follow-up research, which of the following disorders is most likely to be among those given to him at some time in his 28 years? a. b. c. d.

conduct disorder mental retardation schizoid personality disorder schizotypal personality disorder Difficulty: 2 Question ID: 9.1.91 Page Reference: 241 Topic: Antisocial Personality Disorder Skill: Conceptual Answer: a. conduct disorder

9.1.92. Mark has a longstanding pattern of deceitful and manipulative behaviors. He has an arrest record that traces back to his high school days. He has been arrested for driving while intoxicated, for using cocaine, and for petty larceny. Each time he has been arrested, he has been able to explain his behavior in such a way that he has been put on probation. However, those who know him well are certain that he has no real remorse for his actions. If Mark received a diagnosis, what is the most likely one? a. b. c. d.

schizoid personality disorder antisocial personality disorder borderline personality disorder narcissistic personality disorder

Difficulty: 2 Question ID: 9.1.92 Page Reference: 241 Topic: Antisocial Personality Disorder Skill: Applied Answer: b. antisocial personality disorder

9.1.93. How does Terrie Moffitt view the antisocial behavior of adolescents? a. b. c. d.

as usually time-limited and often adaptive as usually time-limited but always maladaptive as the adolescent version of conduct disorder as almost always leading to adult antisocial behavior Difficulty: 2 Question ID: 9.1.93 Page Reference: 241-242 Topic: Antisocial Personality Disorder Skill: Conceptual Answer: a. as usually time-limited and often adaptive

9.1.94. Which of the following is typical of Terrie Moffitt's category of life-course–persistent antisocial behavior? a. b. c. d.

equal numbers of women and men rarely associated with antisocial personality disorder expressed through different problem behaviors at different ages much more common than adolescence-limited antisocial behavior Difficulty: 2 Question ID: 9.1.94 Page Reference: 241-242 Topic: Antisocial Personality Disorder Skill: Conceptual Answer: c. expressed through different problem behaviors at different ages

9.1.95. Long-term studies of antisocial behavior in psychopaths suggest that these behaviors tend to a. b. c. d.

decrease in middle age. remain constant throughout adulthood. increase over time throughout adulthood. fluctuate depending on levels of testosterone.

Difficulty: 1 Question ID: 9.1.95 Page Reference: 242 Topic: Antisocial Personality Disorder Skill: Factual Answer: a. decrease in middle age.

9.1.96. Studies of antisocial personality disorder in biological and adoptive families have found that the highest rates of antisocial personality disorder (ASPD) are found in children a. b. c. d.

who are raised in adverse environments. whose adoptive parent had ASPD. whose biological parent had ASPD. whose biological parents had ASPD and who are raised in adverse environments. Difficulty: 2 Question ID: 9.1.96 Page Reference: 243 Topic: Antisocial Personality Disorder Skill: Factual Answer: d. whose biological parents had ASPD and who are raised in adverse environments.

9.1.97. Why is it thought that children with a difficult temperament are more likely to end up showing life-course-persistent antisocial behavior? a. b. c. d.

They have a certain defective gene. They have grown up under adverse circumstances. They evoke maladaptive reactions from their parents. Their brains are unable to form new neural pathways. Difficulty: 2 Question ID: 9.1.97 Page Reference: 243 Topic: Antisocial Personality Disorder Skill: Conceptual Answer: c. they evoke maladaptive reactions from their parents

9.1.98. In laboratory studies, individuals are asked to learn a sequence of responses in order to receive a reward or punishment. How do the responses of psychopaths compare to the responses of normal control groups? a. b. c. d.

Psychopaths have a much more difficult time learning. Psychopaths show high aversion to anticipated punishment. Psychopaths show high intelligence and better overall performance. Psychopaths do not seem to be affected by the anticipated punishment.

Difficulty: 1 Question ID: 9.1.98 Page Reference: 244 Topic: Antisocial Personality Disorder Skill: Conceptual Answer: d. Psychopaths do not seem to be affected by the anticipated punishment.

9.1.99. A psychologist is studying individuals who have been diagnosed with antisocial personality disorder. The research involves hooking up physiological devices near the eye. What is this researcher investigating? a. b. c. d.

signs of tiredness eye blink startle responses shiftiness of the eyes as an indication of deception rapid-eye-movements as indications of dreaming while awake Difficulty: 2 Question ID: 9.1.99 Page Reference: 244 Topic: Antisocial Personality Disorder Skill: Applied Answer: b. eye blink startle responses

9.1.100. Which is a hypothesis put forward to explain the reduced startle response of psychopaths when presented with fear inducing stimuli? a. b. c. d.

The brainstem of this group has been damaged before birth. Their chronic alcoholism has produced brain deficits. The are emotionally impoverished. This is not a finding for psychopaths. Difficulty: 2 Question ID: 9.1.100 Page Reference: 244 Topic: Antisocial Personality Disorder Skill: Conceptual Answer: c. The are emotionally impoverished.

9.1.101. Which hypothesis offers an explanation for why psychopaths often do not respond normally to punishment? a. b. c. d.

They are preoccupied with the potential for a successful outcome. They have never been punished. They have been punished too often. They lack the necessary cognitive skills to understand punishment.

Difficulty: 2 Question ID: 9.1.101 Page Reference: 244 Topic: Antisocial Personality Disorder Skill: Conceptual Answer: a. They are preoccupied with the potential for a successful outcome. 9.1.102. Your neighbor who has the diagnosis of antisocial personality disorder told you he is going to see a psychiatrist at the mental health clinic. You are surprised by his statement and conclude that he has been a. b. c. d.

ordered by a judge to seek psychotherapy. involved with a religious movement and "seen the light." involved in a serious committed relationship and wants to alter his behavior. arrested several times and feels he has embarrassed his family enough with his behavior. Difficulty: 1 Question ID: 9.1.102 Page Reference: 244 Topic: Antisocial Personality Disorder Skill: Applied Answer: a. ordered by a judge to seek psychotherapy.

9.1.103. What is one of the factors that complicates treatment of antisocial personality disorder? a. b. c. d.

poor verbal skills low level of overall intelligence high rate of comorbid alcoholism and other substance dependence strong emotional ties to therapists that represent parental figures Difficulty: 1 Question ID: 9.1.103 Page Reference: 244 Topic: Antisocial Personality Disorder Skill: Factual Answer: c. high rate of comorbid alcoholism and other substance dependence

9.1.104. As a forensic psychologist working for a federal prison system you have been asked to design a treatment for antisocial personality disorder. You are aware that most programs have limited success at best, but you also know that there are some positive findings with regard to a. b. c. d.

psychoanalytic programs that have the inmate seeing a psychiatrist five times a week. behavioral programs originally designed for the treatment of deviant sexual crimes. humanistic programs that focus on learning empathy skills. No programs show any significant success rate at all.

Difficulty: 3 Question ID: 9.1.104 Page Reference: 244 Topic: Antisocial Personality Disorder Skill: Applied Answer: b. behavioral programs originally designed for the treatment of deviant sexual crimes.

Short Answer 9.2.105. In the DSM-IV-TR, Axis II is for which type of disorders? Difficulty: 1 Question ID: 9.2.105 Page Reference: 219 Topic: Overview Skill: Factual Answer: personality

9.2.106. __________ refers to a person’s most basic, characteristic styles of relating to the world, especially those styles that are evident during the first year of life. Difficulty: 2 Question ID: 9.2.106 Page Reference: 222 Topic: Symptoms Skill: Factual Answer: Temperament

9.2.107. __________ personality disorder is defined in terms of a pervasive pattern of indifference to other people, coupled with a diminished range of emotional experience and expression. Difficulty: 1 Question ID: 9.2.107 Page Reference: 224 Topic: Diagnosis Skill: Factual Answer: a. Schizoid

9.2.108. __________ ______________disorder is defined in terms of a persistent pattern of irresponsible and remorseless behavior that begins during childhood or adolescence and continues into the adult.

Difficulty: 1 Question ID: 9.2.108 Page Reference: 226 Topic: Diagnosis Skill: Factual Answer: Antisocial personality

9.2.109. According to the textbook the __________ disorders may be more related to cultural expectations than any other kind of mental disorder. Difficulty: 2 Question ID: 9.2.109 Page Reference: 232 Topic: Frequency Skill: Conceptual Answer: personality

9.2.110. _________-__________ psychology is the scientific study of ways that human behavior and mental processes are influenced by social and cultural factors.

Difficulty: 2 Question ID: 9.2.110 Page Reference: 233 Topic: Frequency Skill: Factual Answer: a. Cross-cultural

9.2.111. A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, is the DSM definition of __________ personality disorder.

Difficulty: 1 Question ID: 9.2.111 Page Reference: 224 Topic: Schizotypal Personality Disorder Skill: Factual

Answer: a. schizotypal

9.2.112. ____________ is defined as stealing objects that are not needed for personal use or for their financial value and theft is not motivated by anger or vengeance. Difficulty: 2 Question ID: 9.2.112 Page Reference: 237 Topic: Borderline Personality Disorder Skill: Factual Answer: a. Kleptomania

9.2.113. In psychodynamic therapy, the __________ relationship is defined as the way in which the patient behaves toward the therapist that reflects early primary relationships. In this type of therapy it is interpreted in order to improve the patients’ ability to experience themselves and other people in a more realistic and integrated way. Difficulty: 2 Question ID: 9.2.113 Page Reference: 239 Topic: Borderline Personality Disorder Skill: Conceptual Answer: transference

9.2.114. Cleckley and Hare investigate a disorder defined by egocentricity and lack of empathy that they call __________ . Difficulty: 2 Question ID: 9.2.114 Page Reference: 240-241 Topic: Antisocial Personality Disorder Skill: Factual Answer: psychopathy

9.2.115. ____________ refers to enduring patterns of thinking and behavior that define the person and distinguish him or her from other people. Difficulty: 1 Question ID: 9.2.115 Page Reference: 219 Topic: Overview Skill: Factual

Answer: Personality

Essay 9.3.116. What do we mean when we say a disorder is ego-syntonic? Difficulty: 1 Question ID: 9.3.116 Page Reference: 221 Topic: Overview Skill: Conceptual Answer: Personality disorders are described as ego-syntonic, which means the ideas or impulses with which they are associated are acceptable to the person. These people do not see themselves as disturbed and do not have insight into their problem. Most other forms of mental disorder are egodystonic, which means the people are distressed by their symptoms.

9.3.117. Describe the five-factor model of personality. Difficulty: 1 Question ID: 9.3.117 Page Reference: 223-224 Topic: Symptoms Skill: Conceptual Answer: Neuroticism: identifies individuals who are prone to psychological distress, unrealistic ideas, excessive cravings or urges, and maladaptive coping response. Extraversion: assesses quantity and intensity of interpersonal interaction, activity level, need for stimulation, and capacity for joy. Openness to experience: assesses proactive seeking and appreciation of experiences for its own sake, toleration for and exploration of the unfamiliar. Agreeableness: assesses the quality of one's interpersonal orientation along a continuum from compassion to antagonism in thoughts, feelings, and actions. Conscientiousness: assesses the individual's degree of organization, contrasts dependable, fastidious people with those who are lackadaisical and sloppy.

9.3.118. The DSM-IV-TR describes personality disorders in terms of discrete categories. Discuss the limitations of this approach.

Difficulty: 2 Question ID: 9.3.118 Page Reference: 228-229 Topic: Diagnosis Skill: Conceptual Answer: Use of discrete categories leaves no way of describing people with traits who don't meet the criteria for a disorder. Because of common overlap in personality disorders, the final diagnosis (either

using one diagnosis or two) doesn't provide an accurate description of individual traits. The dimensional approach is more complete, especially for individuals on the boundary of two disorders. The dimensional approach is also less complicated, as it is based on five dimensions rather than various traits associated with 10 different disorders.

9.3.119. Discuss gender differences in the rate of diagnosis of personality disorders and include a discussion of the possibility of gender bias in this process. Difficulty: 2 Question ID: 9.3.119 Page Reference: 230-231 Topic: Frequency Skill: Conceptual Answer: In general the rate of diagnosis of personality disorder is approximately equal for males and females. One exception is antisocial personality disorder, which is five times higher (5%) in men than women (1%). Some critics of these definitions in the DSM-IV-TR suggest that some definitions are inherently biased towards one sex or the other in that they are based on sex role stereotypes. They suggest, for example, that the criteria for antisocial personality disorder reflect traditional stereotypical male behavior. Therefore these definitions may turn traditional sex role behaviors into “disorders” and minimize the extent to which women may simply be trying to cope with unreasonable or oppressive environmental circumstances, including discrimination and sexual abuse. Women do not, however, seem to meet diagnostic criteria for various personality disorders without experiencing significant distress in their lives in general. There is research evidence that indicates that clinicians of both sexes tend to diagnose women with borderline and dependent personality disorder at rates greater than men exhibiting the same presenting complaints.

9.3.120. Discuss the results of studies of the prevalence of personality disorders based on community and clinical samples. Difficulty: 2 Question ID: 9.3.120 Page Reference: 230-231 Topic: Frequency Skill: Conceptual Answer: Community-based samples of adults have yielded lifetime prevalence rates of having at least one Axis II diagnoses at about 10 percent. The highest prevalence rates are for schizotypal, histrionic, antisocial, obsessive-compulsive, and dependent personality disorders. Narcissistic personality disorder seems to be the least common. Borderline personality disorder seems to be the most common in both inpatient and outpatient settings.

9.3.121. Discuss the etiology of borderline personality disorder. Difficulty: 2 Question ID: 9.3.121 Page Reference: 238-239 Topic: Borderline Personality Disorder

Skill: Conceptual Answer: Genetic factors do not seem to play a role in borderline personality disorder. However, it is premature to conclude that genes play no role because they may play a role in the development of neuroticism (a trait that is clearly related to this concept). Borderline patients seem to suffer from the negative consequences of parental loss in childhood. Studies of patients with borderline personality disorder point toward the influence of widespread problematic relationships with their parents. Separation appears to be only one aspect of this complicated picture. Adolescent girls with borderline personality disorder report a pervasive lack of supervision, frequent witnessing of domestic violence, and being subject to inappropriate behavior by parents and other adults, including verbal, physical, and sexual abuse.

9.3.122. What are some of the key characteristics of Hervey Cleckley's description of psychopathy? What are the key characteristics of the DSM definition of antisocial personality disorder? Difficulty: 2 Question ID: 9.3.122 Page Reference: 220-221 Topic: Antisocial Personality Disorder Skill: Conceptual Answer: In his book, The Mask of Sanity, Hervey Cleckley described psychopaths as impulsive, self-centered, pleasure-seeking individuals who seemed to lack emotions such as anxiety, shame, and guilt. These individuals were also seen as intelligent and superficially charming, but also chronically deceitful, unreliable, and incapable of learning from experience. This approach places primary emphasis on emotional deficits and personality traits. These characteristics were difficult to diagnose reliably. Consequently, the DSM-III placed special emphasis on observable behaviors and repeated conflicts with authorities, including a failure to conform to social norms. Psychopathy and antisocial personality disorder are two different attempts to define the same disorder. However, they are sufficiently different in that they do not identify the same people. According to critics, DSM-III blurred the distinction between antisocial personality and criminality. However, Cleckley was clear on this point: all criminals are not psychopaths, and all psychopaths are not convicted criminals. The DSM-IV-TR criteria require the presence of the symptoms of conduct disorder prior to age 15. In addition, the individual must exhibit at least three of seven signs of irresponsible and antisocial behavior after age 15. One of these signs, lack of remorse, did not appear in DSM-III but was one of Cleckley's original criteria.

9.3.123. Explain how genetic factors, family processes, and the social environment interact in the etiology of antisocial behavior. Difficulty: 2 Question ID: 9.3.123 Page Reference: 240-241 Topic: Antisocial Personality Disorder Skill: Conceptual Answer: Children with a difficult temperament may be especially irritating to their parents. Their resistance to disciplinary efforts may discourage parents from maintaining persistent discipline, and this type of child might be most likely to evoke maladaptive reactions from parents who are poorly equipped to deal with this kind of behavior. As a result, parents might be driven either to use unusually harsh

punishments or to abandon any attempt at discipline. This interaction fosters the development of poorly controlled behavior, which is then perpetuated when the person selects friends who share similar antisocial interests and problems.

Chapter 10 Eating Disorders Total Assessment Guide (T.A.G.) Question Factual Type Overview Multiple 1, 3, 4, 5, 6, 8, 9 pp. 249-252 Choice Short Answer 86 Essay Symptoms of Multiple 10, 11, 12, 14, 15, Anorexia Choice 17, 19, 25 pp. 252-254 Short Answer Essay Symptoms of Multiple 28, 30, 31, 33, 36 Bulimia Choice pp. 254-256 Short Answer 87, 88, 89 Essay Diagnosis of Multiple 42, 44, 45 Eating Disorders Choice pp. 256-258 Short Answer 90 Essay Frequency of Multiple 46, 48, 53 Eating Disorders Choice pp. 258-261 Short Answer 91, 92 Essay Causes of Eating Multiple 54, 56, 57, 70, 73 Disorders Choice pp. 261-265 Short Answer 93, 94, 95 Essay Treatment of Multiple 76 Anorexia Choice Nervosa Short Answer pp. 265-266 Essay Treatment of Multiple 82, 83 Bulimia Nervosa Choice pp. 266-268 Short Answer Essay Prevention of Multiple 85 Eating Disorders Choice pp. 268-268 Short Answer 98 Essay *This question covers more than one topic.

Conceptual

Topic

Applied

13, 18, 23, 24, 27

16, 20, 21, 22, 26

99* 32, 34, 35

29, 37, 38

100 39, 41, 43

101 49, 51

50, 47, 52

102 58, 59, 61, 62, 63, 64, 65, 67, 71, 72

55, 60, 66, 68, 69

99*, 103, 104 77, 78

74, 75

96 80 97 106 84

105 79, 81

Chapter 10: Eating Disorders

Multiple Choice 10.1.1. What is the primary characteristic of anorexia nervosa? a. b. c. d.

self-induced vomiting eating non-nutrient substances repeated episodes of binge eating starving oneself Difficulty: 1 Question ID: 10.1.1 Page Reference: 249 Topic: Overview Skill: Factual Answer: d. starving oneself

10.1.2. During a lecture on eating disorders, the lecturer tells the audience, "Let's be candid, anorexia is a misnomer." Most of the people around you are puzzled until the expert explains. What does she say? a. b. c. d.

"Anorexia nervosa is much less prevalent than is generally believed." "Anorexia is actually a form of suicide among clinically depressed adolescents." "The emphasis should be on the nervosa because this is a neurological disorder." "The term anorexia means 'loss of appetite' but people with this disorder are actually hungry." Difficulty: 2 Question ID: 10.1.2 Page Reference: 249 Topic: Overview Skill: Applied

Answer: d. "The term anorexia means 'loss of appetite' but people with this disorder are actually hungry."

10.1.3. Individuals who are attempting to become extremely thin by refusing to eat suffer from a. b. c. d.

obesity phobia. bulimia nervosa. anorexia nervosa. anti-obesity obsession.

Difficulty: 1 Question ID: 10.1.3 Page Reference: 249 Topic: Overview Skill: Factual Answer: c. anorexia nervosa.

10.1.4. Some experts suggest that a better term than “eating” disorder would be “___________” disorder. a. b. c. d.

nutrition food avoidant starvation dieting Difficulty: 2 Question ID: 10.1.4 Page Reference: 249 Topic: Overview Skill: Factual Answer: d. dieting

10.1.5. The chief characteristic of bulimia nervosa is a. b. c. d.

self-induced vomiting. binge eating. self-starvation. a preoccupation with food. Difficulty: 1 Question ID: 10.1.5 Page Reference: 249 Topic: Overview Skill: Factual Answer: b. binge eating.

10.1.6. For both anorexia and bulimia, the rate of occurrence in females compared to males is about a. b. c. d.

2 to 1. 5 to 1. 10 to 1. equal.

Difficulty: 1 Question ID: 10.1.6

Page Reference: 249 Topic: Overview Skill: Factual Answer: c. 10 to 1.

10.1.7. According to the National Centers for Disease Control and Prevention, at any point in time ___ percent of high school females are attempting to lose weight compared with ___ percent of males. a. b. c. d.

44; 15 15; 44 10; 2 2; 10 Difficulty: 2 Question ID: 10.1.7 Page Reference: 249 Topic: Overview Skill: Conceptual Answer: a. 44; 15

10.1.8. A national survey found that almost _____ of American women have a negative body image, particularly concerning their waist, hips, and/or thighs. a. b. c. d.

1 percent 25 percent 50 percent 75 percent Difficulty: 2 Question ID: 10.1.8 Page Reference: 249 Topic: Overview Skill: Factual Answer: c. 50 percent

10.1.9. According to the textbook European American and Latina women report higher rates of body dissatisfaction than a. b. c. d.

Asian women. African American women. Middle Eastern women. No difference was found. Difficulty: 2 Question ID: 10.1.9

Page Reference: 249 Topic: Overview Skill: Factual Answer: b. African American women.

10.1.10. What is the body mass index (BMI)? a. b. c. d.

an indicator of the amount of muscle in the body the proportion of body fat to lean tissue in the body a useful indicator for comparing one's weight to expected weights the proportion of daily calories derived from foods that contain needed nutrients Difficulty: 1 Question ID: 10.1.10 Page Reference: 251 Topic: Symptoms of Anorexia Skill: Factual Answer: c. a useful indicator for comparing one's weight to expected weights

10.1.11. In the case of Serrita, whose struggle with anorexia was described in your text, what was her attitude about her condition that is common to many diagnosed with anorexia? a. b. c. d.

She admitted to being too thin and acknowledged her need to gain weight. She admitted to being too thin but denied that she needed to gain weight. She denied that she was too thin. She admitted to being too thin but blamed it on a biochemical deficiency. Difficulty: 1 Question ID: 10.1.11 Page Reference: 250 Topic: Symptoms of Anorexia Skill: Factual Answer: c. She denied that she was too thin.

10.1.12. Falling below what percent of your expected, normal body weight is associated with anorexia nervosa? a. b. c. d.

95 percent 90 percent 85 percent 80 percent

Difficulty: 1 Question ID: 10.1.12

Page Reference: 251 Topic: Symptoms of Anorexia Skill: Factual Answer: c. 85 percent

10.1.13. The average victim of anorexia looses about what percent of normal body weight? a. b. c. d.

10 percent 30 percent 50 percent 75 percent Difficulty: 2 Question ID: 10.1.13 Page Reference: 251 Topic: Symptoms of Anorexia Skill: Conceptual Answer: b. 30 percent

10.1.14. An inaccurate perception of body size and shape is known as a. b. c. d.

anorexia. distorted self image. distorted body image. none of the above Difficulty: 1 Question ID: 10.1.14 Page Reference: 251 Topic: Symptoms of Anorexia Skill: Factual Answer: c. distorted body image.

10.1.15. About what percent of people with anorexia nervosa are estimated to die of starvation, suicide, or medical complications stemming from their extreme weight loss. a. b. c. d.

1 percent 5 percent 15 percent 45 percent

Difficulty: 1 Question ID: 10.1.15

Page Reference: 251 Topic: Symptoms of Anorexia Skill: Factual Answer: b. 5 percent

10.1.16. One early study found that young women with anorexia nervosa ____________ the size of various body parts in comparison to a normal control group. a. b. c. d.

overestimate underestimate accurately estimate avoid considering Difficulty: 2 Question ID: 10.1.16 Page Reference: 251 Topic: Symptoms of Anorexia Skill: Applied Answer: a. overestimate

10.1.17. One reason why individuals with anorexia steadfastly deny problems with their weight seems to be because they a. b. c. d.

don't trust others enough to admit the truth. have a distorted body image and do not perceive their appearance accurately. never feel hungry. are often at or near normal weight. Difficulty: 1 Question ID: 10.1.17 Page Reference: 251 Topic: Symptoms of Anorexia Skill: Factual Answer: b. have a distorted body image and do not perceive their appearance accurately.

10.1.18. Agnes, who suffers from anorexia, is dangerously thin but has been steadfastly refusing eat enough to gain weight. If Agnes could honestly explain to you why she doesn't eat, what would she probably say? a. b. c. d.

"I'm not hungry." "I don't enjoy the taste of food and it makes me sick." "I am intensely afraid of becoming fat." "I want to die." Difficulty: 1

Question ID: 10.1.18 Page Reference: 250 Topic: Symptoms of Anorexia Skill: Conceptual Answer: c. "I am intensely afraid of becoming fat."

10.1.19. What is amenorrhea? a. b. c. d.

disturbed body image absence of menstruation less than 85 percent expected body weight undue influence of body shape on self-evaluation Difficulty: 1 Question ID: 10.1.19 Page Reference: 253 Topic: Symptoms of Anorexia Skill: Factual Answer: b. absence of menstruation

10.1.20. A patient's medical chart includes the word lanugo. You can tell from the chart that the patient has anorexia nervosa. What will you expect to observe when the patient is examined? a. b. c. d.

brittle bones a wide eyed stare irregular heart beat fine, downy hair on the face and trunk Difficulty: 1 Question ID: 10.1.20 Page Reference: 253 Topic: Symptoms of Anorexia Skill: Applied Answer: d. fine, downy hair on the face and trunk

10.1.21. Jane's physician is distressed by her anorexia nervosa. Her weight loss is bad enough, but her medical tests show clear signs of an electrolyte imbalance. What is the physician's major concern? a. b. c. d.

possible cardiac problems a low level of serotonin that often precedes suicide a low level of dopamine that often leads to motor difficulties brain abnormalities suggesting epileptic-like seizures Difficulty: 1 Question ID: 10.1.21

Page Reference: 253 Topic: Symptoms of Anorexia Skill: Applied Answer: a. possible cardiac problems 10.1.22. A film producer wants to make a movie describing several cases of young women who have been diagnosed as suffering from anorexia nervosa. He is especially interested in exploring some of the psychological dynamics related to the disorder. Which of the following titles might be the best choice for the film? a. b. c. d.

"A Struggle for Control: Anorexia Nervosa" "Anorexia Nervosa: I Don't Want to Grow Up" "How Depression Masquerades as Eating Disorders" "Sexual Disorders and Anorexia Nervosa: A Two-Way Street" Difficulty: 2 Question ID: 10.1.22 Page Reference: 253 Topic: Symptoms of Anorexia Skill: Applied Answer: a. "A Struggle for Control: Anorexia Nervosa"

10.1.23. Janice suffers from anorexia and is extremely careful about how much she eats. How does she probably feel about this? a. b. c. d. other.

She takes great pride in her control and self-denial. She feels like she has no control over her behavior. She is greatly ashamed and desperately wants help. Since she doesn't believe she has a problem, she has no strong feelings about this one way or the

Difficulty: 1 Question ID: 10.1.23 Page Reference: 253 Topic: Symptoms of Anorexia Skill: Conceptual Answer: a. She takes great pride in her control and self-denial. 10.1.24. People diagnosed with anorexia who do not also binge eat or purge, when compared to those who have both symptoms, are generally less a. b. c. d.

comorbid. depressed. anxious. self-obsessed. Difficulty: 2 Question ID: 10.1.24

Page Reference: 254 Topic: Symptoms of Anorexia Skill: Conceptual Answer: b. depressed. 10.1.25. Which of these are likely to be comorbid with anorexia nervosa? a. b. c. d.

bipolar disorder and somatization disorder depression and obsessive-compulsive disorder agoraphobia and borderline personality disorder hypochondriasis and dependent personality disorder Difficulty: 1 Question ID: 10.1.25 Page Reference: 253 Topic: Symptoms of Anorexia Skill: Factual Answer: b. depression and obsessive-compulsive disorder

10.1.26. Ken will do almost anything for extra credit. He sees a sign recruiting participants for research on eating. When he inquires, he is told the study involves semi-starvation. He is a bit leery now, so he heads over to the library to read up on the topic. What he finds persuades him to look for other ways to earn extra credit. What did he find? a. Semi-starvation experiments are associated with a high mortality rate. b. The experience will lead to symptoms similar to posttraumatic stress disorder. c. Semi-starvation permanently alters the biological mechanisms that control eating. d. Participants are likely to develop obsessions and compulsions concerning food that continue after they return to their normal weight. Difficulty: 2 Question ID: 10.1.26 Page Reference: 253 Topic: Symptoms of Anorexia Skill: Applied Answer: d. Participants are likely to develop obsessions and compulsions concerning food that continue after they return to their normal weight. 10.1.27. In the two cases of eating disorders presented in your text—Serrita with anorexia and Michelle with bulimia—there was a very clear difference in their emotional reactions to their behavior. Serrita felt _________ while Michelle felt _________. a. b. c. d.

shame; pride pride; shame out of control; in control depressed; euphoric Difficulty: 2

Question ID: 10.1.27 Page Reference: 250 & 254 Topic: Symptoms of Anorexia Skill: Conceptual Answer: b. pride; shame

10.1.28. What types of food are individuals with bulimia nervosa most likely to consume during an episode of binge eating? a. b. c. d.

high protein foods high calorie foods foods that are high in cholesterol non-nutritive, high bulk substances Difficulty: 1 Question ID: 10.1.28 Page Reference: 255 Topic: Symptoms of Bulimia Skill: Factual Answer: b. high calorie foods

10.1.29. Assume that each of the following individuals has a diagnosis of bulimia nervosa. Which of them is most likely to engage in an episode of binge eating at this point? a. Ann was upset over failing two exams and she also had an argument with her parents. b. Farrah is wondering what will happen to her town now that a major employer has cut back on jobs. c. Diane is watching television and feels sleepy as she listens to the reports of political polls. d. Barbara just won a scholarship to the college she wanted to attend and she is going out to celebrate. Difficulty: 1 Question ID: 10.1.29 Page Reference: 255 Topic: Symptoms of Bulimia Skill: Applied Answer: a. Ann was upset over failing two exams and she also had an argument with her parents. 10.1.30. In the middle of an episode of binge eating, how is a woman likely to describe how she feels? a. b. c. d.

delusional lacking control in a hypnotic trance invigorated and energetic Difficulty: 1 Question ID: 10.1.30

Page Reference: 255 Topic: Symptoms of Bulimia Skill: Factual Answer: b. lacking control

10.1.31. What are the primary characteristics of bulimia nervosa? a. b. c. d.

pica and amenorrhea low body weight and pica binge eating and purging eating non-nutrient substances and sexual dysfunctions Difficulty: 1 Question ID: 10.1.31 Page Reference: 254-255 Topic: Symptoms of Bulimia Skill: Factual Answer: c. binge eating and purging

10.1.32. The DSM-IV-TR criteria for bulimia nervosa refer to compensatory behavior. Which of the following represents this type of behavior? a. b. c. d.

going to the gym to watch others exercise use of laxatives after an episode of bingeing feeling out of control during an episode of bingeing fantasizing about food rather than giving in to the temptation to eat Difficulty: 2 Question ID: 10.1.32 Page Reference: 255 Topic: Symptoms of Bulimia Skill: Conceptual Answer: b. use of laxatives after an episode of bingeing

10.1.33. Bulimia nervosa almost always involves purging. This means that individuals with bulimia nervosa a. b. c. d.

engage in self-induced vomiting. try to rid themselves of what they feel to be evil demons. use various means to eliminate the food that they have consumed during their binges. cannot easily be distinguished from individuals with anorexia nervosa.

Difficulty: 1 Question ID: 10.1.33

Page Reference: 255 Topic: Symptoms of Bulimia Skill: Factual Answer: c. use various means to eliminate the food that they have consumed during their binges.

10.1.34. Although bulimia nervosa is often referred to as the "binge-purge" disorder, this is misleading because a. b. c. d.

it is not really a disorder because most people binge at least occasionally. there are other ways to compensate for binges that don't involve purging. some individuals with bulimia nervosa overeat frequently but not always in the form of a binge. bulimia nervosa involves bingeing or purging, but not both. Difficulty: 1 Question ID: 10.1.34 Page Reference: 255 Topic: Symptoms of Bulimia Skill: Conceptual Answer: b. there are other ways to compensate for binges that don't involve purging.

10.1.35. Which of the following symptoms is a diagnostic criteria for both anorexia nervosa and bulimia nervosa? a. b. c. d.

fasting bingeing excessive emphasis on body shape and weight intense fear of becoming pregnant Difficulty: 1 Question ID: 10.1.35 Page Reference: 255 Topic: Symptoms of Bulimia Skill: Conceptual Answer: c. excessive emphasis on body shape and weight

10.1.36. Which psychological problem often occurs with bulimia nervosa? a. b. c. d.

depression gender identity disorder antisocial personality disorder histrionic personality disorder

Difficulty: 1 Question ID: 10.1.36

Page Reference: 255-256 Topic: Symptoms of Bulimia Skill: Factual Answer: a. depression

10.1.37. As a clinician with a client you have diagnosed with bulimia nervosa, you would also be concerned about comorbid conditions. You would be least concerned about the possibility of a. b. c. d.

depression. an anxiety disorder. bipolar disorder. borderline personality disorder. Difficulty: 2 Question ID: 10.1.37 Page Reference: 256 Topic: Symptoms of Bulimia Skill: Applied Answer: c. bipolar disorder.

10.1.38. Janet is making her annual visit to the dentist. As he is examining her mouth, she senses some concern. She asks if he has found cavities and he says no. He finally comes right out and asks if she has bulimia. What clue suggested this possible diagnosis? a. b. c. d.

eroded dental enamel large gaps between teeth teeth that are growing in crooked open sores at the base of the teeth Difficulty: 1 Question ID: 10.1.38 Page Reference: 256 Topic: Symptoms of Bulimia Skill: Applied Answer: a. eroded dental enamel

10.1.39. Helen suffers from an eating disorder characterized by frequent binges. We can be reasonably certain that Helen a. b. c. d.

suffers from bulimia nervosa. suffers from either bulimia nervosa or anorexia nervosa of the binge-eating/purging type. also purges. does not purge. Difficulty: 2

Question ID: 10.1.39 Page Reference: 256 Topic: Diagnosis of Eating Disorders Skill: Conceptual Answer: b. suffers from either bulimia nervosa or anorexia nervosa of the binge-eating/purging type. 10.1.40. Ann has the diagnosis of anorexia nervosa restricting type. The team of professionals that is going to treat her looks at the diagnosis and what does it tell them? a. She rarely engages in bingeing or purging. b. Her personality characteristics have made it difficult to determine if she has a problem at all. c. She has a rare form of anorexia nervosa in which she is able to maintain her weight within five pounds of her expected weight. d. The treatments that can be used are limited to those that can address the underlying biological malfunctions responsible for the disorder. Difficulty: 2 Question ID: 10.1.40 Page Reference: 257 Topic: Diagnosis of Eating Disorders Skill: Applied Answer: a. She rarely engages in bingeing or purging. 10.1.41. The validity of the distinction between restrictive type and binge eating/purging type of anorexia nervosa is questioned mainly because a. b. c. d.

they are both express a gender bias. they do not differ in terms of comorbidity, recovery, relapse, or mortality. individuals diagnosed with either describe themselves in similar terms. There is no question about the validity of the distinction. Difficulty: 2 Question ID: 10.1.41 Page Reference: 257 Topic: Diagnosis of Eating Disorders Skill: Conceptual Answer: b. they do not differ in terms of comorbidity, recovery, relapse, or mortality.

10.1.42. What two subtypes of bulimia nervosa are described in DSM-IV? a. b. c. d.

purging and nonpurging restricted and unrestricted life-threatening and non life-threatening depression induced and non-depression induced Difficulty: 1 Question ID: 10.1.42

Page Reference: 257 Topic: Diagnosis of Eating Disorders Skill: Factual Answer: a. purging and nonpurging

10.1.43. Which is most accurate with regard to the distinction between purging and nonpurging subtypes of bulimia nervosa? a. b. c. d.

Experts in the field have recommended dropping the distinction. Research continues to validate the distinction. This distinction is most useful in deciding on treatment strategies. There is little difference between the two in behavior, but significant difference in prognosis. Difficulty: 1 Question ID: 10.1.43 Page Reference: 257 Topic: Diagnosis of Eating Disorders Skill: Conceptual Answer: a. Experts in the field have recommended dropping the distinction.

10.1.44. Which of the following individuals would meet the common criteria for defining obesity? a. b. c. d.

a person who weighs 10 percent more than the expected weight a person who weighs 20 percent more than the expected weight a person who weighs 40 percent more than the expected weight a person who weighs 100 percent more than the expected weight Difficulty: 1 Question ID: 10.1.44 Page Reference: 258 Topic: Diagnosis of Eating Disorders Skill: Factual Answer: b. a person who weighs 20 percent more than the expected weight

10.1.45. While paging through the DSM-IV you find a diagnosis called binge eating disorder. How is this disorder listed? a. b. c. d.

personality disorder diagnostic category requiring further study medical condition affecting mental disorders eating disorder

Difficulty: 2 Question ID: 10.1.45

Page Reference: 258 Topic: Diagnosis of Eating Disorders Skill: Factual Answer: b. diagnostic category requiring further study

10.1.46. Which of the following statements about the prevalence of eating disorders is most accurate? a. b. c. d.

Anorexia is common throughout the population. Anorexia is rare in the general population but common among certain segments. The prevalence of bulimia is declining while the prevalence of anorexia is increasing. Bulimia is increasingly most rapidly among young males. Difficulty: 1 Question ID: 10.1.46 Page Reference: 258 Topic: Frequency of Eating Disorders Skill: Factual Answer: b. Anorexia is rare in the general population but common among certain segments.

10.1.47. A researcher discussing the prevalence of eating disorders makes reference to what she says is a cohort effect for these disorders. What does this mean? a. Eating disorders tend to run in close-knit families. b. Women born after 1960 have a higher rate of bulimia nervosa than women born prior to 1960. c. Families that place a special emphasis on eating meals together have high rates of eating disorders. d. The frequency of eating disorders is strongly related to the rate among friends, especially in high school. Difficulty: 2 Question ID: 10.1.47 Page Reference: 258 Topic: Frequency of Eating Disorders Skill: Applied Answer: b. Women born after 1960 have a higher rate of bulimia nervosa than women born prior to 1960.

10.1.48. What have epidemiologists found concerning the frequency of eating disorders? a. b. c. d.

Bulimia nervosa is more common than anorexia nervosa. Anorexia nervosa is more common than bulimia nervosa. Bulimia nervosa and anorexia nervosa occur at the same rates. The rates of these eating disorders have reached a peak and are now declining. Difficulty: 1

Question ID: 10.1.48 Page Reference: 258-259 Topic: Frequency of Eating Disorders Skill: Factual Answer: a. Bulimia nervosa is more common than anorexia nervosa.

10.1.49. Which of the following is a reason frequently given by scientists to explain the much higher rate of eating disorders among females? a. b. c. d.

Women are much more likely than men to base their self-image on body image. Men are not concerned about their appearance. Men do not have to be concerned about the cultural image of good looks. Women do not tend to judge men based on their appearance. Difficulty: 2 Question ID: 10.1.49 Page Reference: 259 Topic: Frequency of Eating Disorders Skill: Conceptual Answer: a. Women are much more likely than men to base their self-image on body image.

10.1.50. Although it is certainly an unusual source of data for researchers, some have looked at Playboy centerfolds and Miss America Beauty pageant contestants. How is this research relevant to eating disorders? a. The emphasis on thinness is a relatively recent phenomenon in the last 20 years. b. Their facial features indicated they had dieted beyond the point of medical safety. c. Between 1959 and 1988, their ratio of weight to height for these groups declined dramatically. d. In their interviews, almost all of them gave subtle clues suggesting they were in deep conflict concerning weight control. Difficulty: 2 Question ID: 10.1.50 Page Reference: 259 Topic: Frequency of Eating Disorders Skill: Applied Answer: c. Between 1959 and 1988, their ratio of weight to height for these groups declined dramatically.

10.1.51. A cross-cultural researcher is investigating the relationship between body weight and wealth in Third World countries. Which of the following is most likely to summarize the relationship? a. b. c.

There is no relationship between body weight and wealth. There is a strong positive relationship between body weight and wealth. There is a strong negative relationship between body weight and wealth.

It is the same as the relationship found in industrialized nations. Difficulty: 2 Question ID: 10.1.51 Page Reference: 259 Topic: Frequency of Eating Disorders Skill: Conceptual Answer: b. There is a strong positive relationship between body weight and wealth.

10.1.52. Your friend is a whiz when it comes to maps. He decides to create a computerized map showing the countries where eating disorders are likely to occur. He asks you for assistance in creating this visual image. What will you tell him? a. b. c. d.

These disorders occur in nearly all societies. These disorders occur only in the United States and Canada. These disorders occur in cultures with small population growth. These disorders occur almost exclusively in North America, Europe, and Japan. Difficulty: 2 Question ID: 10.1.52 Page Reference: 259-260 Topic: Frequency of Eating Disorders Skill: Applied Answer: d. These disorders occur almost exclusively in North America, Europe, and Japan.

10.1.53. Which of the following ages falls within the typical age range for the onset of eating disorders? a. b. c. d.

7 10 17 35 Difficulty: 1 Question ID: 10.1.53 Page Reference: 261 Topic: Frequency of Eating Disorders Skill: Factual Answer: c. 17

10.1.54. Which of the following occupations is associated with an elevated risk for developing eating disorders? a. b. c.

nurse singer secretary

gymnast Difficulty: 1 Question ID: 10.1.54 Page Reference: 261 Topic: Causes of Eating Disorders Skill: Factual Answer: d. gymnast

10.1.55. You have been asked to design a targeted prevention program of eating disorders. Which group would receive the most focus in your program design? a. b. c. d.

lower-class 20- to 24-year-old black females upper-class 16- to 20- year-old black females lower-class 24- to 30- year-old white females upper-class 16- to 20-year-old white females Difficulty: 3 Question ID: 10.1.55 Page Reference: 261 Topic: Causes of Eating Disorders Skill: Applied Answer: d. upper-class 16- to 20-year-old white females

10.1.56. The tendency to develop eating disorders seems related to which of the following variables? a. b. c. d.

high school grades degree of extraversion exposure to popular media ratio of female to male friends Difficulty: 1 Question ID: 10.1.56 Page Reference: 261 Topic: Causes of Eating Disorders Skill: Factual Answer: c. exposure to popular media

10.1.57. Compared to families of individuals with anorexia nervosa, which of the following are you more likely to find in families of individuals with bulimia nervosa? a. b. c. d.

cohesion and the absence of conflict conflict and rejection multiple instances of eating disorders medical illnesses affecting many family members

Difficulty: 1 Question ID: 10.1.57 Page Reference: 262 Topic: Causes of Eating Disorders Skill: Factual Answer: b. conflict and rejection 10.1.58. Which of the following characterizes the concept proposed by Minuchin of the enmeshed family? a. b. c. d.

mood disorders run in the family family members are overly involved in one another's lives the children in the family were born within short periods of time family members have overlapping responsibilities within the home Difficulty: 2 Question ID: 10.1.58 Page Reference: 262 Topic: Causes of Eating Disorders Skill: Conceptual Answer: b. family members are overly involved in one another's lives

10.1.59. What have researchers found concerning the relationship between eating disorders and an individual's report of sexual abuse? a. Sexual abuse is reported much more frequently by those with eating disorders than other pathologies. b. The rate of reports of sexual abuse among those with eating disorders is lower than in the general population. c. Sexual abuse is reported in anorexia at higher rates than other pathologies, but not in bulimia. d. The rate of reports of sexual abuse among those with eating disorders is similar to that found in other pathologies. Difficulty: 1 Question ID: 10.1.59 Page Reference: 262 Topic: Causes of Eating Disorders Skill: Conceptual Answer: d. The rate of reports of sexual abuse among those with eating disorders is similar to that found in other pathologies.

10.1.60. The A&E cable channel is presenting the biography of Dr. Hilde Bruch. The presentation includes interviews with Dr. Bruch, who is asked to explain her theory of the development of eating disorders. What does she say? a.

Impulsive, out of control young women use eating disorders as a means of rebelling.

b. Overly compliant young women use dieting as a means to wrest some control from their parents. c. A fear of sexual dysfunction motivates some young adolescents to try to stop the maturation process cold in its tracks. d. The scapegoating of a young adolescent female leaves her with no other means to deal with the stress of living in a dysfunctional family. Difficulty: 2 Question ID: 10.1.60 Page Reference: 262 Topic: Causes of Eating Disorders Skill: Applied Answer: b. Overly compliant young women use dieting as a means to wrest some control from their parents.

10.1.61. Which of the following findings seems to support Hilde Bruch's view of the etiology of eating disorders? a. The rate of anorexia nervosa has been increasing in recent decades. b. Anorexia nervosa is found almost exclusively in the United States, Europe, and Japan. c. The parents of children with eating disorders are very likely to have used strict, punitive discipline. d. Young women with eating disorders tend to set unrealistic, perfectionistic goals. Difficulty: 2 Question ID: 10.1.61 Page Reference: 262 Topic: Causes of Eating Disorders Skill: Conceptual Answer: d. Young women with eating disorders tend to set unrealistic, perfectionistic goals.

10.1.62. An expert on eating disorders describes those with such disorders as "lacking introceptive awareness." Which of the following characterizes this lack? a. b. c. d.

They do not recognize internal cues of emotional states as well as hunger. They do not understand how other people try to influence their behavior in subtle ways. They do not pay attention to the nonverbal behavior of individuals during conversations. They often confuse hunger pangs with signs of deeper psychological significance.

Difficulty: 2 Question ID: 10.1.62 Page Reference: 263 Topic: Causes of Eating Disorders Skill: Conceptual Answer: a. They do not recognize internal cues of emotional states as well as hunger.

10.1.63. Researchers are finding an increased rate of which mental disorder in both victims of eating disorders and their family members? a. b. c. d.

schizotypal personality disorder panic attack depression PTSD Difficulty: 2 Question ID: 10.1.63 Page Reference: 263 Topic: Causes of Eating Disorders Skill: Conceptual Answer: c. depression

10.1.64. An expert on eating disorders is giving a talk about the relationship between eating disorders and depression. Which of the following would be an appropriate title for this talk? a. b. c. d.

"Depression: The Primary Cause of Eating Disorders" "Depression: Both Cause and Effect" "Successful Treatment of Eating Disorders Has No Effect on Depression" "Eating Disorders Are Symptoms of Depression" Difficulty: 2 Question ID: 10.1.64 Page Reference: 263 Topic: Causes of Eating Disorders Skill: Conceptual Answer: b. "Depression: Both Cause and Effect"

10.1.65. Efforts to understand the relationship between depression and eating disorders have focused on which of the following depressive symptoms? a. b. c. d.

psychomotor retardation sleep disturbances low self-esteem generalized anxiety Difficulty: 2 Question ID: 10.1.65 Page Reference: 263 Topic: Causes of Eating Disorders Skill: Conceptual Answer: c. low self-esteem

10.1.66. A group of research participants is in front of a series of schematic figures of women ranging from very thin to very obese. What is the researcher investigating? a. b. c. d.

body-size delusional systems deficits in sensory perception dissatisfaction with one's body image the effects of punishment on eating behavior Difficulty: 2 Question ID: 10.1.66 Page Reference: 263 Topic: Causes of Eating Disorders Skill: Applied Answer: c. dissatisfaction with one's body image

10.1.67. ___________ or negative mood states commonly trigger episodes of binge eating according to Vogele and Gibson. a. b. c. d.

Anapraxsis. Hysteria. Anhedonia. Dysphoria. Difficulty: 2 Question ID: 10.1.67 Page Reference: 263 Topic: Causes of Eating Disorders Skill: Conceptual Answer: d. Dysphoria.

10.1.68. Ann suffers from bulimia and has been gaining weight. Her parents are concerned and have been encouraging her to go on a diet. What would you tell her and her parents? a. "She lacks the will power to diet successfully." b. "She has an unconscious reason to maintain weight." c. "An inherited endocrine dysfunction is most likely responsible for the difficulty she has losing weight." d. "Dieting is likely to contribute directly to subsequent binge eating." Difficulty: 3 Question ID: 10.1.68 Page Reference: 264 Topic: Causes of Eating Disorders Skill: Applied Answer: d. "Dieting is likely to contribute directly to subsequent binge eating."

10.1.69. A medical technician looks up from the microscope and says to his supervisor, "I think we have a case of hyperlipogenesis here. " What would this information tell the physician about the patient whose tests were just analyzed? a. The patient suffered cardiac arrest secondary to an eating disorder. b. The patient's body is storing an abnormally large amount of fat in fat cells. c. The patient's endocrine system is working at a high rate that will soon lead to exhaustion. d. The patient's heart rate has increased as a result of having to push more blood through clogged arteries. Difficulty: 2 Question ID: 10.1.69 Page Reference: 264 Topic: Causes of Eating Disorders Skill: Applied Answer: b. The patient's body is storing an abnormally large amount of fat in fat cells.

10.1.70. A weight level the body seems to defend by adjusting its rate of energy use is called the a. b. c. d.

weight set point. ideal weight. metabolic weight. energy/weight balance. Difficulty: 1 Question ID: 10.1.70 Page Reference: 264 Topic: Causes of Eating Disorders Skill: Factual Answer: a. weight set point.

10.1.71. With respect to the role of genetics in eating disorders, it is most likely that a. anorexia is inherited, but not bulimia. b. bulimia is inherited, but not anorexia. c. genetics might influence some personality characteristics that increase the risk for eating disorders. d. eating disorders are responses to cultural pressures and are totally unrelated to genetics. Difficulty: 2 Question ID: 10.1.71 Page Reference: 264 Topic: Causes of Eating Disorders Skill: Conceptual Answer: c. genetics might influence some personality characteristics that increase the risk for eating disorders.

10.1.72. What have researchers concluded concerning the role of neurophysiological factors in eating disorders? a. b. c. d.

Eating disorders result from abnormal brain functioning. Neurophysiological changes are the effects of eating disorders, not the cause. Serotonin plays the key role in eating disorders. No neurophysiological factors have been identified. Difficulty: 2 Question ID: 10.1.72 Page Reference: 264 Topic: Causes of Eating Disorders Skill: Conceptual Answer: b. Neurophysiological changes are the effects of eating disorders, not the cause.

10.1.73. Although extremely rare, eating disorders have been linked to lesions in the a. b. c. d.

striatum. cerebellum. hippocampus. hypothalamus. Difficulty: 1 Question ID: 10.1.73 Page Reference: 264 Topic: Causes of Eating Disorders Skill: Factual Answer: d. hypothalamus.

10.1.74. What is the first goal of the treatment of anorexia nervosa? a. b. c. d.

gaining at least a minimal amount of weight developing insight into negative feelings about weight removing the social stigma associated with the illness exploring possible reasons for the illness such as social pressure

Difficulty: 1 Question ID: 10.1.74 Page Reference: 265 Topic: Treatment of Anorexia Nervosa Skill: Applied Answer: a. gaining at least a minimal amount of weight

10.1.75. In establishing an eating disorder clinic your group of professionals is keen to include all of the therapies that are currently being used to treat these disorders. You will likely include several different therapies, but not

a. b. c. d.

token economies. Bruch's psychodynamic therapy. cognitive behavioral therapy. feminist therapies. Difficulty: 2 Question ID: 10.1.75 Page Reference: 265 Topic: Treatment of Anorexia Nervosa Skill: Applied Answer: a. token economies.

10.1.76. The most widely studied form of family therapy for eating disorders involves parents initially taking complete control over the child’s eating. Age-appropriate autonomy is returned to the child as eating improves. This system is called the a. b. c. d.

parental control method. pyschodynamic method. Montreux method. Maudsley method. Difficulty: 2 Question ID: 10.1.76 Page Reference: 265 Topic: Treatment of Anorexia Nervosa Skill: Factual Answer: d. Maudsley method.

10.1.77. In one study ___________ lead to a 70 to 80 percent reduction in binge eating and purging. a. b. c. d.

psychodynamic therapy aversive conditioning client centered therapy cognitive behavior therapy Difficulty: 2 Question ID: 10.1.77 Page Reference: 266 Topic: Treatment of Anorexia Nervosa Skill: Conceptual Answer: d.

cognitive behavior therapy

10.1.78. Frances suffers from bulimia nervosa and is seeing a therapist who is focusing on normalizing her eating patterns and on her dysfunctional attitudes. Which form of therapy is her therapist providing? a. b. c. d.

psychodynamic therapy aversive conditioning interpersonal therapy cognitive behavior therapy Difficulty: 1 Question ID: 10.1.78 Page Reference: 266 Topic: Treatment of Anorexia Nervosa Skill: Conceptual Answer: d. cognitive behavior therapy

10.1.79. Paula suffers from bulimia nervosa and is considering treatment with an antidepressant medication. Knowing that you have been studying this issue, she asks your opinion. What should you tell her? a. "Antidepressants have been shown to be very effective." b. "Antidepressants will help you with your purging but not with your bingeing." c. "Relapse is common when medication is stopped." d. "Because antidepressants make you feel better, you will be less motivated to deal with your eating disorder." Difficulty: 2 Question ID: 10.1.79 Page Reference: 268 Topic: Treatment of Bulimia Nervosa Skill: Applied Answer: c. "Relapse is common when medication is stopped." 10.1.80. Which form of therapy is emerging as an effective treatment for bulimia nervosa because patients continue to improve after the end of therapy? a. b. c. d.

psychodynamic therapy behavior therapy interpersonal therapy selective serotonin reuptake inhibitors Difficulty: 2 Question ID: 10.1.80 Page Reference: 266 Topic: Treatment of Bulimia Nervosa Skill: Conceptual Answer: c. interpersonal therapy

10.1.81. A clinical psychologist named Dr. Cognitive is proposing a study of the effectiveness of several forms of therapy for treating anorexia nervosa. She sends her proposal to the ethics committee for review. Although they approve it from an ethics standpoint, one of the members of the committee writes her a note saying, "Be aware of the allegiance effect." When Dr. Cognitive looks at the proposal, what may cause her concern? a. Clients will show greater recovery when they are treated by the same therapists across time. b. Clients will work hard to recover to demonstrate that their choice of therapist is indeed the best. c. Because she is a cognitive therapist she is more likely to find that form of therapy to be the most successful. d. Funding agencies will be more likely to give grants to researchers who are responsive to the needs of the granting agency. Difficulty: 3 Question ID: 10.1.81 Page Reference: 267 Topic: Treatment of Bulimia Nervosa Skill: Applied Answer: c. Because she is a cognitive therapist she is more likely to find that form of therapy to be the most successful.

10.1.82. A news report describes a treatment that does not address eating disorders directly, and was actually used as the placebo treatment in several early studies, yet has been found to be more effective after 12 months than therapies that are directed at eating disorders. Which form of therapy is described there? a. b. c. d.

interpersonal therapy antianxiety medications antidepressant medications education about nutrition and health Difficulty: 2 Question ID: 10.1.82 Page Reference: 266 Topic: Treatment of Bulimia Nervosa Skill: Factual Answer: a. interpersonal therapy

10.1.83. How do long-term outcomes for the treatment of anorexia nervosa compare to the long-term outcomes for the treatment of bulimia nervosa? a. b. c.

The long-term success is greater for bulimia nervosa. The long-term success is greater for anorexia nervosa. There is no difference in long-term outcomes for treating these disorders.

d. Although there is a higher mortality rate for anorexia, the success of treatment is otherwise better for anorexia. Difficulty: 2 Question ID: 10.1.83 Page Reference: 268 Topic: Treatment of Bulimia Nervosa Skill: Factual Answer: a. The long-term success is greater for bulimia nervosa.

10.1.84. A third generation of more successful prevention efforts for eating disorders does not directly focus on body image or disordered eating. Instead, they attack the thinness ideal indirectly, or focus on

a. b. c. d.

eliminating unhealthy eating habits rather than promoting healthy habits. promoting healthy eating rather than eliminating unhealthy habits. encouraging healthy communications styles in families. eliminating unhealthy communication styles in families. Difficulty: 2 Question ID: 8.1.84 Page Reference: 268 Topic: Prevention of Eating Disorders Skill: Conceptual Answer: b. promoting healthy eating rather than eliminating unhealthy habits.

10.1.85. A research design in which neither the patient nor the therapist knows if the patient is receiving the treatment in question or the placebo is known as a. b. c. d.

double blind. double control. dependent control. post hoc. Difficulty: 1 Question ID: 10.1.85 Page Reference: 267 Topic: Prevention of Eating Disorders Skill: Factual Answer: a. double blind.

Short Answer 10.2.86. Eating disorders are severe disturbances in eating behavior that result from the sufferer’s obsessive fear of gaining weight. Some experts have suggested that __________ disorder would be a more accurate term.

Difficulty: 2 Question ID: 10.2.86 Page Reference: 249 Topic: Overview Skill: Factual Answer: dieting

10.2.87. ____________ eating is defined as eating an amount of food that is clearly larger than most people would eat under similar circumstances in a fixed period of time, for example, less than 2 hours. Difficulty: 2 Question ID: 10.2.87 Page Reference: 254 Topic: Symptoms of Bulimia Skill: Factual Answer: Binge

10.2.88. ____________ involves behaviors designed to eliminate consumed food from the body. Difficulty: 1 Question ID: 10.2.88 Page Reference: 255 Topic: Symptoms of Bulimia Skill: Factual Answer: Purging

10.2.89. ____________ is often comorbid with bulimia, especially in bulimic patients who self induce vomiting. Difficulty: 1 Question ID: 10.2.89 Page Reference: 255-256 Topic: Symptoms of Bulimia Skill: Factual Answer: Depression

10.2.90. ____________ includes two subtypes; the restricting type and the binge eating/purging type. Difficulty: 2 Question ID: 10.2.90 Page Reference: 257 Topic: Diagnosis of Eating Disorders

Skill: Factual Answer: Anorexia nervosa

10.2.91. A __________ is a group that shares some feature in common, for example, year of birth. Difficulty: 1 Question ID: 10.2.91 Page Reference: 258 Topic: Frequency of Eating Disorders Skill: Factual Answer: cohort

10.2.92. Psychological studies repeatedly show that exposure to images of super-thin women increases body image __________ among girls and young women. Difficulty: 1 Question ID: 10.2.92 Page Reference: 260 Topic: Frequency of Eating Disorders Skill: Factual Answer: dissatisfaction

10.2.93. Some experts argue that pressures to be strong and muscular have created a new eating disorder among males sometimes called “reverse anorexia” which is characterized by excessive emphasis on extreme muscularity and often accompanied by the abuse of anabolic steroids. This is referred to by some as the __________ complex. Difficulty: 2 Question ID: 10.2.93 Page Reference: 252 Topic: Causes of Eating Disorders Skill: Factual Answer: Adonis

10.2.94. Recognition of internal cues, including hunger and various emotional states is called what type of awareness? __________

Difficulty: 2 Question ID: 10.2.94 Page Reference: 263 Topic: Causes of Eating Disorders Skill: Factual

Answer: interoceptive

10.2.95. A __________ body image is a highly critical evaluation of one’s weight and shape that is thought, by clinicians, to contribute to the development of eating disorders. Difficulty: 1 Question ID: 10.2.95 Page Reference: 263 Topic: Causes of Eating Disorders Skill: Factual Answer: negative

10.2.96. Predictors of a better prognosis for eating disorders include an early age of onset, conflict-free parent–child relationships, early treatment, less weight loss, and the absence of binge eating and __________ . Difficulty: 1 Question ID: 10.2.96 Page Reference: 266 Topic: Treatment of Anorexia Nervosa Skill: Conceptual Answer: purging

10.2.97. In the long run, viewed in a timeframe longer than 12 months, the most effective form of psychotherapy for the treatment of bulimia nervosa seems to be __________ .

Difficulty: 2 Question ID: 10.2.97 Page Reference: 266 Topic: Treatment of Bulimia Nervosa Skill: Conceptual Answer: interpersonal

10.2.98. Third generation eating disorder prevention programs that have had the most success in reducing binge eating are ones that focus on __________ weight or eating programs.

Difficulty: 2 Question ID: 10.2.98 Page Reference: 268 Topic: Prevention of Eating Disorders Skill: Factual

Answer: healthy

Essay 10.3.99. Discuss the research on the perceptions of weight or shape among individuals with eating disorders. Difficulty: 3 Question ID: 10.3.99 Page Reference: 252-253 Topic: Symptoms of Anorexia Skill: Conceptual Answer: Many individuals with eating disorders tend to deny that they have any problem at all with weight. Even medical complications are not likely to dissuade them. Other people with the disorder apparently suffer from a disturbance in the way body weight and shape is experienced. Some experts claim this stems from what is termed a distorted body image, or an inaccuracy in how people with anorexia nervosa actually perceive their body size and shape. For example, one study found that young women with anorexia nervosa overestimated the size of various body parts in comparison to a normal control group. However, not all people with anorexia nervosa suffer from a distorted body image. Moreover, many people without an eating disorder inaccurately estimate the size of their body. At the least, people with eating disorders are unduly influenced by their self-evaluations of their body weight or shape.

10.3.100. Explain why bulimia nervosa and anorexia nervosa are both considered to be characterized by a struggle for control. Difficulty: 3 Question ID: 10.3.100 Page Reference: 253-255, 262 Topic: Symptoms of Bulimia Skill: Conceptual Answer: People with bulimia feel out of control and ashamed of their lack of control, and their disorder is an attempt to regain a sense of control. People with anorexia pride themselves in self-control and their disorder is typified by excessive self-control.

10.3.101. How does the DSM-IV-TR handle obesity and binge eating disorder? Difficulty: 2 Question ID: 10.3.101 Page Reference: 258 Topic: Diagnosis of Eating Disorders

Skill: Conceptual Answer: Diagnostic criteria for binge eating disorder are included in an appendix of DSM. This section of the manual is for disorders that require further study. This proposed disorder involves episodes of binge eating much like those found in bulimia nervosa but without compensatory behavior. Research has demonstrated that binge eating is associated with a number of psychological and physical difficulties other than anorexia nervosa and bulimia nervosa. Among these problems is obesity, or excess body fat, a circumstance that roughly corresponds with a body weight 20 percent above the expected weight. The DSM considered classifying obesity as an eating disorder, but they decided that too little information was available to justify this move. Calling obesity a "mental disorder" is controversial, moreover, especially given the high prevalence of overweight individuals in the United States.

10.3.102. What patterns in the epidemiology of eating disorders suggest sociocultural influences on their development? Difficulty: 2 Question ID: 10.3.102 Page Reference: 258-260 Topic: Frequency of Eating Disorders Skill: Conceptual Answer: The prevalence of eating disorders is higher in industrialized societies such as North America, Europe, and Japan. In the United States, the prevalence is higher in whites than blacks, those in higher socioeconomic groups, and women in jobs where slimness is valued. Eating disorders are also more frequent among groups who move into new areas where eating disorders exist, such as among Arabs and Asians who move to Western countries. Finally, in the United States, there is an increasing number of eating disorder cases among well-to-do African Americans.

10.3.103. Summarize the research on the biological factors involved in eating and weight regulation. Difficulty: 2 Question ID: 10.3.103 Page Reference: 264 Topic: Causes of Eating Disorders Skill: Conceptual Answer: Homeostatic mechanisms govern the regulation of weight around a certain set point that is a fixed weight or small range of weights. Maintaining our weight near a set point is adaptive. If weight declines as in a famine, metabolism slows in an attempt to return to the set point. The process works like a thermostat to regulate the heating and cooling of air temperature near a given setting. The behaviors following dietary restraint are part of the body's attempt to maintain a weight at a set point through behavioral actions. The body also attempts to do this through physiological actions. When food intake is reduced, there is a slowing of the metabolic rate (rate at which the body expends energy). This reaction has survival value and is likely a product of evolution. However, the body does not distinguish between intentional attempts to lose weight and potential starvation. Thus, the individual struggles against a biological need.

10.3.104. Summarize what is currently know about the role of genetics and neurophysiology in eating disorders. Difficulty: 2 Question ID: 10.3.104 Page Reference: 264-265 Topic: Causes of Eating Disorders Skill: Conceptual Answer: Concordance rates for bulimia are higher for monozygotic twins than for dizygotic twins. However, the difference can be explained by several different heritable mechanisms. Genetics may influence personality characteristic that lead to bulimia or a certain body type or weight set point may be inherited. Researchers have also found that eating disorders are associated with elevations in endogenous opioids, low levels of serotonin, and diminished neuroendocrine function. These biological changes, however, appear to be the effects of eating disorders rather than the cause of them. In rare instances, a hormonal disturbance or a lesion in the hypothalamus has been linked to eating disorders.

10.3.105. As a clinical psychologist who specializes in the treatment of bulimia nervosa, you have been asked to design a program based on the successful work of Fairburn utilizing a variety of cognitivebehavioral techniques. Discuss the program you would design. Difficulty: 2 Question ID: 10.3.105 Page Reference: 265 Topic: Treatment of Anorexia Nervosa Skill: Applied Answer: Fairburn conceptualizes the cause of Bulimia nervosa as a combination of cognitive errors including an excessive emphasis on weight and shape; perfectionism; and dichotomous “black or white” thinking that leaves the client trapped. His program, that we will replicate, involves three stages. The first stage involves psycho-education in an attempt to convince the client of the necessity of developing more normal eating patterns and end the cycle of eating restraint followed by binging and purging. Second we would introduce traditional cognitive therapy methods that aim to convince the client of their cognitive errors, such as illogical and dysfunctional beliefs about the importance of weight the connection between self image and weight. This stage would draw heavily on the methods introduced by Beck. Third, as clients develop more logical and reasonable cognitions and beliefs we would attempt to consolidate these into day to day realistic expectations about weight, diet and strategies for relapse prevention.

10.3.106. Describe the research on the effectiveness of different forms of therapy for treating bulimia nervosa.

Difficulty: 2 Question ID: 10.3.106 Page Reference: 265-267 Topic: Treatment of Bulimia Nervosa Skill: Conceptual

Answer: Although interpersonal therapy does not directly address eating disorders, it has emerged as a very successful form of treatment. This therapy focuses on difficulties in close relationships. Interpersonal therapy was studied in an investigation of the effectiveness of cognitive behavior therapy. The researchers used interpersonal therapy as a placebo control group in their study. They were interested in studying the effectiveness of cognitive behavior therapy and needed a credible placebo. At the end of the study, cognitive therapy was more effective than interpersonal therapy. However, at the 12-month follow-up the interpersonal therapy group continued to improve. They equaled those of the cognitive behavior therapy group and outdistanced those in the behavior therapy alone group.

Chapter 11 Substance Abuse Disorders Total Assessment Guide (T.A.G.) Topic Overview pp. 271-275

Symptoms pp. 275-283

Diagnosis pp. 283-286

Frequency pp. 286-290

Causes pp. 290-296

Treatment pp. 296-299

Question Type Multiple Choice Short Answer Essay Multiple Choice

Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay

Factual 1, 3, 5, 6, 7, 8, 9, 11, 12 106 16, 18, 19, 21, 23, 24, 26, 28, 30, 31, 32, 34, 38, 39, 41, 42, 46 110, 111, 112 50, 54, 55, 56

57, 60, 61, 65, 66, 67

71, 73, 76, 77, 80

Conceptual 4

117 13, 20, 29, 35, 36, 37, 40, 43, 45, 48

Applied 2, 10

14, 15, 17, 22, 25, 27, 33, 44, 47

107, 108, 109 118, 119 49, 51, 53

113 120 62, 63, 64, 68

58, 59

69, 72, 81, 82, 84, 85

70, 74, 75, 78, 79, 83

121, 122, 123 86, 87, 95, 98, 99, 103

90, 92, 93, 97, 100, 101

114, 115 88, 89, 91, 94, 96, 102, 104, 105 116

124

Chapter 11: Substance Use Disorders

Multiple Choice 11.1.1. According the World Health Organization ______ use was responsible for 5 percent of the total burden of disease and disability worldwide in 2004. a. b. c. d.

heroin alcohol cocaine marijuana Difficulty: 1 Question ID: 11.1.1 Page Reference: 272 Topic: Overview Skill: Conceptual Answer: b. alcohol

11.1.2. Your friend misses work and has serious family difficulties because he uses drugs. However, he is not addicted to drugs. What DSM-IV diagnosis should be made in this case? a. b. c. d.

substance abuse substance craving substance dependence substance ingestion habit Difficulty: 3 Question ID: 11.1.2 Page Reference: 272 Topic: Overview Skill: Applied Answer: a. substance abuse

11.1.3. DSM-IV defines substance abuse in terms of a. b. c. d.

addiction. tolerance and withdrawal. craving and lack of control. interference with obligations at work and home.

Difficulty: 1

Question ID: 11.1.3 Page Reference: 272 Topic: Overview Skill: Factual Answer: d. interference with obligations at work and home.

11.1.4. You are reading an older text on alcohol and other drugs. The text has numerous references to the word addiction, which you find later has been replaced by ____________________. The two terms have essentially the same meaning. a. b. c. d.

abuse. anhedonia. substance dependence. self destructive tendencies. Difficulty: 1 Question ID: 11.1.4 Page Reference: 272 Topic: Overview Skill: Conceptual Answer: c. substance dependence.

11.1.5. What term is used to describe chemicals that can alter a person's mood, perception, or brain functioning? a. b. c. d.

legal drugs illegal drugs psychoactive substances exogenous brain substances Difficulty: 1 Question ID: 11.1.5 Page Reference: 272 Topic: Overview Skill: Factual Answer: c. psychoactive substances

11.1.6. Polysubstance abuse refers to abuse of a. b. c. d.

synthetic drugs. more serious drugs. prescription drugs. several types of drugs.

Difficulty: 1 Question ID: 11.1.6 Page Reference: 272 Topic: Overview Skill: Factual Answer: d. several types of drugs.

11.1.7. While watching a television show you hear one of the characters, a physician, talk about narcotic analgesics. What is another name for these drugs? a. b. c. d.

opiates hypnotics cannabinoids benzodiazepines Difficulty: 1 Question ID: 11.1.7 Page Reference: 272 Topic: Overview Skill: Factual Answer: a. opiates

11.1.8. What type of drug is alcohol? a. b. c. d.

opiate analgesic central nervous system stimulant central nervous system depressant Difficulty: 1 Question ID: 11.1.8 Page Reference: 273 Topic: Overview Skill: Factual Answer: d. central nervous system depressant

11.1.9. Which term describes central nervous system depressants that are used to relieve anxiety? a. b. c. d.

opiates hypnotics analgesics anxiolytics

Difficulty: 1 Question ID: 11.1.9 Page Reference: 272 Topic: Overview Skill: Factual Answer: d. anxiolytics

11.1.10. For a class assignment you are asked to find information on cocaine. A reference book on drugs lists them by major category. Under which category will you find cocaine? a. b. c. d.

opiates stimulants depressants hallucinogens Difficulty: 1 Question ID: 11.1.10 Page Reference: 273 Topic: Overview Skill: Applied Answer: b. stimulants

11.1.11. In its presentation of diagnostic criteria the DSM-IV-TR uses which term for the more severe pattern of drug use that leads to increased doses, tolerance, and withdrawal? a. b. c. d.

addiction dependence abuse craving Difficulty: 2 Question ID: 11.1.11 Page Reference: 272 Topic: Overview Skill: Factual Answer: b. dependence

11.1.12. Ernest Hemingway, the case presented at the start of chapter 11, suffered from a. b. c. d.

anxiety disorder. cocaine dependence. alcohol dependence. borderline personality disorder.

Difficulty: 1 Question ID: 11.1.12 Page Reference: 274 Topic: Overview Skill: Factual Answer: c. alcohol dependence.

11.1.13. Which of the following offers a useful basis for distinguishing between people who are dependent on alcohol and those who are not? a. b. c. d.

legal involvement due to drinking the amount of money spent on alcohol the number of problems due to drinking the amount of alcohol consumed each week Difficulty: 2 Question ID: 11.1.13 Page Reference: 275 Topic: Symptoms Skill: Conceptual Answer: c. the number of problems due to drinking

11.1.14. Which of the following is an example of psychological dependence on alcohol? a. b. c. d.

not wanting to drink alone drinking to relieve negative moods ability to drink more and more over time cognitive impairments due to alcohol abuse Difficulty: 2 Question ID: 11.1.14 Page Reference: 275 Topic: Symptoms Skill: Applied Answer: b. drinking to relieve negative moods

11.1.15. You are designing a research study to test the effectiveness of a new type of treatment program for alcohol dependence, and you want to be able to assess changes in your subjects' craving for alcohol. Which of the following would be a good index of their craving? a. b. c. d.

the amount of alcohol they drink the discomfort they experience when they don't drink their need to increase the amount that they drink the amount of time they spend planning to drink

Difficulty: 2 Question ID: 11.1.15 Page Reference: 275 Topic: Symptoms Skill: Applied Answer: d. the amount of time they spend planning to drink

11.1.16. Tolerance for a psychoactive substance refers to a. b. c. d.

withdrawal. psychological dependence. the ability to consume several drugs at the same time with limited adverse effects. requiring more of a substance to achieve the same effect that lower doses used to achieve. Difficulty: 1 Question ID: 11.1.16 Page Reference: 275 Topic: Symptoms Skill: Factual

Answer: d. requiring more of a substance to achieve the same effect that lower doses used to achieve.

11.1.17. Metabolic tolerance involves changes in _____________ while pharmacodynamic tolerance involves changes in _____________. a. b. c. d.

neurons; enzymes enzymes; neurons brain; neuron neuron; brain Difficulty: 3 Question ID: 11.1.17 Page Reference: 275 Topic: Symptoms Skill: Applied Answer: b. enzymes; neurons

11.1.18. When in reaction to psychoactive drug use neurons adapt by reducing the number of receptors or by reducing their sensitivity to the drug, this is known as a. b. c. d.

down regulation. up regulation. neuron regulation. metabolic regulation.

Difficulty: 2 Question ID: 11.2.18 Page Reference: 275 Topic: Symptoms Skill: Factual Answer: a. down regulation.

11.1.19. In one type of tolerance, cues that are regularly associated with the administration of a drug begin to function as conditioned stimuli and elicit a conditioned response that is opposite in direction to the natural effect of the drug in the process of a. b. c. d.

tolerance conditioning. drug conditioning. metabolic conditioning. behavioral conditioning. Difficulty: 2 Question ID: 11.1.19 Page Reference: 275 Topic: Symptoms Skill: Factual Answer: d. behavioral conditioning.

11.1.20. What happens to a drinker's biological system to cause withdrawal from alcohol? a. b. c. d.

It is deprived of essential vitamins. It has become psychologically dependent. It rebounds after functioning in a chronically depressed state. It rebounds after functioning in a chronically stimulated state. Difficulty: 2 Question ID: 11.1.20 Page Reference: 276 Topic: Symptoms Skill: Conceptual Answer: c. rebounds after functioning in a chronically depressed state

11.1.21. Delirium tremens is a collection of symptoms that result when a person is withdrawing from a. b. c. d.

opiates. alcohol. stimulants. hallucinogens.

Difficulty: 2 Question ID: 11.1.21 Page Reference: 276 Topic: Symptoms Skill: Factual Answer: b. alcohol.

11.1.22. The police find a man in a seedy part of town; he looks in "bad shape" so they call for an ambulance. On the way to the hospital the paramedic calls the hospital base with the following: approximately 50-year-old white male, heavy sweating, hand tremors, seems delirious, and appears to be experiencing hallucinations. When the patient arrives at the hospital, the emergency room physician suspects that the patient is experiencing a. b. c. d.

cocaine withdrawal. barbiturate overdose. a schizophrenic episode. alcohol withdrawal delirium. Difficulty: 2 Question ID: 11.1.22 Page Reference: 276 Topic: Symptoms Skill: Applied Answer: d. alcohol withdrawal delirium.

11.1.23. Based on reports from people who use drugs, which psychoactive substance is least associated with tolerance and withdrawal effects? a. b. c. d.

opiates sedatives and hypnotics marijuana and hashish cocaine Difficulty: 1 Question ID: 11.1.23 Page Reference: 276 Topic: Symptoms Skill: Factual Answer: c. marijuana and hashish

11.1.24. Which of the following are signs of alcohol intoxication according to DSM-IV-TR? a. b. c. d.

anhedonia, hallucinations, and delusions nystagmus, rapid heart beat, and convulsions slurred speech, lack of coordination, and nystagmus feelings of pleasure, nausea, and constriction of the pupils of the eye

Difficulty: 1 Question ID: 11.1.24 Page Reference: 277 Topic: Symptoms Skill: Factual Answer: c. slurred speech, lack of coordination, and nystagmus

11.1.25. The police found C. Gram Seven along the highway. They immediately transported him to the emergency room where it was determined that his alcohol concentration was 600 mg percent. The police report probably described Mr. Seven as a. b. c. d.

dead. stuporous. unconscious. uncoordinated. Difficulty: 2 Question ID: 11.1.25 Page Reference: 277 Topic: Symptoms Skill: Applied Answer: a. dead.

11.1.26. What is the legal limit of alcohol concentration for driving in most states, as measured in number of milligrams (mg) of alcohol per 100 milliliters of blood (percent)? a. b. c. d.

10 mg percent 100 mg percent 200 mg percent 400 mg percent Difficulty: 1 Question ID: 11.1.26 Page Reference: 277 Topic: Symptoms Skill: Factual Answer: b. 100 mg percent

11.1.27. Charles is administered a blood alcohol level test and the results show 350 mg percent. Which of the following characterizes his state? a. b. c. d.

slightly intoxicated very intoxicated, at risk of slipping into coma unaffected by the small amount he drank earlier his driving is impaired, but he could walk home

Difficulty: 3 Question ID: 1.1.27 Page Reference: 277 Topic: Symptoms Skill: Applied Answer: b. very intoxicated, at risk of slipping into coma

11.1.28. What is a blackout? a. b. c. d.

losing consciousness and passing out a time-limited period of dementia experience of nausea and vomiting an inability to remember what has happened Difficulty: 1 Question ID: 11.1.28 Page Reference: 277 Topic: Symptoms Skill: Factual Answer: d. an inability to remember what has happened

11.1.29. Which of the following statements about the relationship between the misuse of alcohol and death is true? a. b. c. d.

Alcohol is responsible for relatively few deaths directly. Alcohol related deaths due to injury are more common among young men. Alcohol related deaths due to disease are more common among young men. The number of alcohol-related deaths in the U.S. has been steadily declining for the past 20 years. Difficulty: 3 Question ID: 11.1.29 Page Reference: 278 Topic: Symptoms Skill: Conceptual Answer: b. Alcohol related deaths due to injury are more common among young men.

11.1.30. What is the physiological basis of the short-term effects of nicotine? a. b. c. d.

blocks release of GABA and acetylcholine increases release of GABA and acetylcholine blocks release of norepinephrine and dopamine increases release of norepinephrine and dopamine

Difficulty: 1 Question ID: 11.1.30 Page Reference: 278 Topic: Symptoms Skill: Factual Answer: d. increases release of norepinephrine and dopamine

11.1.31. The textbook suggests that withdrawal from nicotine is on a par with a. b. c. d.

heroin. LSD. marijuana. sugar. Difficulty: 1 Question ID: 11.1.31 Page Reference: 278 Topic: Symptoms Skill: Factual Answer: a. heroin

11.1.32. Why are cocaine and amphetamines called stimulant drugs? a. b. c. d.

They activate the sympathetic nervous system. They activate the parasympathetic nervous system. They reduce the level of GABA available in the brain. They increase the level of GABA available in the brain. Difficulty: 1 Question ID: 11.1.32 Page Reference: 279 Topic: Symptoms Skill: Factual Answer: a. They activate the sympathetic nervous system.

11.1.33. In your role as a police officer you sometimes come across individuals who are seem to be hallucinating and have delusions of persecution. In addition to the possibility that these individuals may have a mental disorder or be under the influence of various hallucinogenic drugs you must also consider the possibility of a. b. c. d.

marijauana withdrawal. amphetamine use. acute depression. None of these would produce those symptoms.

Difficulty: 3 Question ID: 11.1.33 Page Reference: 279 Topic: Symptoms Skill: Applied Answer: b. amphetamine use.

11.1.34. Prolonged use of amphetamines has been linked to an increase in violent behavior, but it is not easy to interpret this link because a. b. c. d.

there are many different definitions of violence. people are usually not willing to admit that they have taken amphetamines. the violence could be due to the drug user's lifestyle, not the drug itself. very few people actually engage in prolonged use of amphetamines. Difficulty: 1 Question ID: 11.1.34 Page Reference: 279 Topic: Symptoms Skill: Factual Answer: c. the violence could be due to the drug user's lifestyle, not the drug itself.

11.1.35. Alex is listening to a lecture on the history of opiate drugs and he learns something that he finds very surprising. What has he heard the lecturer say? a. b. c. d.

"Heroin is a synthetic opiate made from morphine." "Heroin has actually been legally available by prescription in the U.S. for years." "Heroin is a synthetic drug that was originally developed as an antidepressant." "Heroin is not really an opiate because it is synthetic and does not actually come from poppies." Difficulty: 1 Question ID: 11.1.35 Page Reference: 280 Topic: Symptoms Skill: Conceptual Answer: a. "Heroin is a synthetic opiate made from morphine."

11.1.36. The active substances in opium are a. b. c. d.

LSD and PCP. cocaine and heroin. codeine and morphine. marijuana and cocaine.

Difficulty: 2 Question ID: 11.1.36 Page Reference: 280 Topic: Symptoms Skill: Conceptual Answer: c. codeine and morphine.

11.1.37. A research participant in a study of drug effects has experienced a brief, intense, dreamlike euphoria with a sense of increased visual and auditory sensitivity. The brief sense of pleasure is very powerful. Which drug has this subject likely received? a. b. c. d.

PCP LSD heroin cocaine Difficulty: 1 Question ID: 11.1.37 Page Reference: 280 Topic: Symptoms Skill: Conceptual Answer: c. heroin

11.1.38. Which category of drugs is made up of those used to treat anxiety disorders and sleeping problems? a. b. c. d.

opiates stimulants benzodiazepines selective serotonin reuptake blockers Difficulty: 2 Question ID: 11.1.38 Page Reference: 281 Topic: Symptoms Skill: Factual Answer: c. benzodiazepines

11.1.39. The family of drugs that includes barbiturates to benzodiazepines are also know informally as all of the following EXCEPT a. b. c. d.

tranquilizers. sedatives. hypnotics. neuroleptics.

Difficulty: 1 Question ID: 11.1.39 Page Reference: 281 Topic: Symptoms Skill: Factual Answer: d. neuroleptics

11.1.40. People who stop taking relatively high doses of benzodiazepines can experience an abrupt return of the anxiety they were using the drugs to suppress. This is called a. b. c. d.

return of the repressed. high anxiety. rebound anxiety syndrome. discontinuance syndrome. Difficulty: 2 Question ID: 11.1.40 Page Reference: 281 Topic: Symptoms Skill: Conceptual Answer: d. discontinuance syndrome.

11.1.41. What is the most common active ingredient in marijuana? a. b. c. d.

LSD PCP THC LOB Difficulty: 1 Question ID: 11.1.41 Page Reference: 281 Topic: Symptoms Skill: Factual Answer: c. THC

11.1.42. Cannabis intoxication is often accompanied by temporal disintegration. This means that a. b. c. d.

the drug breaks down quickly in the body. people have trouble retaining and organizing information. intoxication can quickly lead to a nervous breakdown. intoxication leads to social withdrawal and isolation.

Difficulty: 1 Question ID: 11.1.42 Page Reference: 281 Topic: Symptoms Skill: Factual Answer: b. people have trouble retaining and organizing information.

11.1.43. Follow-up studies of adults who used cannabis over a period of several years a. b. c. d.

found evidence of cognitive decline associated with the drug. did not find evidence of cognitive decline associated with the drug. found evidence of brain damage in several areas of the central nervous system. found evidence of cognitive enhancement in creative skills. Difficulty: 2 Question ID: 11.1.43 Page Reference: 282 Topic: Symptoms Skill: Conceptual Answer: b. did not find evidence of cognitive decline associated with the drug.

11.1.44. While out in the wild, a group of vacationers pick some mushrooms. Later in the day, they use them in cooking the evening meal. Several members of the group begin to experience strange sensations and even hallucinations. The drug in the mushrooms was most likely a. b. c. d.

PCP. marijuana. psilocybin. exogenous opiates. Difficulty: 2 Question ID: 11.1.44 Page Reference: 282 Topic: Symptoms Skill: Applied Answer: c. psilocybin.

11.1.45. Which of the following is least likely to be experienced while under the influence of MDMA, also known as ecstasy? a. b. c. d.

increased sensory awareness enhanced mood difficulty regulating body temperature vivid hallucinations

Difficulty: 2 Question ID: 11.1.45 Page Reference: 282 Topic: Symptoms Skill: Conceptual Answer: d. vivid hallucinations

11.1.46. What hallucinogen at higher doses can induce psychotic behavior, including delusional thinking, catatonic behavior, manic excitement, and sudden mood changes? a. b. c. d.

LSD PCP cocaine alcohol Difficulty: 1 Question ID: 11.1.46 Page Reference: 282 Topic: Symptoms Skill: Factual Answer: b. PCP

11.1.47. You are a psychologist for a drug treatment program aimed at adolescents. In evaluating new clients you would be most concerned about the long-term continuous use of which substance? a. b. c. d.

PCP psilocybin mushrooms LSD MDMA Difficulty: 2 Question ID: 11.1.47 Page Reference: 282 Topic: Symptoms Skill: Applied Answer: a. PCP.

11.1.48. People who stop taking hallucinogens after continued use a. b. c. d.

usually experience flashbacks. show significant withdrawal effects. often return to drug use. show no withdrawal effects.

Difficulty: 1 Question ID: 11.1.48 Page Reference: 282 Topic: Symptoms Skill: Conceptual Answer: d. show no withdrawal effects.

11.1.49. What evidence led developers of DSM to the distinction between substance abuse and substance dependence? a. Substance abuse is more severe than dependence. b. Substance abusers do not suffer serious impairment. c. People who are dependent on substances do not all abuse substances. d. People whose adjustment is impaired by substance abuse do not all progress to a level of dependence. Difficulty: 2 Question ID: 11.1.49 Page Reference: 283-284 Topic: Diagnosis Skill: Conceptual Answer: d. People whose adjustment is impaired by substance abuse do not all progress to a level of dependence. 11.1.50. Which of the following must a person exhibit in order to be diagnosed with substance dependence in the DSM-IV-TR? a. b. c. d.

delirium tremens tolerance and withdrawal a pattern of compulsive use concealed substance use and blackouts Difficulty: 1 Question ID: 11.1.50 Page Reference: 284 Topic: Diagnosis Skill: Factual Answer: c. a pattern of compulsive use

11.1.51. With regard to the diagnosis of substance dependence in the DSM-IV-TR, if tolerance and/or withdrawal are noticed, an additional specification is also made. This specification is a. b. c. d.

substance dependence. substance abuse. physiological dependence. physiological abuse.

Difficulty: 2 Question ID: 11.1.51 Page Reference: 284-285 Topic: Diagnosis Skill: Conceptual Answer: c. physiological dependence.

11.1.52. Mindy was just arrested for driving while intoxicated (DWI). Why would we not necessarily diagnose Mindy as an alcohol abuser? a. b. c. d.

She is female, and abuse is only seen in males. DSM excludes DWI as a criterion for alcohol abuse. DSM requires a recurrent pattern. Intoxication is not pathological. Difficulty: 2 Question ID: 11.1.52 Page Reference: 284 Topic: Diagnosis Skill: Applied Answer: c. DSM requires a recurrent pattern.

11.1.53. The workgroup that is preparing the definition of substance use disorders that will be used in the DSM-V may collapse substance dependence and substance abuse into a single disorder with a continuous range of severity. In the case of alcohol, this disorder may be called “________________.” a. b. c. d.

delirium tremens alcohol use disorder Korsakoff's disorder alcoholism Difficulty: 3 Question ID: 11.1.53 Page Reference: 284 Topic: Diagnosis Skill: Conceptual Answer: b. alcohol use disorder.

11.1.54. Although the course of alcoholism is different in every individual, nearly all cases of alcoholism involve a. b. c.

onset before age 20. antisocial behavior. a predictable sequence of phases.

alternating periods of heavy use and abstinence. Difficulty: 1 Question ID: 11.1.54 Page Reference: 285 Topic: Diagnosis Skill: Factual Answer: d. alternating periods of heavy use and abstinence.

11.1.55. What pattern of drinking-related behavior was reported by George Vaillant in his longitudinal study of males? a. b. c. d.

Most of the men stopped drinking prior to age 30. Those who remained abstinent for six years were unlikely to relapse. The majority of the men drank so heavily, they were dead before the age of 40. The rate of abstinence was low and changed little over the course of the follow-up. Difficulty: 1 Question ID: 11.1.55 Page Reference: 285 Topic: Diagnosis Skill: Factual Answer: b. Those who remained abstinent for six years were unlikely to relapse.

11.1.56. Which problems commonly occur along with alcoholism? a. b. c. d.

schizophrenia and bipolar disorder adjustment disorder and somatization disorder mood disorder and antisocial personality disorder dependent personality disorder and specific phobia Difficulty: 1 Question ID: 11.1.56 Page Reference: 285 Topic: Diagnosis Skill: Factual/Definitional Answer: c. mood disorder and antisocial personality disorder

11.1.57. Why are amphetamines the most serious drug problem in Japan? a. Amphetamines are readily available as over-the-counter diet aids. b. There is a limited amount of land for cultivation of plant-based drugs and amphetamines are synthetic drugs. c. Government agencies have managed to intercept most shipments of drugs that have a detectable odor.

d. These drugs have a long history of use there by people who use them to get a boost in energy and to increase the number of hours they can work. Difficulty: 1 Question ID: 11.1.57 Page Reference: 286 Topic: Frequency Skill: Factual Answer: b. There is a limited amount of land for cultivation of plant-based drugs and amphetamines are synthetic drugs. 11.1.58. As a behavioral advisor to the World Health Organization it is your job to assess drug use and abuse in indigenous populations. You have been assigned to study the use of coca leaves, the plant from which cocaine is derived, among Indians of South America. In reading about past findings you discover a. b. c. d.

that these native groups have very few drug use problems. that these native groups have very serious drug use problems. that these native groups are so hostile to the WHO that no studies have been done. that these native groups have almost been wiped out due to local drug wars. Difficulty: 2 Question ID: 11.1.58 Page Reference: 286 Topic: Frequency Skill: Applied Answer: a. that these native groups have very few drug use problems.

11.1.59. You have been asked to design a targeted drug prevention program. Your task is to decide on which sex, if any, should receive more attention. You decide that it depends on which drug or drugs are under consideration and that a. b. c. d.

for alcohol abuse the focus should be on women, who have a higher rate of alcohol abuse. for alcohol dependence the focus should be on women, who have a higher rate than men. for drug abuse, in general, the focus should be on men who have the highest rate. for drug dependence in general the rates are equal, so each sex will have to be targeted. Difficulty: 2 Question ID: 11.1.59 Page Reference: 287 Topic: Frequency Skill: Applied Answer: c. for drug abuse, in general, the focus should be on men who have the highest rate.

11.1.60. Among all men and women who have ever used alcohol roughly what percent will develop serious alcohol related problems? a. b. c.

10 20 30

50 Difficulty: 1 Question ID: 11.1.60 Page Reference: 287 Topic: Frequency Skill: Factual Answer: b. 20

11.1.61. According to the National Epidemiologic Survey on Alcohol and Related Conditions the lifetime prevalence of alcohol abuse for men is approximately what percentage of the general population? a. b. c. d.

5 15 25 50 Difficulty: 1 Question ID: 11.1.61 Page Reference: 287 Topic: Frequency Skill: Factual Answer: c. 25

11.1.62. Alcohol-related disorders are a. b. c. d.

on the decline in the United States. relatively rare forms of mental disorders. among the most common forms of mental disorders. not widely enough studied to draw firm conclusions. Difficulty: 2 Question ID: 11.1.62 Page Reference: 287 Topic: Frequency Skill: Conceptual Answer: c. among the most common forms of mental disorders.

11.1.63. How does the rate of alcohol problems compare in men and women? a. b. larger. c. d.

Although the difference in the rates is narrowing, the rate is still much higher among men. The rate is much higher among males and the difference between males and females is growing Community surveys indicate that the rates are virtually identical. Although in the past males have had much higher rates, females now have higher rates.

Difficulty: 2 Question ID: 11.1.63 Page Reference: 287-288 Topic: Frequency Skill: Conceptual Answer: a. Although the difference in the rates is narrowing, the rate is still much higher among men.

11.1.64. Bob and Vickie each weigh 150 pounds. They go out drinking and each has three beers. According to the textbook why does Vickie become intoxicated sooner? a. b. c. d.

Men's bodies have lower water content. Women's bodies have lower water content. Men's digestive functioning is less efficient. Women's digestive functioning is less efficient. Difficulty: 1 Question ID: 11.1.64 Page Reference: 288 Topic: Frequency Skill: Conceptual Answer: b. Women's bodies have lower water content.

11.1.65. According the National Comorbidity Study the lifetime prevalence of nicotine dependence is approximately a. b. c. d.

2 percent. 10 percent. 25 percent. 40 percent. Difficulty: 2 Question ID: 11.1.65 Page Reference: 288 Topic: Frequency Skill: Factual Answer: c. 25 percent

11.1.66. Which statement is most accurate? a. b. c.

Younger people do not drink as much alcohol as older people. Older people do not drink as much alcohol as younger people. Younger men drink less alcohol than older men.

There is not a significant difference in the drinking habits between young and old. Difficulty: 2 Question ID: 11.1.66 Page Reference: 288 Topic: Frequency Skill: Factual Answer: b. Older people do not drink as much alcohol as younger people.

11.1.67. Which age group has the highest prevalence rates for alcohol dependence? a. b. c. d.

adolescents the elderly young adults the middle aged Difficulty: 1 Question ID: 11.1.67 Page Reference: 288 Topic: Frequency Skill: Factual Answer: c. young adults

11.1.68. Which of the following are you most likely to find among the elderly in the United States? a. b. c. d.

higher rates of alcohol abuse than among younger people higher rates of drug abuse than among younger people prescription drug abuse and dependence illegal drug abuse and dependence Difficulty: 1 Question ID: 11.1.68 Page Reference: 288-289 Topic: Frequency Skill: Conceptual Answer: c. prescription drug abuse and dependence

11.1.69. Which of the following characteristics are strong predictors of adolescents' initial experimentation with drugs? a. b. c. d.

extroversion and agreeableness introversion and impulsiveness rebelliousness and extroversion introversion and conscientiousness

Difficulty: 1 Question ID: 11.1.69 Page Reference: 290 Topic: Causes Skill: Conceptual Answer: c. rebelliousness and extroversion

11.1.70. Why are investigators interested in the fast flush phenomenon? a. b. c. d.

It is often seen in people of Asian ancestry and might explain why they drink less. It is often seen in people of Asian ancestry and might explain why they drink more. It is often seen in young people and might explain why they drink more. It is often seen in females and might explain why they drink less. Difficulty: 3 Question ID: 11.1.70 Page Reference: 291 Topic: Causes Skill: Applied Answer: a. It is often seen in people of Asian ancestry and might explain why they drink less.

11.1.71. The lifetime prevalence of alcoholism among families of alcoholics is higher than in the general population, by a factor of about a. b. c. d.

2. 3-5. 10-15. 20. Difficulty: 2 Question ID: 11.1.71 Page Reference: 291 Topic: Causes Skill: Factual Answer: b. 3-5.

11.1.72. What have researchers concluded from research on the concordance rates of monozygotic (MZ) and dizygotic (DZ) twins? a. b. c.

The role for genetics is much larger for males than it is for females. Genetic factors play a small role in etiology of alcoholism among women. Similar concordance rates for MZ and DZ twins suggest no significant role for genetics.

d. Concordance rates suggest a role for genetics, and higher concordance among males reflects the higher prevalence of alcoholism among males. Difficulty: 2 Question ID: 11.1.72 Page Reference: 291 Topic: Causes Skill: Conceptual Answer: d. Concordance rates suggest a role for genetics, and higher concordance among males reflects the higher prevalence of alcoholism among males.

11.1.73. What is the estimated heritability of serious alcohol-related problems? a. b. c. d.

13 percent 33 percent 66 percent 86 percent Difficulty: 2 Question ID: 11.1.73 Page Reference: 291 Topic: Causes Skill: Factual Answer: c. 66 percent

11.1.74. Genetic factors in the cause of alcohol abuse could be somewhat indirect. It has been suggested, for example, that genes that influence __________________ may cause a person to be more likely to risk alcohol dependence. a. b. c. d.

intelligence depression ADHD sensation seeking Difficulty: 3 Question ID: 11.1.74 Page Reference: 292 Topic: Causes Skill: Applied Answer: d. antisocial personality disorder

11.1.75. Being reared by an alcoholic parent, in the absence of other etiological factors, a. b.

still significantly increases the chance of developing the disorder. does not appear to be a critical consideration in the development of the disorder.

c. d.

increases the risk of alcohol dependence, but decreases the risk of abuse. reduces the risk of alcohol related problems but increases the risk of drug related problems.

Difficulty: 2 Question ID: 11.1.75 Page Reference: 292 Topic: Causes Skill: Applied Answer: b. does not appear to be a critical consideration in the development of the disorder.

11.1.76. Which of the following conclusions about the genetics of alcohol abuse and dependence can be legitimately drawn from adoption studies? a. b. c. d.

Genetics do not play a very significant role. There appears to be a strong association with antisocial personality traits. Being reared by an alcoholic parent can fully account for the known risk. There is too much inconsistency in the studies to allow us to draw any conclusions. Difficulty: 1 Question ID: 11.1.76 Page Reference: 291 Topic: Causes Skill: Factual Answer: b. There appears to be a strong association with antisocial personality traits.

11.1.77. Scientists who study the biological basis of addiction have devoted considerable attention to understanding the rewarding properties of drugs. Much of this attention has focused on a. b. c. d.

serotonin. dopamine. norepinephrine. GABA. Difficulty: 1 Question ID: 11.1.77 Page Reference: 292 Topic: Causes Skill: Factual Answer: b. dopamine.

11.1.78. You have access to an fMRI facility and plan to study brain regions associated with drug addiction. You advise your team that it would be wise to focus on a.

the reward pathways of the brain.

b. c. d.

the ventral tegmental area of the brain. the amygdala. All of the above are important areas for this study. Difficulty: 2 Question ID: 11.1.78 Page Reference: 292 Topic: Causes Skill: Applied Answer: d. All of the above are important areas for this study.

11.1.79. What evidence has been cited by scientists who propose that alcoholism is related to endogenous opioid production? a. b. c. d.

Alcohol is an opioid derivative. Rats given morphine refuse alcohol. The symptoms of withdrawal from alcohol and heroin are similar. Opioid-antagonists can reduce the subjective "high" of drinking. Difficulty: 3 Question ID: 11.1.79 Page Reference: 293 Topic: Causes Skill: Applied Answer: d. Opioid-antagonists can reduce the subjective "high" of drinking.

11.1.80. Several genes that affect the reception of which neurotransmitter have been seen to correlate with the risk of alcohol dependence? a. b. c. d.

norepinephrine GABA serotonin MAO Difficulty: 2 Question ID: 11.1.80 Page Reference: 293 Topic: Causes Skill: Factual Answer: b. GABA

11.1.81. Some theorists associate alcoholism with exaggerated activation of an endogenous system in response to alcohol stimulation. Which system do they suggest? a.

the alcohol system

b. c. d.

the dopamine system the opiod system the amygdala system Difficulty: 2 Question ID: 11.1.81 Page Reference: 293 Topic: Causes Skill: Conceptual Answer: c. the opiod system

11.1.82. Traditional learning theory has held that people drink because a. b. c. d.

parents model drinking behavior. drinking is reinforced by stress reduction. abstinence is punished through social disapproval. drinking is on an intermittent reinforcement schedule. Difficulty: 2 Question ID: 11.1.82 Page Reference: 294 Topic: Causes Skill: Conceptual Answer: b. drinking is reinforced by stress reduction.

11.1.83. A researcher is using the balanced placebo design to investigate the effects of alcohol on aggression. What has this research added to our knowledge of alcohol? a. b. c. d.

Given a choice, most participants prefer tonic to alcohol. Expectations play an important role in the effects attributed to alcohol. Alcohol has powerful placebo effects in the treatment of many medical conditions. The effects of alcohol are the result of an inherited failure to metabolize the drug. Difficulty: 2 Question ID: 11.1.83 Page Reference: 294 Topic: Causes Skill: Applied Answer: b. Expectations play an important role in the effects attributed to alcohol.

11.1.84. Longitudinal studies of adolescent alcohol use and their expectancy patterns have found that a. b. c.

those with positive expectations go on to consume greater amounts of alcohol. those with negative expectations go on to consume greater amounts of alcohol. those with positive expectations go on to consume lesser amounts of alcohol.

those who consume greater amounts of alcohol go on to have more positive expectations.

Difficulty: 2 Question ID: 11.1.84 Page Reference: 294 Topic: Causes Skill: Conceptual Answer: a. those with positive expectations go on to consume greater amounts of alcohol.

11.1.85. A team of researchers has decided to employ the high-risk research design in a longitudinal study of adolescent alcohol use. What will they have to do to conduct such a study? a. b. c. d.

put their subjects in risky situations select subjects based on the presence of specific risk factors take the risk of investigating an unlikely cause assess the risky behaviors displayed by the subjects Difficulty: 2 Question ID: 11.1.85 Page Reference: 295 Topic: Causes Skill: Conceptual Answer: b. select subjects based on the presence of specific risk factors

11.1.86. The treatment of alcoholism and other types of substance use disorders is an especially difficult task because a. b. c. d.

no effective treatment techniques have been developed. it is unethical to use drugs in the treatment of substance use disorders. many people with substance use disorders do not acknowledge their difficulties. very few professionals have any expertise in the treatment of substance use disorders. Difficulty: 1 Question ID: 11.1.86 Page Reference: 296 Topic: Treatment Skill: Conceptual Answer: c. many people with substance use disorders do not acknowledge their difficulties.

11.1.87. One of the controversies involving the treatment of substance use disorders is whether a. b.

total abstinence from drinking or drug use is the only acceptable goal. people recovering from substance use disorders should be allowed to treat others.

c. d.

treatment should begin before the person has stopped the drinking or drug use. it is appropriate to encourage people to seek help when they are not ready to admit to a problem.

Difficulty: 2 Question ID: 11.1.87 Page Reference: 296 Topic: Treatment Skill: Conceptual Answer: a. total abstinence from drinking or drug use is the only acceptable goal.

11.1.88. Detoxification refers to a. b. c. d.

psychotherapy for substance abuse. symptoms of withdrawal from drug dependence. removal of the drug on which the person is dependent. deterioration of brain tissue secondary to drug abuse. Difficulty: 1 Question ID: 11.1.88 Page Reference: 296 Topic: Treatment Skill: Factual Answer: c. removal of the drug on which the person is dependent.

11.1.89. What is Antabuse? a. b. c. d.

a safe substitute for alcohol a 12 step program for alcoholism a drug that blocks the breakdown of alcohol a drug that induces an altered state of consciousness Difficulty: 1 Question ID: 11.1.89 Page Reference: 296 Topic: Treatment Skill: Factual Answer: c. a drug that blocks the breakdown of alcohol

11.1.90. What is likely to occur if Larry takes Antabuse and then has a shot of whiskey? a. b. c. d.

He will become aggressive. He will become violently ill. He will become intoxicated more quickly. He will not feel the effects of the alcohol.

Difficulty: 2 Question ID: 11.1.90 Page Reference: 296 Topic: Treatment Skill: Applied Answer: b. He will become violently ill.

11.1.91. What is one of the major problems in treating alcoholism with Antabuse? a. b. c. d.

The treatment has a high mortality rate. Voluntary compliance with drug taking is low. The side effects of the drug include tardive dyskinesia. The treatment must be court ordered. Difficulty: 1 Question ID: 11.1.91 Page Reference: 296 Topic: Treatment Skill: Factual Answer: b. Voluntary compliance with drug taking is low.

11.1.92. A relative was admitted to the hospital and given doses of naltrexone for problems related to alcohol. How will this drug affect the man? a. b. c. d.

It will block the action of GABA. It will block the action of norepinephrine. It will increase levels of dopamine in the brain. It will decrease the level of endogenous opioids. Difficulty: 2 Question ID: 11.1.92 Page Reference: 296 Topic: Treatment Skill: Applied Answer: d. It will decrease the level of endogenous opioids.

11.1.93. In the long term treatment of alcoholic patients, SSRIs a. b. c.

appear to be very helpful. can significantly reduce the occurrence of acute withdrawal symptoms. can be helpful with patients who also have a diagnosis of major depression.

have not been shown to be of any value.

Difficulty: 2 Question ID: 11.1.93 Page Reference: 297 Topic: Treatment Skill: Applied Answer: c. can be helpful with patients who also have a diagnosis of major depression.

11.1.94. What is the first step of the Alcoholics Anonymous 12-step program? a. b. c. d.

seeing a psychotherapist checking into a hospital detox program admitting that one is powerless over alcohol recognizing that one must recover on one's own Difficulty: 1 Question ID: 11.1.94 Page Reference: 297 Topic: Treatment Skill: Factual Answer: c. admitting that one is powerless over alcohol

11.1.95. What is an underlying notion that supports the 12-step program of Alcoholics Anonymous? a. b. c. d.

spiritual ideas about recovery psychological theories of defense mechanisms biological evidence of changes accompanying abstinence scientific evidence of cognitive changes accompanying abstinence Difficulty: 2 Question ID: 11.1.95 Page Reference: 297 Topic: Treatment Skill: Conceptual Answer: a. spiritual ideas about recovery

11.1.96. What is one of the most important aspects of Alcoholics Anonymous? a. b. c. d.

a stable social network emphasis on overall physical health treatment by mental health professionals biological interventions such as Antabuse

Difficulty: 1 Question ID: 11.1.96 Page Reference: 297 Topic: Treatment Skill: Factual Answer: a. a stable social network

11.1.97. Barbara is seeing a therapist to help her with her drinking problem, and her therapist is trying to improve her social skills and her ability to solve problems. This therapist is probably a a. b. c. d.

psychiatrist. recovering alcoholic. cognitive behavior therapist. motivational counselor. Difficulty: 2 Question ID: 11.1.97 Page Reference: 297 Topic: Treatment Skill: Applied Answer: c. cognitive behavior therapist.

11.1.98. Norman is having a disagreement with Tim about the value of Alcoholics Anonymous. Tim says that people who stick with AA over time tend to remain sober, but Norman replies, a. b. c. d.

"No, there is no evidence to show that." "Yes, but that could be due to the personality traits of the people who continue with AA." "No, the studies show that the longer you stay in AA, the worse off you are." "Yes, but most of the people who attend AA do not have serious drinking problems." Difficulty: 2 Question ID: 11.1.98 Page Reference: 297 Topic: Treatment Skill: Conceptual Answer: b. "Yes, but that could be due to the personality traits of the people who continue with

AA."

11.1.99. The cognitive behavioral model of relapse prevention is concerned with the abstinence violation effect. What is the abstinence violation effect? a.

a patient's tendency to lie about concealed drinking

b. c. d.

the fact that drinking in public is illegal in some states a patient's feeling that he or she is being controlled by the therapist the pattern of going back to chronic drinking if one slips up even a little Difficulty: 2 Question ID: 11.1.99 Page Reference: 297 Topic: Treatment Skill: Conceptual Answer: d. the pattern of going back to chronic drinking if one slips up even a little

11.1.100. Rebecca is trying to recover from alcoholism. Her therapist is attempting to help her reduce the abstinence violation effect. This is a problem for Rebecca because as soon as she has even a small drink, she thinks, a. b. c. d.

"I am a worthless person." "I can recover on my own; I don't need help." "I'm only doing something wrong if it's illegal." "I've messed up; I may as well go ahead and get drunk." Difficulty: 2 Question ID: 11.1.100 Page Reference: 298 Topic: Treatment Skill: Applied Answer: d. "I've messed up; I may as well go ahead and get drunk."

11.1.101. At the mental health center a young man will begin what is called motivational interviewing. What can this man expect during the session that will follow? a. Several members of law enforcement organizations will "lay it out" for this client—either he "shapes up or he will go to jail." b. A physician will try to ascertain the reasons behind this man's failure to comply with instructions to take Antabuse on a daily basis. c. Using a nonconfrontational approach, an interviewer will help him to resolve his ambivalence about using drugs and to make a definite commitment to change. d. A number of recovered drug addicts will confront him with what awaits if he does not change his ways. Difficulty: 3 Question ID: 11.1.101 Page Reference: 298 Topic: Treatment Skill: Applied Answer: c. Using a nonconfrontational approach, an interviewer will help him to resolve his ambivalence about using drugs and to make a definite commitment to change.

11.1.102. Comprehensive reviews of the research literature regarding treatment of alcoholism and drug abuse tell us that a. b. c. d.

most people in treatment show long-term improvement. many people improve for a while but relapse is common. success rates are higher for alcoholism than for drug abuse. success rates are higher for drug abuse than for alcoholism. Difficulty: 1 Question ID: 11.1.102 Page Reference: 299 Topic: Treatment Skill: Factual Answer: b. many people improve for a while but relapse is common.

11.1.103. What is the general conclusion on research designed to match certain types of patients to particular alcohol treatment programs? a. b. c. d.

There is little evidence for the effectiveness of matching. The primary variable predicting treatment success is the accuracy of the match. The success of these matches depends primarily on the client's level of comorbid conditions. Age, socioeconomic status, and other demographic factors are the key to creating a good match. Difficulty: 2 Question ID: 11.1.103 Page Reference: 299 Topic: Treatment Skill: Conceptual Answer: a. There is little evidence for the effectiveness of matching.

11.1.104. Comprehensive reviews of the research literature regarding treatment of alcoholism and drug abuse tell us that a. in-patient treatment is more effective than out-patient treatment. b. professional treatment is more effective than self-help approaches such as AA. c. treatment aimed at reducing alcohol or drug use is more effective than treatment aimed at total abstinence. d. there is little evidence to suggest that one form of treatment is more effective than another. Difficulty: 1 Question ID: 11.1.104 Page Reference: 299 Topic: Treatment Skill: Factual

Answer: d. there is little evidence to suggest that one form of treatment is more effective than another.

11.1.105. Successful long-term outcome for the treatment of alcoholism is best predicted by a. b. c. d.

how much treatment the person receives. whether the person can afford private treatment. the person's coping resources and available social support. the severity of the negative consequences that will motivate the person to seek help. Difficulty: 1 Question ID: 11.1.105 Page Reference: 299 Topic: Treatment Skill: Factual Answer: c. the person's coping resources and available social support.

Short Answer 11.2.106. Addiction is an older term that is often used to describe problems such as alcoholism. The term has been replaced in official terminology by the term substance __________ . Difficulty: 2 Question ID: 11.1.106 Page Reference: 272 Topic: Overview Skill: Factual Answer: dependence 11.2.107. A term that is frequently used to describe a forceful urge to use drugs is __________ . Difficulty: 2 Question ID: 11.1.107 Page Reference: 272 Topic: Symptoms Skill: Conceptual Answer: craving

11.2.108. The symptoms that can be thought of as the "flip side" of tolerance symptoms are known as __________ . Difficulty: 2 Question ID: 11.1.108 Page Reference: 272 Topic: Symptoms

Skill: Conceptual Answer: withdrawal 11.2.109. Some theorists have suggested that nicotine mimics the effects of which class of psychoactive medications? Difficulty: 2 Question ID: 11.1.109 Page Reference: 278 Topic: Symptoms Skill: Conceptual Answer: antidepressants

11.2.110. Cocaine is a member of a group of drugs known as __________ stimulants. Difficulty: 1 Question ID: 11.1.110 Page Reference: 279 Topic: Symptoms Skill: Factual Answer: psychomotor

11.2.111. The dried leaves and/or flowers of a cannabis plant is know as __________ . Difficulty: 1 Question ID: 11.1.111 Page Reference: 281 Topic: Symptoms Skill: Factual Answer: marijuana

11.2.112. ___________ refers to the dried resin from the top of the female cannabis plant. Difficulty: 1 Question ID: 11.1.112 Page Reference: 281 Topic: Symptoms Skill: Factual Answer: Hashish

11.2.113. ____________ disorder (the childhood manifestation of ASPD) is strongly related to the subsequent development of alcohol dependence.

Difficulty: 2 Question ID: 11.1.113 Page Reference: 285 Topic: Diagnosis Skill: Conceptual Answer: Conduct

11.2.114. Natural rewards, such as food and sex, as well as many drugs of abuse increase __________ levels in brain reward pathways. Difficulty: 2 Question ID: 11.1.114 Page Reference: 292 Topic: Causes Skill: Factual Answer: dopamine

11.2.115. One of the most interesting and important advances in neuroscience research was the discovery of the endogenous opioids known as __________ . Difficulty: 2 Question ID: 11.1.115 Page Reference: 293 Topic: Causes Skill: Factual Answer: endorphins and enkeppalins

11.2.116. Abstinence during a treatment program that allows for the removal of a drug on which a person has become dependent is known as __________ . Difficulty: 2 Question ID: 11.1.116 Page Reference: 296 Topic: Treatment Skill: Factual Answer: detoxification

Essay 11.3.117. Compare the two major categories of drug-related problems described in the DSM-IV-TR. Difficulty: 2 Question ID: 11.3.117 Page Reference: 272-273 Topic: Overview Skill: Conceptual Answer: Substance dependence is the more severe of the disorders; it refers to a pattern of repeated self-administration that often results in tolerance (need for increased amounts of a drug to achieve intoxication), withdrawal, and unpleasant physical and psychological effects that the person experiences when he or she tries to stop taking the drug. Substance abuse is the less severe pattern; it is defined in terms of interference with the person's ability to fulfill major role obligations at work or at home.

11.3.118. What are the symptoms and causes of withdrawal? Which drugs cause serious signs of withdrawal? Difficulty: 2 Question ID: 11.3.118 Page Reference: 275-276 Topic: Symptoms Skill: Conceptual Answer: The symptoms occur when a person stops taking a drug and they can persist for days. If a heavy drinker stops drinking alcohol he may experience hand tremors, sweating, nausea, anxiety, and insomnia. The especially serious symptoms include convulsions and hallucinations. In some cases, delirium may develop. The symptoms of withdrawal related to other drugs vary. Withdrawal symptoms are most obvious for alcohol, opioids, and sedatives, hypnotics, and anxiolytics. Withdrawal signs are not often seen after repeated use of cannabis or hallucinogens and can be relatively light for cocaine. When an individual uses a psychoactive drug the body, especially the brain, reacts against it. This process, known as tolerance, has the effect of reducing the impact of the drug. When this person stops taking the drug, the processes that caused the tolerance are still in place until the body has a chance to undo them. During this period of time an individual will experience symptoms that are essentially the opposite of taking the drug which are called withdrawal symptoms.

11.3.119. Discuss the other disorders commonly associated with alcohol abuse. Difficulty: 2 Question ID: 11.3.119 Page Reference: 285-286 Topic: Symptoms Skill: Conceptual

Answer: Correlations between other disorders are often seen with alcohol use. Personality disorders, mood disorders, and anxiety disorders, for example. The correlation with depression and anxiety is complex because alcohol could be an attempt to reduce these emotions, but alcohol can also cause them. Perhaps alcohol abuse and several disorders share a common diathesis. This appears to be the case with eating disorders, but the exact diathesis is still under investigation. 11.3.120. Discuss cultural differences in drug-related problems. Difficulty: 2 Question ID: 11.3.120 Page Reference: 286-287 Topic: Diagnosis Skill: Conceptual Answer: There are fascinating differences in drug use and what is considered drug abuse across cultures. In part, the use of drugs is determined by availability, which is determined in part by demand, climate, and history. For example, opium is used most heavily in Southeast Asia and some Middle Eastern countries where opium grows naturally and there is a long history of cultivation. Cocaine is used more in South American countries where coca trees originate and there is a centuries long history of use. Japan is an example of a country where land is scarce so synthetic drugs which can be manufactured indoors are more common. Social history can radically influence the effects of drugs. South American Indians have used coca leaves for perhaps 20,000 years and have learned to do so in ways that do not lead to addiction or drug problems.

11.3.121. Discuss the ways that parent behaviors influence the likelihood that an adolescent will abuse substances. Difficulty: 2 Question ID: 11.3.121 Page Reference: 290-291 Topic: Causes Skill: Conceptual Answer: Parents might model the use of substances for recreational or stress reduction purposes. Adolescents might be influenced by their parents' positive attitudes and expectations about the effects of substance use. If the parents are alcoholic, they may not provide sufficient monitoring of the adolescent. If the parents show high conflict and negative affect, the adolescent may be motivated to spend more time with peers.

11.3.122. Review the evidence for the role of brain's reward systems in a model of the cause of drug addiction in general.

Difficulty: 2 Question ID: 11.3.122 Page Reference: 292-293

Topic: Causes Skill: Conceptual Answer: A good deal of research into the etiology of drug abuse and addiction focuses on the brain’s reward systems. Older models of drug addiction looked at the effects of tolerance and withdrawal, but more recent research suggests that drugs that have the potential to contribute to addiction all share the property of directly or indirectly facilitating the firing of the brain’s reward centers. One primary circuit in this pathway is the medial forebrain bundle, which connects the ventral tegmental area to the nucleus accumbens. Connections from these structures to the frontal and prefrontal cortex as well as areas of the limbic system, such as the amygdala, also moderate the influence of reward. For many years, scientists have known electrical stimulation of the medial forebrain bundle can serve as a powerful source of positive reinforcement for animals and now know that addictive drugs injected into the mesolimbic dopamine pathway also act as powerful positive reinforcers. Different drugs produce these rewarding effects in different ways. Amphetamines, for example, block the reuptake of dopamine in the reward circuits which causes an increase in the firing of reward messages. Measures of brain concentrations of dopamine increase in the medial prefrontal cortex and the limbic system after ingesting cocaine. Alcohol, on the other hand, does fire these same reward systems, but much more indirectly. Its main effect is on the neurotransmitter GABA. Alcohol seems to eventually reduce the activity of GABA which would normally inhibit the firing of pleasure systems. Some theorists associate alcoholism with exaggerated activation of the endogenous opioid system in response to alcohol consumption. Studies have suggested that blocking opioid receptors reduces an animal’s interest in alcohol. Overall there is considerable empirical and clinical evidence that points to a central role of the brain’s pleasure circuits in the creation of the craving that is the hallmark of current models of drug addiction.

11.3.123. Discuss what balanced placebo and longitudinal designs can tell us about possible role of expectations as factors both in alcohol and drug effects and in the onset of alcohol and drug problems. Difficulty: 3 Question ID: 11.3.123 Page Reference: 294-295 Topic: Causes Skill: Conceptual Answer: Using the balanced placebo design, researchers have shown that subjects' expectations about how a drug will affect their behavior can account for many of the effects that are usually attributed to the drug itself. For example, subjects who believed they had ingested alcohol but who had actually consumed only tonic water displayed exaggerated aggression and reported enhanced feelings of sexual arousal. Expectations may constitute one of the primary reasons for continued and increasingly heavy consumption of alcoholic beverages. Longitudinal studies have found that adolescents who initially have the most positive expectations about the effects of alcohol go on to consume greater amounts of alcoholic beverages.

11.3.124. Describe the uses of short-term motivational therapy in the treatment of substance use disorders. Difficulty: 2 Question ID: 11.3.124 Page Reference: 298 Topic: Treatment

Skill: Conceptual Answer: Many people with substance use disorders do not seek or take full advantage of treatment opportunities because they fail to recognize the severity of their problems. Motivational interviewing is a nonconfrontational procedure that can be used to help people resolve their ambivalence about using drugs and make a definite commitment to change their behavior. The procedure is based on the notion that in order to make a meaningful change, people must begin by recognizing the inconsistency between their current behavior and their long-term goals. For example, chronic heavy drinking is not compatible with academic or occupational success. Motivational interviewing begins with a discussion of problems--issues reported by the patient as well as concerns that have been expressed by others such as friends and family members. The person is asked to reflect on feedback that is provided in a nonthreatening way. The therapist does not confront the person, argue about the reasons for drinking, or demand action. Instead, the therapist responds empathically in an effort to avoid or minimize defensive reactions that will interfere with attempts to change.

Chapter 12 Sexual and Gender Identity Disorders Total Assessment Guide (T.A.G.) Topic Overview pp. 303-306

Sexual Dysfunctions pp. 306-318

Question Type Multiple Choice Short Answer Essay Multiple Choice

Short Answer

Paraphilias pp. 318-328

Gender Identity Disorders pp. 328-329

Essay Multiple Choice

Short Answer Essay Multiple Choice Short Answer Essay

Factual 3, 6, 8, 10

15, 21, 25, 28, 29, 31, 32, 33, 37, 38, 39, 42, 43, 50 101, 102, 103, 104, 106 52, 53, 56, 57, 59, 66, 67, 69, 71, 77, 78, 79, 80, 82, 89, 91, 94, 95 108, 109, 110

Conceptual 1, 2, 4, 7, 12, 13

112 16, 19, 20, 23, 24, 26, 27, 30, 34, 36, 40, 41, 45, 46, 48, 49 105 113, 114, 115 54, 55, 60, 61, 62, 64, 70, 72, 73, 74, 75, 76, 81, 83, 86, 90, 92, 93 116, 117 96, 99

97,100 111

119

Applied 5, 9, 11

14, 17, 18, 22, 35, 44, 47, 51

107

58, 63, 65, 68, 84, 85, 87, 88

118 98

Chapter 12: Sexual and Gender Identity Disorders Multiple Choice 12.1.1. What was the major contribution made by William Masters and Virginia Johnson? a. b. c. d.

classifying sexual perversions describing the human sexual response cycle outlining the effects of childhood sexual abuse documenting the diversity of normal sexual behavior Difficulty: 1 Question ID: 12.1.1 Page Reference: 304 Topic: Overview Skill: Conceptual Answer: b. describing the human sexual response cycle

12.1.2. What was the basis of the descriptions of the human sexual response cycle offered by William Masters and Virginia Johnson? a. b. c. d.

detailed interviews with thousands of adults observations of people engaged in sexual activities cross-cultural analysis of texts on human sexuality analogue studies of the sexual behavior of primates Difficulty: 1 Question ID: 12.1.2 Page Reference: 304 Topic: Overview Skill: Conceptual Answer: b. observations of people engaged in sexual activities

12.1.3. What are the phases of the human sexual response cycle described by Masters and Johnson? a. b. c. d.

id, ego, and superego pre-erotic, erotic, and post-erotic physiological, emotional, and eros excitement, orgasm, and resolution Difficulty: 2 Question ID: 12.1.3 Page Reference: 304 Topic: Overview Skill: Factual Answer: d. excitement, orgasm, and resolution

12.1.4. Some of the most dramatic physiological changes during sexual excitement are due to vasocongestion, which refers to a. b. c. d.

increased muscular tension. elevated respiration rates. engorgement of blood vessels. decreased neurotransmitter activity. Difficulty: 1 Question ID: 12.1.4 Page Reference: 304 Topic: Overview Skill: Conceptual Answer: c. engorgement of blood vessels.

12.1.5. Kevin has just reached orgasm and finds that he is unable to get an erection again. Although this concerns him greatly, it is actually a normal phenomenon called a. b. c. d.

a plateau. dyspareunia. vasocongestion. a refractory period. Difficulty: 2 Question ID: 12.1.5 Page Reference: 305 Topic: Overview Skill: Applied Answer: d. a refractory period.

12.1.6. What is the final phase of the human sexual response cycle? a. b. c. d.

orgasm plateau resolution vasocongestion Difficulty: 1 Question ID: 12.1.6 Page Reference: 305 Topic: Overview Skill: Factual Answer: c. resolution

12.1.7. What is the major difference between men and women in the sexual response cycle? a. b. c. d.

Men do not have an excitement phase. Women do not have an excitement phase. Women may be able to respond to stimulation during the resolution phase. Men typically are able to respond to stimulation during the resolution phase. Difficulty: 2 Question ID: 12.1.7 Page Reference: 305 Topic: Overview Skill: Conceptual Answer: c. Women may be able to respond to stimulation during the resolution phase.

12.1.8. Sexual dysfunctions can affect which of the phases in the sexual response cycle? a. b. c. d.

excitement orgasm resolution any of the phases Difficulty: 2 Question ID: 12.1.8 Page Reference: 305 Topic: Overview Skill: Factual Answer: d. any of the phases

12.1.9. What point concerning sexual problems was highlighted by the case of Bill and Margaret described in the text? a. b. c. d.

Couples who are not truly in love have high rates of sexual dysfunction. Clinicians have tended to neglect biological factors involved in human sexual behavior. Their thoughts about the meaning of sexual behavior were extremely important. Usually one person is responsible for the disorder. Difficulty: 3 Question ID: 12.1.9 Page Reference: 305 Topic: Overview Skill: Applied Answer: c. Their thoughts about the meaning of sexual behavior were extremely important.

12.1.10. What new social attitude about sex led to the belief that sexual dysfunctions are a legitimate topic of psychological inquiry? a. b. c. d.

that men enjoy sex more than women that sex is primarily for the purpose of procreation that sex fosters marital intimacy and is a source of pleasure that there is less tolerance for variations in sexual behavior Difficulty: 1 Question ID: 12.1.10 Page Reference: 306 Topic: Overview Skill: Factual Answer: c. that sex fosters marital intimacy and is a source of pleasure

12.1.11. Which of the following was characteristic of the interviews Alfred Kinsey conducted between 1938 and 1956 about sexual behavior? a. b. c. d.

They focused on subjective distress. They focused on experiences that resulted in orgasm. They were structured to make psychiatric diagnosis possible. They classified perversions as sadism, masochism, and fetishism. Difficulty: 2 Question ID: 12.1.11 Page Reference: 306 Topic: Overview Skill: Applied Answer: b. They focused on experiences that resulted in orgasm.

12.1.12. The incredible diversity of sexual experiences reported by his subjects led Alfred Kinsey to a. b. c. d.

reject the distinction between normal and abnormal sexual behavior. investigate the distinction between normal and abnormal sexual behavior. conclude that homosexuals and heterosexuals were fundamentally different. conclude that homosexuals and heterosexuals were identical in their responses. Difficulty: 2 Question ID: 12.1.12 Page Reference: 306 Topic: Overview Skill: Conceptual Answer: a. reject the distinction between normal and abnormal sexual behavior.

12.1.13. What was one of Alfred Kinsey's conclusions based on interviews with 18,000 men and women between 1938 and 1956? a. b. c. d.

Homosexuality was a perversion. Low sexual desire is a form of psychopathology. There is little diversity in normal sexual behaviors. Distinctions among sexual orientations were essentially meaningless. Difficulty: 1 Question ID: 12.1.13 Page Reference: 306 Topic: Overview Skill: Conceptual Answer: d. distinctions among sexual orientations were essentially meaningless

12.1.14. You have come to the part of your Abnormal Psychology textbook that covers the sexual dysfunctions, where there are several case studies presented. Which of the following might well be one of those cases? a. b. c. d.

someone who displays deviant sexual behavior someone with an anatomical defect that interferes with normal sexual behavior someone whose sexual desire is inhibited someone who has an excessive interest in sex Difficulty: 1 Question ID: 12.1.14 Page Reference: 306 Topic: Sexual Dysfunctions Skill: Applied Answer: c. someone whose sexual desire is inhibited

12.1.15. From the extensive information it collected concerning patterns of sexual activity, what did the National Health and Social Life Survey reveal concerning the achievement of orgasms by men and women? a. The rates of having orgasms are low for both men and women. b. A larger percentage of men than women report that they always have an orgasm. c. Women are able to achieve orgasm more often than men, although they do not report this to their partners. d. Men and women did not differ significantly in either the frequency or the satisfaction related to orgasms. Difficulty: 1 Question ID: 12.1.15 Page Reference: 306 Topic: Sexual Dysfunctions Skill: Factual Answer: b. A larger percentage of men than women report that they always have an orgasm.

12.1.16. From the extensive information it collected concerning patterns of sexual activity, what did the National Health and Social Life Survey reveal concerning the physical and emotional satisfaction of men and women? a. b. c. d.

The rates of satisfaction are low for both men and women. A much larger percentage of men than women report being satisfied. A much larger percentage of women than men report being satisfied. Men and women did not differ significantly in their satisfaction. Difficulty: 2 Question ID: 12.1.16 Page Reference: 306 Topic: Sexual Dysfunctions Skill: Conceptual Answer: d. Men and women did not differ significantly in their satisfaction.

12.1.17.

The National Health and Social Life Survey found that

a. The percentage of women who always achieve orgasm during sex is relatively small, yet the percentage who report being extremely physically satisfied is relatively high. b. The percentage of men who always achieve orgasm during sex is relatively small, yet the percentage who report being extremely physically satisfied is relatively high. c. The percentage of women who always achieve orgasm during sex is relatively high, yet the percentage who report being extremely physically satisfied is relatively low. d. The percentage of men who always achieve orgasm during sex is relatively high, yet the percentage who report being extremely physically satisfied is relatively low. Difficulty: 2 Question ID: 12.1.17 Page Reference: 306-307 Topic: Sexual Dysfunctions Skill: Applied Answer: a. The percentage of women who always achieve orgasm during sex is relatively small, yet the percentage who report being extremely physically satisfied is relatively high.

12.1.18. Based on the results of the National Health and Social Life Survey, all of the following are accurate EXCEPT a. b. c. d.

a very high percentage of women had experienced vaginal intercourse. masturbation was very common in women. less than 10 percent of women had ever engaged in oral intercourse. in the year of the survey a very high percentage of men had had sex with only one partner.

Difficulty: 3 Question ID: 12.1.18 Page Reference: 306 Topic: Sexual Dysfunctions Skill: Applied Answer: c. less than 10 percent of women had ever engaged in oral intercourse.

12.1.19. With regard to the DSM-IV-TR, failure to achieve orgasm a. b. c. d.

is a specific diagnostic category. is never considered indicative of a disorder. may be considered indicative of a disorder if an individual's partner considers it so. may be considered indicative of a disorder if the person in question is distressed by it. Difficulty: 2 Question ID: 12.1.19 Page Reference: 309 Topic: Sexual Dysfunctions Skill: Conceptual Answer: d. may be considered indicative of a disorder if the person in question is distressed by it.

12.1.20. According to DSM-IV-TR, it is possible for a person to be uninterested in sex or to have difficulty engaging in sexual relations and yet not be diagnosed with any sexual dysfunction because a. b. c. d.

sexual dysfunctions require deviant sexual behavior. the person might not experience any distress or interpersonal difficulty. the person would probably pretend to be interested and to deny any difficulty. sexual dysfunctions are only diagnosed when there is also a major personality disorder. Difficulty: 2 Question ID: 12.1.20 Page Reference: 309 Topic: Sexual Dysfunctions Skill: Conceptual Answer: b. the person might not experience any distress or interpersonal difficulty.

12.1.21. Hypoactive sexual desire refers to a. b. c. d.

low sex drive. excessive sex drive. situational sexual dysfunction. sexual attraction to unusual objects.

Difficulty: 1 Question ID: 12.1.21 Page Reference: 309 Topic: Sexual Dysfunctions Skill: Factual Answer: a. low sex drive.

12.1.22. After gathering data on the typical individuals who seek treatment for hypoactive sexual desire, how will researchers describe them? a. b. c. d.

They are confused about sexual identity. They are likely to have been abused as children. They are likely to have other mental and medical disorders. They are overwhelmed with guilt and anxiety concerning sexual activity. Difficulty: 2 Question ID: 12.1.22 Page Reference: 309 Topic: Sexual Dysfunctions Skill: Applied Answer: c. They are likely to have other mental and medical disorders.

12.1.23. Mary has a strong and active aversion to sexual stimuli that has been diagnosed as sexual aversion disorder. When her psychologist is asked to explain further, she is likely to say that the disorder can be viewed as a form of a. b. c. d.

phobic disorder. bipolar disorder. generalized anxiety disorder. schizoid personality disorder. Difficulty: 2 Question ID: 12.1.23 Page Reference: 309 Topic: Sexual Dysfunctions Skill: Conceptual Answer: a. phobic disorder.

12.1.24. A client was recently diagnosed as having erectile dysfunction. What would you conclude about this man? a. b. c. d.

He is by definition experiencing dyspareunia. He does not an erection because he is not subjectively aroused. He ejaculates immediately upon insertion during intercourse. He may be subjectively aroused, but blood does not flow to his penis.

Difficulty: 2 Question ID: 12.1.24 Page Reference: 309 Topic: Sexual Dysfunctions Skill: Conceptual Answer: d. He may be subjectively aroused, but blood does not flow to his penis.

12.1.25. The condition in women that is characterized by sexual desire that is not accompanied by physiological responses necessary to achieve intercourse, such as vaginal lubrication, is known as a. b. c. d.

inhibited sexual desire. inhibited sexual arousal. premature sexual satisfaction. hypoactive sexual arousal. Difficulty: 1 Question ID: 12.1.25 Page Reference: 310 Topic: Sexual Dysfunctions Skill: Factual Answer: b. inhibited sexual arousal.

12.1.26. Identifying the boundaries for defining premature ejaculation has been problematic for clinicians. What is the preferred way to address this difficulty? a. b. c. d.

measure the amount of elapsed time to orgasm determine if orgasm occurs before the person wishes it determine if the couple achieves mutual orgasm measure the partner's satisfaction Difficulty: 2 Question ID: 12.1.26 Page Reference: 311 Topic: Sexual Dysfunctions Skill: Conceptual Answer: b. determine if orgasm occurs before the person wishes it

12.1.27. Why do psychologists consider sexual arousal to be a hypothetical construct? a. b. c. d.

It cannot be measured directly. Its definition differs across cultures. It has such diverse expression across individuals. It can be objectively measured for research purposes.

Difficulty: 2 Question ID: 12.1.27 Page Reference: 311 Topic: Sexual Dysfunctions Skill: Conceptual Answer: a. It cannot be measured directly.

12.1.28. An operational definition is based on a. b. c. d.

theoretical ideas, not observable data. measurable characteristics of a phenomenon. conventional ideas, not scientific measurement. treatment guidelines for psychiatric disorders. Difficulty: 1 Question ID: 12.1.28 Page Reference: 311 Topic: Sexual Dysfunctions Skill: Factual Answer: b. measurable characteristics of a phenomenon.

12.1.29. A vaginal photometer and a penile plethysmograph can be used as measures of a. b. c. d.

orgasm. sexual arousal. sexual satisfaction. blood flow to the vagina or penis. Difficulty: 1 Question ID: 12.1.29 Page Reference: 311 Topic: Sexual Dysfunctions Skill: Factual Answer: b. sexual arousal.

12.1.30. Which of the following characterizes a woman whose orgasmic impairment is generalized? a. b. c. d.

She has never achieved orgasm by any means. She can reach orgasm only through masturbation. She is averse to all forms of sexual expression. She can reach orgasm with her lover, but not with her husband.

Difficulty: 2

Question ID: 12.1.30 Page Reference: 312 Topic: Sexual Dysfunctions Skill: Conceptual Answer: a. She has never achieved orgasm by any means.

12.1.31. Dyspareunia refers to a. b. c. d.

sexual aversion. premature ejaculation. sexual attraction to unusual objects. genital pain associated with sexual intercourse. Difficulty: 1 Question ID: 12.1.31 Page Reference: 312 Topic: Sexual Dysfunctions Skill: Factual Answer: d. genital pain associated with sexual intercourse.

12.1.32. What is vaginismus? a. b. c. d.

a male's desire to be female a form of pseudohermaphroditism involuntary muscle spasms that prevent intercourse an infection caused by a sexually transmitted disease Difficulty: 1 Question ID: 12.1.32 Page Reference: 312 Topic: Sexual Dysfunctions Skill: Factual Answer: c. involuntary muscle spasms that prevent intercourse

12.1.33. What can we conclude about the epidemiology of dyspareunia? a. b. c. d.

It occurs only in men. It occurs only in women. It is much more common in men. It is much more common in women.

Difficulty: 1

Question ID: 12.1.33 Page Reference: 312 Topic: Sexual Dysfunctions Skill: Factual Answer: d. it is much more common in women

12.1.34. One recommendation made by the Consensus Development Conference on Female Sexual Dysfunction was the addition of a new category for a. b. c. d.

hypopsexual pain disorders. iatrogenic sexual disorders. noncoital sexual pain disorders. factious sexual disorder. Difficulty: 2 Question ID: 12.1.34 Page Reference: 312 Topic: Sexual Dysfunctions Skill: Conceptual Answer: c. noncoital sexual pain disorders.

12.1.35. Martha has been diagnosed as having vaginismus. Besides difficulty having intercourse, what else would cause her difficulty? a. b. c. d.

urinating masturbating to orgasm getting a vaginal examination becoming sexually aroused by men Difficulty: 2 Question ID: 12.1.35 Page Reference: 312 Topic: Sexual Dysfunctions Skill: Applied Answer: c. getting a vaginal examination

12.1.36. Some clinicians have suggested that certain individuals present symptoms such as reckless and uncontrolled sexual behavior that should have a new diagnosis in the next edition of the DSM of a. b. c. d.

sexual behavior disorder. hyperactive sexual behavior. hypoactive sexual behavior. sexual desire disorder. Difficulty: 2

Question ID: 12.1.36 Page Reference: 313 Topic: Sexual Dysfunctions Skill: Conceptual Answer: a. sexual behavior disorder.

12.1.37. What is the most frequent form of male sexual dysfunction? a. b. c. d.

dyspareunia erectile disorder premature ejaculation male orgasmic disorder Difficulty: 1 Question ID: 12.1.37 Page Reference: 313 Topic: Sexual Dysfunctions Skill: Factual Answer: c. premature ejaculation

12.1.38. Which of the following describes the sexual performance of men between the ages of 70 and 74? a. b. c. d.

Very few men this age obtain an erection. Over 60 percent of these men are sexually active. Less than 50 percent of these men are sexually active. Erection is rarely a problem, but premature ejaculation usually is a problem. Difficulty: 1 Question ID: 12.1.38 Page Reference: 313 Topic: Sexual Dysfunctions Skill: Factual Answer: b. Over 60 percent of these men are sexually active.

12.1.39. As women get older, how does their physiological response to sexual stimulation change? a. b. c. d.

slower rate of lubrication increased risk of vaginismus less responsiveness in the clitoris increased blood flow to the vaginal walls

Difficulty: 1

Question ID: 12.1.39 Page Reference: 313 Topic: Sexual Dysfunctions Skill: Factual Answer: a. slower rate of lubrication

12.1.40. Which of the following characterizes the effect of very low levels of testosterone in males? a. b. c. d.

painful urination attraction to homosexual stimuli lack of erection when viewing erotica inhibited response to sexual fantasies Difficulty: 2 Question ID: 12.1.40 Page Reference: 314 Topic: Sexual Dysfunctions Skill: Conceptual Answer: d. inhibited response to sexual fantasies

12.1.41. Which of the following characterizes the association between testosterone levels and men's level of sexual appetite? a. b. c. d.

There is no association. Very low levels of testosterone predict inhibited desire. Very high levels of testosterone predict excessive interest. There is a nearly a one-to-one ratio between testosterone levels and sexual desire. Difficulty: 2 Question ID: 12.1.41 Page Reference: 314 Topic: Sexual Dysfunctions Skill: Conceptual Answer: b. Very low levels of testosterone predict inhibited desire.

12.1.42. Which of these behaviors has a tendency to increase risk for erectile dysfunction? a. b. c. d.

taking aspirin smoking cigarettes eating a high fat diet sleeping more than eight hours a night

Difficulty: 1

Question ID: 12.1.42 Page Reference: 315 Topic: Sexual Dysfunctions Skill: Factual Answer: b. smoking cigarettes

12.1.43. The abuse of alcohol and other drugs can lead to a. b. c. d.

inhibited orgasm in men but not women. inhibited orgasm in both men and women. inhibited sexual desire in men but not women. inhibited sexual desire in both men and women. Difficulty: 1 Question ID: 12.1.43 Page Reference: 315 Topic: Sexual Dysfunctions Skill: Factual Answer: b. inhibited orgasm in both men and women.

12.1.44. In taking a history your client makes several remarks that indicate that her parents had quite negative attitudes regarding sexual behavior. As you continue to explore issues of sex you will be on the look out for indications of a. b. c. d.

drug-induced sexual dysfunctions nystagmus hyperactive sexual desire hypoactive sexual desire Difficulty: 3 Question ID: 12.1.44 Page Reference: 315 Topic: Sexual Dysfunctions Skill: Applied Answer: d. hypoactive sexual desire

12.1.45. As a psychological factor contributing to impaired sexual arousal, Masters and Johnson gave primary emphasis to a. b. c. d.

the need for control. depression. performance anxiety. guilt. Difficulty: 2

Question ID: 12.1.45 Page Reference: 316 Topic: Sexual Dysfunctions Skill: Conceptual Answer: c. performance anxiety.

12.1.46. What did Bach and his colleagues find concerning sexual dysfunction in men? a. b. c. d.

Their excessive interest in erotica interfered with normal sexual relationships. They experienced high levels of disgust related to most forms of sexual expression. They experienced negative emotions when aroused in the presence of erotic stimuli. They experienced arousal in response to stimuli outside of personal relationships. Difficulty: 2 Question ID: 12.1.46 Page Reference: 316 Topic: Sexual Dysfunctions Skill: Conceptual Answer: c. They experienced negative emotions when aroused in the presence of erotic stimuli.

12.1.47. Which best summarizes the treatment program for sexual dysfunction devised by Masters and Johnson that became very popular and successful? a. b. c. d.

better late than never practice makes perfect see no evil an eye for an eye Difficulty: 1 Question ID: 12.1.47 Page Reference: 316 Topic: Sexual Dysfunctions Skill: Applied Answer: b. practice makes perfect

12.1.48. What is the rationale for sensate focus in sex therapy? a. The couple needs to focus on erotic sensations rather than performance demands. b. The couple needs to understand their intrapsychic conflicts. c. Receiving support from other couples with similar problems is a key to successful treatment. d. Successful treatment requires ruling out other possible medical or physical causes of sexual dysfunction.

Difficulty: 2

Question ID: 12.1.48 Page Reference: 316 Topic: Sexual Dysfunctions Skill: Conceptual Answer: a. The couple needs to focus on erotic sensations rather than performance demands.

12.1.49. Maria and John go to a therapist because they consistently have difficulty accomplishing intercourse. The therapist recommends a procedure called sensate focus, which means that Maria and John will be expected to a. b. c. d.

explore their painful emotions in therapy. spend time together relaxing and holding hands. go to a physician, to rule out medical problems. attempt to have intercourse every night for a week. Difficulty: 2 Question ID: 12.1.49 Page Reference: 316 Topic: Sexual Dysfunctions Skill: Conceptual Answer: b. spend time together relaxing and holding hands.

12.1.50. In their therapy for sexual dysfunctions, Masters and Johnson thought that, in addition to sensate focus, it was also important to include a. b. c. d.

appropriate medications. substance abuse counseling. communication training. treatment of underlying medical problems. Difficulty: 1 Question ID: 12.1.50 Page Reference: 316-317 Topic: Sexual Dysfunctions Skill: Factual Answer: c. communication training.

12.1.51. A physician prescribes Viagra to treat a patient's erectile dysfunction and advises him to be aware of possible side effects such as a. b. c. d.

insomnia and muscular pain. headaches and altered vision. hallucinations and body rashes. constipation and rapid heartbeat.

Difficulty: 2 Question ID: 12.1.51 Page Reference: 317 Topic: Sexual Dysfunctions Skill: Applied Answer: b. headaches and altered vision.

12.1.52. Which of the following is characteristic of a man with a paraphilia? a. b. c. d.

inhibited sex drive aversion to his own sexuality physically incapable of having an erection sexually aroused by unusual things or situations Difficulty: 1 Question ID: 12.1.52 Page Reference: 318 Topic: Paraphilias Skill: Factual Answer: d. sexually aroused by unusual things or situations

12.1.53. The compulsive and inflexible features of paraphilias make them similar to a. b. c. d.

mood disorders addictions sexual dysfunctions antisocial personality disorder Difficulty: 1 Question ID: 12.1.53 Page Reference: 318 Topic: Paraphilias Skill: Factual Answer: b. addictions

12.1.54. What is the central problem in paraphilias? a. b. c. d.

inhibited sexual desire physiological problems prevent arousal the individual feels guilt about the behavior sexual arousal is detached from a reciprocal, loving adult relationship

Difficulty: 1

Question ID: 12.1.54 Page Reference: 318 Topic: Paraphilias Skill: Conceptual Answer: d. sexual arousal is detached from a reciprocal, loving adult relationship

12.1.55. Paraphilias have been compared to addictions because both of these problems involve a. b. c. d.

illegal activity. feelings of compulsion. a genetic predisposition. neurotransmitter imbalances. Difficulty: 1 Question ID: 12.1.55 Page Reference: 319 Topic: Paraphilias Skill: Conceptual Answer: b. feelings of compulsion.

12.1.56. Which of the following situations is an example of necrophilia? a. b. c. d.

A man has sexual contact with a corpse. A young man is sexually attracted to a woman's neck. A woman is attracted to certain body parts of a man. A woman has an interest in unusual sexual practices with men. Difficulty: 1 Question ID: 12.1.56 Page Reference: 320 Topic: Paraphilias Skill: Factual Answer: a. A man has sexual contact with a corpse.

12.1.57. Dean finds it impossible to reach orgasm unless he is holding and kissing a woman's shoe. This problem is a paraphilia known as a. b. c. d.

fetishism. pedophilia. frotteurism. transvestic fetishism.

Difficulty: 2

Question ID: 12.1.57 Page Reference: 320 Topic: Paraphilias Skill: Factual Answer: a. fetishism.

12.1.58. Sam is looking for a job to earn money and put him near the stimuli he uses to achieve sexual excitement. He is offered what he views as the "ideal job" at a shoe store; however, he is fired when his interactions with customers provide evidence that he has a paraphilia known as a. b. c. d.

voyeurism. fetishism. klismaphilia. exhibitionism. Difficulty: 2 Question ID: 12.1.58 Page Reference: 320 Topic: Paraphilias Skill: Applied Answer: b. fetishism.

12.1.59. Which of the following is characterized by sexual arousal when dressing in clothing of the opposite gender? a. b. c. d.

transsexualism pseudohermaphroditism transvestic fetishism gender identity disorder Difficulty: 1 Question ID: 12.1.59 Page Reference: 320 Topic: Paraphilias Skill: Factual Answer: c. transvestic fetishism

12.1.60. Men who cross-dress and develop persistent discomfort with their gender role or identity, would be assigned a subtype diagnosis of transvestic fetishism with gender a. b. c. d.

fetishism. reversal. distaste. dysphoria. Difficulty: 3

Question ID: 12.1.60 Page Reference: 320 Topic: Paraphilias Skill: Conceptual Answer: d. dysphoria.

12.1.61. A drag queen who is gay and who cross-dresses would probably not be diagnosed with transvestic fetishism because a. b. c. d.

the person with transvestic fetishism will hold but not dress in clothing of the opposite sex. people with transvestic fetishism only dress in clothing of other people of the same sex. the drag queen will not be sexually aroused by cross-dressing. people who are gay cannot be diagnosed with any mental disorder. Difficulty: 2 Question ID: 12.1.61 Page Reference: 320-321 Topic: Paraphilias Skill: Conceptual Answer: c. the drag queen will not be sexually aroused by cross-dressing.

12.1.62. Which of these individuals would most clearly fit the DSM diagnostic criteria for transvestic fetish? a. b. c. d.

Carl, who collects women's boots and shoes and masturbates while holding these objects Danny, a gay man, who is known among members of the gay community as a drag queen Dennis, who dresses in women's clothing as part of his job in a Las Vegas nightclub act Barry, a heterosexual, who dresses in women's clothing for the purpose of sexual arousal Difficulty: 2 Question ID: 12.1.62 Page Reference: 320-321 Topic: Paraphilias Skill: Conceptual Answer: d. Barry, a heterosexual, who dresses in women's clothing for the purpose of sexual

arousal

12.1.63. Ted dreams and daydreams about being humiliated during sexual encounters. He finds the fantasies to be quite arousing. What diagnosis would be made in this case? a. b. c. d.

Ted would qualify for the diagnosis of fetishism. Ted would not meet the criteria of masochism because he enjoys the fantasies. Ted would not meet the criteria of masochism because he does not act on his fantasies. Ted would qualify for the diagnosis of sexual masochism.

Difficulty: 2 Question ID: 12.1.63 Page Reference: 320-321 Topic: Paraphilias Skill: Applied Answer: d. Ted would qualify for the diagnosis of sexual masochism.

12.1.64. Which of the following individuals is most likely to engage in masochistic sexual activity? a. Helen, who works as a nursing assistant at the local nursing home b. Iris, who just graduated from a small state college and loves to collect military items c. Frank, who is a paramedic and is frequently the first one on the scene of a terrible accident d. Gary, who is highly educated and whose social activities are often described in the social column of the newspaper Difficulty: 2 Question ID: 12.1.64 Page Reference: 320-321 Topic: Paraphilias Skill: Conceptual Answer: d. Gary, who is highly educated and whose social activities are often described in the social column of the newspaper

12.1.65. Your text describes the masochistic behaviors of Daphne Merkin, but then suggests that she might not necessarily qualify for a diagnosis of sexual masochism because a. b. c. d.

she acknowledged her interests in masochistic sex. she married the people with whom she indulged her masochistic desires. it is not clear that she experienced subjective distress or social impairment. she never allowed herself to be seriously hurt. Difficulty: 2 Question ID: 12.1.65 Page Reference: 321-322 Topic: Paraphilias Skill: Applied Answer: c. it is not clear that she experienced subjective distress or social impairment.

12.1.66. Sexual sadism involves sexual arousal associated with a. b. c. d.

exposing oneself. rubbing against someone. feeling pain and humiliation. hurting or humiliating someone else.

Difficulty: 1 Question ID: 12.1.66 Page Reference: 322 Topic: Paraphilias Skill: Factual Answer: d. hurting or humiliating someone else.

12.1.67. Another common term for exhibitionism is a. b. c. d.

peeping. indecent exposure. S and M. stalking. Difficulty: 1 Question ID: 12.1.67 Page Reference: 322 Topic: Paraphilias Skill: Factual Answer: b. indecent exposure.

12.1.68. A female friend of yours is expressing great concern about the possibility that she might one day encounter an exhibitionist. To help her deal with her fears you tell her that exhibitionists a. b. c. d.

rarely touch or otherwise molest their victims. are only dangerous to people they know. are only dangerous to women who are in the company of young children. will always run away whenever their intended victim screams for help. Difficulty: 1 Question ID: 12.1.68 Page Reference: 322 Topic: Paraphilias Skill: Applied Answer: a. rarely touch or otherwise molest their victims.

12.1.69. Which of the following represents a case of voyeurism? a. b. c. d.

A man fondles a black boot while he masturbates. A man exposes his genitals to people in the subway. A man uses binoculars to watch his neighbors undress. A man rubs up against an unsuspecting young woman in a crowded department store.

Difficulty: 1

Question ID: 12.1.69 Page Reference: 322 Topic: Paraphilias Skill: Factual Answer: c. A man uses binoculars to watch his neighbors undress.

12.1.70. A person with a paraphilia known as frotteurism is likely to do which of the following? a. b. c. d.

expose himself to neighbors feel aroused when he is hit or kicked rub up against someone in a crowded bank feel a need to see a certain object to reach orgasm Difficulty: 2 Question ID: 12.1.70 Page Reference: 322 Topic: Paraphilias Skill: Conceptual Answer: c. rub up against someone in a crowded bank

12.1.71. A person with a paraphilia that entails recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a young child is suffering from a. b. c. d.

rapism. pedophilia. necrophilia. voyeurism. Difficulty: 1 Question ID: 12.1.71 Page Reference: 322 Topic: Paraphilias Skill: Factual Answer: b. pedophilia.

12.1.72. What can be concluded regarding the long-term effects of those who have been victims of early child sexual abuse? a. They almost always become abusers themselves. b. They almost always end up engaging in risky sexual behaviors. c. They might not necessarily suffer any pervasive or intense negative consequences. d. They become unable to establish any meaningful forms of reciprocal intimacy in a variety of situations and relationships. Difficulty: 3

Question ID: 12.1.72 Page Reference: 323 Topic: Paraphilias Skill: Conceptual Answer: c. They might not necessarily suffer any pervasive or intense negative consequences.

12.1.73. Incest refers to sexual activity between all of the following except a. b. c. d.

a step father and a step son. a mother and her daughter. a biological brother and sister. All of the above involve incest. Difficulty: 1 Question ID: 12.1.73 Page Reference: 323 Topic: Paraphilias Skill: Conceptual Answer: d. All of the above involve incest.

12.1.74. Which of the following seems to fit the diagnostic criteria for pedophilia? a. Ten-year-old Dave, who sexually molested his younger sister in their home b. Twenty-year-old Barry, who had sexual intercourse repeatedly with a 16-year-old neighbor c. Twenty-five-year-old Dan, who masturbates while he holds baby rattles and bottles d. Alan, who has never molested any children but spends most of his day fantasizing about such contacts, which has made it impossible for him to date women his age Difficulty: 2 Question ID: 12.1.74 Page Reference: 323 Topic: Paraphilias Skill: Conceptual Answer: d. Alan, who has never molested any children but spends most of his day fantasizing about such contacts, which has made it impossible for him to date women his age

12.1.75. Many incest perpetrators would not be considered pedophiles because a. b. c. d.

they have no sexually arousing fantasies. their victims are often postpubescent adolescents. they employ force and they humiliate their victims. incest is a crime, not a mental disorder.

Difficulty: 3

Question ID: 12.1.75 Page Reference: 323 Topic: Paraphilias Skill: Conceptual Answer: b. their victims are often postpubescent adolescents.

12.1.76. Why is rape not included as a paraphilia in DSM-IV-TR? a. b. c. d.

Rape is not always sexually motivated. Rape is a legal, not psychological problem. The focus of the sex drive is not an inanimate object. Rape is too common a problem to be considered a paraphilia. Difficulty: 2 Question ID: 12.1.76 Page Reference: 324 Topic: Paraphilias Skill: Conceptual Answer: a. Rape is not always sexually motivated.

12.1.77. In a study by Laumann, et al (NHSLS) of coercive sex it was estimated that what percentage of women had been forced to participate in a sexual act against their will? a. b. c. d.

1 percent 10 percent 20 percent 45 percent Difficulty: 1 Question ID: 12.1.77 Page Reference: 323 Topic: Paraphilias Skill: Factual Answer: c. 20 percent

12.1.78. "Crossing" of paraphilic behaviors refers to the fact that a. b. c. d.

almost all paraphilias cross-dress. these behaviors are against cultural norms. people who exhibit one paraphilia often exhibit others. people with these problems are unsure of their sexual orientation.

Difficulty: 2

Question ID: 12.1.78 Page Reference: 324 Topic: Paraphilias Skill: Factual Answer: c. people who exhibit one paraphilia often exhibit others.

12.1.79. Most paraphilias are exhibited by men, with the exception of a. b. c. d.

masochism. fetishism. frotteurism. exhibitionism. Difficulty: 1 Question ID: 12.1.79 Page Reference: 324 Topic: Paraphilias Skill: Factual Answer: a. masochism.

12.1.80. According to the classification scheme for sexual offenders developed by Knight and Guay, what category would describe a man who is preoccupied with nonviolent sexual fantasies, shows deficits in his ability to process social cues from women, and has feelings of inferiority? a. b. c. d.

sadistic vindictive nonsadistic opportunistic Difficulty: 2 Question ID: 12.1.80 Page Reference: 324 Topic: Paraphilias Skill: Factual Answer: c. nonsadistic

12.1.81. According to Knight and Guay’s categorical system of rape motivations an individual who appears to be intent on violence exclusively toward women would be classified as what type of rapist? a. b. c. d.

nonsadistic misogynist vindictive opportunistic Difficulty: 2

Question ID: 12.1.81 Page Reference: 324 Topic: Paraphilias Skill: Conceptual Answer: c. vindictive

12.1.82. Which part of the brain has been implicated in some paraphilias? a. b. c. d.

thalamus cerebellum temporal lobes parietal lobes Difficulty: 1 Question ID: 112.1.82 Page Reference: 325 Topic: Paraphilias Skill: Factual Answer: c. temporal lobes

12.1.83. According to Marshall and Seidman, the core feature of unusual sexual behavior is not deviant sexual arousal but a. b. c. d.

a failure to achieve intimacy in adult relationships. deficient sexual arousal. aggression. the absence of career achievement. Difficulty: 2 Question ID: 12.1.83 Page Reference: 326 Topic: Paraphilias Skill: Conceptual Answer: a. a failure to achieve intimacy in adult relationships.

12.1.84. Several background factors have been observed repeatedly among people who engage in atypical sexual behaviors. All of the following are listed in the textbook except a. b. c. d.

lack of early church or school based sex education. early crossing of normative sexual boundaries. lack of a consistent parenting environment. lack of ability in social situations.

Difficulty: 3

Question ID: 12.1.84 Page Reference: 325 Topic: Paraphilias Skill: Applied Answer: a. lack of early church or school based sex education.

12.1.85. Money described the development of paraphilias using a geographic metaphor for a mental picture representing a person’s ideal sexual relationship that he called a a. b. c. d.

love handle. love guide. love map. love GPS. Difficulty: 2 Question ID: 12.1.85 Page Reference: 326 Topic: Paraphilias Skill: Applied Answer: c. love map.

12.1.86. Under what set of circumstances do men with paraphilias usually enter treatment? a. b. c. d.

voluntarily at the request of a loved one in order to receive a reduced sentence for a crime referral from marital therapists Difficulty: 2 Question ID: 12.1.86 Page Reference: 326 Topic: Paraphilias Skill: Conceptual Answer: c. in order to receive a reduced sentence for a crime

12.1.87. Michael is ordered to undergo aversion therapy for pedophilia. What will this treatment entail? a. b. c. d.

education about sexual norms confrontation by other men with similar problems therapy to increase insight to the consequences of pedophilia receiving electrical shock when sexually aroused by pictures of children

Difficulty: 2

Question ID: 12.1.87 Page Reference: 326 Topic: Paraphilias Skill: Applied Answer: d. receiving electrical shock when sexually aroused by pictures of children

12.1.88. You are a cognitive behavioral therapist who has started to see a client suffering from a paraphilia. What are you likely to try to do with this client? a. b. c. d.

investigate deep-seated conflicts about his sexuality provide training to help him overcome cognitive and social deficits help him to understand that his behavior is illegal and might lead to imprisonment refer him to a self-help group that will help him with his addiction Difficulty: 2 Question ID: 12.1.88 Page Reference: 326 Topic: Paraphilias Skill: Applied Answer: b. provide training to help him overcome cognitive and social deficits

12.1.89. What do research results tell us about the effectiveness of psychological treatments for sexual offenders? a. b. c. d.

Most offenders can be helped. Only the offenders who admit their guilt can be helped. In general, treatment is not very successful. Psychological treatment works best when combined with medications. Difficulty: 1 Question ID: 12.1.89 Page Reference: 326 Topic: Paraphilias Skill: Factual Answer: c. In general, treatment is not very successful.

12.1.90. The California Sex Offender Treatment and Evaluation Project was designed for men convicted of either rape or child molestation. The treatment was comprehensive using cognitive behavioral therapy and several other interventions. In a carefully controlled study their results a. found no difference in subsequent sexual crimes between treatment and control group. b. suggest a 13 percent reduction in subsequent recidivism between the therapy group and the control group. c. found an actual increase in recidivism in the therapy group. d. found a significant increase in violent crime in both groups.

Difficulty: 2 Question ID: 12.1.90 Page Reference: 326 Topic: Paraphilias Skill: Conceptual Answer: a. found no difference in subsequent sexual crimes between treatment and control group.

12.1.91. One approach to the treatment of paraphilias involves drugs that a. b. c. d.

reduce the levels of testosterone. increase the levels of testosterone. reduce the levels of estrogen. increase the levels of estrogen. Difficulty: 1 Question ID: 12.1.91 Page Reference: 327 Topic: Paraphilias Skill: Factual Answer: a. reduce the levels of testosterone.

12.1.92. All of the following types of drugs have been used to treat paraphilias except a. b. c. d.

antidepressants. hormones. amphetamines. antianxiety drugs. Difficulty: 2 Question ID: 12.1.92 Page Reference: 327 Topic: Paraphilias Skill: Conceptual Answer: c. amphetamines.

12.1.93. Consistent with therapy developed by Marshall is the theory that SSRIs reduce paraphilias because they reduce a. b. c. d.

social anxiety. depression. libido or sex drive. anger.

Difficulty: 2

Question ID: 12.1.93 Page Reference: 326-327 Topic: Paraphilias Skill: Conceptual Answer: a. social anxiety.

12.1.94. The U.S. Congress and all 50 states have passed laws that are intended to protect society from people who have been convicted of violent or repeated sexual offenses. One set of laws, sometimes called Megan’s laws, are actually called a. b. c. d.

community protection laws. child protection laws. community notification laws. Megan's laws. Difficulty: 2 Question ID: 12.1.94 Page Reference: 327 Topic: Paraphilias Skill: Factual Answer: c. community notification laws.

12.1.95. Sexual predator laws allow the state to a. b. c. d.

force a sexual predator to undergo a therapy prescribed by the state. force a sexual predator to live in a specified location. force a sexual predator to wear a GPS tracking devise at all times. keep a sexual predator in either a prison or mental hospital for life. Difficulty: 2 Question ID: 12.1.95 Page Reference: 328 Topic: Paraphilias Skill: Factual Answer: d. keep a sexual predator in either a prison or mental hospital for life.

12.1.96. Which of the following is most likely to be diagnosed with gender identity disorder? a. b. c. d.

Harry, who is sexually attracted to boys Mary, who looks like a female, but feels herself to be more like a male Carl, who likes to dress in women's cloths as he makes love to his wife None of the above are likely candidates.

Difficulty: 2

Question ID: 12.1.96 Page Reference: 328 Topic: Gender Identity Disorders Skill: Conceptual Answer: b. Mary, who looks like a female, but feels herself to be more like a male.

12.1.97. Which of the following is another name for gender identity disorder in adults? a. b. c. d.

homosexuality transsexualism transvestic fetishism pseudohermaphroditism Difficulty: 1 Question ID: 12.1.97 Page Reference: 328 Topic: Gender Identity Disorders Skill: Factual Answer: b. transsexualism

12.1.98. People suffering from gender identity disorder are likely to dress up in the clothing of the opposite sex because a. b. c. d.

the clothing represents a fetish. the clothing is sexually arousing. it helps them to adopt the role of the gender with which they identify. they want to make themselves more attractive to members of their own sex. Difficulty: 2 Question ID: 12.1.98 Page Reference: 328 Topic: Gender Identity Disorders Skill: Applied Answer: c.it helps them to adopt the role of the gender with which they identify.

12.1.99. What can we conclude from the ease with which pseudohermaphrodites adopt a male gender identity at adolescence? a. b. c. d.

Learning can override hormonal influences. Prenatal hormones affect later gender identity. Social reinforcement and norms dictate gender identity. Secondary sex characteristics determine gender identity.

Difficulty: 3

Question ID: 12.1.99 Page Reference: 329 Topic: Gender Identity Disorders Skill: Conceptual Answer: b. Prenatal hormones affect later gender identity. 12.1.100. What is one of the documented benefits of sex reassignment surgery? a. b. c. d.

increased sex drive improved sensate focus reduced anxiety and depression decreased transvestic fetishism Difficulty: 1 Question ID: 12.1.100 Page Reference: 329 Topic: Gender Identity Disorders Skill: Factual Answer: c. reduced anxiety and depression

Short Answer 12.2.101. ____________ sexual desire is defined in terms of lack of sexual fantasies and lack of interest in sexual experiences. Difficulty: 1 Question ID: 12.1.101 Page Reference: 308 Topic: Sexual Dysfunctions Skill: Factual Answer: Hypoactive

12.2.102. ____________sexual arousal in a woman means she can neither achieve or maintain genital responses, such as lubrication and swelling, that are necessary to complete sexual intercourse comfortably. Difficulty: 2 Question ID: 12.2.102 Page Reference: 309 Topic: Sexual Dysfunctions Skill: Factual Answer: Inhibited

12.2.103. _____________ validity is the extent to which specific measures produce results that are consistent with the theoretical idea of interest. Difficulty: 3 Question ID: 12.2.103 Page Reference: 311 Topic: Sexual Dysfunctions Skill: Factual Answer: Construct

12.2.104. The ICD, the World Health Organization list of diseases, includes a disorder that is not included in the DSM-IV-TR called __________ sexual drive. Difficulty: 2 Question ID: 12.2.104 Page Reference: 312 Topic: Sexual Dysfunctions Skill: Factual Answer: excessive

12.2.105. The influence of male sex hormones on sexual behavior is thought to be on sexual __________ rather than on sexual performance. Difficulty: 2 Question ID: 12.2.105 Page Reference: 314 Topic: Sexual Dysfunctions Skill: Conceptual Answer: appetite

12.2.106. Changing the way in which people think about sex is called __________ restructuring. Difficulty: 2 Question ID: 12.2.106 Page Reference: 316 Topic: Sexual Dysfunctions Skill: Factual Answer: cognitive

12.2.107. Your female client has had her ovaries removed and as a result is feeling less interested in sex. Which hormone are you likely to prescribe for her? Difficulty: 3 Question ID: 12.2.107 Page Reference: 317 Topic: Sexual Dysfunctions Skill: Applied Answer: testosterone

12.2.108. For some people, sexual arousal is strongly associated with unusual things and situations, such as inanimate objects, sexual contact with children, exhibiting their genitals to strangers, or inflicting pain on another person. When a person is preoccupied with or consumed by these interests we say they are suffering from a __________ . Difficulty: 2 Question ID: 12.2.108 Page Reference: 318 Topic: Paraphilias Skill: Factual Answer: paraphilia

12.2.109. The association of sexual arousal with nonliving objects is called __________ . Difficulty: 1 Question ID: 12.2.109 Page Reference: 320 Topic: Paraphilias Skill: Factual Answer: fetishism

12.2.110. “Acts involving nonconsensual sexual penetration obtained by physical force, by threat of bodily harm, or when the victim is incapable of giving consent by virtue of mental illness, mental retardation, or intoxication” is the legal definition of __________ . Difficulty: 1 Question ID: 12.2.110 Page Reference: 323 Topic: Paraphilias Skill: Factual Answer: rape

12.2.111. Our sense of ourselves as being either male or female is known as __________ identity. Difficulty: 1 Question ID: 12.2.111 Page Reference: 328 Topic: Gender Identity Disorders Skill: Factual Answer: gender

Essay 12.3.112. What is the sequence of phases of the sexual response cycle described by Masters and Johnson? Describe each one. Difficulty: 2 Question ID: 12.3.112 Page Reference: 304 Topic: Overview Skill: Conceptual Answer: (1) excitement phase: increases continuously from initial stimulation to orgasm; may last from a few minutes to several hours. One of the most dramatic physiological changes is vasocongestion-engorgement of blood vessels in various organs, especially the genitals. Sexual excitement also increases muscular tension, heart rate, and respiration rate. These physiological responses are accompanied by subjective feelings of arousal. (2) orgasm phase: distinct from the gradual buildup of sexual excitement; this sudden release of tension is almost always experienced as intensely pleasurable. (3) resolution phase: may last 30 minutes or longer; the person's body returns to its resting state.

12.3.113. What is the National Health and Social Life Survey? What are some of its key findings? What is the procedure of probability sampling used in this survey? Difficulty: 2 Question ID: 12.3.113 Page Reference: 306 Topic: Sexual Dysfunctions Skill: Conceptual Answer: Probability sampling is a procedure in which every member of a specified population has a known probability of selection. This procedure increases the chances that the results can be generalized. The NHSLS surveyed 3,500 men and women between the ages of 18 and 59 throughout the United States. Some of the key findings are: - married couples have sex more often than single people married couples reported more physical and emotional satisfaction from sex than single people did people in younger generations were more likely than people in older generations to have had premarital sex - one-third of the sample said they had sex with a partner at least twice a week; another third had sex with a partner a few times a month; and the remaining third had sex with a partner a few times a year or didn't have sexual partners at all.

12.3.114. The penile plethysmograph and the vaginal photometer measure physiological events directly related to sexual arousal, but they do not measure sexual arousal itself. Instead, they are said to be reflections of a hypothetical construct called "sexual arousal." Using this example, explain the following terms: hypothetical construct, construct validity, and operational definition. Difficulty: 2 Question ID: 12.3.114 Page Reference: 311 Topic: Sexual Dysfunctions Skill: Conceptual Answer: A hypothetical construct is a theoretical idea that refers to something that can't be observed directly. For example, arousal involves a subjective feeling of being aroused, which cannot be directly observed. In order to use such an idea scientifically, it must be defined in terms of observable indicators, even if these indicators do not define the idea completely. These observable indicators are the operational definition. In the case of arousal, observable factors such as penile circumference and vaginal engorgement are used as indicators of arousal. If these indicators turn out to be related to other indicators of arousal, such as the person's subjective report, then the indicators are said to have construct validity. This means that they are thought to be valid, if incomplete, indicators of the hypothetical construct.

12.3.115. Discuss the approach to viewing problem of uncontrolled sexual behavior as a form of addiction. Difficulty: 2 Question ID: 12.3.115 Page Reference: 312-313 Topic: Sexual Dysfunctions Skill: Conceptual Answer: Although DSM-IV includes unusually low sexual desire as a sexual dysfunction, it does not mention unusually high sexual desire. In contrast, ICD-10 does include a category called excessive sexual desire with symptoms such as seeking new sexual encounters out of boredom with old ones, frequent use of pornography, and legal problems resulting from sexual behaviors. Additional features include obsessive thoughts about sexual encounters, guilt resulting from problematic sexual behavior, and rationalization for continued reckless sexual behavior. One approach to the problems views uncontrolled sexual behavior as a form of addiction. Replace the word substance with the term sexual behavior in substance dependence and you have a version of a definition of sexual addiction. The person develops a tolerance to previous sexual patterns and forms of sexual experience; the person experiences symptoms of withdrawal when deprived of sexual opportunities; and the person engages in repeated patterns of compulsive sexual behavior. Opposition to this proposal is based on several factors. One is the somewhat circular definition of the problem. Another limitation is the heterogeneous nature of excessive or uncontrolled sexual behavior. Failure to control sexual impulses can be associated with several disorders in DSM-IV, including paraphilias, impulse control disorders, and bipolar mood disorder.

12.3.116. Explain how paraphilias are usually viewed in terms of more than just deviant sexual behavior. Difficulty: 2 Question ID: 12.3.116 Page Reference: 318-319 Topic: Paraphilias Skill: Conceptual Answer: DSM-IV-TR requires that the person's behavior leads to clinically significant distress or impairment. Paraphilias usually interfere with a person's life, especially relationships with other people. The central problem is not just that there are reactions to unusual sexual stimuli; sexual arousal is dependent on images that are detached from a reciprocal, loving relationship with another adult. Compulsion and lack of flexibility are also important features of paraphilic behaviors. 12.3.117. Explain why some paraphilias are considered by ethologists or evolutionary psychologists to be "courtship disorders." Difficulty: 3 Question ID: 12.3.117 Page Reference: 325 Topic: Paraphilias Skill: Conceptual Answer: For male primates, sexual behavior involves a sequence of three steps: location and appraisal of potential partners; exchange of signals of mutual interest; and tactile interactions that set the stage sexual for intercourse. Voyeurism, exhibitionism, and frotteurism in humans may represent aberrant versions of these basic processes. 12.3.118. Summarize the psychological treatments used to treat paraphilias and their efficacy. Difficulty: 2 Question ID: 12.3.118 Page Reference: 326-327 Topic: Paraphilias Skill: Applied Answer: The treatments that are used for paraphilias have unique problems and limited success. Perhaps at the heart of the problem is that most individuals labeled as paraphilias do not feel that they are in need of therapy. They are being asked to undergo some very unpleasant procedures in order to forgo pleasurable behaviors. Often they are in therapy via court order. Several procedures known as aversion therapy illustrate this problem. Aversion therapies live up to their name. They are an attempt to pair unpleasant sensations with the stimuli that have the client finds attractive, such a children. It is hoped that in future the stimuli, children, will elicit nausea rather than sexual arousal, though that goal is somewhat questionable ethically. Cognitive behavioral strategies have also been used. In these procedures an attempt is made to both change the client’s attitudes and beliefs through logic and debate and teach them social and interpersonal skills that they may be lacking through a straightforward process of education and practice. Unfortunately all procedures lack empirical evidence of efficacy. One large evaluation project, SOTEP, is mentioned in the textbook; this was a controlled study that compared a comprehensive treatment program that included cognitive therapy, skills training, relaxation, relapse prevention, etc., with a control group. The results indicated no significant difference between the therapy group and the control group.

12.3.119. Explain what cases of pseudohermaphroditism tell us about what factors influence the development of gender identity. Difficulty: 3 Question ID: 12.3.119 Page Reference: 329 Topic: Gender Identity Disorders Skill: Conceptual Answer: Pseudohermaphrodites are genetically male but are born with ambiguous genitalia. Prenatally, they are exposed to male hormones, but the effects of these hormones are not apparent until adolescence, when the individual begins to show male sex characteristics. Many of these people are raised as girls, but then make an easy transition to a male gender identity at adolescence. This suggests that prenatal sex hormones, rather than how the person is raised or socialized, determine later gender identity.

Chapter 13 Schizophrenic Disorders Total Assessment Guide (T.A.G.) Topic Overview pp. 332-335

Symptoms pp. 335-339

Diagnosis pp. 339-343

Frequency pp. 343-344

Causes pp. 344-354

Treatment pp. 354-358

Question Type Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice

Short Answer Essay Multiple Choice Short Answer Essay

Factual 3, 4, 5, 7

Conceptual

Applied

1, 2, 8

10, 13, 17, 18, 19, 20, 21, 24, 25, 28 110, 111, 112, 113 121 31, 33, 39, 40, 41, 42, 44, 45, 47 114, 115

9, 14, 15, 16, 23, 27 109

11, 12, 22, 26

29, 30, 34, 36, 48

32, 35, 37, 38, 43, 46

50, 51, 52

107, 108

116 122 53, 55, 58, 60, 61, 66, 72, 75, 76, 79, 83 118 123 90, 91, 92, 93, 94, 96, 103, 106 119, 120 127

54, 59, 62, 63, 65, 67, 70, 71, 73, 74, 77, 82, 85, 86, 88, 89 117 124, 125, 126 89, 97, 100, 101, 102, 104

56, 57, 64, 68, 69, 78, 80, 81, 84, 87

95, 98, 99, 105

Chapter 13: Schizophrenic Disorders Multiple Choice 13.1.1. Ted is taking notes in an abnormal psychology course; the topic today is the diagnosis of schizophrenia. When Ted reviews the material next week, how might he summarize the material on the symptoms used to identify schizophrenia? a. b. c. d.

No single symptom is indicative of schizophrenia. Delusions and hallucinations define the disorder. Psychosis is not found in any condition other than schizophrenia. The "negative" symptoms indicate the absence of schizophrenia. Difficulty: 1 Question ID: 13.1.1 Page Reference: 333 Topic: Overview Skill: Conceptual Answer: a. No single symptom is indicative of schizophrenia.

13.1.2. What is the long-term outcome for people with schizophrenia? a. b. c. d.

Most people recover. Most people do not recover completely. Males have a higher recovery rate than females. Those who develop the disorder while young rarely recover completely. Difficulty: 1 Question ID: 13.1.2 Page Reference: 333-335 Topic: Overview Skill: Conceptual Answer: b. Most people do not recover completely.

13.1.3. The most common age when the symptoms of schizophrenia are seen is a. b. c. d.

before age three. between six and ten years old. in adolescence and early adulthood. after age 40.

Difficulty: 2 Question ID: 13.1.3 Page Reference: 334 Topic: Overview Skill: Factual Answer: c. in adolescence and early adulthood.

13.1.4. The experience of most schizophrenics may be seen as falling into three phases; prodromal, active, and a. b. c. d.

terminal. residual. acute. chronic. Difficulty: Question ID: 13.1.4 Page Reference: 334 Topic: Overview Skill: Factual Answer: b. residual.

13.1.5. When does the prodromal phase of schizophrenia occur? a. b. c. d.

after the active phase at the point of greatest disturbance before active psychotic symptoms are present when the patient is treated with neuroleptic medications Difficulty: 1 Question ID: 13.1.5 Page Reference: 334 Topic: Overview Skill: Factual Answer: c. before active psychotic symptoms are present

13.1.6. In January, Rita was beginning to perform poorly at work, was neglecting her appearance, becoming withdrawn, and exhibiting odd behaviors. In June, she showed the full blown symptoms of schizophrenia. Her behavior in January can be considered part of which phase of the disorder? a. b. c. d.

active residual prodromal undifferentiated

Difficulty: 2 Question ID: 13.1.6 Page Reference: 334 Topic: Overview Skill: Applied Answer: c. prodromal

13.1.7. The phase of schizophrenia in which the most dramatic symptoms of psychosis have improved, but the person continues to be impaired in various ways is labeled a. b. c. d.

prodromal. active. residual. acute. Difficulty: 1 Question ID: 13.1.7 Page Reference: 334 Topic: Overview Skill: Factual Answer: c. residual.

13.1.8. Marvin has a long history of schizophrenia. His doctors say that he is currently in the residual phase, from which we can conclude that he a. b. c. d.

has recovered. has recently suffered an acute relapse. continues to be impaired in various ways. is experiencing hallucinations but not delusions. Difficulty: 1 Question ID: 13.1.8 Page Reference: 334 Topic: Overview Skill: Conceptual Answer: c. continues to be impaired in various ways.

13.1.9. Symptoms of schizophrenia that include hallucinations and delusions and are also called psychotic symptoms are know as a. b. c. d.

positive symptoms. negative symptoms. aberrant symptoms. hallucinatory symptoms.

Difficulty: 1 Question ID: 13.1.9 Page Reference: 335 Topic: Symptoms Skill: Conceptual Answer: a. positive symptoms.

13.1.10. Which of the following is an example of a positive symptom of schizophrenia? a. b. c. d.

flat affect hallucinations social withdrawal lack of initiative Difficulty: 1 Question ID: 13.1.10 Page Reference: 335 Topic: Symptoms Skill: Factual Answer: b. hallucinations

13.1.11. During an interview a patient says he frequently hears the voice of his sister coming from his image in the bathroom mirror. The psychologist who is conducting the interview most likely writes that the patient presents evidence of a. b. c. d.

delusions. hallucinations. negative symptoms. loose associations. Difficulty: 2 Question ID: 13.1.11 Page Reference: 336 Topic: Symptoms Skill: Applied Answer: b. hallucinations.

13.1.12. The feature that hallucinations in schizophrenia share in common is a. b. c. d.

visual experience. auditory experience. the voice of God. sensory experience.

Difficulty: 2 Question ID: 13.1.12 Page Reference: 336 Topic: Symptoms Skill: Applied Answer: d. sensory experience.

13.1.13. What are delusions? a. b. c. d.

examples of disorganized speech rigidly held, idiosyncratic beliefs sensory experiences in the absence of external stimuli lifelong convictions that are limited to one's cultural group Difficulty: 1 Question ID: 13.1.13 Page Reference: 336 Topic: Symptoms Skill: Factual Answer: b. rigidly held, idiosyncratic beliefs

13.1.14. When patients who are suffering delusions are confronted with contradictory evidence a. b. c. d.

they defend their beliefs with conviction. they concede their error but develop a new delusion. they defend their beliefs but only half-heartedly, knowing they are in error. they are unable to engage in coherent speech. Difficulty: 2 Question ID: 13.1.14 Page Reference: 336 Topic: Symptoms Skill: Conceptual Answer: a. they defend their beliefs with conviction.

13.1.15. How do positive and negative symptoms compare in terms of their course over time? a. b. c. d.

negative symptoms fluctuate negative symptoms are more stable positive symptoms get steadily worse positive symptoms steadily improve

Difficulty: 2 Question ID: 13.1.15 Page Reference: 337 Topic: Symptoms Skill: Conceptual Answer: b. negative symptoms are more stable

13.1.16. Which of the following is considered one of the earliest signs that something is wrong in someone who may eventually meet the criteria for schizophrenia? a. b. c. d.

insomnia social isolation loose associations auditory hallucinations Difficulty: 1 Question ID: 13.1.16 Page Reference: 337 Topic: Symptoms Skill: Conceptual Answer: b. social isolation

13.1.17. Monty, who has been diagnosed as suffering from schizophrenia, shows only the slightest smile when happy or the slightest frown when upset. His limited emotional expressiveness is called a. b. c. d.

catatonia. anhedonia. dissociation. blunted affect. Difficulty: 2 Question ID: 13.1.17 Page Reference: 337 Topic: Symptoms Skill: Factual Answer: d. blunted affect.

13.1.18. What term is used to describe patients who feel no joy or excitement, even when doing things they formerly enjoyed? a. b. c. d.

anhedonia blunted affect affective disorder inappropriate affect

Difficulty: 1 Question ID: 13.1.18 Page Reference: 337 Topic: Symptoms Skill: Factual Answer: a. anhedonia

13.1.19. Avolition refers to a. b. c. d.

lack of motivation. lack of speech. loose associations. inappropriate affect. Difficulty: 1 Question ID: 13.1.19 Page Reference: 337 Topic: Symptoms Skill: Factual Answer: a. lack of motivation.

13.1.20. What is alogia? a. b. c. d.

lack of speech illogical speech inability to understand speech lack of grammatical structure in speech Difficulty: 1 Question ID: 13.1.20 Page Reference: 337 Topic: Symptoms Skill: Factual Answer: a. lack of speech

13.1.21. What is another term for disorganized speech? a. b. c. d.

delusion catatonia thought disorder tardive dyskinesia

Difficulty: 1 Question ID: 13.1.21 Page Reference: 338 Topic: Symptoms Skill: Factual Answer: c. thought disorder

13.1.22. Which of the following individuals exhibits behavior that would be described by the term disorganized speech? a. b. c. d.

Harold, who uses words in peculiar ways Pat, who tends to overuse the past tense Susan, whose speech contains some grammatical errors. Rebecca, who discusses strong convictions about preposterous ideas Difficulty: 2 Question ID: 13.1.22 Page Reference: 338 Topic: Symptoms Skill: Applied Answer: a. Harold, who uses words in peculiar ways

13.1.23. During an interview, a patient suffering from schizophrenia gives answers that seem to be responses to the questions but become lost in irrelevant details. What term is used to describe this phenomenon? a. b. c. d.

alogia hallucination perseveration tangentiality Difficulty: 2 Question ID: 13.1.23 Page Reference: 339 Topic: Symptoms Skill: Conceptual Answer: d. tangentiality

13.1.24. What aspect of the symptoms of schizophrenia is described by the term "loose associations"? a. b. c. d.

social withdrawal shifting topics too abruptly disruptions in neurotransmitter functioning lack of relation between cognitive and emotional symptoms

Difficulty: 1 Question ID: 13.1.24 Page Reference: 339 Topic: Symptoms Skill: Factual Answer: b. shifting topics too abruptly

13.1.25. Catatonia refers to disturbances in a. b. c. d.

speech. motor function. emotional expression. capacity for intimacy. Difficulty: 1 Question ID: 13.1.25 Page Reference: 339 Topic: Symptoms Skill: Factual Answer: b. motor function.

13.1.26. Tania suffers from schizophrenia, and hospital staff have observed that she has been purposelessly pacing back and forth and rubbing her hands together in a special pattern for several hours. Tania is exhibiting a. b. c. d.

paranoia. catatonia. motor fluidity. dementia. Difficulty: 2 Question ID: 13.1.26 Page Reference: 339 Topic: Symptoms Skill: Applied Answer: b. catatonia.

13.1.27. Mark is a patient who has been diagnosed with catatonia. Which of these symptoms might characterize his catatonic condition? a. b. c. d.

He appears frozen, like a mannequin. He answers "Bohemia" to every question asked. He believes he sees his dead father in the room. He writes to the CIA about Napoleon's attempts to capture him.

Difficulty: 2 Question ID: 13.1.27 Page Reference: 339 Topic: Symptoms Skill: Conceptual Answer: a. He appears frozen, like a mannequin.

13.1.28. Melissa begins giggling when discussing a recent car accident in which her brother was killed, and cries when telling a joke she heard on television. What term do we for this behavior? a. b. c. d.

anhedonia catatonia delusional thinking inappropriate affect Difficulty: 1 Question ID: 13.1.28 Page Reference: 339 Topic: Symptoms Skill: Factual Answer: d. inappropriate affect

13.1.29. Emil Kraepelin suggested that several types of psychosis should be distinguished from manicdepressive disorders and classified together under one category called a. b. c. d.

schizophrenia. mood disorder. thought disorder. dementia praecox. Difficulty: 2 Question ID: 13.1.29 Page Reference: 339 Topic: Diagnosis Skill: Conceptual Answer: d. dementia praecox.

13.1.30. Eugen Bleuler coined the name “schizophrenia” to replace Emil Kraepelin's term “dementia praecox.” Bleuler wanted a different name because he disagreed with the notion, implied by the name “dementia praecox,” that the disorder always a. b. c. d.

had a viral cause. resulted in memory loss. involved split personality and dissociative fugue. had an early onset and ended in profound deterioration.

Difficulty: 2 Question ID: 13.1.30 Page Reference: 339 Topic: Diagnosis Skill: Conceptual Answer: d. had an early onset and ended in profound deterioration.

13.1.31. With regard to schizophrenia, splitting of mental associations refers to a. b. c. d.

the meaning of the word schizophrenia. a positive symptom. a negative symptom. none of the above Difficulty: 2 Question ID: 13.1.31 Page Reference: 339 Topic: Diagnosis Skill: Factual Answer: a. the meaning of the word schizophrenia.

13.1.32. DSM-IV-TR requires that two separate types of symptoms be present to justify a diagnosis of schizophrenia, except when a. b. c. d.

any one symptom has lasted for more than one year. delusions are bizarre or hallucinations involve a running commentary. the symptoms show evidence of a thought disorder. there is also evidence of a significant manic or depressive episode. Difficulty: 2 Question ID: 13.1.32 Page Reference: 340 Topic: Diagnosis Skill: Applied Answer: b. delusions are bizarre or hallucinations involve a running commentary.

13.1.33. For a diagnosis of schizophrenia, DSM-IV-TR requires a decline in the person's functioning and the presence of active psychotic symptoms over a continuous period of at least a. b. c. d.

one week. one month. six months. one year.

Difficulty: 2 Question ID: 13.1.33 Page Reference: 340 Topic: Diagnosis Skill: Factual Answer: b. one month.

13.1.34. Schizophreniform disorder is distinguished from schizophrenia in that schizophreniform disorder is characterized by a. b. c. d.

a lack of psychotic symptoms. more severe psychotic symptoms. longer duration of psychotic symptoms. shorter duration of psychotic symptoms. Difficulty: 2 Question ID: 13.1.34 Page Reference: 340 Topic: Diagnosis Skill: Conceptual Answer: d. shorter duration of psychotic symptoms.

13.1.35. A graduate student is learning to use the DSM-IV-TR, and is overwhelmed by all of the information. When he comes to the subtypes of schizophrenia, he learns that the subtypes are organized in a hierarchy. What does this tell the student? a. Each subtype has one symptom that distinguishes it from the others. b. The subtypes are based on the number of symptoms a patient exhibits. c. The highest subtype in the hierarchy for which symptoms are present is the only one diagnosed, even if symptoms of lower subtypes are also present. d. The subtypes are listed in order of their severity, and patients often progress up and down the list. Difficulty: 3 Question ID: 13.1.35 Page Reference: 340 Topic: Diagnosis Skill: Applied Answer: c. The highest subtype in the hierarchy for which symptoms are present is the only one diagnosed, even if symptoms of lower subtypes are also present. 13.1.36. Brenda has been diagnosed with the paranoid subtype of schizophrenia. What specific symptoms would you expect to see highlighted in her clinical record? a. b. c. d.

severe motor disturbances silly, child-like behaviors disorganized, even incoherent, speech delusions with persecutory or grandiose content

Difficulty: 2 Question ID: 13.1.36 Page Reference: 341 Topic: Diagnosis Skill: Conceptual Answer: d. delusions with persecutory or grandiose content

13.1.37. A newly admitted patient exhibits incoherent speech, poorly organized hallucinations, and delusions that do not make sense. What is the likely diagnosis? a. b. c. d.

paranoid schizophrenia catatonic schizophrenia disorganized schizophrenia undifferentiated schizophrenia Difficulty: 2 Question ID: 13.1.37 Page Reference: 341 Topic: Diagnosis Skill: Applied Answer: c. disorganized schizophrenia

13.1.38. Which of these individuals is most likely to receive the diagnosis of schizophrenia of the residual type? a. b. c. d.

Beverly, who is currently psychotic Carol, who is showing the first signs of schizophrenia David, who was formerly psychotic but continues to have some problems Eileen, who may have inherited the genes for schizophrenia but shows no symptoms Difficulty: 2 Question ID: 13.1.38 Page Reference: 341 Topic: Diagnosis Skill: Applied Answer: c. David, who was formerly psychotic but continues to have some problems

13.1.39. The type of schizophrenia associated most with motor immobility is a. b. c. d.

catatonic. residual. disorganized. undifferentiated.

Difficulty: Question ID: 13.1.39 Page Reference: 340-341 Topic: Diagnosis Skill: Factual Answer: a. catatonic. 13.1.40. The type of schizophrenia where speech is incoherent and affect is flat and inappropriate is most likely to be diagnosed as which type? a. b. c. d.

paranoid residual disorganized demented Difficulty: 1 Question ID: 13.1.40 Page Reference: 341 Topic: Diagnosis Skill: Factual Answer: c. disorganized

13.1.41. The type of schizophrenia that includes schizophrenic patients who display prominent psychotic symptoms and either meet the criteria for several subtypes or otherwise do not meet the criteria for the catatonic, disorganized, or paranoid types is labeled a. b. c. d.

differentiated. undifferentiated. residual. standard. Difficulty: 2 Question ID: 13.1.41 Page Reference: 341 Topic: Diagnosis Skill: Factual Answer: b. undifferentiated.

13.1.42. The textbook suggests that there is a great irony involved in research on schizophrenia which is that a. the original physicain who developed the diagnostic category was later diagnosed with schizophrenia himself. b. for over 100 years we have known the diagnostic category that we now recognize as schizophrenia may well be composed of many different kinds of mental disorders. c. we have had a clear model of the cause of schizophrenia for over 100 years, but still no effective treatment. d. None of these are what the textbook suggests.

Difficulty: 3 Question ID: 13.1.42 Page Reference: 341 Topic: Diagnosis Skill: Factual Answer: b. for over 100 years we have known the diagnostic category that we now recognize as schizophrenia may well be composed of many different kinds of mental disorders.

13.1.43. At a conference on schizophrenia, a psychologist presents a critique of the subtypes. What major criticism is likely to be included in the presentation? a. b. c. d.

The subtypes have distinctly different etiologies. Several of the subtypes are more like mood disorders. Dozens of subtypes add to the confusion surrounding the disorder. The subtypes are unstable over time and have poor diagnostic reliability. Difficulty: 2 Question ID: 13.1.43 Page Reference: 341 Topic: Diagnosis Skill: Applied Answer: d. The subtypes are unstable over time and have poor diagnostic reliability.

13.1.44. Schizoaffective disorder involves a. b. c. d.

split personality. emotionally-based delusions. "cut off" emotions and lack of expressiveness. overlapping symptoms of schizophrenia and a major mood disorder. Difficulty: 1 Question ID: 13.1.44 Page Reference: 341 Topic: Diagnosis Skill: Factual Answer: d. overlapping symptoms of schizophrenia and a major mood disorder.

13.1.45. What diagnostic category is used to describe individuals who experience transient symptoms of schizophrenia and complete recovery? a. b. c. d.

catatonia anhedonia split personality brief psychotic disorder

Difficulty: 1 Question ID: 13.1.45 Page Reference: 342 Topic: Diagnosis Skill: Factual Answer: d. brief psychotic disorder

13.1.46. Two patients are in the local mental hospital, one with the diagnosis of delusional disorder, the other with schizophrenia. What is the major difference between the two patients? a. The patient with delusional disorder shows evidence of a mood disorder. b. The patient with schizophrenia has negative, but not positive symptoms. c. The patient with schizophrenia has no history of schizophrenia in the family. d. The content of the delusions in delusional disorder is not bizarre, and there is no social or occupational impairment except in areas related to the delusions. Difficulty: 2 Question ID: 13.1.46 Page Reference: 342 Topic: Diagnosis Skill: Applied Answer: d. The content of the delusions in delusional disorder is not bizarre, and there is no social or occupational impairment except in areas related to the delusions.

13.1.47. According to DSM-IV-TR, brief psychotic disorder refers to psychotic symptoms lasting how long? a. b. c. d.

less than twenty-four hours one day to one month one month to six months six months to twelve months Difficulty: 1 Question ID: 13.1.47 Page Reference: 342 Topic: Diagnosis Skill: Factual Answer: b. one day to one month

13.1.48. After reviewing the results of the follow-up research conducted by Manfred Bleuler, what conclusion could we reach concerning the outcome of schizophrenia? a. The long-term prospects for people with this disorder remains dismal in most cases. b. About half of those diagnosed with schizophrenia will either recover or exhibit at least some improvement. c. Contrary to general opinion, schizophrenia is more of an episodic disorder from which recovery rates tend to be quite high. d. The deterioration that occurs in schizophrenia is not reversible, and consequently few, if any, people will make any meaningful recovery. Difficulty: 2 Question ID: 13.1.48 Page Reference: 342 Topic: Diagnosis Skill: Conceptual Answer: b. About half of those diagnosed with schizophrenia will either recover or exhibit at least some improvement. 13.1.49. Worldwide, how many people out of every 100 will experience or display symptoms of schizophrenia at some time during their lives? a. b. c. d

1 5 10 15 Difficulty: 1 Question ID: 13.1.49 Page Reference: 343 Topic: Frequency Skill: Factual Answer: a. 1

13.1.50. Rich always heard that there are no gender differences in the rate of schizophrenia; however, he has just been told that closer inspection yields certain differences of interest. Which of the following describes some of those differences? a. b. c. d.

Men have more positive symptoms and a more chronic course. Men develop the disorder earlier and have a more chronic course. Women develop the disorder later and have a more chronic course. Women have more negative symptoms and a less chronic course. Difficulty: 2 Question ID: 13.1.50 Page Reference: 343 Topic: Frequency Skill: Conceptual

Answer: b. Men develop the disorder earlier and have a more chronic course. 13.1.51. Cross-cultural studies of the rate of schizophrenia show a. b. c. d.

higher rates in Western cultures. higher rates in rural populations. higher rates in urban populations. higher rates in poor societies. Difficulty: 2 Question ID: 13.1.51 Page Reference: 344 Topic: Frequency Skill: Conceptual Answer: c. higher rates in urban populations.

13.1.52. Cross-cultural studies of the rate of schizophrenia in various types of communities found that clinical and social outcomes at two- and five-year follow-ups were significantly better in developing countries such as Nigeria and India. What aspect of life in these cultures has been hypothesized to account for these outcomes? a. b. c. d.

less stressful lifestyles milder forms of schizophrenia greater tolerance and acceptance of people with schizophrenia racial differences in response to medication and dietary factors Difficulty: 1 Question ID: 13.1.52 Page Reference: 344 Topic: Frequency Skill: Conceptual Answer: c. greater tolerance and acceptance of people with schizophrenia

13.1.53. What do studies of concordance rates for schizophrenia in monozygotic (MZ) and dizygotic (DZ) twins show? a. b. c. d.

almost 100 percent concordance in MZ twins, 0 percent in DZ very low rates of concordance in either type of twin consistent evidence of higher concordance in DZ than MZ consistent evidence of higher concordance in MZ than DZ Difficulty: 1 Question ID: 13.1.53 Page Reference: 345 Topic: Causes Skill: Factual

Answer: d. consistent evidence of higher concordance in MZ than DZ 13.1.54. What evidence suggests that the development of schizophrenic disorders is not entirely explained by genetics? a. b. c. d.

MZ twins are not 100 percent concordant. DZ twins are not 100 percent concordant. Concordance rates for MZ twins are less than for DZ twins. Concordance rates for DZ twins are less than for MZ twins. Difficulty: 2 Question ID: 13.1.54 Page Reference: 345 Topic: Causes Skill: Conceptual Answer: a. MZ twins are not 100 percent concordant

13.1.55. Leonard Heston conducted an adoption study of the possible causes of schizophrenia. What was the major finding in his study? a. There was no evidence of a genetic influence on schizophrenia. b. Adopted individuals had higher rates of schizophrenia regardless of the mental health status of their parents. c. The environment one grows up in has a much greater impact on the incidence of schizophrenia than do genetic factors. d. Adopted children born to mothers who were schizophrenic developed schizophrenia at a higher rate than did children born to normal mothers. Difficulty: 2 Question ID: 13.1.55 Page Reference: 345-346 Topic: Causes Skill: Factual Answer: d. Adopted children born to mothers who were schizophrenic developed schizophrenia at a higher rate than did children born to normal mothers.

13.1.56. A research report you are reading uses the term spectrum of schizophrenia disorders. Which of the following best illustrates this concept? a. Mood disorders with psychotic features are similar to schizophrenia. b. The rate of schizophrenia depends on the types of viruses that are prevalent in a given environment. c. A family with a member suffering from schizophrenia is at higher risk for disorders such as schizoaffective disorder. d. Efforts to understand one's place in the world lead many to experience an existential crisis that appears similar to schizophrenia.

Difficulty: 2 Question ID: 13.1.56 Page Reference: 346 Topic: Causes Skill: Applied Answer: c. A family with a member suffering from schizophrenia is at higher risk for disorders such as schizoaffective disorder.

13.1.57. The Office of the Surgeon General asked for an update on genetic linkage and schizophrenia. Attention is being paid to a form of the COMT gene (called the Val allele) which seems to a. b. c. d.

decrease the rate of apoptosis. alter the functioning of the amygdala. affect the breakdown of dopamine. alter GABA activity. Difficulty: 3 Question ID: 13.1.57 Page Reference: 346 Topic: Causes Skill: Applied Answer: c. affect the breakdown of dopamine.

13.1.58. What have researchers discovered from their examinations of the pregnancy and birth records of people who later develop schizophrenia? a. Their mothers experienced more complications at the time of labor and delivery. b. Their mothers experienced fewer complications at the time of labor and delivery. c. Their mothers experienced more complications during pregnancy but not at the time of labor and delivery. d. Their mothers experienced fewer complications during pregnancy. Difficulty: 1 Question ID: 13.1.58 Page Reference: 346-347 Topic: Causes Skill: Factual Answer: a. Their mothers experienced more complications at the time of labor and delivery.

13.1.59. What is one of the indirect lines of evidence supporting the hypothesis that viral infections play a role in the etiology of some cases of schizophrenia? a. b.

The rates of schizophrenia tend to be elevated during periods of famine. There is slightly elevated rate of schizophrenia among people born in the winter months.

c. There is a correlation between indices of air pollution and rates of schizophrenia around the world. d. High doses of drugs designed to fight viral infections can reduce some of the symptoms of schizophrenia. Difficulty: 2 Question ID: 13.1.59 Page Reference: 347 Topic: Causes Skill: Conceptual Answer: b. There is slightly elevated rate of schizophrenia among people born in the winter months.

13.1.60. What has research shown concerning the link between schizophrenia and the lateral ventricles of the brain? a. b. c. d.

On average, schizophrenics have enlarged lateral ventricles. All patients with schizophrenia have enlarged lateral ventricles. Enlarged lateral ventricles are found only in schizophrenia. Enlarged lateral ventricles predict early onset of schizophrenia. Difficulty: 1 Question ID: 13.1.60 Page Reference: 347 Topic: Causes Skill: Factual Answer: a. On average, schizophrenics have enlarged lateral ventricles.

13.1.61. Based on the results of magnetic resonance imaging (MRI), what areas of the brain have been found to be smaller in people with schizophrenia compared to those without the disorder? a. b. c. d.

corpus callosum and pons parts of the limbic system cerebellum and basal ganglia prefrontal cortex and medulla Difficulty: 2 Question ID: 13.1.61 Page Reference: 348 Topic: Causes Skill: Factual Answer: b. parts of the limbic system

13.1.62. Studies using magnetic resonance imaging (MRI) have found diminished size of structures in the limbic systems of schizophrenics' brains. Why is this finding potentially important? a.

The limbic system integrates cognition and emotion.

b. c. d.

The limbic system coordinates eye tracking and visual perception. The limbic system is the seat of consciousness and sense of identity. Abstract reasoning and problem solving are organized in the limbic system. Difficulty: 3 Question ID: 13.1.62 Page Reference: 348 Topic: Causes Skill: Conceptual Answer: a. The limbic system integrates cognition and emotion.

13.1.63. In studies of twins in which one twin had schizophrenia and the other did not, the schizophrenic twins always showed reduced activity in which lobe of the brain when compared with their unaffected cotwins? a. b. c. d.

occipital frontal parietal medulla Difficulty: Question ID: 13.1.63 Page Reference: 348 Topic: Causes Skill: Conceptual Answer: b. frontal

13.1.64. A study was done in the Netherlands following WWII that looked at the causes of schizophrenia. Based on the finding of this study a logical social policy would be one that a. b. c. d.

assisted pregnant mothers with nutrition. taught communication skills to young families. provided housing for poor families. None of the above follow from that study. Difficulty: 2 Question ID: 13.1.64 Page Reference: 347 Topic: Causes Skill: Applied Answer: a. assisted pregnant mothers with nutrition.

13.1.65. Measures of blood flow in various areas of the cerebral cortex show that while working on various tasks, schizophrenic patients do not show expected increases in blood flow to the a.

cerebellum and corpus callosum.

b. c. d.

occipital lobes and parietal lobes. prefrontal cortex and temporal lobes. lateral ventricles and corpus callosum. Difficulty: 2 Question ID: 13.1.65 Page Reference: 348 Topic: Causes Skill: Conceptual Answer: c. prefrontal cortex and temporal lobes.

13.1.66. The neurological impairments found in schizophrenic patients have also been studied in the unaffected twins of schizophrenic patients. Compared to the neurological impairments of "well" twins, the neurological impairments in their schizophrenic twins are a. b. c. d.

marked by more activity in the occipital lobe. marked by a larger hippocampus and smaller amygdala. marked by a smaller hippocampus and amygdala. about the same as the "well" twin. Difficulty: 2 Question ID: 13.1.66 Page Reference: 348 Topic: Causes Skill: Factual Answer: c. marked by a smaller hippocampus and amygdala.

13.1.67. The newspaper contains a report of a research team in Europe that has found a brain area in a group of schizophrenic patients that is smaller than the same area in normal individuals. The article was written by a well-known science writer who has a keen understanding of schizophrenia. What is he likely to conclude? a. Dietary factors account for most differences in brain size. b. A complex disorder such as schizophrenia is not likely to be traced to a single brain site. c. The differences are probably the result of differences in the size of the individuals that made up the respective groups. d. Most such differences have been found to be the result of drug treatments for the disorder, rather than reflecting some underlying cause.

Difficulty: 1 Question ID: 13.1.67 Page Reference: 349 Topic: Causes Skill: Conceptual

Answer: b. A complex disorder such as schizophrenia is not likely to be traced to a single brain site.

13.1.68. The most consistent findings as to the cause of schizophrenia point toward structural as well as functional irregularities in regions of the brain which play an important role in cognitive and emotional processes. All of the following are included in this list of brain regions EXCEPT a. b. c. d.

frontal cortex. parietal lobe. limbic systems. temporal lobe. Difficulty: 3 Question ID: 13.1.68 Page Reference: 348-349 Topic: Causes Skill: Applied Answer: b. parietal lobe.

13.1.69. The current emphasis on using brain imaging procedures with patients suffering from schizophrenia is based on the belief that such procedures a. b. c. d.

can assist with diagnosis. might identify the neuropathology that causes schizophrenia. allow us to determine which medication will be of greatest benefit to the patients. will show that schizophrenia is actually a form of split personality. Difficulty: 2 Question ID: 13.1.69 Page Reference: 349 Topic: Causes Skill: Applied Answer: b. might identify the neuropathology that causes schizophrenia.

13.1.70. One of the first neurochemical theories of schizophrenia focused on altered activity of this system. a. b. c. d.

serotonin. dopamine. norepinephrine. estrogen. Difficulty: 1 Question ID: 13.1.70 Page Reference: 349 Topic: Causes

Skill: Conceptual Answer: b. dopamine.

13.1.71. Current neurochemical hypotheses regarding schizophrenia focus on a. b. c. d.

dopamine deficiencies. excessive levels of dopamine. a broad array of neurotransmitters. dietary deficiencies. Difficulty: 2 Question ID: 13.1.71 Page Reference: 350 Topic: Causes Skill: Conceptual Answer: c. a broad array of neurotransmitters.

13.1.72. Which of the following describes the relationship between the rate of schizophrenia and social class found in studies done in Chicago 50 years ago? a. b. c. d.

The highest rates are found in the upper classes. The highest rates are found in the lower classes. The highest rates are found in the middle classes. The rates of schizophrenia are similar across classes. Difficulty: 2 Question ID: 13.1.72 Page Reference: 350 Topic: Causes Skill: Factual Answer: b. The highest rates are found in the lower classes.

13.1.73. What does the social causation hypothesis propose as the cause of the high rate of schizophrenia in the lower classes in the United States? a. b. c. d.

inappropriate mothering labeling and rejection by society stressful events and poor health care high negative emotions in lower class families Difficulty: 2 Question ID: 13.1.73 Page Reference: 350 Topic: Causes Skill: Conceptual

Answer: c. stressful events and poor health care

13.1.74. According to the social selection hypothesis, the rate of schizophrenia is higher in the lower classes in the United States because a. b. c. d.

the stresses of living in poverty trigger schizophrenic symptoms. poor health care and nutrition trigger schizophrenic symptoms. schizophrenics are less able to find or hold good jobs. only poor schizophrenics are labeled as mentally ill. Difficulty: 2 Question ID: 13.1.74 Page Reference: 350 Topic: Causes Skill: Conceptual Answer: c. schizophrenics are less able to find or hold good jobs.

13.1.75. High rates of schizophrenia are found in groups that have a. b. c. d.

migrated to a new country. stayed in the same small town of village for their whole lifetime. moved within a given country frequently. None of these are accurate. Difficulty: 2 Question ID: 13.1.75 Page Reference: 350 Topic: Causes Skill: Factual Answer: a. migrated to a new country.

13.1.76. Expressed emotion refers to a. b. c. d.

family members being negative and intrusive. family members showing acceptance and caring. the appropriateness of a schizophrenic person's affect. the schizophrenic person's stated desire to engage in social relations.

Difficulty: 1 Question ID: 13.1.76 Page Reference: 350 Topic: Causes Skill: Factual

Answer: a. family members being negative and intrusive.

13.1.77. What conclusion is warranted concerning the causal role of disturbed communication in families? a. Disturbed communication is a significant cause of schizophrenia. b. Disturbed communication does not cause people to develop schizophrenia. c. Disturbed communication is responsible for the onset of schizophrenia, but not for its continuation. d. Disturbed communication is a cause of schizophreniform disorder but not schizophrenia. Difficulty: 2 Question ID: 13.1.77 Page Reference: 351 Topic: Causes Skill: Conceptual Answer: b. Disturbed communication does not cause people to develop schizophrenia.

13.1.78. Expressed emotion in families is thought to influence the a. b. c. d.

development of schizophrenia. probability of relapse by schizophrenic patients. content of delusions shown by schizophrenic patients. display of positive or negative symptoms by schizophrenic patients. Difficulty: 3 Question ID: 13.1.78 Page Reference: 351 Topic: Causes Skill: Applied Answer: b. probability of relapse by schizophrenic patients.

13.1.79. Which of the following symptoms of schizophrenia is most difficult for family members to accept and tolerate? a. b. c. d.

delusions withdrawal hallucinations disorganized speech Difficulty: 1 Question ID: 13.1.79 Page Reference: 352 Topic: Causes Skill: Factual

Answer: b. withdrawal

13.1.80. Which of the following conclusions about expressed emotion (EE) is most accurate? a. b. c. d.

EE is a significant cause of schizophrenia. EE is a poor predictor of relapse in schizophrenic patients. EE is a better predictor of outcome for mood and eating disorders than it is for schizophrenia. EE is a significant cause of both schizophrenia and mood disorders. Difficulty: 3 Question ID: 13.1.80 Page Reference: 352 Topic: Causes Skill: Applied

Answer: c. EE is a better predictor of outcome for mood and eating disorders than it is for schizophrenia.

13.1.81. Research seems to show that expressed emotion tends to be more common in Western than in non-Western or developing countries. What aspect of schizophrenia has this observation been used to explain? a. b. c. d.

less severe long-term outcomes in developing countries differences in the content of delusions from culture to culture differences in the types of symptoms commonly seen in various cultures more positive response to drug treatments of schizophrenia in developing countries Difficulty: 3 Question ID: 13.1.81 Page Reference: 352 Topic: Causes Skill: Applied Answer: a. less severe long-term outcomes in developing countries

13.1.82. In psychopathology research, groups of schizophrenic patients are sometimes compared to groups of "patient controls." In such research, patient controls are used to a. b. c. d.

determine whether certain factors are specific to schizophrenia or apply to other disorders. identify the differences between people with schizophrenia and people without mental disorder. control for differences between subjects in severity of illness. control for subject and experimenter bias. Difficulty: 3 Question ID: 13.1.82 Page Reference: 352 Topic: Causes Skill: Conceptual

Answer: a. determine whether certain factors are specific to schizophrenia or apply to other disorders. 13.1.83. A component or trait that lies somewhere on the pathway between the genotype, which lays the foundation for the disorder, and full-blown symptoms of the disorder is known as a. b. c. d.

anhedonia. a phenotype. a schizotype. an endophenotype. Difficulty: 2 Question ID: 13.1.83 Page Reference: 353 Topic: Causes Skill: Factual Answer: d. an endophenotype.

13.1.84. A research group is focusing on the discovery of a specific measure, such as a biochemical assay or a psychological test, and they are interested in knowing whether it might be useful in identifying people who are vulnerable to schizophrenia. This team is looking for what type of marker? a. b. c. d.

vulnerability schizotypic phenotypic None of these are correct. Difficulty: 3 Question ID: 13.1.84 Page Reference: 353 Topic: Causes Skill: Applied Answer: a. vulnerability

13.1.85. For a specific test to function as a vulnerability marker for schizophrenia, it is necessary that the proposed test a. b. c. d.

distinguishes between those who have schizophrenia and those who don't. measures the level of dopamine and serotonin. be designed to accommodate the communication difficulties typical of schizophrenia. is used only with people who have no family history of schizophrenia. Difficulty: 2 Question ID: 13.1.85 Page Reference: 353-354 Topic: Causes Skill: Conceptual

Answer: a. distinguishes between those who have schizophrenia and those who don't.

13.1.86. The identification of deficits in working memory is particularly interesting with regard to schizophrenia because it links to other evidence regarding brain functions and this disorder. Processes that are associated with central executive processing are associated with brain activity located in an area of the prefrontal cortex that seems to be dysfunctional in schizophrenia known as a. b. c. d.

preoptic. dorsolateral. verbal. posterior. Difficulty: 3 Question ID: 13.1.86 Page Reference: 354 Topic: Causes Skill: Conceptual Answer: b. dorsolateral.

13.1.87. Research on the relationship between dysfunctional smooth-pursuit eye movement and schizophrenia has suggested that this dysfunction may be a. b. c. d.

absent in other mental disorders. induced by an environmental toxin. present in all forms of schizophrenia. associated with a predisposition to schizophrenia. Difficulty: 3 Question ID: 13.1.87 Page Reference: 354 Topic: Causes Skill: Applied Answer: d. associated with a predisposition to schizophrenia.

13.1.88. The real test of any potential vulnerability marker for schizophrenia will be its ability to a. b. c. d.

identify the neuropathology involved in schizophrenia. show that people with a family history of schizophrenia are at greater risk for the illness. predict the later appearance of schizophrenia. identify the right medications to be used to treat the illness. Difficulty: 2 Question ID: 13.1.88 Page Reference: 354 Topic: Causes

Skill: Conceptual Answer: c. predict the later appearance of schizophrenia.

13.1.89. Antipsychotic medication does relieve the symptoms of schizophrenia in many cases. Unfortunately a substantial minority of schizophrenic patients does not improve on classical antipsychotic drugs. This is the case for how many patients? a. b. c. d.

10 percent 25 percent 50 percent 75 percent Difficulty: 2 Question ID: 13.1.89 Page Reference: 355 Topic: Treatments Skill: Conceptual Answer: b. 25 percent

13.1.90. After patients recover from acute psychotic episodes after receiving antipsychotic medications, there is a high probability that they will have another episode if they discontinue medication. According to the textbook what percent of patients have a relapse in the first year after hospital discharge? a. b. c. d.

10-15 percent 25-30 percent 45-50 percent 65-70 percent Difficulty: 2 Question ID: 13.1.90 Page Reference: 355 Topic: Treatment Skill: Factual Answer: d. 65-70 percent

13.1.91. Which of the following symptoms is likely to show the most improvement with the use of antipsychotic medication? a. b. c. d.

alogia avolition blunted affect hallucinations Difficulty: 2 Question ID: 13.1.91 Page Reference: 355

Topic: Treatment Skill: Factual Answer: d. hallucinations

13.1.92. Most studies find that about half of the patients who receive medication are rated as being much improved after what length of time? a. b. c. d.

twenty-four hours forty-eight hours four to six weeks two to four months Difficulty: 2 Question ID: 13.1.92 Page Reference: 355 Topic: Treatment Skill: Factual Answer: c. four to six weeks

13.1.93. For patients with schizophrenia being treated with classical antipsychotic drugs, the real-world rates of relapse are significantly higher than best-case rates because a. b. c. d.

the best-case rates are based on inaccurate assumptions about neurochemistry. many patients stop taking their medication to avoid unpleasant side effects. best-case rates are promoted by pharmaceutical companies trying to market their drugs. classical antipsychotic drugs only work for short periods of time. Difficulty: 2 Question ID: 13.1.93 Page Reference: 355 Topic: Treatment Skill: Factual Answer: b. many patients stop taking their medication to avoid unpleasant side effects.

13.1.94. Extrapyramidal symptoms, a common side effect of traditional medications used to treat schizophrenia, are disturbances in a. b. c. d.

attention. motor functions. affect regulation. weight regulation. Difficulty: 1 Question ID: 13.1.94 Page Reference: 355

Topic: Treatment Skill: Factual Answer: b. motor functions.

13.1.95. An outpatient at the mental health clinic has been taking his prescription antipsychotic drug for several weeks. This week the psychiatrist ordered another drug, Cogentin, that needs to be taken with the antipsychotic drug. Why was this drug prescribed? a. b. c. d.

The patient has recently developed anxiety symptoms. The patient has developed extrapyramidal symptoms that need to be minimized. The new drug works as a booster to increase the effectiveness of the antipsychotic drug. The new drug will counter the effects of the antipsychotic drug on the patient's white blood count. Difficulty: 2 Question ID: 13.1.95 Page Reference: 355 Topic: Treatment Skill: Applied Answer: b. The patient has developed extrapyramidal symptoms that need to be minimized.

13.1.96. What is one common problem with prolonged use of traditional antipsychotic medications for treating psychosis? a. b. c. d.

alogia anhedonia schizotaxia tardive dyskinesia Difficulty: 1 Question ID: 13.1.96 Page Reference: 355 Topic: Treatment Skill: Factual Answer: d. tardive dyskinesia

13.1.97. Why is the new class of antipsychotic medications called "atypical"? a. b. c. d.

They do not produce extrapyramidal symptoms. They are used for unusual types of schizophrenia. They are effective for a small number of patients. They are usually used for non-schizophrenic disorders. Difficulty: 2 Question ID: 13.1.97 Page Reference: 355

Topic: Treatment Skill: Conceptual Answer: a. They do not produce extrapyramidal symptoms.

13.1.98. As a clinician treating schizophrenia you are pleased that your patients have access to second generation antipsychotic drugs as they are as effective as first generation drugs and produce fewer motor problems. However, all of the following give you cause for concern EXCEPT a. b. c. d.

they are not more effective for treating negative symptoms. the side effects of weight gain can be very debilitating for some clients. most have more extrapyramidal side effects than first generation drugs. in some cases side effects include diabetes and coronary artery disease. Difficulty: 3 Question ID: 13.1.98 Page Reference: 355 Topic: Treatment Skill: Applied Answer: c. most have more extrapyramidal side effects than first generation drugs.

13.1.99. One action that all antipsychotic drugs share is a. b. c. d.

extrapyramidable side effects. coronary side effects. they act by blocking dopamine receptors. tardictive properties. Difficulty: 3 Question ID: 13.1.99 Page Reference: 355 Topic: Treatment Skill: Applied Answer: c. they act by blocking dopamine receptors.

13.1.100. Most second generation antipsychotics_______________ than traditional drugs. a. b. c. d.

produce a broader range of neurochemical actions in the brain. are less expensive increase dopamine production more work on a narrower range of brain regions

Difficulty: 2 Question ID: 13.1.100 Page Reference: 356

Topic: Treatment Skill: Conceptual Answer: a. produce a broader range of neurochemical actions in the brain.

13.1.101. Many patients who did not respond to traditional antipsychotic drugs respond to new antipsychotic drugs such as clozapine, which have their major effect on a. b. c. d.

GABA levels. neuropeptides. dopamine systems. serotonin systems. Difficulty: 2 Question ID: 13.1.101 Page Reference: 356 Topic: Treatment Skill: Conceptual Answer: d. serotonin systems.

13.1.102. What is the major goal of most family treatment programs? a. b. c. d.

They help family members improve their coping skills. They instruct family members in the methods of administering drug treatments. The program encourages family members to keep the patient as calm and sedate as possible. The program recognizes that the family must receive the same forms of therapy as the patient. Difficulty: 1 Question ID: 13.1.102 Page Reference: 356 Topic: Treatment Skill: Conceptual Answer: a. They help family members improve their coping skills.

13.1.103. A comprehensive, integrated program aimed at the improvement of the cognitive abilities of schizophrenic patients, including those that are concerned with performance on laboratory tasks (such as attention, working memory, and problem solving) as well as social cognition, is known as a. b. c. d.

cognitive schizophrenic therapy. cognitive enhancement therapy. cognitive behavioral therapy. social skills training. Difficulty: 2 Question ID: 13.1.103

Page Reference: 357 Topic: Treatment Skill: Factual Answer: b. cognitive enhancement therapy.

13.1.104. What is the key to the assertive community treatment programs for schizophrenia? a. They seek out the patients to provide services. b. They encourage members of the community to interact with patients. c. They use some of the same techniques used in assertive training for socially shy people. d. They insist that patients must live on their own in the community, without relying on drug treatments. Difficulty: 2 Question ID: 13.1.104 Page Reference: 357 Topic: Treatment Skill: Conceptual Answer: a. They seek out the patients to provide services.

13.1.105. What have outcome studies found regarding the value of assertive community treatment programs for schizophrenia? a. b. c. d.

They are effective but very costly. They can effectively reduce the number of days that patients spend in psychiatric hospitals. They can only work when they are staffed by psychiatrists and psychologists. They can dramatically reduce the need for dangerous antipsychotic medications. Difficulty: 2 Question ID: 13.1.105 Page Reference: 357-358 Topic: Treatment Skill: Applied

Answer: b. They can effectively reduce the number of days that patients spend in psychiatric hospitals.

13.1.106. Institutionalized schizophrenics are sometimes helped with the use of token economies. What is the basis of these programs? a. b. c. d.

payment for unskilled labor rewards for appropriate behavior education about how to manage money the family, not the state, pays for treatment Difficulty: 1

Question ID: 13.1.106 Page Reference: 358 Topic: Treatment Skill: Factual Answer: b. rewards for appropriate behavior

Short Answer 13.2.107. The phase of schizophrenia that precedes the active phase, but is characterized by deteriorating functioning, is known as the __________ phase. Difficulty: 2 Question ID: 13.2.107 Page Reference: 334 Topic: Overview Skill: Factual Answer: prodromal

13.2.108. The __________ phase follows the active phase of schizophrenia. Difficulty: 1 Question ID: 13.2.108 Page Reference: 334 Topic: Overview Skill: Factual Answer: residual

13.2.109. A schizophrenic client who is exhibiting lack of initiative, social withdrawal, and anhedonia would be showing __________ symptoms. Difficulty: 2 Question ID: 13.2.109 Page Reference: 335 Topic: Symptoms Skill: Conceptual Answer: negative

13.2.110. When seen in a schizophrenic client, a rigidly held, idiosyncratic belief or preposterous idea is known as a __________ .

Difficulty: 2

Question ID: 13.2.110 Page Reference: 336 Topic: Symptoms Skill: Factual Answer: delusion

13.2.111. When a schizophrenic demonstrates flattened emotions or restricted expression of verbal or nonverbal emotions it is known as __________ affect. Difficulty: 2 Question ID: 13.2.111 Page Reference: 337 Topic: Symptoms Skill: Factual Answer: blunted

13.2.112. Impoverished thinking in a schizophrenic client is known as __________ . Difficulty: 2 Question ID: 13.2.112 Page Reference: 337 Topic: Symptoms Skill: Factual Answer: alogia

13.2.113. In a schizophrenic client, obviously incongruent and inconsistent emotional responses to situations are termed inappropriate __________ . Difficulty: 1 Question ID: 13.2.113 Page Reference: 339 Topic: Symptoms Skill: Factual Answer: affect

13.2.114. ________ schizophrenia is characterized by motor immobility or purposeless movement. Difficulty: 2 Question ID: 13.2.114 Page Reference: 340 Topic: Diagnosis Skill: Factual

Answer: Catatonic

13.2.115. The __________ type of schizophrenia includes individuals who are in "partial remission." Difficulty: 2 Question ID: 13.2.115 Page Reference: 341 Topic: Diagnosis Skill: Factual Answer: residual

13.2.116. Current literature suggests that __________ are 30 to 40 percent more likely to develop schizophrenia than the opposite sex. Difficulty: 1 Question ID: 13.2.116 Page Reference: 343 Topic: Frequency Skill: Factual Answer: men

13.2.117. In support of the theory that viral infection may play a role in the etiology of schizophrenia is the observation that children born during which season are more likely to develop the disorder? __________ Difficulty: 2 Question ID: 13.2.117 Page Reference: 347 Topic: Causes Skill: Conceptual Answer: winter

13.2.118. Neural circuits in the __________ prefrontal cortex may function improperly in schizophrenia. Difficulty: 2 Question ID: 13.2.118 Page Reference: 349 Topic: Causes Skill: Factual Answer: dorsolateral

13.2.119. The textbook refers to drugs that are used to treat schizophrenia as __________ medications.

Difficulty: 2 Question ID: 13.2.119 Page Reference: 354 Topic: Treatment Skill: Factual Answer: antipsychotic

13.2.120. Prolonged treatment with antipsychotic drugs can lead to the development of tardive __________ , a syndrome that consists of abnormal involuntary movements of the mouth and face, such as tongue protrusion, chewing, and lip puckering. Difficulty: 2 Question ID: 13.2.120 Page Reference: 355 Topic: Treatment Skill: Factual Answer: dyskinesia

Essay 13.3.121. Describe the three major dimensions of symptoms associated with schizophrenia, and give examples of each. Difficulty: 2 Question ID: 13.3.121 Page Reference: 335 Topic: Symptoms Skill: Conceptual

Answer: First are positive symptoms, also called psychotic symptoms. These are characterized by the presence of some aberrant response, such as hallucinations or delusions. Second are negative symptoms, which are defined in terms of responses or functions that appear to be missing. They may be more subtle and more difficult to recognize than positive symptoms, and they include such symptoms as lack of initiative, social withdrawal, and deficits in emotional responding. The third dimension is disorganization, which includes such symptoms as bizarre behavior and disorganized speech.

13.3.122. Are gender differences found in schizophrenia? Generally, what are the two hypotheses about gender differences in schizophrenia? Difficulty: 2 Question ID: 13.3.122 Page Reference: 343-344

Topic: Frequency Skill: Conceptual Answer: Men are about 40 percent more likely to develop schizophrenia according to recent studies. Moreover, men show an earlier onset by about four or five years. The premorbid functioning of men tends to be poor and is marked by more schizotypal traits. In contrast, the premorbid functioning of women is good and is marked by fewer schizotypal traits. Men tend to exhibit more negative symptoms; women tend to have more hallucinations and paranoia. In the men the course of the disorder tends to be chronic and they show a poorer response to treatment. The course of schizophrenia in women is less likely to be chronic and they show a better response to treatment. Gender differences in the age of onset and symptomatic expression of schizophrenia can be interpreted in several ways. One approach assumes schizophrenia is a single disorder and that its expression varies in men and women. A common, genetically determined vulnerability to schizophrenia might be expressed differently in men and women. Mediating factors that might account for this difference could be biological differences between men and women (e.g., hormones) or different environmental demands (timing and form of stress associated with typical male and females sex roles). An alternative approach suggests that there are two qualitatively distinct subtypes of schizophrenia: one with an early onset that affects men more often than women, and another with a later onset that affects women more often than men.

13.3.123. Discuss the evidence that suggests the dopamine hypothesis as a factor in the cause of schizophrenia. Difficulty: 2 Question ID: 13.3.123 Page Reference: 349-350 Topic: Causes Skill: Conceptual Answer: The dopamine hypothesis derives from the discovery that all of the first generation of antipsychotic drugs reduced the activity of the neurotransmitter dopamine. It was then hypothesized that too much dopamine or too much dopamine activity was a causal factor in the etiology of this disorder. After the therapeutic effects were observed studies showed that most antipsychotic drugs block or prevent dopamine from interacting with dopamine receptors. Eventually it was observed that a drug’s therapeutic effects were directly and strongly correlated with their ability to block dopamine reception. Studies of schizophrenic patients’ brains after death have found that some patients have an excessive number of receptors in the striatum. This would be another way for there to be excess dopamine activity in the brain without it being caused by excess levels of the neurotransmitter itself. Recent attention is focused on other neurotransmitters and receptors.

13.3.124. Explain the difference between the social causation hypothesis and the social selection hypothesis in the explanation of higher rates of schizophrenia among the lower classes in the United States. Difficulty: 2 Question ID: 13.3.124 Page Reference: 350 Topic: Causes Skill: Conceptual

Answer: The social causation hypothesis holds that members of the lower classes experience more stressors, which trigger the manifestation of schizophrenia. The social selection hypothesis holds that schizophrenic individuals are less able to complete education and keep a good job, and so their status drifts down to the lower class.

13.3.125. Explain what is meant by expressed emotion (EE) and why researchers have been so interested in it. Discuss its relevance to our understanding of schizophrenia and other disorders. Difficulty: 2 Question ID: 13.3.125 Page Reference: 351-352 Topic: Causes Skill: Conceptual Answer: EE is an aspect of disturbed communication within families where one member suffers from schizophrenia. It is associated with family members who make statements that reflect negative or intrusive attitudes toward the patient. Family members may express hostility toward the patient or be repeatedly critical. Other family members appear to be overprotective or too closely identified with the patient. Patients who live in a family high in EE were more likely to relapse than patients from low EE families. Average relapse rates are 52 percent for patients in high EE families and 22 percent for patients in low EE families. However, the influence of EE is not unique to schizophrenia. Patients with mood disorders, eating disorders, panic disorder with agoraphobia, and obsessive-compulsive disorder are also more likely to relapse following discharge from a hospital if they are living with a high EE relative.

13.3.126. What criteria should be met by a potential marker for vulnerability to schizophrenia? Difficulty: 2 Question ID: 13.3.126 Page Reference: 353-354 Topic: Causes Skill: Conceptual Answer: It should distinguish persons who have schizophrenia from those who do not. It should be a stable characteristic over time. The proposed measure of vulnerability should identify more people among the biological relatives of schizophrenic patients than among people in the general population. The proposed measure of vulnerability should be able to predict the future development of schizophrenia among those who have not yet experienced psychotic episodes.

13.3.127. What are the atypical antipsychotic drugs and why are they used?

Difficulty: 2 Question ID: 13.3.127 Page Reference: 355-356 Topic: Treatment Skill: Factual

Answer: The term atypical is used because these drugs do not produce extrapyramidal symptoms and may not be associated with tardive dyskinesia. The drugs include Clozapine (Clozaril), risperidone (Risperdal), olanzapine (Zyprexa). All of these drugs block serotonin receptors, in addition to other neurochemical actions.

Chapter 14 Dementia, Delirium, and Amnestic Disorders Total Assessment Guide (T.A.G.) Topic Overview pp. 361-365

Symptoms pp. 365-378

Question Type Multiple Choice Short Answer Essay Multiple Choice

Short Answer

Factual 3, 6

Treatment and Management pp. 383-384

Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay

Applied

4, 5

1, 2, 7

10, 12, 14, 16, 19, 24, 27, 29, 32, 36, 37, 41, 45, 55, 61, 62, 64

8, 11, 13, 17, 21, 22, 26, 28, 34, 43, 49, 52, 54, 57, 60, 63

97, 98, 99, 100 9, 15, 18, 20, 23, 25, 30, 31, 33, 35, 38, 39, 40, 42, 44, 46, 47, 48, 50, 51, 53, 56, 58, 59, 65, 66 101, 102, 103, 104, 105, 106, 107

Essay Frequency of Delirium and Dementia pp. 378-380 Causes pp. 380-383

Conceptual

109, 110, 111, 112 67, 68, 69, 70

71, 72, 74, 78, 81, 82, 83, 84, 87

92, 93, 95, 96

113 73, 75, 77, 79, 86

76, 80, 85, 88

114 89, 90

91, 94

108 115

Chapter 14: Dementia, Delirium, and Amnestic Disorders Multiple Choice 14.1.1. Stanley is 65, and for the past couple of years he has been suffering a gradual worsening of his memory as well as some language difficulties and problems with his reasoning and decision making. What is the most likely diagnosis? a. b. c. d.

delirium organic psychosis dementia schizophrenia Difficulty: 1 Question ID: 14.1.1 Page Reference: 362 Topic: Overview Skill: Applied Answer: c. dementia

14.1.2. A 68-year-old man is brought to the emergency room by his family. Family members tell the physician that their relative has been confused, agitated, and exhibiting memory impairments. These symptoms developed in the last few days; he has no prior history of memory problems. Based on the family's information, the physician suspects the man is experiencing delirium. Which of the following questions would provide information that could confirm this diagnosis? a. b. c. d.

"Does schizophrenia run in your family?" "Is he taking any medications at this time?" "Does he experience any difficulties with motor movements?" "Do any members of the family suffer from Huntington's disease?" Difficulty: 2 Question ID: 14.1.2 Page Reference: 362 Topic: Overview Skill: Applied Answer: b. "Is he taking any medications at this time?"

14.1.3. Which of the following is characteristic of amnestic disorder? a. b. c. d.

usually worse at night language abilities are unaffected reduced awareness of one's surroundings impaired reasoning and decision-making

Difficulty: 2 Question ID: 14.1.3 Page Reference: 362 Topic: Overview Skill: Factual Answer: b. language abilities are unaffected 14.1.4. Which of the following individuals exhibits behavior that would most likely meet the criteria for amnestic disorder? a. Kim has severe memory impairments along with aphasia and apraxia. b. Jose has difficulty with motor functions, frequently exhibits tremors, and has developed depression. c. Steve has severe difficulty in learning new information, but his use of language is otherwise unaffected. d. Al has been in a confused state with agitation and hyperactivity and memory impairment that began two days ago. Difficulty: 2 Question ID: 14.1.4 Page Reference: 362 Topic: Overview Skill: Conceptual Answer: c. Steve has severe difficulty in learning new information, but his use of language is otherwise unaffected. 14.1.5. The cognitive symptoms seen in dementia, delirium, and amnestic disorders a. b. c. d.

are not seen in any other disorders. are seen in other disorders as well but are not defining features. are seen in other disorders but are not as severe. are only seen in schizophrenia and other psychotic disorders. Difficulty: 3 Question ID: 14.1.5 Page Reference: 362 Topic: Overview Skill: Conceptual Answer: b. are seen in other disorders as well but are not defining features.

14.1.6. At the insistence of family members you take your elderly grandfather to a general practice physician who refers him to a neurologist. When you ask for a description of neurologists, the general practitioner tells you they are a. b. c. d.

psychologists specializing in neuroses. psychiatrists specializing in nervous disorders. psychologists specializing in neuropsychological testing. physicians specializing in diseases of the brain and nervous system.

Difficulty: 1 Question ID: 14.1.6 Page Reference: 362 Topic: Overview Skill: Factual Answer: d. physicians specializing in diseases of the brain and nervous system.

14.1.7. You are head of an assessment team that needs some testing to determine the level and type of cognitive impairment being experienced by your client. You call on the services of which type of team member for this assessment? a. b. c. d.

psychiatric social worker neuropsychiatrist neuropsychologist psychiatric nurse Difficulty: 2 Question ID: 14.1.7 Page Reference: 362 Topic: Overview Skill: Applied Answer: c. neuropsychologist

14.1.8. What was one of the first indications that 84-year-old Mary (whose case was described in the text) was suffering from dementia? a. b. c. d.

She could not remember her age. She reported hearing voices calling her. Some of her animals were found dead because she forgot to feed them. After being admitted to a nursing home, she became agitated and belligerent. Difficulty: 1 Question ID: 14.1.8 Page Reference: 364 Topic: Symptoms Skill: Applied Answer: c. Some of her animals were found dead because she forgot to feed them.

14.1.9. Which of the following is characteristic of delirium? a. b. c. d.

agnosia delusions identity confusion clouded consciousness

Difficulty: 1 Question ID: 14.1.9 Page Reference: 365 Topic: Symptoms Skill: Factual Answer: d. clouded consciousness

14.1.10. Typically the symptoms of delirium a. b. c. d.

develop rapidly and then remain at a steady level as they slowly develop. develop slowly and fluctuate throughout the day. occur rapidly and then fluctuate throughout the day. None of the above are accurate. Difficulty: 2 Question ID: 14.1.10 Page Reference: 365 Topic: Symptoms Skill: Conceptual Answer: c. occur rapidly and then fluctuate throughout the day.

14.1.11. A group of medical students is learning the criteria used to diagnose cognitive disorders. The professor is discussing evidence of disturbances of consciousness along with changes in cognition such as memory deficits that occur rapidly. What type of disorder is being discussed? a. b. c. d.

dementia delirium amnestic disorder depersonalization Difficulty: 2 Question ID: 14.1.11 Page Reference: 365 Topic: Symptoms Skill: Applied Answer: b. delirium

14.1.12. While hospitalized, Jack's physician notices that he is beginning to show signs of delirium. Which of the following was a possible clue that led the physician to suspect that Jack was experiencing delirium? a. b. c. d.

He reported paranoid delusions. He was experiencing fleeting perceptual disturbances. Motor functions on his right side have slowed. He appeared sedated and didn't show much emotion.

Difficulty: 2 Question ID: 14.1.12 Page Reference: 365 Topic: Symptoms Skill: Conceptual Answer: b. He was experiencing fleeting perceptual disturbances.

14.1.13. In trying to make a differential diagnosis between delirium and dementia each of the following would be accurate EXCEPT a. Delirium has a rapid onset and typically fluctuates. Dementia develops slowly and steadily. b. Delirium often involves hallucinations and dementia rarely. c. With delirium one has consistently poor insight, but with dementia there are often insightful periods. d. Sleep is more disturbed with delirium than dementia. Difficulty: 2 Question ID: 14.1.13 Page Reference: 365 Topic: Symptoms Skill: Applied Answer: c. With delirium one has consistently poor insight, but with dementia there are often insightful periods. 14.1.14. Last year, Bob was admitted and released from the hospital within two days. The diagnosis was a cognitive disorder. Since that time he has held down a job as a carpenter. Which of the following disorders is most likely to have caused Bob's hospitalization? a. b. c. d.

delirium dementia Parkinson's disease Huntington's disease Difficulty: 2 Question ID: 14.1.14 Page Reference: 365 Topic: Symptoms Skill: Conceptual Answer: a. delirium

14.1.15. Your textbook states that the hallmark of dementia is _________. a. b. c. d.

aphasia hallucinations delirium memory loss

Difficulty: 2 Question ID: 14.1.15 Page Reference: 367 Topic: Symptoms Skill: Factual Answer: d. memory loss

14.1.16. A television report described a case of a person who exhibited a disturbance in consciousness accompanied by memory deficits and disorientation to time and place. If these symptoms occurred in the last 24 hours, you believe the diagnosis is a. b. c. d.

apraxia. dementia. delirium. amnestic disorder. Difficulty: 2 Question ID: 14.1.16 Page Reference: 365 Topic: Symptoms Skill: Conceptual Answer: c. delirium.

14.1.17. Ms. Castle is in the early stages of dementia. Which of the following is most characteristic of the type of problem she is likely to exhibit? a. b. c. d.

She shows writhing movements. She cannot be understood when she speaks. She can't remember the new neighbor she met yesterday. She can't remember the name of the town she grew up in. Difficulty: 2 Question ID: 14.1.17 Page Reference: 367 Topic: Symptoms Skill: Applied Answer: c. She can't remember the new neighbor she met yesterday.

14.1.18. What is the most obvious problem during the beginning stages of dementia? a. b. c. d.

chorea delirium retrograde amnesia anterograde amnesia

Difficulty: 1 Question ID: 14.1.18 Page Reference: 367 Topic: Symptoms Skill: Factual Answer: d. anterograde amnesia

14.1.19. After suffering a head injury in a car accident, Molly cannot remember anything that happened before the accident. What term will her physician use to describe her condition? a. b. c. d.

agnosia apraxia retrograde amnesia dissociative amnesia Difficulty: 2 Question ID: 14.1.19 Page Reference: 367 Topic: Symptoms Skill: Conceptual Answer: c. retrograde amnesia

14.1.20. Aphasia refers to various types of loss or impairment in a. b. c. d.

language. spatial ability. muscle coordination. neurotransmitter production. Difficulty: 1 Question ID: 14.1.20 Page Reference: 367 Topic: Symptoms Skill: Factual Answer: a. language.

14.1.21. Two patients on the neurology ward at the hospital have different memory problems. Ann has difficulty remembering what happened before a car accident, whereas Carson's difficulty is in learning to remember new material. At a case conference, how will these two cases be described? a. b. c. d.

Ann has apraxia; Carson has aphasia Ann has aphasia; Carson has apraxia Ann has retrograde amnesia; Carson has anterograde amnesia Ann has anterograde amnesia; Carson has retrograde amnesia

Difficulty: 2 Question ID: 14.1.21 Page Reference: 367 Topic: Symptoms Skill: Applied Answer: c. Ann has retrograde amnesia; Carson has anterograde amnesia

14.1.22. A neuropsychologist is describing several patients at a case conference. He says John does not know the names of common objects such as shoes, shirts, and screwdrivers. Jill does not know how to use such objects. When he asks what terms are used to describe their difficulties, what should he hear? a. b. c. d.

John exhibits apraxia; Jill exhibits aphasia John exhibits aphasia; Jill exhibits apraxia John exhibits retrograde amnesia; Jill exhibits anterograde amnesia John exhibits anterograde amnesia; Jill exhibits retrograde amnesia Difficulty: 2 Question ID: 14.1.22 Page Reference: 367 Topic: Symptoms Skill: Applied Answer: b. John exhibits aphasia; Jill exhibits apraxia

14.1.23. Which problem is experienced by someone with apraxia? a. b. c. d.

cannot understand speech forgets the names of objects muscles are too weak to move cannot translate ideas into meaningful action Difficulty: 1 Question ID: 14.1.23 Page Reference: 367 Topic: Symptoms Skill: Factual Answer: d. cannot translate ideas into meaningful action

14.1.24. In a study of mental functioning comparing young adults to individuals in their sixties, a psychologist asks questions such as, "You are about to buy a new car, what factors will you have to consider?" What is the psychologist doing and what is he likely to find? a. The psychologist is using questions that tap fluid intelligence; the older group will perform at a higher level. b. The psychologist is using questions that tap wisdom; the two groups will not differ in their performance. c. The psychologist is using questions that tap wisdom; the young adults will outperform the older group. d. The psychologist is using questions designed to tap fluid intelligence; the two groups will not differ in their responses to these types of items. Difficulty: 2 Question ID: 14.1.24 Page Reference: 366 Topic: Symptoms Skill: Conceptual Answer: b. The psychologist is using questions that tap wisdom; the two groups will not differ in their performance.

14.1.25. What two terms does Paul Baltes and colleagues use to describe aspects of mental functioning? a. b. c. d.

verbal and visual acquired and innate academic and practical fluid intelligence and wisdom Difficulty: 2 Question ID: 14.1.25 Page Reference: 366 Topic: Symptoms Skill: Factual Answer: d. fluid intelligence and wisdom

14.1.26. A psychologist holds out a comb and asks Mr. Bonte "What is this called in my hand?" Mr. Bonte replies, "I have no idea what that's called." The psychologist then asks Mr. Bonte to show what he would do with the object. Mr. Bonte says, "How should I know? I don't know what it is!" Mr. Bonte's response led the psychologist to describe his condition as a. b. c. d.

aphasia. agnosia. apraxia. Alzheimer's disease.

Difficulty: 2 Question ID: 14.1.26 Page Reference: 367 Topic: Symptoms Skill: Applied Answer: b. agnosia.

14.1.27. Which of these individuals is experiencing visual agnosia? a. b. c. d.

Tim, who cannot see as a result of a sensory deficit Ted, who knows what an object is for, but not its name Teresa, who cannot move the mouth muscles to name an object Tess, who does not recognize a pencil as something meaningful Difficulty: 2 Question ID: 14.1.27 Page Reference: 367 Topic: Symptoms Skill: Conceptual Answer: d. Tess, who does not recognize a pencil as something meaningful

14.1.28. People with dementia often show difficulty with abstract thinking. Which of the following questions to a person with dementia would help to demonstrate this difficulty? a. b. c. d.

"What time is it?" "What was the name of your first grade teacher?" "Why are a basketball and a football helmet alike?" "What would you like to have for supper tonight?" Difficulty: 2 Question ID: 14.1.28 Page Reference: 368 Topic: Symptoms Skill: Applied Answer: c. "Why are a basketball and a football helmet alike?"

14.1.29. The disruption of short-term memory, perceptual skills, and higher-level cognitive abilities for people with dementia can also lead to a. b. c. d.

hallucinations. disruptions of judgment. aggressive outbursts and use of obscene language. disorientation to time, place and person.

Difficulty: 2 Question ID: 14.1.29 Page Reference: 368 Topic: Symptoms Skill: Conceptual Answer: b. disruptions of judgment.

14.1.30. The Mini-Mental State Examination is used to assess a. b. c. d.

cognitive impairment. microscopic brain lesions. a patient's level of depression. clinicians' qualifications as neurologists. Difficulty: 1 Question ID: 14.1.30 Page Reference: 368-369 Topic: Symptoms Skill: Factual Answer: a. cognitive impairment.

14.1.31. Your aunt who is in her 70s has been referred to a professional. The aunt is given a series of tests that assess cognitive, sensorimotor, perceptual, and speech function. It is most likely that your aunt is seeing a a. b. c. d.

physician. neuropsychologist. psychiatrist. mneumonist. Difficulty: 1 Question ID: 14.1.31 Page Reference: 368 Topic: Symptoms Skill: Factual Answer: b. neuropsychologist.

14.1.32. What is the relationship of personality changes, emotional difficulties, and motivational problems to dementia? a. b. c. d.

They are essential to the diagnosis of dementia. They only occur in early-onset forms of dementia. They are frequently associated with dementia and have an impact on the person's adjustment. They are among the most important causes of dementia.

Difficulty: 1 Question ID: 14.1.32 Page Reference: 369 Topic: Symptoms Skill: Conceptual Answer: c. They are frequently associated with dementia and have an impact on the person's adjustment.

14.1.33. Dyskinesia is a symptom characterized by a. b. c. d.

involuntary movements. exaggerated emotionality. inability to name objects. loss of memory for past events. Difficulty: 1 Question ID: 14.1.33 Page Reference: 369 Topic: Symptoms Skill: Factual Answer: a. involuntary movements.

14.1.34. Imagine you were listening to Jimmie G (the case study presented in the textbook) as he was recounting his life. What note would you jot down that would help in your assessment of the case? a. He referred to the doctor as "doc." b. He was interested in children playing baseball. c. He spoke of his post WWII experiences in the present tense. d. He thought there was something wrong with his nerves because he was interviewed by a neurologist. Difficulty: 2 Question ID: 14.1.34 Page Reference: 370 Topic: Symptoms Skill: Applied Answer: c. He spoke of his post WWII experiences in the present tense.

14.1.35. Which type of amnestic disorder is associated with chronic alcoholism? a. b. c.

Pick's disease Alzheimer's disease Huntington's disease

Korsakoff's syndrome Difficulty: 1 Question ID: 14.1.35 Page Reference: 371 Topic: Symptoms Skill: Factual Answer: d. Korsakoff's syndrome

14.1.36. The current perspective on the etiology of Korsakoff's syndrome emphasizes the role of a. b. c. d.

a vitamin deficiency. disruption of neurotransmitter functioning. a head injury that typically occurs while intoxicated. heavy alcohol use, regardless of nutritional habit. Difficulty: 2 Question ID: 14.1.36 Page Reference: 371 Topic: Symptoms Skill: Conceptual Answer: d. heavy alcohol use, regardless of nutritional habit.

14.1.37. Korsakoff's syndrome is thought to be caused by a. b. c. d.

damage to specific parts of the brain. a recessive gene. an as-yet unidentified virus. the isolation and loneliness of old age. Difficulty: 1 Question ID: 14.1.37 Page Reference: 371 Topic: Symptoms Skill: Factual Answer: a. damage to specific parts of the brain.

14.1.38. What were the two forms of dementia described by Emil Kraepelin in his 1910 textbook on psychiatry? a. b. c. d.

aphasia and apraxia Huntington's disease and Pick's disease Alzheimer's disease and senile dementia retrograde amnesia and anterograde amnesia

Difficulty: 1 Question ID: 14.1.38 Page Reference: 371 Topic: Symptoms Skill: Factual Answer: c. Alzheimer's disease and senile dementia

14.1.39. What was the critical factor that distinguished between the two forms of dementia described by Emil Kraepelin? a. b. c. d.

presence or absence of psychotic symptoms age of onset organic versus psychosocial etiology auditory versus visual hallucinations Difficulty: 1 Question ID: 14.1.39 Page Reference: 371 Topic: Symptoms Skill: Factual Answer: b. age of onset

14.1.40. You need to look up the DSM-IV-TR diagnostic criteria for dementia and delirium. Under what heading will you find these disorders? a. b. c. d.

psychotic disorders cognitive disorders somatoform disorders organic mental disorders Difficulty: 1 Question ID: 14.1.40 Page Reference: 371 Topic: Symptoms Skill: Factual Answer: b. cognitive disorders

14.1.41. DSM-IV-TR lists many specific forms of dementia, which are distinguished primarily on the basis of a. b. c.

the specific types of brain lesions. the specific types of chromosomal abnormalities. degree of severity.

age of onset. Difficulty: 2 Question ID: 14.1.41 Page Reference: 372 Topic: Symptoms Skill: Conceptual Answer: a. the specific types of brain lesions.

14.1.42. Alzheimer's disease is distinguished from other types of dementia in DSM IV-TR based on a. b. c. d.

muscular impairment. personality changes. gradual speed of onset. more significant memory impairment. Difficulty: 1 Question ID: 14.1.42 Page Reference: 372 Topic: Symptoms Skill: Factual Answer: c. gradual speed of onset.

14.1.43. A doctor has just finished her examination of a seventy-two-year-old patient who is has recently been showing significant and worsening memory loss and other forms of cognitive impairment, and the doctor says, "This woman is definitely suffering from Alzheimer's disease." Why should you be skeptical about this diagnosis? a. b. c. d.

Alzheimer's disease only affects younger people. Alzheimer's disease does not typically involve memory problems. A definite diagnosis of Alzheimer's can only be determined by an autopsy. The patient's condition is worsening, but Alzheimer's disease involves very stable symptoms. Difficulty: 2 Question ID: 14.1.43 Page Reference: 373 Topic: Symptoms Skill: Applied Answer: c. A definite diagnosis of Alzheimer's can only be determined by an autopsy.

14.1.44. What are the distinguishing characteristics of the brain lesions found in Alzheimer's disease? a. b. c.

microtubules and dopamine deposits neurofibrillary tangles and amyloid plaques ballooning of nerve cells and loss of myelin sheaths

clogged arteries in the train and enlarged microtubules Difficulty: 1 Question ID: 14.1.44 Page Reference: 373 Topic: Symptoms Skill: Factual Answer: b. neurofibrillary tangles and amyloid plaques

14.1.45. Neurofibrillary tangles, which are typically found in patients with Alzheimer's disease, a. b. c. d.

are unique to that disease and allow for definite diagnosis. are found in adults with other cognitive disorders. have not yet been identified. do not appear until the end stage of the disease. Difficulty: 2 Question ID: 14.1.45 Page Reference: 373 Topic: Symptoms Skill: Conceptual Answer: b. are found in adults with other cognitive disorders.

14.1.46. Which of the following describes the amyloid plaques found in Alzheimer's disease? a. b. c. d.

asymmetrical neurofibrils ballooning of nerve cells clogged arteries in the frontal lobes a central core of protein material surrounded by clumps of debris from destroyed neurons Difficulty: 1 Question ID: 14.1.46 Page Reference: 373 Topic: Symptoms Skill: Factual Answer: d. a central core of protein material surrounded by clumps of debris from destroyed

neurons

14.1.47. Frontotemporal dementia (FTD) is a rare form of dementia associated with atrophy of the frontal and temporal lobes of the brain. In FTD __________________ generally precede(s) the onset of cognitive impairment. a. b. c.

extreme anxiety personality changes lose of long-term memory

hallucinations

Difficulty: 1 Question ID: 14.1.47 Page Reference: 375 Topic: Symptoms Skill: Factual Answer: b. personality changes

14.1.48. Many conditions other than those that attack the brain tissue directly can also produce symptoms of dementia. These can be either medical conditions or other types of mental disorders. One cause of dementia is the severe interruption of blood flow to the brain; known as __________. a. b. c. d.

stroke myocardial infection vascular occlusion vasodementia Difficulty: 2 Question ID: 14.1.48 Page Reference: 375 Topic: Symptoms Skill: Factual Answer: a. stroke

14.1.49. In comparison to Alzheimer patients, patients with frontotemporal dementia (FTD) are a. more likely to engage in impulsive sexual actions and roaming and aimless exploration. b. less likely to engage in impulsive sexual actions and roaming and aimless exploration. c. likely to engage in impulsive sexual actions and roaming and aimless exploration at about the same rate. d. more likely to develop impaired perception. Difficulty: 3 Question ID: 14.1.49 Page Reference: 375 Topic: Symptoms Skill: Applied Answer: a. more likely to engage in impulsive sexual actions and roaming and aimless exploration.

14.1.50.

All of the following brain regions are implicated in Huntington’s disease EXCEPT

a. b. c. d.

Putamen. Head of caudate nucleus. Parietal lobe. Amygdaloid body. Difficulty: 2 Question ID: 14.1.50 Page Reference: 375 Topic: Symptoms Skill: Factual Answer: c. Parietal lobe

14.1.51. Chorea is a symptom of a. b. c. d.

vascular dementia. Alzheimer's disease. Parkinson's disease. Huntington's disease. Difficulty: 2 Question ID: 14.1.51 Page Reference: 375 Topic: Symptoms Skill: Factual Answer: d. Huntington's disease.

14.1.52. You are reading a medical chart in which a patient is referred to as displaying chorea. If you met this patient, you might expect a lot of a. b. c. d.

restless and fidgety movements. incoherent speech. obscene language. listlessness and psychomotor retardation. Difficulty: 2 Question ID: 14.1.52 Page Reference: 375 Topic: Symptoms Skill: Applied Answer: a. restless and fidgety movements.

14.1.53. The cognitive and motor deficits associated with Huntington's disease are due to neuronal degeneration in the a.

hippocampus.

b. c. d.

frontal lobe. basal ganglia. medial thalamus.

Difficulty: 1 Question ID: 14.1.53 Page Reference: 375 Topic: Symptoms Skill: Factual Answer: c. basal ganglia.

14.1.54. Franklin has Huntington's disease, and on that basis we can be virtually certain that a. b. c. d.

Franklin is at least 70 years old. Franklin has a history of excessive alcohol consumption. Franklin's family has a history of this disease. Franklin can be effectively treated with anti-Parkinsonian drugs. Difficulty: 2 Question ID: 14.1.54 Page Reference: 375 Topic: Symptoms Skill: Applied Answer: c. Franklin's family has a history of this disease.

14.1.55. What are the typical symptoms that mark a diagnosis of Parkinson's disease? a. b. c. d.

chorea, tremors, and retardation tremors, dementia, and postural abnormalities writhing, aimless exploration, and depression tremors, reduction in voluntary movements, and rigidity Difficulty: 2 Question ID: 14.1.55 Page Reference: 377 Topic: Symptoms Skill: Conceptual Answer: d. tremors, reduction in voluntary movements, and rigidity

14.1.56. All of the following symptoms are characteristic of Parkinson's disease EXCEPT a. b. c.

tremor. muscle rigidity. postural abnormalities.

catatonia.

Difficulty: 2 Question ID: 14.1.56 Page Reference: 377 Topic: Symptoms Skill: Factual Answer: d. catatonia

14.1.57. What is one way that Huntington's disease and Parkinson's disease can usually be distinguished? a. b. c. d.

Only Parkinson's disease involves motor symptoms. Huntington's disease usually leads to dementia while Parkinson's does not. It is possible to recover from Huntington's disease but not Parkinson's. Only Huntington's disease carries a risk for depression. Difficulty: 2 Question ID: 14.1.57 Page Reference: 375-377 Topic: Symptoms Skill: Applied Answer: b. Huntington's disease usually leads to dementia while Parkinson's does not.

14.1.58. A stroke occurs when a. b. c. d.

the heart stops beating. blood flow to the brain is interrupted. a seizure disrupts neuronal transmissions. head injury causes damage to the frontal lobe. Difficulty: 1 Question ID: 14.1.58 Page Reference: 375 Topic: Symptoms Skill: Factual Answer: b. blood flow to the brain is interrupted.

14.1.59. What is an infarct? a. b. c.

dementia due to depression clogged arteries in the brain a surgical procedure to clear brain plaques

an area of dead brain tissue caused by a stroke

Difficulty: 1 Question ID: 14.1.59 Page Reference: 375 Topic: Symptoms Skill: Factual Answer: d. an area of dead brain tissue caused by a stroke

14.1.60. Although Marsha is unable to move the right side of her body, the other side of her body is mobile. What is the most likely cause of this problem? a. b. c. d.

stroke Pick's disease Parkinson's disease neurofibrillary tangles Difficulty: 2 Question ID: 14.1.60 Page Reference: 375 Topic: Symptoms Skill: Applied Answer: a. stroke

14.1.61. All of the following are indications of vascular dementia except a. b. c. d.

Parkinsonian symptoms. focal neurological signs. weakness in the extremities. laboratory evidence of blood vessel disease. Difficulty: 2 Question ID: 14.1.61 Page Reference: 375-377 Topic: Symptoms Skill: Conceptual Answer: a. Parkinsonian symptoms.

14.1.62. Vascular dementia and Alzheimer's disease have very similar a. b. c.

cause. rate of onset. motor impairments.

cognitive impairments.

Difficulty: 2 Question ID: 14.1.62 Page Reference: 375 Topic: Symptoms Skill: Conceptual Answer: d. cognitive impairments.

14.1.63. A pathologist has just finished an autopsy and includes in her report a reference to "Lewy bodies." This means that in her autopsy she has discovered a. b. c. d.

senile plaques filled with protein. ballooning of nerve cells and enlarged areas between adjacent neurons. rounded clumps of protein surrounded by masses of destroyed neural tissue. rounded deposits in nerve cells often found in the brains of patients with Parkinson's disease. Difficulty: Question ID: 14.1.63 Page Reference: 377 Topic: Symptoms Skill: Applied Answer: d. rounded deposits in nerve cells often found in the brains of patients with Parkinson's

disease.

14.1.64. A group of clinicians has identified a syndrome they call dementia with Lewy bodies. This newly identified syndrome overlaps with which of these disorders? a. b. c. d.

Down syndrome and Pick's disease Alzheimer's disease and Down syndrome Parkinson's disease and Alzheimer's disease Huntington's disease and Parkinson's disease Difficulty: 2 Question ID: 14.1.64 Page Reference: 377 Topic: Symptoms Skill: Conceptual Answer: c. Parkinson's disease and Alzheimer's disease

14.1.65. Approximately what percentage of patients diagnosed with dementia also show signs of major depressive disorder?

a. b. c. d.

10 percent 25 percent 35 percent over 50 percent Difficulty: 2 Question ID: 14.1.65 Page Reference: 377-378 Topic: Symptoms Skill: Factual Answer: b. 25 percent

14.1.66. "Pseudodementia" refers to a condition in which a. b. c. d.

symptoms are faked. memory loss is not severe. motor impairment affects cognitive functioning. cognitive impairment is produced by major depression. Difficulty: 2 Question ID: 14.1.66 Page Reference: 378 Topic: Symptoms Skill: Factual Answer: d. cognitive impairment is produced by major depression.

14.1.67. Approximately what percentage of individuals over the age of ninety will exhibit symptoms of moderate to severe dementia? a. b. c. d.

5 percent 15 percent 30 percent 40 percent Difficulty: 2 Question ID: 14.1.67 Page Reference: 378 Topic: Frequency of Delirium and Dementia Skill: Factual Answer: d. 40 percent

14.1.68. The average time between the diagnosed onset of Alzheimer's disease and death is a. b.

six months. one year.

c. d.

six years. twelve years.

Difficulty: 2 Question ID: 14.1.68 Page Reference: 378 Topic: Frequency of Delirium and Dementia Skill: Factual Answer: c. six years.

14.1.69. All of the following are true with regard to the incidence of Alzheimer's disease EXCEPT a. b. c. d.

The incidence of AD is about the same for men and women until age 90. The incidence of AD is greater for men at all ages. After age 90 the incidence of AD decreases for men. After age 90 the incidence of AD increases for women. Difficulty: 2 Question ID: 14.1.69 Page Reference: 378 Topic: Frequency of Delirium and Dementia Skill: Factual Answer: b. The incidence of AD is greater for men at all ages.

14.1.70. Studies suggest that a. b. c. d.

Alzheimer's disease is more common is Asian countries compared to North America. Alzheimer's disease is most common in North America and Europe. Alzheimer's disease is most common in developing countries. None of the above is accurate. Difficulty: 1 Question ID: 14.1.70 Page Reference: 379 Topic: Frequency of Delirium and Dementia Skill: Factual Answer: b. Alzheimer's disease is most common in North America and Europe.

14.1.71. All of the following have been seen to cause delirium EXCEPT a. b. c.

antipsychotic medications. antihistamines. pain killers.

stimulants.

Difficulty: 1 Question ID: 14.1.71 Page Reference: 380 Topic: Causes Skill: Factual Answer: b. antihistamines.

14.1.72. One Swedish study of genetic factors in the cause of dementia found the following concordance rate for monozygotic twins. a. b. c. d.

1 percent 20 percent 40 percent over 50 percent Difficulty: 2 Question ID: 14.1.72 Page Reference: 380 Topic: Causes Skill: Factual Answer: d. over 50 percent

14.1.73. ALL of the following are true with regard to genetic studies of the cause of Alzheimer's disease EXCEPT. a. There are markers for Alzheimer’s disease on a dozen gene alleles. b. There are markers for Alzheimer's disease on the chromosome 21. c. There are associations between the gene responsible for producing amyloid precursor protein, or APP, and Alzheimer’s disease. d. There are markers for Alzheimer's disease on the same gene associated with Down syndrome. Difficulty: 3 Question ID: 14.1.73 Page Reference: 380 Topic: Causes Skill: Conceptual Answer: d.

14.1.74. What is genetic linkage analysis? a.

microscopic analysis of nerve cell damage

b. c. d.

documentation of patterns of inheritance in families educating family members about chances of inheritance locating a gene that is responsible for a disorder or trait Difficulty: 1 Question ID: 14.1.74 Page Reference: 376 Topic: Causes Skill: Factual Answer: d. locating a gene that is responsible for a disorder or trait

14.1.75. In studies of extended families in which some members are affected by a disease and other members are unaffected by it, which of the following must be established in order to identify genetic linkage? a. b. c. d.

Both affected and unaffected members have the marker. Family members affected by the disease do not have the marker. The marker is only present in one family and not in other families. Family members with the disease have the marker; unaffected members do not have the marker. Difficulty: 2 Question ID: 14.1.75 Page Reference: 380-381 Topic: Causes Skill: Conceptual

Answer: d. family members with the disease have the marker; unaffected members do not have the marker

14.1.76. A new form of dementia has just been discovered, and researchers have determined that the disorder is transmitted genetically as an autosomal dominant trait. If a child's father has one of the genes and the mother has none of the genes for the disorder, what is the probability that the child will inherit this disorder? a. b. c. d.

25 percent 50 percent 75 percent 100 percent Difficulty: 2 Question ID: 14.1.76 Page Reference: 381 Topic: Causes Skill: Applied Answer: b. 50 percent

14.1.77. If the Word Health Organization assembled the most respected researchers on the genetics of Alzheimer's disease and asked them to review the research, which of the following would make for the most appropriate title for that report? a. b. c. d.

"A Single Disease, a Single Gene" "How Toxins Affect Genetic Vulnerability" "Link Identified: Distractibility as the Key" "Alzheimer's Disease: No Single Genetic Path" Difficulty: 2 Question ID: 14.1.77 Page Reference: 381 Topic: Causes Skill: Conceptual Answer: d. "Alzheimer's Disease: No Single Genetic Path"

14.1.78. The senile plaques and neurofibrillary tangles that are typical in Alzheimer's disease are also found in people with a. b. c. d.

schizophrenia. Down syndrome. Parkinson's disease. Korsakoff's syndrome. Difficulty: 1 Question ID: 14.1.78 Page Reference: 381 Topic: Causes Skill: Factual Answer: b. Down syndrome.

14.1.79. What do patients with Alzheimer's disease and Down Syndrome have in common? a. b. c. d.

Pick's bodies an extra chromosome neurofibrillary tangles degeneration of the substantia nigra Difficulty: 2 Question ID: 14.1.79 Page Reference: 381 Topic: Causes Skill: Conceptual

Answer: c. neurofibrillary tangles

14.1.80. Why are researchers who study Alzheimer's disease also very interested in Down syndrome? a. b. c. d.

both are known to be caused by a recessive gene people with Down syndrome almost always develop Alzheimer's both have been linked to dopamine and serotonin deficiencies the possible link of both to chromosome 21 Difficulty: 2 Question ID: 14.1.80 Page Reference: 381 Topic: Causes Skill: Applied Answer: d. the possible link of both to chromosome 21

14.1.81. Which neurotransmitter is implicated in the development of Parkinson's disease? a. b. c. d.

GABA dopamine serotonin norepinephrine Difficulty: 1 Question ID: 14.1.81 Page Reference: 382 Topic: Causes Skill: Factual Answer: b. dopamine

14.1.82. Which of the following is a correct pairing of a disorder with the neurotransmitter thought to play a significant role in its etiology? a. b. c. d.

Pick's disease and dopamine Alzheimer's disease and ACh Parkinson's disease and GABA Huntington's disease and serotonin Difficulty: 2 Question ID: 14.1.82 Page Reference: 382 Topic: Causes Skill: Factual Answer: b. Alzheimer's disease and ACh

14.1.83. Huntington's disease has been associated with which neurotransmitter? a. b. c. d.

GABA Dopamine MAO Serotonin Difficulty: 2 Question ID: 14.1.83 Page Reference: 382 Topic: Causes Skill: Factual Answer: a. GABA

14.1.84. What is the suspected cause of Creutzfeldt-Jakob disease? a. b. c. d.

dopamine deficiency a slow-acting virus overexposure to aluminum an abnormality on chromosome 21 Difficulty: 2 Question ID: 14.1.84 Page Reference: 382 Topic: Causes Skill: Factual Answer: b. a slow-acting virus

14.1.85. What etiology for Alzheimer's disease is suggested by the presence of beta-amyloid at the core of senile plaques? a. b. c. d.

dopamine deficiency radiation overdose immune system dysfunction circulatory system dysfunction Difficulty: 2 Question ID: 14.1.85 Page Reference: 382 Topic: Causes Skill: Applied Answer: c. immune system dysfunction

14.1.86. Exposure to what type of trauma as an adult puts an individual at greater risk of developing Alzheimer's disease? a. b. c. d.

exposure to lead being knocked unconscious exposure to radioactivity loosing consciousness due to carbon monoxide Difficulty: 2 Question ID: 14.1.86 Page Reference: 382 Topic: Causes Skill: Conceptual Answer: b. being knocked unconscious

14.1.87. According to research on Catholic nuns, what factor reduces the incidence of Alzheimer's disease? a. b. c. d.

spirituality level of education acceptance of authority a low fat, high carbohydrates diet Difficulty: 1 Question ID: 14.1.87 Page Reference: 382-383 Topic: Causes Skill: Factual Answer: b. level of education

14.1.88. One possible theoretical explanation for the negative correlation between education and rate of Alzheimer's disease in nuns is a. b. cause. c. d.

education may encourage "brain work" which increases neuronal density. going to college is also correlated with family social economic status which may be the real nuns who are educated rise in the church hierarchy and thus lead a less stressful life. There is no theory proposed to explain this observation. Difficulty: 2 Question ID: 14.1.88 Page Reference: 383 Topic: Causes Skill: Applied

Answer: a. education may encourage "brain work" which increases neuronal density.

14.1.89. Which of the following disorders has the best chance for successful treatment and recovery? a. b. c. d.

delirium Down syndrome primary dementia secondary dementia Difficulty: 2 Question ID: 14.1.89 Page Reference: 383 Topic: Treatment and Management Skill: Conceptual Answer: a. delirium

14.1.90. It is generally believed that accurate diagnosis is especially important in dealing with cognitive disorders because a. insurance companies only pay benefits when an organic basis has been confirmed. b. the diagnosis can identify specific medical conditions that can then sometimes be successfully treated. c. cognitive disorders are too easily confused with schizophrenia and other psychotic disorders. d. once diagnosed, most cognitive disorders can be successfully treated. Difficulty: 1 Question ID: 14.1.90 Page Reference: 383 Topic: Treatment and Management Skill: Conceptual Answer: b. the diagnosis can identify specific medical conditions that can then sometimes be successfully treated.

14.1.91. A patient's medical chart indicates that her physician recommended a trial of donepezil (Aricept). What is the likely diagnosis? a. b. c. d.

Down syndrome Alzheimer's disease Parkinson's disease Huntington's disease Difficulty: 2 Question ID: 14.1.91 Page Reference: 383 Topic: Treatment and Management

Skill: Applied Answer: b. Alzheimer's disease 14.1.92. A group of experimental drugs focuses on blocking the construction of neurofibrillary tangles by keeping tau protein anchored to microtubules as a possible treatment for a. b. c. d.

Kraeplin's disease. Huntington's disease. Alzheimer's disease. All of the above are correct. Difficulty: 2 Question ID: 14.1.92 Page Reference: 383 Topic: Treatment and Management Skill: Factual Answer: c. Alzheimer's disease.

14.1.93. Effective management of patients with dementia can be improved by helping them to a. b. c. d.

express their frustrations openly. accept the terminal nature of their illness. follow a structured and predictable daily schedule. restrict their intake of high calorie foods. Difficulty: 1 Question ID: 14.1.93 Page Reference: 383 Topic: Treatment and Management Skill: Factual Answer: c. follow a structured and predictable daily schedule.

14.1.94. You are asked to assist in the design of a living environment that would be most beneficial for patients with dementia. Which of the following would NOT be particularly helpful? a. b. c. d.

alternate routes to the dining room to allow patients’ choices clearly visible common areas that can be seen from the patient's room locked access so patients can't accidentally wander away clearly labeled hallways and rooms

Difficulty: 2 Question ID: 14.1.94 Page Reference: 383-384 Topic: Treatment and Management Skill: Applied

Answer: a. alternate routes to the dining room to allow patients’ choices.

14.1.95. Patients in nursing homes who suffer from dementia are less likely to have problems with agitation, and they may sleep better, if they are a. b. c. d.

given high doses of sedative medication. encouraged to be physically active. allowed to take frequent naps. given numerous opportunities to learn new information. Difficulty: 1 Question ID: 14.1.95 Page Reference: 384 Topic: Treatment and Management Skill: Factual Answer: b. encouraged to be physically active.

14.1.96. In the United States what percentage of primary care for people with dementia and Alzheimer’s disease is provided by family members? a. b. c d.

10 20 60 80 Difficulty: 1 Question ID: 14.1.96 Page Reference: 384 Topic: Treatment and Management Skill: Factual Answer: c. 80

Short Answer 14.2.97. A gradual worsening loss of memory and related cognitive functions, including the use of language, as well as reasoning and decision making is known as __________ . Difficulty: 1 Question ID: 14.2.97 Page Reference: 362 Topic: Overview Skill: Factual

Answer: dementia

14.2.98. ____________ is a confusional state that develops over a short period of time and is often associated with agitation and hyperactivity. Difficulty: 1 Question ID: 14.2.98 Page Reference: 362 Topic: Overview Skill: Factual Answer: Delirium

14.2.99. A physician who deals primarily with diseases of the brain and the nervous system is known as a __________ . Difficulty: 1 Question ID: 14.2.99 Page Reference: 362 Topic: Overview Skill: Factual Answer: neurologist

14.2.100. A professional that has particular expertise in the assessment of specific types of cognitive impairment is known as a __________ . Difficulty: 1 Question ID: 14.2.100 Page Reference: 363 Topic: Overview Skill: Factual Answer: neuropsychologist

14.2.101. ____________ amnesia refers to the loss of memory for events prior to the onset of an illness or the experience of a traumatic event. Difficulty: 1 Question ID: 14.2.101 Page Reference: 367 Topic: Symptoms Skill: Factual Answer: Retrograde

14.2.102. ____________ is a term that describes various types of loss or impairment in language that are caused by brain damage. Difficulty: 2 Question ID: 14.2.102 Page Reference: 367 Topic: Symptoms Skill: Factual Answer: Aphasia

14.2.103. A term that means "perception without meaning" is __________ . Difficulty: 1 Question ID: 14.2.103 Page Reference: 367 Topic: Symptoms Skill: Factual Answer: agnosia

14.2.104. ____________ is a term that describes involuntary movements that also involve tics, tremors, and jerky movements of the face and limbs called chorea. Difficulty: 1 Question ID: 14.2.104 Page Reference: 370 Topic: Symptoms Skill: Factual Answer: Dyskinesia

14.2.105. In Alzheimer’s disease the microtubules of neurons disintegrate in the absence of tau proteins, and the whole neuron shrivels and dies. The disorganized tangles of tau that are left at the end of this process are known as __________ tangles. Difficulty: 1 Question ID: 14.2.105 Page Reference: 373 Topic: Symptoms Skill: Factual Answer: neurofibrillary

14.2.106. FTD is an acronym for ___________ dementia.

Difficulty: 1 Question ID: 14.2.106 Page Reference: 375 Topic: Symptoms Skill: Factual Answer: Frontotemporal

14.2.107. Unusual involuntary muscle movements known as chorea (from the Greek word meaning “dance”) represent the most distinctive feature of __________ __________ . Difficulty: 1 Question ID: 14.2.107 Page Reference: 375 Topic: Symptoms Skill: Factual Answer: Huntington's disease

14.2.108. Some drugs are designed to relieve cognitive symptoms of dementia by boosting the action of a neurotransmitter that is involved in memory and whose level is reduced in patients with Alzheimer’s disease called __________ . Difficulty: 2 Question ID: 14.2.108 Page Reference: 383 Topic: Treatment and Management Skill: Factual Answer: acetylcholine and ACh

Essay 14.3.109. What are some of the features that distinguish delirium from dementia? Difficulty: 2 Question ID: 14.3.109 Page Reference: 365-366 Topic: Symptoms Skill: Conceptual Answer: (1) Onset: sudden in delirium, slow in dementia; (2) Duration: brief in delirium, extended in dementia; (3) Course: fluctuating in delirium, nonfluctuating in dementia; (4) Attention:

impaired in delirium, intact in dementia; (5) Hallucinations: visual/tactile, vivid in delirium, rare in dementia; (6) Insight: lucid intervals in delirium, consistently poor in dementia; (7) Sleep: disturbed in delirium, less disturbed in dementia 14.3.110. Describe the emotional changes that may accompany dementia. Difficulty: 2 Question ID: 14.3.110 Page Reference: 369 Topic: Symptoms Skill: Conceptual Answer: The affect of dementia patients can be flat, with an apathetic appearance. However, emotional expression can also become exaggerated and less predictable. Depression often accompanies dementia.

14.3.111. Discuss the most common form of amnestic disorder and what is known or suspected about its etiology. Difficulty: 2 Question ID: 14.3.111 Page Reference: 370-372 Topic: Symptoms Skill: Conceptual Answer: The most common form of amnestic disorder is alcohol-induced persisting amnestic disorder, also known as Korsakoff's syndrome. In this disorder, memory is impaired but other cognitive functions are not. The disorder is caused by chronic alcoholism. One widely accepted theory holds that alcoholics tend to be at risk for a thiamine deficiency, but it is now thought that prolonged exposure to alcohol can have direct toxic effects on the brain, independent of vitamin deficiencies.

14.3.112. What signs and symptoms can be used to distinguish depression from dementia? Difficulty: 2 Question ID: 14.3.112 Page Reference: 378 Topic: Symptoms Skill: Conceptual Answer: Depression: uneven progression over weeks, the person complains of memory loss, the symptoms are often worse in the morning and better as the day goes on, the person is aware of and may exaggerate the disability, the person may abuse alcohol or other drugs. Dementia: there is an even progression over months or years, there are attempts to hide the memory loss, the symptoms are worse later in the day or when fatigued, the person is unaware of the symptoms or minimizes the disability, drug abuse is rare.

14.3.113. Explain why it is difficult for epidemiologists to get an accurate picture of the number of cases of dementia, and the types of dementia, in the U.S. population. Difficulty: 2 Question ID: 14.3.113 Page Reference: 373 Topic: Frequency of Delirium and Dementia Skill: Conceptual Answer: Generally the epidemiologists' problem is one of diagnosis. Mild symptoms of dementia are difficult to distinguish from problems associated with normal aging. Mild symptoms are hard to detect reliably. In order to diagnose dementia, multiple assessments are required over time, whereas epidemiological assessments are usually made at one time point. Finally, the undifferentiated dementias require post mortem analysis of brain tissue to make an accurate diagnosis of a specific type of dementia.

14.3.114. Describe what chromosome 21 has to do with our understanding of Alzheimer's disease and Down syndrome. Difficulty: 2 Question ID: 14.3.114 Page Reference: 380-381 Topic: Causes Skill: Conceptual Answer: Down syndrome is associated with trisomy 21 (having 3 copies of chromosome 21 rather than 2). Down syndrome and Alzheimer's disease patients both have neurofibrillary tangles and senile plaques in brain tissue. This similarity led researchers to search for a gene for Alzheimer's on chromosome 21, the source of the abnormalities in Down syndrome. Such a gene has been located for the Alzheimer's disease found in some families, but not all families. It appears that the gene responsible for the production of proteins used to make amyloid (the core of senile plaques) is located on chromosome 21.

14.3.115. Describe the ways that a demented person's environment can be constructed to minimize the patient's distress. Difficulty: Question ID: 14.3.115 Page Reference: 383-384 Topic: Treatment and Management Skill: Conceptual Answer: Labeling rooms and other parts of the environment, because the patient cannot remember directions and may get lost; arranging rooms so that spaces that the patient uses are visible from his or her room, since the patient may forget about these other areas or get lost; make sure the environment is secure, so that the patient does not wander off.

Chapter 15 Mental Retardation and Pervasive Developmental Disorders Total Assessment Guide (T.A.G.) Topic Overview pp. 388-389

Intellectual Disabilities pp. 389-403

Question Type Multiple Choice Short Answer Essay Multiple Choice

Short Answer

Autistic Spectrum Disorders pp. 403-416

Essay Multiple Choice

Short Answer Essay

Factual

Conceptual

Applied

3, 5, 6, 9, 11, 12, 15, 17, 19, 20, 21, 26, 29, 30, 34, 35, 38, 39, 41, 43, 44, 46, 47, 50, 51, 54, 55, 59, 60, 62, 64, 65, 67, 68, 70 110, 111, 112, 113, 114, 115, 116, 117, 119, 120 125 71, 72, 76, 79, 80, 85, 86, 87, 89, 90, 91, 94, 100, 104, 108 121, 124

2, 4, 10, 18, 22, 23, 24, 25, 36, 37, 42, 45, 48, 49, 52, 53, 56, 63, 66, 69

7, 8, 13, 14, 16, 27, 28, 31, 32, 33, 40, 57, 58, 61

118

126, 127, 128 74, 75, 77, 78, 81, 83, 84, 93, 95, 96, 97, 98, 99, 101, 107 122, 123 129, 130, 131, 132

73, 82, 88, 92, 102, 103, 105, 106, 109

Chapter 15: Mental Retardation and Pervasive Developmental Disorders

Multiple Choice 15.1.1. You are watching the film Rain Man and based on your course work in abnormal psychology recognize that an appropriate diagnostic category for the character Raymond portrayed by Dustin Hoffman is a. b. c. d.

Rett's disorder. fetal alcohol syndrome. mild mental retardation. autism. Difficulty: 1 Question ID: 15.1.1 Page Reference: 389 Topic: Overview Skill: Factual Answer: d. autism.

15.1.2. Your teacher uses the story of Chris Burke, who plays Corky Thatcher on Life Goes On, in an abnormal psychology class. What point is your professor trying to illustrate with this story? a. The deficits associated with autism can be overcome with love and attention. b. A great deal of damage can be done when someone is labeled as having Down syndrome. c. People with Down syndrome have a natural ability to relate to others and can make great actors. d. People with Down syndrome might have subaverage intelligence but it does not necessarily keep them from adapting well in life. Difficulty: 1 Question ID: 15.1.2 Page Reference: 389 Topic: Intellectual Disabilities Skill: Conceptual Answer: d. People with Down syndrome might have subaverage intelligence but it does not necessarily keep them from adapting well in life.

15.1.3. The American Association on Intellectual and Developmental Disabilities (AAIDD) uses a different term for DSM "mental retardation," which is a. b. c. d.

intellectually challenged. savantism. intellectual disability. All of the above are used by the AAIDD.

Difficulty: 2 Question ID: 15.1.3 Page Reference: 389 Topic: Intellectual Disabilities Skill: Factual Answer: c. intellectual disability.

15.1.4. The AAIDD and the DSM-IV-TR agree that all of the following are criteria for what the DSM refers to as mental retardation EXCEPT a. b. c. d.

significant limitation in intellectual functioning (IQ<70). significant limitation in adaptive functioning. significant perceptual impairment. onset before age 18. Difficulty: 2 Question ID: 15.1.4 Page Reference: 390 Topic: Intellectual Disabilities Skill: Conceptual Answer: c. significant perceptual impairment.

15.1.5. According to DSM-IV-TR criteria, a person can only be diagnosed as mentally retarded if he/she has an IQ that is below approximately a. b. c. d.

25. 50. 70. 90. Difficulty: 2 Question ID: 15.1.5 Page Reference: 391 Topic: Intellectual Disabilities Skill: Factual Answer: c. 70.

15.1.6. The DSM-IV-TR criteria for mental retardation require a low IQ and deficits in adaptive functioning provided that they are a. b. c. d.

present before age 18. considered irreversible. present for more than one year. unrelated to biological causes.

Difficulty: 1 Question ID: 15.1.6 Page Reference: 391 Topic: Intellectual Disabilities Skill: Factual Answer: a. present before age 18. 15.1.7. Twenty-nine-year-old Brenda has an IQ of 67, yet she finished fourth grade. She lives with her boyfriend, pays her bills with money she earns as a factor worker, and is able to live without supervision. What is Brenda's most likely diagnosis in terms of the DSM-IV classification of mental retardation (MR)? a. b. c. d.

would be considered MR because of low IQ would not be considered MR, because she is over 18 would be considered MR because of low educational status would not be considered MR, because she is functioning adaptively Difficulty: 3 Question ID: 15.1.7 Page Reference: 391 Topic: Intellectual Disabilities Skill: Applied Answer: d. would not be considered MR, because she is functioning adaptively

15.1.8. Al is 64 years old; he is currently a patient at a local hospital where a psychological battery revealed that he has subaverage intelligence and related deficits. Physicians and psychologists believe that his condition is the result of a degenerative brain disease. What is Al's most likely diagnosis? a. b. c. d.

dementia delirium emotional trauma Asperger's disorder Difficulty: 3 Question ID: 15.1.8 Page Reference: 396 Topic: Intellectual Disabilities Skill: Applied Answer: a. dementia

15.1.9. Both the American Association on Intellectual and Developmental Disabilities and DSM-IV-TR define subaverage intellectual functioning in terms of a. b. c. d.

academic performance. a score on an individualized intelligence test. observations and assessments by teachers. observations and assessments by pediatricians.

Difficulty: 1 Question ID: 15.1.9 Page Reference: 390 Topic: Intellectual Disabilities Skill: Factual Answer: b. a score on an individualized intelligence test.

15.1.10. What system was used in early intelligence tests to compute an IQ? a. b. c. d.

comparing a score to group norms dividing chronological age by mental age dividing mental age by chronological age translating a score into standard deviations Difficulty: 2 Question ID: 15.1.10 Page Reference: 391 Topic: Intellectual Disabilities Skill: Conceptual Answer: c. dividing mental age by chronological age

15.1.11. What is the mean and standard deviation of most intelligence tests? a. b. c. d.

mean of 85, standard deviation of 15 mean of 100, standard deviation of 30 mean of 100, standard deviation of 15 mean of 115, standard deviation of 30 Difficulty: 2 Question ID: 15.1.11 Page Reference: 391 Topic: Intellectual Disabilities Skill: Factual Answer: c. mean of 100, standard deviation of 15

15.1.12. Many human characteristics such as height are distributed so the majority of scores fall in the middle of the distribution, with fewer extreme scores. What do we call this type of distribution? a. b. c. d.

bimodal curve standardized curve normal distribution expected distribution

Difficulty: 2 Question ID: 15.1.12 Page Reference: 391 Topic: Intellectual Disabilities Skill: Factual Answer: c. normal distribution

15.1.13. The cutoff score for mental retardation is approximately two standard deviations below the mean. If IQ scores were normally distributed, this would mean that approximately what percentage of the population would fall below this cutoff? a. b. c. d.

0.5 percent 2 percent 9 percent 15 percent Difficulty: 2 Question ID: 15.1.13 Page Reference: 391 Topic: Intellectual Disabilities Skill: Applied Answer: b. 2 percent

15.1.14. Which child is most likely to show a significant change in IQ score if retested five years later? a. b. c. d.

Ann who is four years old Bob who is ten years old Cara who is thirteen years old Darla who is seventeen years old Difficulty: 2 Question ID: 15.1.14 Page Reference: 391 Topic: Intellectual Disabilities Skill: Applied Answer: a. Ann who is four years old

15.1.15. A potential problem for the interpretation of IQ scores is the observation that IQ scores in general are rising across generations. The phenomenon is known as the a. b. c. d.

IQ effect. Flynn effect. Regression to the Mean Effect. None of the above are correct.

Difficulty: 1 Question ID: 15.1.15 Page Reference: 391 Topic: Intellectual Disabilities Skill: Factual Answer: b. Flynn effect.

15.1.16. A psychologist has collected some data representing the number of friends college students report they have. The data set follows: 6, 4, 3, 2, 7, 3, 8, 5. If the psychologist reports 3 as a measure of central tendency, which measure was used? a. b. c. d.

mode mean median standard deviation Difficulty: 2 Question ID: 15.1.16 Page Reference: 392 Topic: Intellectual Disabilities Skill: Applied Answer: a. mode

15.1.17. What do we call the midpoint of a frequency distribution? a. b. c. d.

mode norm mean median Difficulty: 1 Question ID: 15.1.17 Page Reference: 392 Topic: Intellectual Disabilities Skill: Factual Answer: d. median

15.1.18. IQ scores are derived from standard scores, and to calculate a standard score you need to know a. b. c. d.

the mode. the normal distribution. the mean and standard deviation. the mode and the median. Difficulty: 2

Question ID: 15.1.18 Page Reference: 392 Topic: Intellectual Disabilities Skill: Conceptual Answer: c. the mean and standard deviation.

15.1.19. In statistical calculations the square root of the variance is called the a. b. c. d.

standard deviation. standard variation. derived variation. All of the above mean the same thing. Difficulty: 1 Question ID: 15.1.19 Page Reference: 392 Topic: Intellectual Disabilities Skill: Factual Answer: a. standard deviation.

15.1.20. The statistic in which the differences from the mean are squared (to eliminate negative numbers) before they are added together and divided by their total number is called the a. b. c. d.

standard deviation. mean deviations. median. variance. Difficulty: 2 Question ID: 15.1.20 Page Reference: 392 Topic: Intellectual Disabilities Skill: Factual Answer: d. variance.

15.1.21. The statistic in which you add a group of scores together and then divide by the number of those scores is called the a. b. c. d.

median. mean. mode. variance.

Difficulty: 1

Question ID: 15.1.21 Page Reference: 392 Topic: Intellectual Disabilities Skill: Factual Answer: b. mean.

15.1.22. A culture-fair IQ test a. b. c. d.

is designed to be used with one particular culture. contains material equally familiar to people from diverse backgrounds. recognizes cultural differences in the definition of intelligence. is impossible to construct, which is why IQ testing is invalid. Difficulty: 1 Question ID: 15.1.22 Page Reference: 391 Topic: Intellectual Disabilities Skill: Conceptual Answer: b. contains material equally familiar to people from diverse backgrounds.

15.1.23. Compared to IQ scores of people in the normal range of intelligence, evidence indicates that the IQ tests scores of people with mental retardation are a. b. c. d.

more reliable and valid. less reliable and valid. more free of cultural bias. less free of cultural bias. Difficulty: 2 Question ID: 15.1.23 Page Reference: 393 Topic: Intellectual Disabilities Skill: Conceptual Answer: a. more reliable and valid.

15.1.24. What evidence do psychologists put forth in support of the validity of intelligence tests? a. The mean IQ score in the population is 100. b. IQ scores correlate significantly with school achievement. c. Estimates of the heritability of intelligence are approximately 50 percent. d. IQ scores in preschool years are moderately correlated with IQ scores based on tests administered at the end of high school.

Difficulty: 1

Question ID: 15.1.24 Page Reference: 393 Topic: Intellectual Disabilities Skill: Conceptual Answer: b. IQ scores correlate significantly with school achievement.

15.1.25. What is the primary purpose for which IQ tests were designed? a. b. c. d.

to detect the extraordinarily gifted to assess level of adaptive functioning to rank people according to intelligence to measure potential for school achievement Difficulty: 1 Question ID: 15.1.25 Page Reference: 393 Topic: Intellectual Disabilities Skill: Conceptual Answer: d. to measure potential for school achievement

15.1.26. In addition to an IQ test, which of the following instruments might be used to make a diagnosis of mental retardation? a. b. c. d.

Scholastic Aptitude Test Vineland Adaptive Behaviour Scales Halstead Reitan Neuropsychological Battery Minnesota Multiphasic Personality Inventory Difficulty: 2 Question ID: 15.1.26 Page Reference: 393 Topic: Intellectual Disabilities Skill: Factual Answer: b. Vineland Adaptive Behavior Scales

15.1.27. Which of the following events is the most likely reason that a person formerly classified as mentally retarded would no longer be classified as such a few years later? a. b. c. d.

The person turned 18. The person's IQ increased significantly. The person became financially independent. The demands of work are different than the demands of school.

Difficulty: 2

Question ID: 15.1.27 Page Reference: 394 Topic: Intellectual Disabilities Skill: Applied Answer: d. The demands of work are different than the demands of school. 15.1.28. Martin is now 17 years of age and his IQ scores have been steadily declining for the past several years and he has been losing important skills. His most recent IQ score is 55. As you think about whether to diagnose Martin with mental retardation, you remind yourself that this is an unusual case because a. his IQ score is now below the cutoff of 70, warranting a diagnosis of late onset mental retardation. b. he has not yet turned 18 so it is too soon to make a diagnosis. c. mental retardation does not usually involve loss of skills or notable change in condition. d. IQ scores with people with mental retardation are unreliable and should not be used to confirm a diagnosis. Difficulty: 2 Question ID: 15.1.28 Page Reference: 394 Topic: Intellectual Disabilities Skill: Applied Answer: c. mental retardation does not usually involve loss of skills or notable change in condition. 15.1.29. In 1866 what did the British physician Langdon Down describe for the first time? a. b. c. d.

characteristics of autism. a subgroup of mental retardation. the case of the "wild boy of Aveyron." the condition of pervasive developmental disorder. Difficulty: 1 Question ID: 15.1.29 Page Reference: 394 Topic: Intellectual Disabilities Skill: Factual Answer: b. a subgroup of mental retardation.

15.1.30. Alfred Binet and Theophile Simon developed the first intelligence test in 1905 in response to a request by the French government to identify a. b. c. d.

men fit for the military. extraordinarily gifted individuals. civil service personnel needing further training. children in need of special educational services. Difficulty: 1

Question ID: 15.1.30 Page Reference: 394 Topic: Intellectual Disabilities Skill: Factual Answer: d. children in need of special educational services. 15.1.31. Jim has been diagnosed as mentally retarded. In her report, a social worker notes that Jim is likely to need close supervision for community living over a long term. What term does the DSM-IV-TR use to describe the type of mental retardation that would need this level of support? a. b. c. d.

mild moderate severe profound Difficulty: 2 Question ID: 15.1.31 Page Reference: 394-395 Topic: Intellectual Disabilities Skill: Applied Answer: c. severe

15.1.32. Jerry is 21 years old and lives in a group home with people similar to him. When he was six years old, his IQ was determined to be 54. Subsequent IQ tests indicate that it has changed little; he has few physical impairments. Although he was much older than the other students when he finished, he was able to complete sixth grade. What is Jerry's most likely diagnosis? a. b. c. d.

mild mental retardation severe mental retardation profound mental retardation moderate mental retardation Difficulty: 2 Question ID: 15.1.32 Page Reference: 394 Topic: Intellectual Disabilities Skill: Applied Answer: a. mild mental retardation

15.1.33. A psychologist administered an IQ test to Jonathan, age 12, and found his IQ was 30. Jonathan also exhibits poor motor development and poor communication skills. What is the most likely diagnosis? a. b. c. d.

savant syndrome Korsakoff's syndrome severe mental retardation moderate mental retardation Difficulty: 1

Question ID: 15.1.33 Page Reference: 395 Topic: Intellectual Disabilities Skill: Applied Answer: c. severe mental retardation

15.1.34. The majority of individuals with mental retardation are classified as mildly mentally retarded. What level of academic functioning do these individuals typically achieve? a. b. c. d.

kindergarten second grade sixth grade 10th grade Difficulty: 2 Question ID: 15.1.34 Page Reference: 394 Topic: Intellectual Disabilities Skill: Factual Answer: c. sixth grade

15.1.35. What category of mental retardation has the smallest number of individuals? a. b. c. d.

mild severe profound moderate Difficulty: 1 Question ID: 15.1.35 Page Reference: 395 Topic: Intellectual Disabilities Skill: Factual Answer: c. profound

15.1.36. What did the developers of the DSM-IV-TR seek to accomplish when they decided that mental retardation should be coded on Axis II rather than Axis I? a. The new coding would focus attention on the biological basis of most forms of mental retardation. b. The Axis II coding would focus attention on the emotional problems associated with mental retardation. c. The Axis II coding would separate mental disorders from other forms of mental disorders that tend to have environmental causes. d. The Axis II designation would focus attention on the failure of most individuals with mental retardation to understand their disabilities.

Difficulty: 2 Question ID: 15.1.36 Page Reference: 395 Topic: Intellectual Disabilities Skill: Conceptual Answer: b. The Axis II coding would focus attention on the emotional problems associated with mental retardation.

15.1.37. Even though more than 2.3 percent of people have IQs below the 70 cutoff, the best estimate is that only 1 percent of the population has mental retardation. The prevalence of mental retardation is lower that the prevalence of low IQs because a. b. c. d.

IQ tests are not reliable. most forms of mental retardation have biological causes. many adults with low IQs have adequate adaptive skills. only people younger than age 18 can be diagnosed with mental retardation. Difficulty: 2 Question ID: 15.1.37 Page Reference: 395 Topic: Intellectual Disabilities Skill: Conceptual Answer: c. many adults with low IQs have adequate adaptive skills.

15.1.38. Approximately what percentage of cases of mental retardation can be attributed to known biological abnormalities? a. b. c. d.

5 percent 20 percent 50 percent 80 percent Difficulty: 1 Question ID: 15.1.38 Page Reference: 395 Topic: Intellectual Disabilities Skill: Factual Answer: c. 50 percent

15.1.39. What is the most common recognized biological cause of mental retardation? a. b. c. d.

PKU Down syndrome lead poisoning fragile X syndrome

Difficulty: 1 Question ID: 15.1.39 Page Reference: 396 Topic: Intellectual Disabilities Skill: Factual Answer: b. Down syndrome

15.1.40. Which of the following mentally retarded individuals is most likely to be diagnosed with a form of retardation that is due to a known biological origin? a. b. c. d.

Beverly, who has physical handicaps Edward, whose family lives in a poor neighborhood Sara, whose mental retardation is in the mild range Robert, who was six years old when his retardation was diagnosed Difficulty: 2 Question ID: 15.1.40 Page Reference: 396 Topic: Intellectual Disabilities Skill: Applied Answer: a. Beverly, who has physical handicaps

15.1.41. Trisomy 21 is another name for a. b. c. d.

Down syndrome. Turner syndrome. Kanner's syndrome. fragile X syndrome. Difficulty: 1 Question ID: 15.1.41 Page Reference: 396 Topic: Intellectual Disabilities Skill: Factual Answer: a. Down syndrome.

15.1.42. A researcher has collected nationwide data for the age of mothers at the time of birth of their children and the incidence of Down syndrome. What relationship between mothers' age and Down syndrome is this researcher likely to find? a. b. c. d.

a very weak relationship incidence of Down syndrome increases with mothers' age incidence of Down syndrome decreases with mothers' age incidence of Down syndrome increases with mothers' age up to age 35 then decreases

Difficulty: 1 Question ID: 15.1.42 Page Reference: 396 Topic: Intellectual Disabilities Skill: Conceptual Answer: b. incidence of Down syndrome increases with mothers' age

15.1.43. By their 30s, individuals with Down syndrome develop brain pathology that is similar to that found in a. b. c. d.

Alzheimer's disease. Parkinson's disease. Huntington's disease. Korsakoff's syndrome. Difficulty: 1 Question ID: 15.1.43 Page Reference: 396 Topic: Intellectual Disabilities Skill: Factual Answer: a. Alzheimer's disease.

15.1.44. Fragile X syndrome is characterized by a. b. c. d.

an extra Y sex chromosome. an extra X sex chromosome. a missing X sex chromosome. an abnormality on the X sex chromosome. Difficulty: 1 Question ID: 15.1.44 Page Reference: 396 Topic: Intellectual Disabilities Skill: Factual Answer: d. an abnormality on the X sex chromosome.

15.1.45. A researcher is investigating the biological and psychological characteristics of a sample of individuals with XYY syndrome. Which of the following is he likely to find? a. b. c. d.

They have criminal records. They experience delusions and hallucinations. Their mean IQ is about 10 points lower than average. Their behavior is likely to meet the criteria for pervasive developmental disorder.

Difficulty: 2 Question ID: 15.1.45 Page Reference: 396 Topic: Intellectual Disabilities Skill: Conceptual Answer: c. Their mean IQ is about 10 points lower than average.

15.1.46. Which of the following occurs only in females? a. b. c. d.

XYY syndrome Turner syndrome fragile X syndrome Klinefelter syndrome Difficulty: 2 Question ID: 15.1.46 Page Reference: 396 Topic: Intellectual Disabilities Skill: Factual Answer: b. Turner syndrome

15.1.47. What can a caretaker do to diminish the mental retardation associated with PKU? a. b. c. d.

use long term behavior modification schedule monthly blood transfusions serve foods that are low in phenylalanine teach the child to communicate via sign language Difficulty: 1 Question ID: 15.1.47 Page Reference: 396-397 Topic: Intellectual Disabilities Skill: Factual Answer: c. serve foods that are low in phenylalanine

15.1.48. You are reading the chapter of your textbook that covers mental retardation, and you come to a discussion of phenylketonuria, Tay-Sachs disease, Hurler syndrome, and Lesch-Nyhan syndrome. They are all included in the same section of this chapter because they a. b. c. d.

are all mild forms of mental retardation. only affect boys. are caused by recessive gene pairings. are all linked to chromosome 21.

Difficulty: 2 Question ID: 15.1.48 Page Reference: 397 Topic: Intellectual Disabilities Skill: Conceptual Answer: c. are caused by recessive gene pairings.

15.1.49. At what point during pregnancy is a mother likely to contract rubella (German measles) that can cause her child to be born with severe mental retardation? a. b. c. d.

in the first three months in the last three months in the second three months right before and during delivery Difficulty: 2 Question ID: 15.1.49 Page Reference: 397 Topic: Intellectual Disabilities Skill: Conceptual Answer: a. in the first three months

15.1.50. Which disease that can result in mental retardation in children can be transmitted from the mother to the child during delivery? a. b. c. d.

rubella encephalitis toxoplasmosis genital herpes Difficulty: 1 Question ID: 15.1.50 Page Reference: 398 Topic: Intellectual Disabilities Skill: Factual Answer: d. genital herpes

15.1.51. Which of the following causes of mental retardation results from infection of the brain? a. b. c. d.

encephalitis Turner syndrome Klinefelter syndrome fetal alcohol syndrome

Difficulty: 1 Question ID: 15.1.51 Page Reference: 398 Topic: Intellectual Disabilities Skill: Factual Answer: a. encephalitis

15.1.52. You are reading the chapter of your textbook that covers mental retardation, and you come to a discussion of rubella, human immunodeficiency virus, syphilis, and encephalitis. They are all included in the same section of this chapter because they are all a. b. c. d.

caused by recessive gene pairings. infectious diseases that can cause mental retardation. the most common forms of death for people with severe and profound mental retardation. the result of per-natal and peri-natal complications. Difficulty: 2 Question ID: 15.1.52 Page Reference: 398 Topic: Intellectual Disabilities Skill: Conceptual Answer: b. infectious diseases that can cause mental retardation.

15.1.53. Which of the following symptoms are associated with fetal alcohol syndrome? a. b. c. d.

severe mental retardation and gaze aversion profound mental retardation and sensory deficits mild mental retardation and learning disabilities moderate mental retardation and motor dysfunctions Difficulty: 1 Question ID: 15.1.53 Page Reference: 398 Topic: Intellectual Disabilities Skill: Conceptual Answer: c. mild mental retardation and learning disabilities

15.1.54. The Surgeon General of the United States recommends that what level of alcohol consumption is safe for pregnant women? a. b. c. d.

1 ounce per day 1 ounce per week 1 ounce per month zero alcohol

Difficulty: 1 Question ID: 15.1.54 Page Reference: 398 Topic: Intellectual Disabilities Skill: Factual Answer: d. zero alcohol

15.1.55. What is one common cause of lead exposure in children? a. b. c. d.

insulation canned foods heating systems chips of lead-based paint Difficulty: 1 Question ID: 15.1.55 Page Reference: 398 Topic: Intellectual Disabilities Skill: Factual Answer: d. chips of lead-based paint

15.1.56. What is the problem in Rh incompatibility during pregnancy? a. b. c. d.

Chromosomal abnormalities cause retardation. Unmetabolized amino acids cause brain damage. Brain infection causes damaging cranial pressure. The mother's antibodies attack the blood cells of the fetus. Difficulty: 2 Question ID: 15.1.56 Page Reference: 398 Topic: Intellectual Disabilities Skill: Conceptual Answer: d. the mother's antibodies attack the blood cells of the fetus

15.1.57. Which of these newborns represents the clearest example of a premature birth? a. b. c. d.

Sal who has PKU David who weighs under 5 pounds Barbara who is 20 inches tall Eve who was born after 40 weeks of gestation

Difficulty: 2 Question ID: 15.1.57 Page Reference: 399 Topic: Intellectual Disabilities Skill: Applied Answer: b. David who weighs under 5 pounds

15.1.58. A nurse in a pediatrician's office is instructing the new assistant. They review files in order to help the assistant become familiar with the job and the terminology. When they review one file, they see the word anoxia. What could they conclude about the child based on this description? a. b. c. d.

The baby suffered oxygen deprivation and may be mentally retarded. The child prefers to play by himself rather than in social groups. The child has not developed language at the same rate as other children of his age. The baby has a rare genetic disorder that predisposes him to develop behavioral difficulties. Difficulty: 2 Question ID: 15.1.58 Page Reference: 399 Topic: Intellectual Disabilities Skill: Applied Answer: a .The baby suffered oxygen deprivation and may be mentally retarded.

15.1.59. What types of mental retardation are described by the term cultural-familial? a. b. c. d.

those due to drug abuse during pregnancy those resulting from sexually transmitted diseases those that run in families and are linked to poverty those that are due to chromosomal abnormalities common in certain ethnic groups Difficulty: 1 Question ID: 15.1.59 Page Reference: 399 Topic: Intellectual Disabilities Skill: Factual Answer: c. those that run in families and are linked to poverty

15.1.60. What is the general estimate of the normal range of intelligence that can be attributed to a genetic factor? a. b. c. d.

10 percent 25 percent 50 percent 75 percent

Difficulty: 2 Question ID: 15.1.60 Page Reference: 399 Topic: Intellectual Disabilities Skill: Factual Answer: d. 75 percent 15.1.61. A researcher is describing a theory of the interaction of genes and the environment on intelligence and uses the term reaction range. Which of the following is an example of this concept? a. The effects of environment occur only at the lower ends of the distribution of intelligence scores. b. An individual who may have genes for lower IQ can reach a higher level of intelligence in an enriched environment. c. Psychologists are developing new tests of intellectual functioning that are thought to be more culture-free than previous tests. d. There is a very specific level of intelligence that can be affected by genetic factors; the rest is the result of the environment. Difficulty: 2 Question ID: 15.1.61 Page Reference: 399-400 Topic: Intellectual Disabilities Skill: Applied Answer: b. An individual who may have genes for lower IQ can reach a higher level of intelligence in an enriched environment.

15.1.62. Which of the following pairs of individuals show the highest correlation in IQ scores? a. b. c. d.

adoptive parent and child biological parent and child monozygotic twins reared apart biological siblings reared together Difficulty: 1 Question ID: 15.1.62 Page Reference: 399 Topic: Intellectual Disabilities Skill: Factual Answer: c. monozygotic twins reared apart

15.1.63. Why does cultural-familial retardation occur more frequently among the poor? a. b. c. d.

Poor nutrition causes PKU. Impoverished environments can be less intellectually stimulating. Chromosomal abnormalities are more common in the lower classes. Sexually transmitted diseases are more common in the lower classes.

Difficulty: 2 Question ID: 15.1.63 Page Reference: 399 Topic: Intellectual Disabilities Skill: Conceptual Answer: b. Impoverished environments can be less intellectually stimulating.

15.1.64. Which of the following is an example of the eugenics movement in the United States? a. b. c. d.

the selective breeding of people with high IQs the investigation of the human genome the forced sterilization of people with mental retardation the establishment of Head Start programs Difficulty: 1 Question ID: 15.1.64 Page Reference: 401 Topic: Intellectual Disabilities Skill: Factual Answer: c. the forced sterilization of people with mental retardation

15.1.65. Between 1927 and 1979 more than ______ citizens of Virginia were forcibly sexually sterilized. a. b. c. d.

1000 4000 8000 80,000 Difficulty: 2 Question ID: 15.1.65 Page Reference: 401 Topic: Intellectual Disabilities Skill: Factual Answer: c. 8000

15.1.66. Which of the following is an example of the primary prevention of a biological cause of mental retardation? a. b. c. d.

vaccinations for rubella medical screening for PKU programs such as Sesame Street enrolment in Head Start programs

Difficulty: 2 Question ID: 15.1.66 Page Reference: 400 Topic: Intellectual Disabilities Skill: Conceptual Answer: a. vaccinations for rubella

15.1.67. What is amniocentesis? a. b. c. d.

an untreatable brain infection a failure of amino acids to bind an inability to metabolize phenylalanine a procedure for detecting genetic abnormalities of a fetus Difficulty: 2 Question ID: 15.1.67 Page Reference: 400 Topic: Intellectual Disabilities Skill: Factual Answer: d. a procedure for detecting genetic abnormalities of a fetus.

15.1.68. What has research on the effectiveness of Head Start revealed? a. b. c. d.

long-term increases in IQ levels no reduction in cultural-familial retardation short-term increases in IQ and academic achievement improved health but no differences in academic performance Difficulty: 1 Question ID: 15.1.68 Page Reference: 401 Topic: Intellectual Disabilities Skill: Factual Answer: c. short-term increases in IQ and academic achievement

15.1.69. What would be the goal of a tertiary prevention program for people with mental retardation? a. b. c. d.

to prevent pregnant women from abusing alcohol to deal with the various socioemotional difficulties faced by people with mental retardation to encourage the use of amniocentesis to reduce the incidence of infectious diseases that can cause retardation

Difficulty: 2 Question ID: 15.1.69 Page Reference: 402 Topic: Intellectual Disabilities Skill: Conceptual Answer: b. to deal with the various socioemotional difficulties faced by people with mental retardation

15.1.70. Insuring that handicapped children are provided with educational opportunities in the least restrictive environment possible, generally in a regular classroom, is termed a. b. c. d.

regularizing. residential schooling. public schooling. mainstreaming. Difficulty: 1 Question ID: 15.1.70 Page Reference: 402 Topic: Intellectual Disabilities Skill: Factual Answer: d. mainstreaming.

15.1.71. Which of the following characterizes the physical appearance of autistic children? a. b. c. d.

uncoordinated movements small head circumference normal physical appearance "mongoloid" facial features Difficulty: 1 Question ID: 15.1.71 Page Reference: 404 Topic: Autistic Spectrum Disorders Skill: Factual Answer: c. normal physical appearance

15.1.72. Which of the following is one of the classic symptoms of autism? a. b. c. d.

"mongoloid" facial features delayed physical development impaired communication ability inability to metabolize phenylalanine

Difficulty: 1 Question ID: 15.1.72 Page Reference: 405 Topic: Autistic Spectrum Disorders Skill: Factual Answer: c. impaired communication ability

15.1.73. You are attempting to design ways of observing young children that predict an increased risk for autism. Based on the recent NIMH research you would look for all of the following signs EXCEPT a. b. c. d.

exceptional artistic or mathematical ability. orienting to their names less than others. engaging in repetitive movements more than others. looking at other children less than others. Difficulty: 3 Question ID: 15.1.73 Page Reference: 404-405 Topic: Autistic Spectrum Disorders Skill: Applied Answer: a. exceptional artistic or mathematical ability.

15.1.74. A common problem with PDD is where the subtleties of speech production are unusual: disturbed in rate, rhythm, and intonation. The disturbed child or adult sounds unusual to the normal listener, even when the speech content is normal. This is labeled a. b. c. d.

aphonia. dysprosody. dysrythmia. All of the above are correct. Difficulty: 2 Question ID: 15.1.74 Page Reference: 405 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: b. dysprosody.

15.1.75. What do psychologists mean when they say that an autistic individual lacks a theory of mind? a. The individual's brain is so damaged there is no mind there. b. These individuals fail to appreciate that other people have a point of reference that differs from their own. c. The disorder is so devastating that there is no chance of recovery and it affects the mental health of other family members. d. The inability to bond to caretakers has left these individuals in an existential vacuum, without a way of explaining the complexity that surrounds them. Difficulty: 3 Question ID: 15.1.75 Page Reference: 405 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: b. These individuals fail to appreciate that other people have a point of reference that differs from their own.

15.1.76. Gaze-aversion in children with pervasive developmental disorder is thought to be an indication of a. b. c. d.

visual hallucinations. perceptual difficulties. motor coordination problems. discomfort with social interactions. Difficulty: 1 Question ID: 15.1.76 Page Reference: 407 Topic: Autistic Spectrum Disorders Skill: Factual Answer: d. discomfort with social interactions.

15.1.77. Temple Grandin was diagnosed as autistic when she was young. What aspect of her life has been of special interest to psychologists? a. She has given birth to children who show no signs of autism. b. She has managed to live longer than most individuals with autism. c. She earned a Ph.D. in animal science and developed widely used techniques for animal management. d. Her experience with autism has allowed her to become a clinician who has expertise in treating autistic children.

Difficulty: 2 Question ID: 15.1.77 Page Reference: 403 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: c. She earned a Ph.D. in animal science and developed widely used techniques for animal management. 15.1.78. Why does Temple Grandin describe herself as "an anthropologist on Mars"? a. Her autism has left her with difficulties in understanding normal social behaviors so she must rely on deliberate observations to infer others' feelings. b. She can communicate with other autistic individuals using a code that she has developed. c. Like most people with autism, she has unusual beliefs, including a belief that she has had a past life as an alien. d. Like an anthropologist, the search for clues to understand the causes of autism requires digging deeply into one's past. Difficulty: 1 Question ID: 15.1.78 Page Reference: 403-404 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: a. Her autism has left her with difficulties in understanding normal social behaviors so she must rely on deliberate observations to infer others' feelings.

15.1.79. Approximately what percentage of children with autistic disorder remain mute? a. b. c. d.

5 percent 10 percent 25 percent 50 percent Difficulty: 2 Question ID: 15.1.79 Page Reference: 405 Topic: Autistic Spectrum Disorders Skill: Factual Answer: d. 50 percent

15.1.80. Which of the following is a common language problem among autistic children? a. b. c. d.

using "you" instead of "I" rambling and meaningless stories poor articulation due to deafness preference for gestures rather than verbal language

Difficulty: 2 Question ID: 15.1.80 Page Reference: 405 Topic: Autistic Spectrum Disorders Skill: Factual Answer: a. using "you" instead of "I"

15.1.81. What basic problem is reflected in the communication difficulties and impaired social relationships of autistic children? a. b. c. d.

motor impairments perceptual impairment depression and sleeplessness lack of social imitation and reciprocity Difficulty: 1 Question ID: 15.1.81 Page Reference: 405 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: d. lack of social imitation and reciprocity

15.1.82. How would a psychologist describe the behavior of children with autism and other pervasive developmental disorders? a. b. c. d.

psychotic restrictive and repetitive manipulative and antisocial dependent and emotionally needy Difficulty: 2 Question ID: 15.1.82 Page Reference: 406 Topic: Autistic Spectrum Disorders Skill: Applied Answer: b. restrictive and repetitive

15.1.83. How do psychologists interpret the self-stimulation behavior of children with autistic disorder? a. b. c. d.

as a form of death wish as a way to increase sensation to a desirable level as a method for screening out unpleasant stimuli as an effort to overcome their social isolation

Difficulty: 2 Question ID: 15.1.83 Page Reference: 407 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: b. as a way to increase sensation to a desirable level

15.1.84. Why are the apparent sensory deficits seen in some autistic children referred to as "apparent"? a. There is no impairment in the sense organ but the individual's responding makes it appear otherwise. b. There is no way to assess the sensory functioning of children with autism. c. What appears to be a deficit is often a form of willful behavior. d. Parents incorrectly perceive these children as having deficits. Difficulty: 2 Question ID: 15.1.84 Page Reference: 407 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: a. There is no impairment in the sense organ but the individual's responding makes it appear otherwise.

15.1.85. What is savant performance? a. b. c. d.

extreme sociability self-injurious behavior very high IQ and superior intelligence an exceptional skill in a specific area Difficulty: 1 Question ID: 15.1.85 Page Reference: 408 Topic: Autistic Spectrum Disorders Skill: Factual Answer: d. an exceptional skill in a specific area

15.1.86. The extraordinary ability to recite the day of the week for any date is an example of a rare characteristic of autism called a. b. c. d.

echolalia. dysprosody. savant performance. Asperger's syndrome.

Difficulty: 1 Question ID: 15.1.86 Page Reference: 408 Topic: Autistic Spectrum Disorders Skill: Factual Answer: c. savant performance. 15.1.87. Recent studies of the IQs of children with autistic disorder indicate that approximately what percentage of these children might also qualify for a diagnosis of mental retardation? a. b. c. d.

10 percent 25 percent 50 percent 75 percent Difficulty: 2 Question ID: 15.1.87 Page Reference: 408 Topic: Autistic Spectrum Disorders Skill: Factual Answer: c. 50 percent

15.1.88. While paging through back issues of a journal, you come across the term childhood schizophrenia. You wonder why you haven't heard it in your abnormal psychology class, so you ask your professor. What will he tell you about this term? a. The term is used for cases in which schizophrenia begins very early in life. b. The term has been replaced with autistic disorder because the symptoms are identical. c. Because parents reacted too strongly to the word schizophrenia, clinicians stopped using it. d. Although used in the past for autistic disorder and pervasive developmental disorder, the term does not accurately describe the observed symptoms. Difficulty: 2 Question ID: 15.1.88 Page Reference: 409 Topic: Autistic Spectrum Disorders Skill: Applied Answer: d. Although used in the past for autistic disorder and pervasive developmental disorder, the term does not accurately describe the observed symptoms. 15.1.89. Which of these diagnoses is given to people who exhibit symptoms of autism but do not have any major problems in communication and generally function higher in other areas? a. b. c. d.

Rett's disorder Asperger's disorder childhood schizophrenia childhood disintegrative disorder

Difficulty: 1 Question ID: 15.1.89 Page Reference: 409 Topic: Autistic Spectrum Disorders Skill: Factual Answer: b. Asperger's disorder

15.1.90. Which pervasive developmental disorder that occurs mostly in females involves language and social impairment, deceleration of head growth, and poor coordination after a period of normal development? a. b. c. d.

Rett's disorder Asperger's disorder childhood schizophrenia childhood disintegrative disorder Difficulty: 1 Question ID: 15.1.90 Page Reference: 409 Topic: Autistic Spectrum Disorders Skill: Factual Answer: a. Rett's disorder

15.1.91. What characteristic of childhood disintegrative disorder factor distinguishes it from other pervasive developmental disorders? a. b. c. d.

a recessive gene that has been identified two years of normal development hallucinations and delusions good communication skills Difficulty: 1 Question ID: 15.1.91 Page Reference: 409 Topic: Autistic Spectrum Disorders Skill: Factual Answer: b. two years of normal development

15.1.92. Your family is discussing autism because a neighbor was recently diagnosed as suffering from autism. Most of the members of the family say they are not surprised because autism occurs in better-

educated families. You recognize that this is not true so you tell your family it was the result of a referral bias. They look at you with puzzlement and ask you to explain. What do you say? a. Better educated families with autistic children tend to demand more of therapists. b. Better educated families are more likely to seek diagnosis and treatment for their children at specialty clinics. c. These families tend to blame themselves for their child's autism and often are the source of media reports on autism. d. These families tend to be sought out by researchers seeking individuals to study in research on autism. Difficulty: 2 Question ID: 15.1.92 Page Reference: 411 Topic: Autistic Spectrum Disorders Skill: Applied Answer: b. Better educated families are more likely to seek diagnosis and treatment for their children at specialty clinics. 15.1.93. Who is most likely to suffer from autism? a. b. c. d.

Jane, an eight-year-old, from a middle class family Jill, a five-year-old, from a lower socioeconomic family Jack, a nine-year-old whose brother has autistic disorder Jim, a 13-year-old whose brother has been diagnosed as having mental retardation Difficulty: 2 Question ID: 15.1.93 Page Reference: 411 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: c. Jack, a nine-year-old whose brother has autistic disorder

15.1.94. What is the risk of autism among the siblings of autistic patients? a. b. c. d.

lower than in the general population twice as high as in the general population the same as that of the general population 100 times higher than in the general population Difficulty: 2 Question ID: 15.1.94 Page Reference: 411 Topic: Autistic Spectrum Disorders Skill: Factual Answer: d. 100 times higher than in the general population

15.1.95. Some research has suggested that the brains of people diagnosed with autism compared to individuals without that diagnosis are a. b. c. d.

larger. smaller. less active. consume more glucose. Difficulty: 2 Question ID: 15.1.95 Page Reference: 412 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: a. larger.

15.1.96. What has research revealed about the parents of autistic children? a. b. c. d.

They are cold and distant. They are physically abusive. They use child-rearing styles that are similar to those used by other parents. They are usually highly intelligent and of the upper class. Difficulty: 2 Question ID: 15.1.96 Page Reference: 411 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: c. They use child-rearing styles that are similar to those used by other parents.

15.1.97. Recent research into the cause of autism has considered all of the following neurotransmitters and neuropeptides EXCEPT a. b. c. d.

endorphins. dopamine. vasopresson. oxytocin. Difficulty: 2 Question ID: 15.1.97 Page Reference: 412 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: b. dopamine.

15.1.98. What has research on twins revealed concerning a possible genetic etiology for autistic disorder?

a. High MZ concordance rates suggest a strong role for genetic factors. b. Similar concordance rates for MZ and DZ twins point to a significant role for the environment. c. Concordance rates have been low and inconsistent, suggesting little, if any, role for genetic factors. d. Analysis of the concordance rates suggest that a predisposition to dementia is the primary etiological factor. Difficulty: 1 Question ID: 15.1.98 Page Reference: 411 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: a. High MZ concordance rates suggest a strong role for genetic factors.

15.1.99. Some theorists propose that autism is related to elevated levels of endorphins. Although not yet proven, an association between endorphins and autism would seem to explain which aspect of autistic disorder? a. b. c. d.

impaired communication self-destructive behavior impaired social interaction repetitive and stereotyped motor behavior Difficulty: 2 Question ID: 15.1.99 Page Reference: 412 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: c. impaired social interaction

15.1.100. What is the typical course of autism? a. b. c. d.

a lifelong disorder resolves itself at puberty resolves itself by age five or six improves itself in young adulthood Difficulty: 1 Question ID: 15.1.100 Page Reference: 412-413 Topic: Autistic Spectrum Disorders Skill: Factual Answer: a. a lifelong disorder

15.1.101. Which of the following six-year-old children with autism has the best prognosis?

a. b. c. d.

Sally, who has unusual mathematic abilities Tommy, who has unusual musical abilities Andy, who has developed some language skills Tammy, who does not engage in any self-injuring behavior Difficulty: 2 Question ID: 15.1.101 Page Reference: 414 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: c. Andy, who has developed some language skills

15.1.102. You are advising a school about the adoption of programs for their autistic students. Several treatment options are presented, but one caught your attention. It is a relatively widely used program, but recent evidence from the APA concludes that it is ineffective. You will advise against the use of a. b. c. d.

facilitated communication. risperidone. behavior modification. All of the above are valid treatments. Difficulty: 2 Question ID: 15.1.102 Page Reference: 413 Topic: Autistic Spectrum Disorders Skill: Applied Answer: a. facilitated communication.

15.1.103. What is the current evidence regarding the value of secretin as a treatment for autism? a. b. c. d.

Results continue be very promising. Results of controlled studies have been negative. These drugs can significantly improve communication. They are effective with Asperger's but not with autism. Difficulty: 2 Question ID: 15.1.103 Page Reference: 414 Topic: Autistic Spectrum Disorders Skill: Applied Answer: b. Results of controlled studies have been negative.

15.1.104. The most promising approach in the treatment of autism involves

a. b. c. d.

secretin. facilitated communication. intensive behavior modification. psychodynamic psychotherapy. Difficulty: 1 Question ID: 15.1.104 Page Reference: 414 Topic: Autistic Spectrum Disorders Skill: Factual Answer: c. intensive behavior modification.

15.1.105. A behavior therapist spent months working with an autistic child who finally managed to say a few words. What is one reason that so much time and effort is needed to make such small changes in the behavior of autistic children? a. b. c. d.

These children do not imitate behavior. These children do not respond to primary reinforcers. Sensory deficits make it difficult to communicate with autistic children. Due to the presence of hallucinations, there is little time during which the child is actually lucid. Difficulty: 2 Question ID: 15.1.105 Page Reference: 414 Topic: Autistic Spectrum Disorders Skill: Applied Answer: a. These children do not imitate behavior.

15.1.106. The findings of a study of autistic children conducted by Lovaas found a. b. c. d.

using American Sign Language produced the strongest results. no difference between three groups. the group receiving intensive behavior modification did the best in school. a group of children receiving empathy training did the best in school. Difficulty: 2 Question ID: 15.1.106 Page Reference: 415 Topic: Autistic Spectrum Disorders Skill: Applied Answer: c. the group receiving intensive behavior modification did the best in school.

15.1.107. Which of these would be the most effective reinforcer for changing specific behaviors associated with autism?

a. b. c. d.

a pat on the head the child's favorite food a smile and the comment "great!" getting to play a game with mother Difficulty: 2 Question ID: 15.1.107 Page Reference: 415 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: b. the child's favorite food

15.1.108. Behavior modification to reduce self-injurious behaviors has been most successful in programs that rely on the use of a. b. c. d.

extinction. punishment. response cost. positive reinforcement. Difficulty: 1 Question ID: 15.1.108 Page Reference: 415 Topic: Autistic Spectrum Disorders Skill: Factual Answer: b. punishment.

15.1.109. Research indicates that the highly structured operant behavior therapy techniques developed by Ivor Lovaas and his colleagues a. b. c. d.

can be very effective within very short periods of time. only work when combined with antipsychotic medications. lead only to temporary improvements. can be effective but only when provided many hours a week for many years. Difficulty: 2 Question ID: 15.1.109 Page Reference: 415 Topic: Autistic Spectrum Disorders Skill: Applied Answer: d. can be effective but only when provided many hours a week for many years.

15.2.110. Modern intelligence tests yield a score that is indicative of intelligence known as an intelligence __________ .

Difficulty: 1 Question ID: 15.2.110 Page Reference: 391 Topic: Intellectual Disabilities Skill: Factual Answer: quotient

15.2.111. In calculating a "deviation IQ" it is assumed that intelligence follows what type of distribution? __________ Difficulty: 1 Question ID: 15.2.111 Page Reference: 391 Topic: Intellectual Disabilities Skill: Factual Answer: normal and bell shaped

15.2.112. IQ scores are designed so that they have a standard deviation of 15 and a mean (average) of __________ . Difficulty: 1 Question ID: 15.2.112 Page Reference: 391 Topic: Intellectual Disabilities Skill: Factual Answer: 100 15.2.113. One potential problem with deviation IQ scores is the research suggests that IQ scores are rising with each successive generation. This is called the __________ effect.

Difficulty: 2 Question ID: 15.2.113 Page Reference: 391 Topic: Intellectual Disabilities Skill: Factual Answer: Flynn 15.2.114. If your client has an IQ score between 20 and 40 he or she is likely be said to be suffering from __________ mental retardation.

Difficulty: 2 Question ID: 15.2.114 Page Reference: 395 Topic: Intellectual Disabilities Skill: Factual Answer: severe

15.2.115. The most common form of mental retardation with a known biological cause is the chromosomal disorder known as __________ __________ . Difficulty: 1 Question ID: 15.2.115 Page Reference: 396 Topic: Intellectual Disabilities Skill: Factual Answer: Down syndrome

15.2.116. The genetic disorder in which a female is missing one X chromosome (an XO individual) is known as __________ syndrome. Difficulty: 2 Question ID: 15.2.116 Page Reference: 396 Topic: Intellectual Disabilities Skill: Factual Answer: Turner

15.2.117. Mental retardation has been associated with several recessive gene pairings. One causes an absence of or an extreme deficiency in phenylalanine hydroxylase, an enzyme that metabolizes phenylalanine. The acronym (initials) for this disorder are __________ . Difficulty: 2 Question ID: 15.2.117 Page Reference: 396 Topic: Intellectual Disabilities Skill: Factual Answer: PKU

15.2.118. ____________ is the movement dedicated to the genetic improvement of the human race through legislated breeding rules.

Difficulty: 2 Question ID: 15.2.118 Page Reference: 401 Topic: Intellectual Disabilities Skill: Conceptual Answer: Eugenics

15.2.119. Drawing amniotic fluid and testing the fetal DNA for possible genetic abnormalities is a procedure called __________ . Difficulty: 2 Question ID: 15.2.119 Page Reference: 400 Topic: Intellectual Disabilities Skill: Factual Answer: amniocentesis

15.2.120. The process of devising ways to accommodate people with mental retardation so that their lives are as much as possible like other members of society is called __________ . Difficulty: 1 Question ID: 15.2.120 Page Reference: 400 Topic: Intellectual Disabilities Skill: Factual Answer: normalization

15.2.121. ____________ developmental disorders begin early in life and involve severe impairments in relationships, communication, and behaviors. These difficulties are pronounced in autism. Difficulty: 1 Question ID: 15.2.121 Page Reference: 403 Topic: Autistic Spectrum Disorders Skill: Factual Answer: Pervasive

15.2.122. People with autism are said to lack a theory of __________ in that they fail to appreciate that other people have a point of reference that differs from their own. Difficulty: 1 Question ID: 15.2.122

Page Reference: 405 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: mind

15.2.123. ____________ patients have a higher intellectual functioning and better communication skills than those referred to as autistic individuals. Difficulty: 2 Question ID: 15.2.123 Page Reference: 409 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: Asperger's

15.2.124. Recent theorizing as to the cause of PDD has looked at the functioning of __________ neurons that fire both when an individual performs an action and when the individual observes another performing the same action. Difficulty: 1 Question ID: 15.2.124 Page Reference: 412 Topic: Autistic Spectrum Disorders Skill: Factual Answer: mirror

Essay 15.3.125. What are the requirements for making the diagnosis of mental retardation? Difficulty: 2 Question ID: 15.3.125 Page Reference: 391 Topic: Intellectual Disabilities Skill: Factual

Answer: (1) Significant limitations in intellectual functioning, as measured by a standardized IQ test, with scores of 70 below. (2) Significant limitations in adaptive functioning in such areas as communication, self-care, interpersonal skills, academic skills, etc. (3) Onset before age 18.

15.3.126. Describe the controversy around the issue of whether IQ tests are "culture fair." Difficulty: 2 Question ID: 15.3.126 Page Reference: 391-392 Topic: Intellectual Disabilities Skill: Conceptual Answer: On average, the IQ scores of African Americans and Latino Americans are lower than those of Caucasians and Asian Americans, and the rates of mental retardation are also higher in these former groups. Some of these differences have been attributed to bias in the composition of intelligence tests, which may be geared toward the majority group. It is for this reason that the AAIDD requires valid assessment that considers cultural and linguistic diversity.

15.3.127. Although more than 2 percent of the population have IQs below 70, only about 1 percent of people are diagnosed as mentally retarded at any one point in time. Explain this discrepancy. Difficulty: 2 Question ID: 15.3.127 Page Reference: 393-394 Topic: Intellectual Disabilities Skill: Conceptual Answer: Many young children who are mentally retarded are not identified as such because it is difficult to obtain a reliable IQ score from people this age. Also, many adults who have IQs under 70 function adaptively, and thus are not considered mentally retarded.

15.3.128. Describe the concept of a reaction range and how it relates to intelligence level. Difficulty: 2 Question ID: 15.3.128 Page Reference: 399-400 Topic: Intellectual Disabilities Skill: Conceptual Answer: Genes and environment interact to produce intelligence. The concept of a reaction range holds that heredity establishes the upper and lower limits of possible IQ, but environmental factors determine where an individual's IQ falls within that range.

15.3.129. What are the typical symptoms seen in autism and other pervasive developmental disorders? Difficulty: 2 Question ID: 15.3.129 Page Reference: 403-404 Topic: Autistic Spectrum Disorders Skill: Conceptual

Answer: The three defining symptoms of autism are impaired social interaction, impaired communication, and restricted, repetitive, and stereotyped patters of behavior. Also sometimes seen are sensory deficits, self-injurious behavior, and savant performance.

15.3.130. What is meant by a "theory of mind" as it applies to autism, and how can it be illustrated? Difficulty: 2 Question ID: 15.3.130 Page Reference: 405-406 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: The theory is that people with autism fail to appreciate that other people have a point of reference that differs from their own. In the "Sally-Ann task," the child is shown two dolls, Sally who has a basket, and Ann who has a box. While Sally is gone, Ann takes a marble out of Sally's basket and puts it in her box. The child is then asked where will Sally look for the marble when she returns. Sally of course should look for the marble in her basket, because that's where it was when she left and she did not see Ann hide it in the box. However, children with autism, lacking a theory of mind, fail to appreciate Sally's perspective and say Sally should look in the box because that is what they saw.

15.3.131. Explain why the term "childhood schizophrenia" is an inappropriate label for autism. Difficulty: 2 Question ID: 15.3.131 Page Reference: 409 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: The symptoms of autism and schizophrenia are very different, and the two disorders remain different over time. The symptoms of autism manifest themselves in early childhood, whereas the symptoms of schizophrenia are not present until adolescence.

15.3.132. What evidence suggests that there is a genetic component to the etiology of autistic disorder? Difficulty: 2 Question ID: 15.3.132 Page Reference: 411-412 Topic: Autistic Spectrum Disorders Skill: Conceptual Answer: The prevalence of autism is as much as 100 times higher among the siblings of a child with autism. Researchers have also found higher concordance rates among MZ than DZ twins. In the largest twin study to date, concordance rates were 60 percent for MZ twins and 0 percent for DZ twins. Concordance rates for social or cognitive disorder were 92 percent for MZ pairs and 10 percent for DZ pairs, suggesting that autism may be the extreme manifestation of an underlying cognitive disorder. All twins in this study were carefully screened for known heritable conditions that may have distorted the results of earlier studies. The fact that only a few conditions were detected by screening suggests that

most cases of autism are caused by a genetic abnormality that has yet to be detected, not by known genetic or infectious illnesses.

Chapter 16 Psychological Disorders of Childhood Total Assessment Guide (T.A.G.) Topic Overview pp. 420-421

Externalizing Disorders pp. 421-437

Question Type Multiple Choice Short Answer Essay Multiple Choice

Short Answer

Factual 1, 2, 5

Multiple Choice

Short Answer

Applied

3, 4, 6

129 10, 12, 13, 15, 18, 19, 20, 21, 29, 33, 34, 37, 38, 41, 43, 45, 50, 51, 56, 58, 67, 68, 70

9, 11, 14, 23, 24, 27, 28, 30, 36, 46, 52, 53, 55, 59, 60, 63, 72

113, 114, 115 8, 16, 17, 22, 25, 26, 31, 32, 35. 39, 40, 42, 44, 47, 48, 49, 54, 57, 61, 62, 64, 65, 66, 69, 71, 73, 74 116, 117, 118, 119, 120, 121, 122, 123

Essay Internalizing and Other Disorders pp. 437-446

Conceptual

79, 81, 83, 86, 88, 90, 94, 95, 96, 97, 98, 99, 100, 101, 102, 105, 108 124, 125, 126, 127, 128

Essay

130, 131, 132, 136 75, 76, 80, 82, 84, 87, 91, 92, 104, 106, 109, 110, 111

77, 78, 85, 89, 93, 103, 107 112

134

135

133

Chapter 16: Psychological Disorders of Childhood

Multiple Choice 16.1.1. What is the major contribution of a developmental psychopathology perspective on children's problems? a. b. c. d.

offers greater focus on genetic factors suggests ways that biological processes account for these types of problems provides norms across the lifespan that can be used to determine whether a behavior is abnormal highlights the importance of environmental differences across different socioeconomic groups Difficulty: 1 Question ID: 16.1.1 Page Reference: 420 Topic: Overview Skill: Factual

Answer: c. provides norms across the lifespan that can be used to determine whether a behavior is abnormal

16.1.2. In the DSM-IV-TR classification of mental disorders, children and adolescents a. are only diagnosed with Axis II disorders. b. may suffer from most of the disorders included in DSM-IV-TR. c. are only diagnosed with Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence. d. are not given any diagnosis of mental disorder until they have reached age 12. Difficulty: 1 Question ID: 16.1.2 Page Reference: 420 Topic: Overview Skill: Factual Answer: b. may suffer from most of the disorders included in DSM-IV-TR.

16.1.3. Which of the following is likely to be diagnosed as an externalizing disorder? a. b. c. d.

excessive anxiety depressive mood somatic complaints serious misconduct

Difficulty: 1 Question ID: 16.1.3 Page Reference: 420 Topic: Overview Skill: Conceptual Answer: d. serious misconduct

16.1.4. Which of the following is likely to be diagnosed as an internalizing disorder? a. b. c. d.

excessive anxiety conduct problems oppositional behavior problems with attention and hyperactivity Difficulty: 1 Question ID: 16.1.4 Page Reference: 420 Topic: Overview Skill: Conceptual Answer: a. excessive anxiety

16.1.5. What are the most commonly diagnosed psychological problems in children? a. b. c. d.

eating disorders internalizing disorders externalizing disorders developmental disorders Difficulty: 1 Question ID: 16.1.5 Page Reference: 420 Topic: Overview Skill: Factual Answer: c. externalizing disorders

16.1.6. How does DSM-IV-TR handle internalizing disorders? a. They are coded on Axis III because many of these disorders have biological causes. b. Childhood disorders are listed on Axis I as "early onset" versions of adult disorders. c. DSM does not have a separate listing of such disorders; it notes that children may qualify for many "adult" disorders. d. DSM has a limited list of childhood disorders because the manual focuses on disorders that begin and continue into adulthood.

Difficulty: 1 Question ID: 16.1.6 Page Reference: 420 Topic: Overview Skill: Conceptual Answer: c. DSM does not have a separate listing of such disorders; it notes that children may qualify for many "adult" disorders. 16.1.7. Jeremy is an eight-year-old boy whose case is described in the text. Based on a recommendation from his teacher, he was evaluated by a psychologist. Which of the following was a finding that would be significant in planning a treatment program for Jeremy? a. Jeremy has a sibling who was mentally retarded and autistic. b. He had an older sister who expressed herself better verbally than did Jeremy. c. Although he had an IQ of 108, his achievement test scores were a grade behind his current grade. d. His mother took him to the psychologist only reluctantly because she did not believe he had a problem. Difficulty: 2 Question ID: 16.1.7 Page Reference: 421 Topic: Overview Skill: Applied Answer: c. Although he had an IQ of 108, his achievement test scores were a grade behind his current grade. 16.1.8. Many externalizing disorders are characterized by a. b. c. d.

overcontrolled behavior. symptoms of sadness and anxiety. violations of age-appropriate social rules. expression of worry through physical symptoms. Difficulty: 1 Question ID: 16.1.8 Page Reference: 421 Topic: Externalizing Disorders Skill: Factual Answer: c. violations of age-appropriate social rules.

16.1.9. The PTA invited a speaker to address the topic of crime and adolescents. What information might the speaker cite in this talk to parents of young people? a. The rate of crime committed by young people is increasing in spite of intervention efforts. b. Five percent of juvenile offenders account for about half of all juvenile arrests. c. Most of the crimes committed by young people are committed against schools and are generally taken as signs of rebellion.

Young people under the age of 18 frequently engage in serious, violent crimes. Difficulty: 2 Question ID: 16.1.9 Page Reference: 422 Topic: Externalizing Disorders Skill: Applied Answer: b. Five percent of juvenile offenders account for about half of all juvenile arrests.

16.1.10. Evidence for a syndrome of externalizing behavior problems has been demonstrated by statistical analysis of a. b. c. d.

arrest reports. clinicians' diagnoses of children. children's descriptions of their own behavior. checklists on which adults rate children's psychological symptoms. Difficulty: 2 Question ID: 16.1.10 Page Reference: 422 Topic: Externalizing Disorders Skill: Conceptual Answer: d. checklists on which adults rate children's psychological symptoms.

16.1.11. Six-year-old Nick's parents have been called to school repeatedly during the past two years for a variety of problems ranging from disobeying teachers to bullying classmates. Their position is that like any other boy his age, Nick is testing the limits. How should school officials respond if they are taking a developmental psychopathology perspective? a. All children test the limits, but the only way they become adults is to stop that testing. b. Although it is normal for children to test the limits, your son's limit testing is not age appropriate. c. We just want to make you aware of your son's behavior, we do expect that he will outgrow this stage soon. d. Testing the limits is a sign of a deeply rooted psychological disturbance that needs to be treated. Difficulty: 3 Question ID: 16.1.11 Page Reference: 422 Topic: Externalizing Disorders Skill: Applied Answer: b. Although it is normal for children to test the limits, your son's limit testing is not age appropriate.

16.1.12. Adolescents often engage in rule violations, so it is essential to distinguish between _________ and _________ antisocial behavior. a. b. c. d.

externalized; internalized biologically-based; psychologically-based adolescent-limited; life-course-persistent intentional; unintentional Difficulty: 2 Question ID: 16.1.12 Page Reference: 422 Topic: Externalizing Disorders Skill: Conceptual Answer: c. adolescent-limited; life-course-persistent

16.1.13. A researcher is looking for a way to predict adult personality disorder. Based on recent research it would be a good idea to focus on the variable of ____________. a. b. c. d.

callousness. anxiety. persistence. intelligence. Difficulty: 2 Question ID: 16.1.13 Page Reference: 422 Topic: Externalizing Disorders Skill: Conceptual Answer: a. callousness

16.1.14. Chris begins to show externalizing and antisocial behaviors at age 6. Doug begins to show these behaviors at age 16. What would a clinical psychologist conclude concerning the differences in the problems these two individuals present? a. b. c. d.

Chris's problems are less disruptive to other people. Chris's problem is likely to persist throughout life. Chris's problem will probably have a shorter duration. Chris's problem will be more related to health problems. Difficulty: 2 Question ID: 16.1.14 Page Reference: 422 Topic: Externalizing Disorders Skill: Applied

Answer: b. Chris's problem is likely to persist throughout life.

16.1.15. Why are negativity, anger, and aggression, as motivations in children, important in our consideration of behavior disorders in children? a. They influence our judgments of intent and remorse. b. They tend to be associated with higher than average rates of brain damage. c. The presence of these characteristics indicates a greater likelihood of a suicide attempt. d. The DSM diagnostic criteria for several externalizing disorders place great emphasis on these characteristics. Difficulty: 2 Question ID: 16.1.15 Page Reference: 423 Topic: Externalizing Disorders Skill: Conceptual Answer: a. They influence our judgments of intent and remorse.

16.1.16. Hyperactivity is most notable in a. b. c. d.

unfamiliar places. a physician's office. structured situations such as classrooms. unstructured situations such as playgrounds. Difficulty: 1 Question ID: 16.1.16 Page Reference: 423 Topic: Externalizing Disorders Skill: Factual Answer: c. structured situations such as classrooms.

16.1.17. What is the Continuous Performance Test used for? a. b. c. d.

as a measure of sustained attention as a measure of hyperactivity as a measure of neurological abnormalities as a measure of academic achievement

Difficulty: 1 Question ID: 16.1.17 Page Reference: 423 Topic: Externalizing Disorders Skill: Factual

Answer: a. as a measure of sustained attention

16.1.18. You are listening to a radio talk show and you hear the terms "hyperactivity" and "ADD," but with your knowledge of abnormal psychology you know that these two terms now referred to in DSMIV-TR as a. b. c. d.

hyperkinesis. hyperactivity/impulsivity disorder. attention-deficit/hyperactivity disorder. soft neurological syndrome. Difficulty: 2 Question ID: 16.1.18 Page Reference: 423 Topic: Externalizing Disorders Skill: Conceptual Answer: c. attention-deficit/hyperactivity disorder.

16.1.19. General “spaciness,” frequent shifts from one uncompleted activity to another, careless mistakes, and poor organization are descriptors for a. b. c. d.

normal children. attention deficits. conduct disorders. None of the above fit. Difficulty: 2 Question ID: 16.1.19 Page Reference: 423 Topic: Externalizing Disorders Skill: Conceptual Answer: b. attention deficits.

16.1.20. According to the DSM-IV-TR which conditions must be met before a diagnosis of attentiondeficit/hyperactivity disorder can be assigned? a. b. c. d.

The individual in question must be male. At least some symptoms must be evident before age 7. There can be no symptoms of conduct disorder. All of the above must be met. Difficulty: 2 Question ID: 16.1.20 Page Reference: 424 Topic: Externalizing Disorders

Skill: Conceptual Answer: b. At least some symptoms must be evident before age 7.

16.1.21. With regard to the attempt to differentiate between attention-deficit/hyperactivity disorder (ADHD) from oppositional defiant disorder (ODD), it is known that a. b. c. d.

ADHD is a psychological problem while ODD is biological. ADHD is a biological problem while ODD is psychological. ADHD is an internalized problem while ODD is externalized. None of the above is widely agreed to by the professionals. Difficulty: 3 Question ID: 16.1.21 Page Reference: 425 Topic: Externalizing Disorders Skill: Conceptual Answer: d. None of the above are widely agreed to by the professionals.

16.1.22. Offenses against the law that are crimes against people or property that are illegal at any age are known as _________________. a. b. c. d.

status offenses. index offenses. immoral behavior. felonies. Difficulty: 1 Question ID: 16.1.22 Page Reference: 426 Topic: Externalizing Disorders Skill: Factual Answer: b. index offenses.

16.1.23. How would a psychologist describe the relationship of the symptoms of attention deficit and hyperactivity in attention-deficit/hyperactivity disorder? a. b. c. d.

They are independent symptoms. Hyperactivity causes attention problems. The attention problems cause hyperactivity. They are two ways of identifying the same set of symptoms. Difficulty: 3 Question ID: 16.1.23 Page Reference: 425 Topic: Externalizing Disorders

Skill: Applied Answer: a. They are independent symptoms.

16.1.24. A psychologist is evaluating a child and trying to determine if the child loses his temper, argues with adults, is often spiteful and vindictive. Which disorder is the focus of the psychologist's questions? a. b. c. d.

conduct disorder Tourette's syndrome oppositional defiant disorder attention-deficit/hyperactivity disorder Difficulty: 1 Question ID: 16.1.24 Page Reference: 425 Topic: Externalizing Disorders Skill: Applied Answer: c. oppositional defiant disorder

16.1.25. What is the current consensus regarding the relationship between attention-deficit/hyperactivity disorder and oppositional-defiant disorder? a. b. c. d.

The two disorders are essentially the same. Conduct disorder tends to resolve itself with time, ADHD is more often a lifelong problem. The two disorders are fundamentally different. The two are separate but frequently comorbid. Difficulty: 2 Question ID: 16.1.25 Page Reference: 425 Topic: Externalizing Disorders Skill: Factual Answer: d. The two are separate but frequently comorbid.

16.1.26. Which of the following is NOT one of the subtypes of attention-deficit/hyperactivity disorder currently included in DSM-IV-TR? a. b. c. d.

predominantly inattentive type predominantly hyperactive-impulsive type predominantly conduct disordered type combined type Difficulty: 1 Question ID: 16.1.26 Page Reference: 425-426 Topic: Externalizing Disorders

Skill: Factual Answer: c. predominantly conduct disordered type

16.1.27. Tim has been diagnosed as having oppositional defiant disorder; Vince has been diagnosed as having conduct disorder. What is the major difference between these two boys? a. b. c. d.

Tim is older than Vince. Compared to Tim, Vince has a much better prognosis. Vince has engaged in more serious forms of rule violations than has Tim. They demonstrate the same symptoms, but Tim is more likely to be mentally retarded. Difficulty: 2 Question ID: 16.1.27 Page Reference: 426 Topic: Externalizing Disorders Skill: Applied Answer: c. Vince has engaged in more serious forms of rule violations than has Tim.

16.1.28. Everyone in the sixth grade and throughout the entire school knows Carl is a bully. He likes his reputation and calls himself the "enforcer." He gets a kick out of being cruel to small animals and has used a baseball bat as a weapon. He was referred to the mental health center for an evaluation. When the report is returned to the school, what diagnosis is likely to have been made? a. b. c. d.

conduct disorder juvenile delinquent oppositional defiant disorder attention-deficit/hyperactivity disorder Difficulty: 2 Question ID: 16.1.28 Page Reference: 426 Topic: Externalizing Disorders Skill: Applied Answer: a. conduct disorder

16.1.29. Which is NOT a criteria for the diagnosis of conduct disorder in the DSM-IV-TR? a. b. c. d.

often initiates physical fights has been physically cruel to animals frequently breaks the law has forced someone into sexual activity Difficulty: 2 Question ID: 16.1.29 Page Reference: 426 Topic: Externalizing Disorders

Skill: Conceptual Answer: c. frequently breaks the law 16.1.30. Your friend is looking over your shoulder while you are reading in your abnormal psychology textbook about conduct disorders, and your friend says, "Conduct disorder just sounds just another term for juvenile delinquency." What should you say to your friend? a. b. c. d.

"That's correct." "That's incorrect, because people with conduct disorders do not usually break the law." "That's incorrect, because conduct disorder is diagnosed in children, not adolescents." "That's incorrect, because juvenile delinquency is a legal classification, not psychological." Difficulty: 2 Question ID: 16.1.30 Page Reference: 425-426 Topic: Externalizing Disorders Skill: Applied

Answer: d. "That's incorrect, because juvenile delinquency is a legal classification, not psychological."

16.1.31. The Centers for Disease Control and Prevention found that approximately ___ percent of children in the United States had a lifetime diagnosis of ADHD. a. b. c. d.

1 5 10 15 Difficulty: 1 Question ID: 16.1.31 Page Reference: 426 Topic: Externalizing Disorders Skill: Factual Answer: c. 10

16.1.32. What is Michael Rutter's family adversity index? a. a measure of family predictors of behavior problems among children b. an index of the number of arguments within a family during a specified period of time c. a summary of the number of family members who have ever experienced any mental disorder in the past d. an indication of the likelihood that family members are genetically predisposed to develop mental disorders Difficulty: 1 Question ID: 16.1.32 Page Reference: 427

Topic: Externalizing Disorders Skill: Factual Answer: a. a measure of family predictors of behavior problems among children

16.1.33. Psychologists typically do not use a sample that accurately reflects the characteristics of some larger group of people. Instead, they often use convenience samples—groups of people who are easily recruited and studied. A more generalizable sample would be known as a. b. c. d.

representative. random. cross-sectional. None of the above are accurate. Difficulty: 2 Question ID: 16.1.33 Page Reference: 427 Topic: Externalizing Disorders Skill: Conceptual Answer: a. representative

16.1.34. What would a researcher want to use in order for research results to be generalizable? a. b. c. d.

a small convenience sample a large representative sample data on the whole population of interest information from interviews and other "global" measures Difficulty: 2 Question ID: 16.1.34 Page Reference: 427 Topic: Externalizing Disorders Skill: Conceptual Answer: b. a large representative sample

16.1.35. What did Michael Rutter find in the study of the association between family adversity and externalizing disorders? a. There were no externalizing problems if there were no family problems. b. There was no association between family problems and externalizing disorders. c. The presence of one adversity factor was associated with a much higher rate of externalizing disorders. d. The presence of two adversity factors was associated with a much higher rate of externalizing disorders. Difficulty: 1 Question ID: 16.1.35

Page Reference: 427 Topic: Externalizing Disorders Skill: Factual Answer: d. The presence of two adversity factors was associated with a much higher rate of externalizing disorders.

16.1.36. Jack lives in a small apartment with his mother, father, and four brothers and sister. The family struggles to pay the rent and put food on the table. His mother has been quite depressed. What is the future for this child? a. b. c. d.

Jack is at high risk for developing Down syndrome. Jack is at high risk for an externalizing problem. Jack is at high risk for an internalizing problem. Jack is at high risk for developing an eating disorder. Difficulty: 2 Question ID: 16.1.36 Page Reference: 427 Topic: Externalizing Disorders Skill: Applied Answer: b. is at high risk for an externalizing problem

16.1.37. Inborn behavioral characteristics including activity level, emotionality, and sociability are known as a. b. c. d.

genotype. personality. temperament. All of the above are correct. Difficulty: 2 Question ID: 16.1.37 Page Reference: 428 Topic: Externalizing Disorders Skill: Conceptual Answer: c. temperament.

16.1.38. What is the general conclusion of researchers who have investigated the influence of genetic factors on attention-deficit/hyperactivity disorder? a. Genetic factors substantially contribute to this disorder. b. The concordance rate for MZ twins is high, however, symptoms appear to be reactions to other mental disorders. c. Genetic factors seem to play no role in the development of this disorder, which is related to rapid alterations in environmental stimulation.

d. The concordance rate among dizygotic twins is higher than for monozygotic twins, suggesting that environmental factors are the most important determinant of this disorder. Difficulty: 2 Question ID: 16.1.38 Page Reference: 429 Topic: Externalizing Disorders Skill: Conceptual Answer: a. Genetic factors substantially contribute to this disorder.

16.1.39. What percentage of the variance in the symptoms of attention-deficit/hyperactivity disorder seem to be explained by genetic factors? a. b. c. d.

5 percent 25 percent 50 percent 90 percent Difficulty: 2 Question ID: 16.1.39 Page Reference: 429 Topic: Externalizing Disorders Skill: Factual Answer: d. 90 percent

16.1.40. Which of the following is NOT one of the temperaments described by Chess and Thomas? a. b. c. d.

easy difficult slow-to-warm-up aggressive Difficulty: 1 Question ID: 16.1.40 Page Reference: 428 Topic: Externalizing Disorders Skill: Factual Answer: d. aggressive

16.1.41. Which of the following most accurately describes the role of genetics in attentiondeficit/hyperactivity disorder (ADHD), oppositional-defiant disorder (ODD), and conduct disorder (CD)? a. b. c. d.

substantial for ADHD but less substantial for ODD and CD substantial for ODD but less substantial for ADHD and CD substantial for all three disorders not substantial for any of these disorders

Difficulty: 2 Question ID: 16.1.41 Page Reference: 429 Topic: Externalizing Disorders Skill: Conceptual Answer: a. substantial for ADHD but less substantial for ODD and CD

16.1.42. In a hospital corridor you overhear physicians discussing a patient's "soft signs." You ask your own physician what they meant and find that they were referring to a. b. c. d.

neurological symptoms such as delays in fine motor coordination. symptoms that only appear in evidence from low-tech types of testing equipment. indications that suggest a low level of a certain neurotransmitter is present. an area of the brain that experienced a direct blow that causes seizure-like symptoms. Difficulty: 1 Question ID: 16.1.42 Page Reference: 429 Topic: Externalizing Disorders Skill: Factual Answer: a. neurological symptoms such as delays in fine motor coordination.

16.1.43. In a large sample of males followed from birth into adulthood, child maltreatment predicted significantly more adolescent conduct problems if the boys were genetically predisposed to a. b. c. d.

high rather than low MAOA activity. low rather than high MAOA activity. low rather than high dopamine activity. high rather than low dopamine activity. Difficulty: 3 Question ID: 16.1.43 Page Reference: 429 Topic: Externalizing Disorders Skill: Conceptual Answer: b. low rather than high MAOA activity.

16.1.44. The process of shaping children’s behavior and attitudes to conform to the expectations of parents, teachers, and society as a whole is known as a. b. c. d.

shaping. behavior modification. parenting style. socialization.

Difficulty: 1 Question ID: 16.1.44 Page Reference: 429 Topic: Externalizing Disorders Skill: Factual Answer: d. socialization.

16.1.45. According to the textbook, what is the most effective parenting style? a. b. c. d.

secure indulgent authoritarian authoritative Difficulty: 2 Question ID: 16.1.45 Page Reference: 429 Topic: Externalizing Disorders Skill: Conceptual Answer: d. authoritative

16.1.46. The people next door emphasize obedience through the enforcement of their guidelines and the use of punishment. For example, when their 14-year-old was five minutes late returning from a basketball game last weekend, they immediately grounded the youngster for two weeks. What style of parenting has been described? a. b. c. d.

indulgent neglectful authoritative authoritarian Difficulty: 2 Question ID: 16.1.46 Page Reference: 429 Topic: Externalizing Disorders Skill: Applied Answer: d. authoritarian

16.1.47. Children with serious conduct problems often have parents who are a. b. c. d.

indulgent. neglectful. authoritarian. authoritative.

Difficulty: 1 Question ID: 16.1.47 Page Reference: 429 Topic: Externalizing Disorders Skill: Factual Answer: b. neglectful.

16.1.48. Which of the following most clearly captures how Gerald Patterson uses the term coercion? a. b. c. d.

purposeful punishment for bad behavior inadvertent punishment for bad behavior purposeful reinforcement for bad behavior inadvertent reinforcement for bad behavior Difficulty: 2 Question ID: 16.1.48 Page Reference: 429-430 Topic: Externalizing Disorders Skill: Factual Answer: d. inadvertent reinforcement for bad behavior

16.1.49. What term is used for a brief period of isolation after misbehavior? a. b. c. d.

coercion time-out detachment negative attention Difficulty: 1 Question ID: 16.1.49 Page Reference: 430 Topic: Externalizing Disorders Skill: Factual Answer: b. time-out

16.1.50. Which of the following situations illustrates the concept of negative attention and its potential consequences? a. When a child misbehaves he or she is sent out of the class for a specified period of time as a timeout. b. The parents of a two-year-old pay no attention to the child until she is quiet for least two minutes. c. The second-grade teacher says the entire class must be quiet before they go for recess. Any sounds from the class delay or reduce recess time. Now the class remains quiet on cue from the teacher. d. The parents of a young man tend to punish his misbehaviors in front of their other children who find his antics during the punishment to be entertaining.

Difficulty: 2 Question ID: 16.1.50 Page Reference: 429-430 Topic: Externalizing Disorders Skill: Conceptual Answer: d. The parents of a young man tend to punish his misbehaviors in front of their other children who find his antics during the punishment to be entertaining.

16.1.51. Ricky's mother tends to scold him when he fights with other children while Ricky's father tends to encourage him to fight. This pattern of inconsistent discipline has been linked to a. b. c. d.

internalizing disorders. externalizing disorders. higher levels of anxiety. higher levels of depression. Difficulty: 2 Question ID: 16.1.51 Page Reference: 430 Topic: Externalizing Disorders Skill: Conceptual Answer: b. externalizing disorders.

16.1.52. Researchers have given children either psychostimulant drugs or placebo for attentiondeficit/hyperactivity disorder. They were interested in mothers' reaction to their children. What did they find? a. Parent's behavior seems to be the primary cause of much of a child's hyperactivity. b. When their children are on medication, mothers are less negative and less controlling. c. Based on the response of parents, the effects of psychostimulant can be attributed to a placebo effect. d. Parents do not seem to respond any differently to children when they are on or off psychostimulant medication.

Difficulty: 2 Question ID: 16.1.52 Page Reference: 432 Topic: Externalizing Disorders Skill: Applied Answer: b. When their children are on medication, mothers are less negative and less controlling.

16.1.53. Cross-cultural research that compared Japan, Canada, Europe, and the United States with regard to correlates of crime in those countries suggests that which variable most effectively reduces crime rates? a. b. c. d.

stiffer penalties for youth offenders. more crimes that carried mandatory minimum sentences which result in longer prison terms. programs to reduce the rate of child poverty. Based on the research none of these would likely have an effect on crime rates. Difficulty: 1 Question ID: 16.1.53 Page Reference: 431 Topic: Externalizing Disorders Skill: Applied Answer: c. programs to reduce the rate of child poverty.

16.1.54. Which of the following is likely to characterize children with externalizing disorders? a. b. c. d.

detachment hallucinations anaclitic depression inability to delay gratification Difficulty: 2 Question ID: 16.1.54 Page Reference: 432 Topic: Externalizing Disorders Skill: Factual Answer: d. inability to delay gratification

16.1.55. A group of children previously identified as having various externalizing problems were put in a social situation and observed. Based on the research of Dodge what are observers likely to see? a. b. c. d.

These children tend to ignore the behavior of other children. They tend to overinterpret the aggressive intentions of their peers. Their high level of energy is seen as a positive element by other children. These children tend to be preoccupied with their own behavior and its effects on others. Difficulty: 2 Question ID: 16.1.55 Page Reference: 432 Topic: Externalizing Disorders Skill: Applied Answer: b. They tend to overinterpret the aggressive intentions of their peers.

16.1.56. One reason why a child might turn out well-behaved despite growing up in difficult family circumstances involves what temperament theorists call a. b. c. d.

goodness of fit. age-appropriate accommodation. life-course persistence. the internalization of an externalized disorder. Difficulty: 1 Question ID: 16.1.56 Page Reference: 432 Topic: Externalizing Disorders Skill: Conceptual Answer: a. goodness of fit.

16.1.57. Approximately what percentage of ADHD children who are treated with psychostimulant medication for attention deficit/hyperactivity disorder show improvement in behavior? a. b. c. d.

5 percent 30 percent 75 percent 90 percent Difficulty: 1 Question ID: 16.1.57 Page Reference: 432 Topic: Externalizing Disorders Skill: Factual Answer: c. 75 percent

16.1.58. How do psychostimulant drugs affect normal children? a. b. c. d.

induce a period of depression increase energy but decrease alertness have no observable effects on normal children improve attention and decrease motor activity

Difficulty: 2 Question ID: 16.1.58 Page Reference: 432 Topic: Externalizing Disorders Skill: Conceptual Answer: d. improve attention and decrease motor activity

16.1.59. Ted's pediatrician has prescribed Ritalin for the young boy. Which of the following is the most likely pattern of drug use that will occur? a. b. c. d. is out.

Ted will take multiple doses every day throughout the year. Ted will take one dose each day when he feels the need to concentrate. Ted will take one dose per week throughout the year and into his adolescent years. Ted will take several doses per day during the school year, but will not take the drug when school

Difficulty: 2 Question ID: 16.1.59 Page Reference: 433 Topic: Externalizing Disorders Skill: Applied Answer: d. Ted will take several doses per day during the school year, but will not take the drug when school is out. 16.1.60. Eight-year-old Julio attends an elementary school where a lot of children are taking Ritalin. After his teacher suggested that his parents take him to a pediatrician for an evaluation, Julio was put on Ritalin. If Julio has a typical response to the drug, what is likely to happen? a. b. c. d.

Julio has a minor improvement in his hyperactivity. Julio responds positively to the drug and his hyperactivity decreases. Julio has strong side effects and must be taken off the drug immediately. Julio experiences the paradoxical effect and his behavior actually gets worse. Difficulty: 2 Question ID: 16.1.60 Page Reference: 432-433 Topic: Externalizing Disorders Skill: Applied Answer: b. Julio responds positively to the drug and his hyperactivity decreases.

16.1.61. Studies of the long-term benefits of psychostimulant medication for attentiondeficit/hyperactivity disorder show a. b. c. d.

significant improvement in both learning and behavior. no significant improvement in learning or behavior. improved learning but no improvement in behavior. improved behavior but no improvement in learning. Difficulty: 2 Question ID: 16.1.61 Page Reference: 433 Topic: Externalizing Disorders Skill: Factual Answer: b. no significant improvement in learning or behavior.

16.1.62. The parents of a child who has just been put on Ritalin are given a pamphlet describing some of the benefits and side effects of the drug. What types of side effects might the parents expect to see? a. b. c. d.

itching and rashes nausea and vomiting depression and anxiety decreased appetite and sleeping difficulties Difficulty: 1 Question ID: 16.1.62 Page Reference: 434 Topic: Externalizing Disorders Skill: Factual Answer: d. decreased appetite and sleeping difficulties

16.1.63. The parents of an eight-year-old boy are talking to their pediatrician who has just prescribed Ritalin for their son. The pediatrician wants to make sure that the parents are aware of the possible side effects and will report them if and when they occur. Which of the following side effects might occur? a. b. c. d.

hallucinations and nervousness heart palpitations and enuresis suicidal thoughts and agitation slowed physical growth and motor tics Difficulty: 2 Question ID: 16.1.63 Page Reference: 434 Topic: Externalizing Disorders Skill: Applied Answer: d. slowed physical growth and motor tics

16.1.64. Compared to Europe, Canada, and Australia, psychostimulant use in the United States is a. b. c. d.

about equal. about half the rate. three to 10 times higher. None of the above are accurate. Difficulty: 2 Question ID: 16.1.64 Page Reference: 434 Topic: Externalizing Disorders Skill: Factual Answer: c. three to 10 times higher.

16.1.65. If a child diagnosed with attention-deficit/hyperactivity disorder does not respond to psychostimulant drugs, which of the following categories of drugs would most likely be prescribed? a. b. c. d.

antimanic antianxiety antipsychotic antidepressant Difficulty: 2 Question ID: 16.1.65 Page Reference: 434 Topic: Externalizing Disorders Skill: Factual Answer: d. antidepressant

16.1.66. Behavioral family therapy seems to be promising as a treatment for a. b. c. d.

conduct disorder. oppositional defiant disorder. antisocial personality disorder. attention-deficit/hyperactivity disorder. Difficulty: 1 Question ID: 16.1.66 Page Reference: 434-435 Topic: Externalizing Disorders Skill: Factual Answer: b. oppositional defiant disorder.

16.1.67. What is one of the key elements of behavioral family therapy? a. teaching parents to systematically reward positive behavior and ignore or mildly punish misbehavior b. teaching both parents and their children to use the techniques of progressive relaxation training c. contacting a negotiator immediately when there is any hint that a serious situation is about to erupt d. encouraging both parents and their children to go to "neutral corners" for at least 30 minutes following any confrontation Difficulty: 2 Question ID: 16.1.67 Page Reference: 436 Topic: Externalizing Disorders Skill: Conceptual Answer: a. teaching parents to systematically reward positive behavior and ignore or mildly punish misbehavior

16.1.68. What has research shown concerning the association between diet and attentiondeficit/hyperactivity disorder? a. b. c. d.

Sugar increases hyperactivity. Preservatives increase hyperactivity. Food additives increase hyperactivity. There is no relationship between diet and hyperactivity. Difficulty: 2 Question ID: 16.1.68 Page Reference: 435 Topic: Externalizing Disorders Skill: Conceptual Answer: d. There is no relationship between diet and hyperactivity.

16.1.69. What is a central process for many behavioral family therapists in treating adolescents with conduct disorder? a. b. c. d.

getting the parents to be less authoritative promoting adolescent's involvement in deciding the rules helping the parents gain more control over the adolescent fostering empathic understanding rather than behavior management Difficulty: 2 Question ID: 16.1.69 Page Reference: 436 Topic: Externalizing Disorders Skill: Factual Answer: b. promoting adolescent's involvement in deciding the rules

16.1.70. What did a 13-year follow-up study find about the effect of multisystemic therapy on recidivism rates among seriously troubled youth? a. b. c. d.

increased rates when compared to those not receiving the treatment decreased rates but rates that are still quite high decrease rates from high to quite low no effect Difficulty: 2 Question ID: 16.1.70 Page Reference: 436 Topic: Externalizing Disorders Skill: Conceptual Answer: b. decreased rates but rates that are still quite high

16.1.71. What has research shown concerning residential programs such as Achievement Place? a. b. c. d.

long-term reductions in aggression few results while the teen is still in the group home lower rates of recidivism once the teen leaves the program effective results while the teen is living in the group home Difficulty: 2 Question ID: 16.1.71 Page Reference: 436 Topic: Externalizing Disorders Skill: Factual Answer: d. effective results while the teen is living in the group home

16.1.72. An expert on problem behaviors of adolescents tells a gathering of professionals the following, "The primary goal of treating these young people should be diversion." If the group then goes out and follows this suggestion, what will they try to accomplish? a. They will develop more after-hour programs for young people. b. They will develop more family-based treatment programs because these adolescents are the products of their environments. c. They will do whatever they can to keep youngsters out of a juvenile justice system that seems to create more delinquency. d. The seriousness of the crimes that they commit must be impressed upon these young people in order that they accept responsibility and have any chance of living a normal adult life. Difficulty: 1 Question ID: 16.1.72 Page Reference: 438 Topic: Externalizing Disorders Skill: Applied Answer: c. They will do whatever they can to keep youngsters out of a juvenile justice system that seems to create more delinquency.

16.1.73. What is the long-term prognosis for children who have oppositional defiant disorder or conduct disorder into adulthood? a. about half have problems with antisocial behavior in adulthood b. there is a high probability of full recovery of normal functioning in the majority of cases c. although some of their symptoms will decrease, they often have trouble with peers and tend to be mentally retarded d. there is a high rate of development of a wide range of pathologies from anxiety disorders to psychotic disorders

Difficulty: 1 Question ID: 16.1.73 Page Reference: 437 Topic: Externalizing Disorders Skill: Factual Answer: a. about half have problems with antisocial behavior in adulthood

16.1.74. Which of the following would NOT be considered a symptom of an internalizing disorder? a. b. c. d.

sadness anxiety aggression somatic complaints Difficulty: 1 Question ID: 16.1.74 Page Reference: 438 Topic: Externalizing Disorders Skill: Factual Answer: c. aggression

16.1.75. Which of the following is an example of an internalizing symptom? a. b. c. d.

sadness fighting talking back hyperactivity Difficulty: 2 Question ID: 16.1.75 Page Reference: 438 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: a. sadness

16.1.76. The criteria for the diagnoses of phobia and depression in children are slightly different from those used to diagnose these disorders in adults. What do the criteria take into account in defining disorders in children? a. b. c. d.

Children experience more frequent suicidal ideation. Children have limited cognitive capacity for insight. The response of children to medications is more variable. Children experience an array of different physiological symptoms.

Difficulty: 2 Question ID: 16.1.76 Page Reference: 438 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: b. Children have limited cognitive capacity for insight.

16.1.77. A psychologist is reluctant to use parents' observations of their children in determining levels of their children's depression. However, parents often insist on being consulted. What is the psychologist likely to find when parents are asked to evaluate their children's levels of depression? a. Parents tend to underestimate the extent of depression reported by their children. b. Parents frequently mistake the symptoms of depression as signs of a developing psychotic process. c. Parents tend to overreact to minor symptoms and overestimate the severity of the depression. d. Whenever parents are involved in such data collection, they immediately put themselves in the role of the therapist and begin treatment, often with disastrous results. Difficulty: 3 Question ID: 16.1.77 Page Reference: 438 Topic: Internalizing and Other Disorders Skill: Applied Answer: a. Parents tend to underestimate the extent of depression reported by their children.

16.1.78. All of the following children are eight years old. Which of them is likely to be free of the major symptoms of their disorders by late adolescence? a. b. c. d.

Dean, who has a fear of water Jill, who has severe depression Juan, who has an obsessive-compulsive disorder Jack, who has attention-deficit/hyperactivity disorder

Difficulty: 3 Question ID: 16.1.78 Page Reference: 438 Topic: Internalizing and Other Disorders Skill: Applied Answer: a. Dean, who has a fear of water

16.1.79. Which fear is prevalent between ages 5 to 8? a.

darkness

b. c. d.

school-related fears separation from parents not being able to breathe Difficulty: 1 Question ID: 16.1.79 Page Reference: 438-439 Topic: Internalizing and Other Disorders Skill: Factual Answer: b. school-related fears

16.1.80. The main difference between children’s fears and anxiety is a. b. c. d.

that fear is a reaction to a real and immediate danger. anxiety is a reaction to a real and immediate danger. fear involves the brain’s limbic system. anxiety involves the brain’s limbic system. Difficulty: 2 Question ID: 16.1.80 Page Reference: 438 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: a. that fear is a reaction to a real and immediate danger.

16.1.81. How should we characterize separation anxiety in a one-year-old child? a. b. c. d.

a normal fear highly unusual a sign of pathology not upsetting for the child Difficulty: 1 Question ID: 16.1.81 Page Reference: 438-439 Topic: Internalizing and Other Disorders Skill: Factual Answer: a. a normal fear

16.1.82. What is a problematic consequence of separation anxiety disorder? a. b. c. d.

delinquency hyperactivity school refusal fighting with peers

Difficulty: 1 Question ID: 16.1.82 Page Reference: 439 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: c. school refusal

16.1.83. The peer sociometric method involves a. b. c. d.

training children to make friends. teachers' ratings of children's friendships. children's ratings of their peers' popularity. sociologists' observations of children's alliances. Difficulty: 1 Question ID: 16.1.83 Page Reference: 439 Topic: Internalizing and Other Disorders Skill: Factual Answer: c. children's ratings of their peers' popularity.

16.1.84. Which of the types of children identified in peer sociometric studies is most likely to develop an externalizing disorder? a. b. c. d.

average rejected neglected controversial

Difficulty: 2 Question ID: 16.1.84 Page Reference: 439 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: b. rejected

16.1.85. A researcher conducts a peer sociometric analysis of hundreds of children in the local school system. Several years later the researcher checks the status of the children including Amy who was identified as a neglected child. If Amy developed a problem, which of the following is most likely? a. b.

loneliness hyperactivity

c. d.

schizophrenia obsessive-compulsive personality disorder Difficulty: 2 Question ID: 16.1.85 Page Reference: 439 Topic: Internalizing and Other Disorders Skill: Applied Answer: a. loneliness

16.1.86. According to peer sociometric methods, which of the following groups of children has the highest rate of internalizing symptoms? a. b. c. d.

average rejected neglected controversial Difficulty: 1 Question ID: 16.1.86 Page Reference: 439 Topic: Internalizing and Other Disorders Skill: Factual Answer: c. neglected

16.1.87. How could a researcher summarize how DSM-IV-TR has dealt with childhood disorders over the several editions of the manual? a. b. c. d.

focus on psychotic symptoms from scarcity to overabundance eating and sleeping disorders take priority childhood disorders are miniature versions of adult disorders Difficulty: 2 Question ID: 16.1.87 Page Reference: 440-441 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: b. from scarcity to overabundance

16.1.88. A rare disorder involving the persistent eating of non nutritive substances such as paint and dirt is called a. b.

pica. encopresis.

c. d.

rumination disorder. Tourette's disorder. Difficulty: 1 Question ID: 16.1.88 Page Reference: 441 Topic: Internalizing and Other Disorders Skill: Factual Answer: a. pica.

16.1.89. Which of the following people exhibits behavior that is most likely to lead to the diagnosis of Tourette's disorder? a. b. c. d.

Barry, who has various tics Stephanie, who suffers epileptic seizures Manuel, who has difficulty moving her arms and legs Sid, who suffers frequent dissociative episodes Difficulty: 2 Question ID: 16.1.89 Page Reference: 441 Topic: Internalizing and Other Disorders Skill: Applied Answer: a. Barry, who has various tics

16.1.90. Tourette's disorder is characterized by a. b. c. d.

motor and verbal tics. uncontrolled urination. eating non-nutritive substances. regurgitation and re-chewing of food. Difficulty: 1 Question ID: 16.1.90 Page Reference: 441 Topic: Internalizing and Other Disorders Skill: Factual Answer: a. motor and verbal tics.

16.1.91. Jack is given an IQ test and academic achievement tests. Based on which test results might he be classified as having a learning disability? a. b. c.

IQ less than 70 achievement score two grades behind normal IQ score significantly higher than achievement test score

average achievement test scores, but unusual learning style Difficulty: 2 Question ID: 16.1.91 Page Reference: 440 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: c. IQ score significantly higher than achievement test score

16.1.92. What has research shown us about the causes of learning disorders? a. b. c. d.

Learning disorders usually have a specific neurological cause. Learning disorders usually have a specific genetic cause. Learning disorders usually have a specific psychological cause. No specific cause has been identified that is common to all learning disorders. Difficulty: 2 Question ID: 16.1.92 Page Reference: 440 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: d. No specific cause has been identified that is common to all learning disorders.

16.1.93. The parents of four-year-old Sam are concerned because their son wets his bed most nights. They have heard stories describing the future of children who wet their beds. They seek the advice of their physician who finds that Sam has no medical problems that might cause this bedwetting. What is the physician likely to say? a. b. c. d.

Sam probably also meets the criteria for encopresis. Sam has not yet reached the age at which bedwetting is considered abnormal. Sam is probably just going through the beginning stages of oppositional defiant disorder. Sam probably suffers from autistic disorder and the bedwetting reflects his immaturity. Difficulty: 2 Question ID: 16.1.93 Page Reference: 441 Topic: Internalizing and Other Disorders Skill: Applied Answer: b. Sam has not yet reached the age at which bedwetting is considered abnormal.

16.1.94. Bedwetting is another name for a. b. c.

pica. enuresis. rumination.

encopresis. Difficulty: 1 Question ID: 16.1.94 Page Reference: 441 Topic: Internalizing and Other Disorders Skill: Factual Answer: b. enuresis.

16.1.95. The bell and pad device is used to treat a. b. c. d.

pica. enuresis. selective mutism. Tourette's disorder. Difficulty: 1 Question ID: 16.1.95 Page Reference: 441 Topic: Internalizing and Other Disorders Skill: Factual Answer: b. enuresis.

16.1.96. What is one of the criticisms of DSM-IV-TR's section on disorders of childhood? a. b. c. d.

too few externalizing categories too many internalizing categories too few disorders affecting children too many disorders that are not mental disorders

Difficulty: 1 Question ID: 16.1.96 Page Reference: 441 Topic: Internalizing and Other Disorders Skill: Factual Answer: d. too many disorders that are not mental disorders

16.1.97. Which of these disorders has been used as an example of the overinclusive listing of childhood disorders in DSM-IV-TR? a. b. c.

isolated child syndrome reluctant school attender humor impaired personality disorder

developmental coordination disorder Difficulty: 1 Question ID: 16.1.97 Page Reference: 441 Topic: Internalizing and Other Disorders Skill: Factual Answer: d. developmental coordination disorder

16.1.98. Which of the following characterizes the association between gender and internalizing disorders in adolescence? a. b. c. d.

more common in boys more common in girls in both genders, decrease with age equally prevalent among men and women Difficulty: 1 Question ID: 16.1.98 Page Reference: 443 Topic: Internalizing and Other Disorders Skill: Factual Answer: b. more common in girls

16.1.99. How do the changes with age of the prevalence rates for externalizing and internalizing disorders compare? a. b. c. d.

Externalizing disorders increase with age, while internalizing disorders decrease. Externalizing disorders decrease with age, while internalizing disorders increase. Both increase with age. Both decrease with age.

Difficulty: 1 Question ID: 16.1.99 Page Reference: 443 Topic: Internalizing and Other Disorders Skill: Factual Answer: b. Externalizing disorders decrease with age, while internalizing disorders increase. 16.1.100. All of the following are true for a comparison of the suicide rate for males 15-24 year olds with that of the total population from 1950 to 1995 in the United States except a. b. c.

From 1900 to 1970 the suicide rate for males 15-24 was below the general population. 1970 was the year when the two rates changed places. Both rates have been increasing since 1960.

Currently the rate for males 15-24 is considerably higher than the general population. Difficulty: 1 Question ID: 16.1.100 Page Reference: 443 Topic: Internalizing and Other Disorders Skill: Factual Answer: a. From 1900 to 1970 the suicide rate for males 15-24 was below the general population.

16.1.101. In comparison to adult suicide attempts, suicide attempts by adolescents are a. b. c. d.

less impulsive. less likely to require therapy. more likely to follow family conflict. more motivated by depression than anger. Difficulty: 1 Question ID: 16.1.101 Page Reference: 444 Topic: Internalizing and Other Disorders Skill: Factual Answer: c. more likely to follow family conflict.

16.1.102. Since the 1960s, suicide rates have tripled for males in which age group? a. b. c. d.

age 8-12 age 15-24 the middle aged elderly Difficulty: 1 Question ID: 16.1.102 Page Reference: 443 Topic: Internalizing and Other Disorders Skill: Factual Answer: b. age 15-24

16.1.103. A child identified as fitting the description called inhibited to the unfamiliar is brought to the research institute (Kagan & Snidman, 1991) where a group of developmental, social, and physiological psychologists are studying differences between these children and other children. A child described as inhibited is placed in a room by himself; researchers observe through a one-way mirror and also check physiological measures. What might they expect to find? a. b.

The child's heart rate accelerates. The child looks around for an adult.

c. d.

The child's brain waves show a sleep-like pattern. The child runs around and moves his arms in stereotyped patterns. Difficulty: 2 Question ID: 16.1.103 Page Reference: 444 Topic: Internalizing and Other Disorders Skill: Applied Answer: a. The child's heart rate accelerates.

16.1.104. You are attending a psychology conference and look in at a session in progress. The speaker uses the term anaclitic depression, which puzzles you because it is not familiar. You ask the speaker for an explanation. What are you told? a. "The term describes a form of depression that is related to weather." b. "It is a form of biologically induced depression that can be seen in young children." c. "It is a term used for the lack of social responsiveness that can occur when an infant does not have a consistent attachment figure." d. "The term is used to describe what happens when young children model the behavior of their parents who have a history of depression." Difficulty: 2 Question ID: 16.1.104 Page Reference: 444-445 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: c. "It is a term used for the lack of social responsiveness that can occur when an infant does not have a consistent attachment figure."

16.1.105. What is the typical outcome among nonhuman primates who are raised in isolation without a parent or substitute attachment figure? a. b. c. d.

Their social development is normal. They show problems until adolescence. They show no problems until adolescence. They have dramatically troubled relationships. Difficulty: 1 Question ID: 16.1.105 Page Reference: 444 Topic: Internalizing and Other Disorders Skill: Factual Answer: d. They have dramatically troubled relationships.

16.1.106. Infants who are fearful about exploration and are not easily comforted by their attachment figure are displaying a. b. c. d.

troubled attachment. anxious attachment. secure attachment. reactive attachment. Difficulty: 1 Question ID: 16.1.106 Page Reference: 444-445 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: b. anxious attachment.

16.1.107. What would you conclude after reviewing the literature on anxious attachments and their relationship to future problems? a. b. c. d.

Anxious attachments are the primary risk factor for eating disorders. Anxious attachments are not as great a risk factor as was believed in the past. Such attachments are a general risk factor for a number of internalizing problems. Such attachments are a major risk factor for medical conditions due to poor child care. Difficulty: 1 Question ID: 16.1.107 Page Reference: 444-445 Topic: Internalizing and Other Disorders Skill: Applied Answer: c. Such attachments are a general risk factor for a number of internalizing problems.

16.1.108. What is a characteristic sign of the last stage of children's reaction to loss, similar to the grief following the loss of an attachment figure? a. b. c. d.

protest despair numbness detachment Difficulty: 1 Question ID: 16.1.108 Page Reference: 445 Topic: Internalizing and Other Disorders Skill: Factual Answer: d. detachment

16.1.109. Researchers have often failed to find a relationship between childhood loss and depression during adult life. This failure can be attributed to a. b. c. d.

reliance on retrospective research designs. the resilience of children. the tendency of adults to minimize early losses. the failure to use representative samples. Difficulty: 2 Question ID: 16.1.109 Page Reference: 445 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: b. the resilience of children.

16.1.110. Recent research comparing various treatments for adolescent depression found that a. Biological treatments alone are the most effective with children and adolescents. b. Medication alone is effective in reducing the risk of suicide in children and adolescents. c. Medication alone produced a higher risk of suicide in children and adolescents than medication combined with CBT. d. CBT alone produced a higher risk of suicide in children and adolescents than medication combined with CBT. Difficulty: 2 Question ID: 16.1.110 Page Reference: 445 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: c. Medication alone produced a higher risk of suicide in children and adolescents than medication combined with CBT. 16.1.111. What have researchers determined concerning the treatment of anxiety disorders in children? a. Psychodynamic therapy seems to be the most effective treatment. b. Drug treatments have been shown to be unhelpful in treating these problems. c. Cognitive behavior therapy and family therapy both have been successful. d. Family therapy seems to be the most effective long-term treatment because these are really family caused disorders. Difficulty: 2 Question ID: 16.1.111 Page Reference: 446 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: c. Cognitive behavior therapy and family therapy both have been successful.

16.1.112. A teacher who knows that you are taking a course in abnormal psychology, and because she is concerned about a student who seems depressed, asks you whether her student is likely to outgrow his current problems. What should you tell her? a. Children are resilient and usually outgrow their depression. b. Children who have experienced childhood depression are six times more likely kill themselves as young adults. c. What looks like depression in young children is almost always a form of age-appropriate behavior. d. Depression in young girls may get worse with age, but with young boys it usually gets better. Difficulty: 2 Question ID: 16.1.112 Page Reference: 446 Topic: Internalizing and Other Disorders Skill: Applied Answer: b. Children who have experienced childhood depression are six times more likely kill themselves as young adults.

Short Answer 16.2.113. Psychologists become concerned only when a child deviates substantially from developmental __________ . Difficulty: 1 Question ID: 16.2.113 Page Reference: 420 Topic: Overview Skill: Factual Answer: norms 16.2.114. ____________ disorders are characterized by children’s failure to control their behavior according to the expectations of parents, peers, teachers, and/or legal authorities. Difficulty: 1 Question ID: 16.2.114 Page Reference: 420 Topic: Overview Skill: Factual Answer: Externalizing

16.2.115. ________ disorders are characterized by a child's feeling of anxiety, fear or prolonged sadness. Difficulty: 1 Question ID: 16.2.115

Page Reference: 420 Topic: Overview Skill: Factual Answer: Internalizing

16.2.116. Some problems of adolescents are called "adolescent limited" because they tend to go away as the child develops. Other problems are more serious and long lasting and are labeled "life course __________ ." Difficulty: 1 Question ID: 16.2.116 Page Reference: 422 Topic: Externalizing Disorders Skill: Factual Answer: persistent

16.2.117. Children who have difficulty sitting still are likely to be diagnosed as "hyperactive," but if they are distractible and have difficulty finishing tasks they are more likely to be diagnosed as being __________ __________ . Difficulty: 1 Question ID: 16.2.117 Page Reference: 424 Topic: Externalizing Disorders Skill: Factual Answer: attention deficit

16.2.118. A child who exhibits behaviors that could be characterized as negative, hostile, and defiant may get diagnosed with __________ __________ disorder. Difficulty: 2 Question ID: 16.2.118 Page Reference: 425 Topic: Externalizing Disorders Skill: Factual Answer: oppositional defiant

16.2.119. A disorder that is more serious than ODD marked by serious rule violations and often by illegal behavior is called __________ disorder. Difficulty: 1 Question ID: 16.2.119

Page Reference: 426 Topic: Externalizing Disorders Skill: Factual Answer: conduct

16.2.120. Inborn behavioral characteristics including activity level, emotionality, and sociability are said by Thomas, Chess, and others to form a child’s __________ . Difficulty: 1 Question ID: 16.2.120 Page Reference: 428 Topic: Externalizing Disorders Skill: Factual Answer: temperament

16.2.121. Parenting that is both loving and firm is labeled __________ . Difficulty: 1 Question ID: 16.2.121 Page Reference: 429 Topic: Externalizing Disorders Skill: Factual Answer: authoritative

16.2.122. Gerald Patterson labels the process that happens when a parent positively reinforces a child's obnoxious behavior by giving into it as __________ . Difficulty: 2 Question ID: 16.2.122 Page Reference: 429-430 Topic: Externalizing Disorders Skill: Factual Answer: coercion

16.2.123. The procedure in which a child is isolated following misbehavior is known as __________ __________ . Difficulty: 1 Question ID: 16.2.123 Page Reference: 430 Topic: Externalizing Disorders Skill: Factual

Answer: time out

16.2.124. __________ anxiety disorder is defined by symptoms such as persistent and excessive worry for the safety of an attachment figure, fears of getting lost or being kidnapped, and refusal to be alone. Difficulty: 2 Question ID: 16.2.124 Page Reference: 438-439 Topic: Internalizing and Other Disorders Skill: Factual Answer: Separation

16.2.125. School refusal used to be more widely known as school __________ . Difficulty: 1 Question ID: 16.2.125 Page Reference: 439 Topic: Internalizing and Other Disorders Skill: Factual Answer: phobia

16.2.126. Significant departures from age appropriate norms in a specific area of development are also know as developmental __________ .

Difficulty: 2 Question ID: 16.2.126 Page Reference: 439 Topic: Internalizing and Other Disorders Skill: Factual Answer: deviations

16.2.127. Infants who are fearful about exploration and are not easily comforted by their attachment figures may be described as having developed what type of attachment? __________ Difficulty: 1 Question ID: 16.2.127 Page Reference: 445 Topic: Internalizing and Other Disorders Skill: Factual Answer: Anxious

16.2.128. Emotional __________ is a general process by which children learn to identify, evaluate, and control their feelings based on the reactions, attitudes, and advice of their parents and others in their social world. Difficulty: 2 Question ID: 16.2.128 Page Reference: 445 Topic: Internalizing and Other Disorders Skill: Factual Answer: regulation

Essay 16.3.129. What special problems are associated with the assessment and diagnosis of children's psychological problems? Difficulty: 1 Question ID: 16.3.129 Page Reference: 420 Topic: Overview Skill: Conceptual Answer: Few children or adolescents identify themselves as having an emotional or behavioral problem. Instead, some adult, often a parent or teacher, decides that the child has a problem. Sometimes, a child is unable to recognize or admit to his or her difficulties. Other times, however, the problem is as much the adult’s as the child’s. For example, a stressed parent may have trouble coping with normal misbehavior. This can make the assessment of externalizing disorders difficult.

16.3.130. Mental health professionals sometimes use convenience samples of patients who have presented for treatment. Give an example of when this would not be a methodological problem, and when it would be a methodological problem. Difficulty: 2 Question ID: 16.3.130 Page Reference: 427 Topic: Externalizing Disorders Skill: Conceptual Answer: The use of convenience samples is not a problem in studies where the convenience sample is the same as the population of interest, such as studies of the effectiveness of medication or therapy techniques for people in therapy. Such samples are problematic, however, when conclusions about causality are drawn and generalizations are made to larger populations.

16.3.131. What evidence supports the notion that genetic factors play a role in ADHD?

Difficulty: 2 Question ID: 16.3.131 Page Reference: 429 Topic: Externalizing Disorders Skill: Conceptual Answer: A recent study of 4,000 Australian twins has provided evidence that strongly supports the view that genetic factors contribute to ADHD. The concordance rate for MZ twins was 80 percent; whereas the rate for DZ was 40 percent. These concordance rates are close to what one would expect for a purely genetic disorder. Genetic factors explain 90 percent of the variance of ADHD symptoms. At this point, however, a specific gene (or genes) responsible has not been isolated.

16.3.132. Explain the "paradoxical effect" of psychostimulant medication on children with attention deficit/hyperactivity disorder. How was this supposed effect used as evidence for minimal brain damage? How has this idea been shown to be erroneous? Difficulty: 2 Question ID: 16.3.132 Page Reference: 432 Topic: Externalizing Disorders Skill: Conceptual Answer: Psychostimulant medications were found to "speed up" adults but slow down hyperactive children. This unexpected effect in children was taken as evidence of underlying brain abnormalities known as minimal brain damage. Later evidence showed, however, that normal children without attention deficit/hyperactivity disorder show similar effects (improved attention and decreased motor activity) when given psychostimulants.

16.3.133. What are some of the side effects of psychostimulant medication? Difficulty: 2 Question ID: 16.3.133 Page Reference: 434 Topic: Externalizing Disorders Skill: Applied Answer: Some side effects are relatively minor, such as decreased appetite, increased heart beat, and sleeping difficulties. Others are more serious, such as an increase in motor tics in a small percentage of cases. Evidence that psychostimulants can slow physical growth is an important concern. Another side effect that concerns some psychologists is that parents, teachers, and children may credit the pills, not the child, for the improved behavior.

16.3.134. Discuss the problem of identifying depression and anxiety in children. Difficulty: 2 Question ID: 16.3.134

Page Reference: 438-439 Topic: Internalizing and Other Disorders Skill: Conceptual Answer: There is a major problem in identifying many emotional reactions of children because their ability to be self-aware and their interpretation of emotions can vary widely. The textbook reports a study in which there was essential no correlation at all between children’s ratings of their depression and parent’s ratings. A child who is chronically depressed or anxious can readily find external reasons to explain their negative feelings. They can even take those external reasons and present a picture of someone who is angry at the perceived sources of their negative feelings rather than focus on the internal feel of sadness or anxiety. In addition children are constantly changing and developing. Their interpretations of events and internal feelings can change with a change in circumstance, a new group of friends or a book they have read. It is also the case that in childhood problems that are noticeable to others will likely be referred. As adults an individual can choose themselves to seek treatment even if the underlying emotional problem is not obvious to others.

16.3.135. What are some of the reasons that more boys are treated for psychological problems than are girls, but more women are treated in therapy than are men? Difficulty: 2 Question ID: 16.3.135 Page Reference: 443 Topic: Internalizing and Other Disorders Skill: Applied Answer: Externalizing problems are more common in boys; these problems are more noticeable as a problem. The prevalence of externalizing behaviors decreases with age, whereas the prevalence of internalizing disorders increases with age. By adulthood, internalizing disorders (typically in women) are more common.

16.3.136. Compare the concept of status offense with juvenile delinquency. Difficulty: 2 Question ID: 16.3.136 Page Reference: 426 Topic: Externalizing Disorders Skill: Conceptual Answer: Most of the symptoms of conduct disorder involve index offenses—crimes against people or property that are illegal at any age. But conduct disorder is not identical to the concept of juvenile delinquency. A few diagnostic criteria are comparable to status offenses—acts that are illegal only because of the youth’s status as a minor. Examples are running away from home and truancy from school. However, juvenile delinquency is a legal classification, not a mental health term. Adolescents who repeatedly break the law have conduct disorders whether or not they are arrested and convicted. And clearly one could be diagnosed with conduct disorder having never doing something that is illegal.

Chapter 17 Adjustment Disorders and Life-Cycle Transitions Total Assessment Guide (T.A.G.) Topic Overview pp. 449-453

The Transition to Adulthood pp. 453-457 Family Transitions pp. 457-464

Question Type Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay

The Transition to Later Life pp. 464-470

Multiple Choice Short Answer

Factual

Conceptual

2, 3, 6, 7, 8, 9, 11, 12, 13, 14, 17 93, 94

4, 5, 10, 15, 16

1, 18

103 20, 22, 23, 26, 30

27, 32

19, 21, 24, 25, 28, 29, 31 95 33, 34, 40, 42, 44, 45, 46, 49, 50, 55, 57, 59 96, 97

62, 64, 66, 70, 72, 79, 80, 81, 82, 84, 88, 89, 91, 92 98, 99, 100, 101, 102

Essay

104 35, 36, 38, 41, 43, 45, 48, 51, 52, 53, 58, 60

Applied

37, 39, 47, 54, 56, 61

105, 106, 108, 109 63, 65, 67, 71, 74, 77, 83, 85, 86, 90

68, 69. 73, 75, 76, 78, 87

110, 111

107

Chapter 17: Adjustment Disorders and Life-Cycle Transitions

Multiple Choice 17.1.1. Donna has experienced what her therapist calls clinically significant symptoms of stress. However, they are not severe enough to warrant classification as one of the mental disorders associated with traumatic stressors. In order for her insurance carrier to pay for her therapy, the therapist must provide a diagnosis. What diagnosis will the therapist report? a. b. c. d.

adjustment disorder acute stress disorder life-cycle transition posttraumatic stress disorder Difficulty: 2 Question ID: 17.1.1 Page Reference: 450 Topic: Overview Skill: Applied Answer: a. adjustment disorder

17.1.2. Adult development is characterized by a. b. c. d.

little change or growth. a sequence of time limited stages. coping with fairly predictable challenges. a series of qualitatively different stages. Difficulty: 1 Question ID: 17.1.2 Page Reference: 450 Topic: Overview Skill: Factual Answer: c. coping with fairly predictable challenges.

17.1.3. Which of the following is characteristic of life-cycle transitions? a. b. c. d.

They involve very little conflict. Few adults ever experience them. They have all the hallmarks of mental disorders. They are struggles in the process of moving from one stage into a new one.

Difficulty: 1 Question ID: 17.1.3 Page Reference: 450 Topic: Overview Skill: Factual Answer: d. They are struggles in the process of moving from one stage into a new one.

17.1.4. Chuck M (case described in the text) illustrates the common theme that Erik Erikson suggested for life-cycle transitions. a. b. c. d.

growth conflict adjustment None of the above were suggested by Erikson. Difficulty: 2 Question ID: 17.1.4 Page Reference: 451 Topic: Overview Skill: Conceptual Answer: b. conflict

17.1.5. In order to meet the DSM-IV-TR definition of an adjustment disorder an individual's experience must meet two conditions: symptoms in response to stress and a. b. c. d.

symptoms not severe enough to be labeled a mental disorder. symptoms severe enough to be labeled a mental disorder. the presence of depression. There is only the one criteria listed in the question. Difficulty: 2 Question ID: 17.1.5 Page Reference: 450 Topic: Overview Skill: Conceptual Answer: a. symptoms not severe enough to be labeled a mental disorder.

17.1.6. Which of the following characterizes Erik Erikson's conceptualization of human development? a. b. c. d.

Role confusion and identity are resolved by age 5. Each stage involves a crisis of the healthy personality. Psychosocial development is finished by young adulthood. Healthy people experience little conflict during adult development.

Difficulty: 1 Question ID: 17.1.6 Page Reference: 451 Topic: Overview Skill: Factual Answer: b. Each stage involves a crisis of the healthy personality.

17.1.7. You need to look up the DSM-IV-TR definition for "partner relational problem." Where should you look? a. b. c. d.

adjustment disorders other conditions that may be a focus of clinical attention stress disorders relational and other interpersonal disorders Difficulty: 2 Question ID: 17.1.7 Page Reference: 450 Topic: Overview Skill: Factual Answer: b. other conditions that may be a focus of clinical attention

17.1.8. How are life-cycle transitions handled in the DSM-IV-TR? a. b. c. d.

listed as causes of depression listed under relationship problems listed as a category of mental disorders listed as other conditions that may be a focus of attention Difficulty: 2 Question ID: 17.1.8 Page Reference: 450 Topic: Overview Skill: Factual Answer: d. listed as other conditions that may be a focus of attention

17.1.9. What do adjustment disorders, acute stress disorders, and posttraumatic disorder share in common? a. b. c. d.

All are Axis II diagnoses. Stress is an etiological factor. The symptoms are similar to depression. Symptoms do not exist for more than six months.

Difficulty: 1 Question ID: 17.1.9 Page Reference: 450 Topic: Overview Skill: Factual Answer: b. Stress is an etiological factor.

17.1.10. Erik Erikson's major contribution to a model of psychosocial development a. b. c. d.

was to introduce the concept of childhood sexuality. was to extend the field of developmental psychology to younger ages, below 1 year. was to extend the field of developmental psychology into adulthood. Erikson accomplished all of the above. Difficulty: 2 Question ID: 17.1.10 Page Reference: 451 Topic: Overview Skill: Conceptual Answer: c. was to extend the field of developmental psychology into adulthood.

17.1.11. What struggle did Erik Erikson view as the primary life task of adolescence? a. b. c. d.

integrity versus despair identity versus role confusion generativity versus stagnation intimacy versus self-absorption Difficulty: 1 Question ID: 17.1.11 Page Reference: 452 Topic: Overview Skill: Factual Answer: b. identity versus role confusion

17.1.12. According to Erik Erikson, the resolution of the identity crisis typically occurs in what developmental stage? a. b. c. d.

childhood adolescence middle age old age

Difficulty: 1 Question ID: 17.1.12 Page Reference: 452 Topic: Overview Skill: Factual Answer: b. adolescence

17.1.13. Erik Erikson viewed the primary life task of young adulthood to be a struggle between a. b. c. d.

integrity and despair. role confusion and identity. generativity and stagnation. intimacy and self-absorption. Difficulty: 2 Question ID: 17.1.13 Page Reference: 452 Topic: Overview Skill: Factual Answer: d. intimacy and self-absorption.

17.1.14. According to Erik Erikson, when does the struggle of generativity versus stagnation occur? a. b. c. d.

adolescence young adulthood middle age old age Difficulty: 1 Question ID: 17.1.14 Page Reference: 452 Topic: Overview Skill: Factual Answer: c. middle age

17.1.15. According to Erik Erikson, the healthy resolution of the last stage of psychosocial development involves a. b. c. d.

a coherent sense of identity. balance between closeness and independence. career achievements and a sense of direction. acceptance of one’s own life cycle.

Difficulty: 2 Question ID: 17.1.15 Page Reference: 452 Topic: Overview Skill: Conceptual Answer: d. acceptance of one’s own life cycle.

17.1.16. According to Erikson's view of adult development, despair comes from a. b. c. d.

superego guilt. a sense of failure. the impossible desire to change the past. biological depression. Difficulty: 2 Question ID: 17.1.16 Page Reference: 452 Topic: Overview Skill: Conceptual Answer: c. the impossible desire to change the past.

17.1.17. According to Daniel Levinson's social model of adult development, the "midlife crisis" involves a. b. c. d.

becoming less driven and more compassionate. conflict between generativity and stagnation. conflict between intimacy and self-absorption. moving away from family and assuming an adult role. Difficulty: 1 Question ID: 17.1.17 Page Reference: 453 Topic: Overview Skill: Factual Answer: a. becoming less driven and more compassionate.

17.1.18. Your professor is telling the class that people need to develop social clocks. Thinking this is an odd phrase, you look it up in your textbook and discover that it refers to a. b. c. d.

how people keep track of their social appointments. the idea that time is a social phenomenon. how people evaluate whether they are on time for age-related goals. the influence that others have on peoples' ability to achieve their goals in a timely manner.

Difficulty: 2 Question ID: 17.1.18 Page Reference: 453 Topic: Overview Skill: Applied Answer: c. how people evaluate whether they are on time for age-related goals.

17.1.19. How would Erik Erikson describe the period of moratorium? a. b. c. d.

intimacy with a sexual partner hard work and financial independence uncertainty and experimentation with different roles balance between independence and closeness with parents Difficulty: 1 Question ID: 17.1.19 Page Reference: 453 Topic: The Transition to Adulthood Skill: Factual Answer: c. uncertainty and experimentation with different roles

17.1.20. According to Erik Erikson, why do teens need to experiment with different roles? a. b. c. d.

to avoid moratorium to find a unique niche in society to ease their separation from their parents to distract parents from their own conflicts Difficulty: 2 Question ID: 17.1.20 Page Reference: 454 Topic: The Transition to Adulthood Skill: Conceptual Answer: b. to find a unique niche in society

17.1.21. What question seems to summarize the conflict of adolescence as viewed by Erik Erikson? a. b. c. d.

"Who am I?" "Is life worth living?" "Is there meaning to life?" "How much money can I accumulate?"

Difficulty: 1

Question ID: 17.1.21 Page Reference: 452 Topic: The Transition to Adulthood Skill: Factual Answer: a. "Who am I?"

17.1.22. According to ego psychologist Karen Horney, why do adolescents experience conflict with their parents? a. b. c. d.

They are in a developmental stage of despair. They have not yet achieved a stable identity. They are insecurely attached to their parents. They experience competing needs with respect to their parents. Difficulty: 2 Question ID: 17.1.22 Page Reference: 454 Topic: The Transition to Adulthood Skill: Conceptual Answer: d. They experience competing needs with respect to their parents.

17.1.23. Researchers used beepers to signal adolescents and adults at various times to assess their emotional states. Compared to adults, they found that young people between the ages of 13 and 18 tend to experience a. b. c. d.

more stable moods than adults. more intense moods than adults. less intense moods than adults. similar emotional experiences to adults. Difficulty: 2 Question ID: 17.1.23 Page Reference: 454 Topic: The Transition to Adulthood Skill: Conceptual Answer: b. more intense moods than adults.

17.1.24. How does DSM-IV-TR address the problem of "identity disorder"? a. b. c. d.

It is listed under adjustment disorders. It was replaced with the term dissociative identity disorder. It was listed in an earlier edition but is no longer listed as a disorder. It is listed as a disorder usually first diagnosed in adolescence. Difficulty: 1

Question ID: 17.1.24 Page Reference: 455 Topic: The Transition to Adulthood Skill: Factual Answer: c. It was listed in an earlier edition but no longer listed as a disorder.

17.1.25. How would we describe a teen with identity diffusion? a. b. c. d.

in the middle of an identity crisis not actively seeking new adult roles actively searching for new adult roles never questioned his childhood identity Difficulty: 1 Question ID: 17.1.25 Page Reference: 455 Topic: The Transition to Adulthood Skill: Factual Answer: b. not actively seeking new adult roles

17.1.26. At age 10, Joseph decided to become a priest. By age 20 he had never considered any other options or questioned his earlier decision. What term is used to by some psychologists to describe this style of coping with identity conflict? a. b. c. d.

identity diffusion identity moratorium identity achievement identity foreclosure Difficulty: 2 Question ID: 17.1.26 Page Reference: 455 Topic: The Transition to Adulthood Skill: Conceptual Answer: d. identity foreclosure

17.1.27. Rebecca is a college graduate who has made decisions about her long-term goals. What does research tell us about where she may be in terms of Erikson's view of development? a. Rebecca probably is an identity achiever and she has increased confidence in social interactions. b. Rebecca is in a stage of identity moratorium and will probably remain there until she finds a job. c. Rebecca has probably reached a level of identity characterized by a high degree of generativity. d. Like most college students, Rebecca has delayed the establishment of an identity and it shows in her impulsive behavior.

Difficulty: 2 Question ID: 17.1.27 Page Reference: 455 Topic: The Transition to Adulthood Skill: Applied Answer: a. Rebecca probably is an identity achiever and she has increased confidence in social interactions. 17.1.28. In the 1960s, many college students were considered to have an identity status called alienated identity achievement. How could we describe these individuals? a. b. c. d.

They did not assume an adult role. They experienced identity diffusion. They remained in a period of moratorium. They had an adult identity that conflicted with society's values. Difficulty: 1 Question ID: 17.1.28 Page Reference: 454 Topic: The Transition to Adulthood Skill: Factual Answer: d. They had an adult identity that conflicted with society's values.

17.1.29. While surfing the net you come across the term "forgotten half," which you found leads to a Web site. What population might this Web site attract? a. b. c. d.

the elderly who live alone women who do not work outside of the home adolescents and young adults who do not go to college young people who are in the bottom half of their classes in term of achievement Difficulty: 1 Question ID: 17.1.29 Page Reference: 454 Topic: The Transition to Adulthood Skill: Factual Answer: c. adolescents and young adults who do not go to college

17.1.30. In 2008 approximately what percentage of black males and females were neither in school nor employed? a. b. c. d.

5. 10. 20. 30. Difficulty: 2

Question ID: 17.1.30 Page Reference: 455 Topic: The Transition to Adulthood Skill: Conceptual Answer: c. 20.

17.1.31. What is one of the criticisms of Erik Erikson's views on adult psychosocial development? a. b. c. d.

ignores old age ignores intrapsychic processes ignores the importance of relationships for women's identity focuses on conflicts rather than pleasant aspects of growth Difficulty: 1 Question ID: 17.1.31 Page Reference: 456 Topic: The Transition to Adulthood Skill: Factual Answer: c. ignores the importance of relationships for women's identity

17.1.32. What treatment approach do many clinicians suggest for those experiencing distress associated with transitions to adult life? a. b. c. d.

psychoanalytic behavioral supportive and nondirective challenging and confrontational Difficulty: 2 Question ID: 17.1.32 Page Reference: 456 Topic: The Transition to Adulthood Skill: Applied Answer: c. supportive and nondirective

17.1.33. Family transitions are major changes in family life and family relationships that typically involve a. b. c. d.

coping with some type of mental disorder. the addition or loss of members of a family household. a need to change the communication patterns within the family. major changes in the personality structure of members of the family. Difficulty: 1 Question ID: 17.1.33

Page Reference: 457 Topic: Family Transitions Skill: Factual Answer: b. the addition or loss of members of a family household.

17.1.34. Social scientists often conceptualize family change in terms of the developmental course of family relationships that they label a. b. c. d.

family stages. family life cycle. psychosexual stages. None of the above are correct. Difficulty: 1 Question ID: 17.1.34 Page Reference: 457 Topic: Family Transitions Skill: Factual Answer: b. family life cycle.

17.1.35. What does the textbook suggests about the relationship between the age of children in a family and family conflict? a. b. c. d.

There is no significant relationship between children's ages and marital satisfaction. Marital satisfaction increases with the birth of children and falls when those children leave home. Marital satisfaction declines with the birth of children and rises when those children leave home. None of the above are accurate. Difficulty: 2 Question ID: 17.1.35 Page Reference: 457 Topic: Family Transitions Skill: Conceptual

Answer: c. Marital satisfaction declines with the birth of children and rises when those children leave home.

17.1.36. Psychologists are not so much interested in the content of family struggles as the process. They have focused their attention on what types of struggles? a. b. c. d.

dominance and subservience intergenerational and cross-generational financial and relational power and intimacy Difficulty: 2

Question ID: 17.1.36 Page Reference: 458 Topic: Family Transitions Skill: Conceptual Answer: d. power and intimacy

17.1.37. As a couples therapist, when you start working with a family that is experiencing a lot of conflict you are on the look out for a commonly observed pattern of a. b. c. d.

social isolation. demand and withdrawal. familial withdrawal. All of the above are noted in the textbook. Difficulty: 2 Question ID: 17.1.37 Page Reference: 458 Topic: Family Transitions Skill: Applied Answer: b. demand and withdrawal.

17.1.38. A psychologist is trying to understand the level of cooperation and conflict evident in the social exchanges of a family. This psychologist is focusing on a. b. c. d.

reciprocity. boundaries. roles. rules. Difficulty: 1 Question ID: 17.1.38 Page Reference: 458 Topic: Family Transitions Skill: Conceptual Answer: a. reciprocity.

17.1.39. You are a family therapist in a first interview with a couple. You note a style of communication that has been seen in couples who are basically unhappily married. This indicator is a. b. c. d.

their expression of anger to each other. their tendency to blame their conflict on each other’s personality. their tendency to blame their conflict on circumstances. All of the above are mentioned in the textbook as warning signs. Difficulty: 2

Question ID: 17.1.39 Page Reference: 458 Topic: Family Transitions Skill: Applied Answer: b. their tendency to blame their conflict on each other’s personality.

17.1.40. Marital conflict and distress tend to be associated with an increased risk for the development of which disorder among women? a. b. c. d.

depression bipolar dissociative fugue generalized anxiety Difficulty: 1 Question ID: 17.1.40 Page Reference: 458 Topic: Family Transitions Skill: Factual Answer: a. depression

17.1.41. Frank and Consuela are happily married, while Tyrone and Amanda are unhappily married. Both couples have been having some disputes lately. Frank and Consuela are likely to blame their disputes on ________, while Tyrone and Amanda blame their disputes on ________. a. b. c. d.

the other's personality; temporary circumstances temporary circumstances; the other's personality their children; their finances their finances; their children Difficulty: 2 Question ID: 17.1.41 Page Reference: 458 Topic: Family Transitions Skill: Conceptual Answer: b. temporary circumstances; the other's personality

17.1.42. Which of the following is an example of a scapegoating pattern of family relationships? a. b. c. d.

One family member is blamed for all the family problems. One family member bullies another family member out of jealousy. One family member complains of problems that are denied by other family members. One family member takes on all the responsibility for solving the family's problems. Difficulty: 1

Question ID: 17.1.42 Page Reference: 459 Topic: Family Transitions Skill: Factual Answer: a. One family member is blamed for all the family problems.

17.1.43. Theorists who have proposed that the classification of troubled relationships should replace the diagnosis of individuals base this proposal on their belief that a. b. c. d.

diagnosing individuals stigmatizes them. relationships can be classified more reliably than individuals. troubled relationships last longer and thus can be more easily classified. psychological problems reside in the individual's relationships. Difficulty: 2 Question ID: 17.1.43 Page Reference: 459 Topic: Family Transitions Skill: Conceptual Answer: d. psychological problems reside in the individual's relationships.

17.1.44. The textbook reports that in 2007 approximately what percentage of births in the United States were to unmarried women? a. b. c. d.

10 percent 20 percent 40 percent 60 percent Difficulty: 2 Question ID: 17.1.44 Page Reference: 459 Topic: Family Transitions Skill: Factual Answer: c. 40 percent

17.1.45. Why have divorce rates declined since the early 1980s? a. The average age of the population is getting older. b. There have been increases in nonmarital childbearing and cohabitation. c. State governments have mandated pre-marital programs to help reduce the divorce rates. d. More ministers are refusing to perform marriages for couples that have not known each other for a significant amount of time, and governments have raised the age at which someone can get married. Difficulty: 1

Question ID: 17.1.45 Page Reference: 459 Topic: Family Transitions Skill: Conceptual Answer: b. There have been increases in nonmarital childbearing and cohabitation.

17.1.46. The textbook reports an estimate that out of a sample of 100 marriages occurring today, how many would be expected to end in divorce? a. b. c. d.

20 40 60 80 Difficulty: 1 Question ID: 17.1.46 Page Reference: 459 Topic: Family Transitions Skill: Factual Answer: b. 40

17.1.47. Behavior geneticists study the concordance rates of monozygotic (MZ) and dizygotic (DZ) twins to estimate the environmental and genetic influences on behavior. Which of the following provides evidence for an environmental impact on behavior? a. b. c. d.

MZ concordance rates less than 100 percent DZ concordance rates less than 100 percent MZ concordance rates greater than DZ concordance rates DZ concordance rates greater than MZ concordance rates Difficulty: 2 Question ID: 17.1.47 Page Reference: 461 Topic: Family Transitions Skill: Applied Answer: a. MZ concordance rates less than 100 percent

17.1.48. What is one of the limitations in the use of a heritability ratio? a. b. c. d.

It cannot be generalized to the whole population. It reflects only theoretically diverse environments. Its calculation ignores environmental variance in a sample. It can only be used to describe biological characteristics. Difficulty: 2

Question ID: 17.1.48 Page Reference: 461 Topic: Family Transitions Skill: Conceptual Answer: a. It cannot be generalized to the whole population.

17.1.49. John Gottman, a researcher on marital interaction, has described one pattern of problematic communication called stonewalling. How would he describe this pattern? a. b. c. d.

One spouse is consistently isolated and withdrawn. One spouse is consistently insulting to the other spouse. One spouse attacks the other's personality rather than actions. One spouse denies responsibility for marital difficulties. Difficulty: 2 Question ID: 17.1.49 Page Reference: 460 Topic: Family Transitions Skill: Factual Answer: a. One spouse is consistently isolated and withdrawn.

17.1.50. Based on observations of marital interactions, John Gottman classified four problematic communication styles. How would he describe the problem labeled as contempt? a. b. c. d.

A spouse shows disinterest in the marriage. A spouse is consistently isolated and withdrawn. A spouse hurls angry insults at the other spouse. A spouse denies responsibility for the marital problem. Difficulty: 1 Question ID: 17.1.50 Page Reference: 460 Topic: Family Transitions Skill: Factual Answer: c. A spouse hurls angry insults at the other spouse.

17.1.51. Compared to more traditional unions, what has research shown concerning marriages in which both spouses are androgynous? a. b. c. d.

The marriage is happier and less distressed. There are virtually no differences in stress or communications. The marriage is less happy and more distressed. There is less stress initially but the level of stress rises dramatically. Difficulty: 2

Question ID: 17.1.51 Page Reference: 460 Topic: Family Transitions Skill: Conceptual Answer: a. The marriage is happier and less distressed.

17.1.52. Which process is thought to mediate genetic influences on divorce? a. b. c. d.

Twins rarely divorce. Divorced couples produce fewer offspring. Genes influence personality traits associated with divorce. Unmarried couples reproduce at lower rates than married couples. Difficulty: 2 Question ID: 17.1.52 Page Reference: 462 Topic: Family Transitions Skill: Conceptual Answer: c. genes influence personality traits associated with divorce

17.1.53. Which of the following is an example of how environments are partially heritable? a. b. c. d.

a child is raised in her parents' home a shy person chooses to work in a library communities are segregated by socioeconomic status one's genetic background is related to one's cultural background Difficulty: 2 Question ID: 17.1.53 Page Reference: 462 Topic: Family Transitions Skill: Conceptual Answer: b. a shy person chooses to work in a library

17.1.54. Researchers responsible for the study of the genetic factors on divorce have been invited to share their research at a conference that you are attending. As you listen to their studies it is very important to remember that a. b. c. d.

most studies in this area are experiments that tell you very little about correlation. most studies in this field are biases by conflict of interest. correlational studies are the best source of information about what causes what. correlational studies do not give you information about what causes what. Difficulty: 2 Question ID: 17.1.54

Page Reference: 460 Topic: Family Transitions Skill: Applied Answer: d. correlational studies do not give you information about what causes what. 17.1.55. McGue and Lykken found that for divorce the concordance rates were a. b. c. d.

higher for DZ twins than MZ twins. higher for MZ twins than for DZ twins. very similar for DZ and MZ twins. impossible to calculate with any accuracy for twins. Difficulty: 2 Question ID: 17.1.55 Page Reference: 462 Topic: Family Transitions Skill: Factual Answer: b. higher for MZ twins than for DZ twins.

17.1.56. What is one reason that the higher concordance rates for divorce among monozygotic (MZ) compared to dizygotic (DZ) twins do not necessarily demonstrate genetic contributions? a. b. c. d.

MZ and DZ twins may not share the same trait-relevant environment. Both MZ and DZ twins may be subject to social influence. There may be a higher divorce rate among parents of MZ twins. There may be a higher divorce rate among parents of DZ twins. Difficulty: 3 Question ID: 17.1.56 Page Reference: 462 Topic: Family Transitions Skill: Applied Answer: a. MZ and DZ twins may not share the same trait-relevant environment.

17.1.57. The Premarital Relationship Enhancement Program (PREP) involves couples meeting in small groups to discuss marital relations and to learn communication skills. What has research revealed concerning the effectiveness of this program? a. Couples that go through this program report higher marital satisfaction than control couples. b. Couples that go through this program report less marital satisfaction than controls three years later. c. Couples that go through this program report more satisfaction, but also more conflict than controls. d. Despite the best of intentions of its developers, the program has little effect on marital satisfaction. Difficulty: 1 Question ID: 17.1.57

Page Reference: 462 Topic: Family Transitions Skill: Factual Answer: a. Couples that go through this program report higher marital satisfaction than control couples.

17.1.58. Typically, a marital therapist's work involves helping spouses to a. b. c. d.

identify and voice disagreements. save their marriage and avoid divorce. address one partner's problem behavior. avoid disagreements and focus on the positive. Difficulty: 1 Question ID: 17.1.58 Page Reference: 463 Topic: Family Transitions Skill: Conceptual Answer: a. identify and voice disagreements.

17.1.59. Which of the following describes the effectiveness of cognitive behavioral couple therapy that addresses communication styles and problem solving? a. b. c. d.

very little relapse less effective than individual therapy leads to significant improvements very significant short and long term improvement Difficulty: 1 Question ID: 17.1.59 Page Reference: 464 Topic: Family Transitions Skill: Factual Answer: c. leads to significant improvements

17.1.60. What is the focus of cognitive behavioral marital therapy? a. b. c. d.

changing one partner's psychopathology improving the couple's communication and problem solving talking about the marriage in individual therapy changing how parents act toward their troubled child

Difficulty: 2 Question ID: 17.1.60

Page Reference: 464 Topic: Family Transitions Skill: Conceptual Answer: b. improving the couple's communication and problem solving

17.1.61. Your friend has been having some psychological problems, and he tells you that he and his wife are seeing a couples therapist. You are surprised that he is receiving couples therapy, since he is the one with problems. When you ask your psychology professor about this, she explains that a. b. c. d.

there must have been some mistake. successful couples therapy can remove the cause of an individual spouse's problem. your friend was probably resistant to individual therapy and couples therapy is less threatening. your friend's problems must actually be marital problems, not individual problems. Difficulty: 2 Question ID: 17.1.61 Page Reference: 463-464 Topic: Family Transitions Skill: Applied Answer: b. successful couples therapy can remove the cause of an individual spouse's problem.

17.1.62. Ageism refers to a. b. c. d.

changes as one grows older. prejudice against the elderly. the study of aging and the elderly. the incorporation of age norms in research. Difficulty: 1 Question ID: 17.1.62 Page Reference: 465 Topic: The Transition to Later Life Skill: Factual Answer: b. prejudice against the elderly.

17.1.63. What has research discovered concerning the personality among elderly people? a. b. c. d.

They tend to be less inwardly focused. They are more irritable and complaining. They are greatly affected by depression and anxiety. They are similar to the personality shown in middle age.

Difficulty: 1

Question ID: 17.1.63 Page Reference: 465 Topic: The Transition to Later Life Skill: Conceptual Answer: d. They are similar to the personality shown in middle age.

17.1.64. The cessation of menstruation is called a. b. c. d.

menarche. menopause. moratorium. maturation. Difficulty: 1 Question ID: 17.1.64 Page Reference: 465 Topic: The Transition to Later Life Skill: Factual Answer: b. menopause.

17.1.65. Hormone (estrogen) replacement therapy during menopause is effective for reducing a. b. c. d.

depression. infertility. cancer risk. physical symptoms. Difficulty: 2 Question ID: 17.1.65 Page Reference: 465 Topic: The Transition to Later Life Skill: Conceptual Answer: d. physical symptoms.

17.1.66. How are estrogen levels during menopause related to depression? a. b. c. d.

The depression reduces the estrogen levels. Decreased estrogen begins a long chain of biological changes that lead to depression. Lower levels of estrogen lead to the symptoms of depression. Estrogen levels and depression are not related.

Difficulty: 1 Question ID: 17.1.66

Page Reference: 465 Topic: The Transition to Later Life Skill: Factual Answer: d. Estrogen levels and depression are not related.

17.1.67. Which of the following individuals is most likely to suffer from osteoporosis? a. b. c. d.

Jill, who is 24 years old Jack, who is 56 years old Betty, who is 71 years old Diane, who is 18 years old Difficulty: 2 Question ID: 17.1.67 Page Reference: 466 Topic: The Transition to Later Life Skill: Conceptual Answer: c. Betty, who is 71 years old

17.1.68. You are a psychologist assigned to assess older individuals in a community centre. Given the research you will be looking for predictors of psychological well-being such as a. b. c. d.

signs of Erikson's concept of integrity. positive relationships. comfort with living alone. None of the above are supported by research. Difficulty: 2 Question ID: 17.1.68 Page Reference: 466 Topic: The Transition to Later Life Skill: Applied Answer: b. positive relationships.

17.1.69. What conclusion was drawn by the authors about the case of Mrs. J, who had great difficulty accepting her loss? He husband had died in a nursing home that Mrs. J. believed to be inadequate. She was referred because of her anger over this and her inability to stop thinking about it. a. b. c. d.

Hers was an example of pathological depression. Her reaction was seen as normal grieving. She was diagnosed as clinically grieving. She was an example of grief compounded by OCD.

Difficulty: 2

Question ID: 17.1.69 Page Reference: 467 Topic: The Transition to Later Life Skill: Applied Answer: b. Her reaction was seen as normal grieving.

17.1.70. A specific form of grieving in response to the death of a loved one is known as a. b. c. d.

grieving. loss. bereavement. reactive depression. Difficulty: 1 Question ID: 17.1.70 Page Reference: 467 Topic: The Transition to Later Life Skill: Factual Answer: c. bereavement.

17.1.71. Which is one of the reasons that older people have fewer friendships? a. b. c. d.

They become more irritable and demanding. They have lost most of the people they once cared about. They become more selective in their companions. They spend more time with their family. Difficulty: 2 Question ID: 17.1.71 Page Reference: 467 Topic: The Transition to Later Life Skill: Conceptual Answer: c. They become more selective in their companions.

17.1.72. What is bereavement? a. b. c. d.

a form of clinical depression a period of adjustment to old age a specific form of grief about death a process of coping with any separation or loss Difficulty: 1 Question ID: 17.1.72

Page Reference: 467 Topic: The Transition to Later Life Skill: Factual Answer: c. a specific form of grief about death 17.1.73. Mrs. Pallagio's husband died at age 70. For the next year, she finds herself thinking about him constantly. Every night she talks out loud to his photo. How would a clinical psychologist describe these behaviors? a. b. c. d.

a normal part of grieving a sign of delusional thinking a sign of abnormal obsessions evidence of an abnormal lack of anger Difficulty: 2 Question ID: 17.1.73 Page Reference: 468 Topic: The Transition to Later Life Skill: Applied Answer: a. a normal part of grieving

17.1.74. What element is important in both the Bowlby and Kubler-Ross models of bereavement? a. b. c. d.

anger bargaining moratorium identity crisis Difficulty: 1 Question ID: 17.1.74 Page Reference: 467-468 Topic: The Transition to Later Life Skill: Conceptual Answer: a. anger

17.1.75. After reviewing the literature on the model of bereavement proposed by Kubler-Ross, what would researchers conclude about the validity of the model? a. There are actually more stages than proposed by Kubler-Ross. b. Many people do not go through the stages in the sequence proposed and some show no signs of any of the stages. c. Men, but not women, seem to proceed through the stages in different orders and at different speeds. d. The bargaining stage does not occur very often because most people realize the futility of such a response.

Difficulty: 2

Question ID: 17.1.75 Page Reference: 468 Topic: The Transition to Later Life Skill: Applied Answer: b. Many people do not go through the stages in the sequence proposed and some show no signs of any of the stages.

17.1.76. The textbook suggests that if you had a patient who just lost a loved one you would be most concerned about an adverse reaction if a. b. c. d.

they lost a parent. they lost their spouse. they lost a child. The book suggests that all three would tend to generate the same type of emotional reaction. Difficulty: 2 Question ID: 17.1.76 Page Reference: 468 Topic: The Transition to Later Life Skill: Applied Answer: c. they lost a child.

17.1.77. Which of the following is most accurate as to the rate of affective disorders in younger vs. older Americans? a. Affective disorders are more common in older adults. b. Affective disorders are more common in younger adults. c. Younger adults and older adults experience affective disorders at about the same rate. d. The rates are about the same for two age groups except for older males who have a very high rate of affective disorders. Difficulty: 2 Question ID: 17.1.77 Page Reference: 468 Topic: The Transition to Later Life Skill: Conceptual Answer: b. Affective disorders are more common in younger adults.

17.1.78. An epidemiologist has received a grant to survey the elderly population to determine the prevalence of mental disorders. Based on existing research, which disorder would you predict has the highest prevalence among the elderly? a.

anxiety

b. c. d.

depression schizophrenia cognitive disorder Difficulty: 2 Question ID: 17.1.78 Page Reference: 468 Topic: The Transition to Later Life Skill: Applied Answer: d. cognitive disorder

17.1.79. The rates for completed suicide among the elderly a. b. c. d.

are the lowest of any age group. are the highest of any age group. are low overall but very high for rational suicide. are high but have been steadily declining for years. Difficulty: 1 Question ID: 17.1.79 Page Reference: 468 Topic: The Transition to Later Life Skill: Factual Answer: b. are the highest of any age group.

17.1.80. The multidisciplinary study of aging is known as a. b. c. d.

ageism. gerontology. moratorium studies. life-cycle studies. Difficulty: 1 Question ID: 17.1.80 Page Reference: 468 Topic: The Transition to Later Life Skill: Factual Answer: b. gerontology.

17.1.81. Most elderly people fall in which category? a. b. c. d.

young young-old old-old oldest-old

Difficulty: 1 Question ID: 17.1.81 Page Reference: 469 Topic: The Transition to Later Life Skill: Factual Answer: b. young-old

17.1.82. How do gerontologists define individuals who fall within the classification called "young-old?" a. b. c. d.

over age 55 young adults in nursing homes age in the 60s and 70s, in good health young adults with health problems and stubborn personalities Difficulty: 1 Question ID: 17.1.82 Page Reference: 469 Topic: The Transition to Later Life Skill: Factual Answer: c. age in the 60s and 70s, in good health

17.1.83. The most significant trend in the average age of the United States population in the next 30 years is due to a. b. c. d.

baby boom generation reaching old age. medical advances increasing the number of older and frail adults. immigration of young families resulting in a younger population. divorce and remarriage resulting in more children and a younger population. Difficulty: 2 Question ID: 17.1.83 Page Reference: 469 Topic: The Transition to Later Life Skill: Conceptual Answer: a. baby boom generation reaching old age.

17.1.84. The proportion of the population of the United States age 65 and older should peak in what year? a. b. c. d.

It already has, 2008. 2020 2030 It will increase into the foreseeable future.

Difficulty: 2 Question ID: 17.1.84 Page Reference: 469 Topic: The Transition to Later Life Skill: Factual Answer: c. 2030

17.1.85. Which of the following is accurate? a. b. c. d.

The ratio of men to women increases with age. The ratio of women to men increases with age. The ratio of women to men increases until age 75 and then decreases. None of the above are accurate. Difficulty: 2 Question ID: 17.1.85 Page Reference: 470 Topic: The Transition to Later Life Skill: Conceptual Answer: b. The ratio of women to men increases with age.

17.1.86. The percentage of older Americans living in poverty a. b. c. d.

increases with advancing age. decreases with advancing age. stays about the same with advancing age. is currently impossible to assess due to the confidentiality of census information. Difficulty: 2 Question ID: 17.1.86 Page Reference: 470 Topic: The Transition to Later Life Skill: Conceptual Answer: a. increases with advancing age.

17.1.87. A greater emphasis on health behaviors among the elderly in the United States should have a significant effect on a. b. c. d.

extending their life spans. reducing their rate of suicide. reducing their rate of illness and infirmity. improving the conditions of nursing homes.

Difficulty: 2 Question ID: 17.1.87 Page Reference: 470 Topic: The Transition to Later Life Skill: Applied Answer: c. reducing their rate of illness and infirmity.

17.1.88. Among men over 70, which of the following is most frequently listed as making a positive contribution to their quality of life? a. b. c. d.

financial security good health an active lifestyle relationships with family and friends Difficulty: 1 Question ID: 17.1.88 Page Reference: 470 Topic: The Transition to Later Life Skill: Factual Answer: d. relationships with family and friends

17.1.89. Which social factor is thought to moderate the ill effects of bereavement? a. b. c. d.

avoidance of remarriage moving into a nursing home religious affiliation and involvement family members encouraging self-sufficiency Difficulty: 1 Question ID: 17.1.89 Page Reference: 470 Topic: The Transition to Later Life Skill: Factual Answer: c. religious affiliation and involvement

17.1.90. You have decided to major in the field of health psychology and are considering focusing on the elderly. Your chosen subdiscipline would be a. b. c. d.

cognitve-behavioral analysis of aging. gerontological psychology. behavioral gerontology. There is no subdiscipline for this focus. Difficulty: 1

Question ID: 17.1.90 Page Reference: 470 Topic: The Transition to Later Life Skill: Conceptual Answer: c. behavioral gerontology.

17.1.91. Which of the following treatments for depression seem to be more effective among older than among younger people? a. b. c. d.

group therapy psychodynamic therapy cognitive behavior therapy electroconvulsive treatment Difficulty: 1 Question ID: 17.1.91 Page Reference: 470 Topic: The Transition to Later Life Skill: Factual Answer: d. electroconvulsive treatment

17.1.92. What are legal documents that direct health care professionals not to perform certain procedures in order to keep a terminally ill or severely disabled patient alive. a. b. c. d.

wills death wills living wills terminal wills Difficulty: 1 Question ID: 17.1.92 Page Reference: 470 Topic: The Transition to Later Life Skill: Factual Answer: c. living wills

Short Answer 17.2.93. If you are experiencing significant psychological symptoms in response to stress, but those symptoms aren’t severe enough to warrant a diagnosis as a mental disorder, the DSM-IV-TR has a classification for you under what type of disorders? __________ . Difficulty: 1 Question ID: 17.2.93

Page Reference: 450 Topic: Overview Skill: Factual Answer: adjustment

17.2.94. For Erik Erikson getting some sense of "who you are" brings resolution to what type of crisis? __________ Difficulty: 1 Question ID: 17.2.94 Page Reference: 451 Topic: Overview Skill: Factual Answer: identity

17.2.95. Erik Erikson suggested that young people need a period of time that involves uncertainty about themselves and their futures which he labeled a(n) __________ . Difficulty: 1 Question ID: 17.2.95 Page Reference: 453 Topic: The Transition to Adulthood Skill: Factual Answer: moratorium

17.2.96. In genetic studies the formula variance due to genetic factors/Total variance is called the __________ ratio. Difficulty: 2 Question ID: 17.2.96 Page Reference: 461 Topic: Family Transitions Skill: Factual Answer: heritability

17.2.97. A nonrandom association between inborn propensities and environmental experience is referred to as the __________ - __________ correlation. Difficulty: 2 Question ID: 17.2.97 Page Reference: 460 Topic: Family Transitions Skill: Factual

Answer: gene - environment

17.2.98. Social misunderstanding and prejudice against older individuals is labeled __________ . Difficulty: 1 Question ID: 17.2.98 Page Reference: 465 Topic: The Transition to Later Life Skill: Factual Answer: ageism

17.2.99. ____________ is the cessation of menstruation in women. Difficulty: 1 Question ID: 17.2.99 Page Reference: 465 Topic: The Transition to Later Life Skill: Factual Answer: Menopause

17.2.100. Hormone replacement therapy in women generally involves replacing depleted suplies of __________ . Difficulty: 1 Question ID: 17.2.100 Page Reference: 465 Topic: The Transition to Later Life Skill: Factual Answer: estrogen

17.2.101. Researchers have just begun to study the phenomenon of remembering and recounting experiences from the distant past. In the elderly this is called __________ .

Difficulty: 2 Question ID: 17.2.101 Page Reference: 466 Topic: The Transition to Later Life Skill: Factual Answer: reminiscing and reminiscence

17.2.102. ____________ is the multidisciplinary study of aging. Difficulty: 1 Question ID: 17.2.102 Page Reference: 468 Topic: The Transition to Later Life Skill: Factual Answer: Gerontology

Essay 17.3.103. Theories on stages of adult psychosocial development are useful, but must be considered with caution. Explain why. Difficulty: 2 Question ID: 17.3.103 Page Reference: 453 Topic: Overview Skill: Conceptual Answer: Each theory was developed in cultural, historical, and personal contexts that influence the definition of what is normal. Although these theories usually describe adult development as occurring in a sequence of stages, research shows that the order of transitions is not predictable. Once the problems of one stage are resolved, they may again become problems later. Finally, there is evidence that men and women might follow different developmental paths, but these differences typically are not addressed by stage theories of adult development.

17.3.104. What is the cross-cultural evidence on adolescent identity crisis? Difficulty: 2 Question ID: 17.3.104 Page Reference: 452-453 Topic: The Transition to Adulthood Skill: Conceptual Answer: There is some evidence to support some aspects of these models. Individuals identified as identity achievers are less conforming and more confident in social settings. An identity crisis during adolescence may be a phenomenon limited to modern industrialized societies. Affluence, education, and alternative treatments make options possible. In less developed countries, one's role is often decided by one's parents or by economic pressures and lack of options. There are also considerable differences in gender roles across cultures that can influence identity. For example in many cultures a woman’s identity is expected to develop as a result of her marriage and familial roles, not the other way around.

17.3.105. Describe the type of emotional reciprocity found in families with happy relationships compared to those found in families with troubled relationships.

Difficulty: 2 Question ID: 17.3.105 Page Reference: 458 Topic: Family Transitions Skill: Conceptual Answer: Happy families reciprocate pleasantness and ignore negativity in each other. Troubled families ignore pleasantness or see it as manipulative, and reciprocate negativity. An example of a troublesome pattern in families is called demand and withdrawal in which women become increasingly demanding and men withdraw from family communication.

17.3.106. Discuss the argument put forward by some theorists for classifying troubled relationships not just troubled individuals as the current DSM does. Difficulty: 2 Question ID: 17.3.106 Page Reference: 459 Topic: Family Transitions Skill: Conceptual Answer: A current consideration as the DSM-V is being developed is to include a category for “relational disorders.” In this scheme some disorders of childhood such as certain externalizing disorders would be replace by relational disorders such as ineffective parenting. The argument suggests that in some cases the individual behavior, especially of children, is a reaction to relational conditions established not by the individual, but by their circumstances or parental behavior. An example of this type of interactional pattern is one seen in certain families that is labeled “scapegoating” in which one member of the family is identified as the cause of family problems in order for others to avoid responsibility.

17.3.107. Discuss the research findings on the issue of reminiscence in older adults. Difficulty: 2 Question ID: 17.3.107 Page Reference: 466 Topic: The Transition to Later Life Skill: Applied Answer: Reminiscing, sometimes called life review, is a common phenomenon in older adults. Researchers Wong and Watt have developed a taxonomy of different categories of reminiscences. One category is integrative reminiscence in which an individual talks about her or his past in order to achieve some reconciliation of the past. Obsessive reminiscences, on the other hand, focus on a preoccupation with failure and guilt. Evidence indicates that integrative reminiscence is related to successful aging, whereas obsessive reminiscence is associated with less successful adjustment in later life. What is unclear is whether this is cause or effect. It could be that having lived a successful life one tends to talk about it in a positive light and vice versa.

17.3.108. What are the four basic communication problems John Gottman found in his research on marital communication? Difficulty: 2 Question ID: 17.3.108 Page Reference: 460 Topic: Family Transitions Skill: Conceptual Answer: The four are: criticism, contempt, defensiveness, and stonewalling. Criticism is a statement like "You are unimaginative and boring!" A more adaptive complaint is "I wish we could do something different once in a while." Contempt is an insult that may be motivated by anger and is intended to hurt the other person. Defensiveness is a form of self-justification such as denying responsibility, blaming the other person, or "yes-butting"—for example, "Okay, I understand how you feel, but ..." Stonewalling is a pattern of isolation and withdrawal. Complaints are ignored, and for all practical purposes, communication is nonexistent.

17.3.109. Explain how heritability might play a role in divorce, and give an example. Difficulty: 2 Question ID: 17.3.109 Page Reference: 462 Topic: Family Transitions Skill: Conceptual Answer: Twin studies show that the concordance rates for divorce are dramatically higher for MZ twins than for DZ twins, indicating that divorce is partly explained by genetic factors. Even though divorce is commonly assumed to be determined purely by psychological and social factors, behavior geneticists have emphasized that environmental events do not occur at random. There is a geneenvironment correlation, a nonrandom association between inborn propensities and environmental experience. For example, a divorce may be partly determined by impulsivity, which in turn is influenced by genes. McGue and Lykken speculated that divorce may be a consequence of personality factors that are partially shaped by genetics—for example, a tendency toward antisocial behavior.

17.3.110. What are the five stages of bereavement outlined by Elizabeth Kubler-Ross? What is one of the criticisms of this approach? Difficulty: 2 Question ID: 17.3.110 Page Reference: 467-468 Topic: The Transition to Later Life Skill: Conceptual Answer: The five stages are: denial, anger, bargaining, depression, and acceptance. Researchers have questioned whether bereavement follows any clear-cut series of stages. Few people seem to

experience grief in a fixed sequence of stages, many individuals experience some of the stages but not all and in different orders, and some individuals experience none of the stages as outlined by Kubler-Ross.

17.3.111. Define a living will and discuss the explanation for their efficacy in increasing quality of life in older adults. Difficulty: 2 Question ID: 17.3.111 Page Reference: 470 Topic: The Transition to Later Life Skill: Conceptual Answer: A living will is a legal document allowed in some states that instructs health care professionals not carry out certain life saving procedures on terminally ill or severely handicapped individuals. They are seen as an attempt to humanize and dignify the process of dying. In many cases elderly individuals have accepted death as inevitable and choose quality of life over sheer quantity.

Chapter 18 Mental Health and the Law Total Assessment Guide (T.A.G.) Topic Overview pp. 473-476

Mental Illness and Criminal Responsibility pp. 476-483 Civil Commitment pp. 483-491

Mental Health and Family Law pp. 491-494 Professional Responsibilities and the Law pp. 494-496

Question Type Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay Multiple Choice Short Answer Essay

Factual

Conceptual

2, 3, 5, 6

71, 73

7, 10, 14, 15, 20, 21, 25 74, 75, 76 28, 32, 33, 34, 35, 37, 40, 41, 47, 51, 52 77, 78, 79, 81 55, 56, 57, 60

84, 85, 86 9, 13, 18, 19, 23, 26, 27 87, 88, 89 29, 30, 31, 36, 42, 43, 45, 46, 48, 49

Applied 4

8, 11, 12, 16, 17, 22, 24

38, 39, 44, 50

80 90, 91, 92, 93 53, 54, 58, 61

59, 62

94, 95 64, 66

96 65, 67

82 63, 68, 69, 70 83 97

Chapter 18: Mental Health and the Law Multiple Choice 18.1.1. The textbook makes the point early in chapter 18 that a. the legal definition of insanity is not the same as the psychological definition of mental illness. b. the legal definition of insanity is essentially the same as the psychological definition of mental illness. c. there is little overlap between the criminal justice system and the field of abnormal psychology. d. None of the above fit with information presented in the textbook. Difficulty: 1 Question ID: 18.1.1 Page Reference: 473 Topic: Overview Skill: Factual Answer: a. the legal definition of insanity is not the same as the psychological definition of mental illness.

18.1.2. In 1981 John Hinckley tried to kill then president of the United States Ronald Reagan. This case study begins chapter 18 of the textbook. Hinckley had a history of odd behavior and was subsequently found not guilty by reason of insanity. As a result of the Hinckley trial and verdict a. Hinckley was released. b. federal laws were rewritten to make it more difficult to achieve the not guilty by reason of insanity defense. c. Hinckley was released but required to have a secret service agent with him at all times. d. Hinckley was confined to a mental hospital with no chance of release. Difficulty: 2 Question ID: 18.1.2 Page Reference: 474 Topic: Overview Skill: Conceptual Answer: b. federal laws were rewritten to make it more difficult to achieve the not guilty by reason of insanity defense.

18.1.3. The idea that people act out of free will, that they are accountable for their actions when they violate the law, is known as the legal concept of a. b. c. d.

mens rea. innocent until proven guilty. criminal responsibility. individual responsibility.

Difficulty: 2 Question ID: 18.1.3 Page Reference: 476 Topic: Overview Skill: Conceptual Answer: c. criminal responsibility.

18.1.4. There is considerable overlap between the legal systems in the United States and the mental health professions in the area of expert witnesses. Court rulings have imposed some limits on the expert witnesses, requiring that a. b. c. d.

testimony only be given by psychiatrists or medical doctors. only neutral witnesses be used, ones appointed by the judge in a trial. testimony be based on science. None of the above are accurate. Difficulty: 2 Question ID: 18.1.4 Page Reference: 475 Topic: Overview Skill: Applied Answer: c. testimony be based on science.

18.1.5. In U.S. law an exception to criminal responsibility is contained in the concept of a. b. c. d.

insanity. mental illness. not criminally responsible. All of the above are recognized as exceptions in U.S. laws. Difficulty: 2 Question ID: 18.1.5 Page Reference: 476-477 Topic: Overview Skill: Conceptual Answer: a. insanity.

18.1.6. American psychiatrist Thomas Szasz has taken the somewhat radical position that a. even people who commit serious crimes should not be imprisoned if they are suffering from a mental disorder. b. that everyone who commits a crime is mentally ill to some degree. c. even people who are seriously mentally ill should still be held responsible for their behavior. d. that all criminals should be allowed access to psychiatric treatment.

Difficulty: 2 Question ID: 18.1.6 Page Reference: 476 Topic: Overview Skill: Conceptual Answer: c. even people who are seriously mentally ill should still be held responsible for their behavior.

18.1.7. The mental disorder defense was codified in 1843 when _______was found not guilty by reason of insanity. a. b. c. d.

Freud Hinckley M'Naghten Conan-Doyle Difficulty: 1 Question ID: 18.1.7 Page Reference: 477 Topic: Mental Illness and Criminal Responsibility Skill: Factual Answer: c. M'Naghten

18.1.8. Harry Jenkins has pled "not guilty by reason of insanity." The state where Harry is being tried uses the M'Naghten test of insanity. What question will the judge use when instructing the jury on the basis of their decision in this case? a. b. c. d.

Did the defendant know right from wrong? Did the defendant experience an irresistible impulse? Does the defendant have the burden of proving insanity? Did the defendant show behavior that was the product of mental illness? Difficulty: 2 Question ID: 18.1.8 Page Reference: 477 Topic: Mental Illness and Criminal Responsibility Skill: Applied Answer: a. Did the defendant know right from wrong?

18.1.9. What was the basis for the irresistible impulse test used in the late 19th century? a. b.

the legal assumption that everyone knows right from wrong the finding that the M'Naghten test was too broad

c. the finding that even though some people intellectually know that their behavior is illegal they still can't control their behavior d. the observation that some diagnoses are based on evidence of criminal behavior Difficulty: 3 Question ID: 18.1.9 Page Reference: 477 & 479 Topic: Mental Illness and Criminal Responsibility Skill: Conceptual Answer: c. the finding that even though some people intellectually know that their behavior is illegal they still can't control their behavior 18.1.10. A 1954 ruling by a Washington D.C. federal court in Durham v. United States broadened the insanity defense to indicated that an accused is not criminally responsible if his or her unlawful act was the product of mental disease or defect. This came to be known as the a. b. c. d.

mental illness test. D.C. test. Durham test. product test. Difficulty: 2 Question ID: 18.1.10 Page Reference: 477 Topic: Mental Illness and Criminal Responsibility Skill: Factual Answer: d. product test.

18.1.11. If you were a lawyer defending a client who is mentally ill and you were to use the conditions of the American Law Institute model legislation on the insanity defense (1955) you would have to provide evidence that your client a. b. c. d.

was mentally ill at the time of his offense. lacked substantial capacity to appreciate the criminality [wrongfulness] of his offense. lacked a knowledge of the law that he is accused of due to his mental illness. Any of the above would fit the conditions necessary. Difficulty: 2 Question ID: 18.1.11 Page Reference: 477 Topic: Mental Illness and Criminal Responsibility Skill: Applied Answer: b. lacked substantial capacity to appreciate the criminality [wrongfulness] of his offense.

18.1.12. You are a psychologist hired by the defense in a case involving the issue of not guilty by reason of insanity. Based on changes resulting from the Hinckley case and the Defense Reform Act of 1984 it is likely that the thrust of your testimony would be in support of the defendant’s

a. inability to stand trial due to her mental illness. b. inability to appreciate the nature and quality or wrongfulness of her behavior due to her mental illness. c. right to treatment versus imprisonment due to her mental illness. d. inability to discuss the nature of her offense with her attorney due to her mental illness. Difficulty: 2 Question ID: 18.1.12 Page Reference: 477 Topic: Mental Illness and Criminal Responsibility Skill: Applied Answer: b. inability to appreciate the nature and quality or wrongfulness of her behavior due to her mental illness. 18.1.13. What was the major change in the insanity defense contained in the Defense Reform Act? a. The defense was required to prove insanity on the part of the defendant. b. The prosecution was now required to proved the defendant was not insane. c. The court took on the task of proving whether a mental illness existed or not. d. A new, more stringent, standard was imposed on the defense task of proving the defendant was insane. Difficulty: 2 Question ID: 18.1.13 Page Reference: 477 Topic: Mental Illness and Criminal Responsibility Skill: Conceptual Answer: a. The defense was required to prove insanity on the part of the defendant. 18.1.14. In the United States about 1 percent of those charged attempt a defense of not guilty by reason of insanity (NGRI). Of those about what percent are successful? a. b. c. d.

1 percent 15 percent 25 percent 55 percent Difficulty: 2 Question ID: 18.1.14 Page Reference: 478 Topic: Mental Illness and Criminal Responsibility Skill: Factual Answer: c. 25 percent

18.1.15. In most cases of a successful defense based on not guilty by reason of insanity the defendant spends some time in a mental health facility after the verdict. What is true of the time spent in such a facility by the individual?

a. The time spent in a mental health facility is generally shorter than a prison sentence would have been. b. The time spent in a mental health facility is generally longer than a prison sentence would have been. c. The time spent in a mental health facility is on average the same as a prison sentence would have been. d. The time spent in a mental health facility is generally a great deal longer than a prison sentence would have been. Difficulty: 1 Question ID: 18.1.15 Page Reference: 479 Topic: Mental Illness and Criminal Responsibility Skill: Factual Answer: c. The time spent in a mental health facility is on average the same as a prison sentence would have been.

18.1.16. For more than eight years, Marilyn's husband has subjected her to physical and psychological abuse. As a result, she has been treated in the emergency room more than 10 times for a variety of injuries from bruises to broken bones. Each time she is abused, her husband begs for forgiveness. Finally, one night she takes his gun and shoots him as he is sleeping. She is charged with murder. What problem will Marilyn have when she is tried for murder? a. The battered woman defense can be used only when a spouse has a mental disorder. b. A defense of self-defense is typically allowed only when the person's life is in immediate danger. c. The Supreme Court has determined that "battered woman syndrome" cannot be used in cases involving murder. d. Mental health professionals cannot testify concerning a defendant's state of mind except in cases in which a defendant pleads "not guilty by reason of insanity." Difficulty: 2 Question ID: 18.1.16 Page Reference: 480 Topic: Mental Illness and Criminal Responsibility Skill: Applied Answer: b. A defense of self-defense is typically allowed only when the person's life is in immediate danger.

18.1.17. Last year Leslie shot and killed her husband after years of abuse. She has rejected a plea bargain and is ready for trial. Her defense attorney is going to call experts on battered woman syndrome. What question will the prosecution want to ask the experts on battered woman syndrome? a. b. c. d.

"Which DSM diagnosis best fits the defendant and her behavior?" "How can you distinguish dissociation from battered woman syndrome?" "Why does the defendant have complete recall for the events surrounding the killing?" "How can someone who is suffering from learned helplessness bring herself to kill?"

Difficulty: 3 Question ID: 18.1.17 Page Reference: 480 Topic: Mental Illness and Criminal Responsibility Skill: Applied Answer: d. "How can someone who is suffering from learned helplessness bring herself to kill?"

18.1.18. The Supreme Court of the United States has requested a social science review of the evidence on battered woman syndrome. What will that review reveal? a. Scientific evidence supporting the syndrome is weak to nonexistent. b. Proponents of the syndrome are responsible for saving hundreds of lives. c. Evidence from police officers supports the existence and validity of the syndrome. d. The battered woman syndrome relies on a collection of diagnostic categories, including dissociation. Difficulty: 2 Question ID: 18.1.18 Page Reference: 480 Topic: Mental Illness and Criminal Responsibility Skill: Conceptual Answer: a. Scientific evidence supporting the syndrome is weak to nonexistent.

18.1.19. Another attempt to reform the insanity defense was introduced by the American Bar Association in 1995 and was known as a. b. c. d.

not guilty due to mental illness. guilty but mentally ill. guilty but insane. not guilty due to mental mitigation.

Difficulty: 2 Question ID: 18.1.19 Page Reference: 478 Topic: Mental Illness and Criminal Responsibility Skill: Conceptual Answer: b. guilty but mentally ill. 18.1.20. In England a. the M'Naghten rule still applies but is used in only a handful of cases every year. b. the M'Naghten rule still applies and is used in a much greater percentage of cases than similar defenses in the United States.

c. the M'Naghten rule has been changed to "not criminally responsible due to mental illness" and is used very sparingly. d. the M'Naghten rule has been changed to "not criminally responsible due to mental illness" and is attempted quite frequently, but not successfully. Difficulty: 1 Question ID: 18.1.20 Page Reference: 478-479 Topic: Mental Illness and Criminal Responsibility Skill: Factual Answer: a. the M'Naghten rule still applies but is used in only a handful of cases every year.

18.1.21. What term refers to defendants' ability to participate in their own defense? a. b. c. d.

sane free will competence to stand trial morally capable Difficulty: 1 Question ID: 18.1.21 Page Reference: 479 Topic: Mental Illness and Criminal Responsibility Skill: Factual Answer: c. competence to stand trial

18.1.22. Which of the following is most likely to result in an individual being ruled incompetent to stand trial? a. b. c. d.

they are diagnosed with a psychotic disorder. the crime was so abhorrent that a trial is not necessary. the individual does not have enough money for a lawyer. the individual is unable to communicate with counsel because of brain damage. Difficulty: 2 Question ID: 18.1.22 Page Reference: 479 Topic: Mental Illness and Criminal Responsibility Skill: Applied Answer: d. the individual is unable to communicate with counsel because of brain damage.

18.1.23. At what stage of criminal proceedings may the issue of competence be raised? a. b. c.

while the defendant is being read her/his Miranda Rights before and during trial when the defendant needs to instruct his lawyer at the sentencing phase of a trial

at any of the stages mentioned above Difficulty: 2 Question ID: 18.1.23 Page Reference: 479 Topic: Mental Illness and Criminal Responsibility Skill: Conceptual Answer: d. at any of the stages mentioned above

18.1.24. Under U.S. federal law how long can a defendant be held once they are found incompetent to stand trial? a. until they are found competent, potentially for life b. until the are found competent, up to the maximum length of a jail sentence should they have been found guilty c. there is a one year maximum under U.S. federal law d. there is a 10 year maximum under U.S. federal law Difficulty: 2 Question ID: 18.1.24 Page Reference: 482 Topic: Mental Illness and Criminal Responsibility Skill: Applied Answer: a. until they are found competent, potentially for life

18.1.25. What type of evaluation is required in all death penalty cases that can take into account mental disorders? a. b. c. d.

judicial mitigation compassionate psychiatric Difficulty: 2 Question ID: 18.1.25 Page Reference: 482 Topic: Mental Illness and Criminal Responsibility Skill: Factual Answer: b. mitigation

18.1.26. In the landmark case of Atkins v. Virginia (2002), the U.S. Supreme Court ruled—consistent with laws already in effect in many states—that a. b.

schizophrenia is a mitigating factor that makes the death penalty unconstitutional. schizophrenia is not a mitigating factor that makes the death penalty unconstitutional.

c. d.

mental retardation is a mitigating factor that makes the death penalty unconstitutional. mental retardation is not a mitigating factor that makes the death penalty unconstitutional. Difficulty: 2 Question ID: 18.1.26 Page Reference: 482 Topic: Mental Illness and Criminal Responsibility Skill: Conceptual Answer: c. mental retardation is a mitigating factor that makes the death penalty unconstitutional.

18.1.27. With regard to sexual predator laws a. b. c. d.

the Supreme Court ruled them unconstitutional because they constitute "double jeopardy." the Supreme Court ruled them constitutional because they do not constitute punishment. they require forced treatment for repeat sexual offenders. None of the above are accurate. Difficulty: 2 Question ID: 18.1.27 Page Reference: 482-483 Topic: Mental Illness and Criminal Responsibility Skill: Conceptual

Answer: b. the Supreme Court ruled them constitutional because they do not constitute punishment.

18.1.28. The discovery of antipsychotic drugs in the 1950s lead directly to a. b. c. d.

a drop in the crime rate across the United States. an increase in the populations of mental health institutions as demand for the treatment increased. an increase in the number of mental patients now eligible for the death penalty. the deinstitutionalization of many mental patients.

Difficulty: 1 Question ID: 18.1.28 Page Reference: 483-484 Topic: Civil Commitment Skill: Factual Answer: d. the deinstitutionalization of many mental patients.

18.1.29. In the United States only under certain circumstances can you confine someone on the suspicion that they might commit a crime except in the circumstance of a. b.

civil commitment. mental health commitment.

c. d.

mental retardation. psychopaths. Difficulty: 2 Question ID: 18.1.29 Page Reference: 483 Topic: Civil Commitment Skill: Conceptual Answer: a. civil commitment.

18.1.30. One justification for civil commitment to psychiatric hospitals is the philosophy of parens patriae. This is the government's responsibility to a. b. c. d.

care for society's weaker members. keep the mentally ill from having children. reimburse family members who care for the mentally ill. provide police power and protection for society at large. Difficulty: 2 Question ID: 18.1.30 Page Reference: 484 Topic: Civil Commitment Skill: Conceptual Answer: a. care for society's weaker members.

18.1.31. The involuntary commitment of "mentally disordered" individuals to mental hospitals is objectionable to civil libertarians because a. b. c. d.

the state's authority is limited to parens patriae. no crime has usually been committed. police powers belong to the people. mentally disordered people need treatment, not punishment. Difficulty: 1 Question ID: 18.1.31 Page Reference: 484 Topic: Civil Commitment Skill: Conceptual Answer: b. no crime has usually been committed.

18.1.32. Most states provide for two types of civil commitment procedures, emergency and a. b. c.

psychological. legal. procedural.

formal. Difficulty: 1 Question ID: 18.1.32 Page Reference: 484 Topic: Civil Commitment Skill: Factual Answer: d. formal.

18.1.33. Today, the emergency commitment procedures in most states allow an acutely disturbed individual to be confined to a a. b. c. d.

jail for a few days. mental hospital for a few days. jail until the person agrees to be treated. mental hospital until treatment is finished. Difficulty: 1 Question ID: 18.1.33 Page Reference: 484 Topic: Civil Commitment Skill: Factual Answer: b. mental hospital for a few days.

18.1.34. While the grounds for civil commitment vary from state to state there is some commonality. Which of the following is NOT a generally accepted rationale? a. b. c. d.

an inability to care for oneself being a danger to harm oneself being mentally ill being a danger to harm someone else

Difficulty: 2 Question ID: 18.1.34 Page Reference: 483 Topic: Civil Commitment Skill: Factual Answer: c. being mentally ill

18.1.35. Approximately ___ percent of the mentally disturbed have no history of violence. a. b. c.

10 20 50

90 Difficulty: 1 Question ID: 18.1.35 Page Reference: 485 Topic: Civil Commitment Skill: Factual Answer: d. 90

18.1.36. Which type of mental patient commits acts of violence at a higher rate than others? a. b. c. d.

schizophrenia major depression bipolar disorder any type that also abuses drugs and alcohol Difficulty: 2 Question ID: 18.1.36 Page Reference: 485 Topic: Civil Commitment Skill: Conceptual Answer: d. any type that also abuses drugs and alcohol

18.1.37. Professional, clinical predictions that an individual patient will behave violently are correct approximately what percentage of the time? a. b. c. d.

10 percent 25 percent 33 percent 50 percent

Difficulty: 1 Question ID: 18.1.37 Page Reference: 486 Topic: Civil Commitment Skill: Factual Answer: c. 33 percent

18.1.38. Dr. Davis has incorrectly hospitalized someone as dangerous who is in fact not dangerous. Dr. Eliot has incorrectly released someone from the hospital who is in fact still dangerous. Dr. Davis has made a ___________ error while Dr. Eliot has made a __________ error. a.

justifiable; unjustifiable

b. c. d.

unjustifiable; justifiable false positive; false negative false negative; false positive Difficulty: 2 Question ID: 18.1.38 Page Reference: 486 Topic: Civil Commitment Skill: Applied Answer: c. false positive; false negative

18.1.39. When Supreme Court Justice Blackmun heard that the prediction of violence is wrong 2 out of 3 times, he concluded that predicting violence using a coin flip would be more accurate. Why was he wrong? a. b. c. d.

The specificity of a coin flip is above 50%. The sensitivity of a coin flip is above 50%. The base rate of violence is much lower than 50%. The coin flip is random, not based on clinical judgment. Difficulty: 3 Question ID: 18.1.39 Page Reference: 486 Topic: Civil Commitment Skill: Applied Answer: c. The base rate of violence is much lower than 50%.

18.1.40. What is a base rate? a. b. c. d.

how frequently an event occurs in a population the number of guesses made about the event the accuracy of predictions about the event in the past the amount of information available to make a prediction Difficulty: 1 Question ID: 18.1.40 Page Reference: 486 Topic: Civil Commitment Skill: Factual Answer: a. how frequently an event occurs in a population

18.1.41. The base rate of the actual occurrence of serious violence is what percentage? a. b.

1 percent 3 percent

c. d.

9 percent 27 percent Difficulty: 2 Question ID: 18.1.41 Page Reference: 486 Topic: Civil Commitment Skill: Factual Answer: b. 3 percent

18.1.42. What is the general conclusion concerning making predictions of future violence? a. b. c. d.

Clinical judgment is better than chance. Clinical judgment is equivalent to flipping coins. The number of false positives is unaffected by the base rate. Such predictions should be made by individuals with experience in police work. Difficulty: 2 Question ID: 18.1.42 Page Reference: 486 Topic: Civil Commitment Skill: Conceptual Answer: a. Clinical judgment is better than chance.

18.1.43. The accuracy of predictions of violence is better when the focus is on a. b. c. d.

violence against others. violence against oneself. imminent violence. violence that may occur over the long term. Difficulty: 2 Question ID: 18.1.43 Page Reference: 486 Topic: Civil Commitment Skill: Conceptual Answer: c. imminent violence.

18.1.44. The Wyatt decision established all of the following rights for mental patients except a. b. c. d.

qualified staff. adequate medication. humane conditions. an individualized treatment plan.

Difficulty: 2 Question ID: 18.1.44 Page Reference: 487 Topic: Civil Commitment Skill: Applied Answer: b. adequate medication.

18.1.45. What is the most important issue about the least restrictive environment alternative? a. b. c. d.

Less restrictive environments are often not available. Treatment in these settings is usually prohibitively expensive. Insurance companies won't pay the expenses for alternative treatments. Treatment in a less restrictive environment is usually less effective. Difficulty: 2 Question ID: 18.1.45 Page Reference: 487 Topic: Civil Commitment Skill: Conceptual Answer: a. less restrictive environments are often not available

18.1.46. A mental patient involuntarily admitted to a mental hospital may refuse treatment if they can a. b. c. d.

give a good reason. provide a bond. understand the treatment. provide informed consent.

Difficulty: 2 Question ID: 18.1.46 Page Reference: 489 Topic: Civil Commitment Skill: Conceptual Answer: d. provide informed consent.

18.1.47. A newer, more assertive form of treating patients who lack insight is the process of court ordered treatment in the community known as a. b. c. d.

deinstitutionalized commitment. outpatient treatment. community commitment. outpatient commitment. Difficulty: 2

Question ID: 18.1.47 Page Reference: 489 Topic: Civil Commitment Skill: Factual Answer: d. outpatient commitment.

18.1.48. There have been benefits to the deinstitutionalization of many mental patients, but one serious problem that has resulted is reflected in the percentage of homeless individuals who should be receiving treatment for mental disorders but are not. This percentage is approximately a. b. c. d.

10 percent. 30 percent. 50 percent. 60 percent. Difficulty: 2 Question ID: 18.1.48 Page Reference: 490 Topic: Civil Commitment Skill: Conceptual Answer: b. 30 percent.

18.1.49. "Rotting with their rights on" refers to one problem with a. b. c. d.

deinstitutionalization. institutionalization. community commitment. mandatory jail terms. Difficulty: 1 Question ID: 18.1.49 Page Reference: 490 Topic: Civil Commitment Skill: Conceptual Answer: a. deinstitutionalization.

18.1.50. Individuals can use a legal procedure to list their preferences for treatment should they be found mentally ill in the future through a procedure known as a. b. c. d.

sanity wills. advance psychiatric directives. treatment contracts. community mental health directives. Difficulty: 2

Question ID: 18.1.50 Page Reference: 489 Topic: Civil Commitment Skill: Applied Answer: b. advance psychiatric directives.

18.1.51. What is the basic premise of deinstitutionalization for the mentally ill? a. b. c. d.

They should be hospitalized if they are homeless. They should be placed in private, not public, hospitals. They need to be hospitalized under more humane conditions. They can be better served in the community rather than in hospitals. Difficulty: 1 Question ID: 18.1.51 Page Reference: 490 Topic: Civil Commitment Skill: Factual Answer: d. They can be better served in the community rather than in hospitals.

18.1.52. What is one of the reasons that deinstitutionalization has not worked as well as its proponents had hoped? a. b. c. d.

Patients end up staying in the hospital for a longer period of time. There aren't enough hospital beds. Patients who are discharged after short stays are admitted more frequently. There are no effective community-based treatment models.

Difficulty: 1 Question ID: 18.1.52 Page Reference: 490 Topic: Civil Commitment Skill: Factual Answer: c. Patients who are discharged after short stays are admitted more frequently.

18.1.53. The goals of family courts have generally been more _______ than legal. a. b. c. d.

procedural psychological lenient semi-professional Difficulty: 1 Question ID: 18.1.53

Page Reference: 491 Topic: Mental Health and Family Law Skill: Conceptual Answer: b. psychological

18.1.54. Legal custody refers to a. b. c. d.

where the child lives at what time. foster care placement of abused children. winning material possessions in a divorce settlement. how the parents will make decisions about their child's life. Difficulty: 2 Question ID: 18.1.54 Page Reference: 491 Topic: Mental Health and Family Law Skill: Conceptual Answer: d. how the parents will make decisions about their child's life.

18.1.55. About what percentage of children alive today in the United States will experience a divorce in their family? a. b. c. d.

10 percent 20 percent 40 percent 60 percent Difficulty: 1 Question ID: 18.1.55 Page Reference: 491 Topic: Mental Health and Family Law Skill: Factual Answer: c. 40 percent

18.1.56. A neutral third party who helps partners in divorce decisions is known as a a. b. c. d.

mediator. unbiased lawyer. facilitator. family counselor. Difficulty: 1 Question ID: 18.1.56 Page Reference: 492 Topic: Mental Health and Family Law

Skill: Factual Answer: a. mediator.

18.1.57. In 1962 Henry Kempe focused public attention on a family problem that had not received much attention when he wrote about a. b. c. d.

a mentally disordered defendant. post traumatic stress disorder. divorce mediation. the "battered child syndrome." Difficulty: 1 Question ID: 18.1.57 Page Reference: 492 Topic: Mental Health and Family Law Skill: Factual Answer: d. the "battered child syndrome."

18.1.58. Each form of child abuse is mentioned in the book EXCEPT? a. b. c. d.

physical neurological sexual neglect

Difficulty: 2 Question ID: 18.1.58 Page Reference: 492-493 Topic: Mental Health and Family Law Skill: Conceptual Answer: b. neurological

18.1.59. In reviewing hospital security tapes several parents are observed trying to do physical harm to their children. These parents may be diagnosed as having? a. b. c. d.

child abuse syndrome schizophrenia psychopathy Munchausen-by-proxy Difficulty: 2 Question ID: 18.1.59 Page Reference: 493 Topic: Mental Health and Family Law

Skill: Applied Answer: d. Munchausen-by-proxy

18.1.60. Between 1976 and 2006 what has happened to the number of child abuse cases in the United States? a. b. c. d.

they are about the same they have declined they have declined dramatically they have increased dramatically Difficulty: 1 Question ID: 18.1.60 Page Reference: 493 Topic: Mental Health and Family Law Skill: Factual Answer: d. they have increased dramatically

18.1.61. The files at Child Protective Services are piled high. What is most likely outcome of the reports of alleged child abuse? a. b. c. d.

Due to cutbacks, most cases will never be investigated. In most cases, the parents lose custody of their children. Over two thirds of the reports will not be substantiated after an investigation. The majority of cases will be verified and will be turned over to prosecutors. Difficulty: 2 Question ID: 18.1.61 Page Reference: 493 Topic: Mental Health and Family Law Skill: Conceptual Answer: c. Over two thirds of the reports will not be substantiated after an investigation.

18.1.62. Children taken from their family homes can be adopted, but only in the case of a. b. c. d.

the death of both parents. the divorce of the parents. if the child has been abused in some way. the termination of parental rights. Difficulty: 2 Question ID: 18.1.62 Page Reference: 493 Topic: Mental Health and Family Law Skill: Applied

Answer: d. the termination of parental rights.

18.1.63. Each of the following types of medial malpractice claims are common except a. b. c. d.

the inappropriate use of medication. over billing on the part of the therapist. negligent treatment. sexual relations between therapist and client. Difficulty: 2 Question ID: 18.1.63 Page Reference: 494 Topic: Professional Responsibilities and the Law Skill: Factual Answer: b. over billing on the part of the therapist.

18.1.64. In Osheroff vs. Chestnut Lodge, Osheroff successfully sued the lodge because the a. the scientific literature provided evidence that suggested he should have received a different treatment. b. the lodge had overbilled him. c. they treatment provided was not consistent with the type of theoretical orientation the lodge advertised. d. All of the above were part of his claim.

Difficulty: 2 Question ID: 18.1.64 Page Reference: 495 Topic: Professional Responsibilities and the Law Skill: Conceptual Answer: a. the scientific literature provided evidence that suggested he should have received a different treatment.

18.1.65. As a therapist you are well aware of your responsibilities with regard to confidentiality. Before you start, however, you need to inform your client that in certain cases you will be required to report your conversation to the authorities. You are required to do this in cases of a. b. c. d.

divorce. involving the IRS. illegal activity. child abuse. Difficulty: 2 Question ID: 18.1.65

Page Reference: 495 Topic: Professional Responsibilities and the Law Skill: Applied Answer: d. child abuse.

18.1.66. Your client has just admitted to you that she intends to run her car into her ex-husband's house, hopefully as he answers the door. As a result of which court decision are you now required to inform the police? a. b. c. d.

Megan California Tarosoff Mendonza Difficulty: 2 Question ID: 18.1.66 Page Reference: 495 Topic: Professional Responsibilities and the Law Skill: Conceptual Answer: c. Tarosoff

18.1.67. A friend of yours, who has been carrying a terrible secret about her family, informs you that she is seeing a psychologist and plans to divulge her secret because she knows that what she shares in therapy is confidential. What should you tell her? a. "You are correct; psychologists have an ethical obligation not to reveal private communications." b. "Be careful, because mental health professionals sometimes may be compelled by law to reveal confidential information." c. "There are no restrictions to prevent your psychologist from revealing your secret." d. "Psychologists are always allowed to share confidential information with members of a client's family." Difficulty: 2 Question ID: 18.1.67 Page Reference: 495 Topic: Professional Responsibilities and the Law Skill: Applied Answer: b. "Be careful, because mental health professionals sometimes may be compelled by law to reveal confidential information."

18.1.68. Many psychologists consider it ethical to inform clients before therapy or counseling begins that they can be required to divulge information from the counseling session especially in cases involving a. b.

child abuse. plans for divorce.

c. d.

repressed memories. tax evasion. Difficulty: 1 Question ID: 18.1.68 Page Reference: 495 Topic: Professional Responsibilities and the Law Skill: Factual Answer: a. child abuse.

18.1.69. The legal case of Tarasoff v. Regents of the University of California (1976) established that therapists must a. b. c. d.

refrain from sex with clients. report suspected cases of child abuse. notify police of a patient's imminent suicide attempt. warn potential victims of a patient's intent to harm them. Difficulty: 1 Question ID: 18.1.69 Page Reference: 495 Topic: Professional Responsibilities and the Law Skill: Factual Answer: d. warn potential victims of a patient's intent to harm them.

18.1.70. Subsequent California court decisions have extended the Tarasoff decision to the duty to a. b. c. d.

warn. protect. inform. involve. Difficulty: 1 Question ID: 18.1.70 Page Reference: 495 Topic: Professional Responsibilities and the Law Skill: Factual Answer: b. protect.

Short Answer 18.2.71. The legal definition of insanity is not the same as the scientific definition of __________ __________ . Difficulty: 2 Question ID: 18.2.71

Page Reference: 473 Topic: Overview Skill: Factual Answer: mental illness

18.2.72. Criminal law assumes that human behavior is the product of __________ __________ . Difficulty: 2 Question ID: 18.2.72 Page Reference: 476 Topic: Overview Skill: Conceptual Answer: free will

18.2.73. Mental health professionals make an assumption that human behavior is determined by biological, psychological, and social forces which is known as __________ . Difficulty: 2 Question ID: 18.2.73 Page Reference: 476 Topic: Overview Skill: Factual Answer: determinism

18.2.74. The 1843 M'Naghten decision was the beginning of the __________ defense in Western law. Difficulty: 2 Question ID: 18.2.74 Page Reference: 477 Topic: Mental Illness and Criminal Responsibility Skill: Factual Answer: insanity

18.2.75. _________ _________ syndrome is a term coined by the psychologist Lenore Walker (1979) to describe her observations about the psychological effects of chronic abuse. Difficulty: 2 Question ID: 18.2.75 Page Reference: 480 Topic: Mental Illness and Criminal Responsibility Skill: Factual Answer: Battered woman

18.2.76. A defendant’s ability to understand the legal proceedings that are taking place against them and to participate in their own defense defines the concept of __________ . Difficulty: 1 Question ID: 18.2.76 Page Reference: 479 Topic: Mental Illness and Criminal Responsibility Skill: Factual Answer: competence

18.2.77. Using legal proceedings to confine an individual to a mental health facility against their will is known as what type of commitment? __________ Difficulty: 1 Question ID: 18.2.77 Page Reference: 483 Topic: Civil Commitment Skill: Factual Answer: civil

18.2.78. The case of Lake v. Cameron established a patient's right to treatment in what type of environment? __________ __________

Difficulty: 2 Question ID: 18.2.78 Page Reference: 488 Topic: Civil Commitment Skill: Factual Answer: least restrictive

18.2.79. The question of a patient's right and ability to refuse treatment revolves around the issue of __________ __________ . Difficulty: 1 Question ID: 18.2.79 Page Reference: 489 Topic: Civil Commitment Skill: Factual Answer: informed consent

18.2.80. A new legal device that addresses the issue of treatment for patient's who lack insight yet are eligible for release into the community is outpatient __________ . Difficulty: 2 Question ID: 18.2.80 Page Reference: 489 Topic: Civil Commitment Skill: Conceptual Answer: commitment

18.2.81. The process that removed mental patients from hospitals and placed them in the community was know as __________ . Difficulty: 2 Question ID: 18.2.81 Page Reference: 490 Topic: Civil Commitment Skill: Factual Answer: deinstitutionalization

18.2.82. _________ __________ involves the accidental or intentional infliction of harm to a child due to acts or omissions on the part of an adult responsible for the child’s care.

Difficulty: 1 Question ID: 18.2.82 Page Reference: 492 Topic: Mental Health and Family Law Skill: Factual Answer: Child abuse

18.2.83. ____________ is the ethical obligation not to reveal private communications that is basic to psychotherapy.

Difficulty: 1 Question ID: 18.2.83 Page Reference: 495 Topic: Professional Responsibilities and the Law Skill: Factual Answer: Confidentiality

Essay 18.3.84. Describe the various ways in which the legal system and the mental health professions interact, overlap, and, at times, find themselves in conflict. Difficulty: 2 Question ID: 18.3.84 Page Reference: 473-477 Topic: Overview Skill: Conceptual Answer: The legal system in the United States and the several mental health professions overlap and interact in a variety of ways. Both define behavior that is out of the ordinary, but in the legal professions the term insanity tends to be used and in the mental health professions, mental illness. The former is a legal term that has implications for a defendant. For example in some cases an individual can commit a crime but be found “not guilty by reason of insanity” if his mental illness makes it impossible for him to appreciate the nature and quality of his act, to understand what is right and what is wrong. Even here there is overlap with the mental health professions because laws do not actually define what constitutes insanity; they leave it up to expert testimony by psychiatrists and/or clinical psychologists to present the information to a judge or jury. Even before a trial the question of a defendant’s competence to stand trial can be raised. Actually a defendant’s competence can be raised at any time, before trial, during trial, during sentencing, or as a result of sentencing. Again, mental health professionals are used to help make the determination of competence and in some cases to provide treatment mandated by the courts. An extreme form of conflict between the two fields in one in which the legal system wants to have mental health professionals administer treatments so that a defendant can be temporarily competent so that a death sentence can be imposed. Most mental health professionals see this as against their ethical codes. Mental health professionals are involved in divorce cases and determinations of custody. The extreme case here is where a parent is accused of being so incompetent at parenting that the court considers termination of their parental rights. Once again mental health professionals will assess and present expert testimony that a judge or jury will use to make this determination. At time the legal profession oversees the mental health professions by hearing law suits against those professionals by clients who feel that they are the victims of neglect or wrong-doing at the hands of a mental health professional. All in all, there is very concerted and long-standing interaction between the two areas of activity.

18.3.85. Discuss the role of expert witnesses and the limitations placed on them by court rulings. Difficulty: 2 Question ID: 18.3.85 Page Reference: 475 Topic: Overview Skill: Conceptual Answer: Judges and juries need to make determinations about defendants in a number of situations. Does their mental illness meet the definition of criminally insane, or does it quality them for not guilty by reason of insanity? Does their offense make them too dangerous for parole? Neither judges nor juries have expert psychological knowledge that allows them to make these decisions so they have mental health experts testify with this information. One problem with the system is that most often both

sides will provide conflicting and contradictory testimony and it is still a difficult task for judge and jury to choose between the two. The Daubert decision, and others, have limited experts to presenting scientifically supportable testimony.

18.3.86. Compare and contrast the assumptions about the nature of the cause of human behavior held by the legal system with that of mental health professionals. Difficulty: 2 Question ID: 18.3.86 Page Reference: 476 Topic: Overview Skill: Conceptual Answer: The legal system starts with the assumption that individuals are in possession of “free will,” that they have control over their behavior and that they make choices for the most part freely. Thus the law can hold people accountable for their actions. Mental health professions tend to start from the assumption of “determinism.” All human behavior is the result of complex interactions between genetics, biological factors, past experience, local conditions, social pressures, etc. and they recognize that some times, as the result of brain tumors or social coercion, individuals actually can be made to behave against their will. The law does make one exception with regard to the assumption of free will in the “insanity” defense that recognizes that an individual can be suffering from a mental disorder that so clouds their reason, perception, or judgment that it no longer makes any logical or legal sense to hold them fully responsible for their actions. At this point the two definitions overlap and a judge and/or jury needs to sort out the issue of responsibility.

18.3.87. Briefly outline the conditions inherent in the M'Naghten ruling for find a defendant not guilty by reason of insanity and then discuss the changes that have occurred in U.S. law that have modified the conditions for its successful application. Difficulty: 3 Question ID: 28.3.87 Page Reference: 477-478 Topic: Mental Illness and Criminal Responsibility Skill: Conceptual Answer: The basic condition laid down in the M’Naghten ruling was that a defendant could be found not guilty by reason of insanity (NGRI) if they were suffering a “defect of reason” (mental disorder) that made it impossible for them to understand right from wrong. If the individual genuinely believes that God has ordered them to harm someone then it must be “right” because God ordered it and anything order by God must, by definition, be “right.” Court cases over the years have changed this basic rule, Parsons, for example, expanded it to include conditions in which the person might intellectually know that what they are doing is wrong, but they were overcome by an “irresistible impulse.” This is almost like OCD or an epileptic seizure in which a misfire in a specific brain centre essentially forces an individual to behave against their will. Durham introduced the “product” rule which suggested that if one’s behavior was the product of a mental disorder or mental disease then they could be found NGRI. This does potentially create some problems because antisocial personality disorder is in the DSM and most criminals would be so diagnosed. Durham was overruled in 1972 and replaced by the Defense Reform Act of 1984 in which an individual who suffers from a mental disorder and as a result of that

disorder can’t comprehend the nature and quality of their actions can be found NGRI. Many states and the federal government use some variant of this position.

18.3.88. How does Lenore Walker's concept of the battered woman syndrome explain why it is so hard for a battered woman to leave an abusive relationship?

Difficulty: 2 Question ID: 18.3.88 Page Reference: 480 Topic: Mental Illness and Criminal Responsibility Skill: Conceptual Answer: Battered women often remain in an abusive relationship for incomprehensibly long periods of time. The reluctance to leave can seem foolish. To the battered woman, leaving the relationship often seems wrong or impossible. She may feel trapped by finances or out of concern for her children. Chronic abuse may cause her to lose perspective on the extent of the maltreatment.

18.3.89. Discuss the conditions that need to be met in order for an individual to be found "competent to stand trial." Difficulty: 2 Question ID: 18.3.89 Page Reference: 479-480 Topic: Mental Illness and Criminal Responsibility Skill: Conceptual

Answer: A person can be found unfit for a variety of reasons from brain damage to schizophrenia. Basically to be found fit to stand trial they must be able to understand the nature and object of the proceedings, the possible consequences of the trial, and they must be able to communicate with their lawyer, to direct their own defense. The issue of competence refers to an individual’s current mental state, not to that when the crime occurred. The legal definition of competence is not the same as a mental health professional’s. An individual may be schizophrenic, but if they can communicate coherently with their lawyer they are “competent to stand trial.” Only individuals who are very disordered will likely meet the legal definition of incompetent.

18.3.90. What are the two broad rationales for the government's power to put people into psychiatric hospitals against their will, through civil commitment procedures? Difficulty: 2 Question ID: 18.3.90 Page Reference: 484-485 Topic: Civil Commitment Skill: Conceptual

Answer: Parens patriae which means “state as parent”: the government has a humanitarian responsibility to care for its weaker members. Sometimes this means placing them in places where it is less likely they will be harmed or harm themselves. Police power: the government has a responsibility to protect the public safety, health, and welfare. So sometimes it isolates individuals from others that the state decides they are likely to harm.

18.3.91. A public policy official reads that the rates of violence are five times higher among patients with serious mental illness than among the general population. Based on this evidence, the public policy official recommends legislation that would allow patients with serious illness to be detained for longer periods than other people when arrested for minor offences. What is the scientific evidence suggesting that such a policy is not justified?

Difficulty: 2 Question ID: 18.3.91 Page Reference: 485 Topic: Civil Commitment Skill: Conceptual Answer: Ninety percent of the mentally ill have no history of violence. In general the false positive rate for the prediction of violence is 67 percent. A current psychotic episode is predictive of violence, but past psychotic episodes are not predictive of violence. Other factors besides mental illness also increase the risk for violence, such as poverty and drug use.

18.3.92. Discuss three rights mental patients have in the United States with regard to treatment and how they are sometimes contradictory. Difficulty: 2 Question ID: 18.3.92 Page Reference: 487-488 Topic: Civil Commitment Skill: Conceptual Answer: Americans have the right to treatment, the right to treatment in the least restrictive environment and the right to refuse treatment. The first right makes it more likely they will receive the treatment they need, even if they are poor. The Wyatt decision expanded the individual’s right to treatment by trained staff and under humane conditions. The second means that they cannot be held against their will in order to receive that treatment unless they pose a threat. This sometimes makes it less likely that they will receive treatment. Being held against one’s will in a mental health facility can make them resistant to treatment plans. The third means that even if they are somewhat confused or even delusional about the nature of their treatment they can refuse it in most states. It means that they can refuse treatment based on their misunderstanding caused by their mental disorder. They are then denied treatment because of the combination of their disease and their own rights.

18.3.93. Discuss how outpatient or community commitment meets some of the concerns of over paternalism and addresses some of the needs created by deinstitutionalization.

Difficulty: 2 Question ID: 18.3.93 Page Reference: 483-484 Topic: Civil Commitment Skill: Conceptual Answer: When patients were released from mental hospitals in the programs of deinstitutionalization many had mental health needs that were difficult to meet if they were not to become homeless and indigent. Forcing these individuals back into institutions is seen by many civil libertarians as counter to the Bill of Rights and the Constitution. Community commitment involves legally forcing an individual to do something, such as attend a clinic once a week, where they may receive medical and mental health treatment. It is coercive, but much less so than re-institutionalizing them, and, in some cases, it provides protection for both them and the public.

18.3.94. List and define the types of custody at issue in child custody cases.

Difficulty: 2 Question ID: 18.3.94 Page Reference: 489-490 Topic: Mental Health and Family Law Skill: Conceptual Answer: Physical custody defines where children will live at what times. Legal custody defines who will make decisions with regard to the child. Sole custody refers to a situation in which one parent has all of the responsibility and power for physical and legal custody. This is in contrast to joint custody where two parents share these responsibilities.

18.3.95. Discuss Mnookin's warning about the concept of the child's best interest standard. Difficulty: 2 Question ID: 18.3.95 Page Reference: 491 Topic: Mental Health and Family Law Skill: Conceptual Answer: Mnookin argues that because the concept of the “child’s best interest” is so vague and difficult to define that it actually encourages contentious court battles in which parents bring up as much negative information about each other as possible. He encourages the use of mediation to settle child custody issues out of court in an atmosphere where cooperation and discussion about what is best for the child is encouraged.

18.3.96. Describe the disorder of Munchausen-by-proxy. Difficulty: 2 Question ID: 18.3.96 Page Reference: 493

Topic: Mental Health and Family Law Skill: Conceptual Answer: In Munchausen-by-proxy a child care giver feigns, exaggerates, or induces an illness on a child. This can range from pure fabrication of symptoms, such as warming a child with heating blanket to make it look like they have a fever, to breaking a child’s arm or introducing a bacteria into their food. It has been diagnosed and used as a basis for charges of child abuse in some cases and even as cause of the termination of parental rights in which a child is legally and formally taken away from their parents.

18.3.97. Give at least one example of a case in which confidentiality must be broken by a therapist, and explain why it would necessary.

Difficulty: 3 Question ID: 18.3.97 Page Reference: 495-496 Topic: Professional Responsibilities and the Law Skill: Applied Answer: Suspected child abuse; when the patient is dangerous to self or others; when the patient has threatened to harm someone. Court cases and laws have made it necessary for mental health professionals to report when the have been told about certain crimes, especially child abuse. In addition the Tarasoff ruling expands this to include the necessity to warn potential victims, through the authorities. Confidentiality must be broken in order to protect people's lives and to protect victims of child abuse.