Abnormal Psychology Perspectives with MyPsychKit, 4E David J.A. Dozois Philip Firestone
Email: richard@qwconsultancy.com
Abnormal Psychology: Perspectives, 4e Dozois/Firestone
CHAPTER 1 Concepts of Abnormality throughout History 1)Your housemate has been overly concerned with keeping the kitchen clean. In fact, he scrubs the sinks and counters for half an hour each time someone puts something on them. In order to determine his diagnosis, a practitioner in North America would be most likely to consult the A) American Medical Association's Treatment Manual (AMA-TM). B) Diagnostic and Statistical Manual, fourth edition (DSM-IV-TR). C) International Classification of Mental and Behavioural Disorders (ICD-10). D) Diagnostic and Statistical Manual, sixth edition (DSM-VI). E) The North American Guide to Psychiatric Disorders (NAPD-IV). Answer: B Diff: 1 Type: MC Skill: Application
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2)Psychopathology refers to A) the same disorder as psychopathy. B) disorders of the brain. C) a physical cause to psychological problems. D) only severe psychological disorders. E) the study of the nature of psychological problems. Answer: E Diff: 2 Type: MC Skill: Factual
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3)What is one difficulty in defining abnormal behaviour? A) eccentric behaviour usually indicates abnormal behaviour B) everyone is to some degree abnormal in their behaviour C) unusual behaviour may not be abnormal according to diagnostic criteria D) all people experience anxiety now and then E) people's behaviour depends on the situation Answer: C Diff: 1 Type: MC Skill: Factual
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4)Abnormal behaviour has been defined as that which occurs infrequently. Which of the following examples illustrates a problem with this definition? A) People with IQs below 70 are considered abnormal. B) Most people get depressed from time to time. C) Mathematical geniuses are considered rare in the population. D) Children often believe in the existence of monsters. .. 1
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E) Anxiety disorders are relatively rare in a given population. Answer: C Diff: 2 Type: MC Skill: Application
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5)Dr. Jayvonna is working with a patient who has to arrange and rearrange her food on her plate after each bite. Although her patient does not find this behaviour strange, other people find it odd. The definition of abnormality applicable to this patient is A) statistically unusual behaviour. B) violating the norms of society. C) distress to self and others. D) personal dysfunction. E) expert diagnosis Answer: B Diff: 1 Type: MC Skill: Application
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6)Perhaps the biggest problem with using inappropriate behaviour as a criterion for abnormal behaviour is A) what is considered appropriate differs over time and location. B) mentally ill people are usually not dangerous. C) social norms tend to be constant over time. D) inappropriate behaviour is often the norm in North American culture. E) killers and murderers are generally sane. Answer: A Diff: 2 Type: MC Skill: Conceptual
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7)Which one of the following groups of principles have been used to define abnormality? A) diagnosis by an expert, personal distress, poor emotional control B) personal distress, delinquent activity, poor emotional control C) violation of norms, abnormal intellectual functioning, personal distress D) infrequency, personal distress, impaired functioning E) psychiatric diagnosis, harmful dysfunction, abnormal intellectual functioning Answer: D Diff: 2 Type: MC Skill: Factual
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8)Changes in the way that abnormality has been viewed over time has resulted in A) a clear understanding of the etiology of disorders. B) effective treatments for all disorders. C) fewer diagnostic categories. .. 2
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D) high reliability of all diagnoses. E) a shift from supernatural to natural causes in explaining disorders. Answer: E Diff: 2 Type: MC Skill: Conceptual
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9)If you lived in a society that explained changes in the weather as being influenced by the gods, you would likely view madness as being caused by A) schizophrenia. B) demon possession. C) brain dysfunction. D) weakness of character. E) irrational thoughts. Answer: B Diff: 1 Type: MC Skill: Application
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10)What type of treatment was thought to be used by Stone Age people to treat madness? A) religious chanting B) death C) herbal brews to poison evil spirits D) trephination E) exorcism Answer: D Diff: 2 Type: MC Skill: Application
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11)Several methods were used during prehistoric times to treat abnormal behaviour. Which approach, however, was NOT common? A) trephination B) bedrest C) induced trances D) special care in asylums E) magic Answer: D Diff: 1 Type: MC Skill: Factual
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12)To whom can we credit with the original idea that dreams play an important role in understanding mental illness? A) Freud B) Aristotle .. 3
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C) Plato D) Hippocrates E) Galen Answer: D Diff: 2 Type: MC Skill: Factual
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13)Hippocrates played a major role in both how the causes and treatment of mental illness were viewed. However, his greatest contribution to psychology was A) being the father of psychoanalysis. B) proving the value of leading a healthy life in preventing madness. C) emphasizing the natural causes of mental illness. D) separating the causes of madness into medical and magical causes. E) his idea that psychological functioning resulted from disturbances of bodily fluids. Answer: C Diff: 1 Type: MC Skill: Conceptual
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14)According to Hippocrates, mental disorders should be treated by which one of the following? A) exorcism B) magical spells C) trephination D) healthy diet and exercise E) food and water deprivation Answer: D Diff: 1 Type: MC Skill: Conceptual
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15)Hippocrates believed that psychological functioning was influenced by imbalances in bodily fluids. Each of the following was considered an essential fluid EXCEPT A) blood. B) black bile. C) brown bile. D) green bile. E) phlegm. Answer: C Diff: 1 Type: MC Skill: Factual
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16)An ancient Greek was behaving quite aggressively and was quite short-tempered. He would likely have been diagnosed as having .. 4
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A) too little yellow bile. B) an excess of blood. C) excess phlegm. D) too much yellow bile. E) an overabundance of black bile. Answer: D Diff: 2 Type: MC Skill: Application
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17)Plato and Aristotle accepted many of Hippocrate's ideas, but rejected others. Which of the following best describes their belief about the cause of mental illness? A) that an imbalance in essential bodily fluids affected functioning B) that brain dysfunction affected behaviour C) that environmental factors played the critical role D) lack of education could cause mental illness E) that mental illness had natural causes Answer: E Diff: 3 Type: MC Skill: Conceptual
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18)The idea that both mental and physical disorders were caused by problems in the body was held by A) Soranus. B) Aristotle. C) Plato. D) the Greek physician Aretaeus. E) Hippocrates. Answer: A Diff: 1 Type: MC Skill: Conceptual
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19)Jennifer is a psychotherapist, and she considers talking about problems to be therapeutic. Which of the following groups would most likely agree with her? A) early Egyptians B) Arabians C) classical Greek and Romans D) Europeans during the Middle Ages E) prehistoric people Answer: C Diff: 2 Type: MC Skill: Application
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20)Early Arabian asylums were established to A) protect society from the mentally ill. B) provide the mentally ill with a safe haven. C) begin the tradition of group therapy. D) reintroduce trephination as a major form of treatment. E) fulfill the requirements of the Koran. Answer: B Diff: 1 Type: MC Skill: Factual
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21)Avicenna's The Canon of Medicine may have included early forms of which of the following modern methods of treatment? A) homeopathic treatment B) dream analysis C) behaviour therapy D) psychotherapy E) bloodletting Answer: C Diff: 3 Type: MC Skill: Conceptual
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22)The notion of “possession” during the Middle Ages was often applied to A) people who disagreed with Church doctrine. B) people who sinned frequently. C) men who beat their wives. D) people who had suffered a nervous breakdown. E) people suffering from a mental illness. Answer: E Diff: 2 Type: MC Skill: Conceptual
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23)During the 13th and 14th centuries, a women caught talking to her garden plants would A) be treated by either prayer or exorcism of demons. B) be treated with hypnotism. C) be treated using special herbs and potions. D) be accused of witchcraft and tortured to prevent her evil powers from spreading. E) be considered psychotic. Answer: A Diff: 1 Type: MC Skill: Conceptual
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24)The spiritus vitae was A) a disorder where people begin to dance in the streets and drink red wines. B) a spirit believed to possess individuals and cause madness. C) a bodily fluid believed by Paracelsus to result in mental illness. D) a naturalistic cause of madness. E) the venom of the tarantula. Answer: D Diff: 1 Type: MC Skill: Factual
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25)Your sister suddenly begins to leap about, jumping and dancing in the streets. During the Middle Ages, she would most likely be diagnosed with A) melancholia. B) trephination. C) the Tarantella. D) an excess of phlegm. E) spiritus vitae. Answer: C Diff: 2 Type: MC Skill: Application
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26)According to Paracelsus, St. Vitus' Dance was caused by A) tarantula bites. B) psychic conflicts. C) imbalances in bodily fluids. D) mania. E) possession by evil spirits. Answer: B Diff: 2 Type: MC Skill: Factual
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27)Which of the following persons and treatments DO NOT match? A) Paracelsus and hypnotism B) Hippocrates and rest C) Galen and sympathetic listening D) Weyer and chanting E) Avicenna and behavior therapy Answer: D Diff: 1 Type: MC Skill: Conceptual
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28)What do the views of Paracelsus, Teresa of Avila, and St. Vincent de Paul have in common? A) They all attempted to develop a new system of classification. B) They believed that religious approaches could lead to a cure. C) They established asylums to humanely care for the mad. D) They argue for a more naturalistic approach to viewing mental illness. E) Each of them contributed to Freud's system of psychoanalysis. Answer: D Diff: 1 Type: MC Skill: Conceptual
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29)The term “bedlam” originated from A) a method of treatment used in early asylums. B) the lack of beds that was common in early asylums. C) the bizarre behaviour known as St. Vitus' dance. D) moments of frenzy among mad people. E) behaviour of the patients in deplorable early European asylums. Answer: E Diff: 1 Type: MC Skill: Factual
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30)Early treatment of the mentally ill in the United States A) was more successful than many of the earlier treatments had been. B) was more humane than most of the approaches outside North America. C) was at times similar in cruelty to early supernatural treatments. D) differed from European treatment due to different societal values. E) was less successful than treatments introduced during the Middle Ages. Answer: C Diff: 2 Type: MC Skill: Application
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31)Treatment in the town of Gheel is similar to A) modern day treatment programs. B) a humanistic approach. C) a community treatment approach. D) that of the early Greeks. E) treatment advocated by many of the early Europeans. Answer: C Diff: 1 Type: MC Skill: Conceptual
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32)English “workhouses” were A) established during the Enlightenment period to deal with the insane. B) run by the patients. C) run by physicians. D) were special places where the mentally ill could work. E) used to hide the poor from society. Answer: E Diff: 1 Type: MC Skill: Factual
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33)Which of the following individuals is known for promoting a more humanitarian approach in mental hospitals? A) Benedict Morel B) Philippe Pinel C) St. Vincent de Paul D) Johannes Weyer E) Benjamin Rush Answer: B Diff: 1 Type: MC Skill: Factual
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34)This individual's campaign to improve the conditions for the mentally ill resulted in the opening of 32 state hospitals, including two in Canada. A) Dorothea Dix B) Cabanis C) Benjamin Rush D) William Tuke E) Philippe Pinel Answer: A Diff: 1 Type: MC Skill: Factual
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35)The mental hygiene movement A) resulted in a reduction in the number of people in institutions. B) resulted in an increase of patients in mental institutions. C) led to an increase in moral therapy. D) was criticized by Philippe Pinel. E) led to the advent of antipsychotic drugs. Answer: B Diff: 2 Type: MC Skill: Conceptual
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36)All of the following are valid criticisms of the mental hygiene movement EXCEPT A) psychosocial treatments were less effective due to the large number of patients. B) physical treatments were often unpleasant. C) living conditions in the asylum were unpleasant. D) the original goals of the movement were less than nobel. E) overcrowding in asylums prevented proper care. Answer: A Diff: 2 Type: MC Skill: Conceptual
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37)Moral therapy implies that A) psychological therapy should be administered by the Church. B) psychological therapy should be used more often. C) mentally ill patients can benefit from spiritual enlightenment. D) mentally ill patients need to be taught a moralistic approach to life. E) mentally ill patients can be treated without chemical or physical restraints. Answer: E Diff: 2 Type: MC Skill: Conceptual
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38)Which of the following accomplishments are NOT attributed to Pinel? A) looking to natural explanations as the cause of mental illness B) clearly describing the symptoms of disorders C) emphasizing the role of psychological and social factors in the development of mental illness D) developing a systematic approach to classifying disorders E) bringing moral therapy to North America Answer: E Diff: 2 Type: MC Skill: Factual
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39)Cabanis (1757-1808) introduced the idea that personal factors as well as somatic factors accounted for mental disorders. His theories encouraged the __________ approach to treatment. A) physical B) social C) institutional D) psychological E) biological Answer: D Diff: 1 Type: MC Skill: Factual .. 10
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40)__________ introduced “degeneration” theory, which proposed that abnormal functioning was transmitted by hereditary processes. A) Pinel B) Cabanis C) Charles Darwin D) Cesare Lombroso E) Benedict Morel Answer: E Diff: 1 Type: MC Skill: Factual
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41)Clinical Psychiatry, published by Kraepelin in 1883, was an important textbook because it A) introduced pioneering treatments for severe mental disorders. B) explained the causes of many common mental disorders. C) attempted to classify mental illnesses. D) joined together the professions of clinical psychology and psychiatry. E) described methods of treatment for psychiatric disorders. Answer: C Diff: 2 Type: MC Skill: Factual
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42)Which of the following are classification systems of mental illness? A) CP-10 B) GPI C) ECT D) WRS-R E) DSM-IV-TR Answer: E Diff: 1 Type: MC Skill: Factual
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43)“All mental disorders are the result of biological problems.” Who would be most likely to agree with this statement? A) Breuer B) Kraepelin C) Pinel D) Freud E) Watson
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Answer: B Diff: 1 Type: MC Skill: Application
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44)Kraepelin's system of classification of mental illness A) did not influence later classification systems. B) suggested that psychological factors caused disorders. C) failed to recognize that certain groups of symptoms tended to occur together. D) recognized that different disorders were distinct. E) offered suggestions for treatment. Answer: D Diff: 2 Type: MC Skill: Factual
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45)Groups of symptoms that tend to occur together are called A) biological. B) disabilities. C) categories. D) diatheses. E) syndromes. Answer: E Diff: 1 Type: MC Skill: Factual
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46)Symptoms during the later stages of general paresis of the insane may show similarity to A) bipolar disorder. B) disorders such as Alzheimer's. C) antisocial personality disorder. D) autism. E) schizophrenia. Answer: B Diff: 3 Type: MC Skill: Conceptual
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47)The germ theory of disease led to the idea that A) it was important to wash your hands after being with psychiatric patients. B) only biological treatments are beneficial for mental illness. C) heredity plays an important role in the transmission of mental disease. D) General Paresis of the Insane may be a consequence of syphilis. E) germs may cause anxiety.
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Answer: D Diff: 2 Type: MC Skill: Application
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48)Somatogenesis refers to A) a disorder where people feel their body is not theirs. B) the idea that mental disorders are caused by biological factors. C) somatization disorder. D) a method of treating general paresis. E) the idea that mental disorders are caused by psychological factors. Answer: B Diff: 1 Type: MC Skill: Factual
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49)Insulin-induced comas were used by Sakel during the mid-20th century to treat A) schizophrenics. B) anxiety disorders. C) depression. D) diabetics. E) alcoholics. Answer: A Diff: 1 Type: MC Skill: Factual
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50)ECT (electric shock therapy) proved to be most successful in treating A) epilepsy. B) anxiety. C) drug addiction. D) depression. E) schizophrenics. Answer: D Diff: 1 Type: MC Skill: Factual
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51)Dr. Ramos treats patients suffering from mood disorders, and she believes that their illnesses are a result of imbalances of chemicals in the brain. She would most likely adhere to which field of psychology? A) psychopharmacology B) cognitive psychology C) psychoanalysis D) clinical psychology E) health psychology
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Answer: A Diff: 1 Type: MC Skill: Application
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52)Jason has been given Ritalin to control his hyperactive moods. He is receiving A) pharmacotherapy. B) palliative therapy. C) psychotherapy. D) psychosurgery. E) psychoanalysis. Answer: A Diff: 1 Type: MC Skill: Application
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53)Mesmer believed that hysteria was the result of A) a wandering uterus. B) disturbances in the distribution of magnetic fluids. C) imbalances in brain chemicals. D) too little of the neurotransmitter acetylcholine. E) animal magnetism. Answer: B Diff: 2 Type: MC Skill: Factual
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54)You are one of Mesmer's assistants during the 1700s. Your treatment of choice for dealing with hysteria would be considered a predecessor of A) psychopharmacotherapy. B) hypnotism. C) spiritual healing. D) the cathartic method. E) psychotherapy. Answer: B Diff: 2 Type: MC Skill: Application
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55)__________ believed that hypnotism was not valuable in treating hysterics. A) Braid B) Breuer C) Charcot D) Janet E) Watson
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Answer: E Diff: 2 Type: MC Skill: Factual
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56)In the mid to late 1800s, several therapists became quite well known. Which of the following represents a correctly matched therapist and his treatment? A) Breuer & talk therapy B) Charcot & anesthesia therapy C) Mesmer & animal hypnosis D) Freud & sex therapy E) Watson & hypnotherapy Answer: A Diff: 2 Type: MC Skill: Conceptual
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57)In writing an essay on behaviourism, you would be likely to include all of the following statements EXCEPT A) abnormal behaviour is learned. B) psychology must be restricted to observable behaviour. C) behavioural approaches produced a revolution in psychological thought. D) Watson acknowledged that abnormal behaviour was likely present at birth. E) behavioural approaches have become established in treatment of disorders. Answer: D Diff: 1 Type: MC Skill: Conceptual
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58)Jonah is afraid of heights. Dr. Morlin employs an approach to deal with Jonah's phobia that involves having Jonah practice exposing himself to high places. This approach would best be viewed as A) psychopharmacological. B) behavioural. C) biological. D) cathartic. E) psychoanalytical. Answer: B Diff: 2 Type: MC Skill: Application
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59)The first asylum for the mentally ill established in Canada was A) Vancouver Psychiatric Hospital. B) Montreal's Allen Memorial Hospital. C) the Rockwood asylum in Kingston.
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D) the Hotel Dieu in Quebec. E) the Hotel Dieu in Calgary. Answer: D Diff: 1 Type: MC Skill: Factual
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60)In which province of Canada was the development of proper places of care for the mentally ill during the early 17th century most accepted? A) Alberta B) Manitoba C) Quebec D) British Columbia E) Ontario Answer: C Diff: 2 Type: MC Skill: Factual
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61)The first textbook printed in Canada dealing with the care and housing of the mentally ill A) encouraged patience and tolerance. B) suggested that the mentally ill be treated at home. C) reflected the moral therapy approach. D) recommended treating them with floggings. E) recommended drug therapy. Answer: D Diff: 2 Type: MC Skill: Factual
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62)Lobotomies were widely used treatments in Canada during the mid-1940s. This treatment involved A) lesioning of the brain by electrodes. B) pharmacotherapy. C) disconnection of the frontal lobes of the brain. D) removal of the cerebellum. E) removal of the ovaries in women. Answer: C Diff: 1 Type: MC Skill: Factual
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63)Montreal's Allen Memorial Hospital was A) the first place in Canada to use psychoanalysis. B) founded by Ewen Cameron. .. 16
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C) a place where the criminally insane were housed. D) the site of a research project funded by the CIA. E) a leading Canadian hospital in the treatment and care of psychiatric patients. Answer: D Diff: 2 Type: MC Skill: Factual
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64)Cameron's experiments were problematic because A) he attempted to brainwash patients through various “treatments”. B) patients agreed to participate. C) he did not realize the CIA were involved. D) they received public approval. E) his patients were not troubled by the research. Answer: A Diff: 1 Type: MC Skill: Conceptual
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65)Dr. Ruth Kajander can be noted for A) unique blend of drug and talk therapy with severely disordered patients. B) her role in the CIA-funded research in Montreal. C) recognizing the value of tranquillizers in treating depression. D) treating and reducing anxiety in patients prior to surgery. E) using chlorpromazine to treat schizophrenics. Answer: E Diff: 2 Type: MC Skill: Factual
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66)Each of the following persons based in Canada contributed to both theory and treatment EXCEPT A) J. F. Lehman. B) Donald Meichenbaum. C) Albert Bandura. D) Ruth Kajander. E) Richard Walters. Answer: A Diff: 1 Type: MC Skill: Conceptual
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67)Which of the following persons and accomplishments are INCORRECTLY matched? A) Breuer and hypnosis B) Meichenbaum and cognitive-behaviour therapy C) Bandura and social learning theory .. 17
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D) Kajander and depression E) Bandura and aggressive behaviour Answer: D Diff: 2 Type: MC Skill: Conceptual
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68)Canadian psychologist Donald Meichenbaum's early work contributed significantly to the growth of __________ therapy. A) moral B) social-behaviour C) psychopharmalogical D) cognitive-behaviour E) social learning Answer: D Diff: 2 Type: MC Skill: Factual
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69)According to the statistical concept, abnormal behaviour is that which occurs relatively infrequently. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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70)Distress must be present in order for an individual to be diagnosed as suffering from a mental disorder. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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71)Many mentally ill people are unpredictable and dangerous to themselves and others. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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72)Thomas Szasz claimed that the labels used to describe mental disorders reflected ways of controlling individuals suffering problems in living. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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73)Sigmund Freud has been called the father of modern medicine. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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74)The bodily fluids believed to influence mental functioning were called humours. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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75)The ancient physician Galen believed that mental disorders were entirely the result of physical causes. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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76)The Arab world's approach to dealing with the mentally ill was that of compassion and humanity. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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77)Galen wrote The Canon of Medicine, one of the most widely read medical books ever written.
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A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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78)Supernatural explanations of mental illness became popular in Europe during the Middle Ages. A) True B) False Answer: A Diff: 1 Type: TF Skill: Conceptual
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79)In the Middle Ages it was generally believed that those who were insane were possessed. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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80)Johannes Weyer rejected the four humours theory of mental illness and claimed that mental illness resulted from disturbances of the spiritus vitae. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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81)Paracelsus believed that psychic conflicts may result in mental illness and treated patients using and early form of hypnotism. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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82)The first mental institution in North America was built by the Moors at San Hippolyto in Mexico. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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83)Teresa of Avila and St. Vincent de Paul influenced the development of a more scientific approach to treating mental illness. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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84)During the 17th century in Europe, the trend was toward an increasingly more humane and rational approach to dealing with the mentally ill. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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85)Philippe Pinel was responsible for bringing moral therapy to North America. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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86)Mesmer's work with hysteria sparked an interest in psychological explanations of disorders. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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87)The early efforts of Canadian provincial governments to care for the insane were characterized by an unsystematic approach. .. 21
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A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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88)Albert Bandura and Richard Walters were responsible for developing cognitive behavioural therapy. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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89)Explanations for abnormal behaviour depend on various factors. Use several examples and describe some reasons why certain behaviours are or are not considered “abnormal.” Answer: Some people hold certain beliefs that others may consider odd or bizarre. However, the difficulty that exists is determining whether or not a particular behaviour is abnormal. For example, extremely religious individuals may believe in spirits and healing powers, but they are not mentally disordered. Although someone may behave in an odd manner, it does not necessarily mean that he or she is psychologically disordered. As well, someone who commits criminal acts is behaving in a deviant manner, but is not mentally disordered. Therefore, it is important to keep in mind that our interpretations or ideas of how other people behave may not necessarily imply that that individual is mentally ill. Diff: 2 Type: ES Page Ref: 2-3 Skill: Conceptual 90)Briefly describe and critique the principles used to establish the criteria for abnormality. Which definition best defines the concept of abnormality? Answer: Several principles are commonly used when determining the definition of abnormality. The statistical concept claims that behaviour should be judged abnormal if it occurs infrequently in the population. However, not all infrequent thoughts or actions should be considered abnormal. Those with an extremely high IQ are rare, but would be considered gifted as opposed to abnormal. As well, some problem behaviours are quite common (e.g., depression, alcoholism). Personal distress and dysfunction are often used as criteria. Manic patients may feel little distress, however, and individuals who feel dissatisfied or in despair would not be labelled abnormal. Schizophrenics, for example, may behave in ways counter to social norms; yet, so do criminals, and not all criminals are diagnosed with a mental disorder. It is generally a mental health expert who determines whether an individual suffers from a disorder, yet some believe that mental illness is socially constructed and judged differently by different persons. None of the .. 22
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above criteria, on its own, is satisfactory in defining abnormal behaviour. No single criterion must be present or sufficient in defining abnormal behaviour, and generally all are used to some degree. Diff: 2 Type: ES Page Ref: 3-7 Skill: Conceptual 91)Approaches to conceptualizing and treating abnormality have changed over time. Why is it valuable to be aware of the historical approaches to treating the mentally ill? Answer: Many changes have occurred throughout time in the ways we have theorized about and treated mental illness. By examining historical accounts, we are better able to understand what we do today. Most of the ideas about abnormal behaviour reflect the general views of the time. When we criticize the ideas and treatments used in the past, we must remember that, in the future, people may scoff at our methods of treatment. Our ideas of what constitutes abnormal behaviour have changed over time. For example, in the past, individuals having visions were seen as gifted, whereas today they would be viewed as psychotic. Supernatural causes, such as possession, were accepted in the past as causing mental illness, while today natural causes such as biology, the environment, or personal experiences are accepted. It is important to keep in mind that many individuals, from Canada and elsewhere, have made discoveries that have influenced where we are today. Many more research and treatment findings will likely influence future treatment and conceptualization of mental disorders. Diff: 2 Type: ES Page Ref: 7-8 Skill: Factual 92)Compare and contrast the causes and treatment methods for madness used in Stone Age cultures and by the ancient Greeks and Romans and the Arabs. Answer: Evidence from prehistory has implied that the Stone Age surgeons cut small holes in the skull (trephination), possibly to release evil spirits that were causing the victim to engage in abnormal behaviour. Hunter-gatherer societies viewed madness as resulting from supernatural causes, and they tended to invoke an emotional release through the use of trances. Greek and Roman thought emphasized more natural causes for madness. Hippocrates believed that madness was caused by an imbalance in bodily fluids, and his treatment methods reflected a more scientific approach. He suggested treatments such as exercise, bleeding and vomiting, and a good diet. Plato emphasized sociocultural causes and looked to the importance of dreams. His treatment approach reflected more of community care, suggesting that relatives should care for the mentally ill at home. Galen stressed both physical and mental sources of disorder, and effective treatments included comfortable surroundings (no stressful procedures), and talking about difficulties. The Arabs held a supportive, compassionate attitude towards the mentally ill. Treatment reflected these attitudes, with asylums being places of refuge and protection. Thus, views of mental illness changed from supernatural to natural, with treatment methods changing as well. Diff: 2 Type: ES Page Ref: 8-10 Skill: Application .. 23
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93)Describe the contributions of two historical persons in Europe who influenced the theory and treatment of mental illness. Answer: Paracelsus (1493-1541) was one of the first to attack the beliefs about the supernatural and offered naturalistic origins to madness. He rejected the four humours theory of Hippocrates and attempted to develop a new system classification where all mental illness was seen to stem from disturbances of the spiritus vitae. He was the first to suggest that psychic conflicts caused mental disorders and utilized an early version of hypnotism as treatment. His view represented a more scientific approach to dealing with mental illness. Philippe Pinel (1745-1826), was one of the leaders of the reform movement to improve conditions for the mentally ill. Pinel was a true humanitarian who carried out dramatic changes in institutions at a time when few accepted his ideas. As well, he influenced psychiatry as a whole by developing a systematic and statistical approach to classifying, managing, and treating mental disorders. He was a scientist who emphasized natural causes to mental illness and firmly believed that the mentally ill should be treated with compassion and respect. Diff: 2 Type: ES Page Ref: 10-15 Skill: Factual 94)Despite its aims, the mental hygiene movement of the 19th century did not meet its goals. Describe the reasons for this movement, the instrumental figures responsible for this movement, and the reasons behind its lack of success. Answer: Conditions for the mentally ill during the 1800s were horrendous. The mentally ill were left wandering from place to place and were rarely taken proper care of. In poorhouses, they were chained up and often taunted by visitors. Thus, reformers insisted on the establishment of mental asylums where proper care would be given to the mentally ill. Dorothea Dix (1802-1877), who became one of the leaders of the mental hygiene movement, visited a local prison, and, horrified by the conditions, became determined to make changes. She was also concerned with the suffering of mental patients, and began a nationwide campaign to improve life for these individuals. Thus, the goal of the mental hygiene movement was to protect and provide humane treatment for the mentally ill. However, the movement of people into large asylums did not make life better. There was a problem with overcrowding, and staff did not have the time to properly care for the considerable number of patients. Physicians replaced psychosocial treatments with physical treatments, which were often cruel rather than compassionate. Diff: 2 Type: ES Page Ref: 14 Skill: Factual 95)Moral therapy was an important approach in the treatment of the mentally ill. Define the basis of this approach, describe the individuals responsible for promoting this approach, and why it lost popularity.
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Answer: Moral therapy, advocated by humanitarian reformers (such as Lett, Pinel, Tuke, and Rush), gained popularity in Europe and North America during the early 1800s. Moral therapy was based on the idea that the insane should be treated humanely, without physical restraints. Patients were to be treated with compassion and respect, in a relaxing, stress-free environment. Most advocates of moral therapy believed they could cure mental illness through peaceful surroundings, proper diet and exercise, and activities. In fact, moral therapy did appear to have positive benefits. However, during the 1900s, moral therapy in Canada lost popularity and was replaced by physical and chemical restraints and somatic therapy. Public institutions became larger, thus decreasing the use of moral therapy. Biological approaches suggested that mental problems could be solved quickly and easily through surgery or medication. Even today, no one therapy quite exemplifies the humane approach of moral therapy. Diff: 2 Type: ES Page Ref: 12-15 Skill: Factual 96)The growth of mental health services in Canada has been characterized by both positive and negative accomplishments. Describe two of the negative practices used and speculate on the importance of these events for modern practices. Answer: Various harsh methods have been used in the name of treating the mentally ill in Canada, even as late as the mid-1900s. One widely used treatment method was psychosurgery, such as prefrontal lobotomies. Tens of thousands of Canadians during the 1940s-60s had the frontal lobes of their brains disconnected or surgically removed. Most of these early lobotomies appeared to be performed to advance research or make life easier for the staff, as opposed to the health of the patient. Another abuse of psychiatric power in Canada was the brainwashing experiments performed by Dr. Ewen Cameron, at Montreal's Allen Memorial Hospital during the late 1950s and early 1960s. Cameron “treated” the patients to massive doses of electroconvulsive therapy, prolonged sensory deprivation, and chemically-induced sleep. During their periods of sleep, he played audiotapes to the patients telling them how horrible they were and they must change. These unfortunate patients were also injected with LSD and were not told that they were being used in a research experiment. These two examples make us aware of the importance of treating patients ethically and with respect and humanity. It is important that people in charge of the mentally ill do not abuse their power and that their treatment be properly monitored. We need to make an attempt to help the mentally ill with as little discomfort as possible. Diff: 2 Type: ES Page Ref: 18-20 Skill: Factual 97)Describe why the discovery that syphilis was the cause of general paresis was important to the modern view of mental illness. Answer: Richard von Krafft-Ebing (1840-1902) was interested in the possibility that patients suffering from General Paresis of the Insane (GPI) may have acquired it through infection. Following Pasteur's germ theory of disease, Krafft-Ebing discovered that GPI was a long-term effect of syphilis. This finding sparked the view that all mental disorders .. 25
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might be caused by infections or some other biological factors. Somatogenesis (the belief that psychopathology is caused by biological factors) became a popular approach for those in the mental health field. There was increased optimism that all disorders would be cured by medical means.The discovery that GPI was caused by syphilis resulted in a more scientific approach to viewing mental illness and encouraged the use of various physical approaches to treatment. Diff: 2 Type: ES Page Ref: 15-16 Skill: Conceptual 98)Compare and contrast the somatogenic and psychogenic approaches to mental health and describe the positive effect that these approaches have had. Answer: The somatogenic approach focuses on biology. Somatogenecists assume that mental illnesses are caused by infections or disrupted biological functioning. The early somatogenecists thought that medication or surgery would “cure” the infection or physical problem, and mental health would be renewed. This approach was quite popular during the late 1800s and resulted in a more scientific approach to psychology, as well as experimentation with different types of physical treatments. During the 1950s, pharmacological agents became available and were associated with the idea that mental disorders are caused by chemical imbalances in the brain. During this time, the effects that neurotransmitters had on behaviour was discovered and many drugs were synthesized which could be used to treat psychiatric patients. This proved to be very valuable. Psychogenic approaches focus on the psychological factors underlying mental illness. These approaches include Freud's psychoanalytic approach, Watson's behaviourism, and numerous others. Mesmer's work with hysteria spurred interest in this approach, treating hysteria with an early form of hypnosis. Charcot and Janet became particularly interested in psychological explanations of hysteria and the use of hypnosis as a treatment. Thus, psychoanalysis was born, as Breuer and Freud began to employ methods such as hypnosis and encouraging patients to talk about their past and their problems. Behaviourists believed that abnormal behaviour was learned and could be unlearned, and that in order for psychology to function as a science, only observable behaviour should be focused on. Although extremely different, both models have generated much research and increased our knowledge about the causes of mental illnesses, and generated effective treatments. Diff: 2 Type: ES Page Ref: 16-18 Skill: Factual
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CHAPTER 2 Theoretical Perspectives on Abnormal Behaviour 1) The view that biology largely determines human behaviour A) became far more popular in the 1990s than it was in the late 1960s or early 1970s. B) became far less popular in the 1990s than it was in the late 1960s or early 1970s. C) remained as popular in the 1990s as it was in the late 1960s or early 1970s. D) has been rejected by 20th century psychologists. E) was not seriously considered by 20th century psychologists. Answer: A Diff: 1 Type: MC Skill: Factual
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2) A theory of abnormal behaviour A) should only consider biological factors. B) should be abandoned when shown to be incorrect, regardless of whether there is a better one available. C) should not be considered useful if it has been shown to be incorrect, even if it generates further research. D) should be judged solely on how well it matches current information. E) should be abandoned only when there is a better one available. Answer: E Diff: 3 Type: MC Skill: Conceptual
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3) Single-factor explanations A) tend to identify risk factors rather than specific causes of dysfunctional behaviour. B) posit one factor which is said to cause a particular psychological disorder. C) are generally preferred over other explanations because of its simplicity. D) often reflect a high level of current comprehensive knowledge of disorders. E) view behaviour as the product of the interaction of several factors. Answer: B Diff: 2 Type: MC Skill: Factual
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4) According to the text, scientific theories, such as those of abnormal psychology, are judged to be valuable for all of the following reasons EXCEPT: A) they make predictions about aspects of the phenomena that had not previously been made. B) they make it possible to specify the evidence necessary to deny the theory. C) they are parsimonious.
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D) they integrate most of what is presently known about the phenomena. E) they describe the enduring truth about an issue. Answer: E Diff: 2 Type: MC Skill: Conceptual
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5) Theories A) are never completely replaced in science because a better theory comes along. B) are not facts, but rather the best approximation possible at the present time. C) represent the known facts of current understanding. D) can be proven correct, if enough evidence is gathered. E) must be shown to be true by scientists. Answer: B Diff: 3 Type: MC Skill: Conceptual
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6) In science, experiments are set up not to prove the worth of a theory, but rather to reject what is called the A) rejection hypothesis. B) test hypothesis. C) experimental hypothesis. D) null hypothesis. E) false hypothesis. Answer: D Diff: 1 Type: MC Skill: Factual
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7) According to the text, which of the following is NOT a general aim of theories about mental disorders? A) to identify characteristics that precede and follow episodes of the problem behaviour B) to predict the course of the disorder C) to identify the factors that maintain the behaviour D) to design effective treatments E) to explain the origins of the problem behaviour Answer: A Diff: 1 Type: MC Skill: Factual
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8) The effects of untreated phenylketonuria (PKU) are A) markedly increased blood levels of phenylalanine, resulting in obsessive-compulsive disorder in adulthood.
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B) markedly increased blood levels of phenylalanine, resulting in severe mental retardation. C) markedly increased blood levels of phenylalanine, resulting in severe dyslexia. D) markedly increased blood levels of glycogen, resulting in severe dyslexia. E) markedly increased blood levels of glycogen, resulting in severe mental retardation. Answer: B Diff: 1 Type: MC Skill: Factual
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9) Baxter et al (1992) conducted brain imaging studies of people suffering from obsessive-compulsive disorder. The results indicated A) excessive activity in the right parietal lobe of those suffering from obsessivecompulsive disorder. B) a defective brain circuit related to the participants' symptoms, which remained defective in those who received strictly psychological treatment. C) a defective brain circuit related to the participants' symptoms, which had been normalized in those who received strictly psychological treatment. D) excessive activity in the left inferior parietal lobe of those suffering from obsessivecompulsive disorder. E) no brain abnormalities in those suffering from obsessive-compulsive disorder. Answer: C Diff: 1 Type: MC Skill: Factual
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10) Biological theories of abnormal behaviour have primarily implicated dysfunctions in A) the brain (central nervous system), the peripheral nervous system, or the endocrine system. B) the peripheral nervous system and the endocrine system, but not the brain. C) the brain and the peripheral nervous system, but not the endocrine system. D) the brain only. E) the brain and the endocrine system, but not the peripheral nervous system. Answer: A Diff: 1 Type: MC Skill: Factual
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11) Dementia, a deterioration in cognitive processes seen in disorders such as Parkinson's or Alzheimer's, has been linked to A) spinal cord injury. B) dysfunction of the reticular activating system of the midbrain. C) dysfunction of the hindbrain. D) the general loss or ineffective functioning of brain cells. E) damage to the cerebellum.
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Answer: D Diff: 1 Type: MC Skill: Factual
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12) Current theories about the brain bases of abnormal behaviour have A) have not seriously considered the roles of neurotransmitters and neuronal damage. B) have given equal weight to the roles of neurotransmitters and neuronal damage. C) given more weight to the role of neurotransmitters than to actual neuronal damage. D) have only considered the role of one neurotransmitter, dopamine. E) given more weight to the role of actual neuronal damage than to neurotransmitters. Answer: C Diff: 2 Type: MC Skill: Factual
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13) Which of the following statements concerning neurotransmitters is NOT true? A) The various neurotransmitters are spread fairly evenly throughout the brain, and are believed to play approximately equal roles in different functions (such as exploratory behaviours). B) The majority of research concerning neurotransmitters has examined dopamine, serotonin, norepinephrine and (more recently) gamma aminobutyric acid (GABA). C) Neurotransmitters either inhibit or activate an impulse in the post-synaptic neuron. D) Neurotransmitters carry their messages across a gap between neurons called a “synapse” or “synaptic cleft”. E) Neurotransmitters are the chemical substances that carry messages from one neuron to the next. Answer: A Diff: 2 Type: MC Skill: Factual
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14) Which of the following is NOT a manner in which disturbances in neurotransmitter systems can result in abnormal behaviour? A) having certain neurotransmitters working in brain circuits not responsive to those transmitters B) having an excess or deficit in the amount of the transmitter-deactivating substance in the synapse C) having too much or too little of the neurotransmitter produced or released into the synapse D) having too few or too many receptors on the dendrites of the receiving neurons E) having the process of reuptake (drawing released neurotransmitters back into the releasing axon) be too rapid or too slow Answer: A Diff: 3 Type: MC Skill: Factual .. 4
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15) An experiment by Canadian neurophysiologist Bryan Kolb and his colleagues demonstrated that the offspring of rats raised in a complex environment exhibited A) decreased synaptic space on the neurons in the their cerebral cortex. B) increased synaptic space on the neurons in their cerebral cortex. C) an increase in the speed of neuronal transmission. D) increased numbers of the neurotransmitter dopamine. E) a decrease in the speed of neuronal transmission. Answer: B Diff: 3 Type: MC Skill: Factual
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16) The autonomic nervous system consists of A) the somatic nervous system and the sympathetic nervous system. B) the somatic nervous system and the parasomatic nervous system. C) the sympathetic nervous system and the parasympathetic nervous system. D) the central nervous system and the peripheral nervous system. E) the somatic nervous system and the endocrine system. Answer: C Diff: 1 Type: MC Skill: Factual
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17) The Canadian physician Hans Selye established the area of study now known as A) biofeedback. B) stress physiology. C) comparative psychology. D) neuropsychology. E) behavioural genetics. Answer: B Diff: 1 Type: MC Skill: Factual
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18) Which of the following has been shown to be involved in fear and anxiety reactions, and thus perhaps in phobias or other anxiety disorders? A) the parasympathetic nervous system B) the sympathetic nervous system C) the gonads D) the somatic nervous system E) the thalamus Answer: B Diff: 1 Type: MC Skill: Factual .. 5
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19) People suffering from Generalized Anxiety Disorder (GAD) A) have been demonstrated to display chronic muscle tension. B) have been described as parasympathetic restrictors because of their consistently low parasympathetic nervous system activity. C) have extremely high levels of the neurotransmitter dopamine. D) have extremely low levels of the neurotransmitter dopamine. E) have been demonstrated to display chronic muscle relaxation. Answer: A Diff: 2 Type: MC Skill: Factual
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20) The hypothalamus A) secretes “releasing” hormones that activate the pituitary gland. B) is activated by hormones released by the pituitary gland. C) is often called the “master gland”. D) directly releases prolactin and adrenocorticotrophic hormone into the body. E) releases sex hormones in response to signals from the pituitary gland. Answer: A Diff: 1 Type: MC Skill: Factual
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21) Which of the following statements is correct? A) Hypoglycemia, a disorder known to be related to a defective thyroid gland, results in a variety of psychiatric symptoms including anxiety and depression. B) Cretinism, a disorder known to be related to the failure of the pancreas to produce balanced levels of insulin or glycogen, produces experiences that mimic anxiety. C) Cretinism, a disorder known to be related to a defective thyroid gland, results in a variety of psychiatric symptoms including anxiety and depression. D) Hypoglycemia, a disorder known to be related to a defective thyroid gland, results in a dwarflike appearance and mental retardation. E) Cretinism, a disorder known to be related to a defective thyroid gland, results in a dwarflike appearance and mental retardation. Answer: E Diff: 3 Type: MC Skill: Factual
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22) Regarding the HPA axis which of the following statements is true? A) Too little cortisol in the long term can have adverse effects. B) Too much cortisol in the long term can have adverse effects. C) Too little cortisol in the short term can have adverse effects. D) Too little glycogen in the long term can have adverse effects. E) Too much glycogen in the short term can have adverse effects. .. 6
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Answer: B Diff: 3 Type: MC Skill: Conceptual
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23) Which seventeenth-century English philosopher thought that aggression and selfinterest were inborn features of all humans? A) Sigmund Freud B) John Locke C) Thomas Hobbes D) William Shakespeare E) William Bentham Answer: C Diff: 1 Type: MC Skill: Factual
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24) Which of the following statements is true? A) Cesare Lombroso declared that criminals could be identified by physiological features they inherited from their degenerate parents. B) Arthur Jensen declared that criminals could be identified by physiological features they inherited from their degenerate parents. C) Arthur Jensen declared that criminals could be identified by psychological features they inherited from their degenerate parents. D) Paul Broca declared that criminals could be identified by physiological features they inherited from their degenerate parents. E) Cesare Lombroso declared that criminals could be identified by psychological features they inherited from their degenerate parents. Answer: A Diff: 3 Type: MC Skill: Factual
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25) Research into the genetic basis of psychiatric disorders typically takes one of three forms. These three methods are: A) adoption studies, family studies, and sibling studies. B) family studies, sibling studies, and adoption studies. C) family studies, twin studies, and adoption studies. D) twin studies, family studies, and sibling studies. E) sibling studies, adoption studies, and twin studies. Answer: C Diff: 2 Type: MC Skill: Conceptual
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26) Genetic linkage studies rely upon A) the identification of environmental factors that relate to a particular psychiatric disorder that runs in families. B) the identification of genetic markers that can be linked to the occurrence of a disorder within the general population. C) the identification of genetic markers that can be linked to the occurrence of a disorder within extended families. D) the identification of environmental factors that relate to a particular psychiatric disorder within the general population. E) the identification of several genes within a single person that combine to produce a particular psychiatric disorder. Answer: C Diff: 2 Type: MC Skill: Conceptual
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27) Sigmund Freud, founder of the psychodynamic school of thought, was a A) behaviourist from Chicago. B) psychologist from Paris. C) psychiatrist from Berlin. D) neurologist from Vienna. E) hypnotist from Oslo. Answer: D Diff: 3 Type: MC Skill: Factual
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28) Which statement is NOT true about Bertha Pappenheim, also known as Anna O.? A) She revealed traumatic past experiences associated with deep emotional responses during hypnosis. B) She became Germany's first social worker. C) She continued to suffer from intermittent recurrence of her problems for years after being told she was 'cured' by Freud's mentor, Josef Breuer. D) She became a leading feminist. E) Though she became quite hostile towards psychoanalysis, she grudgingly allowed the girls in the home she ran to be psychoanalyzed because of their considerable problems. Answer: E Diff: 1 Type: MC Skill: Factual
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29) What are the three levels of consciousness as distinguished by Freud? A) the preconscious, the conscious, and the unconscious B) the conscious, the subconscious, and the unconscious C) the conscious, the preconscious, and the subconscious D) the subconscious , the nonconscious, and the unconscious .. 8
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E) the conscious, the preconscious, and the unconscious Answer: E Diff: 2 Type: MC Skill: Factual
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30) The personality structure Freud called the id A) utilizes what is called “secondary process thinking”. B) is the internalization of the moral standards of society. C) begins to develop in the first year of life in response to experiences in which the infant's instinctual demands are not immediately met. D) represents the rational aspect of one's personality. E) acts according to the pleasure principle. Answer: E Diff: 1 Type: MC Skill: Factual
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31) Which of the following statements concerning the ego is true? A) It develops out of a concern for right and wrong. B) It develops in response to the Oedipal complex. C) It operates according to the pleasure principle. D) It operates according to the reality principle. E) It operates by “primary process thinking”. Answer: D Diff: 2 Type: MC Skill: Factual
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32) The superego A) develops to curb the desires of the id so that the individual does not suffer any unpleasant consequences. B) acts according to the reality principles. C) is the internalization of the moral standards of society. D) operates by “secondary process thinking”. E) represents biological or instinctual drives. Answer: C Diff: 1 Type: MC Skill: Factual
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33) According to Freud, the energy for the sexual drive called eros is referred to as __________. A) libido B) thanatos C) erogeny .. 9
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D) electra E) phallic Answer: A Diff: 1 Type: MC Skill: Factual
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34) In the first year of life, an infant is at the A) anal stage. B) latency stage. C) phallic stage. D) genital stage. E) oral stage. Answer: E Diff: 1 Type: MC Skill: Factual
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35) Alex is a four-year-old boy who starts telling his mother that he wants to marry her. Freud would characterize his behaviour as reflecting A) the Oedipal complex. B) the pleasure principle. C) sublimation. D) the fear of parental loss. E) castration anxiety. Answer: A Diff: 3 Type: MC Skill: Application
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36) Joe is often characterized as “chatter box.” A Freudian therapist would likely feel that he is fixated at which stage of development? A) latency stage B) oral stage C) phallic stage D) genital stage E) anal stage Answer: B Diff: 2 Type: MC Skill: Application
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37) At which stage of development did Freud believe that girls experience the Electra complex? A) oral stage B) phallic stage .. 10
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C) genital stage D) latency stage E) anal stage Answer: B Diff: 2 Type: MC Skill: Factual
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38) Freud's concept of the Oedipal complex is based upon a play by the Greek tragedian, Sophocles. In this play, the character Oedipus A) kills his father and marries his mother. B) kills his brother and marries his mother. C) kills his mother and marries his sister. D) kills his brother and marries his sister. E) kills his father and marries his sister. Answer: A Diff: 1 Type: MC Skill: Factual
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39) Freud believed that girls desired their fathers to gain what they strongly desire - a penis. Freud referred to this desire for the father as the A) Phallic complex. B) Displacement complex. C) Libido complex. D) Electra complex. E) Pandora complex. Answer: D Diff: 1 Type: MC Skill: Factual
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40) The case of Little Hans demonstrates what Freud meant by A) the pleasure principle. B) the reality principle. C) the moral principle. D) reaction formation. E) castration anxiety. Answer: E Diff: 3 Type: MC Skill: Factual
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41) Which of the following is true of the latency stage of development? A) Because sex is especially relevant during this stage, it has received a great deal of attention from psychoanalysts. .. 11
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B) It is a relatively quiescent stage. C) It spans the age range from approximately 3 to 6. D) Children in this stage typically associate with other children of the opposite sex. E) Children in this stage develop their toilet training skills. Answer: B Diff: 3 Type: MC Skill: Factual
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42) Freud believed that the ego employed __________ to allow the expression of libidinal desires in a distorted or symbolic form. A) insight B) object relations C) the id D) defence mechanisms E) primary process thinking Answer: D Diff: 2 Type: MC Skill: Factual
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43) According to Freud, __________ is the most fundamental of the defence mechanisms. A) repression B) denial C) projection D) reaction formation E) sublimation Answer: A Diff: 3 Type: MC Skill: Factual
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44) After putting up with numerous criticisms from his boss all day, John came home and yelled at his wife for no apparent reason. This illustrates the defense mechanism of A) regression. B) reaction formation. C) projection. D) denial. E) displacement. Answer: E Diff: 3 Type: MC Skill: Application
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45) Which of the following statements does NOT represent a valuable aspect of Freud's thinking, according to your text? A) He legitimized discussion and research on sexual matters. B) He recognized that the motives for human behaviour were not always the obvious ones. C) He encouraged a concern with processes beyond our awareness. D) He emphasized the need to support claims with empirical evidence. E) His work on defense mechanisms has witnessed the greatest acceptance among clinicians than any of his ideas. Answer: D Diff: 1 Type: MC Skill: Conceptual
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46) Early behaviourists such as Watson were A) environmentalists. B) psychoanalysts. C) biologists. D) geneticists. E) physicians. Answer: A Diff: 3 Type: MC Skill: Conceptual
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47) Watson's behaviourism was based on A) Freud's ideas concerning the development of the ego. B) the ideas of Freud's followers such as Carl Jung and Alfred Adler. C) classical conditioning. D) operant conditioning. E) social learning theory. Answer: C Diff: 3 Type: MC Skill: Factual
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48) Watson's most famous application of the process of “stimulus-stimulus learning” was to the acquisition of A) obsessive-compulsive disorder. B) post-traumatic stress disorder. C) schizophrenia. D) generalized anxiety disorder. E) phobias.
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Answer: E Diff: 1 Type: MC Skill: Factual
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49) The case of __________ has been interpreted both as an example of Freudian analysis and classical conditioning. A) Little Anna B) Little Otto C) Little Ivan D) Little Albert E) Little Hans Answer: E Diff: 3 Type: MC Skill: Factual
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50) Watson and his student, Rosalie Rayner, demonstrated that A) operant conditioning could instill a fear of a white rat in an eleven-month-old boy. B) classical conditioning could instill a fear of a horse in an eleven-month-old boy. C) classical conditioning could instill a fear of a white rat in an eleven-month-old boy. D) operant conditioning could instill a fear of a spider in an eleven-month-old boy. E) classical conditioning could instill a fear of a spider in an eleven-month-old boy. Answer: C Diff: 2 Type: MC Skill: Factual
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51) Classical conditioning accounts of phobias A) were strongly supported by B.F. Skinner. B) were first described by Freud. C) remain popular to this day. D) cannot explain many facets of phobias. E) help explain why certain fears persist. Answer: D Diff: 1 Type: MC Skill: Factual
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52) Part of Mowrer's two-factor theory of conditioning is derived from the work of __________ concerning __________. A) Burrhus F. Skinner; classical conditioning B) John B. Watson; classical conditioning C) Ivan Pavlov; stimulus-stimulus learning D) Burrhus F. Skinner; operant conditioning E) John B. Watson; operant conditioning
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Answer: D Diff: 2 Type: MC Skill: Factual
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53) Which of the following was NOT discussed by Skinner as a part of operant conditioning? A) negative punishment B) positive reinforcement C) stimulus-stimulus learning D) positive punishment E) negative reinforcement Answer: C Diff: 2 Type: MC Skill: Factual
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54) The two-factor theory explains the persistence of phobias in a way that simple classical conditioning cannot, by adding a __________ component to the process. A) negative reinforcement B) positive reinforcement C) vicarious reinforcement D) negative punishment E) positive punishment Answer: A Diff: 3 Type: MC Skill: Factual
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55) Geris is a clinical psychologist whose therapeutic approach reflects the view that thinking and behaviour are learned and thus can be changed. Further, her approach essentially follows the views expressed by Bandura's social learning theory. Which of the following is most likely Geris' treatment approach? A) cognitive-behavioural B) behavioural C) operant D) neo-psychodynamic E) cognitive Answer: A Diff: 1 Type: MC Skill: Application
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56) Sally became fearful of spiders as a child after repeatedly watching her mother show distress in the presence of a spider. Sally's fear of spiders is most easily accounted for by A) classical conditioning. B) social learning theory. .. 15
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C) cognitive theory. D) operant conditioning. E) stimulus-stimulus learning. Answer: B Diff: 2 Type: MC Skill: Application
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57) Which pair of pre-eminent cognitive theorists have offered accounts of the etiology and treatment of abnormal behaviour? A) Ellis and Beck B) Ellis and Rogers C) Watson and Skinner D) Bandura and Mowrer E) Bandura and Walters Answer: A Diff: 3 Type: MC Skill: Factual
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58) Albert Ellis A) developed a behaviourist view of abnormal behaviour which focused primarily on the role of reinforcement of dysfunctional behaviours. B) believed that people who were low in self-efficacy were more likely to develop low self-worth. C) discussed irrational beliefs, which he believed distort responding and increase feelings of worthlessness and hopelessness. D) argued that people with disorders have underlying cognitive schemata that inappropriately direct their processing of information. E) was the first to develop a form of cognitive-behavioural therapy, entitled “cognitiverational therapy”. Answer: C Diff: 1 Type: MC Skill: Factual
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59) In Beck's theory, content-specificity refers to the idea that A) people perceive themselves to be competent in very specific areas only, thereby limiting their potential for success in other areas. B) people sometimes engage in “all-or-none thinking”. C) people tend to define their self-worth in terms of irrational if-then statements. D) people are biased to selectively attend to information that is consistent with their prevailing schemas. E) people tend to hold beliefs that are related to different kinds of abnormal behaviour.
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Answer: E Diff: 3 Type: MC Skill: Conceptual
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60) Cognitive therapy has enjoyed most success with the treatment of A) phobias. B) eating disorders. C) anxiety and mood disorders. D) schizophrenia. E) personality disorders. Answer: C Diff: 2 Type: MC Skill: Factual
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61) The text claims that humanistic and existential theories can be considered to be variants on the __________ approach to understanding human behaviour, first clearly formulated by __________. A) phenomenological; Locke B) deterministic; Locke C) deterministic; Freud D) phenomenological; Husserl E) deterministic; Husserl Answer: D Diff: 3 Type: MC Skill: Factual
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62) According to the text, two of the most eminent advocates of humanistic psychology were A) Maslow, who discussed self-actualization; and Rogers, who discussed a personcentred approach. B) Maslow, who discussed self-efficacy; and Rogers, who discussed existential angst. C) Maslow, who discussed self-actualization; and Rosenhan, who discussed labelling theory. D) Maslow, who discussed labelling theory; and Rosenhan, who discussed selfactualization. E) Maslow, who discussed a person-centred approach; and Rogers, who discussed selfactualization. Answer: A Diff: 1 Type: MC Skill: Factual
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63) According to Carl Rogers, abnormal behaviour results from A) a person's distorted view of other people. .. 17
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B) a person's distorted need for self-fulfillment. C) a person's distorted view of the world. D) a person's distorted fear of death. E) a person's distorted view of himself or herself. Answer: E Diff: 2 Type: MC Skill: Conceptual
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64) Abraham Maslow believed A) that people are evil and only behave positively as a result of experience that has diverted from the path of self-actualization. B) the fulfillment of self-actualization often leads to abnormal behaviour in some people. C) that people are neither good nor evil and behave positively or negatively as a result of experience that has diverted them from the path of self-actualization. D) that there is a hierarchy of needs, with biological or survival needs at the top. E) that people are good and only behave dysfunctionally as a result of experience. Answer: E Diff: 3 Type: MC Skill: Factual
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65) Which of the following statements is NOT true of the existential approach? A) Considerable research has supported this approach to treatment. B) Treatment is directed at confronting clients with their responsibility for their actions, and helping them find meaning in their lives. C) A key concept is angst, a German word perhaps best translated as a sense of severe distress. D) Two leading exponents are Rollo May and Victor Frankl. E) Awareness of one's existence is a critical feature of human functioning. Answer: A Diff: 2 Type: MC Skill: Factual
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66) Which of the following is true of the Rosenhan study in which normal people were admitted to psychiatric hospitals complaining of hearing voices? A) The on-duty psychiatrists later admitted that they were wrong with their initial diagnoses. B) Once in the hospital, the pseudo-patients' normal behaviour was recognized as normal by the staff. C) Once in the hospital, some of the pseudo-patients did in fact start to show symptoms that confirmed their diagnoses. D) Each was diagnosed as suffering from a different disorder. E) The staff rarely responded to legitimate questions by the pseudo-patients.
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Answer: E Diff: 2 Type: MC Skill: Factual
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67) According to labelling theory, identifying someone as having a disorder A) can lead to the perception by others that the labelled person is dysfunctional and different. B) is an important first step for the person so labelled in seeking the proper type of treatment for their disorder. C) typically has little significance in the way of proper treatment. D) does not lead to unwarranted expectations by others about the person labelled. E) is important because it leads to the proper treatment. Answer: A Diff: 3 Type: MC Skill: Conceptual
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68) With respect to gender differences in the diagnosis of personality disorders, Pantony and Caplan (1991) point out that A) men and women are equally likely to be diagnosed with dependent personality disorder. B) men and women are equally likely to be diagnosed with antisocial personality disorder. C) men are more likely to be diagnosed with antisocial personality disorder and women more likely to be diagnosed with dependent personality disorder. D) gender does not appear to play role in the development of any particular personality disorder. E) men are more likely to be diagnosed with dependent personality and women more likely to be diagnosed with antisocial personality disorder. Answer: C Diff: 3 Type: MC Skill: Conceptual
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69) Which of the following reasons was NOT suggested by the text to potentially account for the finding that people who were aggressive or psychotic were far more likely to be identified among the poor than the middle class? A) Dysfunctional people gravitate to the lower end of the socioeconomic spectrum. B) Being poor produces higher levels of stress, and therefore higher rates of psychological dysfunction are to be expected. C) More acceptable diagnoses are reserved for people from the upper classes. D) Poorer people typically have genetic predispositions toward mental illnesses. E) The resentment at being poor may generate behaviours that are seen by others as antisocial or dysfunctional.
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Answer: D Diff: 2 Type: MC Skill: Factual
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70) Which integrative theory posits that the whole is more than the sum of its parts? A) the diathesis-stress perspective B) systems theory C) the combination approach D) the biopsychosocial model E) social-learning theory Answer: B Diff: 1 Type: MC Skill: Conceptual
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71) According to the diathesis-stress perspective, a diathesis is __________, while a stress is __________. A) either biological or psychological; either biological or psychological B) always biological; either biological or psychological C) always psychological; either biological or psychological D) always biological; always psychological E) always psychological; always biological Answer: A Diff: 3 Type: MC Skill: Conceptual
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72) The biopsychosocial model is illustrated by the finding that A) brain functions have been shown to both influence and be influenced by psychological and social processes. B) brain functions are mostly influenced by early childhood experiences. C) brain functions are influenced most by adult behaviour, such as drug abuse. D) brain functions are influenced by genetic factors only. E) brain functions have been shown to influence psychological and social processes. Answer: A Diff: 3 Type: MC Skill: Factual
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73) Interactionist explanations of human behaviour view behaviour as the product of a variety of factors. A) True B) False
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Answer: A Diff: 1 Type: TF Skill: Factual
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74) In abnormal psychology, the term etiology refers to the prevalence or frequency of a disorder. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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75) The metabolic problem associated with phenylketonuria (PKU) is genetically transmitted as a dominant trait, meaning that only one parent must carry the gene for a child to develop PKU. A) True B) False Answer: B Diff: 3 Type: TF Skill: Factual
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76) The term dementia refers to a deterioration in all cognitive processes, particularly learning and memory. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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77) Neurotransmitters are the chemical substances that carry the messages from one neuron to the next. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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78) The autonomic nervous system (ANS) has two parts: the sympathetic nervous system and the somatic nervous system. A) True B) False
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Answer: B Diff: 2 Type: TF Skill: Factual
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79) Patients suffering from Generalized Anxiety Disorder (GAD) are described as autonomic restrictors because they consistently show less responsivity on ANS measures of arousal (such as heart rate and blood pressure). A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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80) In a twin study concerning the genetic bases of schizophrenia, a pair of twins who both have this disorder are said to display concordance. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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81) Hans Selye was analyzed by Sigmund Freud for a fear of horses. Apparently Freud analyzed this case without ever seeing the patient. A) True B) False Answer: B Diff: 1 Type: TF Skill: Conceptual
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82) Freud felt that there are four structures of personality, the id, the ego, the superego and the collective unconscious. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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83) Freud felt that the ego develops to curb the desires of the id. A) True B) False
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Answer: A Diff: 2 Type: TF Skill: Conceptual
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84) In both girls and boys, Freudians refer to desire for the opposite-sex parent as the Oedipal Complex. A) True B) False Answer: B Diff: 3 Type: TF Skill: Conceptual
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85) Freud felt that children in the latency stage (from age 6 to 12) are in a period of sexual quiescence during which the child focuses on developing intellectual and motor skills. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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86) A teenager who sits in his room all day because his parents will not let him borrow the family car is showing what Freud referred to as regression. A) True B) False Answer: A Diff: 3 Type: TF Skill: Application
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87) What is learned in classical conditioning is the development of a new response (CR) to an old stimulus (UCS). A) True B) False Answer: B Diff: 3 Type: TF Skill: Conceptual
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88) If a behaviour leads to a reduction of distress, negative reinforcement is said to have occurred. A) True B) False
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Answer: A Diff: 3 Type: TF Skill: Conceptual
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89) According to Bandura, self-efficacy concerns the set of beliefs people have about their capabilities to exercise control over events that affect their lives. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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90) Aaron Beck developed rational-emotive behaviour therapy. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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91) The leading exponents of the existential view as applied to human problem behaviour have been Rollo May and Viktor Frankl. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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92) In the diathesis-stress perspective the diathesis refers to a predisposition to develop a disorder. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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93) Briefly describe 4 ways in which abnormal behaviour can result from disturbances in neurotransmitter systems. Answer: 1. There may be too much or too little of the neurotransmitter produced or released into the synapse. 2. There may be too few or too many receptors on the dendrites.
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3. There may be an excess or a deficit in the amount of transmitter-deactivating substance in the synapse. 4. The reuptake process may be too rapid or too slow. Diff: 2 Type: ES Page Ref: 27 Skill: Factual 94) List the three forms research into the genetic bases of psychiatric disorders typically takes, and explain the basic premise of such studies. Answer: A. family (or pedigree) studies, twin studies, and adoption studies B) The premise is to identify a person with a disorder (called the index case or proband) and examine the other people to see if there is a match for the disorder. Diff: 2 Type: ES Page Ref: 31 Skill: Factual 95) Briefly list and define the three levels of awareness (consciousness) discussed by Freud, and state which he believed to be the most important. Answer: 1. The conscious, which contains information of which we are currently aware. 2. The preconscious, which holds information not presently within our awareness, but that can be readily brought into awareness 3. The unconscious, which contains the majority of our memories and drives, and which can only make it to awareness with great difficulty (i.e., by psychoanalytic procedures). 4. Freud felt the unconscious was the most important level of the mind. Diff: 3 Type: ES Page Ref: 32-33 Skill: Conceptual 96) List, in the correct order, the five stages of development discussed by Freud. Answer: Oral, Anal, Phallic, Latency, Genital Diff: 1 Type: ES Page Ref: 33 Skill: Factual 97) Briefly illustrate how Watson and Rayner demonstrated that phobias could result from classical conditioning experiences. Answer: Watson and Rayner showed a white rat to an eleven-month-old boy called Little Albert, to which he displayed no fear. After being sure that he was not fearful of the rat, they followed the rat's appearance with a sudden loud noise, which startled and upset Little Albert. After several presentations of the rat (the CS) with the sudden loud noise (the UCS), Little Albert displayed a conditioned fear to the rat. Diff: 3 Type: ES Page Ref: 35 Skill: Application
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98) Briefly describe Rosenhan's (1973) study in which normal people were admitted to psychiatric hospitals. Upon what basis were they admitted? What diagnosis were they given? How were they viewed and treated once admitted? Answer: Rosenhan had 8 normal people go to a psychiatric hospital and complain of hearing voices that said “empty,” “hollow,” and “thud.” They were all diagnosed with schizophrenia. Once in hospital the “patients” acted normally. However, their behaviour was not seen as such, but rather as symptoms of psychopathology. When the “patients” asked staff reasonable questions, they were largely ignored. Diff: 2 Type: ES Page Ref: 40 Skill: Application
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CHAPTER 3 Classification and Diagnosis 1) A(n) __________ refers to the determination of the nature of an illness, while a(n) __________ refers to the procedure used to gather information necessary to identify the illness. A) examination; investigation B) assessment; diagnosis C) medical examination; clinical interview D) diagnosis; assessment E) diagnostic system; classification system Answer: D Diff: 1 Type: MC Skill: Factual
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2) A clinical assessment could involve all of the following procedures EXCEPT A) being asked questions about what is wrong with you. B) having a CAT scan. C) filling out the MMPI. D) being told what illness you have. E) interviews with the patient's family. Answer: D Diff: 1 Type: MC Skill: Conceptual
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3) Jennifer complains about a sore throat, aching muscles, lack of energy, and occasional dizziness. These __________ may help her doctor determine what is wrong with her. A) symptoms B) hallucinations C) signs D) problems E) behaviours Answer: A Diff: 1 Type: MC Skill: Application
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4) In order to ideally diagnose all mental disorders, it would be useful if we could classify them through all of the following EXCEPT A) determine the specific behaviours displayed for each disorder. B) predict how the individual will behave in the future. C) identify why and when the individual began to display problem behaviours.
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D) identify how the individual will respond to treatment. E) publish a new diagnostic manual. Answer: E Diff: 2 Type: MC Skill: Conceptual
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5) Why has it been so difficult to develop the ideal system for classifying mental disorders? A) treatments tend to be different for different disorders. B) clinical psychologists tend not to use diagnostic systems for classification purposes. C) it was easier to conduct scientific research in the past than it is now. D) it is difficult to determine which aspects of behaviour are most important. E) psychologists find it difficult to conduct structured interviews with patients. Answer: D Diff: 2 Type: MC Skill: Conceptual
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6) The beginning of a modern system of classifying disorders can be attributed to A) the American Psychological Association. B) the Canadian Psychological Association. C) Kraepelin. D) the World Health Organization. E) the American Psychiatric Association. Answer: D Diff: 2 Type: MC Skill: Factual
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7) The International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD), A) was and still is highly influenced by psychoanalytic theory. B) is widely used in North America to diagnosis mental disorders. C) was developed by the APA to classify abnormal behaviour. D) is used mainly by physicians, while the DSM is used by psychologists. E) is a listing of all diseases and mental disorders. Answer: E Diff: 1 Type: MC Skill: Factual
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8) The first two editions of the DSM were considered unsatisfactory classification systems due to all of the following EXCEPT A) categories contained few objective criteria. B) psychoanalytic theory was influential in developing the categories. .. 2
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C) categories were not empirically-based. D) descriptions were brief and vague. E) the psychiatrists on the committee could not agree on the causes of disorders. Answer: E Diff: 2 Type: MC Skill: Factual
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9) DSM-III was a better attempt at classification than earlier systems because it A) took on a dimensional as opposed to a categorical approach. B) it focused more strongly on the theoretical causes of various mental disorders. C) was less rigid than previous approaches. D) required clinicians to evaluate various aspects of the patients' lives. E) it promoted a behavioural rather than a psychodynamic theoretical orientation. Answer: D Diff: 2 Type: MC Skill: Conceptual
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10) The DSM-III presented significant differences compared to its predecessors. Perhaps the MOST important change was A) the fact that it included the number of symptoms required to meet the criterion. B) the fact that is became more empirically-based. C) that it required clinicians to consider five different areas of patient functioning. D) that field trials were carried out to improve reliability. E) the fact that it did not advocate any particular theory. Answer: C Diff: 3 Type: MC Skill: Conceptual
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11) The DSM-IV-TR requires that patients be evaluated along five separate dimensions. This is referred to as a A) diagnostic classification. B) psychological classification. C) multiaxial classification. D) dimensional classification. E) theoretical classification. Answer: C Diff: 1 Type: MC Skill: Factual
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12) All of the following would be included on Axis I EXCEPT A) Alcoholism. B) Alzheimer's disease. .. 3
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C) Anoxeria nervosa. D) Obsessive-compulsive personality disorder. E) ADHD. Answer: D Diff: 1 Type: MC Skill: Factual
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13) What is the main reason for distinguishing between Axis I and Axis II in DSM-IVTR? A) to consider long-term disturbances B) to ensure agreement between clinicians C) to distinguish between psychological and medical problems D) to make sure that every patient is also properly diagnosed with the correct personality disorder E) to offer other interpretations of the disorder Answer: A Diff: 2 Type: MC Skill: Factual
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14) Krysta was attacked several months ago and thereafter developed recurrent panic attacks. Krysta is now afraid of suffering a panic attack and stays holed up in her apartment. Her friendships have suffered and she has not been to school in weeks. Using the DSM-IV-TR, how would you diagnose Krysta's problems? A) Axis I: Panic Disorder; Axis II: dependent personality disorder; Axis IV: Psychosocial and Emotional Problem: physical attack B) Axis I: Panic Attacks and Phobia; Axis III: Medical Conditions: injuries as a result of the physical attack C) Axis I: no diagnosis; Axis II: Hermitism; Axis V: level of current functioning: impairment in social and occupational functioning D) Axis I: Panic Disorder; Axis V: level of current functioning: impairment in social and occupational functioning. E) Axis I: no diagnosis; Axis III: Medical Condition: Respiratory illness Answer: D Diff: 2 Type: MC Skill: Application
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15) David suffers from substance abuse difficulties and has recently learned that he has cancer. His clinician feels that the cancer has resulted in David's drinking more. Where, if at all, would his cancer be considered in the DSM-IV-TR? A) Axis I B) Axis III C) Axis IV
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D) It would not be included in the DSM-IV E) Axis V Answer: B Diff: 2 Type: MC Skill: Application
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16) If Axis IV were excluded from the DSM-IV-TR, __________ would NOT be considered in the diagnosis. A) depression B) chronic back problems C) physical abuse D) histrionic personality disorder E) heroin abuse Answer: C Diff: 2 Type: MC Skill: Application
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17) To determine how well a person is coping with his or her problems, a clinician consulting the DSM-IV-TR would get this information with the __________. A) ICD-10 B) Coping Inventory for Stressful Situations (CISS) C) Global Assessment of Functioning (GAF) Scale D) Assessment of Coping Measure (ACM) E) MMPI Answer: C Diff: 1 Type: MC Skill: Factual
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18) All of the following areas would be considered under Axis V EXCEPT A) severe arguments with family members. B) suicidal behaviour. C) unemployment. D) failing a year in school. E) difficulties resulting from a speech disability. Answer: E Diff: 2 Type: MC Skill: Factual
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19) Which category of disorder is NOT located under Axis I of the DSM-IV-TR? A) Disorders first diagnosed in the elderly B) Factitious disorder C) Sleep disorders .. 5
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D) Adjustment disorders E) Anxiety disorders Answer: A Diff: 1 Type: MC Skill: Factual
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20) Your little brother constantly disobeys your parents, talks back to them, and refuses to acknowledge what they say. What DSM-IV-TR category would fit his symptoms? A) Oppositional Defiant Disorder B) Separation Anxiety Disorder C) Disorders usually First Diagnosed in Infancy, Childhood, and Adolescence D) Adjustment Disorders E) Conduct Disorder Answer: C Diff: 2 Type: MC Skill: Application
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21) Learning disorders usually become apparent A) during adolescence. B) during childhood. C) after psychological testing shows children to be learning disabled. D) after age 18, because children learn at such different rates. E) during the first few weeks of life. Answer: B Diff: 1 Type: MC Skill: Conceptual
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22) This disorder is caused by substance abuse or poor diet, as well as several medical conditions. Sufferers may display inattention and disconnected thoughts. They would most likely be diagnosed with A) ADHD. B) schizophrenia. C) delirium. D) dementia. E) Amnestic syndrome. Answer: C Diff: 2 Type: MC Skill: Conceptual
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23) Joseph is physically addicted to alcohol and he gets the “shakes,” feels nauseated, and becomes anxious if he doesn't have a drink for a day or two. What category of disorder would he fit under, according to the DSM-IV-TR? .. 6
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A) not enough information is provided to make a diagnosis B) Mood disorder C) alcoholism D) General medical disorder (Axis III) E) Substance-related disorder Answer: E Diff: 2 Type: MC Skill: Application
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24) The main feature of schizophrenia is A) poor diet and substance abuse. B) below average level of intelligence. C) excessive fear, worry, and apprehension. D) a marked loss of pleasure from usual activities. E) a loss of contact with the world. Answer: E Diff: 1 Type: MC Skill: Factual
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25) Cindy's daughter recently died, and Cindy has been suffering from many problems lately. She feels very sad, has no appetite, and no energy or initiative to engage in any activities. If Cindy were to see a clinician, she would be given a diagnosis of A) having a mood disorder. B) major depressive disorder C) schizophrenia. D) a normal reaction to the situation. E) bereavement disorder. Answer: B Diff: 2 Type: MC Skill: Application
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26) All of the following symptoms may indicate the presence of an anxiety disorder EXCEPT A) delusions. B) avoidance. C) fear. D) apprehension. E) worry. Answer: A Diff: 1 Type: MC Skill: Factual
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27) Individuals who are overly preoccupied with an imagined defect in their appearance would be classified under what category in DSM-IV-TR? A) gender identity disorders B) somatoform disorders C) factitious disorders D) eating disorders E) body dysmorphic disorder Answer: B Diff: 2 Type: MC Skill: Factual
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28) Which pair of disorders and categories do not match? A) pain disorder : somatoform disorders B) social phobia : anxiety disorders C) hypochondriasis : somatoform disorders D) bereavement disorder : mood disorders E) depersonalization disorder : dissociative disorders Answer: D Diff: 2 Type: MC Skill: Factual
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29) Sarah suffers from a social phobia, which causes her to feel depressed, lethargic, and hopeless. Recently, she has also been diagnosed with depression. This occurrence is referred to as __________. A) multiple disorders B) co-occurrence C) double diagnosis D) comorbidity E) dissociative disorders Answer: D Diff: 1 Type: MC Skill: Application
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30) Comorbidity between two disorders indicates that A) there is some relationship between the disorders in that person. B) the two disorders are independent of each other. C) the two disorders require the same form of treatment. D) the two disorders have the same cause. E) the diagnostic system is poor, failing to include all the relevant criteria in each disorder.
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Answer: A Diff: 2 Type: MC Skill: Conceptual
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31) The dissociative disorder involving two or more distinct personality states is known as A) Dissociative fugue. B) Depersonalization disorder. C) Dissociative amnesia. D) Dissociative identity disorder. E) Identity amnesia. Answer: D Diff: 1 Type: MC Skill: Factual
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32) Which three categories are included in the “Sexual and Gender Identity Disorders” section of the DSM-IV-TR? A) tranvestism, transexuality, and gender identity disorders B) paraphilias, homosexuality, sexual dysfunction C) sexual dysfunction, gender identity disorders, paraphilias D) frigidity, sexual dysfunction, paraphilias E) gynephilia, eroticism, transvestism Answer: C Diff: 1 Type: MC Skill: Factual
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33) The term __________ refers to events which occur during sleep, while the term __________ refers to problems with sleeping. A) sleepwalking disorder; sleep terror disorder B) insomnias; hypersomnias C) nightmares; insomnias D) dyssomnias; parasomnias E) parasomnias; dyssomnias Answer: E Diff: 1 Type: MC Skill: Factual
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34) If you were diagnosed by your psychologist as having an impulse control disorder, you would most likely engage in behaviours such as A) compulsive drinking or eating. B) destroying property and beating up others. C) excessive Internet use.
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D) excessive cleaning of your house. E) engaging in huge spending sprees and excessive sexual behaviour. Answer: B Diff: 2 Type: MC Skill: Conceptual
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35) Axis II of the DSM-IV-TR lists __________ distinct personality disorders. A) two B) four C) six D) ten E) eight Answer: D Diff: 1 Type: MC Skill: Factual
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36) If a person's medical illness appears to be in part psychological the diagnosis is A) somatoform disorder. B) fictitious disorder. C) psychophysiological disorder. D) psychological factors affecting physical condition. E) psychosomatic disorder. Answer: D Diff: 1 Type: MC Skill: Conceptual
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37) Jody is a talented poet who suffers from auditory and visual hallucinations. Those who argue that Jody would be stigmatized if she were diagnosed as schizophrenic would argue that A) the fact that she is a talented poet would be ignored. B) she might unfairly be diagnosed as ill despite the fact that she is talented. C) she might not be allowed to write her poetry in the hospital. D) she might not be asked to participate in poetry readings because of her illness. E) people would view her poems as the result of her illness. Answer: D Diff: 2 Type: MC Skill: Application
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38) Why do some professionals argue that current classification systems are flawed because of their adherence to the medical model? A) Medical illnesses cannot yet be classified. B) Little evidence supports the notion that there are unconscious causes of disorder. .. 10
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C) No mental disorders are caused by medical difficulties. D) Many professionals do not subscribe to the medical model. E) It is next to impossible to classify someone with a disorder due to comorbidity. Answer: C Diff: 2 Type: MC Skill: Conceptual
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39) Despite the problems associated with classification, it is still important that those who are mentally ill receive a proper diagnosis in order to A) offer an explanation for their strange behaviour. B) assist in interventions. C) identifying people who will have trouble living in the community. D) get at the unconscious roots of the problem. E) avoid stigmatization. Answer: B Diff: 1 Type: MC Skill: Factual
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40) Discrete classification refers to __________, while continuous classification is also called __________. A) statistical classification; normative classification B) categorical classification; dimensional classification C) critical classification; current classification D) dimensional classification; categorical classification E) directional classification; bi-directional classification Answer: B Diff: 1 Type: MC Skill: Factual
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41) Mrs. Landin divided her class into two teams based on last names: everyone from AL was on one team and everyone from M-Z was on the other team. This is an example of A) reliable classification. B) dimensional classification. C) alphabetical classification. D) categorical classification. E) normative classification. Answer: D Diff: 1 Type: MC Skill: Application
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42) Why is the categorical approach to classification problematic in the DSM? A) Even if a person has all the symptoms of a disorder, they will not necessarily be diagnosed with a mental disorder. B) There may not be enough categories to cover every disorder. C) Too many people are classified as having a mental disorder. D) Some people may have difficulties, but would not be diagnosed as disordered. E) Not all people diagnosed with the same disorder behave the same way. Answer: D Diff: 1 Type: MC Skill: Factual/Conceptual
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43) Jacob decides to measure three different coping strategies in a group of subjects. To do this, he has each subject fill out a questionnaire that contains statements about behaviours engaged in when faced with a stressful situation. Subjects must decide on a scale of 1 to 5 how often they engage in these behaviours. This is an example of A) categorical classification. B) dimensional classification. C) measurement classification. D) inter-rater classification. E) behaviour classification. Answer: B Diff: 1 Type: MC Skill: Application
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44) Why has it been proposed that a dimensional approach to classification should be adopted as opposed to a categorical approach in the DSM? A) People who need help may not be receiving it because they fall short of diagnostic criteria. B) There are too few categories to cover every possible disorder. C) Either people have a mental disorder or they do not. D) Stigmatization occurs far too often when people are categorized. E) Clinicians would find it much easier to agree on who should receive a diagnosis and who should not. Answer: A Diff: 2 Type: MC Skill: Factual/Conceptual
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45) A __________ approach to classification recognizes that a disorder may be mild or severe, while with a __________ approach, the disorder is either present or not. A) categorical; dimensional B) dimensional; categorical C) discrete; continuous
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D) reliable; valid E) valid; reliable Answer: B Diff: 1 Type: MC Skill: Factual
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46) What is the main criticism of using the dimensional approach to classifying disorders? A) It has been used in the past with little success. B) The categorical approach does not recognize the continuum of behaviour. C) Many more people would be diagnosed as disordered. D) It is difficult to use measurement scales to determine a diagnosis. E) Patients would run out of treatment options under a dimensional approach. Answer: C Diff: 2 Type: MC Skill: Factual
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47) A __________ measurement tool is one that measures what it is supposed to measure, while a __________ measurement results in the same result each time. A) reliable; valid B) predictive; sensitive C) categorical; dimensional D) sensitive; valid E) valid; reliable Answer: E Diff: 1 Type: MC Skill: Factual
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48) Mr. and Mrs. Davidson took their son to a psychologist who diagnosed him as conduct disordered. They decided to get a second opinion from another psychologist and were told their son was just going through a normal phase. This indicates the problem of A) lack of reliability. B) categorical classification. C) misinterpreting symptoms. D) dimensional classification. E) lack of validity. Answer: A Diff: 2 Type: MC Skill: Application
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49) Two clinicians independently come up with the same diagnosis when examining a patient. This demonstrates .. 13
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A) concurrent validity but not necessarily reliability. B) both interrater reliability and validity. C) validity but not interrater reliability. D) neither reliability nor validity. E) interrater reliability but not validity. Answer: E Diff: 2 Type: MC Skill: Application
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50) The study in which Beck et al. (1962) examined the reliability of psychiatrists' diagnoses using the DSM-I indicated that A) the validity of the study itself was quite low. B) most of the time, the psychiatrists agreed on diagnoses. C) interrater agreement was quite high for some disorders and lower for others. D) interrater agreement was generally quite low. E) it is pointless to have more than one psychiatrist examine the same patient. Answer: D Diff: 2 Type: MC Skill: Factual
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51) What was the most significant reason why the psychiatrists in the Beck et al. (1962) study of DSM-I found it difficult to agree on diagnoses? A) Some psychiatrists were better at their job than others. B) The patient did not give the same report to each psychiatrist. C) Each psychiatrist in the study diagnosed patients according to their own particular theories about abnormal behaviour. D) Different techniques were used to determine the diagnosis. E) The DSM-I was not clear about symptoms. Answer: E Diff: 2 Type: MC Skill: Factual
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52) Which of the following scenarios is most similar to the concept of reliability in making a diagnosis? A) You meet a guy at a party who appears to be a very shy person, but it turns out that once you get to know him, he's really talkative. B) You and your brother talk to several people and decide to take a trip to Florida. C) Based on your brother's expensive and elaborate wardrobe, your friend concludes that he must be a little egocentric. D) Your brother is feeling quite ill, so you take his temperature and decide he has the flu. E) You and your brother go see the same movie with different people and both you and your brother think it had fantastic fight scenes.
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Answer: E Diff: 2 Type: MC Skill: Conceptual
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53) Which of the following statements best describes the relationship between reliability and validity? A) As long as a measure is reliable, it does not matter if it is valid. B) If you don't have reliability, you cannot have validity. C) Reliability and validity are independent of one another. D) A tool that is reliable is also likely valid. E) Validity is usually more important than reliability. Answer: B Diff: 1 Type: MC Skill: Factual
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54) Validity in diagnosis is best conceptualized as A) agreement between different clinicians on the diagnosis. B) a diagnosis that makes sense based on the symptoms. C) the ability to predict disorders accurately. D) a discontinuous approach to classification of disorders. E) a categorical classification of disorders. Answer: C Diff: 2 Type: MC Skill: Conceptual
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55) People with schizophrenia have been found to have lower levels of education than non-schizophrenics. This indicates __________ in diagnosis. A) sensitivity B) predictive validity C) concurrent validity D) stigmatization E) reliability Answer: C Diff: 1 Type: MC Skill: Application
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56) Concurrent validity is concerned with A) removing the traditional gender bias in diagnosis. B) ensuring an effective diagnostic system. C) the ability to predict which symptoms belong to a particular diagnostic category. D) the ability of two clinicians to concurrently assign the same diagnosis. E) aspects of the disorder which are not included in the diagnostic criteria.
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Answer: E Diff: 2 Type: MC Skill: Factual
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57) If there was a perfect relationship between a diagnosis of conduct disorder in early adolescence and a diagnosis of antisocial personality disorder in adulthood, this would be evidence for the __________ of the first diagnosis. A) sensitivity B) predictive validity C) concurrent validity D) interrater reliability E) reliability Answer: B Diff: 2 Type: MC Skill: Application
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58) If a measure of substance abuse were able to determine which individuals would go on to abuse serious drugs such as cocaine and LSD, and which individuals would be only transient drug users who would occasionally smoke a joint, it would have A) concurrent validity. B) face validity. C) etiological validity. D) predictive validity. E) measurement reliability. Answer: D Diff: 1 Type: MC Skill: Application
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59) What might women's groups see as the main problem with the diagnostic categories of the DSM? A) Many behaviours associated with being female are viewed as indicative of poor mental health. B) Important traits are ignored once a person is diagnosed with an illness. C) The diagnostic categories are based on the medical model. D) Diagnoses of mental disorders are based on a discrete approach to classification of mental disorders. E) Women are often stigmatized to a greater degree. Answer: A Diff: 2 Type: MC Skill: Conceptual
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60) Rachel is a secretary at a large law firm, where she is treated with a lack of respect, then she goes home to her husband and children where she has to cook and clean while .. 16
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her husband watches T.V. Recently, Rachel was given antidepressants to treat her feelings of sadness and lack of self-worth. The most likely criticism of Rachel's diagnosis of depression would be A) most women become depressed, so Rachel should not necessarily receive this diagnosis. B) normal female behaviour is being medicalized. C) Rachel is more likely suffering from generalized anxiety disorder. D) anti-depressants aren't the best method to treat depression. E) Rachel is facing many difficulties--perhaps changes in her life would remedy the situation. Answer: E Diff: 1 Type: MC Skill: Application
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61) Personality disorders in the DSM are particularly problematic for women because A) it is more difficult to be a women in society than it is to be a man. B) women are seen as having more flawed personalities than men. C) if women have a psychological problem, it is seen as part of their personality. D) gender stereotypes are associated with many of the personality disorders. E) more and more women are being diagnosed with traditionally “masculine” personality disorders. Answer: D Diff: 1 Type: MC Skill: Factual
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62) It is important that clinicians be more aware of cultural issues for all of the following reasons except A) different cultural issues may influence the diagnosis. B) North America is relatively multi-cultural. C) certain syndromes appear only within a particular culture. D) different cultural practices may be unusual to white North Americans, but are normal in the society in which they are found. E) many clinicians now visit and diagnose patients in many different countries. Answer: E Diff: 1 Type: MC Skill: Factual/Conceptual
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63) Although the DSM-IV-TR stresses that cultural and social differences must be taken into account during assessment and diagnosis, A) most diagnoses would remain the same, regardless of culture. B) the psychiatric manuals written in different cultures should be made available here. C) the specifics of the manual are determined mainly by individuals trained in the United States. .. 17
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D) very few cultures present their own unique syndromes. E) most clinicians ignore these differences and treat everyone the same. Answer: C Diff: 1 Type: MC Skill: Conceptual
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64) Elma is from the Philippines, and she claims that she sees the spirits of dead on different occasions, as do other individuals in her culture. It would be important to consider culture in this diagnosis because she could be suffering from A) perhaps nothing - these beliefs could be normal in this culture. B) schizophrenia. C) hauntings. D) some type of psychosis. E) the use of hallucinogens. Answer: A Diff: 1 Type: MC Skill: Application
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65) Taijin kyofusho is a syndrome found only in Japan, which A) concerns of being embarrassed. B) is often mistaken for social phobia. C) concerns a fear of embarrassing others. D) affects mainly Japanese women. E) is usually caused by poor diet. Answer: C Diff: 1 Type: MC Skill: Factual
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66) Research has found that members of African-American and Hispanic populations showing emotional disturbances are more likely than Caucasians to be diagnosed as schizophrenic. This illustrates A) cultural biases. B) interrater reliability. C) misinterpretation of symptoms. D) stigmatization. E) racism. Answer: A Diff: 1 Type: MC Skill: Conceptual
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67) The Ontario Health Survey found that A) approximately 19 percent of the population had both an Axis I and II disorder in a one year period. B) approximately 40 percent of the population had an Axis II disorder in a one year period. C) approximately 19 percent of the population had an Axis I disorder in a one year period. D) approximately 40 percent of the population had both an Axis I and II disorder in a one year period. E) approximately 40 percent of the population had an Axis I disorder in a one year period. Answer: C Diff: 2 Type: MC Skill: Factual
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68) The signs of a diagnostic category are usually recognized by the patient as problematic. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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69) Regardless of the diagnostic system used, it is relatively common that an individual will meet the criteria for more than one disorder. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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70) Kraepelin's classification system is very different from modern classification systems. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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Answer: B Diff: 2 Type: TF Skill: Factual
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72) Axis V indicates that two individuals could be suffering from the same disorder, but may receive extremely different types of treatments. A) True B) False Answer: A Diff: 1 Type: TF Skill: Conceptual
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73) Children rarely develop disorders that are found in adults, such as depression or schizophrenia. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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74) Mania is characterized by extreme elation and activity, grandiosity, and flighty ideas, followed by sadness, lack of energy, and lack of pleasure. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual/Conceptual
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75) Dissociative Identity Disorder involves individuals suddenly and unexpectedly leaving their home, traveling to a new locale, and taking up a new identity. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual/Conceptual
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76) Parasomnias are defined by events such as sleepwalking or waking up in cold sweats. A) True B) False
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Answer: A Diff: 1 Type: TF Skill: Factual
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77) Those suffering from personality disorders find it difficult to change their behaviours and find that these behaviours are present in most aspects of their lives. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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78) The category 'Other Conditions that May be a Focus of Clinical Attention' is used for mental disorders that do not fit under any other category. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual/Conceptual
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79) The DSM-IV-TR uses both categorical and dimensional approaches to classifying mental disorders. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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80) Categorical classification is also called discrete classification. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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81) One example of dimensional classification would be using questionnaires to give people a certain score on a certain criterion. A) True B) False
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Answer: A Diff: 2 Type: TF Skill: Application
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82) An increase in reliability results in an increase in validity. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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83) The DSM system has been criticized as being low in concurrent validity. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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84) In order to deal with gender biases in diagnostic systems, a reconceptualization of the way that women's behaviours are viewed will have to occur. A) True B) False Answer: A Diff: 1 Type: TF Skill: Conceptual
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85) Cultural biases are generally not problematic in the DSM because regardless of where you come from, the symptoms for any one disorder will be similar. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual/Conceptual
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86) Schizophrenia is more common among African American and Hispanic populations than among Caucasian populations. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual .. 22
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87) Why is it impossible to develop the perfect classification system? Answer: In the perfect system, disorders would be classified based on the individual's symptoms, etiology, prognosis, and treatment response. To develop such a system, it would be necessary to assess a large number of people psychologically and physically, a thorough history should be taken, longitudinal observations should be undertaken, and controlled outcome treatment studies should be conducted.However, it is difficult to observe large numbers of people over long periods of time, and even more difficult to determine which events are critical in the development of disorders. As well, different individuals react differently to treatments, and even two people suffering from the same disorder may benefit from different treatments. Diff: 2 Type: ES Page Ref: 45 Skill: Factual/Conceptual 88) Discuss the development of the DSM system. Answer: The first Diagnostic and Statistical Manual (DSM-I) was published by the American Psychological Association in 1952, followed by the DSM-II in 1968. These volumes were unsatisfactory, containing only brief, vague descriptions of the diagnostic categories. These categories were not empirically based and contained few objective criteria, resulting in a rather unreliable system. Major changes were noted in the DSM-III (1980) and the DSM-III-R (1987). Field trials were conducted to improve reliability, psychoanalytic theory was given far less influence, and a required number of symptoms and a necessary time period were included. Most importantly was the introduction of a multiaxial approach, requiring clinicians to provide substantial patient information. DSM-IV (1994) was developed to further improve the system, with 12 field trials conducted to collect new information and various professionals consulted to offer input. The DSM-IV is widely used in North America by professionals diagnosing mental disorders. Diff: 1 Type: ES Page Ref: 46-47 Skill: Factual 89) Describe the five axes of the DSM-IV-TR. Answer: The DSM-IV Multiaxial Classification: Axis I, Clinical Syndromes, consists of the most obvious disorders which are bizarre in nature or pose difficulties in functioning. Categories include Mood Disorders, Anxiety Disorders, Schizophrenia, Childhood Disorders, Sexual and Gender Identity Disorders, Sleep Disorders, and Eating Disorders. Axis II, Personality Disorders, contains the generally less severe, long-term disturbances which still may interfere with the individual's life. These disorders are often missed in the presence of Axis I symptoms. Axis III, General Medical Conditions, covers medical disorders which may play a role in the psychologically functioning or treatment of the individual.
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Axis IV, Psychological and Environmental Problems, collects information on life circumstances, recognizing that outcome and treatment may be affected by unique life situations. Axis V, Global Assessment of Functioning (GAF) Scale, measures ability to cope with the problems associated with the disorder, and provides insight for treatment. Diff: 1 Type: ES Page Ref: 47-48 Skill: Factual 90) Choose one of the Axis I categories of disorder listed in the DSM-IV-TR, and describe this category. Answer: Any one of the following disorders could be described (as described on pages 53-57): Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence, Delirium, Dementia, Amnesia, and Other Cognitive Disorders, Substance-Related Disorders, Schizophrenia and Other Psychotic Disorders, Mood Disorders, Anxiety Disorders, Somatoform Disorders, Factitious Disorder, Dissociative Disorders, Sexual and Gender Identity Disorders, Eating Disorders, Sleep Disorders, Impulse Control Disorders, Adjustment Disorders. Diff: 1 Type: ES Page Ref: 48-52 Skill: Factual 91) Describe the reasons why there is controversy surrounding the classification of mental disorders. Answer: Three main criticisms of classification systems are generally cited: 1) Adherence to the medical model. Professionals argue that there is rarely a distinguishable physical abnormality that characterizes the mental disorders. Critics also argue that the idea that symptoms indicate underlying mental problems of which the patient is unaware is outdated with little supporting evidence. 2) Stigmatization. A person diagnosed with a mental disorder may be unfairly stigmatized by society and may be labelled (e.g. “schizophrenic,” “hyperactive,” etc.) rather than being considered a unique individual with skills and strengths. Once labelled, the individual may have difficulties in society and may even accept the label him or herself, resulting in a worsening of the disorder. 3) Loss of Information. Information about the individual may be ignored, with only the information relating to the disorder being acknowledged. .. 24
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Diff: 2 Type: ES Skill: Factual/Conceptual
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92) Compare and contrast the dimensional versus the categorical approach to classification. Answer: The categorical approach to classification taken by the DSM system: the individual either has the disorder or does not. This approach has been criticized for not recognizing the continuum between abnormal and normal behaviour, and it has been suggested that the categorical approach does not provide a meaningful description of the person's psychological problems. Some clinicians support a dimensional approach to diagnosis, based on a continuum from non-existent to mild to severe. However, the in contrast to the categorical approach, dimensional approach would result in far more people receiving a psychiatric diagnosis and perhaps facing unnecessary stigmatization. Diff: 2 Type: ES Page Ref: 53-54 Skill: Factual/Conceptual 93) Define reliability and validity, and describe the concepts of interrater reliability and concurrent and predictive validity in measuring psychopathology. Answer: If a measurement tool is reliable, it will give the same measurement for an individual or thing every time. A valid measurement tool is one that measures what it is supposed to measure. One form of reliability, interrater reliability, refers to the extent to which two clinicians will independently come up with the same diagnosis of a particular patient. If the diagnostic system does not allow clinicians to agree on signs and symptoms, interrater reliability will remain low. Validity depends on reliability, so that without reliability you cannot have validity. However, a measure can be reliable without being valid. Concurrent validity refers to the ability of the diagnostic category to estimate a person's rating on characteristics that are related to the disorder, but that are not themselves part of the diagnostic criteria. Predictive validity is the ability of a test to predict the future course of an individual's development. Diff: 2 Type: ES Page Ref: 54-55 Skill: Factual/Conceptual 94) Highlight the gender biases evident in the DSM system and suggest possible ways to deal with this. Answer: During the late 1960s, the mental health system was criticized for both gender bias and sexism. The DSM-I and DSM-II were influenced by psychoanalytic theory, which has been accused of sexism. In 1974, a task force was developed by the APA to investigate gender bias and sex-role stereotyping in assessment and therapy. The DSM-III was still far from free of gender bias, however. Critiques of the DSM system have claimed that psychiatric disorders are described in a way that makes diagnosis more probable for women. Assumptions regarding psychopathology are rooted in social norms which value stereotypical male attributes such as assertiveness and devalue stereotypical female attributes such as nurturance. .. 25
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The DSM system has also been accused of not taking life circumstances into account and not recognizing that the oppression of women may affect behaviour. Women's normal reproductive behaviour has been pathologized, as is evident by the developing of the premenstrual dysphoric disorder (PMDD). Particular personality disorders on Axis II (i.e., dependent personality disorder), appear to correspond to exaggerated female stereotypes. In order to deal effectively with these biases, society must come to value behaviours commonly associated with women. Clinicians must recognize their personal biases and make an effort to come to terms with these biases when assessing and treating patients. Diff: 2 Type: ES Page Ref: 55 Skill: Conceptual 95) Why is it important that cultural differences be taken into account when assessing and diagnosing individuals? Answer: North America is a multicultural area, with millions of people of different colours, languages, and religions. Therefore, it is extremely important that clinicians be aware of cultural issues that may influence assessment and diagnosis. Some behaviours which we view as abnormal may be normal in other cultures. For example, during North American aboriginal religious ceremonies, members may have hallucinations. As well, in Hispanic nations, possession by evil spirits remains a popular belief. Individuals from these cultures who sport these beliefs should not necessarily be seen as psychotic. As well, aboriginal children may fare worse on IQ tests because their culture values cooperation as opposed to the values of individualism and competitiveness, which are stressed on the IQ test. Certain syndromes may only appear in certain cultures, such as taifin-kyofu-sho, found only in Japan and characterized by an excessive fear that one will embarrass or offend others. Other research has found that emotional difficulties may be diagnosed differently in African American and Hispanic populations than in white populations. It is important to recognize that what seems normal and abnormal to us may not be normal or abnormal to individuals of other cultures, and neither view is right or wrong. Diff: 2 Type: ES Page Ref: 55-56 Skill: Conceptual
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CHAPTER 4 Psychological Assessment and Research Methods 1) Claire completes a psychological test of personality type twice, the second time 4 weeks after the first. The correlation between her two test scores was very low. Based on this information, the test can be said to exhibit A) low alternate form reliability. B) low split-half reliability. C) high test-retest reliability. D) low test-retest reliability. E) high alternate form reliability. Answer: D Diff: 1 Type: MS Skill: Application
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2) According to the text, which of the following is NOT true of alternate form reliability estimates? A) they are used to circumvent the problem of improvement due to practice which can occur in estimates of test-retest reliability. B) they require the creation of two forms of the same test, in which the questions are phrased slightly differently but are intended to assess the same construct as the first. C) they are used to circumvent the problem of familiarity with questions which can occur in estimates of test-retest reliability. D) a low correlation between the two forms demonstrates good alternate-form reliability. E) a high correlation between the two forms demonstrates good alternate-form reliability. Answer: D Diff: 1 Type: MS Skill: Factual
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3) Which of the following is a measure of internal consistency? A) coefficient gamma B) coefficient beta C) alternate form D) coefficient alpha E) beta correlation Answer: D Diff: 1 Type: MS Skill: Conceptual
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4) A particular questionnaire is intended to measure musical enjoyment. One of the questions is “Do you enjoy listening to music?” This item can be said to have A) internal consistency. B) face validity. .. 1
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C) criterion validity. D) construct validity. E) predictive validity. Answer: B Diff: 1 Type: MS Skill: Conceptual
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5) According to the text, construct validity A) is especially useful when the construct to be measured is clearly defined rather than abstract. B) is important because some qualities are easier to recognize than to define. C) refers to the importance of a test within a specific theoretical framework. D) means that the items on a test resemble characteristics associated with the concept being tested. E) requires that a test's content include a representative sample of behaviours thought to be related to the construct. Answer: C Diff: 3 Type: MS Skill: Factual
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6) Which of the following is NOT true of the actuarial approach? A) Those who endorse it would not rely on intuition in making a decision. B) Those who endorse it argue that there is no substitute for the clinician's experience and personal judgment in coming to decisions. C) Those who endorse it argue that a more objective standard is needed. D) It tends to be more efficient in terms of making predictions in a variety of situations. E) Those who endorse it rely on statistical procedures and formal rules in evaluating data. Answer: B Diff: 3 Type: MS Skill: Conceptual
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7) A(n) __________ assesses brain function by measuring electrical impulses by way of electrodes placed on parts of the scalp. A) MRI (magnetic resonance imaging) B) EEG (electroencephalogram) C) PAT (positron axial tomography) D) PET (positron emission tomography) E) CAT (computerized axial tomography) Answer: B Diff: 1 Type: MS Skill: Factual
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8) In the procedure known as __________, a narrow band of X-rays is projected through the head, and produces a number of images of the brain which are later combined. A) EEG (electroencephalogram) B) CAT (computerized axial tomography) C) PET (positron emission tomography) D) MRI (magnetic resonance imaging) E) PAT (positron axial tomography) Answer: B Diff: 1 Type: MS Skill: Factual
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9) The resolution of the image produced by (an) __________ can be improved by injecting a substance to enhance contrasts between different sorts of tissue. A) PAT (positron axial tomography) B) PET (positron emission tomography) C) MRI (magnetic resonance imaging) D) EEG (electroencephalogram) E) CAT (computerized axial tomography) Answer: E Diff: 3 Type: MS Skill: Factual
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10) According to the text, which of the following results from studies involving CAT scans is NOT true? A) Women with anorexia nervosa show some tissue loss in the temporal lobes. B) Autistic children show atrophy in the cerebellum. C) Schizophrenics have been demonstrated to have smaller frontal lobes. D) People suffering from Alzheimer's tend to show cortical atrophy. E) People suffering from bipolar disorder show some tissue loss throughout the brain. Answer: A Diff: 2 Type: MS Skill: Factual
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11) According to the text, which of the following is NOT true of magnetic resonance imaging (MRI)? A) It is a noninvasive technique. B) fMRI is a recent modification of the MRI. C) It reveals both the structure and functioning of the brain. D) It is slightly dangerous, as it involves the use of high-energy radiation (X-rays). E) It involves producing a strong magnetic field around the patient's head.
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Answer: D Diff: 2 Type: MS Skill: Factual
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12) Which of the following is NOT true of positron emission tomography? A) It involves the use of isotopes with half-lives of minutes to hours. B) It allows a researcher to measure a variety of biological activities in the brain. C) It is capable of showing the distribution of various neurotransmitters within the brain. D) It produces a static image of the brain's anatomy, as do CAT scans and MRIs. E) It involves the injection or inhalation of radioisotopes. Answer: D Diff: 2 Type: MS Skill: Factual
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13) Which of the following is true of the Bender Visual-Motor Gestalt test? A) The main problem with the test is that it produces many false positives. B) It consists of a series of nine cards containing lines and shapes, which children are asked to copy and then draw from memory. C) It is rarely used at present, though it was commonly employed in the past. D) There are currently no standardized scoring systems for this test. E) It is very difficult to administer. Answer: B Diff: 2 Type: MS Skill: Factual
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14) The most popular neuropsychological test is the A) Halstead-Reitan. B) Thematic Apperception. C) Bender Visual-Motor Gestalt. D) Rorschach. E) Luria-Nebraska. Answer: A Diff: 1 Type: MS Skill: Factual
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15) Which of the following is NOT one of the subtests of the Halstead-Reitan? A) the category test B) the tapping test C) the auditory test D) tactual performance test E) the visual test
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Answer: E Diff: 2 Type: MS Skill: Factual
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16) Which of the following was NOT suggested by the text as a problem with the unstructured interview? A) It has poor validity. B) It has poor reliability. C) Clinicians using this type of interview may only look for information that confirms their hypotheses. D) Clients often dislike participating in them. E) The theoretical paradigm of the clinician greatly influences the type of information gathered. Answer: D Diff: 1 Type: MS Skill: Factual
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17) According to the text, the most frequently used semistructured interview in psychiatric settings is the A) Semistructured Mental Interview. B) Mental Status Examination. C) Psychological Functioning Examination. D) The Diagnostic Interview Schedule. E) Psychiatric Status Interview. Answer: B Diff: 2 Type: MS Skill: Factual
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18) According to the text, which of the following is NOT true of structured interviews? A) They reduce the concern over the subjective judgments of the interviewer. B) They have clear rules governing the evaluation of responses. C) They tend to jeopardize rapport. D) They are very specific in the order and wording of questions. E) They are less reliable then unstructured interviews. Answer: E Diff: 2 Type: MS Skill: Factual
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19) According to the text the most widely used structured clinical interview is the A) Structured Clinical Interview for DSM-IIIR (SCID). B) Structured Clinical Interview for Psychiatric Illness (SCIPI). C) The Diagnostic Interview Schedule (DIS-IV).
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D) The DSM-IV-TR. E) Mental Status Examination. Answer: C Diff: 2 Type: MS Skill: Factual
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20) The first scientific study of intellectual functioning was conducted by __________, to test the hypothesis that intelligence has a hereditary aspect. A) Binet B) Lafayette C) Wechsler D) Simon E) Galton Answer: E Diff: 1 Type: MS Skill: Factual
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21) Sir Francis Galton believed that intelligence could best be measured by studying __________, such as an attribute known later as __________. A) spatial abilities; spatial intelligence B) arithmetic skills; mathematical intelligence C) verbal abilities; verbal intelligence D) physiological abilities; sensory intelligence E) physical abilities; athletic intelligence Answer: D Diff: 1 Type: MS Skill: Factual
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22) The first widely accepted and successful test of intelligence was designed by __________ to predict __________. A) Stanford; academic performance B) Binet; academic performance C) Simon; job performance D) Galton; future criminal behaviour E) Wechsler; verbal intelligence Answer: B Diff: 1 Type: MS Skill: Factual
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23) Which of the following is not true of Binet's work, according to the text? A) He was commissioned by the Parisian school board to develop a test that would identify children who might need special education. .. 6
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B) Binet's work was conducted to test the hypothesis that intelligence has a hereditary aspect. C) His work developed into the Stanford-Binet scales, now in their fifth edition. D) He used the intelligence quotient (IQ), determined by dividing a child's performance by the child's chronological age and multiplying by 100. E) He was the first to use a large sample of subjects to establish norms to describe intelligence. Answer: B Diff: 2 Type: MS Skill: Factual
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24) The first widely used intelligence test for adults, the __________, was developed by __________. A) Simon Adult Intelligence Scale; Simon B) Adult Intelligence Index; Wechsler C) Stanford-Binet Scale; Stanford D) Wechsler Adult Intelligence Scale; Wechsler E) Adult Intelligence Index; Stanford University Answer: D Diff: 1 Type: MS Skill: Factual
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25) Aside from his adult intelligence test, Wechsler also developed A) both the Wechsler Intelligence Test for Children (WISC) and the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). B) the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). C) both the Stanford-Binet Scale of Intelligence (SBI) and the Wechsler Intelligence Test for Children (WISC). D) the Stanford-Binet Scale of Intelligence (SBI). E) the Wechsler Intelligence Test for Children (WISC). Answer: A Diff: 1 Type: MS Skill: Factual
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26) The typical correlation between IQ scores and academic performance is in the range of A) .30-.50. B) .50-.70. C) .70-.80. D) .90-1.00. E) 0-.30.
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Answer: B Diff: 3 Type: MS Skill: Factual
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27) Projective tests generally have their roots in A) psychoanalytic principles. B) behaviourist principles. C) cognitive principles. D) existential principles. E) humanistic principles. Answer: A Diff: 1 Type: MS Skill: Factual
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28) Lisa is seeing a clinical psychologist, who has given her a psychological test in which she examines cards with ambiguous inkblots on them. Lisa is likely completing the A) Thematic Apperception Test. B) Rorschach Inkblot Test. C) Freudian Inkblot Test. D) Halstead-Reitan Battery. E) Psychoanalytic Inkblot Test. Answer: B Diff: 1 Type: MS Skill: Application
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29) A clinician has given a client the Rorschach Inkblot Test, and is employing a standardized scoring system created to increase the reliability and validity of the test. They are likely what system? A) the Murray-Exner system B) the Exner system C) the Exner-Murray system D) the Hunsley system E) the Murray system Answer: B Diff: 2 Type: MS Skill: Application
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30) Heather is seeing a clinical psychologist, who has asked her to construct stories about cards depicting ambiguous social interactions. Heather is likely completing the A) Ambiguous Circumstances Exam (ACE). B) Murray-Morgan Apperception Test (MMAT). C) Thematic Apperception Test (TAT).
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D) Rorschach Inkblot Test. E) Sentence Completion Test. Answer: C Diff: 1 Type: MS Skill: Application
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31) Which of the following is NOT true of the Minnesota Multiphasic Personality Inventory (MMPI)? A) It is multiphasic because it assesses many aspects of personality. B) Items were only chosen for inclusion if people known to have the characteristic the scale is measure respond differently to the item than those who did not have the characteristic. C) The results of the MMPI-2, the newest version, give a DSM-IV diagnosis. D) Many of its items appear to have little face validity, meaning that it is difficult to tell what the question is attempting to measure. E) It was originally published in 1943 by Hathaway and McKinley. Answer: C Diff: 2 Type: MS Skill: Factual
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32) Which of the following is one of the MMPI validity scales? A) the Z scale B) the J scale C) the F scale D) the R scale E) the T scale Answer: C Diff: 1 Type: MS Skill: Factual
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33) Which of the following changes was made in the MMPI-II, as compared to the original MMPI? A) The test was standardized using a representative group of patients at a Minnesota state hospital. B) Test items aimed at identifying religious beliefs were added. C) The test was standardized on a much larger number of people, as a relatively small number was used in the original. D) Many of the validity scales, such as the F-scale, were removed. E) Sexist language was removed. Answer: E Diff: 1 Type: MS Skill: Factual .. 9
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34) The Millon Clinical Multiaxial Inventory (MCMII) was developed to help clinicians make decisions within the multiaxial DSM system, especially in the __________ disorders found on Axis __________. A) developmental; 2 B) somatoform; 2 C) medical; 3 D) personality; 2 E) anxiety; 1 Answer: D Diff: 1 Type: MS Skill: Factual
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35) According to the text, the Millon Clinical Multiaxial Inventory (MCMII) has been criticized because it A) consistently underestimates the severity of personality disorders and overdiagnoses somatoform disorders. B) consistently underestimates the severity of depressive symptoms and overdiagnoses anxiety disorders. C) consistently underestimates the severity of personality disorders and overdiagnoses depressive syndromes. D) consistently underestimates the severity of depressive syndromes and overdiagnoses personality disorders. E) consistently underestimates the severity of depressive syndromes and overdiagnoses somatoform disorders. Answer: D Diff: 2 Type: MS Skill: Factual
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36) Walter Mischel argued that personality tests are flawed because A) people fail to give accurate self-reports because of the response set of social desirability. B) people respond to demand characteristics - they respond as they feel the tester would like them to. C) the concept of personality is an illusion. D) the majority have been shown to have extremely low reliability. E) their flawed assumption that personality characteristics are stable. Answer: E Diff: 1 Type: MS Skill: Factual
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37) John is a clinical psychologist who is gathering information on his client, Steve, by taping him while he works. This sort of observation is called .. 10
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A) analogue observation. B) self-monitoring. C) electronic observation. D) in vivo observation. E) actual observation. Answer: D Diff: 1 Type: MS Skill: Application
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38) Kanfer and Philips describe four sets of variables of interest to cognitive-behavioural assessment, referred to by the acronym SORC. Which of the following is not one of these four sets of variables? A) situation B) stimuli C) organismic D) responses E) consequences Answer: A Diff: 3 Type: MS Skill: Factual
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39) When the psychological problems of a patient are fairly well known, __________ tests are appropriate. A) narrow band B) broad band C) objective D) self-report E) projective Answer: A Diff: 1 Type: MS Skill: Factual
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40) One of the primary goals of clinical research is the __________ of clinical phenomena. A) observation B) prediction C) description D) explanation E) control Answer: C Diff: 1 Type: MS Skill: Factual .. 11
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41) According to the text, which of the following allows for the greatest confidence in interpreting and generalization of results? A) the quasi-experiment B) the experiment C) the correlational study D) the psychological test E) the semi-experiment Answer: B Diff: 2 Type: MS Skill: Factual
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42) In an experiment, the __________ group is exposed to a variable which is manipulated, called the __________ variable. A) control; dependent B) experimental; dependent C) experimental; control D) control; independent E) experimental; independent Answer: E Diff: 1 Type: MS Skill: Conceptual
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43) When differences in some dependent variable are found to occur as a function of manipulation of the independent variable, a(n) __________ is obtained. A) experimental effect B) random effect C) pseudo effect D) controlled effect E) correlation Answer: A Diff: 2 Type: MS Skill: Conceptual
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44) Several clinical psychologists are conducting a study about the treatment of Generalized Anxiety Disorder. Before receiving the various treatments, the participants were assessed on a number of psychological measures. According to the terminology in the text, these measures would be referred to as A) early tests. B) advance tests. C) experimental tests. D) pretests. E) posttests. .. 12
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Answer: D Diff: 1 Type: MS Skill: Application
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45) In a study of the effects of a certain antipsychotic drug, the control group receives pill which does not actually contain the drug. This group has received a __________. A) dependent variable B) double-blind C) placebo D) pretest E) pseudo-treatment Answer: C Diff: 1 Type: MS Skill: Application
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46) In the TADS experiment, described in your text, the researchers used a double-blind procedure, meaning that A) both the experimenters and the participants knew what group of adolescents were getting which treatment. B) only the participants themselves knew which treatment they were receiving. C) only the parents of the adolescents involved in the study were aware of which treatment they were receiving. D) neither the participants nor the experimenters knew who was getting medication and who was getting a placebo. E) only the experimenters knew who was getting medication and who was getting a placebo. Answer: D Diff: 2 Type: MS Skill: Factual
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47) When evaluating an experiment, one needs to consider its external validity, or A) the degree to which the results of the study can be generalized to other individuals in different settings. B) the size of the experimental effect reported in the study. C) the degree to which the changes in the independent variables are a result of the manipulation of the dependent variable. D) the degree to which alternative explanations for the results of the study can be ruled out. E) the degree to which the changes in the dependent variables are a result of the manipulation of the independent variable. Answer: A Diff: 3 .. 13
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Skill: Conceptual 48) A confound occurs when A) two or more independent variables exert their influence on a dependent variable at different times. B) an experimental investigation lacks external validity. C) two or more independent variables exert their influence on a dependent variable at the same time. D) the results of an experiment are not significant. E) one independent variable exerts an influence on a dependent variable. Answer: C Diff: 1 Type: MS Skill: Factual
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49) According to the text, the development of classification systems such as the DSMs was largely based upon A) questionnaires. B) experiments. C) correlational studies. D) case studies. E) quasi-experiments. Answer: E Diff: 2 Type: MS Skill: Factual
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50) Which of the following is NOT true of correlational studies? A) A correlation can be either positive or negative. B) Behaviour is not manipulated, but rather quantitatively measured and analyzed statistically. C) They are frequently carried out where experimental manipulation is impossible or unethical. D) They measure the degree of relationship between two variables. E) They generally do not require a large number of participants. Answer: E Diff: 2 Type: MS Skill: Conceptual
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51) If two variables are found not to be related to one another, then the correlation coefficient of the relationship between these two variables should be close to A) zero. B) +0.63. C) -0.50.
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D) -1.00. E) +1.00. Answer: A Diff: 2 Type: MS Skill: Application
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52) Psychologists are usually most interested in correlation coefficients that are greater than or equal to A) 0. B) +1.00. C) +0.30. D) +0.30 or -0.30. E) -0.30. Answer: D Diff: 3 Type: MS Skill: Application
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53) If two variables, A and B, are related then we can say all of the following except A) there is a relationship between A and B. B) some other variable, C, may be causing both A and B. C) A might be causing B. D) A causes B. E) B might be causing A. Answer: D Diff: 2 Type: MS Skill: Conceptual
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54) According to the text, the case study is a(n) __________ approach used in the investigation of abnormal behaviour. A) singular B) nomothetic C) individual D) ideographic E) unitary Answer: D Diff: 1 Type: MS Skill: Factual
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55) Which of the following was NOT presented by the text as a criticism of the case study method of investigating abnormal behaviour? A) The clinician's theoretical background has been shown to influence the information gathered. .. 15
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B) It does not lead to generation of new hypotheses. C) It does not employ the scientific method. D) It cannot demonstrate cause and effect. E) One cannot be certain of the generalizability of the findings. Answer: B Diff: 1 Type: MS Skill: Factual
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56) Though based on the investigation of an individual subject, the __________ design avoids many of the criticisms of the case study by using experimentally accepted procedures. A) nomothetic B) ideographic C) reversal D) quasi-experimental E) single-subject Answer: C Diff: 3 Type: MS Skill: Factual
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57) Linda is clinical psychologist studying the incidence and prevalence of schizophrenia in a certain population. She is carrying out a(n) __________ study. A) longitudinal B) experimental C) etiological D) epidemiological E) ideographic Answer: D Diff: 1 Type: MS Skill: Application
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58) Because of the potential confound of shared environment in __________ studies, behavioural geneticists have often turned to other methods such as adoption studies. A) family B) behavioural genetics C) cross-fostering D) psychological E) adoption Answer: A Diff: 1 Type: MS Skill: Factual
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59) Leanne is conducting a study in which she is examining the difference in rates of bipolar disorder between monozygotic and dizygotic twins pairs. The term most frequently used to describe this sort of study is A) sibling study. B) adoption study. C) twin study. D) matched study. E) zygotic study. Answer: C Diff: 1 Type: MS Skill: Application
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60) There has been a great deal of research, using a wide variety of methods, examining the concordance rates for disorders such as schizophrenia and bipolar disorder. These studies have generally revealed higher concordance rates in __________ than in __________. A) monozygotic twins; adopted relatives B) adopted relatives; biological relatives C) biological relatives; adopted relatives D) dizygotic twins; monozygotic twins E) monozygotic twins; dizygotic twins Answer: E Diff: 2 Type: MS Skill: Factual
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61) A musical child grows older and begins to hang out with other musically-gifted peers, and eventually decides to enter the Faculty of Music when he goes to University. This is known as A) passive gene-environment correlation B) evocative gene-environment correlation C) concordance D) cross-fostering E) active gene-environment correlation Answer: E Diff: 2 Type: MS Skill: Applied
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62) Experimental results concerning the efficacy of a particular treatment are labelled “statistically significant” when A) it is extremely unlikely that the obtained results could have occurred purely by chance and the treatment has been demonstrated to be likely to work in “real life”. B) the treatment results have been compared to non-disturbed samples. C) the treatment has been demonstrated to work in “real life”. .. 17
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D) it is extremely unlikely that the obtained results could have occurred purely by chance. E) it is extremely unlikely that the obtained results could have occurred purely by chance and the treatment has been demonstrated to work in “real life”. Answer: D Diff: 1 Type: MS Skill: Factual
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63) A treatment's practical utility, which does not follow automatically from statistical significance, is referred to as __________ significance. A) treatment B) therapeutic C) clinical D) normative E) practical Answer: C Diff: 2 Type: MS Skill: Factual
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64) According to the text, __________ compares treatment results to non-disturbed samples, in order to evaluate the social validity of a particular treatment. A) social comparison B) experimental significance evaluation C) normative comparison D) clinical significance evaluation E) practical comparison Answer: C Diff: 3 Type: TF Skill: Factual
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65) Alternate-form reliability refers to the degree of reliability within a test. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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66) Coefficient alpha and split-half reliability are both methods for evaluating the internal consistency of a test. A) True B) False
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Answer: A Diff: 2 Type: TF Skill: Factual
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67) Face validity goes one step beyond content validity in its requirement that a test's content include a representative sample of behaviours thought to be related to the construct the test is designed to measure. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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68) Bill is a clinician who feels that when it comes to evaluating and interpreting data about a patient, there is no substitute for the clinician's personal experience and judgment. Bill is most likely endorsing the actuarial approach to prediction. A) True B) False Answer: B Diff: 2 Type: TF Skill: Application
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69) One of the oldest and most well established brain imaging techniques is the electroencephalogram (EEG), which reads the brain's electrical activity via electrodes placed on the scalp. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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70) The Bender Visual-Motor Gestalt Test is the oldest and most commonly used neuropsychological test. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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71) The main problem with the Bender Visual-Motor Gestalt test is that it produces many false negatives.
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A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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72) The Halstead-Reitan consists of six subtests: category, rhythm, tactual performance, tapping, grip strength, and auditory. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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73) The Mental Status Examination is the most frequently used structured clinical interview. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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74) The first scientific study of intellectual functioning was conducted by French psychologist Alfred Binet. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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75) The Exner system was developed in an attempt to increase the reliability and validity of the Thematic Apperception Test (TAT). A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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76) The Minnesota Multiphasic Personality Inventory (MMPI) is based on the contrastedgroups method of ascertaining validity.
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A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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77) The results of an MMPI-II assessment give a clinician a DSM-IV diagnosis. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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78) One criticism of the MMPI-II is that it has no scales devoted to an assessment of faking or lying on the part of the respondents. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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79) The change in behaviour often seen when people are aware of being observed is often called subject reactivity. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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80) Random assignment is a procedure that ensures that each participant in an experiment has an equal probability of being in either the experimental or control groups. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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81) In an experiment, the control group experiences all aspects of the experiment in a manner identical to the experimental group, except for the manipulation of the dependent variable.
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A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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82) When two variables exert their influence at the same time, making it impossible to accurately establish the causal role of either variable, a confound is said to occur. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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83) Generally, psychologists are interested in correlation coefficients only if they are greater than +/-.65. A) True B) False Answer: B Diff: 1 Type: TF Skill: Application
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84) The case study is both the oldest and most currently used approach to the study of abnormal behaviour. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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85) Linda is conducting a study in which neither the subjects nor the experimenters know who is getting medication and who is getting the placebo. This study design is most frequently called a double-unaware design. A) True B) False Answer: B Diff: 1 Type: TF Skill: Application
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86) Briefly define any THREE of the following: test-retest reliability; alternate-form reliability; internal consistency; split-half reliability; coefficient alpha. .. 22
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Answer: Test-retest reliability = the degree to which a test yields the same results when it is given more than once to the same person Alternate-form reliability = the degree to which two alternate forms of a test agree (provide similar results) Internal consistency = the degree of reliability within a test Split-half reliability = a measure of internal consistency; often evaluated by comparing responses on odd- and even-numbered test items Coefficient alpha = a measure of internal consistency; calculated by averaging the intercorrelations of all the items on a given test Diff: 2 Type: ES Page Ref: 61 Skill: Factual 87) Briefly define any TWO of the following: face validity, content validity, criterion validity, construct validity. Answer: Face validity means that the items on a test resemble the characteristics associated with the concept being tested. Content validity is one step beyond face validity in requiring that the test's content include a representative sample of behaviours thought to be related to the construct the test is designed to measure Criterion validity is said to have been achieved when the test results match what is known in the population (i.e., a depression test has criterion validity if it discriminates between depressed and non-depressed people) Construct validity is concerned with the importance of a test within a specific theoretical framework; especially useful for abstract constructs Diff: 2 Type: ES Page Ref: 61-62 Skill: Factual 88) List any TWO brain imaging techniques discussed in the text. Briefly describe what kind of information each technique gathers, and how it does so. Answer: Electroencephalogram (EEG): uses electrodes placed on the scalp; measures brain's electrical activity Computerized Axial Tomography (CAT): a narrow band of X-rays is projected through the head onto (scintillation) crystals, and a computer combines a number of the resulting images; measures brain structures (static image of the brain) Magnetic Resonance Imaging (MRI): a magnetic field is produced around the patient's head, then radio waves are then introduced and turned off, causing electrons to return to their original configuration and in doing so emit radio waves at a frequency which can be detected; the introduction of a small magnetic gradient to the field allows the location of the source to be determined; measures both the structure and functioning of the brain (static image of the brain) Positron Emission Tomography (PET): radiation is detected outside the head; radiation is inhaled or injected, and the radiation is given off and detected by the PET equipment; measures brain functioning (dynamic image of the brain) .. 23
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Diff: 2 Type: ES Skill: Application
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89) Briefly describe any ONE projective test. Answer: Rorschach Inkblot Test: created by Rorschach; asked to describe what they see in the blot; Exner system developed to increase reliability and validity by standardizing scoring Thematic Apperception Test: created by Murray and Morgan; drawings on cards of ambiguous social interactions which individuals create stories about; questions about the reliability and validity of scoring techniques Diff: 2 Type: ES Page Ref: 70-71 Skill: Conceptual 90) What is an analogue observational setting? Why is it used? What is subject reactivity and should one be concerned with it in an analogue observational setting? Answer: An analogue observational setting is created by clinicians (often behaviourists) in order to directly observe a client's behaviour. It is an artificial setting in an office or laboratory set up to elicit specific classes of behaviour in individuals. It is used because in vivo observation is difficult; it is impractical often because of time constraints and money. Subject reactivity refers to the change in behaviour often seen when people know they are being observed. It is a concern for analogue observational settings as well as in vivo. Diff: 3 Type: ES Page Ref: 76 Skill: Conceptual 91) List the four sets of variables in the Kanfer and Phillips (1970) SORC model. Answer: S = stimuli O = organismic R = responses C = consequences Diff: 2 Type: ES Skill: Factual
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92) What is random assignment? In what sort of research design is it found? Answer: Random assignment is a procedure that ensures each subject has an equal probability of being in either the experimental or control group, guaranteeing the equivalence of these two groups. It is found in experiments. Diff: 1 Type: ES Page Ref: 78 Skill: Conceptual 93) Briefly state the difference between a quasi-experimental study and an experiment. Upon which of these have the DSMs been primarily based? .. 24
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Answer: A quasi-experimental study is one in which the subjects in the experimental group are NOT randomly assigned but are selected on the basis of certain characteristics, and in which there is no manipulation of independent variables. Conversely: an experimental study is one in which the subjects are randomly assigned to experimental and control groups, and there is a manipulation of independent variable(s). The DSMs have been primarily based upon quasi-experimental studies. Diff: 2 Type: ES Page Ref: 79 Skill: Conceptual 94) What sort of research design is the ABAB design? What is it also known as? Briefly describe the ABAB design. Answer: The ABAB design is a single-subject design. It is also known as the reversal design. In this sort of study, the first A phase requires the quantification of behaviour in its natural environment, prior to any intervention. In the B phase, the treatment is introduced. The next A phase constitutes the reversal, during which the treatment is stopped. The treatment is provided again in the final B phase. Diff: 1 Type: ES Page Ref: 82 Skill: Factual 95) What is epidemiology? What do the terms incidence and prevalence refer to? Answer: Epidemiology is the study of the incidence and prevalence of disorders in a population. Incidence refers to the number of new cases of a disorder in a particular population over a specified time period. Prevalence is the frequency of a disorder in a population at a given point in time. Diff: 1 Type: ES Page Ref: 83 Skill: Factual
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CHAPTER 5 Anxiety Disorders 1) Anxiety is distinguished from fear and panic because of the emphasis on __________. A) fighting B) the present C) the past D) the future E) fleeing Answer: D Diff: 1 Type: MS Skill: Conceptual
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2) According to the text, biological theories of anxiety emphasize all of the following except: A) neuroanatomy B) structural brain damage C) family history D) neurotransmitters E) genetics Answer: B Diff: 1 Type: MS Skill: Conceptual
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3) The role of GABA in anxiety was discovered after it was found that a class of drugs known as __________ reduce anxiety through their action on GABA. A) tricyclics B) benzodiazepines C) SSRIs D) bicyclics E) monoamine oxidase inhibitors Answer: B Diff: 1 Type: MS Skill: Factual
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4) The three neurotransmitters that appear to be involved in anxiety are A) GABA, serotonin, and norepinephrine. B) norepinephrine, serotonin, and dopamine. C) dopamine, GABA, and serotonin. D) GABA, glutamate, and dopamine. E) glutamate, dopamine, and norepinephrine.
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Answer: A Diff: 2 Type: MS Skill: Conceptual
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5) According to the two-factor theory of phobias, avoidance or escape serves as a __________ which prevents classically conditioned fears from being unlearned. A) positive punisher B) negative reinforcer C) negative punisher D) neutral stimulus E) positive reinforcer Answer: B Diff: 3 Type: MS Skill: Factual
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6) Support for the two-factor theory of fear was found in the case of __________, who developed a fear of __________. A) Little Albert, spiders B) Little Hans; horses C) Little Albert; horses D) Little Albert; rats E) Little Hans; spiders Answer: D Diff: 1 Type: MS Skill: Factual
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7) Approximately __________% of the population may be expected to develop an anxiety disorder at some point in their lives. A) 10 B) 40 C) 25 D) 55 E) 90 Answer: C Diff: 1 Type: MS Skill: Factual
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8) According to DSM-IV-TR, a(n) __________ is defined as a discrete period of intense fear or discomfort accompanied by at least 4 of the 13 somatic, behavioural and cognitive symptoms listed (such as palpitations and fear of dying). A) panic attack B) anxiety attack C) panic episode .. 2
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D) acute attack E) anxiety episode Answer: A Diff: 1 Type: MS Skill: Factual
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9) The behavioural avoidance test (BAT) is used to measure and assess: A) agoraphobic avoidance. B) derealization. C) depersonalization. D) paresthesias. E) fear of dying. Answer: A Diff: 1 Type: MS Skill: Factual
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10) Though panic attacks can occur in a variety of other disorders, in panic disorder they occur A) more intensely. B) predictably. C) for longer periods of time. D) more frequently. E) spontaneously. Answer: E Diff: 2 Type: MS Skill: Factual
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11) Heather avoids situations such as travelling far from home, being alone in or outside the home and going into crowded places. Judging from this description, which of the following terms best encapsulates her behaviour? A) agoraphobia B) social phobia C) specific phobia D) panic attacks E) generalized anxiety Answer: A Diff: 1 Type: MS Skill: Application
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12) The onset of panic disorder is typically A) around childhood. B) around late adolescence or young adulthood. .. 3
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C) near late adulthood. D) early to middle adulthood. E) variable. Answer: D Diff: 2 Type: MS Skill: Factual
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13) Which of the following is NOT true of panic disorder? A) It afflicts more males than females. B) People having panic attacks often feel the are having a heart attack. C) The average age of onset is 25 years. D) It is often underdiagnosed by heath care professionals. E) It is often comorbid with other mental disorders. Answer: A Diff: 1 Type: MS Skill: Factual
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14) Clark's model of panic postulates that panic attacks arise from A) catastrophic misinterpretation of arousal-related bodily sensations. B) the correct interpretation of bodily sensations. C) raised levels of norepinephrine. D) previous conditioning experiences. E) lowered levels of norepinephrine. Answer: A Diff: 1 Type: MS Skill: Factual
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15) The term __________ refers to the fact that people prone to panic attacks tend to catastrophically misinterpret arousal-related bodily sensations. A) panic sensitivity B) alarm sensitivity C) anxiety sensitivity D) panic catastrophizing E) anxiety catastrophizing Answer: C Diff: 1 Type: MS Skill: Factual
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16) Which of the following is NOT one of the four subtypes of specific phobia listed in the DSM-IV? A) animal B) specific situation .. 4
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C) death D) blood injection E) environmental Answer: C Diff: 1 Type: MS Skill: Factual
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17) If the equipotentiality premise concerning specific phobias is true, then it must also be true that A) a person cannot be afraid of both dogs and doors. B) only neutral stimuli that involve animals can become phobias. C) classical conditioning cannot explain the development of phobias. D) only a select number of stimuli are consistently related to phobias. E) all neutral stimuli have the potential for becoming phobias. Answer: E Diff: 3 Type: MS Skill: Conceptual
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18) The nonassociative model of phobias claims that A) evolution endowed humans not to respond fearfully to any kind of stimuli and that learning was necessary for very specific phobias to develop. B) evolution endowed humans to respond fearfully to a select group of stimuli but that learning is necessary to develop the phobia. C) evolution endowed humans to respond fearfully to a select group of stimuli but that learning is not necessary to develop the phobia. D) evolution endowed humans to respond fearfully to any kind of stimuli but that personal experience was necessary for a phobia to develop. E) evolution endowed humans not to respond fearfully to any kind of stimuli and that personal experience is necessary for a phobia to develop. Answer: C Diff: 2 Type: MS Skill: Conceptual
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19) The concept of biological preparedness helps to explain why A) learning to fear snakes is just as easy as learning to fear lamps. B) it is impossible to develop two fears at the same time. C) all stimuli have an equal potential for becoming specific phobias. D) learning to fear snakes is easier than learning to fear lamps. E) learning is not a necessary component in the development of phobias. Answer: D Diff: 2 Type: MS Skill: Conceptual .. 5
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20) Research on disgust sensitivity supports the notion that A) the fear of death is also an important component. B) the cause of phobias may not always involve only fear of danger. C) other emotions, such as anger, are necessary, for some phobias. D) the cause of phobias must also always include a fear of contamination. E) beliefs about being harmed are critical to the onset of some phobias. Answer: B Diff: 2 Type: MS Skill: Conceptual
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21) Jim has a strong fear of eating in restaurants, but otherwise does not experience anxiety. His correct diagnosis would probably be A) agoraphobia. B) non-generalized social phobia. C) generalized social phobia. D) specific phobia. E) panic disorder. Answer: B Diff: 2 Type: MS Skill: Application
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22) __________ has a prevalence rate comparable to unipolar depression. A) social phobia B) PTSD C) generalized anxiety disorder D) OCD E) panic disorder Answer: A Diff: 2 Type: MS Skill: Factual
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23) Cognitive factors associated with social phobia appear to involve A) normal social information processing but negative beliefs about self and others. B) abnormal social information processing despite generally positive beliefs about self and others. C) abnormal social information processing. D) abnormal social information processing and negative beliefs about self and others. E) negative beliefs about self and others. Answer: D Diff: 2 Type: MS Skill: Factual .. 6
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24) __________ are repetitive behaviours or cognitive acts performed in response to obsessions. A) Repeats B) Checks C) Compulsions D) Reiterations E) Motor disturbances Answer: C Diff: 1 Type: MS Skill: Factual
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25) Behavioural or mental acts of neutralization appear to be A) specific to OCD patients. B) specific to male OCD patients. C) specific to female OCD patients. D) not common among OCD patients. E) a normal and common activity. Answer: E Diff: 2 Type: MS Skill: Conceptual
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26) Only the __________ form of thought-action fusion (TAF) is considered to be a pathological OCD belief. A) Likelihood-Other TAF B) Likelihood-Self TAF C) Moral TAF D) Moral-Self TAF E) Likelihood TAF Answer: A Diff: 2 Type: MS Skill: Factual
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27) Subtypes of obsessive-compulsive disorder include all of the following except: A) Contamination and Washing/Cleaning B) Hoarding C) Ordering/Symmetry D) Counting E) Checking Answer: D Diff: 2 Type: MS Skill: Factual .. 7
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28) Which of the following is NOT one of the four clusters of symptoms associated with posttraumatic stress disorder? A) recurrent reexperiencing of the traumatic event B) exposure to a traumatic event C) persistent symptoms of increased arousal D) avoidance of trauma-related stimuli E) repeated and unwanted thoughts Answer: E Diff: 1 Type: MS Skill: Factual
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29) To qualify for a diagnosis of PTSD the individual must display symptoms for longer than __________ following a traumatic event. A) one year B) 1 month C) 3 months D) 6 months E) five years Answer: B Diff: 2 Type: MS Skill: Factual
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30) One of the symptoms of PTSD includes emotional numbing or A) an inappropriate expression of emotion. B) an inability to experience emotional feelings. C) avoiding emotional feelings. D) an inability to control emotions. E) feelings of guilt. Answer: B Diff: 3 Type: MS Skill: Factual
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31) Concerning the risk factors for the development of PTSD __________ appear to be the most powerful predictors. A) childhood factors B) interpersonal traumas C) post-event factors D) psychiatric histories E) pre-event factors
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Answer: C Diff: 1 Type: MS Skill: Factual
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32) A physiological marker of PTSD is A) decreased cortisol secretion. B) smaller frontal lobes. C) a smaller hypothalamus. D) increased cortisol secretion. E) an enlarged hippocampus. Answer: A Diff: 2 Type: MS Skill: Factual
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33) For a diagnosis of generalized anxiety disorder (GAD) the DSM-IV-TR requires that the anxiety must be present more days than not for a period of at least A) 1 year. B) 6 weeks. C) 6 months. D) 6 days. E) 3 years. Answer: C Diff: 1 Type: MS Skill: Factual
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34) Worrying appears to help individuals with GAD avoid: A) panic attacks. B) depression. C) suicidal ideation. D) physiological arousal. E) stress. Answer: D Diff: 2 Type: MS Skill: Factual
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35) Which of the following symptoms is NOT associated with generalized anxiety disorder? A) muscle tension B) sleep disturbance C) irritability D) fear of losing control or going crazy E) restlessness or feeling keyed up or on edge
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Answer: D Diff: 2 Type: MS Skill: Conceptual
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36) Many of the etiological models of GAD are primarily __________ in nature. A) neuropsychological B) genetic C) biological D) behavioural E) cognitive Answer: E Diff: 2 Type: MS Skill: Factual
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37) According to the Dugas, Gagnon, Ladouceur, and Freeston (1998) model of generalized anxiety disorder, which of the following is one of the key elements underlying the disorder? A) excessive amounts of catecholamines B) intolerance of uncertainty C) thought-action fusions D) poor interpersonal relations E) catastrophic misinterpretation of bodily arousal Answer: B Diff: 2 Type: MS Skill: Factual
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38) The most commonly used and effective medications for the treatment of anxiety disorders today are __________. A) antidepressants B) the benzodiazepines C) stimulants D) antianxiety drugs E) minor tranquilizers Answer: A Diff: 3 Type: MS Skill: Factual
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39) __________ was the first psychological treatment to be thoroughly validated for anxiety disorders. A) Psychoanalysis B) Relaxation training C) Exposure therapy
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D) Hypnosis E) Cognitive restructuring Answer: C Diff: 1 Type: MS Skill: Factual
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40) One commonly used technique in cognitive restructuring involves the use of A) response prevention. B) a fear hierarchy. C) dual representation. D) a thought record. E) exposure. Answer: D Diff: 2 Type: MS Skill: Factual
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41) The rationale underlying systematic desensitization is that A) anxiety is due to uncontrollable thoughts or worries. B) anxiety is an outcome of an abnormally functioning HPA-axis. C) anxiety is a learned or conditioned response. D) anxiety is due to a history of child abuse. E) anxiety is due to poor interpersonal skills. Answer: C Diff: 1 Type: MS Skill: Factual
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42) The main treatment for OCD involves exposure and A) worry exposure. B) Ritual prevention. C) interoceptive exposure. D) worry behaviour prevention. E) intense exposure. Answer: B Diff: 1 Type: MS Skill: Factual
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43) Worry imagery exposure was primarily developed for the treatment of __________. A) social phobia B) generalized anxiety disorder C) obsessive-compulsive disorder D) specific phobia E) panic disorder .. 11
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Answer: B Diff: 2 Type: MS Skill: Factual
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44) Virtual reality technologies have become particularly useful in A) exposure therapies. B) cognitive therapies. C) psychodynamic therapy. D) drug therapy. E) cognitive and drug therapies. Answer: A Diff: 2 Type: MS Skill: Factual
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45) __________ treatments of anxiety tend to have lower relapse rates. A) Pharmacological B) Cognitive-behavioural C) Humanistic D) Existential E) Psychoanalytic Answer: B Diff: 1 Type: MS Skill: Factual
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46) Both cognitive restructuring and exposure appear to be useful in the treatment of __________ disorder. A) panic B) obsessive-compulsive C) generalized anxiety D) social anxiety E) phobic Answer: D Diff: 2 Type: TF Skill: Conceptual
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47) Panic could be described as a “false alarm.” A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual .. 12
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48) Mythical and historical accounts of anxiety reactions date as far back as the existence of writing. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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49) Family studies indicate that up to 50% of those suffering from anxiety disorders have an immediate family member who also suffers from an anxiety disorder. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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50) Watson's two-factor model of fear and phobias proposes that fears are acquired through classical conditioning but maintained through operant conditioning. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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51) Mowrer's two-factor theory satisfactorily explains why some stimuli (such as spiders) are more likely to become feared rather than others. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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52) It is possible to have a diagnosis of agoraphobia without history of panic disorder. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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53) Individuals with generalized anxiety disorder often avoid activities such as drinking coffee and having sex because they frequently misinterpret the resulting bodily sensations of arousal. A) True B) False Answer: B Diff: 2 Type: TF Skill: Application
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54) Obsessions are repetitive behaviours performed in response to repetitive, intrusive thoughts. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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55) Research has shown that neutralizing occurs relatively often in people who do not have OCD. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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56) Salkovskis proposed that cognitive intrusions develop into obsessions only when intrusions are appraised as posing a threat for which the person is personally responsible. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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57) Personality disorders are frequently present in more complex and severe cases of PTSD. A) True B) False Answer: A Diff: 3 Type: TF Skill: Factual
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58) The theory behind Eye-Movement Desensitization and Reprocessing, a new method of treating anxiety disorders, has been widely accepted. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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59) Several researchers have examined the role of neurotransmitters and neuroanatomy in anxiety. Briefly discuss the role of one brain region and one neurotransmitter which have been studied. Answer: Amygdala: principal brain region involved in the processing of fear; subcortical region involving neural fear circuit that act independently of higher brain regions. GABA: neurotransmitter; its role discovered after the benzodiazepines were found to reduce anxiety through their action on GABA; one hypothesis is that they increase the release of GABA into the synaptic cleft, thereby depleting the presynaptic neurons of GABA. Diff: 2 Type: ES Page Ref: 92 Skill: Factual 60) What is the two-factor theory? Give an example of how a fear could be acquired and maintained in the context of this theory. Answer: Mowrer's theory. Proposes that fears are acquired by classical conditioning as proposed by Watson but maintained by operant conditioning. Many examples possible. Diff: 2 Type: ES Page Ref: 92 Skill: Conceptual 61) Several findings are inconsistent with Mowrer's two-factor theory of fear. Briefly discuss two such findings. Answer: 1. cannot explain the development of all phobias; fears are sometimes acquired in the absence of conditioning 2. researchers have often failed to create conditioned fears in the lab; some real-life situations which would appear to be fear provoking actually fail to do so 3. cannot explain why some stimuli are more likely to become feared than others Diff: 2 Type: ES Page Ref: 92-93 Skill: Conceptual 62) What does Seligman's biological preparedness theory state? Has the evidence generally supported this theory?
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Answer: Theory states that people and other organisms are biological prepared to acquire fears of certain stimuli; that evolution predisposed organisms to easily learn those associations which facilitate survival. E.g., easier to fear spiders than wooden blocks. Evidence: substantial in non-human species, such as monkeys; less compelling in humans Diff: 2 Type: ES Page Ref: 98 Skill: Conceptual 63) Briefly define “specific phobia”, and list the subtypes discussed in the DSM-IV. How can a phobia be differentiated from regular fear experienced by many people? Answer: A marked and persistent fear and avoidance of specific stimuli or situations; 1) animal phobia, 2) environmental phobia, 3) blood-injection-injury phobia, 4) specific situations phobia. Phobias are distinguishable from ordinary fear in that the fear is excessive or unreasonable, and the fear, avoidance and worries related to the phobic stimulus must interfere significantly with the person's life. Diff: 2 Type: ES Page Ref: 97-98 Skill: Factual 64) Briefly define obsessions and compulsions as they relate to obsessive-compulsive disorder. Provide two examples of each. Answer: Obsessions: thoughts, images or impulses that are persistent, markedly distressing and egodystonic (experienced as unacceptable). Many possible examples, such as: thoughts of violence, sex, contamination, urges to arrange things in order, ... Compulsions: repetitive behaviours (overt actions or cognitive acts) performed in response to an obsession, or according to certain rules or in a stereotyped manner. Many possible examples, such as: repeated washing, checking, seeing reassurance, repeating actions, ordering or arranging objects, ... Diff: 2 Type: ES Page Ref: 102-103 Skill: Conceptual 65) What two reasons did Salkovskis advance to explain why compulsions tend to persist and to be excessive? Provide an example consistent with these two reasons. Answer: 1. They are negatively reinforced by immediate distress reduction. 2) They prevent the person from learning that the dire appraisals are unrealistic. Many examples are possible . . . Diff: 2 Type: ES Page Ref: 103 Skill: Conceptual
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CHAPTER 6 Dissociative and Somatoform Disorders 1) In earlier editions of the DSM, dissociative and somatoform disorders were categorized as A) psychoses. B) depressive disorders. C) somatoform disorders. D) neuroses. E) physical disorders. Answer: D Diff: 1 Type: MC Skill: Factual
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2) At present, dissociative disorders are characterized by A) flat affect. B) severe brain damage. C) delusions and hallucinations. D) alterations of identity, memory, and consciousness. E) poor concentration. Answer: D Diff: 1 Type: MC Skill: Factual
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3) Heather has suddenly left here home and has lost all memory of herself and her past life. She is most likely suffering from A) repression. B) depersonalization. C) dissociative amnesia. D) dissociative fugue. E) dissociative identity disorder. Answer: D Diff: 1 Type: MC Skill: Application
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4) Leanne experiences the sudden feeling of being detached from herself. The term best suited to describe her experience is A) depersonalization. B) dissociative identity disorder. C) dissociative fugue. D) dissociative amnesia. E) repression. .. 1
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Answer: A Diff: 1 Type: MC Skill: Application
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5) Two forms of amnesia are __________ amnesia, in which an individual forgets his or her entire life history, and __________ amnesia, in which a person can remember nothing following a certain point in time. A) localized; continuous B) localized; generalized C) systematized; selective D) generalized; localized E) generalized; continuous Answer: E Diff: 3 Type: MC Skill: Factual
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6) Which of the following is NOT among the five patterns of memory loss described in the DSM-IV-TR? A) localized B) regressive C) generalized D) selective E) continuous Answer: B Diff: 1 Type: MC Skill: Factual
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7) Which of the following matches is incorrect? A) dissociative amnesia : inability to recall important personal information B) depersonalization disorder : presence of two or more personalities C) dissociative identity disorder : presence of two or more personalities D) dissociative fugue : sudden, unexpected flight from home E) depersonalization disorder : feeling of being detached from oneself Answer: B Diff: 1 Type: MC Skill: Factual
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8) Which of the following matches is incorrect? A) continuous amnesia : failure to recall information from a specific date until the present B) selective amnesia : failure to recall only certain categories of information C) localized amnesia : failure to recall information during a specific period of time .. 2
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D) generalized amnesia : failure to recall anything in one's lifetime E) systematized amnesia : failure to recall certain categories of information Answer: B Diff: 2 Type: MC Skill: Factual
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9) A disorder in which people are induced by therapists to remember events that have never occurred is referred to as A) iatrogenic memory syndrome. B) trauma-repression syndrome. C) creative recall syndrome. D) false memory syndrome. E) distorted memory syndrome. Answer: D Diff: 2 Type: MC Skill: Factual
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10) Dissociative fugue is a loss of memory with the added dimension of A) mania. B) substance abuse. C) psychosis. D) physical flight. E) depression. Answer: D Diff: 1 Type: MC Skill: Factual
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11) Wendy feels as though she is outside of her body, observing her own behaviour. This experience is a symptom of A) dissociative fugue. B) dissociative identity disorder. C) dissociative amnesia. D) repressed memory. E) derealization. Answer: E Diff: 1 Type: MC Skill: Factual
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12) Feelings of depersonalization are quite common in young adults, and they are only considered pathological when A) they occur at least 5 times a week. B) they occur in conjunction with substance use. .. 3
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C) they occur in conjunction with derealization disorder. D) they occur in conjunction with feelings of anxiety or depression. E) they are persistent and personally distressing. Answer: E Diff: 1 Type: MC Skill: Factual
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13) Which of the following is NOT true of depersonalization disorder? A) People with this disorder often describe themselves as feeling like a robot that is able to respond to those nearby but without feeling connected to their actions. B) It is characterized by a feeling of detachment from one's self or surroundings. C) It typically is not associated with depression or anxiety; indeed, patients often display an indifference to their symptoms (la belle indifference). D) It is highly related to a history of trauma, particularly emotional abuse. E) A diagnosis of this disorder is usually made in adolescence and tends to be chronic in nature. Answer: C Diff: 1 Type: MC Skill: Conceptual
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14) __________ is the DSM-IV label for the disorder in which certain aspects of a person's identity become detached or dissociated; it was formerly known as __________. A) Multiple personality disorder; dissociative identity disorder B) Dissociative identity disorder; split personality disorder C) Dissociative identity disorder; multiple personality disorder D) Split personality disorder; multiple personality disorder E) Multiple personality disorder; split personality disorder Answer: C Diff: 1 Type: MC Skill: Factual
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15) The different unique personalities in an individual diagnosed with dissociative identity disorder are often referred to as A) alternates. B) others. C) egos. D) splits. E) alters. Answer: E Diff: 2 Type: MC Skill: Factual
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16) Which of the following is TRUE of dissociative identity disorder? A) Alters may have different eyeglass prescriptions and allergies. B) For a diagnosis there must be at least 4 alters which control the person's behaviour. C) Alters typically share the same memories and have similar histories and mannerisms. D) The various personalities always claim to be of the same gender. E) The host is never aware of the various alters. Answer: A Diff: 3 Type: MC Skill: Factual
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17) Which of the following is true of the transition from one alter to another? A) It is often called the “transfer”. B) It cannot be artificially precipitated, such as through hypnotic suggestion. C) It is often precipitated by stress or other identifiable cue in the environment. D) It happens gradually, with the dominant alter fading and the new one growing stronger. E) It is always obvious when a transition between alters has occurred. Answer: C Diff: 1 Type: MC Skill: Factual
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18) Nick Spanos was a leading proponent of the _______ model of DID. A) iatrogenic B) trauma C) medical D) socio-cognitive E) repressed memory Answer: D Diff: 2 Type: MC Skill: Conceptual
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19) Research on dissociative identity disorder suggests that over __________ percent of patients report severe childhood physical and/or sexual abuse. A) 75 B) 90 C) 50 D) 10 E) 25 Answer: B Diff: 2 Type: MC Skill: Factual
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20) According to Merskey, cases of dissociative identity disorder A) represent a legitimate psychiatric disorder. B) are most frequently found in individuals with criminal inclinations. C) may be iatrogenic conditions unintentionally caused by practitioners. D) are frequently cases of individuals faking or malingering their illnesses. E) are more common outside of North America. Answer: C Diff: 2 Type: MC Skill: Factual
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21) Which of the following is true of the treatment and prognosis of dissociative identity disorder? A) There have been few attempts to evaluate the success of the treatments. B) There is considerable evidence that individuals get better without professional help. C) There is general consensus among experts regarding a specific series of steps that are followed. D) In general, the prognosis is optimistic. E) Medication has been found to be useful in treating the disorder. Answer: C Diff: 1 Type: MC Skill: Factual
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22) Which of the following is NOT one of the steps that is usually followed in the treatment of dissociative identity disorder? A) discussing emotionally charges memories of past trauma B) helping patients develop new coping skills C) integrating the various personalities D) using hypnosis to assist the patient in role playing the various alters E) the establishment of trust through a careful discussion of the risks and benefits of therapy Answer: D Diff: 1 Type: MC Skill: Factual
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23) Which of the following medications is sometimes used in the treatment of dissociative identity disorder and associated comorbid disorders? A) a variety of SSRIs B) antipsychotics, such as Haldol C) sodium amytal D) antianxiety drugs, such as Valium E) antidepressants, such as Prozac
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Answer: C Diff: 1 Type: MC Skill: Factual
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24) Which of the following is NOT a somatoform disorder in the DSM-IV-TR? A) body dysmorphic disorder B) hypochondriasis C) conversion disorder D) depersonalization E) pain disorder Answer: D Diff: 1 Type: MC Skill: Factual
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25) Which of the following pairs does NOT match? A) conversion disorder : involuntary motor or sensory symptoms B) somatization disorder : multiple symptoms, including pain, gastrointestinal problems, sexual problems, and psycho-neurological problems C) body dysmorphic disorder : severe preoccupation with defect in appearance of a particular part of the body D) pain disorder : pain without known physical cause E) hypochondriasis : multiple symptoms, including pain, gastrointestinal problems, sexual problems, and psycho-neurological problems Answer: E Diff: 1 Type: MC Skill: Factual
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26) Heather is deliberately faking symptoms of illness in order to gain the attention of doctors. This behaviour is best described by the term A) conversion disorder. B) factitious disorder. C) malingering. D) somatizing. E) faking. Answer: B Diff: 1 Type: MC Skill: Application
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27) Deliberately adopting the sick role and complaining of symptoms to achieve some specific objective is characteristic of A) la belle indifference. B) factitious disorders. C) somatization disorder. .. 7
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D) malingering. E) hypochondriasis. Answer: D Diff: 2 Type: MC Skill: Factual
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28) Sandra is experiencing a loss of vision for which her doctor can find no physical cause. The term best suited to describing her condition is A) factitious disorder. B) hypochondriasis. C) body dysmorphic disorder. D) somatization disorder. E) conversion disorder. Answer: E Diff: 1 Type: MC Skill: Factual
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29) In somatization disorder, patients usually attribute their symptoms to A) feelings of derealization. B) psychological problems. C) an insecure attachment with their parents as children. D) depression. E) medical problems. Answer: E Diff: 1 Type: MC Skill: Factual
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30) In conversion disorder A) there is excessive preoccupation with an imagined or exaggerated body disfigurement. B) people have long-standing fears, suspicions, or convictions about having a serious disease. C) a pattern of multiple, recurring, somatic complaints that have no diagnosable basis are observed, leading the individual to seek medical treatment. D) psychological factors are important in the onset, exacerbation, severity, or maintenance of the patient's pain complaints. E) symptoms are observed in voluntary motor or sensory functions that suggest neurological causes, but these cannot be confirmed. Answer: E Diff: 1 Type: MC Skill: Factual
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31) “Glove anesthesia” refers to A) loss of sensation in the hands when wearing gloves. B) loss of sensation in the extremities. C) loss of sensation in the part of the hands which would be covered by gloves. D) an inability to remember where one has left one's gloves and keys. E) an extreme fear of wearing gloves. Answer: C Diff: 1 Type: MC Skill: Factual
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32) Recently, experts have suggested that conversion disorder might best be viewed as a form of: A) pain disorder B) somatization disorder C) dissociative amnesia D) factitious disorder E) dissociative disorder Answer: E Diff: 2 Type: MC Skill: Factual
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33) The term la belle indifference refers to A) the lack of worry patients with conversion disorder display about their symptoms. B) the lack of awareness of each other displayed by each of the alters in patients suffering from dissociative identity disorder. C) the attitude displayed by people accused of malingering. D) the lack of awareness of their condition displayed by patients suffering from dissociative fugue. E) the lack of concern doctors show for patients suffering from conversion disorder. Answer: A Diff: 2 Type: MC Skill: Factual
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34) The DSM-IV-TR provides for a diagnosis of pain disorder A) regardless of whether the patient also suffers from some medical condition. B) only if the patient also suffers from some medical condition. C) only if the pain is considered psychogenic. D) unless the patient also suffers from some medical condition. E) only if the pain is considered iatrogenic. Answer: A Diff: 2 Type: MC Skill: Factual .. 9
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35) There is some similarity between hypochondriasis and ________. A) panic disorder B) conversion disorder C) depression D) psychogenic pain E) dissociative amnesia Answer: A Diff: 3 Type: MC Skill: Factual
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36) Which of the following represents an overconcern about serious disease? A) malingering B) hypochondriasis C) conversion disorder D) factitious disorder E) pain disorder Answer: B Diff: 3 Type: MC Skill: Factual
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37) Compared with panic disorder suffers, those with hypochondriasis are more likely to be A) be equally concerned with both the immediate and long-term implications of their symptoms. B) suffering from agoraphobia. C) concerned about the immediate effects of an illness. D) concerned with the possibility of heart disease. E) concerned about long-term implications of their symptoms. Answer: E Diff: 3 Type: MC Skill: Application
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38) Joe is excessively preoccupied with the shape of his nose, and, though he has had plastic surgery several times in order to alter its appearance, remains dissatisfied. Joe is most likely suffering from which of the following? A) body dysmorphic disorder B) body disorder C) body dislike disorder D) hypochondriasis E) la belle indifference
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Answer: A Diff: 1 Type: MC Skill: Factual
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39) The most frequently mentioned location of imagined defects in 30 patients with body dysmorphic disorder was the A) hips. B) nose. C) hair. D) teeth. E) buttocks. Answer: C Diff: 2 Type: MC Skill: Factual
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40) Recent research suggests that conversion symptoms in people with conversion disorder result from A) self-hypnosis. B) psychogenic pain. C) malingering. D) therapeutic suggestion. E) valid medical problems. Answer: A Diff: 3 Type: MC Skill: Factual
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41) Somatic disorders were at one time viewed as masked A) aggression. B) anxiety. C) depression. D) psychological conflict. E) obsessions. Answer: D Diff: 3 Type: MC Skill: Factual
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42) Current treatments for somatoform disorders focus on A) integrating the various personalities into a single personality. B) finding the most appropriate pharmacological intervention for the particular individual. C) helping individuals acquire insight into the origins of their difficulties. D) the use of hypnosis to help individuals uncover forgotten memories of traumatic events that may be at the root of many of these disorders. .. 11
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E) affective, cognitive, or social processes that maintain these disorders. Answer: E Diff: 2 Type: MC Skill: Factual
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43) Current thought about somatoform and dissociative disorders suggests that both have are characterized by physical symptoms and/or behaviour thought to be caused or exacerbated by elevated serotonin levels. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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44) Though Hippocratic writing made some reference to dissociative disorders, Plato was among the first to consider the causes involved in these disorders. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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45) Dissociation was emphasized in early Christianity as a function of God's will. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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46) The defining symptom of the dissociative disorders is the disruption of mental processes involved in memory or consciousness that are normally integrated. A) True B) False Answer: A Diff: 1 Type: TF Skill: Conceptual
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47) Dissociative fugue often follows an extremely stressful event. A) True B) False
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Answer: A Diff: 1 Type: TF Skill: Factual
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48) The transition from one alter to another is called a “jump.” A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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49) The separate personalities in a person suffering from dissociative identity disorder are often referred to as “alters.” A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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50) Proponents of false memory syndrome argue that therapists may inadvertently lead patients to uncover repressed memories that have been distorted. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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51) Canadian psychologist Nick Spanos was an articulate supporter of the diagnosis of dissociative identity disorder. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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52) Merskey has argued that dissociative identity disorder is created by the power of suggestion. A) True B) False
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Answer: A Diff: 2 Type: TF Skill: Factual
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53) There is no evidence that people with dissociative disorders score higher on measures of hypnotizability. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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54) Dissociative identity disorder is characterized by the presence of two or more personalities. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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55) Feelings of depersonalization are a rare experience. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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56) The average number of personalities in dissociative personality disorder is five. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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57) Medication is generally not useful in the direct treatment of DID. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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58) In malingering, individuals deliberately fake or generate the symptoms of illness in order to gain their doctor's attention. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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59) Conversion disorder is characterized by voluntary motor or sensory symptoms that reflect underlying neurological, although not anatomical, dysfunction. A) True B) False Answer: B Diff: 3 Type: TF Skill: Factual
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60) Patients with conversion disorder tend to be quite anxious about their symptoms. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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61) Patients with hypochondriasis tend to be quite anxious about their symptoms. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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62) What is the defining symptom of dissociative disorders? What were dissociative disorders categorized as in earlier editions of the DSM? What specific dissociative disorder has changed names recently? Answer: The defining symptom of dissociative disorders is “dissociation,” the disruption of mental processes involved in memory or consciousness that are normally integrated. These disorders used to be called “neuroses.” “Dissociative Identity Disorder” was once called “Multiple Personality Disorder.” Diff: 2 Type: ES Page Ref: 122-125 Skill: Factual
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63) What are the various personalities in a person with dissociative identity disorder called? How many of these personalities must there be for a diagnosis of dissociative identity disorder? Answer: The various personalities are called “alters.” There must be at least two alters for the diagnosis of dissociative identity disorder. Diff: 2 Type: ES Page Ref: 125 Skill: Factual 64) Briefly define malingering and factitious disorders, and distinguish them from somatoform disorders in general. Answer: Malingering is when an individual deliberately pretends to be ill in order to achieve some specific objective (such as not having to write an exam). People with factitious disorder deliberately fake or bring on symptoms of illness in order to gain the attention of medical professionals and satisfy a need to be in a patient role. Somatoform disorders can be distinguished from malingering and factitious disorders because people with the former truly believe they have a serious problem. Diff: 1 Type: ES Page Ref: 128-129 Skill: Factual 65) Identify and describe the major characteristics of four types of dissociative disorders. Answer: Dissociative amnesia: Inability to recall important personal information. Dissociative fugue: Sudden, unexpected flight from home; inability to remember past and who one is. Dissociative Identity Disorder: Presence of two or more personalities. Depersonalization Disorder: Feeling of being detached from oneself Diff: 2 Type: ES Page Ref: 123 Skill: Application 66) Describe five patterns of memory loss characteristic of dissociative amnesia. Answer: Localized amnesia: The person fails to recall information during a very specific time period (e.g., the events immediately surrounding a trauma); Selective amnesia: Only parts of the trauma are recalled while other parts are forgotten; Generalized amnesia: People forget their entire lives; Continuous amnesia: The individual forgets information from a specific date until the present; Systematized amnesia: The individual only forgets certain categories of information. Diff: 2 Type: ES Page Ref: 123 Skill: Factual 67) List and BRIEFLY discuss the defining features of any 3 somatoform disorders from the DSM-IV.
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Answer: Somatization Disorder: Multiple symptoms including pain, gastrointestinal problems, sexual problems; all without known cause Conversion Disorder: Involuntary sensory or motor disruption, e.g., hysterical blindness Pain Disorder: Pain without sufficient known physical cause Hypochondriasis: Excessive concern about serious illness when there is no underlying illness Body Dysmorphic Disorder: Severe preoccupation with defect in appearance in any part of the body Diff: 2 Type: ES Page Ref: 129 Skill: Factual
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CHAPTER 7 Psychophysiological Disorders 1) “Voodoo Death” is a phenomenon in which A) sublimated drives result in heart failure. B) death is directly caused by voodoo. C) ritualistic suicide occurs in Caribbean culture. D) people die as a result of a nervous breakdown. E) the individual dies after learning that he has been cursed. Answer: E Diff: 1 Type: MC Skill: Factual
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2) The early years of research concerning the role of psychological processes on physical health were known as A) psychosomatic medicine. B) cognitive physiology. C) dualistic behaviourism. D) neuropsychophysiology. E) behavioural medicine. Answer: A Diff: 1 Type: MC Skill: Factual
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3) Helen Flanders Dunbar (1935) suggested that A) psychosomatic disorders are caused by true medical conditions. B) the roots of classic psychosomatic disorders lay in interpersonal conflict. C) intrapsychic forces could lead to abnormal brain states and consequently ulcers. D) people with a chronic sense of rage suffered from high blood pressure. E) specific disorders were the natural consequence of emotions and personality traits. Answer: E Diff: 2 Type: MC Skill: Factual
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4) The psychoanalyst Franz Alexander (1950) argued that the roots of psychosomatic disorders A) lay in an imbalance of bodily humours. B) stemmed from an overassertive super-ego. C) were found in interpersonal stressors. D) were unrelated to intrapsychic forces. E) stemmed from characteristic intrapersonal conflict.
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Answer: E Diff: 3 Type: MC Skill: Factual
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5) The theorist __________ argued that the biomedical model of disease should be expanded to a biopsychosocial model. A) Franz Alexander B) Helen Flanders Dunbar C) George Engel D) Walter Cannon E) Hans Selye Answer: C Diff: 2 Type: MC Skill: Factual
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6) Which of the following would most likely be considered a treatable problem in behavioural medicine? A) gallstones B) a stroke C) essential hypertension D) cancer E) cardiac arrythmias due to genetic illness Answer: C Diff: 2 Type: MC Skill: Conceptual
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7) __________ is defined as the application of psychological methods and theories to understand origins of disease, individual responses to disease and the dimensions and determinants of good health. A) Health Psychology B) Behavioural medicine C) Health Physiology D) Biomedicine E) Psychosomatic medicine Answer: A Diff: 3 Type: MC Skill: Factual
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8) A medical condition may be noted on which axis of the DSM-IV-TR? A) III B) V C) II
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D) I E) IV Answer: A Diff: 1 Type: MC Skill: Factual
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9) A specific code meaning “a psychological factor affecting medical condition” may be found on Axis I under A) “Health and psychological factors and illness.” B) “Psychosomatic disturbances.” C) “Psychophysiological and neurological challenges.” D) “Psychogenic medical disorders.” E) “Other conditions that may be a focus of clinical attention.” Answer: E Diff: 3 Type: MC Skill: Factual
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10) A mechanism is A) something which regulates a physical system. B) the means by which unconscious conflict produces psychological disturbances. C) a process, activity of a living system that mediates the influence of an antecedent factor on disease. D) the effect neurotic behaviour has on the family or social environment. E) an axis of internal regulation that involves pulmonary and immunological functioning. Answer: C Diff: 3 Type: MC Skill: Factual
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11) The difference between a sign and a symptom is A) one refers to a lesion and the other a level of functioning. B) one is a mainly objective and the other a mainly subjective indication of illness. C) one refers to a psychological condition and one a medical condition. D) one is an antecedent and one is a consequence of illness. E) neither are directly observable. Answer: B Diff: 3 Type: MC Skill: Conceptual
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12) When a sign involves the specific disruption of bodily tissue or normal function of a bodily system, these disruptions are called A) lesions. B) ulcers. .. 3
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C) mechanisms. D) symptoms. E) challenges. Answer: A Diff: 1 Type: MC Skill: Factual
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13) The body system responsive to psychosocial variables involved in the production of hormones is the A) immune system. B) endocrine system. C) autonomic nervous system. D) central nervous system. E) somatic nervous system. Answer: B Diff: 1 Type: MC Skill: Factual
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14) Perhaps the best known endocrine hormone system known to be highly responsive to psychosocial variables involves the A) ovaries. B) pancreas. C) pineal gland. D) HPA axis. E) testes. Answer: D Diff: 1 Type: MC Skill: Factual
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15) The brain structure that makes up part of the HPA axis is the A) thalamus. B) hypothalamus. C) medulla. D) hippocampus. E) amygdala. Answer: B Diff: 2 Type: MC Skill: Factual
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16) Adrenocorticotrophic hormone A) informs cells in the liver to convert glycogen to usable sugars. B) prompts cells in the adrenal glands to secrete cortisol. .. 4
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C) is released by the pineal gland. D) is a monoamine oxidase inhibitor. E) is a glucocorticoid. Answer: B Diff: 2 Type: MC Skill: Factual
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17) Glucocorticoids A) cause inflammation. B) have not been indicated in the development of neuronal damage in the brain. C) prevent the development of atherosclerosis. D) are only beneficial when released for long periods of time. E) have been indicated in the suppression of immune system function. Answer: E Diff: 2 Type: MC Skill: Factual
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18) Most organs that are innervated by the sympathetic system A) are primarily involved in digestion. B) are typically accompanied by an awareness of their function. C) are also innervated by the parasympathetic branch. D) are not innervated by the parasympathetic branch of the nervous system. E) are under the control of the parasympathetic branch of the nervous system. Answer: C Diff: 1 Type: MC Skill: Factual
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19) Sympathetic is to parasympathetic system as A) accelerator is to brakes. B) brakes are to car. C) deceleration is to acceleration. D) flour and sugar are to baking a cake. E) horse is to buggy. Answer: A Diff: 2 Type: MC Skill: Conceptual
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20) Immune cells are produced and stored in all of the following except the A) thymus gland. B) large intestines. C) lymph nodes.
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D) bone marrow. E) small intestines. Answer: B Diff: 1 Type: MC Skill: Factual
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21) The process of engulfing and digesting invading organisms is called A) suppression. B) cellular inhibition. C) phagocytosis. D) nonspecific immune response. E) lymphocytosis. Answer: C Diff: 1 Type: MC Skill: Factual
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22) Cells that remain permanently altered after an immune episode are called A) B-cells. B) Suppressor T-cells. C) Memory T-cells. D) Helper T-cells. E) Natural Killer. Answer: C Diff: 2 Type: MC Skill: Factual
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23) In the alarm phase of Hans Selye's (1956) General Adaptation Syndrome, the body A) waits for the brain to make a “decision” about the threat. B) mobilizes its defences. C) suffers tissue damage. D) is exhausted due to depletion of energy stores. E) actively fights or copes with the challenge to the system. Answer: B Diff: 3 Type: MC Skill: Factual
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24) The final phase of Hans Selye's General Adaptation Syndrome is the __________ phase. A) adaptation B) resistance C) exhaustion
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D) alarm E) resolution Answer: C Diff: 2 Type: MC Skill: Factual
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25) Kanner, Coyne, Schaefer and Lazarus (1981) suggest that the most common sources of stress in people's lives are A) inner conflicts. B) medical problems. C) hassles. D) drastic life changes. E) financial. Answer: C Diff: 1 Type: MC Skill: Factual
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26) Primary appraisal involves A) deciding whether or not an event is threatening. B) addressing our memory to determine how to deal with a threatening event. C) choosing an appropriate course of action for dealing with the threat. D) inducing a different feeling state as a way to deal with a problem. E) seeking advice from a clinical psychologist about a problem. Answer: A Diff: 2 Type: MC Skill: Factual
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27) Secondary appraisal is analogous to asking the question A) “is there anything I can do about this?” B) “how can I make myself feel better?” C) “can anyone observe how I handle this event?” D) “why is this happening?” E) “is this event threatening?” Answer: A Diff: 1 Type: MC Skill: Factual
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28) Which of the following behaviours may NOT be considered emotion-focused coping? A) watching television B) taking drugs C) thinking about something unrelated to the problem .. 7
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D) drinking E) identifying and rectifying the source of the threat Answer: E Diff: 1 Type: MC Skill: Factual
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29) In a study conducted by Lazarus and colleagues, the researchers found that by __________ the scenes in films depicting rites of passage, arousal was decreased. A) re-watching B) identifying with C) mentally modifying D) intellectualizing or denying E) ignoring Answer: D Diff: 2 Type: MC Skill: Factual
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30) Which of the following was NOT a characteristic of dominant male baboons in Sapolsky's (1995) studies of how social status may affect stress? A) higher levels of circulating lymphocytes B) reduced concentrations of cortisol C) lower levels of high-density lipoprotein cholesterol D) a greater ability to recover from provocation E) lower blood pressure Answer: C Diff: 3 Type: MC Skill: Conceptual
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31) __________ control over stressful events is sufficient to reduce their harmful effects. A) Perceived B) Direct C) Physical D) Internal E) Emotional Answer: A Diff: 1 Type: MC Skill: Factual
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32) Individuals with an internal locus of control typically believe themselves A) to be masters of their own destiny. B) to be more stressed by events than other people. C) to have little control over social situations. .. 8
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D) to be buffeted by the random events in the world. E) to be less healthy than those with an external locus of control. Answer: A Diff: 1 Type: MC Skill: Factual
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33) An example of a job rated as high in decision control and low in psychological demand is A) forester. B) waiter/waitress. C) janitor. D) truck driver. E) secretary. Answer: A Diff: 1 Type: MC Skill: Factual
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34) In a study conducted employing cold viruses, Cohen, Tyrrell, and Smith (1993) discovered that subjects with higher perceived stress and negative affect were A) more likely to have died after a five-year follow-up study. B) more likely to show “hard” immune system changes. C) less likely to recover within a 5-day period. D) more likely to develop another more debilitating illness. E) less likely to show clinical evidence of a cold. Answer: B Diff: 2 Type: MC Skill: Factual
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35) According to Alexander (1950) the role psychological factors might play in the development of ulcers is A) unconscious conflict creates neuronal death in the hypothalamus. B) certain personality types are prone to overeating causing medical problems. C) lowered immune function as a result of stress allows for bacterial infection. D) an unsatisfied desire for love results in an overactivity in the digestive system. E) stress decreases the effectiveness of the mucosal stomach lining. Answer: D Diff: 3 Type: MC Skill: Factual
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36) A study on predictability conducted by Weiss (1970) discovered a relationship between
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A) rats shocked after being provided with a warning tone showed the same ulceration as rats that did not receive a warning stimulus. B) rats shocked after being provided with a warning tone showed ulceration much higher than shocked rats without a warning and unshocked rats. C) rats shocked after being provided with a warning tone showed ulceration only slightly higher than shocked rats. D) shocked rats did not show a great deal of ulceration. E) rats shocked and provided with a warning tone showed greater ulceration than unshocked rats. Answer: C Diff: 1 Type: MC Skill: Factual
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37) A study on controllability by Weiss (1971) discovered that A) rats who could control the stressor suffered the same level of ulceration as rats who could not control the stressor. B) rats who could not exercise control over the stressor did not show any levels of ulceration. C) shocked rats did not show a great deal of ulceration. D) rats who could exercise control over the stressor suffered milder ulceration than rats who could not control the stressor. E) rats who could control the stressor had higher levels of ulceration than those who could not control the stressor. Answer: D Diff: 1 Type: MC Skill: Factual
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38) Which of the following is NOT evidence collected indicating that Helicobacter pylori plays a primary role in the genesis of ulcers? A) Antibodies to the bacterium have been found in the serum of healthy controls. B) This bacterium is present in the stomachs of a large proportion of individuals with ulcer disease. C) Twenty percent of people who test positive for the bacterium show evidence of ulcer. D) Animals injected with H. pylori suffered from ulcer disease. E) The condition of patients treated with drugs to kill H. Pylori improves. Answer: D Diff: 2 Type: MC Skill: Factual
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39) Since the 1950s deaths due to heart attack and stroke have declined by almost A) 25%. B) 10%. C) 70%. .. 10
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D) 50%. E) 90%. Answer: D Diff: 1 Type: MC Skill: Factual
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40) Consistent with the water pump analogy of the cardiovascular system, the peak of the wave of blood flow corresponds with A) the point in the cardiac cycle called the systole. B) the peripheral resistance found in the right ventricle. C) cardiac output. D) the point in the cardiac cycle called the diastole. E) the contraction of the right ventricle. Answer: A Diff: 1 Type: MC Skill: Factual
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41) Which of the following are most closely tied into the regulation of the cardiovascular system? A) serotonergic agonists B) glucocorticoids C) monamine oxidase inhibitors D) dopaminergic antagonists E) catecholamines Answer: E Diff: 3 Type: MC Skill: Factual
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42) Consistent with the plumbing analogy of the cardiovascular system, which of the following best describes atherosclerosis? A) The tubing expands reducing pressure. B) The tubing develops calcium deposits from the water. C) The pump begins to operate sporadically. D) The tubing branch points dry out and become brittle. E) The pump begins to leak water. Answer: B Diff: 2 Type: MC Skill: Conceptual
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43) In terms of cardiovascular functioning, which of the following is a controllable risk factor? A) jogging .. 11
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B) high blood cholesterol C) exercise D) marriage E) high demand occupations Answer: B Diff: 3 Type: MC Skill: Factual
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44) Under precisely defined conditions in a doctor's office, hypertension is defined by A) blood pressure reading of more than 140/80. B) blood pressure reading of more than 120/70. C) decreased tension in blood vessel walls. D) blood pressure reading of more than 160/100. E) cardiac distress under high demand exercise. Answer: A Diff: 2 Type: MC Skill: Factual
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45) The stress reactivity paradigm is used A) to determine the risk of cardiovascular disease as a function of cardiovascular reactivity. B) to show how cardiovascular disease causes stress. C) to measure the effects of risk factors such as smoking on cardiovascular disease. D) to determine the cause of “essential” hypertension. E) to show how the cardiovascular system can be altered by stressful psychosocial stimuli or events. Answer: E Diff: 2 Type: MC Skill: Factual
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46) Type A people in general show more of the following except A) neurotic behaviour. B) hyperalertness. C) competitiveness. D) sense of time urgency. E) hostility. Answer: A Diff: 2 Type: MC Skill: Factual
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47) A number of studies using the __________ have found an association between hostility and increased risk of heart disease. .. 12
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A) The Anger Interview B) Cook-Medley Hostility Scale C) Turner Interruption Test D) Stroop Colour-Word Conflict Test E) Structured Interview Answer: B Diff: 1 Type: MC Skill: Factual
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48) The psychosocial vulnerability model suggests that hostile people A) are innately predisposed to illness. B) experience a more demanding interpersonal life than others. C) are more likely to engage in unhealthy behaviours and less likely to have healthy practices, such as exercise. D) are more at risk for diseases because they experience exaggerated autonomic and neuroendocrine responses during stress. E) create a social world that is antagonistic and unsupportive. Answer: B Diff: 1 Type: MC Skill: Factual
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49) Frasure-Smith, Lesperance, and Talajic (1993) found that depression soon after the heart attack A) had no effect on the risk of dying. B) was associated with a greater than five-fold increase in the risk of dying within six months. C) was associated with a greater than five-fold increase in the risk of another heart attack within 6 months. D) was associated with a greater than five-fold increase in the risk of dying within six months only in men, but not in women. E) was associated with a greater than ten-fold increase in the risk of another heart attack within 6 months. Answer: B Diff: 3 Type: MC Skill: Factual
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50) The INTERHEART study found that of the nine risk factors, the following three had the greatest impact on the risk of heart attack. A) abdominal obesity, psychosocial factors, and low physical activity B) raised lipids, smoking, and psychosocial factors C) psychosocial factors, high blood pressure, and raised lipids D) low consumption of fruits and vegetables, high blood pressure, and diabetes
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E) smoking, low physical activity, and lack of consumption of moderate amounts of alcohol Answer: B Diff: 3 Type: MC Skill: Factual
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51) Cognitive-behavioural techniques aimed at stress management do so by A) teaching control of specific muscle groups. B) helping the individual to re-assess stress causing thought patterns. C) using biofeedback to lower physiological arousal responses. D) encouraging people to invoke images of warmth and heaviness. E) autogenic training. Answer: B Diff: 1 Type: MC Skill: Factual
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52) In a series of interventions for stress performed by Dean Ornish and colleagues (1996), found that __________ predicted the extent of coronary lesions. A) hours spent meditating in a week B) aerobic exercise C) the amount of practice patients devoted to stress management D) the switch to a vegetarian diet E) the number of people involved in group support meetings Answer: C Diff: 2 Type: MC Skill: Factual
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53) Linden and Chambers (1994) in their study on hypertension, discovered that stress management could A) never be as effective as drug treatment. B) actually worse a patient's condition when standard prescription drugs were not given. C) be effective if coupled with drug treatment. D) be as effective as drug treatment if targeted and individualized to each patient. E) be as effective as drug treatment if implemented in a standardized fashion. Answer: D Diff: 2 Type: MC Skill: Factual
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54) Friedman et al. (1986) found that after three years of cardiac counselling implemented through the Recurrent Coronary Prevention Project, patients showed A) an increase in the amount of type A behaviour. B) no change in the amount of type A behaviour. .. 14
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C) half as many occurrences of cardiac events as controls. D) no difference from controls in the occurrences of cardiac events. E) half as many occurrences of cardiac events as controls, but also no reduction in measured Type A behaviour. Answer: C Diff: 2 Type: MC Skill: Factual
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55) A mechanism is a process, an activity of a living system, that mediates the influence of an antecedent factor on disease. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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56) A sign is an unmeasurable subjective experience of illness. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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57) A lesion is a symptom of a physical illness. A) True B) False Answer: B Diff: 1 Type: TF Skill: Conceptual
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58) ACTH is secreted by the pineal gland. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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59) One of the effects produced by cortisol is the reduction of inflammation. A) True B) False
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Answer: A Diff: 1 Type: TF Skill: Factual
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60) The endocrine system is characterized by manufacturing hormones that produce an effect in “targeted” areas of the body. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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61) Evidence has been found to indicate glucocorticoids suppress immune function and promote the development of atherosclerosis. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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62) Most, but not all organs that are innervated by the sympathetic system are also innervated by the parasympathetic branch. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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63) In comparison to sympathetic system innervation, which relies on hormonal transmission, the parasympathetic system operates much more quickly. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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64) Cellular immunity is based on the action of granulocytes and monocytes. A) True B) False
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Answer: B Diff: 2 Type: TF Skill: Factual
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65) In humoral immunity, invading antigens are presented by macrophages to Blymphocytes, some of which remain as memory B-cells. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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66) In the resistance phase of the GAS, the body mobilizes its defenses, in order to deal with a stressor. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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67) Primary appraisal may be thought of as if a person were asking the question “is this a threat to me?”. A) True B) False Answer: A Diff: 1 Type: TF Skill: Conceptual
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68) In terms of psychosocial factors that may affect disease, a dominance hierarchy in monkeys may be seen as analogous to socio-economic-status. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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69) Ischemic heart disease is a condition in which the blood supply to the heart becomes compromised. A) True B) False
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Answer: A Diff: 1 Type: TF Skill: Factual
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70) Cardiac output, one of the aspects of blood pressure, specifically refers to the diameter of the blood vessels. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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71) In 90% of cases of hypertension a specific cause can be identified. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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72) Cardiovascular reactivity refers to how much an individual's cardiovascular function changes in response to a psychologically significant stimulus. A) True B) False Answer: A Diff: 1 Type: TF Skill: Conceptual
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73) Some key type A characteristics are hyperarousal, competitiveness, and hostility. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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74) Techniques employed for stress management range from teaching control of specific muscle groups to autogenic training. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual .. 18
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75) Describe Engel's (1977) argument for a biopsychosocial model of disease. Answer: Engel's argument is that any model explaining disease should incorporate a range of factors. Among these factors are psychological characteristics and societal forces. This spawned from the realization that many, and perhaps all, disease states are influenced directly or indirectly by social or psychological factors. Diff: 1 Type: ES Page Ref: 139 Skill: Conceptual 76) Outline the differences between signs and symptoms. Answer: Symptoms are subjective reports of internal states. An example would be a person suffering from the flu complaining of being hot and tired. Signs are objective indications of an underlying disease process, observable directly by a person with the appropriate training or indirectly through the administration of a specific test. Diff: 1 Type: ES Page Ref: 140 Skill: Conceptual 77) Describe the functioning of the endocrine system. Cite relevant organs, method of transmission, and both the nature and role of cortisol. Answer: The endocrine system functions mainly through the release of hormones into the bloodstream in order to reach target areas. These target areas include the heart, liver or bones. The main organs involved are the hypothalamus, pituitary, and adrenal gland. Cortisol is a highly active hormone that produces a variety of effects in the body including suppressing inflammation, mobilizing glucose from the liver, increasing cardiovascular tone, producing immune-system changes, and inhibiting the activity of other endocrine structures. Diff: 1 Type: ES Page Ref: 141 Skill: Factual 78) Explain the functioning of the autonomic nervous system. Include in your explanation the functioning of both the sympathetic and parasympathetic branches. Answer: The Autonomic Nervous System seems to operate almost entirely out of range of conscious control. The ANS operates of two anatomically distinct parts. The sympathetic branch consists of nerve fibres that emanate from the thoracic and lumbar regions of the spinal cord and make contact with a large number of body organs. These include the: heart, stomach and blood vessels. The parasympathetic branch consists of fibres emanating from the cranial and sacral regions of the spinal cord. The sympathetic system arouses the body for vigorous action. The parasympathetic system returns the body to a more quiescent state. Diff: 1 Type: ES Page Ref: 141-143 Skill: Factual
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79) Explain the process of cellular immunity. Answer: Cellular immunity is based on the action of a class of blood cells called Tlymphocytes. The “T” designation refers to the locus of their production, the thymus gland. Cellular immunity results from a cascade of actions of various types of Tlymphocytes. An antigen is presented to T-lymphocytes by macrophages. The T-cells proliferate and then circulate in the body. Other T-cells participate including Helper Tcells, Natural Killer T-cells and Suppressor T-cells. Diff: 2 Type: ES Page Ref: 144 Skill: Factual 80) State and explain the three stages of Hans Selye's (1956) General Adaptation Syndrome. Does this model treat stress as stimulus or as response? Answer: This is a stress-as-response model. In the alarm phase, the body attempts to adapt by mobilizing its defences. If the challenge persists, the body then enters the resistance phase. In this phase the body actively fights or copes with the challenge through immune and neuroendocrine changes. If the challenge persists still further then the body enters the exhaustion phase. At this point the body has depleted its energy store and can not maintain resistance. It is at this stage that the body may succumb to a disease of adaptation. Diff: 2 Type: ES Page Ref: 146 Skill: Conceptual 81) Briefly explain Lazarus and colleagues' (Lazarus & Folkman, 1984) transactional model of stress. Does this model treat stress as stimulus or as response? Answer: This is neither a stress-as-stimulus nor a stress-as-response model. In this model, stress is an ongoing series of transactions between an individual and his or her environment. Central to this theory is the idea that people constantly evaluate what is happening to them and its implications for themselves. Diff: 1 Type: ES Page Ref: 146 Skill: Conceptual 82) Explain both internal and external loci of control. How may an internal locus of control influence the disease process? Answer: In an internal locus of control the individual believes himself to be master of his/her own destiny. Those with an external locus of control see themselves as being buffeted by the random events of the world. Those with internal loci of control are likely protected against the harmful effects of stress on their health. Diff: 1 Type: ES Page Ref: 148 Skill: Conceptual 83) Explain the evidence for and against the role Helicobacter pylori plays in the formation of gastric ulcers. .. 20
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Answer: The bacterium is present in large proportions of individuals with ulcer disease. Antibodies are present in their serum. Treatment with drugs to eliminate this bacterium produces improvement in affected patients. But, the antibodies are found in normal controls. The bacterium is associated with other diseases. Patients have also been shown to improve without the bacteria being treated. Diff: 2 Type: ES Page Ref: 153-154 Skill: Factual 84) Describe the plumbing analogy for the human cardiovascular system (be sure to include in your description both systolic and diastolic blood pressure). Answer: The heart is a pump, the vasculature is a hose. As the heart pumps, the blood constituents will be transmitted through the tube in cycles that correspond to the pumping action. The peak of the wave of blood flow corresponds to contraction of the left ventricle of the heart at a point during the cardiac cycle, called the systole. When the pump is at rest (the point called the diastole) blood will still be flowing but at a much reduced pressure. So, the blood is always flowing but depending on when the pump was last primed (the heart last contracted; the pressure level is higher or lower. The pressure can be affected by either the amount of blood or the diameter of the tubing. Diff: 2 Type: ES Page Ref: 155-156 Skill: Conceptual
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CHAPTER 8 Mood Disorders and Suicide 1) In Hippocrates’ time, depression was thought to result from an excess of __________ from the spleen. A) yellow bile B) phlegm C) blood D) black bile E) orange bile Answer: D Diff: 1 Type: MC Skill: Factual
Page Ref: 165
2) _________ coined the term manic-depression. A) Hippocrates B) Kraeplin C) Burton D) Cicero E) Freud Answer: B Diff: 1 Type: MC Skill: Factual
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3) Of the nine symptoms of MDD, _____ must be present for a diagnosis. A) 2 B) 3 C) 4 D) 5 E) 6 Answer: D Diff: 2 Type: MC Skill: Factual
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4) Which of the following was mentioned by the text as one of the two important criteria for a diagnosis of a clinical mood disorder? A) substance abuse B) chemical imbalance in the brain C) implications D) presence of dependent personality disorder E) duration
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Answer: E Diff: 1 Type: MC Skill: Factual
Page Ref: 166
5) Relative to other disorders, _______ is rare. A) unipolar mania B) bipolar mood disorder C) unipolar mood disorder D) major depressive disorder E) dysthymic disorder Answer: A Diff: 1 Type: MC Skill: Application
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6) __________ refers to a loss of pleasure or interest in almost all activities or a lack of reactivity to usually pleasurable events. A) Melancholia B) Libido C) Dystonia D) Catatonia E) Anhedonia Answer: E Diff: 1 Type: MC Skill: Conceptual
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7) Though the diagnostic criteria for a major depressive episode require that the episode last at least __________, most usually last much longer. A) 2 days B) 2 weeks C) 2 months D) 4 years E) 2 years Answer: B Diff: 1 Type: MC Skill: Factual
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8) It is estimated that about __________% of Canadians suffer from depression. A) 1.5 B) 5 C) 15 D) 10 E) .5
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Answer: B Diff: 2 Type: MC Skill: Factual
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9) __________ is the most common subtype of depression. A) Melancholic B) Atypical C) Psychotic D) Catatonic E) Dsythymic Answer: B Diff: 2 Type: MC Skill: Factual
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10) The incidence of MDD among ________ is growing faster than in any other age group. A) toddlers B) young children C) adolescents D) young adults E) the elderly Answer: C Diff: 1 Type: MC Skill: Conceptual
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11) The most frequent comorbid condition with depression is A) anxiety. B) histrionic personality disorder. C) schizophrenia. D) substance abuse. E) borderline personality disorder. Answer: A Diff: 1 Type: MC Skill: Factual
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12) Individuals with _______ are less likely to respond to standard treatment than other forms of depression. A) chronic depression B) catatonic C) hypomania D) melancholic E) episodic major depression
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Answer: A Diff: 2 Type: MC Skill: Factual
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13) A person diagnosed with __________ manifests many of the same symptoms as major depression, except that they are less severe and must persist for at least two years. A) dysthymia B) melancholia C) bipolar disorder D) schizoaffective disorder E) anhedonia Answer: A Diff: 1 Type: MC Skill: Factual
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14) Less severe or brief episodes of mania are referred to as A) automanic. B) hypermanic. C) schizo-manic. D) petit-manic. E) hypomanic. Answer: E Diff: 2 Type: MC Skill: Factual
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15) Which of the following words is most descriptive of manic episodes? A) calm B) content C) restrained D) pensive E) flamboyant Answer: E Diff: 1 Type: MC Skill: Conceptual
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16) The hormone __________, secreted by the pineal gland, has been implicated in seasonal affective disorder. A) lanin B) progesterone C) melatonin D) serotonin
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Answer: C Diff: 1 Type: MC Skill: Factual
Page Ref: 171
17) As a form of treatment, Joanne receives phototherapy, in which she sits in front of a light box for a few hours a day every morning. Judging from this treatment, Joanne most likely suffers from A) seasonal affective disorder. B) schizoaffective disorder. C) bipolar depression. D) unipolar depression. Answer: A Diff: 1 Type: MC Skill: Application
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18) Approximately _________ percent of the 70 percent of new mothers who experience depression and mood swings after childbirth is diagnosed with mood disorder with postpartum onset. A) 5-10 B) 10-15 C) 15-20 D) 20-25 Answer: B Diff: 2 Type: MC Skill: Factual
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19) Bipolar disorder has been classified into __________ type(s). A) 3 B) 1 C) 2 D) 4 E) 5 Answer: C Diff: 1 Type: MC Skill: Factual
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20) In Bipolar __________ disorder, there are one or more manic episodes and usually one or more depressive episode. A) 4 B) 5 C) 1 D) 2 E) 3 .. 5
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Answer: C Diff: 2 Type: MC Skill: Factual
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21) In Bipolar __________ disorder, there are at least one hypomanic episode and one or more depressive episode. A) 4 B) 3 C) 1 D) 2 E) 5 Answer: D Diff: 2 Type: MC Skill: Factual
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22) The criteria for the diagnosis of __________ include a duration of at least two years with recurrent periods of mild depression alternating with hypomania. A) rapid cycling depression/mania B) hypomania C) unipolar depression D) bipolar depression E) cyclothymia Answer: E Diff: 2 Type: MC Skill: Factual
Page Ref: 171
23) Clara moves very quickly in and out of depressive and manic episodes, commonly having 5 or more episodes of mania and depression in one year. Of the following disorders, which is Clara most likely suffering from? A) bipolar 1 disorder B) rapid cycling bipolar disorder C) major depression D) bipolar 2 disorder E) cyclothymia Answer: B Diff: 1 Type: MC Skill: Application
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24) Which of the following is NOT true of rapid cycling depression/mania? A) As many as 10-20% of patients with bipolar disorder may display rapid cycling. B) Rapid cycling is linked to a longer and more severe course for bipolar disorders. C) In some patients standard pharmacotherapy can induce rapid cycling. .. 6
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D) Those suffering from it do not respond strongly to pharmacotherapy. E) It is more common in men than in women. Answer: E Diff: 2 Type: MC Skill: Conceptual
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25) The prevalence of seasonal affective disorder is greater where there A) are long summers. B) is less seasonal variation in hours of sunlight. C) is more seasonal variation in hours of sunlight. D) is very little snow. E) are colder temperatures. Answer: C Diff: 1 Type: MC Skill: Factual
Page Ref: 171
26) Along with a 4 percent infanticide rate, postpartum psychosis has a ____ percent suicide rate. A) 5 B) 6 C) 4 D) 2 E) 3 Answer: A Diff: 2 Type: MC Skill: Factual
Page Ref: 172
27) Freud believed that depressed individuals regress to the ___ stage of development. A) Oral B) Anal C) Phallic D) Latent E) Genital Answer: A Diff: 2 Type: MC Skill: Factual
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28) __________ studied how disruptions in attachment, especially in the early parentchild relationship, affect later personality development and vulnerability to depression. A) Jung B) Freud C) Bowlby .. 7
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D) Ainsworth E) Beck Answer: C Diff: 1 Type: MC Skill: Factual
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29) Which of the following is not one of Beck’s cognitive distortions described in the text? A) All-or-none thinking B) Negative feedback seeking C) Overgeneralizations D) Magnification E) Jumping to conclusions Answer: B Diff: 2 Type: MC Skill: Factual
Page Ref: 174
30) In Beck’s model of depression, the diathesis is: A) a stressful life event. B) a negative cognitive schema. C) a genetic predisposition. D) a localized brain dysfunction. E) a neurotransmitter imbalance. Answer: B Diff: 2 Type: MC Skill: Factual
Page Ref: 174
31) After an argument, Jane continues to ask her husband if he still loves her. This is an example of: A) negative feedback seeking. B) stress generation. C) excessive reassurance seeking. D) all-or-none thinking. E) magnification. Answer: C Diff: 2 Type: MC Skill: Applied
Page Ref: 175
32) Beck referred to the negative thoughts depressed people often have about the future, the world and themselves as a A) negative cognitive triangle. B) depressive cognitive triad. .. 8
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C) depressive cognitive triangle. D) negative cognitive triad. E) triple negative triad. Answer: D Diff: 2 Type: MC Skill: Factual
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33) Dividing events into a dichotomy of either all bad or all good is example of which cognitive distortion found in depressed people? A) arbitrary inference B) all-or-none thinking C) selective abstraction D) negative bias E) overgeneralization Answer: B Diff: 1 Type: MC Skill: Factual
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34) Nearly _____ percent of people with major depression have suffered at least one severe loss event prior to onset of their depression. A) 10 B) 25 C) 50 D) 75 E) 90 Answer: D Diff: 2 Type: MC Skill: Factual
Page Ref: 176
35) A strong family link is especially evident in the development of: A) major depression. B) melancholic depression. C) dsythymic disorder. D) bipolar disorder. E) cyclothymia. Answer: D Diff: 1 Type: MC Skill: Factual
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36) Research suggests that the effect of a gene (HTT): A) directly causes depression. B) heightens reactivity to stress. .. 9
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C) lowers levels of serotonin neurotransmitter. D) causes damage to a brain region associated with mood. E) causes damage to a brain region involved with perception. Answer: B Diff: 1 Type: MC Skill: Factual
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37) Brain imaging techniques have shown that depressed individuals have fewer: A) 5-HT receptors B) DA receptors C) NE receptors D) HTT receptors E) CRH receptors Answer: A Diff: 2 Type: MC Skill: Factual
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38) Smaller hippocampal volume in depressed individuals has been linked to: A) cortisol hypersecretion. B) reduced cortisol secretion. C) positive feedback excitation of the HPA axis. D) acute stress. E) reduced ACTH secretion from the pituitary gland. Answer: A Diff: 1 Type: MC Skill: Factual
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39) It has been found that when depressed patients respond to antidepressant medication, they also: A) experience less slow-wave sleep. B) spend more time in REM sleep. C) show an increase in rapid eye movements. D) return to normal levels of REM sleep. E) spend almost no time in REM sleep . Answer: D Diff: 2 Type: MC Skill: Factual
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40) Depressed individuals have been shown to have increased activity in the ___________ leading to continous processing of negative emotional information. A) hippocampus B) hypothalamus .. 10
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C) cingulated cortex D) amygdala E) pituitary gland Answer: D Diff: 1 Type: MC Skill: Factual
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41) One explanation as to why women are more often diagnosed with depression than men is that: A) they are more willing to seek for their symptoms. B) they also show more symptoms associated with bipolar disorder than do men. C) in many cultures women experience role strain. D) the HPA axis is less active in women than it is in men. E) women report higher levels of stressful life events than men. Answer: C Diff: 2 Type: MC Skill: Factual
Page Ref: 179
42) Christine is a therapist who takes as her starting point concerning depression that a person's emotional reactions are determined in part by what he or she thinks. Based on this, Christine is most likely to use __________ therapy to treat her clients. A) humanistic B) neo-psychoanalytic C) Freudian D) cognitive-behavioural E) interpersonal Answer: D Diff: 2 Type: MC Skill: Application
Page Ref: 180
43) Which of the following was NOT discussed in the text as a method in cognitivebehavioural therapy for depression? A) thought records B) activity scheduling C) testing beliefs through behavioural experiments D) interpersonal psychotherpay E) hypnotic sessions Answer: E Diff: 1 Type: MC Skill: Factual
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44) __________ therapy emphasizes that depression often arises as a result of disruptions in an individual's social adjustment. A) Behavioural B) Cognitive-behavioural C) Cognitive D) Interpersonal E) Psychodynamic Answer: D Diff: 1 Type: MC Skill: Factual
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45) Which of the following approaches to treatments emphasizes role transitions (e.g., leaving home for university, becoming a parent)? A) behavioural B) cognitive C) cognitive-behavioural D) interpersonal E) psychodynamic Answer: D Diff: 3 Type: MC Skill: Conceptual
Page Ref: 181
46) The discovery of drugs with antidepressant properties occurred through accidental observation that certain forms of medication used to treat __________ induced depression-like symptoms in patients. A) cancer B) hypertension C) diabetes D) tuberculosis E) AIDS Answer: D Diff: 2 Type: MC Skill: Factual
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47) Currently, the most popular class of antidepressants are the A) selective serotonin reuptake inhibitors (SSRIs) B) monoamine oxidase inhibitors (MAOIs) C) benzodiazepines D) bicyclics E) tricyclics
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Answer: A Diff: 1 Type: MC Skill: Factual
Page Ref: 182
48) Pharmacotherapy is generally considered effective for about __________ percent of people. A) 10 B) 50 C) 20 D) 30 E) 40 Answer: B Diff: 3 Type: MC Skill: Factual
Page Ref: 182
49) Traditionally, __________ is the treatment for bipolar disorder. A) lithium B) Celexa C) Prozac D) Elavil E) clomipramine Answer: A Diff: 1 Type: MC Skill: Factual
Page Ref: 182-183
50) The Canadian Psychiatric Association currently recommends ________ as the firstline treatment for SAD. A) lithium B) ECT C) TMS D) light therapy E) SSRI’s Answer: D Diff: 2 Type: MC Skill: Factual
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51) The main adverse effect of electroconvulsive shock therapy is A) temporary speech difficulties. B) psychotic phases. C) depression. D) memory impairment. E) mania.
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Answer: D Diff: 1 Type: MC Skill: Factual
Page Ref: 185
52) An experimental procedure that uses magnetic fields to alter brain activity is called: A) ECT B) VNS C) CBT D) FFT E) TMS Answer: E Diff: 1 Type: MC Skill: Factual
Page Ref: 185
53) It is estimated that for every completed suicide, there are __________ suicide attempts. A) 5-7 B) 18-20 C) 12-15 D) 2-3 E) 8-10 Answer: E Diff: 1 Type: MC Skill: Factual
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54) The strongest risk factor for completed suicide is: A) being male. B) being female. C) being male between the ages of 50 and 70. D) being female between the ages of 50 and 70. E) being an adolescent female. Answer: A Diff: 2 Type: MC Skill: Factual
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55) Up to _________ percent of people who completed suicide suffered from major depression. A) 10 B) 20 C) 30 D) 50 E) 70
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Answer: E Diff: 2 Type: MC Skill: Factual
Page Ref: 188
56) After mood disorders, __________ is the second most common factor in suicide. A) geographic location B) gender C) alcohol and substance abuse D) age E) contagion Answer: C Diff: 2 Type: MC Skill: Factual
Page Ref: 188
57) Post-mortem studies of people who have committed suicide have found consistent evidence for a hypoactive __________ system. A) serotonin B) dopamine C) norepinephrine D) melatonin E) epinephrine Answer: A Diff: 2 Type: MC Skill: Factual
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58) The Roman physician Hippocrates was the among first to extend the ideas on the relationship between emotional temperament (such as depression) and bodily fluids called humours first proposed by Galen. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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59) A manic episode must be at least one week long, and does not typically last much longer than this. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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60) It is common for an individual to experience an episode of mania without an accompanying depression at some point in their life. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
Page Ref: 171
61) Bipolar disorder is more common than major depression. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
Page Ref: 171
62) The goal of cognitive-behavioural treatment for depression is to identify and resolve unconscious conflict. A) True B) False Answer: B Diff: 1 Type: TF Skill: Conceptual
Page Ref: 180
63) Bowlby categorized early parent-child relationships as secure, avoidant or anxious/ambivalent. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
Page Ref: 173
64) Brown and Harris found that early childhood loss, such as the loss of a parent before age twelve, is a powerful predictor of depression in adulthood. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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65) Recent biochemical theories of depression have examined the role of the postsynaptic receptor in the etiology of depression. .. 16
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A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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66) The most enduring cognitive theory of the mood disorders was developed by Beck. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
Page Ref: 174
67) In a number of comparative studies, interpersonal therapy has been shown to be more effective than antidepressant medication. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
Page Ref: 181
68) Tricyclic antidepressants work by delaying the process of reuptake of serotonin. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
Page Ref: 182
69) The exact mechanism by which transcranial magnetic stimulation (TMS) produces its beneficial results is largely unknown. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
Page Ref: 185
70) Past approaches to therapy with suicide attempts have been quite successful. A) True B) False
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Answer: B Diff: 1 Type: TF Skill: Factual
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71) 90% of the people who complete suicide suffer from a diagnosable mental disorder. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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72) Suicide rates have been changing over the years, but these changes have been consistent among all age groups. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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73) A number of studies have reported a significant association between hopelessness and suicide. A) True B) False Answer: A Diff: 1 Type: TF Skill: Conceptual
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74) Anomic suicide, as discussed by Durkheim, was identified as being motivated by the desire of the individual to fulfill some higher purpose. A) True B) False Answer: B Diff: 1 Type: TF Skill: Conceptual
Page Ref: 188
75) List, define and distinguish between the two broad categories of mood disorders. Answer: Unipolar disorders and bipolar disorders. Unipolar disorders: a change in mood only in the direction of depression or lowered mood, followed by a return to normal mood with recovery
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Bipolar disorders: change in mood occurs in both directions; experience both depression and mania (mood elevation)The distinction is that in the former the change in mood is only in one direction from normal (down) while in the latter it is in both. Diff: 2 Type: ES Page Ref: 166 Skill: Factual 76) Define dysthymia and cyclothymia. Provide one similarity (other than the fact that they are both mood disorders) and one difference between the two. Answer: Dysthymia: many of the same features of major depression (depressed mood) but less severe; must persist for at least 2 years with only brief returns to normal mood. Cyclothymia: duration of at least two years; recurrent periods of mild depression alternating with hypomania Similarity: both require a duration of at least 2 years. Difference: dysthymia is a unipolar mood disorder, cyclothymia is a bipolar mood disorder. Diff: 2 Type: ES Page Ref: 169-171 Skill: Factual 77) What is seasonal affective disorder? What hormone is implicated in it, and how is it best treated? Answer: Seasonal affective disorder: when a mood disorder follows seasonal changes in the amount of sunlight; can be unipolar or bipolar. Melatonin is implicated in the disorder. The best treatment is phototherapy: sitting in front of a light box for between 26 hours a day, preferably in the morning. Diff: 1 Type: ES Page Ref: 171-172 Skill: Factual 78) List, define and provide and example of two of the common types of cognitive distortions listed in the text which occur in the context of depression. Answer: Overgeneralization: drawing a broad conclusion on the basis of a single incident All or nothing thinking: seeing a situation only in extreme terms Jumping to conclusions: drawing a conclusion on the basis of skimpy evidence Magnification: exaggerating importance of errors or problems Diff: 2 Type: ES Page Ref: 174 Skill: Conceptual 79) List and briefly define activity scheduling and behavioural experiments. Answer: Common to all: aspects of cognitive-behavioural treatment of depression Activity scheduling: patients record a baseline measure of their activities, decide which ones they want to add, monitor their behaviour to note how they do and the degree of pleasure/mastery they derive from them .. 19
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Testing beliefs through behavioural experiments: identify a negative belief, design experiments (with the therapist's help) to test them and (ideally) prove them wrong Diff: 2 Type: ES Page Ref: 180-181 Skill: Factual 80) Describe the techniques of TMS and VNS and their effectiveness in treating depression. Answer: TMS: electric current creates magnetic pulse that stimulate nerve cells, increasing blood flow and glucose metabolism in targeted brain regions. VNS: pulse generator delivers electrical signals to the vagus nerve, which is then delivered to the brain. Active TMS relative to sham TMS has led to higher remission rates. Active VNS plus pharmacotherapy led to improvement versus pharmacotherapy alone. Diff: 2 Type: ES Page Ref: 185-186 Skill: Factual 81) Describe the algorithm for evaluation of patients with suicidal ideation that may lead to hospitalization. Answer: Patient expresses suicidal ideation. Patient has a suicide plan. Patient has access to lethal means, poor social support, poor judgment, and cannot make a contract for safety. Diff: 2 Type: ES Page Ref: 190 Skill: Factual
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CHAPTER 9 Schizophrenia 1) An important and basic fact about schizophrenia is its __________. A) homogeneity B) heterogeneity C) relationship to dissociative identity disorder D) simplicity E) universality Answer: B Diff: 1 Type: MC Skill: Factual
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2) The likelihood of developing schizophrenia in North America is about __________ percent. A) 2.5 B) 10 C) 5 D) 1 E) 0.5 Answer: D Diff: 1 Type: MC Skill: Factual
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3) One remaining puzzle concerning schizophrenia is A) how long it has been around. B) why there has been a lack of research on the disorder. C) why it only tends to be found in European and Asian countries. D) the cost of the disorder to society. E) how it relates to multiple personality disorder. Answer: A Diff: 1 Type: MC Skill: Factual/Conceptual
Page Ref: 197-198
4) Positive symptoms of schizophrenia are those that involve A) lack of emotion. B) loss of motivation. C) less serious symptoms. D) speech and language. E) extravagant versions of normal behaviour.
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Answer: E Diff: 1 Type: MC Skill: Factual
Page Ref: 198
5) Which of the following are classified as positive symptoms? A) Social withdrawal and lack of interest in activities B) Spare speech and language C) Lack of coping abilities D) Hallucinations E) Inability to feel pleasure Answer: D Diff: 1 Type: MC Skill: Application
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6) Negative symptoms of schizophrenia include A) flowery speech. B) hallucinations and delusions. C) catatonic behaviour. D) auditory hallucinations only. E) lack of ability to communicate. Answer: E Diff: 1 Type: MC Skill: Factual
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7) The most common type of hallucinations are __________. A) tactile B) visual C) multi-sensory D) auditory E) olfactory Answer: D Diff: 1 Type: MC Skill: Application
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8) A false belief that is strongly held, held even when there is evidence to prove otherwise, is called a A) waxy flexibility. B) delusion. C) hallucinatory concept. D) tangential focus. E) firm conviction.
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Answer: B Diff: 1 Type: MC Skill: Factual
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9) Shandra believes that the weatherman on Cable 10 is delivering messages from outer space to Earth. This is an example of A) a negative symptom. B) alogia. C) a tangential thought. D) a hallucination. E) a delusion. Answer: E Diff: 1 Type: MC Skill: Application
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10) All of the following are types of delusions EXCEPT A) delusions of persecution. B) somatic delusions. C) delusions of emancipation. D) delusions of reference. E) delusions of grandeur. Answer: C Diff: 1 Type: MC Skill: Factual
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11) Heinrich believes he is being followed by the FBI and is convinced that agents are trying to frame him. Heinrich appears to be suffering from A) delusions of reference. B) somatic delusions. C) delusions of grandeur. D) paranoid delusions. E) biblical delusions. Answer: D Diff: 1 Type: MC Skill: Application
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12) The belief that one's neighbours are plotting against you is an example of a __________ delusion. A) persecutory B) somatic C) religious D) grandiose E) referential .. 3
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Answer: A Diff: 2 Type: MC Skill: Factual
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13) The feeling that bugs are crawling around under your skin is A) an example of a delusion of grandeur. B) generally experienced by certain religious tribes. C) indicative of problems in brain functioning. D) only experienced by those on a bad acid trip. E) an example of a somatic delusion. Answer: E Diff: 1 Type: MC Skill: Application
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14) The erroneous belief that one control the weather would be an example of a __________. A) somatic delusion B) paranoid delusion C) delusion of persecution D) delusion of grandeur E) referential delusion Answer: D Diff: 1 Type: MC Skill: Application
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15) Schizophrenia patients with paranoid delusions A) tend to have low IQs and exhibit cognitive abnormalities. B) tend to have very high IQs but nonetheless exhibit some cognitive abnormalities. C) tend to have low IQs. D) are not intellectually impaired but do exhibit some cognitive abnormalities. E) are not intellectually impaired and show no signs of cognitive abnormalities. Answer: D Diff: 2 Type: MC Skill: Factual
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16) Bleuler, in his early descriptions of schizophrenia, gave great emphasis on A) disorganized speech and thought disorder. B) visual hallucinations. C) delusions. D) hallucinations. E) delusions of grandeur.
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Answer: A Diff: 1 Type: MC Skill: Application
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17) The least common of the positive symptoms of schizophrenia is/are __________. A) auditory hallucinations B) delusions of grandeur C) alogia D) thought disorder E) paranoid delusions Answer: D Diff: 2 Type: MC Skill: Factual
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18) When asked how she was feeling, Mona answered “I am fine, just like a bottle of wine . . . that wine was so smooth . . . and I used to drink it with . . . pickles, which I grew in my garden . . . and I had to weed so often.” This response is an example of A) neologisms. B) lack of abstractness. C) tangentiality. D) derailment. E) loosening of associations. Answer: E Diff: 1 Type: MC Skill: Application
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19) All of the following are examples of negative and emotional symptoms of schizophrenia EXCEPT A) alogia. B) anhedonia. C) associative loosening. D) affective flattening. E) avolition. Answer: C Diff: 1 Type: MC Skill: Factual
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20) Devon often sits with one foot behind his head for extended periods of time until a nurse moves it, and then does not move again. A) alogia. B) echopraxia. C) catatonic posturing.
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D) affective flattening. E) waxy flexibility. Answer: E Diff: 1 Type: MC Skill: Application
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21) Dimitri has been diagnosed with schizophrenia. Unless his mother carefully monitors his personal hygiene habits, he tends to ignore them. This is an example of A) anhedonia. B) alogia. C) avolition. D) antilistlessness. Answer: C Diff: 2 Type: MC Skill: Application
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22) The best description of anhedonia is A) poor concentration for an extended period of time. B) the inability to experience pleasure. C) impoverished emotional expression. D) lack of drive or initiative. Answer: B Diff: 1 Type: MC Skill: Factual
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23) A person with schizophrenia displaying flattened affect A) withdraws socially. B) does not express emotion. C) does not experience physiological arousal. D) laughs at inappropriate moments. Answer: B Diff: 2 Type: MC Skill: Factual
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24) If a person describes or presents with __________ hallucinations, no other symptoms are needed for the diagnosis of schizophrenia. A) olfactory B) gustatory C) tactile D) visual E) auditory
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Answer: E Diff: 1 Type: MC Skill: Factual
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25) For a diagnosis, a bizarre delusion must be judged __________. A) possible B) impossible C) plausible D) conceivable E) harmless Answer: B Diff: 1 Type: MC Skill: Factual
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26) Which of the following is not one of the major subtypes of schizophrenia as described by the DSM-IV-TR? A) disorganized B) residual C) schizotypal D) paranoid E) catatonic Answer: C Diff: 1 Type: MC Skill: Factual
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27) The __________ type is the least disabling and the most common of the five DSMIV-TR subtypes. A) disorganized B) residual C) catatonic D) paranoid E) undifferentiated Answer: D Diff: 1 Type: MC Skill: Factual
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28) The __________ is thought to have the best prognosis, whereas the __________ type is thought to have the poorest. A) paranoid; disorganized B) undifferentiated; catatonic C) disorganized; undifferentiated D) residual; undifferentiated E) catatonic; paranoid .. 7
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Answer: A Diff: 2 Type: MC Skill: Factual
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29) Echopraxia and echolalia are symptoms of the __________ type of schizophrenia. A) undifferentiated B) residual C) disorganized D) paranoid E) catatonic Answer: E Diff: 2 Type: MC Skill: Factual
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30) A person now currently experiencing prominent positive psychotic symptoms of schizophrenia would likely be diagnosed with the _________ type. A) psychotic B) residual C) undifferentiated D) catatonic E) paranoid Answer: E Diff: 2 Type: MC Skill: Factual
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31) One criticism of the DSM-IV-TR with respect to diagnosing schizophrenia is A) it does not rely on the person's presenting symptoms and history as the main indications of illness. B) none of the subtypes have received any research support as valid distinctions. C) clinicians tend not to agree with each other's diagnoses. D) clinicians rarely use structured interviews in making a diagnosis. E) the lack of objective criteria for the disorder. Answer: E Diff: 2 Type: MC Skill: Factual
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32) Digit span recall A) is higher in schizophrenia patients than in the normal population. B) is considered to be a potential biological marker of schizophrenia. C) is not sensitive enough to detect a large majority of schizophrenia patients. D) has been shown to be a reliable marker of schizophrenia. E) is deficient in about 50 percent of patients diagnosed with schizophrenia. .. 8
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Answer: E Diff: 2 Type: MC Skill: Factual
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33) Research examining the eye movements of people with schizophrenia has found A) eye movements that mirror visual hallucinations. B) they generally tend to stare vacantly at most objects. C) their eye movements tend to be more erratic. D) they are able to keep slow moving targets in focus, but are unable to rapidly shift their eyes. E) few differences between the eye movements of people with schizophrenia compared to those without the disorder. Answer: C Diff: 1 Type: MC Skill: Factual
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34) A schizophrenogenic mother has been described as A) rejecting. B) depressed. C) overly involved with the child. D) manic and unpredictable. E) a carrier of the schizogene. Answer: A Diff: 1 Type: MC Skill: Factual
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35) For Carl Jung, there was a universal connection between schizophrenia and the __________. A) collective preconscious B) unconscious C) collective unconscious D) subconscious E) collective consciousness Answer: C Diff: 1 Type: MC Skill: Conceptual
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36) The most commonly accepted theory of schizophrenia today is the A) rejecting mother model. B) schizogenetic theory. C) diathesis-stress theory.
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D) social drift theory. E) collective unconscious theory. Answer: C Diff: 1 Type: MC Skill: Factual
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37) The vulnerability-stress perspective purports that A) individuals who undergo a lot of stress and difficulty become more vulnerable to developing schizophrenia. B) individuals with poor coping skills tend to react negatively to stress. C) certain people are vulnerable to schizophrenia, and symptoms generally develop after exposure to stress. D) individuals who are genetically susceptible to schizophrenia are better able to handle severe stress. E) people with schizophrenia are more vulnerable to life stressor than others. Answer: C Diff: 1 Type: MC Skill: Factual
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38) In Meehl's theory of schizophrenia, “hypokrisia” refers to the __________ component of the theory. A) diathesis B) emotional C) social D) stress E) cognitive Answer: A Diff: 2 Type: MC Skill: Factual
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39) If schizophrenia were purely genetic, the concordance rate for monozygotic twins would be about A) 50%. B) 45%. C) 25%. D) 80%. E) 100%. Answer: E Diff: 1 Type: MC Skill: Factual
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40) The concordance rate for schizophrenia for monozygotic twins is A) 100%. B) 25%. C) 67%. D) 10%. E) 48%. Answer: E Diff: 1 Type: MC Skill: Factual
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41) Currently, there is evidence for up to __________ “risk” genes in developing schizophrenia. A) 2 B) 3 C) 5 D) 9 E) 12 Answer: D Diff: 2 Type: MC Skill: Factual
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42) Recent evidence shows that exposure to the flu virus during the __________ month of pregnancy is associated with an increased risk of schizophrenia later in life. A) first B) second C) third D) fourth E) fifth Answer: E Diff: 2 Type: MC Skill: Factual
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43) A proportion of children at risk for schizophrenia show all of the following early behavioural abnormalities EXCEPT A) unusual preoccupation with imaginative companions B) early signs of impaired movement C) more withdrawn and socially reclusive, or more antisocial and aggressive than other children D) cognitive limitations not shared by other children E) early signs of impaired fine motor skills
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Answer: A Diff: 2 Type: MC Skill: Factual/Conceptual
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44) Research on expressed emotion indicates that people with schizophrenia are most likely to suffer a relapse if A) family members are critical and overinvolved. B) family members ignore them and fail to provide support. C) society labels them and rejects them. D) family and peers are unable to see past their illness. E) family members are critical and uninvolved. Answer: A Diff: 2 Type: MC Skill: Factual
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45) One of the first brain regions that interested researchers in linking the brain to schizophrenia was/were the __________. A) occipital lobes B) temporal lobes C) frontal lobes D) parietal lobes E) posterior cortex Answer: C Diff: 1 Type: MC Skill: Factual
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46) Which of the following is an example of a deficit on a frontal lobe task experienced by people with paranoid schizophrenia? A) slower response time to press the keys in the Continuous Performance Task B) sorting cards according to previous sorting rules on the Wisconsin Card Sorting Task C) responding slowly when the sorting rule is changed to 'shape' in the WCST D) responding slowly when the sorting rule is changed to 'colour' in the WCST E) inability to determine whether the symbol presented meets the necessary criterion in the CPT Answer: B Diff: 3 Type: MC Skill: Conceptual
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47) In summarizing the research on the frontal lobe deficiency, one could interpret the research of Lara Davidson (2003) as suggesting that A) frontal brain impairment probably affects some patients with schizophrenia, but the impairment is not a necessary part of the syndrome.
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B) frontal brain impairment probably affects very few patients with schizophrenia, but is not a necessary part of the syndrome. C) frontal brain impairment probably affects all patients with schizophrenia, and is a necessary part of the syndrome. D) an abnormally working frontal brain does not appear to be related at all to the symptoms presented by patients with schizophrenia. E) only the positive symptoms of the illness reflect an abnormally working frontal brain. Answer: A Diff: 3 Type: MC Skill: Factual/Conceptual
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48) According to a meta-analysis by Davidson and Heinrichs (2003), the number one ranked brain and behavioural abnormality is A) impaired general intellectual ability. B) increased neurotransmitter receptors in post-modern brain tissue. C) irregular eye movements when following a point of light. D) impaired ability to filter out redundant information. E) impaired learning and recall of words and stories. Answer: D Diff: 3 Type: MC Skill: Factual
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49) Apart from the frontal lobes, one of the most researched regions of the brain and its relationship to schizophrenia is the A) left parietal lobe. B) left temporal lobe. C) right temporal lobe. D) left occipital lobe. E) right parietal lobe. Answer: B Diff: 2 Type: MC Skill: Factual
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50) All of the following lines of evidence resulted in the conclusion that schizophrenia may be associated with dopamine activity EXCEPT A) People who do not have schizophrenia but who take cocaine can show psychotic reactions. B) Several drugs, including cocaine, lower or inhibit dopamine activity. C) Medications that reduce schizophrenic symptoms inhibit dopamine release. D) People with schizophrenia tend to have a greater number of dopamine receptors in certain areas of their brains. E) Overdoses of amphetamines produce symptoms similar to paranoid schizophrenia.
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Answer: B Diff: 2 Type: MC Skill: Factual
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51) An early treatment for schizophrenia might have involved which of the following? A) insulin coma B) hypnosis C) psychoanalysis D) psychotherapy E) chlorpromazine Answer: A Diff: 1 Type: MC Skill: Factual
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52) The main drawback of anti-psychotic medication in treating schizophrenia is A) its relative ineffectiveness in dealing with the cognitive impairment suffered by schizophrenia patients. B) that the use of medication often requires longer hospital stays. C) its relative lack of effectiveness. D) the occurrence of more frequent relapses of illness. E) its inability to alleviate the frequency and severity of hallucinations and delusions. Answer: A Diff: 2 Type: MC Skill: Factual
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53) The one form of psychotherapy found to be helpful in treating schizophrenia is A) humanistic therapy. B) interpersonal psychotherapy. C) behavioural therapy. D) cognitive-behaviour therapy. E) psychoanalysis. Answer: D Diff: 1 Type: MC Skill: Factual
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54) Evidence suggests that social skills training for those with schizophrenia A) may diminish the incidence of positive and negative symptoms and improve social and behavioural functioning. B) may improve social and behavioural functioning but increase the incidence of positive symptoms. C) may diminish the incidence of negative symptoms but may not improve social and behavioural functioning.
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D) may improve social and behavioural functioning and decrease the incidence of negative symptoms. E) may diminish the incidence of positive symptoms but may not improve social and behavioural functioning. Answer: C Diff: 2 Type: MC Skill: Factual
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55) Schizophrenia is characterized by its complexity. A) True B) False Answer: A Diff: 1 Type: TF Skill: Conceptual
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56) Lifetime prevalence for schizophrenia in North America and Europe has been found to be about 1%. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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57) Auditory hallucinations were extremely common prior to 1700. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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58) The positive and negative symptoms of schizophrenia refer to the “good” and “bad” symptoms. A) True B) False Answer: B Diff: 1 Type: TF Skill: Conceptual
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59) Negative symptoms of schizophrenia refer to exaggerated, distorted adaptations of normal behaviour. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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60) Visual hallucinations tend to be the most common form in schizophrenia. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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61) Dancing down the street is an example of grossly disorganized behaviour. A) True B) False Answer: B Diff: 2 Type: TF Skill: Application
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62) Sluggish schizophrenia is one subtype of schizophrenia found in the DSM-IV-TR system for the classification of mental disorders. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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63) Negative symptoms tend to become more prominent after an individual has suffered from schizophrenia for several years. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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64) Compared to the other subtypes of schizophrenia, the paranoid type is the most serious. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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65) Digit span performance has been studied as a cognitive marker of schizophrenia. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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66) Abnormal functioning of the temporal lobes has been associated with the hallucinations and delusions experienced by people with schizophrenia. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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67) It is difficult to determine whether neurological abnormalities are a cause or consequence of schizophrenic symptoms. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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68) Dopamine receptors in the brains of people with schizophrenia are either too low or not overly sensitive. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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70) Differentiate between the positive and negative symptoms of schizophrenia by providing a brief description of the types of symptoms under each category. Answer: Positive symptoms express extravagant versions of normal behaviours, including delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behaviour. Delusions are false beliefs that are strongly held, despite evidence to the contrary, and do not include religious or cultural beliefs. Delusions tend to take the form of persecutory, religious, or grandiose delusions, as well as delusions of reference. Hallucinations are false perceptions occurring in the absence of any relevant stimulus. The most common type is auditory, where the person hears voices and conversations, with visual, tactile, and olfactory hallucinations occurring more rarely. The speech of people with schizophrenia is often disorganized in various ways, such as derailment, where the person goes off topic during the sentence, or the person may use words that make no sense (neologisms) or words become jumbled (word salad). Grossly disorganized behaviour includes inappropriate emotional reactions, as well as strange behaviours. Catatonia describes a wide range of behaviours and is exemplified by rigid or bizarre body positions and even excessive activity. Negative symptoms reflect a decline in functioning from normal levels. These symptoms include flattened affect or emotional blunting, which involve impoverished emotional expression and reactivity. Slowed thinking or thought blocking are also common, as is avolition, comprised of a loss of energy, motivation, and interest in activities (such as grooming and education). Also included are anhedonia (inability to experience pleasure) and asociality (social withdrawal). Finally, attentional deficits, including distractibility, poor concentration, and a tendency to drift from activities have been commonly described in the literature. Diff: 1 Type: ES Page Ref: 198 Skill: Factual 71) Describe the five subtypes of schizophrenia in the DSM-IV-TR. Answer: The DSM-IV-TR recognizes five subtypes of schizophrenia based on symptomatology. * Paranoid subtype: Determined by the patient's preoccupation with one or more delusions or frequent auditory hallucinations, and an absence of prominent disorganized speech, disorganized behaviour, catatonic behaviour, and flat or inappropriate affect. It is believed to be the least severe subtype. * Disorganized subtype: Characterized by disorganized speech and behaviour, as well as flat and/or inappropriate affect. Generally viewed as the most severe type.
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* Catatonic subtype: Defined by the presence of stupor, rigidity, negativism, bizarre postures, excitement, echolalia or echopraxia. * Undifferentiated subtype: a category for patients who display prominent symptoms but do not fit under any other category. * Residual subtype: diagnosed when an individual who previously met the criteria for one of the subtypes no longer shows the prominent symptoms but continues to show evidence of disturbance by very mild symptoms. Diff: 2 Type: ES Page Ref: 201-202 Skill: Factual 72) The diathesis-stress model has been proposed as a method of explaining the development of schizophrenia. Choose three factors that play a role in vulnerability to schizophrenia and describe the research findings. Answer: (Factors include: developmental influences, genetic factors, biochemical influences, neuroanatomical factors, prenatal and perinatal influences, neurodevelopmental factors, and personality factors). The vulnerability-stress perspective suggests that certain individuals are vulnerable to schizophrenia, and these people develop symptoms after being exposed to certain stressors. Many different factors are believed to increase vulnerability, for example, developmental influences, genetic factors, and biochemical influences. High-risk studies, in which the subjects are children of mothers with schizophrenia, are used to examine developmental influences in the etiology of schizophrenia. Reviews of high-risk studies have found few differences between high- and low-risk children that specifically predicted schizophrenia, although high-risk children tended to have more difficulty with attention tasks and those who later developed schizophrenia tended to have poor neuromotor test scores. Genetic factors appear to play an important role in the development of schizophrenia, however, research is difficult because the gene(s) responsible for schizophrenia has(have) reduced penetrance (certain environmental factors are required in order for the person to develop symptoms). One method of determining the role of genetics is through concordance rates within families. Studies have shown that only around 10% of people who have a parent with schizophrenia end up developing the disorder, and 90% of people who do develop schizophrenia have a first-degree relative with schizophrenia. The concordance rate for identical twins is less than 50%, indicating that genetic factors are not the only ones involved. One marker for schizophrenia that has received much attention is eye-tracking dysfunction. The eye movements of people with schizophrenia are less efficient and more erratic than those without the disorder. Neurotransmitters, particularly dopamine, have received attention in the schizophrenia research. People with schizophrenia are believed to have either too many or too sensitive dopamine receptors, for several reasons. Firstly, the neuroleptic medications used to reduce the hallucinations and delusions in schizophrenia work by blocking the transmission of dopamine. Secondly, the density of dopamine receptors is greater in certain areas of the brain among those with schizophrenia, and finally, overdoses of amphetamines (whose effects are mediated by dopamine) produce symptoms similar to those in paranoid schizophrenia. Recent evidence suggests that glutamate may play a role .. 19
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in the development of the disorder, as may other neurotransmitters. The role of various neurotransmitters in the etiology of schizophrenia appears to be complex, as do other genetic factors. Diff: 2 Type: ES Page Ref: 205-208 Skill: Factual 73) Stress plays a major role, both in the development of schizophrenia and in the severity of symptoms. Briefly describe different areas of stress that have been shown to affect schizophrenia (family, culture, social status). Answer: Stressors in various areas affect the development of schizophrenia. One area of research has been family functioning. In the past, psychoanalysts theorized that psychotic states resulted from the behaviour of the mother, for example, the cold, rigid, rejecting “schizophrenogenic mother.” Another situation described was the “double-bind” situation, where the child receives contradictory messages from another person (the parent). These hypotheses are not supported by current evidence. However, research has shown that people with schizophrenia belonging to families high in expressed emotion (hostility, criticism, overinvolvement) are more likely to suffer relapse. Symptoms and outcome of schizophrenia differs across cultures, with auditory hallucinations being more common in Western culture and more blunting of affect and visual hallucinations in African culture. People experiencing schizophrenia in developing countries tend to have better outcomes, likely due to more social support for patients and families, and an easier time in returning to work. People with schizophrenia are three times more likely to come from the lowest socioeconomic class, either because they drift to a lower class after developing the disease or the stresses associated with being a member of a lower social class (poorer education, fewer opportunities for employment) may play a role in the development of the disorder. Diff: 2 Type: ES Page Ref: 208-209 Skill: Factual/Conceptual
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CHAPTER 10 Eating Disorders 1) Since the 1970s, the prevalence rates of eating disorders A) have increased for all types of eating disorders. B) have increased among 20-30 year olds. C) have decreased among women but increased among men. D) have decreased among men but increased among women. E) have shown an increase, particularly for anorexia nervosa. Answer: E Diff: 1 Type: MC Skill: Factual/Conceptual
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2) An objective food binge is defined by the DSM-IV-TR as A) eating a small amount of food and feeling not in control. B) eating a small amount of food in a specific time period. C) eating a large amount of food in a specific time period. D) eating a normal amount of food in a specific time period. E) eating a large amount of food but feeling in control. Answer: C Diff: 1 Type: MC Skill: Conceptual
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3) Unlike anorexics, bulimics A) suffer from social isolation and depression. B) engage in compensatory behaviours designed to prevent weight gain. C) use weight and shape information as their primary method of self-evaluation. D) have low self-esteem. E) are typically within the normal weight range. Answer: E Diff: 2 Type: MC Skill: Factual
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4) __________ disorders have the highest mortality rates of all of the psychiatric disorders. A) Anxiety B) Substance-related C) Eating D) Psychophysiological E) Mood
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Answer: C Diff: 1 Type: MC Skill: Factual
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5) In the DSM-IV-TR, one feature of anorexia nervosa is refusal to maintain at least __________ of expected body weight. A) 15% B) 35% C) 85% D) 25% E) 50% Answer: C Diff: 1 Type: MC Skill: Factual
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6) In order to be diagnosed with anorexia nervosa according to DSM-IV, females past puberty must miss __________ consecutive menstrual cycles. A) 2 B) 3 C) 4 D) 5 E) 6 Answer: B Diff: 1 Type: MC Skill: Factual
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7) Susan is 16 years old and she is afraid of gaining weight and getting fat. Susan is very dissatisfied with her body and she often tries to lose weight through fad diets and exercise. It would be difficult to determine her diagnosis because A) it is hard to determine whether she meets the DSM-IV-TR criteria. B) Susan could have any one of a number of eating disorders. C) Susan is still too young to have an eating disorder. D) Susan's symptoms are not extreme. E) it is difficult to determine whether she is successful at losing weight. Answer: E Diff: 2 Type: MC Skill: Application
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D) controlling type E) restricting type Answer: E Diff: 2 Type: MC Skill: Factual
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9) What difference is found in the binge/purge type and the restricting type of anorexia nervosa? A) binge eating or purging behaviour B) rigidly controlled diet C) use of laxatives to get rid of unwanted calories D) excessive exercise to burn off calories E) there is no difference between the two subtypes Answer: A Diff: 1 Type: MC Skill: Factual
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10) Why is the distinction between the two subtypes of anorexia nervosa so important? A) different causes of the two types are known to researchers. B) different psychological consequences associated with the binge/purge type C) the binge/purge subtype is associated with fewer impulsive behaviours D) poorer long-term prognosis for the binge/purge subtype E) one type tends to affect younger women, and one older women. Answer: C Diff: 1 Type: MC Skill: Factual
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11) What criteria does the DSM-IV use to define a binge? A) consumption of more food than most people would consume at one time; feeling out of control B) consumption of at least 1000 Calories at one sitting C) consumption of over 1000 Calories at one time; majority from sweets or carbohydrates D) a sense of lack of control over thoughts of eating more food than most people would consume at one time. E) consumption of more food than most people would consume within a one-month period Answer: A Diff: 2 Type: MC Skill: Factual/Conceptual
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12) What does it mean to say that bulimics engage in recurrent compensatory behaviour? A) Bulimics purge to avoid weight gain. B) Bulimics fast or exercise to excess. C) Bulimics engage in self-induced vomiting. D) Bulimics perform strange rituals to prevent weight gain. E) Bulimics misuse laxatives, diuretics, or enemas. Answer: B Diff: 2 Type: MC Skill: Factual
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13) The diagnostic criteria that involves body image dissatisfaction consists of a perceptual component, __________, and an attitude component, __________. A) concern with weight gain; the idea of being fatter than anyone else B) belief that thinness is normal; acceptance of society's image of women C) distorted body image; unhappiness and dissatisfaction with weight D) belief that one is too thin; wanting to gain weight. E) concern with the way others see you; the image of food as evil Answer: C Diff: 2 Type: MC Skill: Conceptual
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14) Binge eating disorder is categorized in the DSM-IV-TR as A) a separate eating disorder. B) a subtype of Anorexia Nervosa. C) a special case of Eating Disorders Not Otherwise Specified. D) a special case of Bulimia Nervosa. E) a special type of mood disorder. Answer: C Diff: 1 Type: MC Skill: Factual
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15) The main difference between binge eating disorder and bulimia is A) men are generally diagnosed with binge eating disorder and women are diagnosed with bulimia. B) those suffering from binge eating disorder binge more often. C) binge eating disorder does not involve a sense of lack of control. D) the amount of calories consumed per binge is higher in bulimia. E) sufferers of binge eating disorder do not engage in compensatory behaviours. Answer: E Diff: 1 Type: MC Skill: Factual
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16) The most common eating disorder is A) bulimia nervosa. B) bulimia nervosa, purging type. C) eating disorder not otherwise specified. D) anorexia nervosa, restricting type. E) anorexia nervosa. Answer: C Diff: 2 Type: MC Skill: Factual
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17) Due to the fact that only small distinctions often separate individuals with different eating disorders, it has been suggested that A) eating disorders are really a subset of mood disorders. B) eating disorders should be considered as one disorder, existing on a continuum of severity. C) eating disorders are not a valid category in the DSM-IV-TR. D) the category of eating disorders should be abandoned altogether, with a new one to replace it. E) a greater variety of subtypes need to be introduced. Answer: B Diff: 2 Type: MC Skill: Factual/Conceptual
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18) One example of a structured interview used to evaluate features and issues related to eating disorders is A) Symptom Checklist 90. B) Beck Depression Inventory. C) Eating Disorder Examination. D) Eating Disorder Inventory. E) Anorexia and Bulimia Checklist. Answer: C Diff: 2 Type: MC Skill: Factual
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19) Lanugo refers to A) the lack of sexual desire among anorexic patients. B) the fine body hair on anorexics. C) the confusion experienced by anorexics as a result of starvation. D) electrolyte imbalance. E) the yellowish skin tone of anorexic patients.
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Answer: B Diff: 1 Type: MC Skill: Factual
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20) Self-induced vomiting may also produce A) heightened sensitivity to cold. B) dry hair and hair loss. C) Russell's sign. D) Lanugo. E) dry skin. Answer: C Diff: 1 Type: MC Skill: Factual
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21) One complication of studying the symptoms of eating disorders is that they can sometimes overlap with __________ disorders. A) personality B) dissociative C) anxiety D) mood E) substance-related Answer: A Diff: 1 Type: MC Skill: Factual
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22) There is a relatively high rate of comorbidity in eating disorders, particularly with A) dissociative amnesia. B) somatic disorder. C) major depressive disorder. D) dissociative identity disorder. E) post-traumatic stress disorder. Answer: C Diff: 1 Type: MC Skill: Factual
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23) Individuals who binge eat are more likely to exhibit comorbid A) depressive disorder. B) conversion disorder. C) dissociative disorder. D) substance abuse. E) anxiety disorder.
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Answer: C Diff: 2 Type: MC Skill: Factual
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24) Individuals with anorexia and bulimia demonstrate signs of __________ dysregulation, supporting the role of dysfunctional neurotransmitter activity in eating disorders. A) serotonin B) GABA C) dopamine D) ACH E) melatonin Answer: A Diff: 2 Type: MC Skill: Factual
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25) Evidence suggests that dieting can A) alter brain serotonin function in women, but not in men. B) increase GABA levels in men, but not in women. C) diminish norepinephrine levels in women. D) alter brain dopamine function in men and women. E) alter overall brain activity in women. Answer: A Diff: 2 Type: MC Skill: Factual
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26) Although the ideal woman, as depicted by the media, is getting __________, women are becoming __________. A) thinner; heavier B) thinner; even more thin C) thinner; thinner D) heavier; thinner E) heavier; heavier Answer: A Diff: 1 Type: MC Skill: Factual
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27) Why is the prevalence of eating disorders among men lower, according to the sociocultural model? A) there is already a match between the ideal man as portrayed by the media and the average man B) woman themselves prefer the look of the ideal woman as portrayed in the media C) media does not target young men .. 7
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D) men feel less pressure to conform to the sociocultural ideal body E) culture does not have a view of the 'ideal' man Answer: C Diff: 2 Type: MC Skill: Conceptual
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28) In Western society, having the 'ideal' body image also perpetuates the idea that these women are A) better sexual partners. B) hard workers and successful. C) ready to bear children. D) more suitable for marriage. E) better able to maintain proper diets. Answer: B Diff: 2 Type: MC Skill: Conceptual
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29) It has been found that eating-disordered mothers A) are more likely to use food for nutritive purposes than non-disordered mothers. B) are more likely to try to prevent the disorder from occurring in their children. C) discourage dieting among their daughters. D) do not seem as interested in their daughters' weights as non-disordered mothers. E) do not feed their children as regularly as non-disordered mothers do. Answer: E Diff: 2 Type: MC Skill: Factual
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30) That certain personality traits seem to contribute to the development of an eating disorder is supported by the fact that A) these traits tend to disappear following recovery of the eating disorder. B) these traits tend to persist before and after an eating disorder has been diagnosed. C) these traits are very common in women who suffer from eating disorders. D) these traits are very present before the onset of an eating disorder but are not shown after an eating disorder is diagnosed. E) these traits are found exclusively in people suffering from an eating disorder. Answer: B Diff: 2 Type: MC Skill: Factual
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31) Eating disorders are sometimes referred to as __________ disorders. A) not-eating B) the hunger .. 8
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C) food D) bizarre E) dieting Answer: E Diff: 2 Type: MC Skill: Conceptual
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32) A study of eating-disordered patients in Toronto found that __________ percent of the patients reported being sexually abused. A) 1 B) 10 C) 15 D) 20 E) 25 Answer: E Diff: 3 Type: MC Skill: Factual
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33) In Garner and Garfinkel's (1980) model of eating disorders, a perpetuating factor would be A) social isolation. B) transition into puberty. C) the death of a loved one. D) a defective gene. E) a critical mother. Answer: A Diff: 3 Type: MC Skill: Conceptual
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34) In Garner and Garfinkel's (1980) model of eating disorders, a precipitating factor would be A) a critical mother. B) depression. C) dieting. D) a biological predisposition. E) reduced basal metabolic rate. Answer: C Diff: 3 Type: MC Skill: Conceptual
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35) Estimates are that for every male who diagnosed with an eating disorder, there are __________ females with these disorders. .. 9
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A) 4-5 B) 20-25 C) 10-15 D) 8-10 E) 2-3 Answer: C Diff: 2 Type: MC Skill: Factual
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36) Which of the following is NOT true concerning gender differences and eating disorders. A) The main features of anorexia and bulimia are similar in males and females. B) Male patients are treated more effectively if separated from female patients. C) It does not appear as though the symptomatology of eating disorders differs across genders. D) Males with eating disorders exhibit much more psychiatric comorbidity than females. E) The treatment response of males is similar to that of female patients. Answer: B Diff: 2 Type: MC Skill: Factual
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37) Within non-clinical populations, there is evidence that A) males are more likely to perceive themselves as overweight. B) males are more likely to be on diets. C) females are more satisfied with their weight than males. D) males are disproportionately affected by weight and shape concerns. E) males would like to increase their weight, whereas females would like to lose weight. Answer: E Diff: 2 Type: MC Skill: Conceptual
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38) Which of the following statements is true? A) Heterosexual males are more likely than homosexual males to be preoccupied with their body size and shape. B) Homosexual females are more likely than heterosexual females to be preoccupied with their body size and shape. C) Homosexual males are more likely than homosexual females to be preoccupied with their body size and shape. D) Heterosexual females are more likely than homosexual females to be preoccupied with their body size and shape. E) Homosexual males are more likely than heterosexual males to be preoccupied with their body size and shape.
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Answer: E Diff: 3 Type: MC Skill: Factual
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39) Bulimia nervosa has been treated with __________ medication. A) antipsychotic B) antidepressant C) bicyclic D) antianxiety E) over the counter Answer: B Diff: 1 Type: MC Skill: Factual
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40) Which of the following is true with respect to biological treatments for anorexia nervosa? A) No medication for treating anorexia nervosa have been successful. B) Antianxiety medication is successful in treating many of the symptoms. C) Antipsychotic medication is successful in treating many of the symptoms. D) Medication along with cognitive-behaviour therapy is effective at treating the symptoms. E) Antidepressant medication is successful in treating many of the symptoms. Answer: A Diff: 3 Type: MC Skill: Factual
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41) The goal of the first stage of cognitive-behaviour therapy for bulimia involves which of the following? A) convincing the patient to accept medication as the primary treatment so that therapy can follow B) focusing on strategies for maintaining change and preventing relapse C) a continued focus on establishing normalized eating D) identifying and modifying dysfunctional thoughts and beliefs E) establishing some degree of control over eating Answer: E Diff: 3 Type: MC Skill: Conceptual
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42) Interpersonal therapy for eating disorders differs from cognitive-behaviour therapy in which of the following ways? A) It does not directly target eating-disordered attitudes and behaviours. B) It focuses on identifying and modifying dysfunctional thoughts and beliefs.
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C) It encourages that patient to use self-monitoring to help patients normalize their eating. D) It uses psychoeducation about normalized eating. E) It teaches problem-solving skills. Answer: A Diff: 2 Type: MC Skill: Factual/Conceptual
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43) In studies that have compared interpersonal therapy with CBT, it has been found that A) interpersonal therapy produced effects equal to CBT, but CBT was better at the conclusion of treatment. B) interpersonal therapy produced effects equal to CBT, and was as equally good at the conclusion of treatment. C) interpersonal therapy works much more quickly than CBT. D) interpersonal therapy produced effects inferior to CBT, but was better at the conclusion of treatment. E) interpersonal therapy produced effects inferior to CBT. Answer: A Diff: 2 Type: MC Skill: Factual/Conceptual
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44) Probably the most important first step in the treatment of anorexia nervosa is A) family therapy. B) nutritional management. C) interpersonal therapy. D) individual psychotherapy. E) forced feeding. Answer: B Diff: 1 Type: MC Skill: Factual/Conceptual
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45) Research has shown that the most effective type of treatment for bulimia nervosa is A) SSRIs. B) interpersonal therapy. C) group therapy. D) cognitive-behavioural therapy. E) supportive psychotherapy. Answer: C Diff: 1 Type: MC Skill: Factual
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46) One therapy that has received empirical support in the treatment of anorexia nervosa is __________ therapy. A) cognitive-behavioural B) interpersonal C) pharmacological D) family E) nutritional Answer: C Diff: 2 Type: MC Skill: Factual
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47) Family therapy appears to have greater effectiveness for: A) adults B) adolescents C) males D) females E) all patients Answer: B Diff: 1 Type: MC Skill: Factual
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48) The Maudsley approach initially attempts to focus on: A) disorted body image B) overcontrolling mothers C) excessive exercise D) weight gain and eating E) binging and purging Answer: C Diff: 2 Type: MC Skill: Factual
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49) Self-help manuals, alone, will not likely be helpful for people suffering from A) binge eating disorder. B) bulimia, purging type. C) bulimia, nonpurging type. D) bulimia nervosa. E) anorexia nervosa. Answer: E Diff: 1 Type: MC Skill: Factual
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50) Bulimia nervosa was first identified and named in the 1970s. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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51) People with anorexia usually develop a list of “feared” foods. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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52) Anorexics do not engage in purging behaviour to maintain weight-loss. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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53) The anorexic disturbance in body image is often linked to low self-esteem. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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54) Bulimics are typically within the normal weight range. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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55) The restricting type of anorexia nervosa is associated with a poorer long-term prognosis. A) True B) False
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Answer: B Diff: 2 Type: TF Skill: Factual
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56) Bulimics tend to be more dissatisfied with their bodies than anorexics. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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57) Some researchers believe that binge eating disorder is really a subtype of bulimia. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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58) The purging type bulimia is believed to be the most severe pathology of the eating disorders. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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59) The Eating Disorder Examination has been found to have poor reliability and validity. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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60) Individuals who binge eat are less likely to exhibit comorbid substance abuse. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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61) High levels of serotonin are associated with satiety, which contributes to the temporary relief of hunger. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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62) The neurotransmitter dopamine has been shown to be related to eating disorders. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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63) Men are more likely than women to be affected by media images of the ideal body type. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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64) Perfectionism is a personality trait found in patients with eating disorders. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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65) The majority of people who are chronic dieters will develop an eating disorder. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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66) Few sufferers of eating disorders have reported early sexual abuse. A) True B) False
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Answer: B Diff: 1 Type: TF Skill: Factual
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67) Homosexual men and women are at a greater risk for developing eating disorders. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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68) Regardless of the type of treatment used, relapse is common in the case of anorexia nervosa. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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69) Both older tricyclics and newer serotonin reuptake inhibitors have been shown to be highly successful in the long-term treatment of bulimia. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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70) Cognitive-behavioural therapy reduces bingeing and purging behaviour by up to 90%, with around half of patients stopping bingeing and purging completely. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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71) Interpersonal therapy has shown similar outcome results as cognitive- behavioural therapy in the treatment of bulimia nervosa. A) True B) False
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Answer: A Diff: 1 Type: TF Skill: Factual
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72) List and briefly describe the DSM-IV criteria for the diagnosis of anorexia nervosa. Answer: The DSM-IV diagnostic criteria for Anorexia Nervosa includes: 1) Refusal to maintain a minimal body weight for age and height (generally considered body weight less than 85% of expected body weight). 2) Intense fear of gaining weight or becoming fat, even when underweight. 3) Disturbance in the experience of body weight and shape, sense of self-worth highly influenced by body weight and shape, and denial of the serious consequences of low body weight. 4) In females past puberty, amenorrhea (the absence of three consecutive menstrual cycles). Diff: 1 Type: ES Page Ref: 225 Skill: Factual 73) Compare and contrast the two subtypes of anorexia nervosa. Answer: DSM-IV subtypes anorexia nervosa into the restricting type and the binge eating/purging type. Approximately half of anorexics belong to either subtype. In the restricting type, low weight is maintained by a rigidly controlled diet and a very low intake of food. In the binge eating/purging type, restraint breaks down regularly and bingeing occurs. Self-induced vomiting, abuse of laxatives, diuretics, and enemas are used to maintain low body weight and to rid the body of calories. In both subtypes, excessive exercise is used to burn off unwanted calories. Although both subtypes are in the same diagnostic category, the distinction between them is important for treatment purposes. There is evidence that the binge-purge subtype is associated with more impulsive behaviours, such as substance abuse, stealing, self-mutilation and suicidal ideation. Treatment outcome studies have shown that the binge-purge subtype has a poorer long-term prognosis. Diff: 2 Type: ES Page Ref: 225 Skill: Factual 74) Describe the DSM-IV criteria for bulimia nervosa and specify the two subtypes. Answer: The DSM-IV diagnostic criteria for Bulimia Nervosa are: 1) Recurrent episodes of binge eating. Binge eating is characterized by a) the amount of food consumed in a set period of time must be definitely larger than what most people would eat in a similar period under similar circumstances; b) a feeling of being out of control over eating (the person feels that she cannot stop eating or cannot control what she is eating). 2) Recurrent compensatory behaviour to prevent weight gain (i.e., self-induced vomiting, use of laxatives, diuretics, or enemas, fasting, or excessive exercise). Those who use mainly vomiting or use of laxatives, etc. to prevent weight gain are classified as the .. 18
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purging sub-type, while those who fast or exercise to excess are classified as the nonpurging sub-type. 3) The binge eating and purging must occur at least twice a week for three months. 4) The person's self-evaluations must be unduly influenced by concerns about bodyweight and shape. Body image disturbance consists of a perceptual as well as an attitudinal component (body image distortion and body image dissatisfaction). 5) The disturbance must not occur exclusively during episodes of anorexia nervosa. Diff: 2 Type: ES Page Ref: 226 Skill: Factual 75) Discuss the medical consequences of eating disorders. Answer: Eating disorders have various serious medical consequences. Due to starvation, the skin of anorexic patients becomes yellowish in colour and they grow fine body hair called lanugo. Eating-disordered patients who purge by vomiting develop serious dental problems due to the acidic content from the stomach. Dehydration occurs, particularly in those who purge, causing dry skin and hair. As well, the purging depletes the body of potassium and chloride, leading to electrolyte imbalance. Electrolyte imbalance affects renal, bowel, and brain functioning, as well as cardio-vascular functioning. Gastrointestinal problems are common; vomiting can cause a swelling of the salivary glands, perforations of the esophageal area and delayed gastric emptying can occur, constipation is common, especially in laxative abusers. Gastric dilation may occur in those who binge and purge, which can result in rupture of the stomach and spillage into the body cavity. This occurrence is often fatal. Amenorrhea (failure to menstruate) or irregular menstruation is common among eating-disordered patients, particularly anorexics. Males with anorexia nervosa often suffer a loss of sexual interest and potency. Finally, eating disorders (anorexia nervosa in particular) are associated with osteoporosis (bone loss) due to lack of calcium and low calcium absorption. Diff: 2 Type: ES Page Ref: 229-230 Skill: Factual 76) Using the Keys study as an example, discuss how many of the symptoms of dieting are the same as those found in individuals with eating disorders. Answer: The majority of cases of eating disorders are preceded by restrictive dieting. Garner and colleagues pointed to the Keys et al. (1950) study to show that there are many similarities between people placed on a semi-starvation diet and those with eating disorders. Keys placed 36 young men on a diet of half the calories they normally consumed (around 1200) and they lost around 25 percent of their body weight. After 3 months, they were re-fed and permitted to regain weight. During the weight loss period, the men became obsessed with food, and experienced intense hunger and cravings. During the re-feeding period, the men often binged and had abnormal eating patterns. These men also experienced depression, anger, irritability, and suffered social problems. Eating disordered individuals often experience similar symptoms of low self-esteem, depressed mood, feelings of failure, and stress. A prospective study of school-girls
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showed that dieters were eight times more likely to develop an eating disorder than nondieters. Diff: 3 Type: ES Page Ref: 230 Skill: Application 77) Briefly describe the types of treatments that have been used for bulimia nervosa. Answer: Many well-controlled treatment outcome studies for bulimia nervosa have been conducted. The two treatments that have received the most attention are anti-depressant medication and cognitive-behavioural therapy. Both older tricyclics (such as imipramine) and serotonin reuptake inhibitors (such as fluoxetine) have been found to relieve symptoms significantly more than placebo. However, these outcome studies tend to be short-term, and evidence suggests that there is a high relapse rate, particularly after medication is discontinued. Cognitive-behavioural therapy has received much empirical support. The first phase of treatment emphasizes educating patients about the disorder and interrupting the bingepurge cycle. Patients learn to normalize eating in order to reduce hunger. During the second phase of treatment, patients are taught to challenge their negative thoughts regarding body image. The third phase of treatment focuses on coping, problem-solving, and relapse prevention. Cognitive-behavioural therapy has been shown to be more effective than antidepressant medication, behavioural treatment, supportive psychotherapy, and stress-management therapy. Diff: 1 Type: ES Page Ref: 237 Skill: Factual
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CHAPTER 11 Substance-related Disorders 1) The first alcohol consumed by humans was A) wine. B) beer. C) vodka. D) mead. E) spirits Answer: D Diff: 1 Type: MC Skill: Factual
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2) Alcohol was widely consumed by the Europeans in part because A) alcoholism was widespread across Europe. B) it made colonizing North and South America an easier task. C) it was believed to have beneficial health effects. D) they wanted North American aboriginals to engage in self-destructive activities. E) the quality of the drinking water was quite poor. Answer: E Diff: 1 Type: MC Skill: Conceptual
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3) Problems in relationships, missing work, failing exams, putting yourself or others in danger . . . These could all be consequences of A) habituation. B) substance intoxication. C) tolerance. D) substance abuse. E) substance dependence. Answer: D Diff: 1 Type: MC Skill: Conceptual
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4) Tolerance and withdrawal symptoms define __________ dependence while, __________ dependence is known as habituation. A) somatic, emotional B) psychological, physical C) habituated, substance D) physical, psychological E) emotional, somatic
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Answer: D Diff: 1 Type: MC Skill: Factual
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5) Tolerance is best defined as A) a need for increased amounts of a substance in order to achieve previous effects. B) a lack of control over the use of a substance. C) physiological changes in the body due to use of a substance. D) being accustomed to a substance due to regular usage. E) a reversible and temporary condition that results from substance use. Answer: A Diff: 1 Type: MC Skill: Factual/Conceptual
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6) Nausea, headache, and tremors are all withdrawal symptoms caused by the A) removal of the substance from the body. B) ingestion of several different substances at one time. C) when a substance loses its addictive qualities. D) ingestion of too much alcohol. E) body's attempt to fight a foreign substance in the bloodstream. Answer: A Diff: 1 Type: MC Skill: Conceptual
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7) Dennis has recently begun college, and he goes out drinking with his friends every week. Generally he will drink to the point that he can barely walk and has trouble talking without slurring his words. So far, he has not failed any exams, but he does prefer to drink rather than study. His use can be described as A) substance dependence. B) substance abuse. C) tolerance. D) habituation. E) substance intoxication. Answer: E Diff: 1 Type: MC Skill: Application
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8) Stephan drinks a lot several times a week. His drinking has negatively affected his marriage and sometimes he arrives for work several hours late due to his drinking the night before. Stephan has also begun to smoke more cigarettes and his nerves get bad if he doesn't have a cigarette at least every hour. His condition would likely be defined as A) polysubstance intoxication. B) synergistic dependence. .. 2
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C) polysubstance dependence. D) impairment of control. E) polysubstance abuse. Answer: E Diff: 1 Type: MC Skill: Application
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9) Sylvia finds that having a few drinks doesn't really affect her very much, but she got extremely dizzy and nauseous after drinking wine when she'd taken an aspirin. These effects resulted because A) the combination of the two drugs had a greater effect than one alone. B) Sylvia hadn't yet developed a tolerance for the drugs. C) Sylvia was displaying withdrawal symptoms. D) she had forgotten to eat before drinking. E) Sylvia was exhibiting an impairment of control. Answer: A Diff: 1 Type: MC Skill: Application
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10) Which of the following statements are TRUE regarding substance abuse and Canada's indigenous populations? A) Aboriginal youths tend to consume more alcohol than Caucasian youths. B) Alcohol use on the aboriginal reserves is more prevalent than other areas in Canada. C) The impact on health of alcohol use by other Canadians is more severe than it is for aboriginal populations. D) Alcohol use by other Canadians is greater than it is in aboriginal populations. E) The rates of health problems associated with alcohol are significantly higher in aboriginal populations. Answer: E Diff: 2 Type: MC Skill: Conceptual
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11) According to a recent survey, approximately __________ of every 5 Canadians reported drinking alcohol in the previous year. A) 1 B) 2 C) 3 D) 4 E) 5 Answer: D Diff: 2 Type: MC Skill: Factual .. 3
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12) The majority of people who have reported drinking can be categorized as __________ drinkers. A) light frequent B) light infrequent C) heavy infrequent D) moderate frequent E) heavy frequent Answer: B Diff: 2 Type: MC Skill: Factual
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13) Susan's friend bought her a drink, and told her that it contained alcohol, even though it didn't. However, after drinking several of these “fake cocktails,” Susan began to feel more relaxed, sociable, and sexually attractive. These effects were probably most influenced by A) Susan's evening out with her friend. B) the fact that Susan's friend lied to her. C) Susan's beliefs about the effects of alcohol. D) Susan was not feeling very well. E) the atmosphere of the bar. Answer: C Diff: 1 Type: MC Skill: Application
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14) Research into the perceived effects of alcohol consumption has shown that A) perceived and actual effects appear unrelated. B) physiological arousal and aggressive behaviour are inversely related to the perceived amount of alcohol consumed. C) most people can tell the difference between the perceived and actual effects of alcohol. D) subjects behave more aggressively and report more sexual arousal when they believed they had consumed alcohol. E) subjects who drank an alcoholic beverage without knowing it reported less sexual arousal, even though physiological measures showed arousal. Answer: D Diff: 2 Type: MC Skill: Factual
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15) Which of the following statements is true regarding the absorption of alcohol? A) Most alcohol is absorbed into the bloodstream from the large intestine. B) Alcohol is generally absorbed by fatty tissues in the body. C) Most alcohol passes directly into the blood from the stomach. .. 4
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D) Alcohol requires digestion to enter the bloodstream. E) Most alcohol is absorbed into the bloodstream from the small intestine. Answer: E Diff: 1 Type: MC Skill: Factual
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16) The removal of alcohol from the body is NOT dependent upon A) the proportion of body fat. B) the amount of alcohol dehydrogenase in the body. C) rate of alcoholic intake. D) the amount of food one consumes prior to drinking. E) whether a person is male or female. Answer: D Diff: 1 Type: MC Skill: Factual
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17) Alcohol is a(n)__________ but the initial effect of alcohol is __________. A) hallucinogen; depressing B) stimulant; relaxing C) depressant; stimulating D) stimulant; depressing E) depressant; relaxing Answer: C Diff: 1 Type: MC Skill: Factual
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18) Susan is of average size and weight. In order for her to maintain a constant BAL, she should consume no more than A) 1 drink every five hours. B) 1 drink every hour. C) 5 drinks in one night. D) 1 drink every two hours. E) 2 drinks per hour. Answer: D Diff: 1 Type: MC Skill: Application
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19) Alcohol begins to affect driving ability at a BAL of A) .05. B) .03. C) .01.
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D) .10. E) .08. Answer: A Diff: 1 Type: MC Skill: Factual
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20) Hangover symptoms such as upset stomach, fatigue, headache, and thirst can be remedied by A) vegetable juice. B) rest and time. C) coffee and cigarettes. D) more alcohol. E) a bowl of cereal. Answer: B Diff: 1 Type: MC Skill: Factual
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21) Moderate consumption of alcohol has been related to A) lower incidence of coronary heart disease. B) liver damage. C) cancer. D) malnutrition. E) damage to the heart muscle. Answer: A Diff: 1 Type: MC Skill: Factual
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22) The two brain regions most damaged by heavy alcohol use are A) limbic system and medulla. B) cerebral cortex and hippocampus. C) basal ganglia and cerebellum. D) thalamus and hypothalamus. E) septum and amygdala. Answer: D Diff: 2 Type: MC Skill: Factual
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23) Korsakoff's psychosis is a disease characterized by memory loss and a loss of contact with reality and results from A) cardiomyopathy. B) cell loss in the brain. C) liver damage. .. 6
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D) alcohol dependence. E) severe malnutrition. Answer: B Diff: 2 Type: MC Skill: Factual
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24) Health care providers recommend that women consume __________ during pregnancy. A) nothing at all B) moderately C) one alcoholic beverage a day D) four to six drinks a day E) two martinis Answer: A Diff: 1 Type: MC Skill: Factual
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25) A general survey conducted by Statistics Canada in 2004 regarding whether drinking had adversely affected people's lives in several areas, it was found that A) the majority of problems involved work or school. B) the number one problem concerned personal happiness. C) men were more likely to report drinking-related problems. D) youths were most likely to report legal violations related to drinking. E) most problems were related to health, finance, and friendships. Answer: E Diff: 1 Type: MC Skill: Factual
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26) Which group represents the greatest number of alcohol-related causes of death? A) motor vehicle accidents, cancer of the liver, Korsakoff's syndrome B) motor vehicle accidents, cancer of the stomach, heart attack C) cirrhosis of the liver, Korsakoff's syndrome, cancer D) motor vehicle accidents, cirrhosis of the liver, suicide E) accidental shootings, cancer of the mouth, suicide Answer: D Diff: 2 Type: MC Skill: Factual
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27) In terms of the genetic influences for becoming an alcoholic, it has been shown that A) most offspring of alcoholics become so themselves. B) the enzyme necessary for breaking down alcohol is not present in alcoholic individuals. .. 7
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C) the brains of alcoholics contain a gene that influences the sensitivity of dopamine receptors to alcohol. D) alcoholics have a specific abnormality on chromosome 10. E) the concordance rate for monozygotic twins is generally higher than it is for dizygotic twins. Answer: E Diff: 3 Type: MC Skill: Factual
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28) If you were a physician examining the brain wave activity of alcoholics, non-problem drinkers, and their children, you would likely find that A) sons and daughters of alcoholics show smaller P300 amplitudes than children of nonalcoholic fathers. B) sons of alcoholic fathers show higher than normal rates of theta waves. C) sons of alcoholic fathers show higher than normal rates of alpha waves. D) sons and daughters of alcoholics show larger P300 amplitudes than children of nonalcoholic fathers. E) sons of alcoholic fathers have lower than normal rates of beta waves. Answer: A Diff: 3 Type: MC Skill: Application
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29) Which of the following statements is true regarding markers of vulnerability to alcohol? A) Men with alcoholic relatives tend to show an increased heart rate after consuming alcohol. B) MAO activity is higher in alcoholics. C) Sons of alcoholic fathers have lower than normal rates of the fast beta wave. D) High levels of serotonin have been associated with the impulsivity, aggressiveness, and antisocial behaviour. E) Men who show the greatest increases in heart rate were less inclined to drink regularly. Answer: A Diff: 2 Type: MC Skill: Factual
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30) The personality characteristic most strongly associated with alcoholism is A) psychoticism. B) negative emotionality. C) perfectionism. D) introversion. E) behavioural disinhibition.
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Answer: E Diff: 2 Type: MC Skill: Factual
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31) Which of the following statements support the alcohol expectancy theory? A) Joe drinks a lot because he believes it will put him in a better mood, even though he actually becomes more aggressive. B) Adolescents are unaffected by positive expectancies of alcohol effects. C) Both alcoholics and nonalcoholics drink less when they believe their drinks contain alcohol. D) Non-problem drinkers are more likely to believe that alcohol will have a positive effect. E) Alcoholics and heavy social drinkers are more likely to believe that alcohol will have a negative effect. Answer: A Diff: 2 Type: MC Skill: Conceptual
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32) Given the behavioural tolerance effect of drug use, an alcoholic might be most severely impaired when drinking A) with his friends at the bar that they frequent once a week. B) at a house that he has never been to before. C) home alone where he always drinks. D) at night when he watches television. E) at an office party. Answer: B Diff: 3 Type: MC Skill: Application
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33) What is the main goal of the Minnesota model for the treatment of alcohol dependence? A) abstinence B) changing the expectations drinkers have about alcohol effects. C) controlled drinking D) treating the withdrawal symptoms E) educating people about the consequences of alcohol abuse Answer: A Diff: 2 Type: MC Skill: Factual
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34) Medications are sometimes used in the treatment of alcoholics, mainly to A) reduce the impact of the stressors that are causing them to drink in the first place. B) decrease feelings of nausea when alcohol is consumed. .. 9
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C) counter the effects of malnutrition caused by drinking excessively. D) ease the negative effects of hangovers. E) reduce the pleasurable feelings that result from drinking. Answer: E Diff: 1 Type: MC Skill: Factual
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35) Rico is an alcoholic, and even though he sometimes tries to quit, he craves alcohol and feels better after drinking it. His doctor has prescribed Naltrexone to help him abstain from alcohol. How does this medication work? A) It blocks the neurotransmitters that mediate alcohol's effects on the brain. B) It reduces the positive expectations about alcohol. C) It blocks the action of the enzyme that metabolizes alcohol, making the individual sick. D) It acts to mimic the effects of alcohol, thus making withdrawal more bearable. E) It reduces some of the tendencies associated with certain personality characteristics that lead to drinking. Answer: A Diff: 2 Type: MC Skill: Application
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36) Antabuse is successful at reducing alcohol use because A) it increases the amount of acetyladehyde dehydrogenase in the body. B) it makes people feel better without having to drink. C) compliance is generally not a problem. D) it changes positive expectancies about alcohol effects to negative ones. E) it causes many unpleasant effects when a person drinks. Answer: E Diff: 2 Type: MC Skill: Conceptual
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37) Alcoholics Anonymous is A) a religious group that condemns the use of alcohol. B) one of the best known approaches to the treatment of alcoholism. C) an intensive, short-term support group for alcoholics. D) a treatment program based on psychodynamic principles. E) a treatment group, consisting of alcoholics at different stages, run by a therapist who was a former alcoholic. Answer: B Diff: 1 Type: MC Skill: Factual
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38) The treatment philosophy of Alcoholics Anonymous is based on a __________ model and the treatment goal is __________. A) personal; support B) disease; abstinence C) physical; somatic D) mental; education E) psychosocial; abstinence Answer: B Diff: 2 Type: MC Skill: Factual
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39) The twelve steps that define AA indicate that A) that alcoholics are powerless to control drinking and must rely on a Higher Power. B) alcoholics can follow these steps on their own and eventually quit drinking. C) success depends on social support. D) alcoholism can be cured if meetings are attended regularly. E) alcoholics must attend mass regularly in conjunction with AA meetings. Answer: A Diff: 1 Type: MC Skill: Conceptual
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40) Classical conditioning approaches to the treatment of alcoholism generally A) focus on the thought and attitudes of alcoholics. B) attempt to associate alcohol with unpleasant stimuli. C) assume that alcoholism is a disease. D) follow the philosophy of Alcoholics Anonymous. E) use contingency management. Answer: B Diff: 1 Type: MC Skill: Factual
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41) Behavioural treatments such as the Community Reinforcement approach utilize which of the following strategies for treating alcoholism? A) Enforcing controlled drinking B) Teaching a family member or a friend to reinforce sobriety C) Punishing the alcoholic with community work when he or she fails to abstain D) Pairing alcohol with an unpleasant stimulus E) Increasing communication between families and partners Answer: B Diff: 2 Type: MC Skill: Conceptual
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42) In relapse prevention treatment, people are taught that a lapse is A) an indication of a severe drinking problem that requires more intense therapy. B) an indication of a brain abnormality underlying the problem. C) a temporary occurrence brought on by a specific situation, from which a person can recover. D) a sign that the addiction to alcohol is probably not treatable. E) a failure to cope with the problems of alcoholism. Answer: C Diff: 1 Type: MC Skill: Factual
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43) Relapse prevention treatment focuses on A) integrating medication, support groups, and contingency contracts to prevent relapse. B) emphasizing the importance of controlled drinking as a means of preventing overconsumption of alcohol. C) involving family members in the treatment to help prevent relapse. D) offering time-limited and specific advice regarding the need to reduce or eliminate alcohol consumption. E) assisting the individual in changing his or her beliefs about drinking. Answer: E Diff: 2 Type: MC Skill: Conceptual
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44) When family members establish roles that are defined by the substance abuse and their behaviour actually prevents changes in the abuse pattern, they are referred to as A) scapegoats. B) facilitators. C) codependents. D) enmeshed. E) resistant. Answer: C Diff: 2 Type: MC Skill: Factual
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45) Interventions that involve the family of alcoholics generally target A) the self-defeating thoughts and distorted beliefs espoused by the family. B) communication and relationship roles. C) how families may be causing relapses. D) the effect of the abuser on other family members. E) the amount of alcohol that everyone in the family drinks.
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Answer: B Diff: 2 Type: MC Skill: Conceptual
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46) Of all the treatment approaches that have been empirically evaluated, __________ has/have the strongest support. A) behavioural treatment B) mutual support groups C) relapse prevention D) pharmacotherapy E) brief interventions Answer: E Diff: 2 Type: MC Skill: Factual
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47) One of the first drugs developed as a treatment for tension and anxiety was/were A) benzodiazepines. B) tranquilizers. C) Valium. D) barbituric acid. E) barbiturates. Answer: D Diff: 1 Type: MC Skill: Factual
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48) At low doses, barbiturates cause __________ but with large doses they can cause __________. A) mild euphoria; lowered respiration, blood pressure, and heart rate B) sleep; coma C) relaxation of the diaphragm muscles; personality changes D) slurred speech; mild euphoria E) blurred vision; muscle paralysis Answer: A Diff: 2 Type: MC Skill: Factual
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49) Deri has been undergoing treatment for barbiturate abuse. The drug has been reduced very slowly for awhile now, and at this time his doctor is reducing it by 10% every day. Deri has begun to feel achy, depressed, anxious, and he is unable to fall asleep. His symptoms have been characterized as the A) tolerance effect. B) abstinence syndrome. C) recurrent withdrawal syndrome. .. 13
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D) treatment relapse. E) dependency problem. Answer: B Diff: 1 Type: MC Skill: Application
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50) Stimulant drugs, such as nicotine, amphetamines, cocaine, and caffeine, achieve their effects by A) increasing the heart rate and blood pressure. B) decreasing the rate of dopamine and serotonin entering the brain. C) increasing the availability of GABA and ACH to the nucleus accumbens. D) increasing the availability of dopamine, serotonin, and norepinephrine to the nucleus accumbens. E) influencing the rate of blood flow into the brain. Answer: D Diff: 2 Type: MC Skill: Factual
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51) The highest usage of tobacco occurs among those aged A) 20 to 24. B) 25 to 30. C) 36 to 40. D) 15 to 20. E) 30 to 35. Answer: A Diff: 2 Type: MC Skill: Factual
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52) Dependence produced by __________ is thought to be even greater than that produced by other addictive substances. A) cocaine B) heroin C) caffeine D) alcohol E) tobacco Answer: E Diff: 1 Type: MC Skill: Factual
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53) Overall, results of psychological smoking cessation programs have been A) mixed. B) promising. .. 14
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C) lacking. D) not at all encouraging. E) very encouraging. Answer: A Diff: 1 Type: MC Skill: Conceptual
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54) During the 1930s, amphetamines were developed as A) a decongestant and asthma treatment. B) treatment for hyperactive children. C) a treatment for alcohol abuse. D) a way to calm psychiatric patients. E) a treatment for obesity. Answer: A Diff: 2 Type: MC Skill: Factual
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55) At low doses, amphetamines cause __________ and at very high doses, they result in __________. A) increased confidence; increased alertness B) increased alertness; restlessness and anxiety C) fatigue and sadness; brain damage D) confusion; hyperactivity E) feelings of exhilaration; toxic psychosis Answer: B Diff: 2 Type: MC Skill: Factual
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56) Jennifer was taken to the hospital by her friends late Saturday night. She complained that she felt weak and nauseous, and when she was examined by the physician, her heartbeat was found to be irregular, her blood pressure was high, and her pupils were dilated. Apparently she had “taken something” at a party, but her friends didn't know what it was. It appears that she had taken A) lsd. B) sedatives. C) benzodiazepines. D) amphetamines. E) barbiturates. Answer: D Diff: 2 Type: MC Skill: Application
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57) In small amounts, cocaine produces __________, while high doses lead to __________. A) anger and aggression; toxic psychosis B) feelings of confidence; brain damage C) feelings of euphoria and well-being; overstimulation of the CNS D) understimulation of the CNS; anger and aggression E) no effects; mood swings and insomnia Answer: C Diff: 2 Type: MC Skill: Factual
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58) Why is treatment for stimulant dependence difficult? A) Doctors are generally reluctant to treat sufferers of substance abuse. B) Stimulant abusers tend to use other drugs to counteract some of the effects of the stimulants, and become dependent on these drugs as well. C) Stimulants are very addicting and it often takes many years to quit using them. D) Psychological and biological treatments must be used in conjunction, never separately. E) It is easier to treat those who are addicted to socially acceptable drugs. Answer: B Diff: 1 Type: MC Skill: Conceptual
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59) At low doses, caffeine can __________ and higher doses __________. A) increase hunger; cause relieve tension B) cause thirst; cause lack of appetite C) increase attention; cause increased nervousness and insomnia D) excessive talkativeness; improve problem-solving skills E) cause headaches; cause drowsiness Answer: C Diff: 1 Type: MC Skill: Factual
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60) Which of the following groups of drugs belong to the opiate family? A) morphine, heroin, methadone B) morphine, nicotine, opium C) caffiene, nicotine, and cocaine D) codeine, benzoic acid, Demerol E) heroin, cocaine, codeine Answer: A Diff: 1 Type: MC Skill: Factual .. 16
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61) Opioids, known as exogenous opiates, tend to mimic the effects of A) serotonin. B) depressants. C) dopamine. D) stimulants. E) the body's natural painkillers. Answer: E Diff: 1 Type: MC Skill: Factual
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62) The immediate effect of heroin is __________ at higher doses it results in __________. A) calming; pupil constriction B) hyperactivity; paranoia C) pleasurable; respiratory failure D) nausea; coma E) anxiety; euphoria Answer: C Diff: 2 Type: MC Skill: Factual
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63) The most commonly used and most widely available illicit drug in Canada is A) speed. B) marijuana. C) cocaine. D) heroin. E) alcohol. Answer: B Diff: 1 Type: MC Skill: Factual
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64) With relatively small doses of cannabis, most users report A) sexual arousal. B) feelings of tension and anxiety. C) paranoia. D) hallucinations. E) a feeling of euphoria and sociability. Answer: E Diff: 1 Type: MC Skill: Conceptual
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65) A syndrome found in long-term cannabis users characterized by apathy, lack of pursuit of vocational goals, self-absorption, and detachment from family and friends is known as A) cannabis sativa. B) amotivational syndrome. C) toxic psychosis. D) abnormal cannabis reaction. E) unusual dependency. Answer: B Diff: 2 Type: MC Skill: Conceptual
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66) Which of the following groups of drugs are found under the category “hallucinogens”? A) cocaine, heroin, psychedelics B) alcohol, LSD, magic mushrooms C) mescaline, acid, marijuana D) amphetamines, marijuana, alcohol E) mescaline, LSD, psilocybin Answer: E Diff: 1 Type: MC Skill: Factual
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67) When Albert Hoffman was investigating ergot (a fungus which affects rye and wheat) in 1938, he accidentally discovered A) hashish. B) cocaine. C) LSD. D) mescaline. E) psilocybin. Answer: C Diff: 1 Type: MC Skill: Application
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68) Hallucinogens have an __________ effect on the CNS and mimic the effects of __________. A) excitatory; dopamine B) inhibitory; serotonin C) excitatory; epinephrine D) excitatory; serotonin E) inhibitory; dopamine
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Answer: D Diff: 1 Type: MC Skill: Factual
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69) Which of the following negative side effects occur due to hallucinogen use? A) flashbacks B) amotivational syndrome C) recurrent headaches D) respiratory problems E) high blood pressure Answer: A Diff: 1 Type: MC Skill: Conceptual
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70) The DSM-IV-TR has categorized pathological gambling as a(n) A) personality disorder. B) obsessive-compulsive disorder. C) substance abuse disorder. D) disorder of impulse control. E) mood disorder. Answer: D Diff: 1 Type: MC Skill: Conceptual
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71) The term “addiction” is described as psychological dependence in the DSM-IV-TR. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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72) Being psychologically accustomed to a substance due to regular usage is defined as habituation. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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73) The First Nations and Inuit Community and Youth Solvent Abuse Survey indicated that 1 in 5 Aboriginal youth had used solvents.
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A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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74) There has been an increase in the consumption of alcohol in Canada in 2003-2004 since 1994. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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75) If your blood alcohol level (BAL) is .08 percent, it means that there are 8 mg of alcohol in 100 mg of blood. A) True B) False Answer: B Diff: 2 Type: TF Skill: Application
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76) The nausea and headache associated with a hangover result from the accumulation of acetylaldehyde. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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77) Biological markers, such as levels of serotonin and MAO, and heart rate, have shown clinical utility for the development of alcoholism. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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78) Although children tend to mimic their parents' drinking behaviour, the linkage between the two tends to be less strong when the parents are either heavy drinkers or nondrinkers. .. 20
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A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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79) Antagonist drugs block the effects of psychoactive drugs. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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80) Contingency contracts are contracts signed by the alcoholic in which he or she promises to attend a treatment group for his or her drinking problem. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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81) Barbiturate withdrawal is similar to but milder than withdrawal from alcohol. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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82) It appears that since the 1960s, there has been a decrease in the number of people who smoked. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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83) Nicotine dependence is thought to be more severe than that produced by alcohol, cocaine, heroin, and caffeine. A) True B) False
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Answer: A Diff: 1 Type: TF Skill: Factual
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84) During the 1800s, cocaine was viewed as harmless and was the principal ingredient in Coca-Cola. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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85) Prolonged use of around 3 cups of coffee a day can result in physical dependence. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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86) “Mainlining” means that the heroin is mixed with cocaine and snorted. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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87) Methadone treatment works by reducing the craving for heroin. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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88) Marijuana has been used in the past to treat rheumatism, gout, depression, and cholera. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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89) Ninety-nine percent of regular cannabis users are diagnosed with a depressive disorder. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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90) Hallucinogens do not appear to be addictive. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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91) Contrast substance abuse with substance dependence. Answer: Substance abuse is defined in the DSM-IV as the recurrent use of a substance that results in adverse consequences at work, school, or home. For example, poor school or work performance may result which is related to substance use. Interpersonal relationships may suffer and deteriorate because of substance use. As well, an individual may use substances in situations where it is physically dangerous, such as prior to driving a vehicle, or may have recurrent legal problems related to substance use. Substance dependence is often referred to as “addiction,” which describes the lack of control the individual has over the substance. There are two forms of dependence: physical and psychological. Physical dependence is characterized in terms of tolerance and withdrawal symptoms. Tolerance is defined as the need for increased amounts of the substance in order to achieve previous effects. Withdrawal symptoms include nausea, headaches, and tremors, which result from the removal of the substance from the body. Psychological dependence refers to being psychologically accustomed to a substance as a result of regular use. When the substance is unavailable, feelings of restlessness, irritability, or uneasiness may be experienced.The individual will spend a great amount of time obtaining or using the substance. Diff: 2 Type: TF Page Ref: 246-247 Skill: Factual 92) Discuss the long-term physical effects of alcohol. Answer: Chronic alcohol consumption can result in many diseases and difficulties. Since alcohol travels through the bloodstream, it comes into contact with every organ in the body. Damage to the body is influenced by genetics, frequency and duration of drinking, and the severity of binges. Alcohol is very high in calories, and heavy drinkers will often reduce their food intake. However, the calories in the alcohol are “empty” calories, and alcohol interferes with the absorption of nutrients in food. Therefore, severe malnutrition .. 23
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and tissue damage can occur. Damage to the liver, the endocrine glands, and the pancreas can result. Alcohol has also been associated with a variety of cancers throughout the body. Heavy alcohol use has been associated with damage to the heart, high blood pressure, and strokes. Research has demonstrated that the consumption of alcohol can kill brain cells, particularly in the hypothalamus and thalamus regions. Cell loss in these areas is associated with Korsakoff's psychosis, a disease characterized by impaired memory and a loss of contact with reality Diff: 2 Type: ES Page Ref: 254 Skill: Factual 93) Define alcohol expectancy theory and discuss the research findings regarding this theory. Answer: The alcohol expectancy theory states that drinking behaviour is largely determined by the reinforcement that an individual expects to receive from it. For example, expectancies identified by a group of social drinkers were that alcohol positively transforms experiences, enhances social, physical, and sexual experiences, increases power and aggression, alters personal characteristics and improves social skills and reduces tension. However, these effects are related to the individual's expectations where alcohol is concerned, and the actual pharmacological effects of alcohol can have the opposite effect of expectation. Alcoholics and heavy drinkers are more likely to believe that alcohol use will result in positive outcomes and both alcoholics and nonproblem drinkers drink more when they are told that their drinks contain alcohol. Diff: 2 Type: ES Page Ref: 257 Skill: Factual/Conceptual 94) Discuss the sociocultural factors that influence drinking patterns. Answer: Alcohol use is influenced by various social and cultural Factors, including family values, attitudes, and expectations. Individuals who are introduced to drinking in environments where excessive drinking is socially acceptable or encouraged face greater risk for developing drinking problems. Cultural and family traditions interact to determine attitudes and behaviour towards drinking. If rates of alcoholism in different countries are compared, patterns of drinking differ widely. For example, In France, daily drinking is common and alcoholics tend to be steady drinkers who rarely lose control but are prone to physical problems. In England, Ireland, and North America, alcoholism is often manifested by heavy drinking binges, loss of control, and adverse negative consequences. In Italy, where drinking tends to be limited to mealtimes and consumption is limited, rates of alcoholism are much lower. Muslim countries often prohibit drinking on religious grounds, and alcoholism rates are very low. Thus, an individual's culture, family, and social values will interact to determine the attitudes towards alcohol and drinking. Diff: 2 Type: ES Page Ref: 257-258 Skill: Factual/Conceptual
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95) Describe the Alcoholics Anonymous (AA) approach to treating alcoholism. Answer: Alcoholics Anonymous (AA) is likely the most well known treatment approach for alcohol problems and is involved with more alcoholics than any other treatment organization. AA is a self-help group consisting of men and women who have alcohol problems and share their stories with each other. The AA philosophy is based on the disease model and the goal of treatment is complete abstinence. AA members believe that there is no cure for alcoholism, that they are powerless to control their drinking and must depend on a Higher Power to help them. The twelve steps define the philosophy and are read at each meeting. Members are encouraged to attend meetings often, and the social support and encouragement provided at the meeting place is viewed as an important component to the success of this form of treatment. Diff: 1 Type: ES Page Ref: 260-261 Skill: Factual/Conceptual 96) Describe the short-term and long-term consequences of tobacco use. Answer: Nicotine is an extremely potent CNS stimulant--a few drops of pure nicotine can cause respiratory failure. Low dosages interfere with thinking, although the amount present in a cigarette can increase alertness and improve mood.However, although the short-term consequences of smoking may be minimal, the long-term consequences are serious. Smoking has been implicated in the development of lung, esophagus, and larynx cancers, emphysema, respiratory illness, heart disease, and other chronic illnesses. Most of these illnesses are not caused by nicotine but by the carbon monoxide and other chemicals found in cigarettes. Second-hand smoke can be even more dangerous, and is associated with significant health risks, including heart disease, lung cancer, and asthma. Diff: 2 Type: ES Page Ref: 264 Skill: Factual 97) Define pathological gambling and describe the similarities between gambling and substance abuse. Answer: Pathological gamblers are those who will risk their reputation, family, life savings, work, freedom, and safety for gambling. They are preoccupied with gambling and are unable to resist gambling despite extremely negative consequences. Pathological gambling shares similarities to drug and alcohol dependence. Some pathological gamblers suffer withdrawal-like symptoms after attempting to stop gambling, both gambling and substance use generate relief and feelings of pleasure, cravings to repeat the behaviour, the ability to alter mood, and arousal level. When engaged in to excess, both behaviours lead to negative consequences. In fact, some individuals believe that gambling should be classified as a type of addictive behaviour as well. Diff: 2 Type: ES Page Ref: 274 Skill: Factual/Conceptual
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98) What appears to be the main substance abuse difficulties faced by Aboriginal Canadians? Answer: Substance abuse issues are of growing concern in Canada's Aboriginal population. Alcohol use on Native reserves does not appear to be more prevalent than elsewhere in Canada, but the impact of alcohol may be greater in Native communities. Rates of health problems associated with alcohol use, for example, dependency, alcoholic psychosis, and liver disease are significantly higher in Native populations. This may be a function of the higher rate of usage of other drugs such as nicotine, marijuana, solvents, heroin and stimulants, which can intensify the negative effects of alcohol. Although Native youths report drinking similar amounts of alcohol as Caucasian youths, they also report smoking twice as much and using marijuana threes times more than Caucasian adolescents. Native youths also report more use of other drugs such as solvents, stimulants, hallucinogens, and tranquilizers. Treatment for substance abuse problems is complicated, since many substance abusers are very young and come from troubled homes. As well, violence and suicide risk are quite high, which further complicates treatment issues. Diff: 2 Type: ES Page Ref: 249 Skill: Factual
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CHAPTER 12 The Personality Disorders 1) Personality theorists describe qualities which are persistently displayed over time and in various situations as A) personality disorders. B) states. C) lasting qualities. D) types. E) traits. Answer: E Diff: 1 Type: MC Skill: Factual
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2) Which of the following statements is true? A) People with personality disorders show a far more restricted range of traits than do most people. B) People with personality disorders show a far less restricted number of traits than do most people. C) People with personality disorders are characterized by their flexibility to adapt to different situations. D) People with personality disorders are far more dependent on situational contexts than are most people. E) People with personality are typically characterized by a number of major personality traits. Answer: A Diff: 2 Type: MC Skill: Factual
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3) The DSM-IV-TR lists __________ specific personality disorders which are organized into __________ broad clusters. A) 10; 3 B) 8; 2 C) 8; 3 D) 10; 2 E) 15; 5 Answer: A Diff: 2 Type: MC Skill: Factual
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4) Which of the following is NOT one of the five criteria used by the DSM-IV-TR in defining a personality disorder? .. 1
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A) requires stability and long duration of symptoms, with onset in adolescence or earlier B) behaviour be rigid and consistent across broad range of personal and social situations C) pattern of behaviour manifested in at least 2 areas: cognition, emotion, interpersonal functioning, or impulse control D) behaviour should lead to clinically significant distress E) behaviour can typically be explained by another mental disorder Answer: E Diff: 2 Type: MC Skill: Factual
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5) Which of the following matches is incorrect? A) anxious and fearful cluster : dependent personality disorder B) anxious and fearful cluster : avoidant personality disorder C) odd and eccentric cluster : paranoid personality disorder D) dramatic, emotional, or erratic cluster : antisocial personality disorder E) odd and eccentric cluster : depressive personality disorder Answer: E Diff: 3 Type: MC Skill: Factual
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6) The disorders listed under Personality Disorder Not Otherwise Specified are A) passive-aggressive and dependent. B) depressive and passive-aggressive. C) paranoid and aggressive. D) avoidant and depressive. E) obsessive-compulsive and schizoid. Answer: B Diff: 2 Type: MC Skill: Factual
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7) According to the text, approximately __________% of the population will have a personality disorder during their life. A) 30-34 B) 9-12 C) 6-9 D) 50 E) 12-15 Answer: C Diff: 2 Type: MC Skill: Factual
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8) Which of the following best describes the relationship between the prevalence rate of personality disorders between outpatients and inpatients? A) They are generally higher among outpatients. B) They are generally lower among outpatients. C) They are higher for antisocial personality disorder, but the same for the remaining personality disorders. D) Outpatients are generally diagnosed with disorders from Cluster A and inpatients with disorders from Cluster B. E) They are generally the same. Answer: B Diff: 2 Type: MC Skill: Factual
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9) Research shows that __________% or more of people with personality disorders never seek treatment for their problems. A) 60 B) 95 C) 20 D) 40 E) 80 Answer: E Diff: 1 Type: MC Skill: Factual
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10) Many personality disorders are __________, which means that the person does not believe they have a problem. A) egoplatonic B) egosyntonic C) egodystonic D) ego accepted E) egotonic Answer: B Diff: 1 Type: MC Skill: Factual
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11) Several researchers have suggested that the diagnostic criteria for some personality disorders are A) culture-biased. B) neither gender- nor culture-biased. C) both gender- and culture-biased. D) age-biased. E) gender-biased.
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Answer: C Diff: 1 Type: MC Skill: Conceptual
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12) According to the text, clinicians have been shown to be reluctant to diagnose males as having __________ personality disorder, while they are sometimes hesitant to diagnose females as having __________ personality disorder. A) antisocial; avoidant B) histrionic; antisocial C) dependent; paranoid D) antisocial; histrionic E) avoidant; antisocial Answer: B Diff: 1 Type: MC Skill: Factual
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13) Research has shown that, on average, __________% of the people identified as suffering from borderline personality disorder through structured interviews are women. A) 80 B) 20 C) 60 D) 100 E) 40 Answer: A Diff: 2 Type: MC Skill: Factual
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14) Because the term has been traditionally applied to women, the name of __________ personality disorder was changed to histrionic personality disorder. A) avoidant B) neurotic C) borderline D) psychotic E) hysterical Answer: E Diff: 1 Type: MC Skill: Factual
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15) Despite the research, the Correctional Service of Canada seems reluctant to accept the fact that A) psychopathy can occur in children. B) psychopathy can occur in men. C) psychopathy is a valid diagnosis. .. 4
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D) psychopathy can occur in women. E) psychopathy exists at all in the prison population. Answer: D Diff: 1 Type: MC Skill: Factual
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16) __________ refers to the co-occurrence in the same person of two or more different disorders, while __________ refers to the similarity of symptoms in two or more different disorders. A) Ego syntonia; ego dystonia B) Overlap; comorbidity C) Multiple personality disorder; multiple symptomalogy D) Ego dystonia; ego syntonia E) Comorbidity; overlap Answer: B Diff: 1 Type: MC Skill: Factual
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17) One study found that almost ______ percent of those diagnosed as borderline met the criteria for APD. A) 10 B) 20 C) 30 D) 40 E) 50 Answer: E Diff: 3 Type: MC Skill: Factual
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18) Pinel described what he called manic sans delire, which was the predecessor of what has become known as A) narcissistic personality disorder. B) paranoid personality disorder. C) avoidant personality disorder. D) dependent personality disorder. E) antisocial personality disorder. Answer: E Diff: 1 Type: MC Skill: Factual
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19) The term psychopath was replaced with sociopath by __________. A) psychologists .. 5
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B) sociologists C) Pinel D) psychiatrists E) Freud Answer: B Diff: 1 Type: MC Skill: Factual
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20) The most influential book ever published on antisocial personality disorder was The Mask Of Sanity by A) Pinel. B) Pritchard. C) Hare. D) Ross. E) Cleckley. Answer: E Diff: 1 Type: MC Skill: Factual
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21) The specific causes of personality disorders were not considered until the development of A) the psychoanalytic movement. B) behaviourism. C) cognitive-behavioural theories. D) the existentialist movement. E) attachment theory. Answer: A Diff: 1 Type: MC Skill: Factual
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22) Psychoanalysts see personality disorders as resulting from A) the failure to resolve the Oedipal or Electra complex. B) disturbances in the parent-child relationship. C) failure to use adequate defense mechanisms. D) penis envy (in women only). E) unsatisfied oral pleasures during infancy. Answer: B Diff: 1 Type: MC Skill: Factual
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23) __________ theory states that children learn how to relate to others by the way in which their parents relate to them. .. 6
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A) Parental B) Parental-attachment C) Relationship D) Attachment E) Individuation Answer: D Diff: 1 Type: MC Skill: Factual
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24) Joan is a psychologist who argues that her client has a personality disorder due largely to the fact that his schemata (i.e., beliefs and assumptions) have become rigid and inflexible. Joan is taking a(n) __________ approach to understanding the etiology of personality disorders. A) attachment B) psychoanalytic C) psychiatric D) behavioural E) cognitive-behavioural Answer: E Diff: 1 Type: MC Skill: Application
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25) Biological accounts of personality disorders have been most thoroughly explored with __________ personality disorder. A) narcissistic B) antisocial C) paranoid D) histrionic E) avoidant Answer: B Diff: 1 Type: MC Skill: Factual
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26) Jane has a tendency to see everything people do as a personal attack on her safety and privacy. Judging from this characteristic, which personality disorder is Jane most likely to have? A) avoidant B) paranoid C) dependent D) narcissistic E) histrionic
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Answer: B Diff: 1 Type: MC Skill: Application
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27) As paranoid personality occurs quite commonly in the relatives of people with __________, a genetic link with this disorder has been proposed. A) depression B) panic disorder C) obsessive-compulsive disorder D) schizophrenia E) bipolar mood disorder Answer: D Diff: 1 Type: MC Skill: Factual
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28) Andrew does not have many friends, and seems determined to actually avoid little involvement with others. He displays little emotional responsiveness, and often seems confused by the emotional displays of others. Judging from this description, which personality disorder is Andrew most likely to have? A) schizotypal B) narcissistic C) avoidant D) schizoid E) anti-social Answer: D Diff: 2 Type: MC Skill: Application
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29) Which of the following is NOT characteristic of a person with schizotypal personality disorder? A) belief in paranormal phenomena B) social isolation C) eccentricity D) excessive focus on himself or herself E) superstitiousness Answer: D Diff: 2 Type: MC Skill: Conceptual
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30) Which of the following personality disorders is characterized by eccentricity of thought and behaviour? A) paranoid B) avoidant .. 8
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C) histrionic D) narcissistic E) schizotypal Answer: E Diff: 1 Type: MC Skill: Factual
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31) Which of the following is NOT true of schizotypal personality disorder? A) The long-term prognosis for those suffering from the disorder is moderate to good. B) Researchers have placed most emphasis on the schizophrenic-like features. C) Low doses of antipsychotic drugs somewhat relieve cognitive problems. D) Many family members of schizophrenics exhibit symptoms of schizotypal personality disorder. E) Antidepressants have been somewhat helpful in relieving symptoms. Answer: A Diff: 2 Type: MC Skill: Factual
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32) The essential distinguishing feature of __________ personality disorder is a pervasive pattern of disregard for, and violation of, the rights of others. A) narcissistic B) avoidant C) schizotypal D) antisocial E) histrionic Answer: D Diff: 1 Type: MC Skill: Factual
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33) The DSM-IV-TR criteria for the diagnosis of antisocial personality disorder presents __________ exemplars reflecting the violation of the rights of others, and __________ or more must be met for the diagnosis to be applied. A) 10; 5 B) 7; 5 C) 7; 3 D) 10; 3 E) 12; 2 Answer: C Diff: 2 Type: MC Skill: Factual
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34) The __________ hypothesis suggests that people with APD have a higher threshold for feeling fear than do other people. A) threshold B) fearlessness C) avoidance D) fear threshold E) self-regulation Answer: B Diff: 1 Type: MC Skill: Factual
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35) Schmauk has suggested that psychopaths are not unresponsive to physical punishment, but rather respond opposite to the punisher's intention, presumably as a way of exercising some degree of control in the face of aversive experiences. This behaviour has been referred to as __________ behaviour. A) irrational B) defiant C) contradictory D) operant E) oppositional Answer: E Diff: 1 Type: MC Skill: Factual
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36) Several researchers have reported that the symptoms of antisocial behaviour eventually end, often around the fourth decade of life. This occurrence has been called the __________ factor. A) responsivity B) exhaustion C) aging D) burnout E) remittance Answer: D Diff: 1 Type: MC Skill: Factual
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37) Reviews of the literature on treatment efficacy for antisocial personality disorder patients has been __________ about the prognosis for those with this disorder. A) cautiously pessimistic B) unequivocally pessimistic C) strongly optimistic D) cautiously optimistic E) unequivocally optimistic .. 10
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Answer: B Diff: 1 Type: MC Skill: Factual
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38) Which of the following is NOT true of the Psychopathy Checklist-Revised? A) It is used both as a research instrument and a clinical tool. B) It discriminates between APD and the other personality disorders. C) The PCL-R score is highly reliable over time. D) It is used in assessments to inform judicial decisions. E) It has good predictive validity regarding recidivism. Answer: B Diff: 1 Type: MC Skill: Factual
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39) Which of the following statements is true? A) Antisocial personality disorder, as measured by the PCL-R, has been demonstrated to be a more reliable construct than psychopathy. B) Antisocial personality disorder, as measured by the PCL-R, has been demonstrated to be as reliable a construct as psychopathy. C) Psychopathy, as measured by the PCL-R, has been demonstrated to be a less reliable construct than antisocial personality disorder. D) Psychopathy, as measured by the PCL-R, has been demonstrated to be a more reliable construct than antisocial personality disorder. E) Antisocial personality disorder, as measured by the PCL-R, has been demonstrated to be a less reliable construct than psychopathy. Answer: D Diff: 2 Type: MC Skill: Factual
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40) Hare gives an estimate that __________ percent of the Canadian population is psychopathic. A) .05 B) 10 C) 5 D) 1 E) .01 Answer: D Diff: 2 Type: MC Skill: Factual
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41) In Porter's (1996) theory, fundamental psychopathy is seen as the result of __________ factors, whereas secondary psychopathy is believed to result from __________ factors. A) biological; psychological B) emotional; social C) psychological; social D) social; psychological E) social; biological Answer: A Diff: 2 Type: MC Skill: Conceptual
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42) Heather shows frequent fluctuations in her mood and great instability in her personal relationships. She is uncertain about who she “really is” and what she would like to do with her life. Judging from this description, which personality disorder is Heather most likely to have? A) antisocial B) dependent C) narcissistic D) borderline E) histrionic Answer: D Diff: 1 Type: MC Skill: Application
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43) Borderline personality disorder has a lifetime prevalence of approximately __________% of the population. A) 12 B) 2 C) 20 D) 0.2 E) 5 Answer: B Diff: 2 Type: MC Skill: Factual
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44) Borderline personality disorder typically begins in __________ and is thought to be more common in __________. A) adolescence; women B) childhood; men C) adulthood; women D) adolescence; men E) adulthood; men .. 12
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Answer: A Diff: 1 Type: MC Skill: Factual
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45) Many people with borderline personality disorder strongly desire intimacy with others, but once they begin to get close to their partner they become anxious and back away. This interpersonal style has been referred to as A) avoidant. B) anxious ambivalent. C) repression. D) anxious avoidant. E) confused. Answer: B Diff: 1 Type: MC Skill: Factual
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46) David has been described as flamboyant and overly dramatic in his emotional displays. He constantly seeks the spotlight in social situations and strongly dislikes being ignored. Judging from this description, which personality disorder is David most likely to have? A) histrionic B) antisocial C) borderline D) schizotypal E) avoidant Answer: A Diff: 1 Type: MC Skill: Application
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47) Egocentricity is the hallmark of which of the following personality disorders? A) histrionic B) avoidant C) borderline D) narcissistic E) antisocial Answer: D Diff: 1 Type: MC Skill: Factual
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48) Clara considers herself extremely talented at all that she does. She is excessively preoccupied with her own interests and demands that others treat her as special. Judging from this description, which personality disorder is Clara most likely to have? .. 13
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A) antisocial B) avoidant C) borderline D) narcissistic E) dependent Answer: D Diff: 1 Type: MC Skill: Application
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49) Joe is extremely sensitive to criticism and disapproval, and as a result actively avoids intimacy with others. However, he is lonely and would like to have more friends. Judging from this description, which personality disorder is Joe most likely to have? A) schizoid B) narcissistic C) borderline D) avoidant E) dependent Answer: D Diff: 1 Type: MC Skill: Application
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50) Sarah finds it very difficult to make decisions, and feels that she desperately needs others to assume responsibilities for important aspects of her life. She accepted a job as a store clerk after asking her husband what job he felt she was best suited for. Judging from this description, which personality disorder is Sarah most likely to have? A) avoidant B) schizotypal C) borderline D) narcissistic E) dependent Answer: E Diff: 1 Type: MC Skill: Application
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51) Research has found that the relatives of men with dependent personality disorder are more likely to experience __________, whereas the relatives of female dependents are more likely to have __________. A) schizophrenia; depression B) panic disorder; depression C) depression; panic disorder D) Generalized Anxiety disorder; schizophrenia E) panic disorder; Generalized Anxiety disorder
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Answer: C Diff: 3 Type: MC Skill: Factual
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52) Which of the following is NOT characteristic of people with obsessive-compulsive personality disorder? A) unable to function independently B) a desire for perfection C) rigidity and inflexibility D) preoccupation with rules and order E) being moralistic and judgmental Answer: A Diff: 2 Type: MC Skill: Factual
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53) Inflexibility and a desire for perfection characterize ___________ disorder. A) narcissistic personality B) dependent personality C) avoidant personality D) obsessive-compulsive personality E) borderline personality Answer: D Diff: 1 Type: MC Skill: Factual
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54) Much research concerning obsessive-compulsive personality disorder relates to the psychoanalytic notion of A) the Oedipal Complex. B) anal retentiveness. C) penis envy. D) phallic fixation. E) oral dependency. Answer: B Diff: 2 Type: MC Skill: Factual
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55) __________, developed by Linehan, has specifically targeted people with borderline personality disorder. A) Neo-psychoanalysis B) Cognitive restructuring therapy C) Object-relations therapy D) Dialectical behaviour therapy E) Operant behaviour therapy .. 15
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Answer: D Diff: 1 Type: MC Skill: Factual
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56) The DSM-IV lists 2 clusters of personality disorders. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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57) The first clear statements of personality disorder were made in 1801 by Pinel. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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58) Many people with personality disorders do not themselves believe that they have a problem. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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59) Borderline personality disorder is the most common diagnosis among inpatient psychiatric patients. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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60) The attempt to reduce gender biases (such as the higher frequency of diagnosis in women) by changing “hysterical personality disorder” to “histrionic personality disorder” was largely successful. A) True B) False
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Answer: B Diff: 2 Type: TF Skill: Factual
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61) Of the personality disorders, antisocial personality disorder has been the most thoroughly explored from a biological perspective. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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62) Studies have shown that many family members of people with schizophrenia exhibit schizotypal symptoms. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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63) When sociologists began to take an interest in psychopathology in the early twentieth century, they saw social conditions as the critical factors and replaced the term “psychopath” with “sociopath.” A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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64) Familial and parental factors, rather than genetic factors appear to be the important risk factors for developing APD. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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65) “Oppositional behaviour” displayed by psychopaths may be the result of severe punishment by their parents that was not contingent on their behaviour. A) True B) False
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Answer: A Diff: 1 Type: TF Skill: Factual
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66) The term “borderline” was used in the past to describe a person on the border between neurosis and psychosis. A) True B) False Answer: A Diff: 1 Type: TF Skill: Conceptual
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67) Borderline personality disorder is thought to be equally common in men and women. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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68) There is a problem distinguishing between avoidant disorder and social phobia. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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69) Cluster C includes avoidant, dependent and obsessive-compulsive personality disorders. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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70) Very little research on obsessive-compulsive personality disorder has been conducted since DSM-III-R was published, save for that concerning distinguishing this personality disorder from obsessive-compulsive disorder. A) True B) False
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Answer: A Diff: 2 Type: TF Skill: Factual
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71) Leading proponents of a cognitive-behavioural treatment approach to personality disorders are Otto Kernberg and Heinz Kohut. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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72) The dialectical behaviour therapy developed by Linehan has specifically targeted antisocial personality disorder. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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73) Several methods have been employed to determine whether the higher prevalence rates of personality disorders in women represents gender-biased criteria, gender-biased application of the criteria, or a true difference in prevalence. Briefly outline two such methods described in the text, and state their findings. Answer: 1. Having professionals make a diagnosis after reading a case history, with the patient described as a woman in half the cases and as a man in the other. Finding: more of the “female” patients were diagnosed with a personality disorder than the “male” (hysterical personality disorder, the precursor of histrionic) 2) Analyzing real cases (the symptoms listed for patients). Finding: while the diagnostic criteria for histrionic personality disorder were found equally among men and women, women were more likely to be diagnosed 3) Comparing diagnosis rates for histrionic personality disorder among patients to rates found in epidemiological studies. Finding: higher diagnosis rates in women for the patients, equal prevalence in the epidemiological studies Diff: 2 Type: ES Page Ref: 283-284 Skill: Factual 74) Briefly define and distinguish between the terms “comorbidity” and “overlap”, and give an example of each in the context of personality disorders. Answer: Comorbidity = the co-occurrence in the same person of two or more different disorders.
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One possible example: a person being diagnosed with both borderline personality disorder and antisocial personality disorder. Overlap = the similarity of symptoms in two or more different diagnoses. One possible example: Suspiciousness about the motivation of others characterizes both paranoid personality disorder and avoidant personality disorder. Diff: 1 Type: ES Page Ref: 284-285 Skill: Conceptual 75) Create 4 brief personality profiles (no more than a 3 or 4 sentences each), each of a prototypical person with a different personality disorder. Be sure to include the central features of each disorder. Answer: No standard answer; must include central features (such as suspiciousness for paranoid personality disorder, etc.). Diff: 2 Type: ES Page Ref: 288-300 Skill: Factual 76) Briefly describe the three most common general approaches to the treatment of personality disorders discussed in the text. Answer: The three general approaches to the treatment of personality disorders are object-relations therapy, cognitive-behavioural approaches, and psychopharmacological. Object-relations: Kernberg and Kohut; treatment is aimed at correcting the flaws in the self that have resulted from unfortunate formative experiences; slow process; gradual changes Cognitive-behavioural: 1. Cognitive restructuring (Beck): challenging core beliefs that are thought to underlie the problems 2. Dialectical behaviour therapy (Linehan): targets borderlines; main feature is acceptance by the therapist of the patient's demanding and manipulative behaviours Psychopharmacological: Borderline patients: amitriptyline (an antidepressant), thiothixene (an antipsychotic), and carbamazepine (an anticonvulsant). Antipsychotics may be most effective with borderlines displaying psychotic-like features, while antidepressants may be most effective for those borderline patients who also met the criteria for major depression. Schizotypal-disordered patients: low doses of thiothixene may be beneficial. Also, schizotypals seem to respond to some extent to antidepressants. Antisocial: Medication has been used for short-term management of problematic and threatening behaviour. However, long-term side-effects, lack of symptom alleviation, and noncompliance indicate that this approach has, at best, a modest impact. In combination with other intervention strategies, however, it may prove helpful.
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Diff: 2 Type: ES Skill: Factual
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CHAPTER 13 Sexual and Gender Identity Disorders 1) Which of the following sexual activities was permissible, according to St. Augustine? A) precoital activities B) sexual activity with a same-sex partner C) sex for recreation D) masturbation E) sex for procreation Answer: E Diff: 1 Type: MC Skill: Factual
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2) Tissot, in his 1776 treatise, ascribed a variety of psychological and physical difficulties to A) masturbation. B) premarital sexual intercourse. C) oral-genital sex. D) sexual activity with a same-sex partner. E) anal sex. Answer: A Diff: 1 Type: MC Skill: Factual
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3) During the 19th century, if you were dull, untrustworthy or lazy, doctors would likely treat you by A) prescribing a high fat and a high sugar diet. B) prescribing a diet of bland food. C) placing you in an institution. D) giving you herbs and spices. E) ointments and lotions. Answer: B Diff: 1 Type: MC Skill: Application
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4) Kellogg's cornflakes and graham crackers were developed to treat the ills of A) sexual dysfunctions. B) fears of sexual intercourse. C) Montezuma's revenge. D) excessive sexuality. E) gastrointestinal problems.
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Answer: D Diff: 1 Type: MC Skill: Conceptual
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5) The first medical textbook on sexual aberrations, __________ was published by __________ in 1901. A) Psychopathia Sexualia; Krafft-Ebing B) Sexual Abnormalities; St. Augustine C) The Treatise of Onanism; Tissot D) Teachings of Christianity; Reverend Sylvester Graham E) Human Sexuality; Dr. John Harvey Kellogg Answer: A Diff: 1 Type: MC Skill: Factual
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6) Research on sexuality during the 20th century was greeted with __________ by most people. A) skepticism B) shock C) animosity D) disinterest E) interest Answer: C Diff: 1 Type: MC Skill: Factual/Conceptual
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7) Which of the following sexual behaviours would receive a diagnosis of sexual dysfunction in the DSM-IV-TR? A) a date rapist B) a man who occasionaly likes to participate in a threesome C) a woman experiencing pain during intercourse D) a man who exposed his genitals to women E) a woman who masturbates excessively Answer: C Diff: 2 Type: MC Skill: Factual
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8) The four stages of the sexual response cycle are A) arousal, intercourse, orgasm, release. B) arousal, foreplay, orgasm, relaxation. C) arousal, bodily response, genital response, orgasm. D) neutrality, arousal, climax, anti-climax. E) excitement, plateau, orgasm, resolution. .. 2
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Answer: E Diff: 1 Type: MC Skill: Factual
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9) All of the following events take place during the excitement phase EXCEPT A) swelling of the genital tissues. B) rapid, shallow breathing. C) elevation of the testes. D) muscles tense. E) increased heart rate. Answer: C Diff: 1 Type: MC Skill: Factual/Conceptual
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10) All of the following statements regarding the four stages of the sexual response cycle are true EXCEPT A) the refractory period is the final stage of the sexual response cycle. B) during the plateau phase, arousal becomes more intense. C) in men, orgasm comprises two stages. D) vasocongestion occurs during the excitement phase. E) rhythmic, muscular contractions are experienced during orgasm. Answer: A Diff: 1 Type: MC Skill: Factual/Conceptual
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11) Which statement is true regarding the refractory period? A) After multiple orgasms, women are briefly unresponsive to further sexual stimulation. B) Men experience a sense of orgasmic inevitability, and ejaculation cannot be prevented. C) Following orgasm, the body returns to its prearoused state. D) Men are unresponsive to sexual stimulation for a certain amount of time. E) Men are responsive to further sexual stimulation, if that stimulation quickly after orgasm. Answer: D Diff: 1 Type: MC Skill: Factual
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12) The stages--desire, excitement, orgasm--were proposed as an alternative model by A) Kinsey. B) Kaplan. C) Krafft-Ebing. D) Masters and Johnson. E) Freud. .. 3
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Answer: B Diff: 1 Type: MC Skill: Factual
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13) Which of the following statements is NOT true regarding the prevalence of sexual dysfunctions? A) There is evidence suggesting that the prevalence of sexual dysfunctions is quite high. B) We know a lot about the prevalence of sexual dysfunctions and their incidence. C) Epidemiological studies looking at the prevalence of sexual dysfunctions are fraught with methodological problems. D) Some studies have shown that lack of sexual interest is one of the most common complaints among women. E) Female hypoactive sexual desire dysfunction is the most prevalent. Answer: B Diff: 1 Type: MC Skill: Conceptual
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14) Shari has come to see you at the Sexual Dysfunctions Clinic, because she is feeling very distressed over the fact that she never feels like engaging in sexual activity with her partner. Shari and her partner have had many arguments over this lack of interest, and she decided to see a therapist. In consulting the DSM-IV-TR, you would likely diagnose her with A) sexual aversion disorder. B) hypoactive sexual desire disorder. C) female sexual arousal disorder. D) female orgasm problems. E) dyspareunia. Answer: B Diff: 1 Type: MC Skill: Application
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15) Hypoactive desire disorder is mainly a __________ issue. A) medical B) biological C) psychological D) genetic E) physiological Answer: C Diff: 1 Type: MC Skill: Conceptual
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16) Which of the following statements are false regarding female sexual arousal disorder? A) It may be one of the least understood of all sexual dysfunctions. B) There is a low correlation between subjective arousal and genital response. C) Arousal is measured directly by the lubrication and vasocongestion of the genital area. D) Women with this disorder want to become aroused, but are unable to. E) Underdiagnosis appears common. Answer: C Diff: 2 Type: MC Skill: Factual
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17) DSM-IV-TR classifies the persistent or recurrent inability to reach or sustain an erection until completion of sexual activity as A) failure to ejaculate. B) hypoactive sexual disorder. C) male orgasmic disorder. D) impotence. E) male erectile disorder. Answer: E Diff: 1 Type: MC Skill: Factual
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18) Which statement is NOT true regarding erectile problems in males? A) The incidence of the disorder decreases with increasing age. B) Erectile difficulties are the most common complaint of men seeking help for sexual dysfunctions. C) Erectile problems can result in embarrassment, depression, and even suicidal inclinations. D) Most men will delay coming to a professional. E) The previous term for this problem was impotence. Answer: A Diff: 1 Type: MC Skill: Conceptual
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19) All of the following statements are true regarding orgasmic disorders EXCEPT A) Orgasmic disorders are some of the most commonly reported sexual dysfunctions. B) female orgasmic disorder is much more common than male orgasmic disorder. C) women are more likely to experience orgasm through masturbation than with a partner. D) orgasmic disorder in men and women is also known as anorgasmia. E) DSM-IV requires a delay in or absence of orgasm following normal excitement, causing distress or interpersonal difficulty.
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Answer: D Diff: 1 Type: MC Skill: Factual
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20) The most common sexual complaint of males is A) erectile disorder. B) dyspareunia. C) premature ejaculation. D) hypoactive disorder. E) orgasmic disorder. Answer: C Diff: 1 Type: MC Skill: Conceptual
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21) Which of following categories and disorders are incorrect? A) Sexual Pain Disorders; vaginismus B) Sexual Pain Disorders; dispareunia C) Sexual Desire Disorders; sexual aversion disorder D) Sexual Desire Disorders; hyperactive sexual desire disorder E) Sexual Arousal Disorders; male erectile disorder Answer: D Diff: 1 Type: MC Skill: Conceptual
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22) What conclusions have been made regarding whether male erectile disorder has organic or psychological causes? A) Recent research has shown that around 95% of all cases of erectile disorder have physical causes. B) Most men suffering from erectile disorder can be classified into suffering either physical or psychological problems. C) When erectile disorder has psychogenic causes, nocturnal penile tumescence (NPT) will not be lowered. D) Psychological treatment can be very effective even when physical impairment is evident. E) Erectile dysfunction may be caused be cardiovascular disease. Answer: D Diff: 3 Type: MC Skill: Conceptual
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23) The monitoring of one's own sexual performance and the perceived responses of one's partner is referred to as __________ and is a common factor associated with __________. A) performance anxiety; arousal disorders .. 6
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B) social anxiety; sexual desire disorders C) Demand response; sexual desire disorders D) sexual anxiety; all sexual dysfunctions E) sexual performance; male erectile disorder Answer: A Diff: 2 Type: MC Skill: Factual
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24) Joan has come to a clinic to discuss her inability to reach orgasm. The most likely cause of her disorder is/are A) a medication she is taking for another health problem. B) a personality disorder. C) a medical condition (such as heart problems). D) psychological factors. E) an undiagnosed Axis I mental disorder. Answer: D Diff: 2 Type: MC Skill: Application
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25) Primary and secondary premature ejaculation is distinguished primarily by A) psychological health. B) experience with sexual partners. C) marital status. D) age of the person. E) ejaculatory control. Answer: E Diff: 1 Type: MC Skill: Conceptual
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26) Sensate focus is a procedure where A) sexual education is a major component. B) couples learn to experience sexual enjoyment without ever having intercourse. C) couples learn techniques to communicate effectively with each other, about all issues, not just sexual issues. D) specific instructions for lovemaking are given, starting with pleasuring and then with intercourse. E) couples learn to be comfortable with each other, to pleasure and enjoy each other at first without sexual intercourse. Answer: E Diff: 1 Type: MC Skill: Factual
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27) Fred and his partner are seeking treatment for Fred's premature ejaculation. The therapist suggests that the couple stimulate Fred's penis to nearly full erection and then firmly press the penis to reduce arousal. This process is repeated until Fred can refrain from ejaculating for extended periods. This treatment technique is referred to as A) pain modification. B) sensate focus. C) diversion therapy. D) the “squeeze” technique. E) arousal desensitization. Answer: D Diff: 2 Type: MC Skill: Application
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28) Nadia and Enrique are in a long-term relationship and have had an active sex life, except that Nadia has never been able to achieve orgasm. If she went to seek treatment, it is likely that the therapist would recommend A) yohimbine hydrochloride. B) medical treatment. C) an in depth examination by a gynecologist prior to any treatments. D) hypnotherapy. E) using private masturbatory techniques. Answer: E Diff: 1 Type: MC Skill: Application
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29) The majority of physical treatments to treat sexual dysfunction have been developed to treat A) male erectile dysfunction. B) arousal disorders. C) pain disorders. D) premature ejaculation. E) hypoactive sexual disorder. Answer: A Diff: 1 Type: MC Skill: Factual
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30) Mitka (1998) found that Viagra generated erections in __________ of men with severe erectile problems. A) 2/3 B) 1/2 C) 1/4 D) 3/4 E) 1/3 .. 8
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Answer: A Diff: 1 Type: MC Skill: Factual
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31) The most common physical treatment for sexual dysfunctions has been A) muscle relaxants. B) surgical interventions for sexual pain disorder. C) medications for sexual pain disorder. D) physical implants for erectile disorder. E) medications for erectile disorder. Answer: D Diff: 2 Type: MC Skill: Factual
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32) Gender identity disorder is diagnosed when A) society's conception of the individual is discrepant with that person's biological sex. B) the individual's gender identity is not consistent with his or her sex. C) the individual shows signs of early sexual maturity. D) the individual prefers to wear clothes not consistent with his or her sex. E) the individual shows signs of hermaphroditism. Answer: B Diff: 2 Type: MC Skill: Factual
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33) Tony is a 10 year old boy who prefers to play stereotypical “girls” games such as “house” and “dolls.” Tony does not enjoy playing with boys or playing games such as trucks and guns. Tony's parents became concerned that something was wrong with their son and they brought him in for an evaluation. Tony reported that he does prefer girls as playmates and that he likes “girls '“ games better as well. He knows that he is a boy and has no urge to wear dresses. Tony would likely be diagnosed with A) nothing, since his behaviour does not meet the criteria for a disorder. B) homosexual tendencies. C) gender role confusion. D) gender dysphoria. E) gender identity disorder. Answer: A Diff: 1 Type: MC Skill: Application
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34) John believes that he is actually a female trapped in a man's body. John wears dresses and make-up, has gotten electrolysis to remove his facial hair and insists on being called
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“Joan.” He is sexually attracted to males and has been labelled effeminate since he was young. John would most likely receive a diagnosis of A) gender dysphoria. B) he would not receive a diagnosis because he is really a woman. C) sexual preference disorder. D) homosexual gender dysphoria. E) transsexualism. Answer: D Diff: 2 Type: MC Skill: Application
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35) The group who experiences sexual arousal to cross-dressing is generally A) men with gender identity disorders. B) those who report being effeminate as children. C) those who like to dress like the opposite-sex, but are sexually attracted to the samesex. D) individuals with heterosexual gender dysphoria. E) those diagnosed with homosexual gender dysphoria. Answer: D Diff: 2 Type: MC Skill: Factual
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36) The main difference among those with heterosexual as opposed to homosexual gender dysphoria is (other than preferred sexual partner) A) homosexuals are more likely to be aroused by cross-dressing. B) homosexuals with gender dysphoria are more likely to develop an interest in crossdressing. C) other than preferred sexual partners, there are no real differences among the two groups. D) heterosexual males with this disorder usually have surgery to change their physical characteristics. E) heterosexual males with this disorder were usually not labelled “sissies” as children. Answer: E Diff: 1 Type: MC Skill: Factual
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37) Research supports the idea that gender identity disorders are caused by A) lack of a same-sex parent model and overprotection by the opposite-sex parent. B) the child's failure to separate from the parent of the opposite sex. C) hormonal disturbances or exposure to chemicals during fetal development. D) a gender identification gene found in twin studies of the disorder. E) there is actually little support for any theory of the origin of gender identity disorder.
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Answer: E Diff: 1 Type: MC Skill: Factual
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38) Treatment of gender identity disorders generally involves __________ and results in __________. A) hormonal therapy; decrease in the desired secondary sex characteristics B) surgery; many problems and dissatisfaction C) cognitive-behaviour therapy; poor outcomes. D) psychological therapy; change in gender conceptualization among children E) sexual reassignment; happiness with the results Answer: E Diff: 1 Type: MC Skill: Factual/Conceptual
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39) The paraphilias listed in DSM-IV include all of the following EXCEPT A) sexual sadism. B) fetishism. C) voyeurism. D) pedophilia. E) homosexuality. Answer: E Diff: 1 Type: MC Skill: Factual
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40) A homosexual in the early 1970s who was conflicted about this sexual preference would have been diagnosed with A) homosexual gender dysphoria. B) gender dysphoria. C) heterosexual gender dysphoira. D) egodystonic homosexuality. E) gender identity disorder. Answer: D Diff: 1 Type: MC Skill: Factual
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41) In future editions of the DSM, we may see a new diagnostic category involving A) excessive sexual drive. B) low sex drive. C) fear of masturbation. D) non-conflicted homosexuality. E) conflicted homosexuality.
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Answer: A Diff: 1 Type: MC Skill: Factual
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42) For the past several years, Jeremy has felt the need to run feathers over his partners body in order to become sexually aroused. Jeremy would likely receive a DSM-IV diagnosis of A) gender identity disorder. B) fetishism. C) partialism. D) sexual sadism. E) frotteurism. Answer: B Diff: 1 Type: MC Skill: Application
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43) Which of the following statements is true regarding fetishes? A) Only specific objects such as items of clothing or body parts can become fetishes. B) It is known that only men develop fetishes. C) Fetishes are unconscious elements from unconscious fantasies. D) Generally, many fetishists are otherwise quite normal. E) Fetishes are often the result of an abnormal childhood sexual experience. Answer: D Diff: 2 Type: MC Skill: Conceptual
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44) Paul finds it necessary to wear his wife's underwear in order to become sexually aroused. Paul would be given a diagnosis of A) transsexualism. B) frotteurism. C) partialism. D) gender identity disorder. E) transvestic fetishism. Answer: E Diff: 1 Type: MC Skill: Application
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45) Transvestic fetishism is frequently related to A) egodystonic homosexuality. B) transsexualism. C) sadomasochism. D) homosexual gender dysphoria. E) heterosexual gender dysphoria. .. 12
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Answer: E Diff: 3 Type: MC Skill: Application
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46) Sexual arousal as a result of inflicting pain or humiliation on others is considered __________, while arousal due to one's own pain is __________. A) sadomasochism; fetishism B) sexual masochism; sexual sadism C) sexual sadism; sexual masochism D) a sexual offense; sadomasochism E) voyeurism; exhibitionism Answer: C Diff: 1 Type: MC Skill: Factual
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47) Joe and Beth have been married for over 10 years and have a satisfying marriage. Beth finds it very arousing and pleasurable to tie Joe up, dress in a leather outfit with spikes, and verbally degrade him. Joe is required to behave submissively during these acts. Both partners find this behaviour sexually enjoyable. Beth's sexual behaviour is best described as A) sexual sadism. B) voyeurism. C) klismaphilia. D) fetishism. E) sexual masochism. Answer: A Diff: 2 Type: MC Skill: Application
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48) Autoerotic asphyxia is seen in sexual ___________. A) sadism B) masochism C) addiction D) fetishism E) transvestism Answer: B Diff: 1 Type: MC Skill: Conceptual
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49) Which of the following is NOT a form of paraphilia? A) zoophilia B) erotophilia .. 13
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C) obscene phone calls D) bestiality E) klismaphilia Answer: B Diff: 1 Type: MC Skill: Factual
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50) The sexual offense with the highest recidivism rate is A) voyeurism. B) exhibitionism. C) child molestation. D) frotteurism. E) fetishism. Answer: B Diff: 1 Type: MC Skill: Factual
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51) Which of the following statements regarding exhibitionists is true? A) There are no reports of exhibitionists ever committing rape. B) It is rare that exhibitionists will commit other sexual offenses. C) A substantial number of exhibitionists go on to more serious offences. D) Most exhibitionists suffer marital problems, usually involving sexual issues. E) Exhibitionism is a relatively rare phenomenon. Answer: C Diff: 2 Type: MC Skill: Conceptual
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52) All of the following statements about voyeurs are true EXCEPT A) voyeurs are frequently referred to as “peeping toms.” B) most voyeurs will eventually begin to commit more serious sexual offenses such as sexual assault. C) about half of voyeurs recognized their interest in voyeurism before the age of 15. D) many voyeurs also engage in exhibitionism. E) voyeurs find it sexually exciting to watch other people undress or engage in sexual activity. Answer: B Diff: 2 Type: MC Skill: Conceptual
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53) An individual committing this offense will become sexually aroused by touching or rubbing up against an unsuspecting person. This activity is A) pedophilia. .. 14
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B) voyeurism. C) sensationism. D) partialism. E) frotteurism. Answer: E Diff: 1 Type: MC Skill: Factual
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54) Pedophilia is diagnosed when the person is at least _____ years old and at least ____ years older than the victim. A) 10; 5 B) 15; 2 C) 25; 5 D) 16; 5 E) 20; 10 Answer: D Diff: 3 Type: MC Skill: Factual
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55) The distinction between a child molester and a pedophile is mostly a matter of: A) preference for sexual behaviour with a child. B) the age of the victims. C) the age of the offender. D) the presence of a mental disorder. E) there is no difference between a child molester and a pedophile. Answer: A Diff: 1 Type: MC Skill: Factual/Conceptual
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56) The diagnosis of ________ has shown poor reliability and validity. A) sexual offender B) child molester C) voyeurism D) frotteurism E) pedophilia Answer: E Diff: 1 Type: MC Skill: Application
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57) The ambiguous nature of the terms recurrent and ________ has possibly contributed to the reduced reliability of diagnosing pedophilia. A) duration .. 15
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B) excitement C) intense D) pleasure E) arousal Answer: C Diff: 2 Type: MC Skill: Factual
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58) The DSM-IV-TR lists ________ other disorders that constitute illegal acts under paraphilias not otherwise specificed. A) 2 B) 3 C) 5 D) 10 E) 13 Answer: B Diff: 2 Type: MC Skill: Conceptual
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59) Which of the following statements concerning rape is true? A) Most rapists demonstrate deviant sexual arousal. B) Strangers constitute a very small percentage of rapists. C) Spouses constitute the highest percentage of rapists. D) A rapist, regardless of the presence of sadism or personality disorder, can be given a DSM-IV-TR diagnosis. E) Strangers constitute the highest percentage of rapists. Answer: B Diff: 2 Type: MC Skill: Conceptual
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60) Which of the following statements is true about rapists? A) Almost all rapists show some evidence of sadism. B) Most rapists are suffering from a DSM-IV-TR disorder at the time of the offense. C) Sadistic rapists are the only rapists who show greater arousal to sexual assault on a woman than to consenting sex. D) Serial sexual murderers are more common than was realized. E) Almost all rapists also suffer from a personality disorder. Answer: C Diff: 2 Type: MC Skill: Conceptual
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61) The technology used to measure men's erectile responses to different types of stimuli is A) phallometry. B) the squeezing technique. C) pornography. D) sensate focus. E) penile arousal assessments. Answer: A Diff: 1 Type: MC Skill: Factual
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62) Canadian studies of phallometric assessments comparing sexual offenders to normal males have found A) rapists clearly show greater sexual arousal to scenes depicting forceful sexual assault than consenting sexual assault. B) most sexual offenders show more arousal to deviant stimuli than normal males. C) only nonfamilial child molesters show greater sexual arousal to children than to adults. D) almost all nonfamilial child molesters appear deviant. E) child molesters in general show greater sexual arousal towards children. Answer: C Diff: 2 Type: MC Skill: Factual
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63) As a behaviourist, you would likely view sexual offending as originating from A) relationship problems. B) conditioning of deviant sexual practices. C) early childhood separation difficulties. D) genetic dysfunctions. E) unconscious conflicts. Answer: B Diff: 1 Type: MC Skill: Conceptual
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64) Freund's courtship disorder theory of sexual offending suggests that A) sexual offenses are very rare occurrences. B) fixation at any one of the stages produces sexual offending. C) humans become aggressive sexually because they are similar to animals. D) child molestation results from disastrous adult relationships. E) there are two phases in human sexual interactions. Answer: B Diff: 2 Type: MC Skill: Conceptual .. 17
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65) A person who sees sexual offenses as developing because of society's differential view of men and women would likely support A) clinical theories of sexual offending. B) conditioning theories of sexual offending. C) social psychological theories of sexual offending. D) theoretical frameworks of offending behaviour. E) feminist theories of sexual offending. Answer: E Diff: 1 Type: MC Skill: Conceptual
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66) An extremely important aspect of the feminist theory of rape is the fact that A) the main function of rape is to humiliate and possess power over the victim. B) rapists do not know how to express their needs for intimacy. C) rape is a means of sexually controlling women. D) rape in an expression of anger toward the self. E) rape has increased over time because women are becoming more dominant in society. Answer: A Diff: 2 Type: MC Skill: Conceptual
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67) Sanday's studies of patriarchal societies and rates of rape showed that A) men were more likely to say they would rape a women, but less likely to actually do it. B) rates of rape are actually higher in matriarchal societies. C) rape was relatively rare in most tribal societies. D) surprisingly, rates of rape were not as high in societies where men were already dominant. E) rates of rape were much higher in patriarchal societies where women were seen as the property of men. Answer: E Diff: 1 Type: MC Skill: Factual
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68) Marshall and colleagues' comprehensive theory of sexual offending integrates which group of variables? A) childhood experience, sociocultural factors, transitory states B) personality disorder, Axis I disorder, sociocultural factors C) sociocultural factors, conditioning, pornography D) childhood experiences, phallometric scores, personality variables E) sexual aggression, negative sexual experiences, substance abuse
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Answer: A Diff: 2 Type: MC Skill: Factual
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69) Anger, depression, intoxication, and boredom are __________ that precede the offense, but only males who are __________ will respond by sexually offending. A) permanent states; genetically predisposed B) transitory states; vulnerable C) factors; deviantly aroused D) primary markers; affected E) phases; powerless Answer: B Diff: 2 Type: MC Skill: Factual
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70) A sexual offender being treated during the early 1960s would likely undergo A) chemical castration. B) segregation. C) castration. D) pairing with an aversive stimulus. E) psychoanalytic psychotherapy. Answer: D Diff: 1 Type: MC Skill: Application
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71) More recent comprehensive programs designed to treat sexual offenders involve components such as A) overcoming the tendency to deny or minimize their offending. B) eliminating the sex drive completely. C) techniques for self-hypnotic control of their urges. D) recognizing the unconscious roots of their problems. E) engaging the offenders' family in treatment. Answer: A Diff: 1 Type: MC Skill: Conceptual
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72) What did Marshall and Barbaree (1988) find in their study of the effects of their community-based program? A) Treated offenders tend to reoffend far less than untreated offenders. B) Despite the benefits of treatment, there is little saving, in terms of financial costs, to society. C) Phallometric assessment scores tend to be less deviant after treatment.
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D) Community-based programs are more successful than prison-based programs. E) Changing sexual offenders deviant sexual behaviours is very difficult to do. Answer: A Diff: 2 Type: MC Skill: Factual
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73) Any sexual activity not performed solely for procreation was once considered abnormal. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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74) Vasocongestion refers to the swelling of the genital tissues during sexual excitement. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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75) The sexual response patterns of both males and females are highly variable and depend on many factors. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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76) Sexual dysfunctions are classified according to which of the three phases (desire, arousal, or orgasm) is affected. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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77) Dyspareunia is a disorder in which the muscles of the vagina contract, causing intense pain at attempted intercourse. A) True B) False .. 20
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Answer: B Diff: 1 Type: TF Skill: Factual
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78) Systematic research has shown that vaginismus is likely caused by a conditioned fear of intercourse. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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79) Success rates for the treatment of vaginismus and premature ejaculation have been as high as 80% and 90%, respectively. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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80) Papaverine rapidly increases heart rate and blood pressure, thus increasing blood flow to the penis, resulting in erection amongst men with erectile disorder. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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81) Feelings of discomfort associated with one's biological sex is referred to as gender identity disorder. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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82) Partialisms are fetishisms with particular items of clothing. A) True B) False
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Answer: B Diff: 2 Type: TF Skill: Factual
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83) Self-induced oxygen deprivation used to achieve orgasm is also referred to as hypoxyphilia or asphyxiophilia. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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84) Voyeurism is the most frequently occurring sexual offense in Western countries. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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85) Frotteurism can be considered a form of sexual aggression belonging to the same category as rape. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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86) The DSM-IV-TR lists four specific paraphilias involving sexual desires that, if enacted, constitute a criminal offence. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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87) Not all child molesters are pedophiles, and some pedophiles may not have committed a sexual offence against a child. A) True B) False
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Answer: A Diff: 1 Type: TF Skill: Factual
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88) Rape, as a criminal offense, was replaced in Canadian law by three crimes of sexual assault, defined by different degrees of forcefulness. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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89) A conservative estimate of the frequency of rape in Canada is that over 75,000 women are raped in Canada every year (around 1 every 7 minutes). A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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90) The idea that conditioning is the basis of acquired preferences motivating men to engage in deviant or unusual sexual practices has received strong empirical support. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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91) According to feminist theories of sexual offending, the sexual aspect of the crime is given more consideration than the power aspect. A) True B) False Answer: B Diff: 1 Type: TF Skill: Conceptual
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92) A vulnerable man may be influenced by media portrayals, such that he may be more likely to offend. A) True B) False Answer: A .. 23
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Diff: 1 Type: TF Skill: Factual
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93) Cost benefit evaluations of sexual offender treatment programs show an approximate savings of $4500, compared to no treatment. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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94) Discuss the historical view of sexual behaviour. In your answer, discuss the beliefs regarding appropriate/inappropriate sexual activity, as described by both religious and scientific belief. Answer: Beliefs about appropriate and deviant sexual behaviour, although very different in today's society than in the past, have been very much influenced by the historical beliefs inherent in religion and science. Judaeo-Christian beliefs, as espoused by the Bible and the Talmud, have been challenged in our society. Christian values developed from the teachings of St. Augustine, who declared that the only acceptable sexual activity was sexual intercourse between a male and a female, for the purposes of procreation. Oral-genital sex, masturbation, anal sex, and sexual activity between same-sex partners were considered sinful. Science in the 16th and 17th centuries attributed all forms of illness to “excessive” sexual activity. Treatises were written by Tissot, Reverend Sylvester Graham, and Dr. John Harvey Kellogg in the 19th century surrounding the ills caused by masturbation. These problems, such as dullness, defective development, ill health and untrustworthiness could be cured with healthy activities and a bland diet. Graham crackers and cornflakes were developed for this purpose. Even today, research on sexuality and sexual problems is much slower than other areas, and many in society would like to ignore the importance of these issues. Diff: 1 Type: ES Page Ref: 306 Skill: Factual 95) Describe the four stages of the sexual response cycle as described by Masters and Johnson. Answer: William Masters and Virginia Johnson were the first to investigate the physiological changes occurring in the normal human sexual response, labeling these events the sexual response cycle. They divided the sexual response cycle into four stages: excitement, plateau, orgasm, and resolution. During the excitement phase, the genital tissues of both males and females fill with blood and swell (vasocongestion). The penis becomes erect and the vaginal area becomes lubricated, the muscles become tense, and the nipples and testes become engorged. Heart rate also increases and breathing becomes more rapid and shallow. During the plateau phase arousal reaches its maximum, with .. 24
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additional swelling of the genital tissues. During orgasm, both sexes experience rhythmic, muscular contractions at about eight-second intervals. Ejaculation occurs with men, and contractions of the uterus and the pelvic muscles surrounding the vagina occurs in women. Blood pressure and heart rate reach a peak during orgasm. Resolution refers to the return of the body to its prearoused state. Shortly after ejaculation, men experience a refractory period, during which they are unresponsive to sexual stimulation, however, women are not subject to this stage and can experience multiple orgasms. Diff: 2 Type: ES Page Ref: 308-309 Skill: Factual 96) Describe the problems evident in diagnosing sexual disorders. Answer: Many issues exist which create problems for diagnosticians evaluating sexual disorders. For one, it is often very difficult to determine what is normal as opposed to what is abnormal. Frequency of behaviour may not be the most important variable in determining whether behaviour is abnormal, since individuals may seek help and be diagnosed even if the majority of the population suffered from the disorder. Reliable diagnoses of satisfaction with present functioning are difficult to obtain, since deciding whether behaviour is persistent, delayed, minimal, or deficient are subjective judgments. In order for a sexual disorder to be diagnosed, DSM-IV requires distress to be experienced. This criterion is problematic because many paraphilias cause distress to the victim but not the person him/herself. Many clinicians ignore this criterion and diagnose the individual regardless of whether he himself is distressed or not. Interestingly, most men who are believed by society to be aberrant are not mentally disordered according to the DSM-IV. Most men who rape women or molest children are not mentally disordered, nor would they meet the criteria for sexual sadism or pedophilia, respectively. Despite this, research has shown that most men who sexually offend do differ from other people in many ways, and treatment should be undertaken. Diff: 2 Type: ES Page Ref: 307 Skill: Conceptual 97) Describe the DSM-IV-TR category of sexual pain disorders. Answer: The DSM-IV-TR category of sexual pain disorders consists of two disorders, dyspareunia and vaginismus. Dyspareunia is characterized by genital pain associated with intercourse. This disorder rarely occurs among men, and when it does it tends to be associated with infections, inflammation, or physical anomalies. To receive a DSM-IVTR diagnosis, dyspareunia must cause marked distress or interpersonal difficulty and not result solely from lack of lubrication or vaginismus. Vaginismus is the persistent involuntary contraction of the muscles in the outer third of the vagina upon attempts at penetration. These muscle contractions prevent insertion of the penis, and generally of tampons or any other object into the vagina.Vaginismus can become so severe that even the thought of vaginal entry may trigger the muscle contractions. Although this disorder may be the result of some painful trauma, it is generally lifelong. Diff: 1 Type: ES Page Ref: 312-313 Skill: Factual .. 25
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98) What appears to be the cause behind male erectile disorder? Use research by Marshall et al., and Abrahamson et al, to support your answer. Answer: The major question surrounding the etiology of male erectile disorder is whether the disorder has an organic or psychological basis. It was previously believed that 95% of all cases of erectile disorder had psychological causes, but recently, it has been estimated that between one-third and two-thirds of all cases have some organic basis. Phallometric testing, using nocturnal penile tumescence (NPT), measures nighttime erections. The idea is that the psychological stresses preventing effective erectile functioning will not be at play during sleep. Various drugs and diseases such as diabetes and vascular disorders may increase the likelihood of erectile problems developing. Marshall, Surridge and Delva (1981) categorized their clients with erectile disorders into three groups. Due to recent surgery or diseases, the first group was classified as having an organic basis to their problem. The psychogenic group reported chronic marital difficulties, depression, and anxiety about their sexual performance, and the third group had mixed organic and psychological signs. NPT was able to correctly classify 9 out of 10 in the organic group and 7 out of 10 in the psychogenic group. Abrahamson and his colleagues examined the idea that performance anxiety resulted in erectile problems in men. This study involved both men with and without erectile dysfunctions. The men were required to watch an erotic film under three conditions: a demand condition where they were required to monitor their responses, a neutral distraction, where they had to estimate the length of a line on the TV screen, and a nodistraction condition. The dysfunctional men showed a significantly lower erectile response when required to monitor their performance than in either of the other conditions, while the demand condition increased the erectile response in normal men. The evidence seems to support the idea that depending on the circumstances, erectile dysfunction can be the result of organic or psychological causes, or an interplay of the two. Diff: 2 Type: ES Page Ref: 314 Skill: Conceptual 99) Describe the psychological treatments used to treat sexual dysfunctions and conclude with how effective these treatments are. Answer: The first treatment approach was that of Masters and Johnson, who described a comprehensive, intensive approach to treatment where both partners stayed at the clinic for two weeks. Most modern treatment programs retain some aspects of Masters and Johnson's program, and typically involve both partners in treatment. The majority of programs begin with an extensive assessment of both partner's sexual history and functioning, followed by sexual education, where information is provided and myths are challenged. Techniques aimed at improving communication are presented, regarding both sexual and non-sexual issues. Generally, clients will be told to privately explore their own bodies and learn what they find pleasurable and arousing. Sensate focus is the final component of most programs. It is a form of desensitization applied to sexual fears. This procedure consists of various steps, so the couple can learn to enjoy their sexual .. 26
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interactions. At first, no attempt is made at intercourse, and couples begin slowly, first just removing each others clothing, then touching each others bodies, next, touching genitals and breasts, and finally, attempting sexual intercourse. The idea behind this process is that couples will become comfortable telling each other what is pleasurable and the anxiety about performance will decrease. Diff: 1 Type: ES Page Ref: 316-317 Skill: Factual 100) List the various paraphilias and describe two of them. Answer: Paraphilias are described by the DSM-IV-TR as unusual sexual interests. They are characterized by recurrent, intense, sexually arousing fantasies, sexual urges, or behaviours involving: non-human objects, the suffering or humiliation of oneself or one's partner, or children or other non-consenting individuals. The paraphilias listed in the DSM-IV-TR include exhibitionism, frotteurism, pedophilia, sexual masochism, sexual sadism, transvestic fetishism, voyeurism (A brief description is found in Table 13.5 on page 320). Other more unusual paraphilias include bestiality, necrophilia, urophilia, klismaphilia, and telephone scatologia. Example of two paraphilias: Sexual sadists are people who derive pleasure from inflicting pain or humiliating other people. Masochists enjoy being the recipient of the pain or humiliation. Generally, elaborate rituals and various equipment are involved in sadistic or masochistic behaviours, such as whips, handcuffs, or other forms of bondage. A particularly dangerous activity under sexual masochism is hypoxyphilia, when the individual undergoes oxygen deprivation while engaging in sexual activity. This activity often results in accidental death. Diff: 2 Type: ES Page Ref: 323 Skill: Factual 101) Briefly describe the comprehensive theories of sexual offending and how these theories contribute to effective treatment. Answer: Comprehensive theories, such as that proposed by Marshall and his colleagues, integrate a broad range of evidence to explain the occurrence of sexual offending. Problems generally begin with disturbed childhood backgrounds. Childhood factors such as inadequate bonds with parents result in a vulnerability and social inadequacy. However, other factors are influential in whether an individual will commit a sexual offense. Sociocultural factors such as acceptance of violence, and the media's portrayal of women, and transitory states, such as intoxication, boredom, anger, and depression may precede offending. These comprehensive theories set the stage for comprehensive programs for the treatment of sexual offenders. These programs attempt to overcome the tendency of sexual offenders' to minimize or deny their offense. Social and relationship skills are focused on, problems with self-esteem, empathy, anger, substance-abuse, and problems in coping are dealt with. Offenders are taught to recognize their areas of risk, and ways to deal with their problems so that they will not reoffend.
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Diff: 2 Type: ES Skill: Factual/Conceptual
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102) Compare and contrast homosexual gender dysphoria with heterosexual gender dysphoria. Answer: Gender identity disorder occurs when an individual experiences a strong and persistent cross-gender identification and persistent discomfort with his or her biological sex (gender dysphoria). Some individuals with GID are attracted to members of the opposite sex (heterosexual gender dysphorics) and others are attracted to members of the same sex (homosexual gender dysphorics). Homosexual gender dysphorics are men who believe they are women, and are attracted to men (or, women who believe they are men and area attracted to women). They do not find cross-dressing sexually arousing, but cross-dress because they really see themselves as women. Many of these men were effeminate as children, and some undergo surgery to change their physical sexual characteristics. Heterosexual gender dysphoria occurs among those who are attracted to the opposite sex but still feel an urge to present themselves as the opposite sex. Unlike homosexual gender dysphorics, heterosexual male dysphorics were not typically effeminate as children, and they tend to find cross-dressing sexually arousing (transvestic fetishism). In fact, heterosexual gender dysphoria is typically preceded by transvestic fetishism, with their arousal to cross-dressing lessening in adulthood and middle-age but the desire to crossdress remaining strong. It is believed by some that heterosexual gender dysphoria rarely occurs among women because the fetishistic cross-dressing is rarely present. Diff: 1 Type: ES Page Ref: 320 Skill: Factual 103) Describe how Freund’s (1990) courtship disorder theory might explain sexual offending. Answer: As with animal courtship, there are four phases in human sexual interactions: 1) looking for and appraising a potential partner; 2) posturing and displaying oneself to the partner; 3) tactile interaction with the partner; and 4) sexual intercourse. Fixation at any one of these stages produces sexual offending: at stage 1, voyeurism; at stage 2, exhibitionism; at stage 3, frotteurisim, and at stage 4, rape. Diff: 2 Type: ES Page Ref: 330 Skill: Factual/Conceptual
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CHAPTER 14 Developmental Disorders 1) In the late nineteenth and early twentieth centuries, the view that mental retardation was inherited was emphasized. At the same time, the __________ movement called for measures such as sterilization and restriction of marriage. A) eugenics B) moral C) sanctity D) purity E) humane Answer: A Diff: 1 Type: MC Skill: Factual
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2) In the twentieth century, new initiatives concerning the developmentally delayed were stimulated by the interest shown by U.S. President __________, who had a sister with a developmental disability. A) John F. Kennedy B) Lyndon B. Johnson C) Jimmy Carter D) Richard Nixon E) George Bush Answer: A Diff: 1 Type: MC Skill: Factual
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3) In North America, the term __________ is used to refer to normal intelligence with specific learning problems (such as reading), while in Britain it refers to mental handicap. A) intellectual disability B) developmental disability C) developmental handicap D) mental retardation E) learning disability Answer: E Diff: 2 Type: MC Skill: Factual
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4) In Canada, the preferred term is __________, whereas in the United States, the term most often used is __________, although the two are often used interchangeably. A) mental retardation; learning disability B) intellectual disability; mental retardation .. 1
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C) mental retardation; developmental handicap D) intellectual disability; learning disability E) mental handicap; developmental disability Answer: B Diff: 2 Type: MC Skill: Conceptual
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5) According to the 1983 American Association on Mental Retardation (AAMR) definition, mental retardation refers to significantly subaverage intellectual functioning accompanied by A) limitations in two or more areas of adaptive behaviour (such as self-care). B) having at least one relative with an IQ below average. C) reading difficulties. D) an Axis I mental disorder. E) having at least one parent with an IQ below average. Answer: A Diff: 1 Type: MC Skill: Factual
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6) The choice of cutoff IQ scores for the diagnosis of mental retardation A) has changed from two standard deviations below the mean to an IQ score of 85. B) has remained at two standard deviations below the mean. C) has changed from two standard deviations below the mean to an IQ score of 60. D) has remained at three standard deviations below the mean. E) has changed from two standard deviations below the mean to an IQ score of 75. Answer: E Diff: 2 Type: MC Skill: Factual
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7) The three domains of adaptive skills used by the AAMR in the definition of mental retardation today are A) conceptual, social, and practical. B) social, intellectual, and conceptual. C) cognitive, social, and emotional. D) behavioural, social, and emotional. E) cognitive, social, and practical. Answer: A Diff: 2 Type: MC Skill: Conceptual
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8) The Adaptive Behaviour Assessment System (ABAS) is particularly useful for assessing the adaptive skills of people aged .. 2
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A) 0-12. B) 7-18. C) 5-89. D) 5-15. E) 18-25. Answer: C Diff: 2 Type: MC Skill: Factual
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9) Approximately __________ percent of developmental disabilities associated with severe intellectual disabilities have genetic causes. A) 5 B) 25 C) 10 D) 45 E) 60 Answer: D Diff: 1 Type: MC Skill: Factual
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10) Though dominant inheritance of mental retardation is very rare, the text mentions two disorders transmitted in this manner. Which of the following is such a disorder? A) phenylketonuria B) Fragile X syndrome C) tuberous sclerosis D) galactosemia E) Tay-Sach's disease Answer: C Diff: 3 Type: MC Skill: Factual
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11) The best known chromosomal abnormality associated with mental retardation is __________; the most common type of this abnormality is __________. A) Fragile X syndrome; trisomy 21 B) Tay-Sachs disease; trisomy 21 C) Down syndrome; trisomy 23 D) Tay-Sachs disease; trisomy 23 E) Down syndrome; trisomy 21 Answer: E Diff: 1 Type: MC Skill: Factual
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12) Prenatal screening for chromosomal abnormalities is possible through __________; this procedure is conducted between the __________ weeks of pregnancy. A) amniocentesis; 8th and 11th B) amniocentesis; 11th and 18th C) ultrasound; 11th and 18th D) ultrasound; 8th and 11th E) amniocentesis; 10th and 12th Answer: B Diff: 2 Type: MC Skill: Factual
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13) Which of the following is NOT true concerning phenylketonuria (PKU)? A) It is now detected through a blood test shortly after birth. B) It is caused by an autosomal recessive gene. C) It is a metabolic disorder. D) It occurs in approximately 1in 100-500 live births in North America. E) It results in an inactive liver enzyme, leading to mental retardation. Answer: D Diff: 1 Type: MC Skill: Conceptual
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14) Which of the following is not a metabolic disorder? A) Tay-Sach's disease B) Gaucher's disease C) Hurler's syndrome D) hyperammonemia E) congenital hypothyroidism Answer: A Diff: 2 Type: MC Skill: Conceptual
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15) Research concerning maternal drinking during pregnancy indicates that A) binge drinking and moderate drinking over a longer period of time are equally damaging. B) moderate drinking over a longer period may be more damaging than binge drinking. C) the effects of binge drinking depend on the type of beverage consumed by the mother. D) neither binge drinking nor moderate drinking over a longer period of time have an effect on the fetus. E) binge drinking may be more damaging than moderate drinking over a longer period. Answer: E Diff: 1 Type: MC Skill: Factual .. 4
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16) __________, a drug prescribed by European physicians in the 1950s and 1960s for nausea, was found to cause limb deficiencies or malformations in infants. A) Dilantin B) Acetaminophen C) Mellaril D) Thalidomide E) Benadryl Answer: D Diff: 1 Type: MC Skill: Factual
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17) In approximately __________% of people diagnosed as having a developmental handicap, no organic cause or brain dysfunction has been identified. A) 75 B) 40 C) 90 D) 25 E) 60 Answer: A Diff: 1 Type: MC Skill: Factual
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18) Fetal alcohol syndrome is found in ______ per1000 live births. A) 1 to 3 B) 5 to 10 C) 10 to 15 D) 20 to 30 E) 40 to 50 Answer: A Diff: 1 Type: MC Skill: Application
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19) Developmental disabilities occur in ________ percent of children with HIV who do not receive appropriate treatment. A) 10-15 B) 20-25 C) 50 D) 65-70 E) 75-90
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Answer: E Diff: 1 Type: MC Skill: Factual
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20) Ames (1992) conducted a longitudinal study of Romanian infants who had spent varying amounts of time in orphanages. Which of the following is NOT one of the findings of this research? A) Approximately three years after adoption over half of the children adopted at an older age were not yet ready for the school grade appropriate to their age. B) The children who had been in the orphanage the longest had the lowest IQs. C) Orphans who entered an infant development program after adoption were found to progress rapidly. D) All of the children at time of adoption were found to be delayed in intelligence. E) Almost 80% of the children at time of adoption were found to be delayed in gross and fine motor skills. Answer: E Diff: 2 Type: MC Skill: Factual
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21) Evaluative reviews of early intervention and prevention programs indicate all of the following EXCEPT: A) Significant improvement in intellectual performance and academic achievement. B) Prevention of behavioural challenges. C) Greater engagement and social competence. D) Lack of preparation for inclusive education and community experience. E) Independence and mastery. Answer: D Diff: 2 Type: MC Skill: Factual
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22) Which of the following is NOT an “essential daily ingredient” for the development of young children as expressed by Ramey and Ramey in their summary of early intervention studies? A) a half hour of appropriate educational television B) encouragement of exploration C) guided rehearsal and extension of new skills D) rich and responsive language environment E) reinforcement of developmental achievements Answer: C Diff: 1 Type: MC Skill: Factual
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23) Which of the following is NOT associated with Down syndrome? A) congenital heart disease B) poor muscle tone C) kidney abnormalities D) congenital cataracts E) gastrointestinal abnormalities Answer: C Diff: 1 Type: MC Skill: Factual
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24) Adults with Down syndrome are at high risk for A) Parkinson-like dementia. B) lung cancer. C) schizophrenia. D) Alzheimer-type dementia. E) Huntington's disease. Answer: D Diff: 1 Type: MC Skill: Factual
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25) __________ is/are the most common hereditary cause of mental retardation. A) Fragile X syndrome B) Phenylketonuria C) Tay-Sachs disease D) Lesch-Nyhan disease E) Down syndrome Answer: A Diff: 3 Type: MC Skill: Factual
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26) Males with __________ show a particular pattern of cognitive functioning: a weakness in sequential processing of information but strengths in simultaneous, holistic processing. A) phenylketonuria B) Tay-Sachs disease C) Fragile X syndrome D) Turner's syndrome E) Down syndrome Answer: C Diff: 1 Type: MC Skill: Factual
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27) The __________ hypothesis, suggested by Amir, states that people will grow more comfortable with people of different ethnic groups as they are exposed to them. A) exposure B) ethnicity-contact C) ethnicity D) contact E) normalization Answer: D Diff: 1 Type: MC Skill: Factual
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28) In recent years, many educational programs for people with developmental disabilities have focused on developing social skills and independent living skills. These programs often use __________ approaches. A) social learning B) operant conditioning C) classical conditioning D) paired-associate conditioning E) modelling Answer: B Diff: 1 Type: MC Skill: Factual
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29) A recent survey of women with mental retardation living in community residences indicated that between __________ percent had been sexually assaulted. A) 75-80 B) 65-70 C) 45-50 D) 85-95 E) 25-30 Answer: A Diff: 2 Type: MC Skill: Factual
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30) A recent Canadian survey of aberrant behaviour among children, adolescents and adults with developmental disabilities found clinically significant aberrant behaviour in roughly __________ percent of children as well as adolescents and adults. A) 100 B) 25 C) 75 D) 50 E) 90
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Answer: D Diff: 2 Type: MC Skill: Factual
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31) Which of the following was NOT a finding of a recent Canadian survey of aberrant behaviour among children, adolescents and adults with developmental disabilities? A) The frequency of problem behaviours did not vary according to sex. B) The frequency of problem behaviours diminished with age. C) One of the most frequently reported behaviours was pica (eating inedible substances). D) Aggression and depression were the most common psychological problems reported in the older group. E) The type and intensity of behaviour varied according to the degree of disability, age, and sex of the child. Answer: A Diff: 2 Type: MC Skill: Factual
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32) Perceiving deviant behaviours to be a function of a developmental disorder is called A) dual diagnosis. B) oversight. C) diagnostic overshadowing. D) diagnostic oversight. E) overshadowing. Answer: C Diff: 1 Type: MC Skill: Factual
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33) The co-occurrence of serious behavioural or psychiatric disorders in people with developmental disabilities has been labelled __________. A) co-diagnosis B) comorbidity C) dual occurrence D) co-prevalence E) dual diagnosis Answer: E Diff: 1 Type: MC Skill: Factual
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34) Estimates of the prevalence rates of dual diagnosis (co-occurrence of behavioural or psychiatric disorders in people with developmental disabilities) range from: A) 10-70%. B) 50-60%. C) 70-80%. .. 9
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D) 5-10%. E) 20-25%. Answer: A Diff: 3 Type: MC Skill: Factual
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35) __________ approaches are generally the intervention of choice for maladaptive behaviours such as aggression and self injury. A) Behavioural B) Cognitive C) Medical D) Psychodynamic E) Existential Answer: A Diff: 1 Type: MC Skill: Factual
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36) Kathy believes that the lives of individuals with disabilities should be as normal as possible. She is working by what has been called the __________ principle, introduced in Scandinavia by Bengt Nirje. A) ordinary B) similarity C) normalization D) regular E) contact Answer: C Diff: 1 Type: MC Skill: Application
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37) The influence of the __________ principle has contributed to the __________ of thousands of people living with disabilities. A) regularity; deinstitutionalization B) regularity; ostracizing C) contact; normalization D) normalization; ostracizing E) normalization; deinstitutionalization Answer: E Diff: 1 Type: MC Skill: Factual
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38) Which of the following is NOT included in the acculturation framework? A) segregation .. 10
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B) assimilation C) integration D) ostracization E) marginalization Answer: D Diff: 2 Type: MC Skill: Factual
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39) The AIMS is an outcome measure designed to measure different levels of __________ of the developmentally disabled. A) assimilation B) marginalization C) normalization D) integration E) segregation Answer: D Diff: 3 Type: MC Skill: Factual
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40) In terms of the AIMS, traditional institutional care could be considered __________ (as discussed in the acculturation framework). A) normalization B) segregation C) assimilation D) integration E) marginalization Answer: B Diff: 2 Type: MC Skill: Factual
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41) For education, volunteer activity, and employment, results of a study using the AIMS Interview found the most frequently occurring category to be A) segregation. B) normalization. C) marginalization. D) integration. E) assimilation. Answer: C Diff: 2 Type: MC Skill: Factual
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42) While issues such as deinstitutionalization were major issues in the 1970s and 1980s, according to the text the focus shifted in the 1990s to A) studying normalization. B) examining mainstreaming. C) reducing marginalization. D) reinstituting institutionalization. E) evaluating quality of life. Answer: E Diff: 3 Type: MC Skill: Factual
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43) Which of the following is NOT a pervasive developmental disorder? A) Child Disintegrative Disorder B) Autism C) Rett Syndrome D) Asperger Disorder E) Down's Syndrome Answer: E Diff: 1 Type: MC Skill: Factual
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44) Autism was first identified as a childhood disorder by A) John Watson. B) Steven Garner. C) Sigmund Freud. D) Aaron Beck E) Leo Kanner. Answer: E Diff: 2 Type: MC Skill: Factual
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45) Autism occurs A) twice as often in females as in males. B) three to four times as often in females as in males. C) twice as often in males as in females. D) only in males. E) three to four times as often in males as in females. Answer: E Diff: 2 Type: MC Skill: Factual
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46) Evidence suggests that an effective predictor of outcome among people with autism is: A) an IQ of 70. B) an IQ above 95. C) the absence of significant psychiatric problems. D) the development of fluent speech by age 5. E) the absence of epilepsy or sensory impairments. Answer: D Diff: 1 Type: MC Skill: Factual
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47) Katie is a baby who stiffens or screams in response to being held by her parents. This behaviour is most likely a sign of which disorder? A) autism B) pervasive developmental disorder C) Tay-Sachs disease D) childhood schizophrenia E) Fragile X syndrome Answer: A Diff: 1 Type: MC Skill: Application
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48) Approximately __________% of autistic children are mute. A) 10 B) 80 C) 40 D) 50 E) 60 Answer: D Diff: 2 Type: MC Skill: Factual
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49) Tim is an autistic child who frequently repeats his mother's phrases, using the same or similar intonation. This behaviour is referred to as A) repetitious verbal mimicking. B) dystonia. C) echolalia. D) imitation. E) pronoun reversal. Answer: C Diff: 1 Type: MC Skill: Application .. 13
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50) Autistic children, rather than referring to themselves as I, often refer to themselves as “he” or “she.” This behaviour is referred to as A) echolalia. B) repetitious verbal mimicking. C) ego dysfunction. D) pronoun reversal. E) dystonia. Answer: D Diff: 1 Type: MC Skill: Factual
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51) A small proportion of autistic people display exceptional behaviour in certain areas, such as mathematics or music. These individuals are referred to as A) savants. B) autists. C) idiots. D) excepts. E) special. Answer: A Diff: 1 Type: MC Skill: Factual
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52) In terms of the diagnosis of autism, higher functioning individuals with higher IQ and fewer symptoms are often categorized as having A) savant disorder. B) Rett's syndrome. C) core autism. D) Asperger disorder. E) Child disintegrative disorder. Answer: D Diff: 1 Type: MC Skill: Factual
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53) The major feature which distinguishes child disintegrative disorder from autism is A) later onset, after several years of normal development. B) total lack of speech comprehension. C) higher adaptive functioning. D) earlier onset, shortly after birth. E) higher IQ.
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Answer: A Diff: 1 Type: MC Skill: Factual
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54) Rett syndrome affects A) males and females equally. B) younger males, but older females. C) adult males and both child and adult females. D) primarily females. E) primarily males. Answer: D Diff: 2 Type: MC Skill: Factual
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55) Rett’s syndrome is distinguishable from autism by which characteristic? A) Speech problems. B) Repetitive hand wringing. C) Lack of social responsiveness. D) Self-injurious behaviour. E) Screaming Answer: B Diff: 1 Type: MC Skill: Factual
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56) Though the etiology of Rett's syndrome is not known, it is thought to be related to A) a hormonal problem. B) an environmental problem. C) a metabolic problem. D) a social problem. E) a genetic problem. Answer: C Diff: 2 Type: MC Skill: Factual
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57) Karen is taking her son David for an assessment concerning a potential diagnosis of autism. They are most likely to be assessed by a A) speech and language specialist. B) psychiatrist. C) multidisciplinary team. D) social worker. E) psychologist.
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Answer: C Diff: 1 Type: MC Skill: Application
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58) The __________ and __________ hypothesis are the two major hypotheses concerning the etiology of autism. A) psychodynamic; psychogenic B) biogenic; environmental C) psychogenic; biological D) social; emotional E) environmental; psychogenic Answer: C Diff: 2 Type: MC Skill: Factual
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59) The __________ hypothesis of autism focused on family characteristics. A) psychodynamic B) biological C) medical D) psychogenic E) social Answer: D Diff: 1 Type: MC Skill: Factual
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60) Which of the following has NOT been found as evidence in favour of a biological theory of autism? A) The brains of people with autism have been found to smaller and lighter. B) About 30% of adolescents with autism have epileptic seizures. C) Abnormal levels of serotonin are found in 30-50% of autistic children. D) Symptoms of autism appear in all cultures. E) A history of prenatal infection and problems during pregnancy are fairly common among mothers of autistic children. Answer: A Diff: 1 Type: MC Skill: Factual
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61) Which of the following drugs was NOT mentioned by the text as having been used in the treatment of autism? A) Resperidone B) Valium C) Naltrexone
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D) haloperidol E) methylphenidate Answer: B Diff: 1 Type: MC Skill: Factual
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62) __________ therapy appears to be very effective in treating many of the problems associated with developmental disabilities and autism. A) Cognitive-Behavioural B) Behaviour C) Interpersonal D) Cognitive E) Psychodynamic Answer: B Diff: 1 Type: MC Skill: Application
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63) Research on facilitated communication (FC) training has shown that the initial success stories of this technique were really based on the A) ouija board effect. B) nocebo effect. C) placebo effect. D) facilitator effect. E) abdication effect. Answer: A Diff: 1 Type: MC Skill: Conceptual
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64) All of the following are examples of learning disorders EXCEPT: A) disorders of written expression B) mathematics disorders C) athletic disorders D) communication disorders E) reading disorders Answer: C Diff: 2 Type: MC Skill: Factual
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65) Shaywitz et al. (2008) have argued that we can identify children who are struggling with reading as early as age: A) 1 or 2 B) 2 or 3 .. 17
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C) 3 or 4 D) 4 or 5 E) 5 or 6 Answer: D Diff: 2 Type: MC Skill: Factual
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66) Mathematical disorder is also known as A) dyscalculia. B) dysalgebra. C) dystonia. D) dyslexia. E) dysgraphia. Answer: A Diff: 1 Type: MC Skill: Factual
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67) The most controversial and least understood of all of the learning disorder subtypes is: A) reading disorder B) autism C) disorder of written expression D) mathematics disorder E) Asperger disorder Answer: C Diff: 1 Type: MC Skill: Factual
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68) Research findings about the etiology of learning disorders are inconclusive, but according to the text it is generally believed that A) psychological causes may be implicated. B) biological causes may be implicated. C) neither biological nor psychological causes are likely to be implicated. D) biological causes may be implicated, but secondary to psychological causes. E) both biological and psychological causes may be implicated. Answer: E Diff: 1 Type: MC Skill: Factual
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69) The Stanford Binet Scale is an assessment of adaptive behaviour. A) True B) False .. 18
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Answer: B Diff: 2 Type: TF Skill: Factual
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70) Inheriting mental retardation through dominant inheritance is common. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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71) In sex-linked inheritance, the abnormal gene is carried on the X chromosome. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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72) Translocation and mosaicism are two other causes of Down syndrome. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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73) People who function intellectually within the mild range of mental retardation are found more frequently within lower socioeconomic groups. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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74) The Dementia Scale for Down Syndrome (DSDS) was developed to detect and rate the severity of dementia among people who are not verbal and who cannot follow test instructions. A) True B) False
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Answer: A Diff: 2 Type: TF Skill: Factual
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75) Until the 1980s, it was common for a person with mental retardation to be diagnosed with a psychiatric disorder. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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76) According to the acculturation framework, assimilation occurs when the minority group participates in the economic, social and cultural life of the dominant society while maintaining its own identity as a unique cultural entity. A) True B) False Answer: B Diff: 1 Type: TF Skill: Conceptual
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77) Clinical research has shown that autism and childhood schizophrenia are very similar in clinical features. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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78) Autistic children often do not seek or enjoy physical contact, such as hugs from their parents. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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79) Children with autism are often very responsive to and become irritated by minor changes in their non-social environment, such as a change in routine or arrangement of furniture. A) True B) False .. 20
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Answer: A Diff: 1 Type: TF Skill: Factual
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80) Generally, Asperger Disorder has been viewed as a mild version of Rett syndrome, associated with higher intellectual functioning. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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81) In the past 30 years, the research focus concerning the etiology of autism has shifted from biological factors to psychogenic factors. A) True B) False Answer: B Diff: 1 Type: TF Skill: Conceptual
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82) In general, biological treatments of autism have not been found to be effective. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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83) The core deficit underlying a reading disorder is an impairment in phonological processing. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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84) Learning disorders in children virtually always improve with age. A) True B) False
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Answer: B Diff: 2 Type: TF Skill: Factual
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85) Dyslexia has not been explained by genetics. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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86) Brain imaging studies of dyslexia fail to show patterns of asymmetry in the language areas of the brain. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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87) The DSM and AAMR definitions of mental retardation both place heavy emphasis on what measure of intelligence? Give one reason why this measure may not accurately reflect people's cognitive abilities? Answer: The DSM and AAMR place heavy emphasis on the use of IQ as a measure of intelligence. This measure may not accurately reflect people's cognitive abilities for two reasons: 1) THE TESTS WERE NOT DEVISED TO TAKE INTO ACCOUNT SENSORY, MOTOR AND LANGUAGE DEFICITS WHICH MAY CONTRIBUTE TO POOR PERFORMANCE AND 2) PEOPLE MAY PERFORM POORLY BECAUSE THEIR LIMITED EXPERIENCE MEANS THAT THE TEST SITUATION IS UNFAMILIAR AND OVERWHELMING. DIFF: 2 Type: ES PAGE REF: 340-341 SKILL: CONCEPTUAL 88) What are the effects of phenylketonuria (PKU)? How is it detected and treated? Answer: PKU is a metabolic disorder which can cause severe mental retardation. It is detected through a blood test shortly after birth. Affected infants are given a lowphenylalanine diet, which is quite effective in preventing mental retardation. Diff: 2 Type: ES Page Ref: 345 Skill: Factual 89) List five of the seven “essential daily ingredients” outlined by Ramey and Ramey (1992) for the development of young children. .. 22
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Answer: Encouragement of exploration; assistance in basic skills, reinforcement of developmental achievements; guided rehearsal and extension of new skills; protection from inappropriate disapproval, teasing or punishment; a rich and responsive language environment; and a supportive and predictable environment in terms of opportunities for learning and patterns of interaction. Diff: 2 Type: ES Page Ref: 347 Skill: Conceptual 90) What is the “contact hypothesis” as suggested by Amir? How has this been related to people with disabilities? Answer: The contact hypothesis states that people will grow more comfortable with people of different ethnic groups if they are exposed to them. This hypothesis has been related to people with disabilities by suggesting that integration should improve the general population's attitude towards people with disabilities. Diff: 1 Type: ES Page Ref: 351 Skill: Conceptual 91) What is the normalization principle? What has it lead to? Answer: The normalization principle was originally introduced in Scandinavia and suggests that the lives of individuals with disabilities should be as normal as possible. This has led to deinstitutionalization (the move from having the disabled live in institutions to them living in the community). Diff: 1 Type: ES Page Ref: 354 Skill: Conceptual 92) What are echolalia and pronoun reversal, and in what disorder are they seen? Answer: Echolalia is a common characteristic of speech seen in children with autism. It involves the child repeating someone else's words or phrases, using the same or similar intonation. It can be immediate (repeating right after someone says something) or delayed. Pronoun reversal is also seen in autistic children, and refers to the fact that such children often refer to themselves as “he” or “she” instead of “I.” Diff: 1 Type: ES Page Ref: 357 Skill: Factual 93) Briefly explain the psychogenic hypothesis concerning the etiology of autism. Is this theory in favour today? Answer: This theory focuses on family characteristics and the child's environment. It was believed that parents of children with autism were obsessive, rigid, and lacking in warmth. There is no empirical evidence that the parental personality characteristics described by the theory occur more frequently in parents of autistic children than in other parents, and as such the theory is not in favour today. .. 23
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Diff: 2 Type: ES Skill: Conceptual
Page Ref: 359
94) What are the three major components found in learning disorders? Answer: 1. A disparity between estimated potential and measures of current academic achievement. 2) An absence of socio-cultural factors or physical problems, such as brain injury, that would explain the learning difficulty. 3) The assumption that underlying learning processes are dysfunctional. Diff: 1 Type: ES Page Ref: 363 Skill: Factual
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CHAPTER 15 Behaviour and Emotional Disorders of Childhood and Adolescence 1) Initial accounts of abnormal child behaviour were attributed to: A) genetic defects B) societal factors C) inadequate parenting D) lack of education E) malnutrition Answer: C Diff: 1 Type: MC Skill: Factual
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2) ___________ provided the first framework for assessing children and adolescents. A) Sigmund Freud B) G. Stanley Hall C) John Watson D) Leo Kanner E) Anna Freud Answer: D Diff: 1 Type: MC Skill: Factual
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3) The prevalence of common child behavioural problems were not documented until the: A) 1970s B) 1950s C) 1960s D) 1940s E) 1930s Answer: C Diff: 1 Type: MC Skill: Factual
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4) The hypothesis that the manifestations and symptoms of childhood- versus adult-onset mood and anxiety disorders are the same: A) is supported by the research to date. B) is not supported by the research to date. C) has not yet been answered by research. D) is impossible to investigate by research. E) has typically not been considered an important issue.
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Answer: A Diff: 1 Type: MC Skill: Factual
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5) Prior to the 1960s, treatments in child psychiatry encompassed mostly family and ________ therapy. A) behavioural B) cognitive C) biogenic D) drug E) psychoanalytic Answer: E Diff: 1 Type: MC Skill: Conceptual
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6) A special issue with regard to assessing and treating children compared to adults is A) children are much more eager to receive treatment. B) children readily recognize when they may be suffering from psychological problems. C) adults are generally easier to treat than children. D) children are better able to understand or explain their problems. E) a child’s problems are typically reported by parents or teachers, and not the child. Answer: E Diff: 1 Type: MC Skill: Factual/Conceptual
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7) Which pair is NOT properly matched? A) mood disorder : internalizing problem B) separation anxiety disorder : externalizing problem C) ADHD : externalizing problem D) conduct disorder : externalizing problem E) reactive attachment disorder : internalizing problem Answer: B Diff: 1 Type: MC Skill: Conceptual
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8) The most common disorders among North American children and youth have been found to be: A) conduct disorder, oppositional defiant disorder, and attention deficit/hyperactivity disorder. B) anxiety disorders, mood disorders, and personality disorders. C) anxiety disorders, conduct disorder, and ADHD. D) strictly consisting of only internalizing problems. E) strictly consisting of only externalizing problems. .. 2
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Answer: C Diff: 2 Type: MC Skill: Factual/Conceptual
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9) The prevalence of having any disorder among children and youth is: A) 1% B) 5% C) 10% D) 15% E) 20% Answer: D Diff: 1 Type: MC Skill: Factual
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10) Children under the age of _______ rarely meet the diagnostic criteria for conduct disorder. A) 8 B) 10 C) 15 D) 12 E) 16 Answer: A Diff: 2 Type: MC Skill: Factual
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11) “Bullycide” has not been formally addressed among the provinces with the exception of: A) British Columbia and Alberta. B) Alberta and Saskatchewan. C) Ontario and Quebec. D) Newfoundland and New Brunswick. E) Manitoba and Ontario. Answer: E Diff: 1 Type: MC Skill: Application
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12) One of the most common psychiatric disorders in childhood and adolescence is: A) depression. B) ADHD. C) conduct disorder. D) anxiety. E) ODD. .. 3
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Answer: B Diff: 2 Type: MC Skill: Factual
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13) What three groups of symptoms are considered important in the diagnostic criteria for ADHD in the DSM-IV-TR? A) inattention, hyperactivity, and impulsivity B) hyperactivity, impulsivity, misbehaviour C) inattention, impulsivity, temper tantrums D) inattention, withdrawal, inappropriate emotion E) inattention, hyperactivity, bullying Answer: A Diff: 1 Type: MC Skill: Factual
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14) Girls are more commonly diagnosed with ______ than are boys. A) ADHD B) ADHD-I C) ADHD-H D) ADHD-HI E) ADHD-II Answer: B Diff: 1 Type: MC Skill: Factual
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15) ADHD-I is especially associated with __________. A) reading disorders B) mathematical achievement C) social difficulties D) restlessness E) conduct problems Answer: B Diff: 2 Type: MC Skill: Factual/Conceptual
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16) Of all the characteristics associated with subtypes ADHD-H and ADHD-HI _____ are most likely to persist into adulthood. A) getting into trouble B) talking to one’s self C) interrupting others D) fidgeting and restlessness E) difficulty playing .. 4
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Answer: D Diff: 1 Type: MC Skill: Factual
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17) ______ percent of children with ADHD have at least one other psychiatric disorder. A) 50 B) 10 C) 25 D) 40 E) 75 Answer: A Diff: 1 Type: MC Skill: Factual
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18) A child diagnosed with ADHD is most likely to be comorbid for ___________ as an adult. A) conduct disorder B) ODD C) substance abuse D) learning disorder E) anxiety disorder Answer: C Diff: 1 Type: MC Skill: Application
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19) The prevalence rate of ADHD in the general population is highest among: A) preschool-aged children. B) infants. C) toddlers. D) children and adolescents. E) adults. Answer: D Diff: 2 Type: MC Skill: Factual
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20) Which of the following developmental trajectories for children with ADHD is NOT true? A) Earlier substance use in adulthood. B) Becoming parents at a later age. C) Higher rates of divorce and separation. D) Lower occupational attainment. E) Four times as many sexually transmitted diseases in adolescence. .. 5
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Answer: B Diff: 3 Type: MC Skill: Conceptual
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21) ADHD was initially referred to as: A) ADD B) ADHD-H C) minimal brain dysfunction D) hyperkinetic syndrome of childhood E) hyperkinetic syndrome of adolescence Answer: C Diff: 2 Type: MC Skill: Factual/Conceptual
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22) The known risk factors for ADHD include all of the following except: A) brain structure and function. B) parenting styles. C) genetics. D) neurotransmitters. E) environmental factors. Answer: B Diff: 2 Type: MC Skill: Factual
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23) Children with ADHD have been found to have reduced brain size of up to _________. A) 1 percent B) 2-4 percent C) 3-8 percent D) 8-10 percent E) 10-15 Answer: C Diff: 2 Type: MC Skill: Factual
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24) MRI studies have shown that ADHD is associated with abnormalities of the ___________. A) prefrontal cortex and basal ganglia B) basal ganglia and hippocampus C) temporal and occipital lobes D) thalamus and prefrontal cortex E) cerebellum and frontal lobes .. 6
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Answer: A Diff: 1 Type: MC Skill: Conceptual
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25) A biological predisposition to ADHD is supported by the fact that the heritability of ADHD may be as high as __________ percent. A) 77 B) 55 C) 10 D) 25 E) 42 Answer: A Diff: 1 Type: MC Skill: Factual
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26) The risk of developing ADHD is increased when a genetic predisposition is combined with: A) low maternal IQ B) maternal drinking C) maternal smoking D) low birth weight E) socioeconomic status Answer: C Diff: 1 Type: MC Skill: Factual
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27) Stimulant medications such as methylphenidate (Ritalin) are often used in the treatment of children with ADHD. These medications A) have not been found to improve any of the symptoms of ADHD. B) are most effective if combined with other forms of treatment. C) require more rigorous research to determine the extent of their benefits. D) increase vigilance, reaction time, short-term memory, and learning of new material. E) are most effective with the more difficult cases. Answer: D Diff: 1 Type: MC Skill: Factual
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28) The most suitable nondrug intervention for children with ADHD appears to be: A) family therapy. B) cognitive-behavioural therapy. C) psychoeducational and school-focused.
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D) individual psychotherapy. E) social skills training. Answer: C Diff: 2 Type: MC Skill: Conceptual
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29) Approximately __________ boys diagnosed with ODD will go on to develop CD. A) 1 in 2 B) 1 in 30 C) 1 in 4 D) 1 in 10 E) 1 in 20 Answer: C Diff: 1 Type: MC Skill: Factual
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30) Jacques, a boy diagnosed with CD, is playing a game of baseball with his classmates during physical education. During the game, Jacques misses the ball when it is thrown to him, and gets hit with it. Jacques would most likely A) get very upset and not play baseball with his classmates anymore. B) run to tell the teacher. C) get really angry for awhile, but get past it later on. D) pick up the ball and throw it back at the kid, hoping to hit him. E) only get really mad if he were hurt. Answer: D Diff: 2 Type: MC Skill: Application
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31) Which statement regarding conduct disorder and comorbidity is NOT true? A) Anxiety disorders and mood disorders are more common in children with CD. B) Between 35 and 40% of children with CD will later be diagnosed with APD. C) Most children first diagnosed with ODD will progress to CD. D) Children who exhibit ADHD are more likely to develop conduct disorder. E) Individuals diagnosed with CD are prone to exhibit ADHD and/or substance abuse problems. Answer: C Diff: 2 Type: MC Skill: Factual
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32) ___________ is likely to lead to future offspring with a high genetic load for conduct problems. A) Comorbidity .. 8
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B) Assortative mating C) Heterotypic continuity D) Gene-Environment interaction E) Homotypic consistency Answer: B Diff: 2 Type: MC Skill: Factual/Conceptual
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33) A diagnosis of antisocial personality disorder requires evidence of conduct disorder before the age of ___. A) 5 B) 7 C) 10 D) 12 E) 15 Answer: E Diff: 1 Type: MC Skill: Factual/Conceptual
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34) Many antisocial parents of children with CD have also been found to have: A) ADHD. B) depression. C) anxiety disorders. D) a substance abuse problem. E) no other known problem. Answer: D Diff: 1 Type: MC Skill: Application
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35) Aggression has been consistently found to be related to: A) overarousal of the autonomic nervous system. B) underarousal of the autonomic nervous system. C) high levels of testosterone. D) low levels of testosterone. E) increased glucose metabolism in the frontal lobe. Answer: B Diff: 2 Type: MC Skill: Conceptual
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36) Julio's mother usually does not ask him where he is going, how he's doing in school, nor does she ever attend his basketball practices. If Julio were to engage in criminal or
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aggressive acts, psychologists would likely cite __________ as a causal factor in the development of his behaviour problems. A) a dysfunctional family environment B) avoidant attachment C) insecure attachment D) difficult temperament E) poor parenting Answer: E Diff: 1 Type: MC Skill: Application
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37) A gene-environment interaction in the development of conduct disorder was shown in a study by Caspi et al. (2002) in which ___ percent of individuals who were severely maltreated in childhood and had low MAOA activity had CD, compared to _____ percent of individuals maltreated in childhood who had high MAOA activity. A) 100; 50 B) 90; 10 C) 80; 40 D) 70; 30 E) 65; 35 Answer: C Diff: 2 Type: MC Skill: Factual
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38) All of the following treatment methods have been tested in controlled trials with children suffering from CD and ODD EXCEPT A) parent management training. B) pharmacological interventions. C) school- and community-based treatments. D) problem-solving skills training. E) Gestalt therapy. Answer: E Diff: 1 Type: MC Skill: Factual
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39) One purpose behind problem-solving skills training is to A) help focus the child's energy on puzzles and games. B) make treatment of the child more effective. C) teach the child to interact better with other children. D) help the child perform better in mathematics. E) help the child perform better on school assignments.
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Answer: C Diff: 1 Type: MC Skill: Conceptual
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40) _______ has been found to be an effective short-term therapy for inpatient aggressive children and adolescents. A) Typical neuroleptics B) Atypical neuroleptics C) Stimulants D) Risperidone E) Lithium Answer: E Diff: 2 Type: MC Skill: Factual
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41) The goal of parent training programs is: A) to address the coercive process that maintains and promotes conduct problems inadvertently. B) to teach parents how to help their children interact more effectively with their peers. C) increase parental monitoring of their children’s whereabouts. D) encourage child compliance with parental rules. E) help parents deal with their children who have become parents. Answer: C Diff: 1 Type: MC Skill: Factual
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42) All of the following regarding the Incredible Years Parent Program are true except: A) A general increase in positive parenting. B) A decrease in harsh discipline. C) Increases in prosocial behaviour. D) Reductions in conduct problems. E) An ineffectiveness when used with teachers. Answer: E Diff: 3 Type: MC Skill: Conceptual
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43) Clinic-based treatments are limited by the fact that: A) children are labelled as mentally ill. B) sometimes the problems are too difficult to treat with only one method. C) it is only available to a minority of children. D) controlled trials have not been conducted to determine their worth. E) children are intimidated by the settings of the clinic.
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Answer: C Diff: 2 Type: MC Skill: Conceptual
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44) According to the Ontario Child Health Study, only ___________ children who suffer from a psychiatric disorder receive services. A) 1 in 6 B) 1 in 3 C) 1 in 8 D) 1 in 10 E) 1 in 15 Answer: A Diff: 1 Type: MC Skill: Application
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45) Cunningham's Community Parent Education Program (COPE) is a large-group, community-based version of __________. A) family therapy B) problem-solving skills training C) functional family therapy D) parent training E) contingency management Answer: D Diff: 2 Type: MC Skill: Factual
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46) The most common fears reported by children and adolescents include all of the following except: A) agoraphobia B) heights C) weather D) animals E) accidents Answer: A Diff: 1 Type: MC Skill: Factual
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47) Which of the following is classified in the DSM-IV as childhood anxiety disorders? A) separation anxiety disorder B) social phobia C) anorexia nervosa D) panic disorder E) obsessive-compulsive disorder .. 12
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Answer: A Diff: 1 Type: MC Skill: Factual
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48) The major criterion of focus for those diagnosing separation anxiety disorder is A) refusal to go to school. B) being away from caregivers. C) nightmares. D) interacting with strangers. E) fear of being alone. Answer: B Diff: 1 Type: MC Skill: Factual
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49) Monah refuses to go to school without her mother staying with her, expresses fears that her mother is going to be in a terrible accident, and cannot sleep unless her mother remains in the room with her. Monah would likely be diagnosed with A) behaviour disorder. B) childhood distress disorder. C) separation anxiety disorder. D) phobic disorder. E) stranger anxiety. Answer: C Diff: 1 Type: MC Skill: Application
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50) Adolescents diagnosed with separation anxiety disorder would most likely display A) concern about a parent. B) sadness and withdrawal. C) nightmares. D) school refusal and headaches or stomach aches. E) excessive distress upon separation from a parent. Answer: D Diff: 2 Type: MC Skill: Factual
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51) Although most children display various fears and anxieties relating to separation from parents, for a clinical diagnosis of SAD to be made, the anxiety must A) begin at a younger age. B) clinically relevant. C) be general in nature.
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D) be more extreme. E) accompanied by aggressive behaviour. Answer: D Diff: 2 Type: MC Skill: Factual
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52) The difference between the behaviours found in SAD and GAD is A) children with ODD do not develop fears. B) children with SAD report having more temper tantrums. C) the distress and uncertainty becomes directed outward to the world around them. D) the behaviours found in SAD develop at an earlier age. E) children with ODD do not typically become aggressive. Answer: C Diff: 2 Type: MC Skill: Factual
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53) Anxiety disorders in children are most often comorbid with which disorder? A) mood B) CD C) ADHD D) childhood schizophrenia E) ODD Answer: A Diff: 1 Type: MC Skill: Factual
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54) _________ affects a significant number of children with anxiety disorders. A) Heterotypic continuity B) Homotypic continuity C) Deliberate self-harm D) Ego syntonia E) Ego dystonia Answer: B Diff: 2 Type: MC Skill: Conceptual
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55) Most children with anxiety disorder have a history of anxious temparement in infancy and early childhood referred to as: A) heterotypic continuity. B) behavioural inhibition. C) emotional inhibition.
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D) insecure attachment. E) homotypic continuity Answer: B Diff: 2 Type: MC Skill: Conceptual
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56) Compared to children who are not behaviourally inhibited, an anxious temperament increases the risk of developing one or more anxiety disorders in later life ______ times. A) 1 to 2 B) 2 to 4 C) 4 to 5 D) 5 to 6 E) 8 to 10 Answer: B Diff: 2 Type: MC Skill: Factual
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57) At 5 years of age, Tyra's parents brought her to a psychologist because she would hide from people at school and refuse to take part in new or different activities. She would best be described as A) developmentally challenged. B) temperamentally bold. C) undercontrolled. D) behaviourally inhibited. E) insecurely attached. Answer: D Diff: 1 Type: MC Skill: Application/Conceptual
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58) Pine’s (2007) model of how anxiety develops in young children proposes that anxiety arises as a result of: A) operant conditioning. B) fear conditioning. C) observational learning. D) cognitive distortions. E) faulty learning. Answer: B Diff: 1 Type: MC Skill: Factual/Conceptual
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59) The Coping Cat program for the treatment of childhood anxiety disorders is based on _______ therapy. .. 15
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A) psycyhodynamic B) behavioural C) family D) drug E) cognitive-behavioural Answer: E Diff: 1 Type: MC Skill: Conceptual
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60) An important component of CBT for the treatment of anxiety in children involves: A) cognitive restructuring of anxiety-arousing thoughts. B) emotion-focused coping. C) learning to live with fear. D) systematic and gradual exposure to anxiety-provoking situations. E) dealing with the consequences of avoidant behaviour. Answer: D Diff: 1 Type: MC Skill: Application
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61) A recent study (Walkup et al. 2008) found that in severe cases of childhood anxiety the best response rates were to a combination of: A) aversion therapy and art therapy. B) CBT and Zoloft. C) zoloft and ECT. D) play therapy and social skills training. E) behaviour therapy and benzodiazepines. Answer: B Diff: 1 Type: MC Skill: Conceptual
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62) One type of pharmacological treatment that shows some promise in the treatment of SAD and GAD is A) Ritalin. B) tricyclic antidepressants. C) selective serotonin reuptake inhibitors. D) antianxiolytics. E) benzodiazepines. Answer: C Diff: 2 Type: MC Skill: Factual
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63) Selective mutism in children is considered by clinicians to be a form of ________. A) specific phobia B) SAD C) social phobia D) GAD E) DSH Answer: C Diff: 2 Type: MC Skill: Factual
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64) Most researchers study child psychopathology within a framework that stipulates that mental disorders have some psychological basis. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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65) Leo Kanner wrote the first text on child psychiatry in 1935. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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66) Early psychoanalytic therapy for child psychiatric problems were influenced by the teachings of Sigmund Freud. A) True B) False Answer: B Diff: 1 Type: TF Skill: Conceptual
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67) Usually parents' and teachers' reports are considered more important in assessing a child's condition than the child's own report. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual/Conceptual
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68) Externalizing problems are also referred to as disorders of overcontrolled behaviour. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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69) The prevalence of mental disorders varies by the sex and age of the child. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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70) ADHD-I is more common in boys than in girls. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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71) The causes of ADHD are relatively well known. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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72) The mainstay of treatment for ADHD is the use of stimulant medication. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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73) Oppositional defiant disorder (ODD) is generally diagnosed by the time children are 5 years old. A) True B) False
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Answer: B Diff: 2 Type: TF Skill: Factual/Conceptual
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74) The DSM-V may include callous-unemotional traits as a criterion for conduct disorder. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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75) Heterotypic continuity suggests that ODD, CD, and APD are different disorders in the same person that appear over time. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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76) Maternal stress and smoking during pregnancy has not been found to be important risk factors for the development of behaviour problems in early childhood. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual/Conceptual
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77) Parent training programs are based on a social learning causal model of conduct problems. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual/Conceptual
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78) Clinic-based treatment for children and youth is preferred over community-based treatment because more individuals are likely to be helped. A) True B) False
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Answer: B Diff: 2 Type: TF Skill: Application/Conceptual
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79) SAD is a common mood disorder diagnosed among young children and adolescents. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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80) GAD was previously termed overanxious disorder of childhood in the DSM-III. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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81) A significant number of children with anxiety disorders also develop obsessivecompulsive disorder. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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82) Suicide is the leading cause of death among Canadian youth aged 10 to 19. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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83) The developmental chronology of childhood disorders suggests that anxiety begins in early childhood, followed by behavioural problems in middle childhood, followed by depressive disorders in late childhood. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual .. 20
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84) The primary aim of treatment for childhood anxiety is reduction of physical symptoms and avoidance behaviour. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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85) Tricyclic antidepressants and benzodiazepines are recommended as the best form of pharmacological treatment for SAD and GAD in children and adolescents. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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86) Describe the three main diagnostic criteria used for Attention-Deficit/Hyperactivity Disorder. Answer: Diagnostic Criteria for ADHD: * Inattention: difficulty sustaining attention in tasks or play activities, failure to finish school-work or chores, easily distracted, difficulty organizing tasks and schoolwork. * Hyperactivity-impulsivity: fidgets with hands or feet, leaves seat in classroom, restlessness, difficulty playing quietly, talks excessively. * Impulsivity: blurts out answers before the question has been completed, difficulty awaiting turn, interrupts others. Diff: 1 Type: ES Page Ref: 374 Skill: Factual 87) Briefly describe four risk factors associated with the development of ADHD. (1) Answer: Brain structure and function: children with ADHD have reduced brain size, abnormalities of the prefrontal cortex and basal ganglia; abnormalities in the metabolism of dopamine and noradrenergic neurotransmitters; and abnormalities in the functioning of genes that regulate those neurotransmitter systems; (2) Genetics: Half of the risk for ADHD in offspring is due to purely genetic factors; heritability may be as high as 77 percent; (3) Prenatal risk factors: Exposure to prenatal toxins including poor diet, mercury and lead exposure, pregnancy and delivery complications, and exposure to alcohol and smoking during pregnancy; (4) Psychosocial risk factors: include low socio-economic status, large family size, paternal criminality, poor maternal mental health, child maltreatment, foster care placement, and family dysfunction. .. 21
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(5) Diff: 2 Type: ES (6) Skill: Factual
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88) Describe the pharmacological treatment of ADHD. Answer: Stimulant medication has been shown to be effective in about 80 percent of children with ADHD symptoms. These medications work by increasing the release of dopamine and norepinephrine from storage sites in nerve terminals and by blocking their reuptake. These drugs include short-acting and long-acting methylphenidate (Ritaline), dextroamphetamine, and amphetamine, which have been shown to increase vigilance, reaction time, short-term memory, and learning of new material, problems relating to impulsivity such as aggressive behaviour, non-compliance, noisiness, and peer relationships. Diff: 2 Type: ES Page Ref: 376-377 Skill: Factual 89) Describe the four major behavioural groupings of conduct disorder by the DSM-IVTR and list some examples of each. Answer: Aggression to people and animals: bullies, threatens, or intimidates others, initiates physical fights, physically cruel to people and/or animals; Destruction of property: fire-setting; Deceitfulness or theft: breaking into houses, lying to obtain goods or favours; Serious violations of rules: chronically truant from school, running away from home. (Other examples are possible). Diff: 2 Type: ES Page Ref: 379 Skill: Factual 90) Explain what is meant by the term heterotypic continuity and the evidence for it. Answer: Most children with conduct disorder had oppositional defiant disorder, and adults with antisocial personality disorder typically show evidence of conduct disorder before age 15. When conduct issues are severe and begin early the trajectory from ODD to CD to APD is robust. This suggests that these three disorders may be part of the same disorders that manifests itself differently as the child gets older. Diff: 2 Type: ES Page Ref: 380 Skill: Factual/Conceptual 91) Discuss the psychosocial risk factors associated with the development of conduct problems. Answer: Studies have consistently demonstrated that poor parenting, including low monitoring, harsh and inconsistent discipline, and child abuse is strongly linked to externalizing difficulties in children and youth. Other correlates include peer rejection, associating with deviant peers, parental psychopathology, lone-parent families, large family size, and teenage parenthood. Children and youth living in poverty are more likely to display conduct problems. .. 22
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Diff: 2 Type: ES Skill: Factual
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92) Evaluate the four different types of treatment generally used for conduct-disordered children. Answer: Four diverse treatment methods have been examined in controlled trials: problem-solving skills training, pharmacological treatment, parent management training, and school and community-based treatments. All of these treatments have shown some promise, although it is very difficult to treat antisocial behaviour, which is very stable and persistent.Problem-solving skills training. Research has shown that CD children are deficient in problem-solving skills and social perception and attributions. These children often misinterpret cues, assuming that others are “out to get them.” Problem-solving skills training combines procedures such as modelling and practice, role playing, and reinforcement contingencies. Pharmacological treatments include the use of mood stabilizers, neuroleptics and stimulants. Lithium has been found to be an effective short-term therapy for inpatient aggressive children and adolescents. Parent training programs focus on developing skills in the parents to reinforce prosocial behaviours in the child while disciplining undesirable behaviours. Interactions between parent and child are considered to maintain and promote conduct problems inadvertently, termed the coercive process. Results show a general increase in positive parenting, decrease in harsh punishment, and reductions in conduct problems. School- and community-based treatments are extremely cost-effective and can be made available to all children. For example, Cunningham's Community Parent Education Program (COPE), is easily accessible to all families, resulting in increased attendance by high-risk families. High-risk children are able to interact with normal peers in a mixed gender setting, and studies have shown behaviour improvements in aggressive children. Diff: 2 Type: ES Page Ref: 382-383 Skill: Factual/Conceptual 93) Describe the diagnostic criteria for separation anxiety disorder (SAD), and the difference between SAD and GAD. Answer: At least three of the following symptoms for a minimum of four weeks: recurrent distress upon separation from a parent; excessive worry about losing a parent; excessive worry that an event will lead to harm to the parentl reluctance to go places without the parent nearby; reluctance to sleep away from the parent; and nightmares about separation or complaints about physical symptoms when separation is anticipated. In GAD, the distress and uncertainty the child feels is directed outward to the world around them. They may be concerned about whether others like them, doing badly at school, storms that may come and damage their home, etc. Diff: 1 Type: ES Page Ref: 385 Skill: Factual
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94) Describe how fear conditioning may result in anxiety disorders in children. Answer: According to Pine (2007) natural threats may become associated (paired or conditioned) with a neutral stimulus that later comes to induce the same fear and avoidance behaviour. People with a genetic predisposition to amygdala dysfunction (or who have behavioural inhibition) would be more prone to to be threatened by such nonnoxious stimuli. Diff: 2 Type: ES Page Ref: 387 Skill: Conceptual 95) Compare and contrast the different types of treatments used for children with anxiety disorders. Answer: Cognitive-behavioural therapy involves education about anxiety and its treatment approach, helping parents and children learn new ways to cope with anxiety (skills building) and systematic and gradual exposure to stressful situation. Children are slowly exposed to the situations they find difficult (such as being away from their parents). Pharmacological treatments include the use of selective serotonin reuptake inhibitors have shown some promise, but more research needs to be conducted to confirm whether these drugs reduce anxiety in children. Tricyclics and benzodiazepines are not recommended for the treatment of anxiety in youth. In severe cases, a combination of CBT and the SSRI Zoloft may be most beneficial. Diff: 2 Type: ES Page Ref: 388 Skill: Factual
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CHAPTER 16 Mental Disorders and Aging 1) In Canada, the age group that will grow the most will be the A) over-65 population. B) over-80 population. C) over-55 population. D) over-35 population. E) over-45 population. Answer: B Diff: 1 Type: MC Skill: Factual
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2) Which of the following provides one reasonable explanation as to why the percentage of older individuals has increased and will likely continue to increase over time? A) higher levels of education B) effective medications that slow the aging process C) more support from younger generations D) substantial drop in new births E) an increase in natural, anti-aging products Answer: A Diff: 1 Type: MC Skill: Conceptual
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3) Veronica has recently learned that her spouse is suffering from cancer. At this time, Veronica would be more __________ to mental difficulties, and may not be able to cope with more problems. A) resigned B) predisposed C) reactive D) resistant E) vulnerable Answer: E Diff: 1 Type: MC Skill: Application
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4) Oftentimes, losses of physical functioning, retirement, or death of loved ones will increase the likelihood that an individual will develop a mental disorder because A) the individual finds it difficult to cope with several losses. B) the individual becomes depressed and disheartened. C) he or she does not go for counseling when it is needed.
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D) these are known risk factors of mental disorders in the aging population. E) he or she lacks support from family and friends. Answer: A Diff: 1 Type: MC Skill: Conceptual
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5) A normal aging process involves A) reminiscing and memory loss. B) decreased functioning of bodily organs. C) some type of pathology. D) an increase in disorders such as Alzheimer's disease. E) development of diseases and poor health. Answer: B Diff: 1 Type: MC Skill: Factual/Conceptual
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6) Why is it important that mental disorders in the elderly be viewed as a cause for concern? A) Mental disorders are more common among the elderly. B) It is far more difficult to diagnose and treat the elderly. C) Older people are more likely to sink into despair. D) Treating mental disorders in the elderly is far more difficult than when they occur in younger people. E) Mental disorders in older people are not normal. Answer: E Diff: 1 Type: MC Skill: Conceptual
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7) Why is it generally believed that older people with mental illnesses do not benefit from treatment? A) Older people are more distrustful of psychologists than are younger people. B) Older people are viewed by many as “set in their ways” and unable to change. C) The types of disorders usually found in older adults are more resistant to treatment. D) Mental illnesses are seen as a normal part of aging. E) Older people tend not to respond to treatment as well as younger people. Answer: B Diff: 2 Type: MC Skill: Factual/Conceptual
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8) Milford retired from his job several years ago, and lately he has been feeling lethargic, unhappy, and useless. He does not want to work in the garden or go fishing with his
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friends. His wife and her friends believe that he is just moody and that everyone will just have to put up with his behaviour. It is likely that A) every older person feels this way after retiring. B) in time, he will likely get past his negative feelings. C) his behaviour reflects a long-standing mental illness that was not apparent until now. D) if he became involved in other activities, his mood would likely improve. E) he is probably suffering from a mood disorder and could benefit from treatment. Answer: E Diff: 1 Type: MC Skill: Application
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9) Historically, the majority of older people with mental disorders were labeled as “eccentric,” and treatment consisted of A) isolation or institutionalization. B) improved diet and fresh air. C) psychoanalysis. D) medications. E) psychosurgery. Answer: A Diff: 1 Type: MC Skill: Factual
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10) Why is it particularly difficult to properly diagnose mental disorders in older adults? A) Side effects of medications may mimic the symptoms of certain disorders. B) Clinicians are largely unfamiliar with the disorders specific to this age group. C) Similar symptoms are indicative of more than one disorder. D) Older adults often are afraid to get help for their problems. E) Older individuals are less able to explain their problems than younger patients. Answer: A Diff: 1 Type: MC Skill: Factual/Conceptual
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11) Older adults are disproportionately underrepresented as users of mental health services for all of the following reasons except: A) Older adults themselves are responsible for not seeking psychological help when they need it. B) Mental health professionals may be less willing or able to treat older adults. C) Psychologists and psychiatrists prefer to work with younger clients. D) Family physicians are less likely to treat older patients and refer them to mental health professionals. E) There is an insufficient number of mental health professionals who specialize in older adults.
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Answer: A Diff: 2 Type: MC Skill: Factual/Conceptual
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12) Large-scale community surveys suggest that A) mental disorders are the most common among older adults. B) men are more likely to have diagnosable health problems across the lifespan. C) there is a linear increase with age in lifetime prevalence rates of combined major disorders. D) except for dementia and sleep disorders, mental disorders are less common among older adults. E) the highest 12-month prevalence of any mental disorder exists among those over 65. Answer: D Diff: 2 Type: MC Skill: Factual/Conceptual
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13) Cross-sectional surveys are limited in that they cannot tell us if the results are due to: A) the paradox of aging. B) normal aging. C) an aging effect. D) a cohort effect. E) client barriers. Answer: D Diff: 1 Type: MC Skill: Factual/Conceptual
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14) The finding that there is a decreasing prevalence of most mental disorders with age should be interpreted cautiously for which of the following reasons? A) Older adults are more likely to remember having symptoms of a disorder. B) Older adults who participate in surveys may reflect a survivor effect. C) Older adults are less likely to express symptoms in somatic ways. D) Older adults are more likely to participate in surveys because they have more time. E) Older adults are more likely to report their symptoms. Answer: B Diff: 2 Type: MC Skill: Factual/Conceptual
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15) The reason that theoretical frameworks of mental disorder have not typically been extended to older adults could be due to the early thinking of _________. A) Freud B) Erikson C) Baltes
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D) Carstensen E) Hayflick Answer: A Diff: 1 Type: MC Skill: Factual
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16) ________ extended psychoanalytic theory by suggesting that there are critical issues for successful functioning across the lifespan. A) Anna Freud B) Sigmund Freud C) Erik Erikson D) Melanie Klein E) Carl Jung Answer: C Diff: 1 Type: MC Skill: Factual/Conceptual
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17) According to the selective optimization with compensation viewpoint, successful aging involves A) practising old skills more so that they are not lost to aging. B) making the most of your skills and substituting areas of strength for areas of weakness. C) focusing on learning new skills, where applicable. D) recognizing that you will begin to slow down as you age. E) continuing to keep activity level high. Answer: B Diff: 2 Type: MC Skill: Factual
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18) In many nursing homes, older individuals play games such as bingo, or get involved in sing-alongs. According to the selective optimization/compensation view, low stress activities such as these are believed to A) keep older people from becoming upset and withdrawn. B) keep older people active. C) ensure that older people with disorders such as Alzheimer's remain active. D) help sharpen memory skills. E) allow older people to socialize. Answer: C Diff: 2 Type: MC Skill: Application
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19) Which of the following findings is consistent with the Socio-emotional Selectivity Theory (SST)? A) Older adults process negative information less deeply than positive information. B) Older adults process positive information less deeply than negative information. C) Older adults tend to focus more on negative information than younger adults. D) Older adults are less likely to respond positively do emotional advertisements. E) Older adults are more future-oriented than are younger adults. Answer: A Diff: 1 Type: MC Skill: Factual/Conceptual
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20) Mood disorders are __________ among older adults than younger adults. A) less common B) more or less common, depending on the type of disorder C) equally prevalent D) more common E) ten times more common Answer: A Diff: 1 Type: MC Skill: Factual
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21) Which of the following statements about suicide and older Canadians is TRUE? A) Older Canadian women were around 6 times more likely to commit suicide than older Canadian men. B) Suicide attempts are more common among young Canadians, but attempts by older Canadians are more successful. C) Older Canadian women were more likely to attempt drug overdose than any other group. D) Older Canadian men were around 3 times more likely to commit suicide than older Canadian women. E) Older Canadians are less likely than younger Canadians to commit suicide. Answer: D Diff: 2 Type: MC Skill: Factual
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22) Who is most likely to commit suicide? A) an unmarried man from Canada B) a widowed elderly man from the U.S. C) a married elderly woman from the U.S. D) a married senior from Canada E) a widowed elderly man from Canada
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Answer: B Diff: 1 Type: MC Skill: Factual
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23) Which pair of factors places an older individual at greatest risk for developing depression? A) low income and poor physical health B) lack of support and poor emotional health C) poor physical and emotional health D) low income and lack of support E) poor physical health and lack of support Answer: E Diff: 1 Type: MC Skill: Factual
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24) Which of the following statements regarding depressive disorders and older adults is TRUE? A) Both major depressive disorder and dysthymic disorder are more prevalent among younger than older adults. B) There is a higher prevalence of depressive disorders among older men. C) There is a higher prevalence of depressive disorders among older women. D) Depressive disorders are easier to treat in older adults. E) Major depressive disorder is one of the less common psychiatric problems among older adults. Answer: A Diff: 2 Type: MC Skill: Factual/Conceptual
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25) What is the main difference in the symptoms of major depressive disorder between younger and older adults? A) Younger adults are more likely to report sleep difficulties. B) Older adults are more likely to report feelings of guilt and sadness. C) Older adults are more likely to report feelings of worthlessness. D) Older adults are more likely to report somatic symptoms. E) Younger adults are more likely to report physical complaints. Answer: D Diff: 3 Type: MC Skill: Factual/Conceptual
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26) One of the major difficulties in determining whether an older adult is suffering from a depressive disorder is A) many people feel that it is normal for older people to be depressed. B) older people don't want to admit that they feel depressed. .. 7
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C) many older people experience higher levels of sadness, but not true depression. D) other medical problems have similar symptoms to depressive disorders. E) depressive disorders are not common among older adults. Answer: D Diff: 2 Type: MC Skill: Factual
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27) Research has shown which of the following treatments to be most effective for older adults suffering from depressive disorders? A) cognitive therapy B) drug therapy C) a wide array of treatments have been shown to be effective D) behavioural therapy E) brief dynamic psychotherapy Answer: C Diff: 1 Type: MC Skill: Factual
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28) Why is drug therapy not necessarily the best choice for older adults who suffer from depressive disorders? A) Drugs have a shorter half-time in older people and are less effective. B) Drug therapy is more effective with younger adults. C) Side effects are tolerated less well in older adults. D) Older adults are less likely to remember to take their medication. E) Older adults do better with psychotherapy. Answer: C Diff: 1 Type: MC Skill: Factual
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29) All of the following statements are true regarding the use of ECT among older adults with depressive disorders EXCEPT A) serious complications such as cardiorespiratory problems may result. B) ECT appears more effective with older than younger adults. C) physicians are generally recommended to consider other treatments. D) it can result in short-term transient memory problems. E) due to the problems, ECT is less likely to be used to treat older adults. Answer: E Diff: 2 Type: MC Skill: Factual
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30) The diagnostic criteria for primary insomnia include all of the following EXCEPT A) The disturbance is not due to the direct physiological effects of a substance or a general medical condition. B) Main complaint is difficulty falling or staying asleep, for at least one month. C) There is significant distress or impairment in some area of functioning. D) Sleep disturbance is frequently accompanied by nightmares which cause nighttime awakening. E) The disturbance does not occur exclusively during the course of another mental disorder. Answer: D Diff: 1 Type: MC Skill: Factual
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31) Sleeping patterns often change in older adults. All of the following are considered changes EXCEPT A) circadian rhythms change. B) changes in the organization of sleep stages. C) less synchronous Stage 2 EEG activity. D) decreases in total sleep time. E) increases in the length of REM periods. Answer: E Diff: 2 Type: MC Skill: Factual
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32) Esther has been having problems falling asleep at night, and when she finally manages to fall asleep, she awakens frequently, for apparently no reason. During the day, she feels extremely tired, depressed, and anxious. If you were Esther's psychologist, what would you suspect to be her problem? A) primary insomnia B) hypersomnia C) somnambulism D) sleep apnea E) nocturnal myoclonus Answer: A Diff: 1 Type: MC Skill: Application
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33) Each of the following factors are believed to cause primary insomnia EXCEPT A) poor sleep environment. B) physical disorders. C) substances. D) comorbidity. E) shift work. .. 9
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Answer: D Diff: 1 Type: MC Skill: Factual
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34) This treatment process involves educating the patient about normal age-related changes in sleeping, and involves techniques such as relaxation training and changing sleep habits. A) brief dynamic therapy B) cognitive-behavioural therapy C) hypnotherapy D) sleep therapy E) remote relaxation transmission Answer: B Diff: 1 Type: MC Skill: Factual/Conceptual
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35) What is an important first step when treating sleep problems such as primary insomnia? A) Determine what stage of sleep is most frequently lost due to the insomnia. B) Determine whether the sleep problems are due to stressful life events before treating them with drugs. C) Ensure that patients are not taking another drug that will contra-indicate the effects of the sedative. D) Determine whether the symptoms are being caused by another drug or disorder. E) Ensure that the sedatives/hypnotics are the proper dosage, especially for older adults. Answer: D Diff: 1 Type: MC Skill: Factual/Conceptual
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36) John's wife Marge has lately been waking up frequently, because her husband continually kicks her throughout the night. John went to his physician, who suspected that John was suffering from A) “The kicks”. B) secondary insomnia. C) poor sleep hygiene. D) primary insomnia. E) nocturnal myoclonus. Answer: E Diff: 1 Type: MC Skill: Application
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37) All of the following statements are true about sleep apnea EXCEPT A) the disorder results in hypoxemia. B) sufferers often have difficulty remembering things. C) sleep apnea is more common in men, especially with age. D) sufferers often fall asleep during meetings, concerts, movies, etc. E) episodes of cessation of breathing occur that last 10 seconds and occur approximately twice per night. Answer: E Diff: 2 Type: MC Skill: Factual
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38) Blockage of the upper airways results in __________ apnea, while __________ apnea is due to impairment of activation in the medullary respiratory centre. A) upper; medullary B) obstructive; central C) upper; central D) obstructive; medullary E) mixed; peripheral Answer: B Diff: 1 Type: MC Skill: Factual
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39) Treatment of sleep apnea often involves all of the following EXCEPT A) learning to avoid sleeping on one's back. B) losing weight. C) avoiding alcohol and hypnotic medication. D) wearing a mask attached to an air compressor while sleeping. E) cognitive-behavioural therapy. Answer: E Diff: 1 Type: MC Skill: Factual
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40) Which of the following problems is common when attempting to diagnose anxiety disorders in older adults? A) Anxiety disorders in older people are often comorbid with substance abuse. B) Older adults often over-report anxiety symptoms. C) Anxiety disorders in older people are often comorbid with personality disorders. D) Most of the scales used to measure symptoms of anxiety have been validated only with younger adults. E) The DSM-IV-TR does not recognize anxiety in older populations.
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Answer: D Diff: 1 Type: MC Skill: Factual
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41) Which of the following statements is TRUE regarding the treatment of anxiety disorders in older adults? A) Psychological methods are usually less effective with older adults. B) Doctors prefer medication despite the side effects. C) A combination of drug and behavioural therapy has been shown to be the most effective. D) Cognitive-behavioural therapy is generally not effective compared to no treatment. E) Pharmacological treatments are effective and have few side effects. Answer: B Diff: 1 Type: MC Skill: Factual/Conceptual
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42) The three most common anxiety disorders among older adults are A) panic disorder, GAD, and social phobia. B) social phobia, obsessive-compulsive disorder, and PTSD. C) specific phobia, panic disorder, and obsessive-compulsive disorder. D) panic disorder, GAD, and PTSD. E) social phobia, specific phobia, and GAD. Answer: E Diff: 1 Type: MC Skill: Factual
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43) An excessive fear of eating out in public or speaking in public is indicative of __________, while fear of a specific object or situation indicates that the individual is suffering __________. A) social phobia; GAD B) specific phobia; social phobia C) specific phobia; GAD D) public anxiety; private anxiety E) social phobia; specific phobia Answer: E Diff: 1 Type: MC Skill: Factual
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44) In contrast to early-onset schizophrenia, late-onset schizophrenia is __________ and mostly affects __________. A) not common; men and women equally B) common; men C) not common; women .. 12
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D) common; women E) not common; men Answer: C Diff: 2 Type: MC Skill: Conceptual
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45) What is the major difference between the symptoms of late and early onset schizophrenia? A) Hallucinations and delusions are more often of a persecutory nature in early-onset cases. B) Hallucinations and delusions are more bizarre in early-onset cases. C) Lack of logical thought is found more often in late-onset schizophrenia. D) Late-onset schizophrenia is more likely to involve disorganized speech and flattened affect. E) Hallucinations and delusions are more bizarre in late-onset cases. Answer: E Diff: 2 Type: MC Skill: Factual
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46) Fred believes that his children are attempting to have him put in an “old-age” home, and he is quite upset. Every time his son and daughter come to visit, Fred tells them that he refuses to go to a home and he knows they are trying to trick him into agreeing. Fred's children are concerned, however, because they have not mentioned a residential home in years. Fred appears to be suffering from A) brief psychotic disorder. B) paranoid schizophrenia. C) late-onset schizophrenia. D) delusional disorder. E) early-onset schizophrenia. Answer: D Diff: 1 Type: MC Skill: Application
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47) The treatment of choice for elderly patients suffering from psychotic disorders is A) neuroleptics. B) psychoanalysis. C) psychological treatment. D) institutionalization. E) psychosurgery. Answer: A Diff: 1 Type: MC Skill: Factual .. 13
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48) Delerium in older patients is often misdiagnosed as A) dementia. B) delusional disorder. C) generalized anxiety disorder. D) late-onset schizophrenia. E) dissociative identity disorder. Answer: A Diff: 1 Type: MC Skill: Factual
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49) The most common mental disorder among older adults is A) dementia. B) delerium. C) anxiety disorder. D) memory loss. E) depression. Answer: A Diff: 1 Type: MC Skill: Factual
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50) Why is dementia no longer referred to as senility or senile dementia? A) Senile dementia affects older people mainly from Asian and European countries. B) The age of political correctness led to a change. C) The deterioration that occurs is no longer believed to be a normal part of the aging process. D) There are many different disorders under the category of dementia. E) Different symptoms were found to be characteristic of both disorders. Answer: C Diff: 2 Type: MC Skill: Conceptual
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51) What is the main difference between pseudo-dementia and dementia? A) Pseudo-dementia has an earlier onset, while dementia develops later. B) Pseudo-dementia involves loss of cognitive functioning, whereas idementia refers to the loss of one's normal personality. C) Pseudo-dementia involves a decrease in the individual's capacity to care for him or herself, while dementia usually does not. D) The loss of cognitive functioning in dementia is reversible. E) The loss of cognitive functioning in pseudo-dementia is generally not degenerative.
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Answer: E Diff: 2 Type: MC Skill: Conceptual
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52) Depression, nutritional deficiency, and other disorders can cause symptoms similar to dementia, such as forgetfulness and difficulty concentrating. These occurrences are also known as A) secondary dementias. B) pseudodementias. C) comorbidity. D) primary dementias. E) senility. Answer: B Diff: 1 Type: MC Skill: Factual
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53) Cortical dementias primarily attack __________, whereas subcortical dementias primarily attack __________. A) the occipital lobes; the frontal lobes B) the cerebellum; the cerebral cortex C) white matter; grey matter D) brainstem areas; the cerebral cortex E) grey matter; white matter Answer: E Diff: 1 Type: MC Skill: Conceptual
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54) __________ interests researchers and clinicians because it is thought to represent a transitional state between normal aging and dementia. A) Impairment of intellect B) Mild cognitive impairment C) Frontotemporal dementia D) Vascular dementia E) Secondary dementia Answer: B Diff: 2 Type: MC Skill: Factual
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55) It is estimated that at least __________ percent of dementias are due exclusively to __________. A) 20; Alzheimer's disease B) 50; vascular insults C) 25; vascular insults .. 15
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D) 50; Alzheimer's disease E) 75; Alzheimer's disease Answer: D Diff: 1 Type: MC Skill: Factual
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56) The diagnostic criteria for MCI include all of the following EXCEPT: A) dementia. B) memory complaints. C) impaired short-term memory. D) otherwise normal cognitive functioning. E) unimpaired social or occupational functioning. Answer: A Diff: 1 Type: MC Skill: Factual
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57) Common symptoms that occur during the first stage of Alzheimer's include A) aggression. B) sleep difficulties. C) speech and language difficulties. D) repetitive actions. E) problems with concentration. Answer: E Diff: 2 Type: MC Skill: Factual/Conceptual
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58) During the middle stage of Alzheimer's disease, sufferers may show A) difficulty recognizing or naming people or things. B) problems with concentration. C) total incontinence. D) stooped posture. E) delusions. Answer: A Diff: 1 Type: MC Skill: Factual
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Answer: B Diff: 1 Type: MC Skill: Factual
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60) Possible protective factors against AD include all of the following EXCEPT A) high-fat protein diets. B) vegetarian diet. C) regular and moderate consumption of red wine. D) dietary antioxidants. E) lipid-lowering drugs. Answer: A Diff: 1 Type: MC Skill: Factual
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61) Treatment of Alzheimer's disease with drugs results in A) slowing, but not stopping the disease. B) reducing the wandering behaviour but not the forgetfulness. C) a reversal of the symptoms. D) halting the progression of the disease. E) reducing mild cognitive impairment but not the physical complications. Answer: A Diff: 1 Type: MC Skill: Factual
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62) The second most common cause of dementia is A) Alzheimer's disease. B) cerebrovascular damage. C) Parkinson's. D) senile dementia. E) alcoholism. Answer: B Diff: 1 Type: MC Skill: Factual
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63) The prognosis of vascular dementia is __________ than for AD, with a __________ progression. A) better; slower B) worse; similar C) worse; faster D) worse; slower E) better; similar
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Answer: C Diff: 2 Type: MC Skill: Factual
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64) Lewy body dementia differs from AD and vascular dementia in that __________ is/are present. A) a dissociative disorder B) recurrent well-formed hallucinations C) delusions of persecution D) aggressive behaviour E) personality disorders Answer: B Diff: 2 Type: MC Skill: Factual
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65) Frontotemporal dementia is a term used to describe a heterogeneous group of disorders including A) Alzheimer's disease. B) Lewy body dementia. C) Pick's disease. D) primary dementia. E) vascular dementia. Answer: C Diff: 2 Type: MC Skill: Factual
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66) Increased pathology is part of the normal aging process and must be accepted as inevitable. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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67) Two myths concerning mental disorders and aging are that mental illness is common among older people and that treatment is not beneficial. A) True B) False Answer: A Diff: 1 Type: TF Skill: Conceptual
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68) “Polypharmacy” means that older people require several medications to treat their mental disorders. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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69) Fortunately, older clients are likely to be better served by the next generation of therapists. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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70) Mental disorders are less common among the older population. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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71) Freud stressed the importance of psychotherapy with older adults. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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72) Older adults are more likely to respond to positive over negative information. A) True B) False Answer: A Diff: 1 Type: TF Skill: Conceptual
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73) Major depressive disorder is four times as common among younger adults than older adults. A) True B) False .. 19
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Answer: A Diff: 2 Type: TF Skill: Factual
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74) Since 1977, suicide rates among all groups of people have been higher in Canada than in the U.S. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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75) Heredity plays a primary role in the development of mood disorders in older individuals. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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76) Elderly patients with depressive disorder are more likely to be treated with ECT and drugs than younger patients. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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77) The primary sleep problems experienced by older adults include feeling tired during the day, awakening often during the night, and waking up too early in the morning. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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78) Pharmacological treatment for nocturnal myoclonus has been relatively successful in reducing the kicking and flexing of the legs. A) True B) False
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Answer: A Diff: 2 Type: TF Skill: Factual
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79) Late onset schizophrenia is relatively common among the elderly in institutional settings. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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80) Side effects of medications for the treatment of psychosis is less serious among the elderly. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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81) Delirium can occur at any age. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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82) Women are twice as likely as men to develop dementia. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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83) Two-thirds of all of the cases of dementia found in older adults is due to Pick's disease. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual .. 21
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84) More than half of individuals diagnosed with MCI will progress to a diagnosis of dementia. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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85) The average course from diagnosis to death for individuals with AD is about 10 years. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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86) Briefly describe and refute some of the common myths associated with mental disorders in older adults. Answer: Many common myths exist regarding mental disorders and aging. One myth is that the development of pathology in older adults is normal and does not require treatment. However, normal aging does not imply the development of pathology, but a slowing down of bodily systems. Even when a large number of older people develop a pathological condition, this does not mean the condition is normal. Stable mental health in older people is typical, and any behavioural changes should be a cause for Concern and treated. Another prevalent myth is that older adults do not respond well to treatment. This myth is false - the evidence shows that older adults are as responsive to treatment as younger adults. It is likely that this myth developed because older people are generally stereotyped as rigid and set in their ways, and fewer older adults seek treatment for mental disorders. It is important that mental health professionals recognize and refute these myths in order to provide older adults with the best possible treatment. Diff: 2 Type: ES Page Ref: 393-394 Skill: Conceptual 87) Describe the selective optimization with compensation (SOC) model. Answer: Old age inevitably brings losses of abilities and skills. Therefore, successful aging entails a) the selection of goals and goal priorities in life, b) optimizing resources that facilitate these goals, and c) compensating for losses by creatively using alternative means to achieving one’s goals despite limited capacities. This framework could be used to maximize functioning in people with mental disorders by building on strengths and avoiding weaknesses.
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Diff: 2 Type: ES Skill: Factual
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88) Briefly describe Socio-Emotional Selectivity Theory (SST). Answer: According to this theory, younger people tend to perceive time as unlimited and therefore have goals that are future-oriented. They are more likely to focus their energy on seeking information and expanding their knowledge. Older people see time as limited, so their goals are more focused on short-term and emotionally meaningful matters. Research supports that as we age, goals shift from being knowledge focused to meaning focused. Diff: 2 Type: ES Page Ref: 397 Skill: Conceptual 89) Point out some of the differences between depressive disorders in younger and older adults. Answer: There is an assumption that older people are more likely to be depressed than younger people, likely because they are aging and many aspects of their lives begin to change. In actuality, major depression is nearly four times higher in younger adults, and dysthymic disorder occurs twice as often in younger adults. However, suicide is more common among older people (especially older men) and attempts are more likely to be successful. As well, the symptoms of major depressive disorder are somewhat different among older adults, who are more likely to report somatic symptoms such as weight loss and are less likely to report feelings of worthlessness or guilt. Diagnosis of depressive disorder is more difficult among older adults. It can be difficult to differentiate between depression and dementia, and depressive symptoms can be the result of other medical conditions or medications. In terms of treatment issues, older adults are more likely to be given ECT or pharmacotherapy, and less likely to be treated with psychotherapy than younger adults, even though psychological treatment is as effective for older adults. Diff: 2 Type: ES Page Ref: 398 Skill: Factual 90) Highlight some of the factors that make it difficult to diagnose sleep disorders in older adults. Answer: Although older adults report more dissatisfaction with sleep (approximately 40% report sleep problems), a number of factors make it difficult to diagnose and treat sleep disorders in older adults. Generally, information about sleep comes from selfreports, which may be distorted by unrealistic expectations. Sleep disturbances may be caused by other physical or mental disorders or medications, so sleep may improve after the other disorder is treated.As well, some changes in sleep habits or patterns are normal, even though the person may not see this. Sleep hygiene (such as eating, drinking, or exercising before bed, sleeping with another person or alone) affects how an individual sleeps, and circumstances such as the loss of a spouse or moving to a different residence may change sleeping situations. .. 23
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Diff: 2 Type: ES Skill: Factual/Conceptual
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91) Discuss common treatments used for older adults suffering from mood disorders. Answer: Major depressive disorder and dysthymia are generally treated with psychotherapy, drug therapy, or ECT. Although psychotherapy is often believed not to work for older adults, short-term therapy has been shown to be quite effective in treating depression among older patients. Antidepressants are effective in older patients, but the side effects of these drugs may be tolerated less well and drug interactions can be a problem for those taking multiple medications. ECT is often used with older patients, and is very effective, but it too causes serious problems such as confusion, falls, and cardiorespiratory problems. Psychological treatments such as cognitive-behavioural therapy are preferred over pharmacological treatments for older adults suffering from mood disorders. It may be beneficial to attempt psychological treatments with older people before giving them medications or ECT, which may result in serious physical problems. Diff: 1 Type: ES Page Ref: 400 Skill: Factual 92) Compare and contrast dementia, pseudo-dementia, cortical and subcortical dementias. Use examples. Answer: Dementia is the most common mental disorder in older adults and refers to a large category of disorders where the individual loses his or her former level of cognitive functioning (i.e., the ability to remember, think, and reason). Pseudo-dementia is used to describe disorders that produce cognitive impairment similar to dementia but that can be reversed. Depression, nutritional deficiency, thyroid disorder can cause symptoms that mimic dementia. Cortical dementias primarily the cerebral cortex and can cause problems in learning new information, loss of short-term memory ability, visuospatial problems, language problems, and eventually poor reasoning and judgment. Subcortical dementias primarily attack the white matter and more primitive parts of the brain, resulting in cognitive slowing, problems retrieving information from memory, and difficulty with executive function. Diff: 1 Type: ES Page Ref: 409 Skill: Factual 93) List the three stages of Alzheimer's disease and the types of symptoms indicative of these three stages. Answer: The Alzheimer's Society of Canada has described three stages that sufferers progress through - first, middle, and late. These stages have also been referred to as the forgetfulness phase, the confusion phase, and the dementia phase. In the first stage, the individual exhibits memory difficulties, unclear thinking, difficulty concentrating on tasks, errors in judgment, and may have a hard time finding words. These symptoms are first recognized by the victim and generally cause distress. During the middle stage, .. 24
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symptoms become more severe and additional symptoms such as speech and language difficulties, problems in orientation, sleep difficulties, wandering, agitation and irritability, and difficulties with employment and social situations. In the late stage, individuals lose their ability to communicate and memory impairment becomes profound. Sufferers develop various physical symptoms such as immobility, incontinence, and vulnerability to disease. Caregivers are burdened, as the sufferer would wander off and get lost, or behave with agitation or aggression. Diff: 2 Type: ES Page Ref: 410 Skill: Conceptual 94) Describe the hypothesized etiology of Alzheimer's disease. Answer: The etiology of Alzheimer's disease is clearly physiological. The brains of Alzheimer's sufferers are characterized by the presence of excessive amounts of plaques (collections of debris suspended in amyloid within nerve cells) and neurofibrillary tangles (abnormal clusters of intertwined filaments in nerve cells). Shrinkage of the cortex is another characteristic. Genetics may play a role, as individuals with Down syndrome who live past 40 years of age begin to show signs of Alzheimer's. As well, Alzheimer's runs in families. Other hypotheses involve abnormalities in the amyloid or proteins of nerve cells, acetylcholine deficiencies, and excessive aluminum in the body. All of these hypotheses are being investigated and knowledge increases every day, but so far the exact etiology is unknown. Diff: 2 Type: ES Page Ref: 410 Skill: Factual/Conceptual
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CHAPTER 17 Therapies 1) Which of the following is false? A) The first treatments for psychological disorders were biological. B) Practices such as bleeding were designed to correct biological imbalances. C) In the latter part of the nineteenth century, very few physical strategies designed to calm disturbed behaviour existed. D) Electroconvulsive treatment is the most controversial biological intervention used to treat disturbed behaviour. E) Psychopharmacology is the most common biological intervention used to treat disturbed behaviour. Answer: C Diff: 1 Type: MC Skill: Factual
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2) Electroconvulsive therapy A) is no longer used in any form to treat any mental illness. B) identifies cardiac failure as its most prominent side effect. C) has only recently chosen to apply higher and more intense currents during treatment. D) has recently opted for shorter courses of treatment. E) was first used to in the 1930s to treat severe depression only. Answer: D Diff: 2 Type: MC Skill: Factual
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3) Electroconvulsive therapy A) is ineffective in ameliorating severe depressive symptoms that have not responded to other treatments. B) reduces depression by a very simple and clearly understood mechanism. C) is quite often a medical practitioner's first choice for treating depression. D) has been shown to work very well with older patients. E) shows no evidence in reducing the likelihood of relapse. Answer: e Diff: 2 Type: MC Skill: Factual
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4) Dr. Jones is developing a drug to treat cancer. He observes that one of the side effects of this drug is that it elevates a person's mood. A year later, this drug becomes an important tool in the treatment of depression. Discoveries of this type in science are A) very common because serendipitous discoveries never occur in science.
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B) uncommon because in reality the ideal method for developing medications is first to understand the pathological process by which a disorder develops, then to identify an agent that will change in the process. C) common because physicians carefully monitoring a patient's reaction to a drug have observed unanticipated benefits in other areas. D) very common as most physicians routinely do this sort of research with their patients. E) very uncommon because science has clearly established biochemical mechanisms that account for most psychological disorders. Answer: C Diff: 2 Type: MC Skill: Conceptual
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5) The development of phenothiazines and related major tranquilizers did all of the following EXCEPT A) helped formerly institutionalized patients to return to the community. B) offered the possibility of reducing psychotic symptoms such as hallucinations. C) were regarded as a major scientific breakthrough. D) replaced psychological therapies as the most common type of treatment. E) made possible the policy of deinstitutionalization. Answer: D Diff: 1 Type: MC Skill: Factual
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6) Which of the following cannot be used to treat hallucinations? A) tricyclics B) dibenzodiazepine C) phenothiazines D) butyrophenone E) clozapine Answer: A Diff: 2 Type: MC Skill: Factual
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7) Ken has been diagnosed with bipolar disorder. As a psychiatrist, what can you prescribe to treat him? A) anxiolytics B) stimulants C) mood stabilizers D) antipsychotics E) antidepressants
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Answer: C Diff: 2 Type: MC Skill: Application
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8) __________ consist of strange muscular movements such as eye-twitching and tongue thrusting, whereas __________ include stooped posture, muscular rigidity, a distinctive shuffling gait, and occasional drooling. A) Parkinsonian effects; extrapyramidal effects B) Extrapyramidal effects; tardive dyskinesia C) anti-Parkinsonian effects; anti-pyramidal effects D) Parkinsonian effects; tardive dyskinesia E) Tardive dyskinesia; Parkinsonian effects Answer: e Diff: 3 Type: MC Skill: Factual
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9) You are a psychiatrist who is treating an elderly schizophrenic patient. You are worried about extrapyramidal effects and serious health risks, and would like to keep these at an absolute minimum. Which of the following drugs would you most likely prescribe? A) clozapine B) olanzapine C) thioridazine D) haloperidol E) fluphenazine Answer: B Diff: 3 Type: MC Skill: Application
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10) Which of the following is true concerning anxiolytics? A) Patients develop tolerance for barbiturates requiring larger doses to achieve the same effects. B) Benzodiazepines are toxic at high levels. C) Benzodiazepines show no addictive properties. D) Anxiolytics increase activity in parts of the central nervous system. E) They can be taken safely along with alcohol. Answer: A Diff: 3 Type: MC Skill: Factual
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11) Which of the following taken in combination with the enzyme tyramine (found in yeast, chocolate and beer) can cause a life-threatening increase in blood pressure? A) monoamine oxidase inhibitors (MAOIs) .. 3
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B) Prozac C) tricyclics (TCAs) D) selective serotonin reuptake inhibitors (SSRIs) E) lithium Answer: A Diff: 3 Type: MC Skill: Factual
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12) Jimmy is a university student with attention deficit disorder who regularly takes Ritalin. He is taking a math exam on Monday at noon. To ensure peak clinical effectiveness of the Ritalin for his exam, at what time would Jimmy be best to take his medication? A) between 7:00 and 11:00 the morning of the exam B) between 11:00 and 12:00 the morning of the exam C) right at the beginning of the exam D) 24 hours before the time of the exam. E) the night before the exam Answer: A Diff: 2 Type: MC Skill: Application
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13) Ken argues that it might be more cost effective for psychologists to prescribe medicine for their patients rather than referring to psychiatrists or physicians. Which of the following arguments would best serve as a rebuttal to Ken's argument? A) Absolutely not, because psychologists do not believe in the efficacy of drug therapy and do not want prescription privileges. B) Absolutely. The provision of education required to competently prescribe would not occur at the expense of training in psychological assessments and interventions making adequate prescription training possible. C) Maybe, but undeserved groups such as the elderly, the chronically mentally ill and those living in rural areas would benefit very little from such a service. D) Maybe, but many major mental disorders (such as schizophrenia) are best treated with psychotherapy, so why prescribe medication. E) One has to be careful when allocating prescription privileges because the biological and pharmaceutical training required of psychologists may be inadequate. Answer: e Diff: 2 Type: MC Skill: Conceptual
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14) Which of the following best describes the current situation regarding prescription privileges for psychologists in Canada? A) The CPA has not taken a stand on the issue of prescription privilege. B) The CPA is in complete support of such privileges. .. 4
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C) The CPA does not believe the extra costs and time needed for extra training is worth the privilege. D) The CPA completely supports the American approach to reducing health care costs. E) The Canadian Psychological Association (CPA) is vehemently opposed to allowing such privileges. Answer: A Diff: 2 Type: MC Skill: Factual
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15) Which of the following best summarizes the current status of psychoactive medication? A) It is most effective for certain types of people suffering from particular types of disorders. B) It effectively guards against relapse and chronic disorder. C) It has excellent curative properties. D) It is generally highly inefficient. E) It is effective for symptom control. Answer: e Diff: 1 Type: MC Skill: Factual
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16) John has been seeing a psychotherapist for the past six months. Although the service provided has been average, John finds out that his psychotherapist has little or no professional training. What can he do to rectify his situation? A) He can't do anything. He should have inquired into the training and background of his psychotherapist before signing on as a client. B) He can ensure that the psychotherapist in question can no longer practice again. C) He can take legal action if he wishes. D) He can ask that the therapy be started over again with the therapist. E) He can obtain a full refund of his expenses. Answer: A Diff: 3 Type: MC Skill: Application
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17) We can trace the roots of psychodynamic therapy to which of the following individuals? A) Sigmund Freud B) Erik Erikson C) Carl Jung D) Carl Rogers E) Karen Horney
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Answer: A Diff: 1 Type: MC Skill: Factual
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18) Which of the following is NOT one of the five basic techniques of psychoanalysis? A) free association B) dream interpretation C) analysis of resistance D) guided imagery E) analysis of transference Answer: D Diff: 1 Type: MC Skill: Factual
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19) Dr. Smith is employing a psychoanalytic approach to treat her client. During their first session, Dr. Smith encourages her client to say anything that comes to his mind. After the session is done, Dr. Smith analyzes what was said by focusing specifically on slips of the tongue and numerous incidents of forgetfulness. During the second session, Dr. Smith focuses on the fact that her patient is unwilling to discuss certain topics and has a tendency to remain quiet.Which three psychoanalytic techniques were most likely used by Dr. Smith during the two treatment sessions? A) free association; analysis of transference; and interpretation B) free association; interpretation; and analysis of transference C) free association; analysis of resistance; and analysis of transference D) free association; dream interpretation; and analysis of resistance E) free association; interpretation; and analysis of resistance Answer: e Diff: 3 Type: MC Skill: Application
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20) A patient who experienced her father as controlling will likely experience the therapist as controlling. According to psychoanalysis, which phenomenon is occurring here? A) resistance B) free association C) denial D) countertransference E) transference Answer: e Diff: 1 Type: MC Skill: Conceptual
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21) “Goals are concrete, conversation replaces free association, therapists are emphatic rather than emotionally detached, and interpretations focus on current life events rather than childhood fears and conflicts.” Which type of psychotherapy is being described here? A) Adler's individual psychology B) time-limited dynamic psychotherapy C) interpersonal psychodynamic therapy D) brief psychodynamic psychotherapy E) ego analysis Answer: D Diff: 2 Type: MC Skill: Conceptual
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22) “I feel that sexual and aggressive instincts are less important than the individual's striving to overcome personal weakness.” Which of the following therapists would be most likely to say this? A) Harry Stack Sullivan B) Karen Horney C) Erik Erikson D) Alfred Adler E) Sigmund Freud Answer: D Diff: 2 Type: MC Skill: Conceptual
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23) Dave is hostile towards everyone. His therapist provides him with feedback indicating that his interpersonal style is perpetuating and provoking conflicts. He teaches Dave to interact with others in a more flexible and positive way. Which type of psychotherapy is Dave's therapist using? A) ego analysis B) time limited dynamic psychotherapy C) interpersonal psychodynamic therapy D) aversion therapy E) brief psychodynamic psychotherapy Answer: C Diff: 2 Type: MC Skill: Conceptual
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24) Whereas psychodynamic approaches focus on the person's __________, humanistic and experiential approaches focus on the person's __________. A) unconscious processes; past experiences B) subjective experiences; unconscious processes C) unconscious processes; subjective experiences .. 7
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D) current experiences; past experiences E) conscious processes; unconscious processes Answer: C Diff: 1 Type: MC Skill: Factual
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25) Carl Rogers developed client-centred therapy in the 1940s as an alternative to A) drug therapy. B) humanistic and experiential approaches. C) existential therapy. D) psychoanalysis. E) cognitive-behavioural therapy. Answer: D Diff: 2 Type: MC Skill: Factual
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26) Which of the following does not take place during client-centered therapy? A) A client is given “unconditional positive regard”. B) A client is valued as a unique individual. C) A client is welcomed into an environment of acceptance. D) A client is diagnosed. E) A client is treated by a therapist who is genuine and empathic. Answer: D Diff: 1 Type: MC Skill: Factual
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27) You are an existential therapist. Which of the following potential clients would be least suited for your type of therapy? A) a juvenile delinquent who has antisocial personality disorder and frequently engages in suicidal behaviour B) a high school student who feels no sense of belonging and has become disillusioned with his studies C) a young lawyer who frequently has panic and anxiety attacks before important cases D) a schizophrenic patient who never takes his medication E) a young mother with dependent personality disorder and recently divorced. Answer: D Diff: 2 Type: MC Skill: Application
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28) Which of the following is not a characteristic of Gestalt therapy? A) It often interprets clients dreams. B) It integrates clients' inner feelings and their external environments. .. 8
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C) It encourages clients to talk freely about other people. D) It helps clients become aware of feelings and needs that have been ignored or distorted. E) It often employs the empty chair technique. Answer: C Diff: 2 Type: MC Skill: Factual
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29) Perhaps the greatest contribution of the humanistic approaches has been A) the experiential approach developed by Al Mahrer at the University of Ottawa. B) the process experiential approach developed by Les Greenberg and his colleagues at York University in Toronto. C) the emphasis that this approach places on the unconscious processes of the client. D) the emphasis that this approach places on the human qualities of the therapist. E) the empty chair technique developed by Fritz Perls. Answer: D Diff: 2 Type: MC Skill: Factual
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30) Behaviour therapy originally arose as a treatment approach for A) alcoholics. B) neurotic patients. C) psychotic patients. D) patients suffering from anxiety disorders. E) patients suffering from depression. Answer: C Diff: 1 Type: MC Skill: Factual
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31) A father has just started teaching his young son to shoot a basketball. Although he is very eager to see him progress, the father comes down hard on his son every time he misses a shot. According to Albert Bandura, how should the father modify his approach? A) He shouldn't change anything. Mastery and self-efficacy will develop even better with criticism. B) He should reward his son with money every time he makes a shot. C) He should maintain a similar standard of criticism even once the behaviour has been mastered. D) He should encourage his son for persistence and effort, even if he is missing shots. E) He shouldn't change anything. By being a harsh critic, the father will help his son develop high standards for the future.
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Answer: D Diff: 1 Type: MC Skill: Application
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32) Albert Ellis' rational-emotive therapy can be described as a A) cognitive-behavioural approach. B) fundamentally humanistic approach. C) psychoanalytic approach. D) purely cognitive approach. E) purely behavioural approach. Answer: D Diff: 2 Type: MC Skill: Factual
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33) A child that is taught how to tie his shoes gradually is learning this skill through A) problem solving. B) exposure. C) response shaping. D) reinforcement. E) behavioural activation. Answer: C Diff: 1 Type: MC Skill: Factual
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34) Jane has a fear of dogs. Her therapist decides to gradually let her interact with some dogs in his presence until her fear disappears. This technique is known as A) behavioural activation. B) reinforcement. C) response shaping. D) exposure therapy. E) systematic desensitization. Answer: D Diff: 1 Type: MC Skill: Application
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35) Donald Meichenbaum developed __________ to train individuals in effective strategies for talking themselves through difficult challenges. A) cognitive restructuring B) response shaping C) assertiveness training D) problem-solving approach E) self-instructional training
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Answer: e Diff: 1 Type: MC Skill: Factual
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36) According to Jerome Frank, the first ingredient in healing is A) awareness. B) an alternative explanation for the problem. C) coming to terms with the less desirable aspects of one's personality. D) the client is supposed to think, feel, or act in a different way. E) hope. Answer: e Diff: 1 Type: MC Skill: Factual
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37) Canadian psychologists Sue Johnson and Les Greenberg developed and evaluated an experiential approach to couples therapy called A) emotion focused therapy. B) group therapy. C) problem focused therapy. D) dynamic therapy. E) family therapy. Answer: A Diff: 2 Type: MC Skill: Factual
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38) Clinical psychologists are among the main providers of psychotherapy. The most commonly endorsed orientation is A) humanistic-experiential. B) eclectic. C) psychodynamic. D) neo-Freudian. E) cognitive-behavioural. Answer: B Diff: 2 Type: MC Skill: Factual
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39) Cohen and colleagues (2008) found that the majority of Canadian clinical psychologists they surveyed identified themselves as _______. A) psychodynamic B) humanistic-existential C) biological D) cognitive-behavioural E) gestalt .. 11
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Answer: D Diff: 3 Type: MC Skill: Factual
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40) Which of the following is false regarding psychotherapy? A) Many of those most in need of help never seek it. B) People may seek therapy for advice and assistance in coping with social roles. C) The Canadian government ensures that all those who are most in need of psychotherapy, adequately receive such a service. D) The majority of people seeking psychotherapy are young-to-middle-aged adults. E) Women are twice as likely as men to consult a psychologist. Answer: C Diff: 2 Type: MC Skill: Factual
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41) Jack is concerned that he is not getting the most out of his psychotherapy. He no longer feels depressed yet has only been to seven sessions. As an expert on treatment length, what would be the best advice you could give him? A) You should tell him to sign on with a new therapist because premature termination most likely is an indication of treatment failure. B) You should tell him that if he truly feels better, he need not continue psychotherapy, as the number of therapy sessions attended is not necessarily related to whether the client's condition has improved. C) You should tell him that even though he feels cured he should continue to attend therapy sessions for a minimum of 13 to 20 sessions, as he will otherwise receive less than optimal benefit from therapy. D) You should point out that without further therapy sessions, relapse will be inevitable. E) You should remind him of the cost of psychotherapy and that dropping out now would be a waste of his money. Answer: B Diff: 2 Type: MC Skill: Application
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42) In his 1952 article, Hans Eysenck A) compiled extensive evidence outlining the strong suits of psychotherapy. B) constructively analyzed the pros and cons of psychotherapy. C) was unable to take a specific stance on psychotherapy. D) that drug therapy was for most people far superior to any of the psychotherapies. E) argued that there was no evidence that psychotherapy had any demonstrable effect. Answer: e Diff: 3 Type: MC Skill: Factual .. 12
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43) “Everybody has won, and all must have prizes.” This line from Alice in Wonderland best conforms with which psychological principle? A) the multiple placebo effect B) emotion focused therapy C) the ripple effect D) the dodo bird verdict E) systematic desensitization Answer: D Diff: 1 Type: MC Skill: Conceptual
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44) Which of the following is true? A) Methodological limitations, such as small sample size, have rarely if ever been an issue in studies comparing treatments. B) The so-called verbal therapies are correctly categorized together as they share much in common. C) The manner by which a researcher chooses to categorize therapies does not appear to affect the conclusions drawn from a study comparing those therapies. D) Using meta-analytic approaches, a number of investigators are now finding significant differences between treatments. E) Kazdin and Bass (1989) found that most studies that found no differences between treatments had a large enough sample size to draw solid conclusions. Answer: D Diff: 2 Type: MC Skill: Factual
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45) Based on the research by Weiss and Weisz (1995) all of the following are accurate EXCEPT A) cognitive-behavioural therapies are always the most effective. B) was ultimately deemed to be inconclusive regarding the overall effectiveness of behavioural versus non-behavioural treatments. C) found that the nonbehavioural treatments had an effect size of 0.42. D) found that the behavioural treatments had an effect size of 0.85. E) there is more evidence to support the efficacy of cognitive-behaviour therapies than other treatments. Answer: A Diff: 3 Type: MC Skill: Factual
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46) Dr. Brown is a firm supporter of cognitive-behavioural treatments. His patient Peter has a fear of dogs. During their first therapy session, Dr. Brown actively challenges
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Peter's beliefs regarding dogs and subjects Peter to many of the symptoms usually experienced in a panic disorder. In this case, Dr. Brown is using the principles of A) aversion therapy and extinction. B) cognitive restructuring and interoceptive exposure. C) extinction and systematic desensitization. D) cognitive restructuring and systematic desensitization. E) exposure therapy and behavioural activation. Answer: B Diff: 2 Type: MC Skill: Conceptual
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47) Which of the following is true? A) Cognitive therapy has shown no effectiveness in treating depression in the elderly. B) Antidepressants and some form of psychotherapy can be more efficacious than either treatment alone, especially for chronic depression. C) Cognitive-behaviour therapy has not been shown to be effective in treating anxiety disorders in children. D) Cognitive-behavioural therapy and interpersonal psychotherapy have both proven ineffective in treating bulimia. E) In searching for the active ingredient of cognitive therapy for depression researchers examined three treatments which were each found to significantly differ from the other two. Answer: B Diff: 2 Type: MC Skill: Factual
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48) With the exception of __________, Axis II disorders have largely been ignored by psychotherapy researchers. A) borderline personality disorder B) dependent personality disorder C) anti-social personality disorder D) histrionic personality disorder E) paranoid personality disorder Answer: A Diff: 2 Type: MC Skill: Factual
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49) Evidence indicates that fewer than __________ percent of treated couples will be able to maintain happy marriages in the years following treatment. A) 40 B) 50 C) 20
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D) 30 E) 10 Answer: B Diff: 3 Type: MC Skill: Application
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50) What is the most beneficial treatment for mildly to moderately distressed couples? A) behavioural marital therapy B) emotionally focused marital therapy C) psychodynamic marital therapy D) marital sex therapy E) cognitive marital therapy Answer: B Diff: 2 Type: MC Skill: Factual
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51) Although research does exist on the effectiveness of psychotherapy, one has to be careful when generalizing these findings to the real world because A) most studies are conducted without the consent of the patients. B) researchers do not have to meet the standards of experimental criteria when comparing therapies. C) researchers do not know or have any control over the participants in their studies. D) most studies are conducted in a research context. E) most studies are conducted without the participation of the therapists. Answer: D Diff: 1 Type: MC Skill: Factual
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52) Which of the following can be effectively treated by self-help material? A) ADHD B) smoking C) alcohol consumption D) overeating E) social skills deficits Answer: e Diff: 2 Type: MC Skill: Factual
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53) While researchers have improved their studies by increasing __________ validity, there has been a corresponding reduction in __________ validity. A) external; internal B) face; criterion .. 15
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C) internal; external D) construct; criterion E) internal; predictive Answer: C Diff: 2 Type: MC Skill: Conceptual
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54) Which of the following is not an example of criteria for designation as an empirically supported therapy? A) At least ten single-case-design studies demonstrating efficacy. B) For A: the treatment effects must have been found by at least five different researchers or research teams. C) At least two group design studies demonstrating efficacy by being superior to pill, psychological placebo, or another treatment. D) Studies must be conducted with treatment manuals. E) For B: the characteristics of the participants must be clearly described. Answer: B Diff: 2 Type: MC Skill: Factual
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55) According to the National Institute for Clinical Excellence (NICE), a person suffering from mild depression for the first time and seeking treatment should A) be prescribed an SSRI. B) take a test to determine whether antidepressants or cognitive-behaviour therapy would work best. C) wait six months to determine if the depression warrants professional intervention. D) be prescribed an SSRI along with CBT. E) be offered brief CBT. Answer: e Diff: 2 Type: MC Skill: Factual
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56) Electroconvulsive therapy is used for disorders like schizophrenia, mood disorders, and anxiety disorders, especially when medication does not work. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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57) Extrapyramidal effects include symptoms similar to those found in Parkinson's disease. .. 16
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A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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58) The main problem with many of the antidepressant drugs is that large doses are highly toxic. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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59) Lithium has been shown to have antidepressant effects. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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60) Stimulants are used to treat children with attention deficit and hyperactivity disorder. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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61) The main goal of Freudian psychoanalysis is to overcome defense mechanisms which the client has developed. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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62) In systematic desensitization, fear-inducing stimuli are arranged in a hierarchy and presented to the client, in hopes of reducing unwanted behaviour. A) True B) False
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Answer: B Diff: 2 Type: TF Skill: Conceptual
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63) Couples treatment has been found effective for problems such as depression or alcoholism in adults and conduct disorder in children. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
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64) In family therapy, the focus is placed on reframing the problem so that family can work on tasks designed to change their ways of interacting with one another. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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65) Research has shown that clinical psychologists with more extensive training and years of experience are more effective. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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66) Often, those most in need of psychological help are not the ones to receive it. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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67) Many of the current psychotherapies are long-term, since clients often face extensive problems and may require years of therapy. A) True B) False
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Answer: B Diff: 1 Type: TF Skill: Factual
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68) Eysenck determined that clients often improve without psychotherapy; there was no evidence that psychotherapy had any demonstrable effect. A) True B) False Answer: A Diff: 2 Type: TF Skill: Conceptual
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69) In a meta-analytic study, data from previous studies are combined by developing a common metric, called an effect size. A) True B) False Answer: A Diff: 3 Type: TF Skill: Conceptual
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70) Research reviews are superior to meta-analyses because they provide more in-depth descriptions about the studies in question. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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71) Various meta-analyses conducted over the years have shown that psychotherapy is effective. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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72) When comparing the effectiveness of various forms of psychotherapy, researchers have found that cognitive-behavioural therapy is the most effective for all types of problems. A) True B) False
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Answer: B Diff: 1 Type: TF Skill: Factual
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73) Effective psychotherapeutic techniques have been developed for both Axis I and Axis II disorders. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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74) Discuss the use of Electroconvulsive therapy (ECT) in treating disorders. Refer to the way it was used in the past and present. Answer: During the 1930s, clinicians noticed that patients with schizophrenia who experienced epileptic seizures showed a reduction in schizophrenic symptoms. They figured that if seizures could be induced, psychotic symptoms would be reduced. With the discovery of effective antipsychotic medication, ECT is no longer used to treat schizophrenia. As now practiced, ECT involves the application of an electrical current to the patient's temples. It is still used to treat severe depression that has not responded to other forms of treatment, although the mechanism by which it works is not known. ECT has previously been associated with severe side effects such as disorientation and memory loss, broken bones, and, in rare cases, death. However, adverse effects are minimized through less intense, briefer currents, shorter courses of treatment, and the use of muscle relaxants to reduce the risk of injury. Diff: 2 Type: ES Page Ref: 417-418 Skill: Factual 75) Describe the side effects of MAOIs, tricyclics, and SSRIs. Answer: Drugs used to treat depression include: monoamine oxidase inhibitors (MAOIs), tricyclics (TCAs), and selective serotonin reuptake inhibitors (SSRIs). The main drawback of MAOIs is the severe dietary restrictions: common foods such as yeast, chocolate, and beer that contain the enzyme tyramine can cause a life-threatening increase in blood pressure. TCAs are associated with nuisance side effects such as dry mouth, blurry vision, constipation, and lightheadedness. SSRIs are as effective as other antidepressants, with fewer side effects. Generally, the side effects include nausea, diarrhea, headache, tremor, and sleepiness. Diff: 2 Type: ES Skill: Factual
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76) Briefly describe the focus of behavioural approaches and provide examples of techniques. Answer: At the heart of behavioural approaches are efforts to reinforce desirable behaviours and ignore undesirable behavoiurs. Response shaping is used to shape behaviour in gradual steps toward a goal, such as teaching a young child to get dressed independently. Behavioural activation is used to help patients develop strategies to increase their overall activity and to counteract their tendencies to avoid activities. In systematic desensitization, fear-inducing stimuli are arranged in a hierarchy, individuals are trained in techniques to achieve deep muscle relaxation. Clients imagine the items of the hierarchy one at a time while remaining relaxed. Assertiveness training is effective for treating anxiety in interpersonal situations, and is often offered to couples experiencing relationship problems or aggressive individuals. Diff: 2 Type: ES Skill: Conceptual
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77) List the four distinct modalities of delivering therapy and provide a brief description of each. Answer: The four distinct modalities of psychotherapy are individuals, couples, groups, and families. Early therapy was conducted exclusively with one person and one therapist. In couples therapy, the focus is on the marital relationship, and the goal is to enhance satisfaction with the relationship. Couples therapy is also successful for problems such as depression, alcoholism, and conduct disorder. Family therapists consider the family to be an important part of the solution to the problem, and focus on reframing the problems and helping family members change their ways of interacting with one another. The goals are to enhance communication and negotiation within the family. Group therapy is cost effective, is a place to practice relating to others, offers exposure to the experiences of others, and may lead to feelings of cohesion. Diff: 2 Type: ES Skill: Factual
Page Ref: 427-428
78) Describe meta-analyses and explain the importance of this technique. Answer: Meta-analysis is a method of quantitatively reviewing previous research. The results of prior research studies are combined by developing a common metric called an effect size. Effect sizes can be calculated from raw data, group means, standard deviations, or from inferential statistics and is the difference between the means of the experimental and control group, divided by the standard deviation of the control group or the pooled sample of both groups. There are numerous advantages to meta-analyses. Statistical analysis, not the researchers' impressions, are used to determine the findings. As well, by including data from many studies, the number of research participants is substantially larger. This increases the .. 21
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power of the study to find an effect in the literature. As a result, meta-analysis is being used more extensively with treatment effectiveness studies. Diff: 3 Type: ES Skill: Conceptual
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79) What does the current evidence say about the effects of psychotherapy, and which orientation is the most effective? Answer: A review by Smith et al. (1980) of 475 controlled studies of psychotherapy found that overall, psychotherapy for any disorder was effective. The overall effect size was .85, which is quite high. As well, effect was unrelated to duration, and there was no correlation between therapist experience and size of effect. Various other studies show similar findings. Many researchers suggest that all psychotherapies produce equivalent effects. However, the failure to find a difference does not mean that a significant difference does not exist; methodological limitations may affect results. Using meta-analytic approaches, investigators examining the effectiveness of cognitive-behavioural versus nonbehavioural approaches for children and adolescents found a larger effect size for cognitivebehavioural treatments. However, this may be due to the fact that cognitive-behavioural therapy has more empirical research on treatment effects. Other meta-analytic studies have found contradictory results. Diff: 2 Type: ES Skill: Application
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80) What types of therapy have been found effective in treating anxiety disorders? Answer: Treatment for specific phobias must involve exposing the individual to the object of the phobia. The person is also encouraged to accept the idea that the feeling of anxiety is not life threatening. In their meta-analytic review, Gould et al. (1995) determined that cognitive-behavioural treatments which combined cognitive restructuring and interoceptive exposure were highly effective. Large effect sizes have been found for treatment of obsessive-compulsive disorder. The first type of treatment involved a combination of exposure to the object of obsession or compulsion and response prevention; the other was cognitive therapy including cognitive restructuring and thought stopping. Cognitive-behavioural treatment has also been found to be effective for treating GAD. Childhood anxiety disorders are also effectively treated. Family based treatment involving a combination of cognitive therapy for the child as well as sessions for the parents dealing with learning reinforcement, communication, responses to stress, and problem-solving are very successful. Diff: 2 Type: ES Skill: Factual
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81) Discuss the argument about whether psychologists should prescribe medication, provide your opinion and several reasons for it. Answer: Many psychologists have argued for prescription privileges. They state that many major mental disorders are treated with medication, it might be more cost-effective for psychologists to prescribe medication rather than psychiatrists, and underserved groups might benefit from expanded opportunities to receive medication. Many physicians are concerned about the effects of psychologists having prescription privileges and argue that a great deal of training in biology is necessary. Diff: 2 Type: ES Skill: Conceptual
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CHAPTER 18 Prevention and Mental Health Promotion in the Community 1) Community psychology had its roots in A) clinical psychology. B) sociological medicine. C) organizational psychology. D) developmental psychology. E) ecological perspective. Answer: A Diff: 1 Type: MC Skill: Factual
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2) Community psychology is necessary for prevention for all of the following reasons EXCEPT A) No treatment will be 100% effective. B) There are not enough trained professionals to treat all of those who need it. C) Treatment services have not reduced rates of disease in the population. D) For health in general, treatment services have not been effective in reducing rates of disease in a population. E) Group therapy has been shown to be more effective than individual therapy. Answer: E Diff: 1 Type: MC Skill: Conceptual
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3) All of the following distinguishes community psychology from clinical psychology EXCEPT A) community psychologists stress the interdependence of the individual, family, and community. B) community psychology takes an ecological approach. C) community psychologists focus on treating groups rather than individuals. D) community psychologists encourage the use of social support groups. E) community psychology focuses on prevention. Answer: C Diff: 2 Type: MC Skill: Conceptual
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4) Primary prevention reduces the __________ of disorder, secondary prevention reduces the __________ of disorder, and tertiary prevention reduces the __________ of disorder. A) appearance; damage; length B) occurrence; duration; damage C) incidence; duration; disability .. 1
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D) disability; duration; incidence E) incidence; likelihood; occurrence Answer: C Diff: 2 Type: MC Skill: Factual
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5) Well-being tends to be the focus of mental health A) primary prevention. B) intervention. C) prevention. D) tertiary prevention. E) promotion. Answer: E Diff: 1 Type: MC Skill: Factual
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6) The public health approach is characterized by all of the following steps EXCEPT A) identifying the disease and developing a reliable method of diagnosis. B) developing prevention programs. C) researchers tend to focus on the person, the environment, and the agent. D) encouraging effective coping strategies. E) developing a theory of the course of development taken by the disease. Answer: D Diff: 1 Type: MC Skill: Conceptual
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7) Reducing stressors while preparing individual's to better cope with stressors is the focus of A) clinical prevention. B) health psychology. C) public health promotion. D) community intervention. E) tertiary prevention. Answer: C Diff: 1 Type: MC Skill: Factual
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8) The local high school has a program which attempts to provide teens with strategies to cope with peer pressures to drink and use drugs. This approach would be characteristic of A) campaigning. B) public health approach. C) drug education. .. 2
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D) secondary prevention. E) tertiary prevention. Answer: B Diff: 2 Type: MC Skill: Application
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9) Suicide prevention hotlines is an example of an application that comes from A) prevention theory. B) primary prevention. C) crisis theory. D) tertiary prevention. E) mental health promotion. Answer: C Diff: 1 Type: MC Skill: Factual
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10) The more general risk factors for poor mental health that an individual has, the more __________ an individual is to disorder. A) handicapped B) resilient C) affected D) protected E) vulnerable Answer: E Diff: 2 Type: MC Skill: Factual
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11) Which of the following is NOT a protective factor for mental health? A) identification with competent role models B) aspirations for the future C) stable care from parents or other caregivers D) attractiveness to peers and adults E) an IQ over 100 Answer: E Diff: 2 Type: MC Skill: Factual
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12) According to the ecological perspective, mental health problems can be viewed as having A) singular etiologies. B) multiple levels of analysis. C) a concern with treating the individual. .. 3
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D) impetus from the disease model. E) an environmental explanation. Answer: B Diff: 2 Type: MC Skill: Factual
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13) The family and social network is a part of A) the exosystem. B) the microsystem. C) the individual. D) the macrosystem. E) the culture. Answer: B Diff: 1 Type: MC Skill: Factual
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14) Which of the following is NOT one of the key pathways towards mental health promotion? A) empowerment B) resources to cope with stress C) competencies D) physical environments E) secure attachment Answer: D Diff: 2 Type: MC Skill: Factual
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15) All of the following are considered central mechanisms which can help people cope with adversity EXCEPT A) promoting physical exercise as a means of dealing with stress. B) creating opportunities for personal growth. C) enhancing self-esteem and self-efficacy. D) reducing the impact of risks. E) helping individuals deal with stressful life events. Answer: A Diff: 2 Type: MC Skill: Factual
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16) Curry and his parents live in East Harlem. Curry's parents do not allow him to hang out on the streets, he must complete his homework and be in by his curfew. Placing limits on Curry's behaviour is an example of A) prevention. .. 4
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B) altering exposure to risk. C) an authoritarian parenting style. D) a secure attachment. E) parental involvement. Answer: B Diff: 2 Type: MC Skill: Application
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17) Joshua was born with PKU, and was immediately placed on a special diet to prevent mental retardation. This is an example of A) biological primary prevention. B) biological tertiary prevention. C) disease prevention. D) reactive treatment. E) biological secondary prevention. Answer: E Diff: 2 Type: MC Skill: Application
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18) Selective high-risk programs choose participants on the basis of A) multiple risk factors. B) characteristics that are external to the participants. C) internal characteristics of the participants. D) the presence of mild or early-developing mental health problems. E) risk factors that differentiate the group from other members. Answer: B Diff: 3 Type: MC Skill: Application
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19) Katie's high school is involved in a special program designed to encourage the students to practice safe sex so as to reduce the likelihood of pregnancy and STDs. This program is an example of A) a high-risk prevention program. B) a universal prevention program. C) a psychological secondary prevention program. D) a biological primary prevention program. E) an indicated high-risk program. Answer: B Diff: 2 Type: MC Skill: Application
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20) A comprehensive ecological program is distinguished from narrowly focused programs by all of the following EXCEPT A) they address a broad range of risk factors. B) they look at a number of possible influences on behaviour. C) they focus on a small number of influences on behaviour. D) they focus mainly on protective factors. E) they concentrate on a wide variety of outcomes. Answer: C Diff: 1 Type: MC Skill: Factual
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21) Which statement best describes the results of the Perry Preschool Project? A) Children at high-risk are better able to complete their academic careers. B) This program is more beneficial to girls than boys. C) Although there were long -term benefits of this program, there were no immediate benefits. D) The short-term benefits appeared to disappear after a couple of years. E) The long-term benefits of the program are unclear. Answer: D Diff: 2 Type: MC Skill: Factual
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22) The main focus of the Prenatal Early Infancy Project is to A) assist the mother's in having regular medical check-ups. B) study children from before birth until late adolescence. C) ensure that the mother's maintained optimal health. D) prevent child abuse and neglect. E) ensure that the mother's did not consume drugs or alcohol during the pregnancy. Answer: D Diff: 2 Type: MC Skill: Factual
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23) Old's Prenatal Early Infancy Project was A) a support group implemented by pregnant women who were at risk for poor outcomes. B) a universal prevention program designed to assist single women who were pregnant for the first time. C) a prevention program designed for pregnant alcoholic women. D) a home-visitation project designed to improve maternal and child functioning. E) a hospital-based health program designed to increase maternal well-being and health. Answer: D Diff: 2 Type: MC Skill: Factual .. 6
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24) In the Early Infancy Prenatal Program, nurse-visited women showed all of the following EXCEPT A) improvement in the quality of their diets. B) fewer kidney infections. C) fewer preterm deliveries. D) abusive behaviour toward their children. E) more informal support and greater use of community services. Answer: D Diff: 1 Type: MC Skill: Factual
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25) Which of the following was NOT one of the long-term benefits of the Early Infancy Prenatal Program? A) Fourteen percent of the poor, unmarried teenage mothers in the control group abused their children, compared to 4% in the nurse-visited group. B) The children in the nurse-visited group showed a better academic outcome than children in the control group. C) Nurse-visited women had lower rates of substance abuse. D) Nurse-visited women had higher rates of employment. E) The children in the nurse-visited group were less likely to visit a physician for injuries or ingestion. Answer: B Diff: 3 Type: MC Skill: Factual
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26) Better Beginnings, Better Futures differs from most prevention projects in that A) it was designed to address child, family, and community development. B) a home-visiting component is included. C) funding was provided by the community members themselves. D) community psychologists are responsible for most decisions. E) it only focused on families falling below the poverty line. Answer: A Diff: 2 Type: MC Skill: Factual
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27) Researchers have found that the most positive and long-lasting impacts of prevention programs occur when A) the programs are long and intensive. B) the programs include free access to psychological help. C) the programs are brief and simple. D) the programs have a follow-up five to ten years later. E) the programs last for one to two years. .. 7
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Answer: A Diff: 1 Type: MC Skill: Factual
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28) Prevention programs have been used to deal with all of the following problems EXCEPT A) problems of children and youth. B) adult illiteracy. C) criminal behaviour and conduct disorder. D) depression. E) violence against women. Answer: B Diff: 1 Type: MC Skill: Factual
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29) What is true regarding the Canadian provinces' reaction to prevention? A) Funding for prevention programs appears to be greatest in the Western provinces. B) There has been an increase in funding to prevention projects. C) Various programs are proposed, yet funding is not provided to prevention. D) Prevention programs are wholeheartedly supported. E) Funding for prevention programs appears to be lagging in the Atlantic provinces. Answer: C Diff: 1 Type: MC Skill: Conceptual
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30) In a recent review of Canadian programs, Waddell et al. (2007) found that only _________ has demonstrated positive mental health outcomes for children. A) the Community Action Program for Children (CAPC) B) the Better Beginnings project C) the Early Head Start project D) The Perry Preschool project E) the Prenatal Early Infancy project Answer: B Diff: 2 Type: MC Skill: Conceptual
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31) The Community Holistic Circle Healing approach was developed to prevent mental disorders associated with: A) child sexual abuse. B) alcohol abuse. C) domestic violence against women. D) inadequate nutrition. .. 8
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E) low levels of academic motivation. Answer: A Diff: 1 Type: MC Skill: Conceptual
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32) In Ontario, Ontario Early Years Centres have been developed as a result of a report entitled: A) The Kirby report. B) A New Perspective on the Health of Canadians. C) Achieving Health for All. D) Reversing the Real Brain Drain: Early Years Study – Final Report. E) Mental Health for Canadians: Striking a Balance. Answer: D Diff: 1 Type: MC Skill: Factual
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33) Which of the following is true of Canada? A) Canada is ahead of many Western European countries in social policies that support families. B) Canada has dramatically reduced rates of child poverty. C) Canada’s national mental health strategy focuses too little on prevention or promotion. D) Beginning in the late 1980s, the federal government increased transfer payments to the provinces. E) There are very few national and provincial early childhood education initiatives. Answer: C Diff: 1 Type: MC Skill: Factual
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34) Although poorer people are more likely to have severe psychological problems, our culture A) concentrates on individual persons rather than on systems. B) emphasizes systemic problems such as child poverty. C) blames the government for all problems. D) provides services only to those who can afford them. E) is attempting to involve lower SES groups in intervention efforts. Answer: A Diff: 1 Type: MC Skill: Conceptual
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35) Studies that have investigated the return on investment (ROI) of early intervention programs have found that the savings obtained come in the form of all of the following EXCEPT: .. 9
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A) reduced attendance in costly special education programs. B) less contact with expensive social services. C) fewer tax dollars allocated to treatment and rehabilitation. D) lower rates of incarceration and delinquency. E) increased tax contributions through steady employment. Answer: C Diff: 1 Type: MC Skill: Factual
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36) The future focus of prevention/promotion programs should be A) documenting outcomes. B) successful implementation. C) children and youth. D) developing more effective programs. E) determining which groups most need help. Answer: B Diff: 2 Type: MC Skill: Factual
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37) A community psychologist would be responsible for diagnosing and treating those of lower socioeconomic status. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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38) Primary prevention focuses on reducing mental health problems and enhancing functioning. A) True B) False Answer: B Diff: 1 Type: TF Skill: Conceptual
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39) According to the crisis theory of Lindemann and Caplan, people in a state of crisis are more open to accepting assistance. A) True B) False
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Answer: A Diff: 2 Type: TF Skill: Conceptual
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40) Specific risk factors are responsible for certain types of mental health problems, and if we intervene early enough, we could prevent specific problems in groups of people. A) True B) False Answer: B Diff: 2 Type: TF Skill: Conceptual
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41) The ecological perspective focuses on the individual, his or her family and social network, schools and workplaces, and social norms and policies. A) True B) False Answer: A Diff: 1 Type: TF Skill: Conceptual
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42) From the view of mental health promotion, mental health is the absence of mental disorder. A) True B) False Answer: B Diff: 1 Type: TF Skill: Conceptual
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43) The only way to reduce the impact of a risk factor is to remove that risk factor from the individual's environment. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
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44) High risk programs always attempt to involve communities that are at risk for particular reasons (i.e., low SES, crime-infested, etc.). A) True B) False
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Answer: B Diff: 2 Type: TF Skill: Factual
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45) Traditionally, health and human services have focused on persons’ deficits and weaknesses. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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46) The Perry Preschool Program and the Prenatal Early Infancy project are examples of high-risk programs because they focus on individuals who are already at a disadvantage for having problems (due to low SES, unemployment, etc.). A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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47) The Better Beginnings, Better Futures project could be considered universal, since it was offered to all children and their families in a given age range. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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48) The Canadian government has been extremely supportive of prevention efforts, and funding for prevention programs is becoming increasingly available. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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49) Recently, some provinces have begun prevention initiatives. A) True B) False
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Answer: A Diff: 2 Type: TF Skill: Conceptual
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50) Generally, early childhood intervention programs have not been found to a high return on investment (ROI). A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
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51) In order to be more successful, community psychology should allow community members to be responsible for the planning and implementation of prevention projects. A) True B) False Answer: A Diff: 1 Type: TF Skill: Conceptual
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52) Distinguish community psychology from clinical psychology. Answer: Community psychology: * emphasis on prevention * ecological perspective * interventions should address multiple levels * attention to people's strengths and the promotion of wellness * importance of social support * orientation to social justice and social change * community psychologist acts as a consultant or planner, and collaborates with community groups to implement and evaluate interventions Clinical psychology: * focus on treatment * focus on the individual * focus on deficits and on reducing maladaptive behaviour * clinical psychologists act as experts in diagnosis and treatment * importance of reliance on professional help Diff: 2 Type: ES Page Ref: 441 Skill: Conceptual
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53) Define the three types of prevention Answer: Primary prevention: involves intervention which reduces the incidence of disorder (is practiced prior to the presence of the disorder) Secondary prevention: reduces the duration of the disorder (before the disorder has caused suffering or disability) Tertiary prevention (treatment): practised after suffering or disability from the disorder has been experienced, with the goal of preventing further disorder (reduces disability). Diff: 1 Type: ES Page Ref: 442 Skill: Conceptual 54) List five categories of general risk factors for poor mental health and identify some general protective factors. Answer: General risk factors: family circumstances, emotional difficulties, school problems, ecological context, constitutional handicaps, interpersonal problems, skill development delays Protective factors: stable care from parents or caregivers, effective problem-solving abilities, attractiveness to peers and adults, being and feeling competent, identification with competent role models, aspirations and an inclination to plan for the future. Diff: 2 Type: ES Page Ref: 445-446 Skill: Application 55) Compare and contrast the high-risk vs. the universal approach to promotion/prevention programs. Answer: High-risk approach: is based on the assumption that there are known risk factors for certain mental health problems, and it is most effective to target individuals most exposed to these risk factors. Universal approach: is designed to include all individuals in a particular geographical area (for example, a neighbourhood or city) or particular setting (a school or workplace). Diff: 1 Type: ES Page Ref: 442 Skill: Factual 56) Briefly describe Old's Prenatal Early Infancy Project; focus on results. Answer: * a high-risk prevention project aimed at preventing child abuse and neglect. * 400 women with their first pregnancy were involved, 85% were considered high-risk (low income, unmarried, or teenaged) and were randomly assigned to the home-visit program or to a control group * Designed to improve: the outcomes of pregnancy, the quality of parenting, and the mother's life course development * Results: the nurse-visited women improved the quality of their diets, had fewer kidney infections, experienced more informal social support, and made greater use of community support systems than the control group.
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* During the first two years after delivery, fewer of the poor, unmarried teen mothers in the nurse-visited group abused or neglected their children, and fewer of their children were brought to the hospital for injuries or ingestion. * In the fifteen year follow-up, the nurse visited women had higher rates of employment, lower rates of substance abuse, and subsequent pregnancies. Diff: 2 Type: ES Page Ref: 450-451 Skill: Factual 57) Highlight the three major goals of the Better Beginnings, Better Futures project. Answer: * Prevention goal: to prevent serious social, emotional, behavioural, physical, and cognitive problems in young children * Promotion goal: to promote the social, emotional, behavioural, physical, and cognitive development of these children * Community development goal: to enhance the abilities of socioeconomically disadvantaged families and communities to provide for their children Diff: 1 Type: ES Page Ref: 452 Skill: Conceptual 58) Briefly outline the prevention and promotion policy in Canada. Answer: Although Canada has been a leader in promoting the concept of prevention, little changed in Canadian health systems. Although funding for programs is now being provided by the federal government, none of these programs, with the exception of the Better Beginnings project, has explicitly focused on the prevention of mental health problems and the promotion of mental health. Canada lags behind many Western European countries in its social policies aimed at helping families. The focus is still on treatment and rehabilitation rather than prevention or promotion. The same problem exists at the provincial level as well in that health funding has not been reallocated from treatment to prevention. There are some positive signs showing that prevention is beginning to take root in provincial health, education, and social services. Diff: 2 Type: ES Page Ref: 454 Skill: Factual 59) Briefly outline future directions for prevention and promotion. Answer: The planning, implementation, and dissemination of prevention programs need to receive more attention. Knowing more about how to implement and disseminate programs will lead to better integration with the plans of schools, communities, and workplaces. Another critical future direction for prevention is to focus more on changing the many social and psychological ills that have its roots in the macrosystem. Diff: 2 Type: ES Page Ref: 455-456 Skill: Factual/Conceptual
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CHAPTER 19 Mental Disorder and the Law 1) Under the law a mental disorder is a condition that is all of the following EXCEPT A) internal. B) volitional. C) not a reflection of situational or contextual factors. D) involuntary. E) stable. Answer: B Diff: 2 Type: MC Skill: Conceptual
Page Ref: 459
2) Given a legal definition of mental disorder, __________ would not normally be considered a mental disorder. A) schizophrenia B) major depressive disorder C) marijuana intoxication D) mental retardation E) dementia Answer: C Diff: 2 Type: MC Skill: Conceptual
Page Ref: 460
3) Canada's Charter of Rights and Freedoms is unique in what respect? A) it protects people with certain mental disorders rights and freedoms, but not others B) it guarantees that people with mental disorders cannot be charged with a criminal offence C) it guarantees rights and freedoms to people who suffer from mental disorder D) it gives some freedoms to people with mental disorders but takes away some rights E) it allows for the discrimination of people with mental disorders under the law Answer: C Diff: 2 Type: MC Skill: Factual
Page Ref: 460
4) In Canada, the issue of involuntary hospitalization is a matter of A) common law. B) consitutional law. C) criminal law. D) statutory law. E) civil mental health law.
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Answer: E Diff: 2 Type: MC Skill: Conceptual
Page Ref: 461
5) The decision as to whether a person is not criminally responsible on account of mental disorder is one aspect of A) criminal law. B) statutory law. C) civil mental health law. D) constitutional law. E) common law. Answer: A Diff: 2 Type: MC Skill: Factual
Page Ref: 461
6) The ancient common law principle parens patriae is recognized in all provinces EXCEPT A) Manitoba. B) Ontario. C) Quebec. D) British Columbia. E) Prince Edward Island. Answer: C Diff: 1 Type: MC Skill: Factual
Page Ref: 462
7) According to epidemiological research, about __________ percent of Canadians will experience a serious mental disorder at some point in their lives. A) 30 B) 10 C) 20 D) 50 E) 75 Answer: C Diff: 2 Type: MC Skill: Factual
Page Ref: 462
8) Ken is a welder who lives in Toronto. Recently, he was diagnosed as being mentally ill. Which specific criteria must be examined to determine whether he should be involuntarily committed to a psychiatric hospital? A) whether or not he will benefit from treatment B) whether or not his mental illness is recognized by the DSM-TR-IV C) whether or not his mental disorder will result in serious bodily harm to another person .. 2
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D) whether or not he needs treatment; demonstrated danger need not be present E) whether or not he will deteriorate mentally or physically if he is not held in hospital Answer: C Diff: 3 Type: MC Skill: Application
Page Ref: 462
9) Civil commitment can only occur under all of the following circumstances EXCEPT A) a person is at risk of harming others. B) a person has a mental disorder. C) a person is unwilling or unable to consent to hospitalization. D) a person is deemed in need of hospitalization by a family member. E) a person is at risk of harming him/herself. Answer: D Diff: 2 Type: MC Skill: Conceptual
Page Ref: 463
10) People who are civilly committed to a psychiatric hospital A) have specific rights prohibiting recommitment once released. B) tend to have similar protection of their rights to those dealt with by criminal law. C) lose their rights just as those convicted of criminal offences do. D) serve a specific sentence. E) lose some, but not all, of their rights, unlike those convicted of criminal offences. Answer: C Diff: 3 Type: MC Skill: Factual
Page Ref: 463
11) The capable wishes principle holds that A) a patient's personal wishes regarding treatment should be given partial weight in the decision-making process. B) a patient's personal wishes regarding treatment should be given the greatest weight in the decision-making process. C) a patient's personal wishes regarding treatment should be given the greatest weight in the decision-making process, regardless of the consequences. D) a patient's personal wishes regarding treatment should be given minimal weight in the decision-making process. E) a treatment that maximizes the chances of a good outcome for the patient is chosen. Answer: B Diff: 2 Type: MC Skill: Conceptual
Page Ref: 464
12) Comparisons of voluntary and involuntary admissions have found that the primary diagnosis for most voluntary patients to be .. 3
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A) anxiety disorder. B) dissociative disorder. C) mood disorder. D) personality disorder. E) psychotic disorder. Answer: C Diff: 2 Type: MC Skill: Factual
Page Ref: 465
13) Comparisons of voluntary and involuntary admissions have found that the primary diagnosis for most involuntary patients to be A) dissociative disorder. B) personality disorder. C) psychotic disorder. D) mood disorder. E) anxiety disorder. Answer: C Diff: 2 Type: MC Skill: Factual
Page Ref: 465
14) In a study comparing patients who had applied for a review of their involuntary hospitalization and those who did not found that those who applied were A) more likely to be older. B) more likely to have a diagnosis of mental retardation. C) more likely to have fewer education and employment problems. D) more likely to have a diagnosis of schizophrenic disorder. E) more likely to be female. Answer: D Diff: 2 Type: MC Skill: Factual
Page Ref: 465
15) Grant and his colleagues reported that of 279 psychiatric patients in British Columbia A) the average age was about 54 years. B) 68 percent of the patients had a history of suicidal behaviour prior to hospitalization. C) almost all patients had prior arrests for violent offences (well above 3/4 of the sample). D) close to the entire sample was employed prior to admission. E) 20 percent had a primary diagnosis of a psychotic disorder. Answer: B Diff: 3 Type: MC Skill: Factual
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16) Which of the following most closely approximates the “typical” Review Panel Applicant as identified by research conducted in British Columbia? (Gray, et al., 1985) A) a male over 30 years of age, educated with few problems with work. B) a male under 30 years of age, uneducated, unskilled, presence of memory deficits C) a male under 30 years of age, problems with work, school and parents, presence of mental retardation and epilepsy D) a male under 30 years of age, transferred from another institution, problems with alcohol abuse, schizophrenic tendencies E) a male under 30 years of age, uneducated, unskilled, presence of mental retardation Answer: D Diff: 3 Type: MC Skill: Factual
Page Ref: 466
17) Identify the untrue statement. A) Most people who commit crimes are likely to have mental disorders. B) Higher prevalence rates of mental illness in inmates have been obtained when samples have consisted only of those inmates referred by jail staff for mental health evaluations. C) Most people with mental disorders are likely to commit crimes. D) The prevalence of mental illness among offenders, generally has been found to be higher than for people in the general population. E) Specific rates of mental illness reported for jail inmates vary considerably among studies. Answer: C Diff: 1 Type: MC Skill: Factual
Page Ref: 467
18) Follow-up research examining the community adjustment of patients released from involuntary hospitalization found that __________ percent were readmitted within a year. A) 45 B) 60 C) 10 D) 25 E) 75 Answer: A Diff: 1 Type: MC Skill: Factual
Page Ref: 466
19) The discretionary approach to violence risk assessment is largely __________, whereas the nondiscretionary approach is primarily __________. A) objective; intuitive B) subjective; objective C) mechanistic; informal
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D) actuarial; clinical E) algorithmic; heuristic Answer: B Diff: 2 Type: MC Skill: Conceptual
Page Ref: 466
20) Historical factors in the HCR-20 include all of the following EXCEPT A) previous violence. B) early maladjustment. C) relationship stability. D) stress. E) prior supervision failure. Answer: D Diff: 3 Type: MC Skill: Factual
Page Ref: 467
21) Clinical factors in the HCR-20 include all of the following EXCEPT A) employment problems. B) lack of insight. C) impulsivity. D) active symptoms of major mental illness. E) negative attitudes. Answer: A Diff: 2 Type: MC Skill: Factual
Page Ref: 467
22) Section 16 of Canada's criminal code recognizes that mental disorder may negate the principal of A) actus reus. B) self-defence. C) mens rea. D) insanity. E) good intention. Answer: C Diff: 2 Type: MC Skill: Conceptual
Page Ref: 468
23) The M'Naghten standard resulted from the fact that A) M'Naghten's crime was the result of his delusions. B) M'Naghten accidentally committed murder. C) M'Naghten tried unsuccessfully to argue that his crime was the result of his delusions.
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D) M'Naghten knowingly committed murder. E) M'Naghten's crime was not the results of his delusions. Answer: A Diff: 2 Type: MC Skill: Factual
Page Ref: 469
24) Ken is charged with first degree murder. He fully comprehends and remembers what he has done, yet shows no remorse and is unable to accept moral responsibility for his actions. Ken should A) be given a normal trial. B) be found not criminally responsible on account of a mental disorder (NCRMD). C) be declared unfit to stand trial. D) be denied the capacity to participate in his legal procedure. E) be automatically sent for psychiatric treatment in a hospital. Answer: A Diff: 2 Type: MC Skill: Application
Page Ref: 470
25) All of the following believed in exculpating mentally ill people EXCEPT A) Judaic law. B) English law. C) Egyptian law. D) Roman law. E) Muslim law. Answer: C Diff: 2 Type: MC Skill: Factual
Page Ref: 468
26) The Hadfield case (Rex v. Hadfield, 1820) A) preceded the passing of the Criminal Lunatics Act. B) led to the Unfit to Stand Trial (UST) act. C) marked the end of the “not guilty by reason of insanity” (NGRI) verdict. D) defined a standard of insanity known as the M'Naghten standard. E) led to a guilty verdict. Answer: A Diff: 1 Type: MC Skill: Application
Page Ref: 469
27) Legal arguments concerning mental disorder tend to focus on A) the suffering caused by the accused person. B) whether the mental disorder causes cognitive impairment. C) the severity of the mental illness. .. 7
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D) the criminal act. E) whether the mental disorder is real or valid. Answer: B Diff: 2 Type: MC Skill: Conceptual
Page Ref: 469
28) The insanity defence remained unchanged for almost a century. When bill C-30 was passed, changing the legislation governing mentally disordered offenders, which of the following changes was implemented? A) All mental disorders recognized in the DSM-IV-TR were recognized in the legal system. B) The APA provided the legal system with a definition of insanity. C) The name of the defence was changed from “not guilty by reason of insanity” (NGRI) to “not criminally responsible on account of a mental disorder” (NCRMD). D) The word “wrong” was abandoned because of its controversial nature. E) The content in section 16 of the Criminal Code was modified. Answer: C Diff: 2 Type: MC Skill: Factual
Page Ref: 468
29) Robert has assaulted a neighbour. Even though he understands the act itself, he is declared, according to the M'Naghten standard, to be insane. Which of the following would most effectively help us judge the accuracy of this claim? A) Robert is unable to give a detailed account of his actions at the time of the offense. B) Robert had been heavily intoxicated at the time of the offense. C) Robert had a long history of mental illness during his childhood. D) It has been determined that at the time of his offense, Robert was suffering from a defect of the mind. E) Robert is unable to understand that the act is wrong. Answer: E Diff: 3 Type: MC Skill: Factual
Page Ref: 469
30) People who are unable to participate actively in their own defence due to mental disorder are A) often referred to a substitute decision-maker who decides what the plea will be. B) automatically declared guilty and sentenced. C) referred to as unfit to stand trial. D) referred to as not criminally responsible on account of mental disorder. E) automatically declared not guilty and acquitted.
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Answer: C Diff: 2 Type: MC Skill: Factual
Page Ref: 470
31) In R. v. Chaulk (1990) the Court decided that A) the word “wrong” should be interpreted to include morally wrong only if the accused does not suffer from a personality disorder. B) the word “wrong” should be interpreted to include morally wrong. C) the word “wrong” means wrong according to law and not morally wrong. D) changes be made to Bill C-30 relating to who can raise the defence of insanity. E) Bill C-30 was unconstitutional. Answer: B Diff: 3 Type: MC Skill: Factual
Page Ref: 469
32) To be considered fit to stand trial, a defendant must A) must have moderate cognitive capacity. B) must have limited cognitive capacity. C) must have an IQ of at least 90. D) must have an IQ of at least 70. E) must have full cognitive capacity. Answer: B Diff: 1 Type: MC Skill: Factual
Page Ref: 470
33) The concepts “fit to stand trial” and “not criminally responsible on account of a mental disorder (NCRMD)” A) both require the examiner to determine the accused's present mental state. B) are unrelated issues. C) are distinct and call for different questions to be answered. D) both require an examiner to determine the accused's mental state at the time of the offence. E) mean the same thing. Answer: C Diff: 2 Type: MC Skill: Factual
Page Ref: 470
34) Which of the following is true? A) In determining whether an individual is fit to stand trial, a person need not understand the possible consequences of the proceedings. B) It has generally been easy to determine the degree of capacity required for fitness for an individual charged with an offence.
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C) In R v. Taylor (1992), the Court stipulated that, when communicating with counsel, the accused must have the ability to act in his or her own best interest. D) The party who raises the issue of an accused's fitness, does not have the burden of proving the issue of unfitness. E) In determining whether an individual is fit to stand trial, his or her ability to communicate with counsel must be evaluated. Answer: E Diff: 2 Type: MC Skill: Factual
Page Ref: 470
35) The Fitness Interview Test (FIT-R) A) identifies whether a person committed an act intentionally or not. B) helps determine what mental disorder a person is suffering from, according to the law. C) was of key use in the Owen Swain case. D) is only used with the most violent offenders. E) helps psychologists and psychiatrists assess whether an individual is fit to stand trial. Answer: E Diff: 1 Type: MC Skill: Factual
Page Ref: 470
36) Which of the following is true regarding NCRMD? A) Of those claiming to be NCRMD, most are found to be NCRMD. B) Of those claiming to be UST, most are found to be UST. C) Very few people charged with criminal offences claim to be NCRMD. D) A large number of people charged with criminal offences claim to be NCRMD. E) A large number of people charged with criminal offences claim to be UST. Answer: C Diff: 2 Type: MC Skill: Factual
Page Ref: 472
37) The four fundamental principles for psychologists in Canada include all of the following EXCEPT A) integrity in relationships B) respect for culture C) responsible caring D) responsibility to society E) respect for the dignity of persons Answer: B Diff: 2 Type: MC Skill: Factual
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38) The five general ethical principles stated in the Code of Ethics include all of the following EXCEPT A) principle of beneficence. B) principle of autonomy. C) principle of fidelity. D) principle of science. E) principle of nonmaleficence. Answer: D Diff: 2 Type: MC Skill: Factual
Page Ref: 473
39) Respect for self-determination is the principle of A) beneficence. B) justice. C) nonmaleficence. D) autonomy. E) fidelity. Answer: D Diff: 1 Type: MC Skill: Factual
Page Ref: 473
40) What is true regarding the four fundamental principles in the Code of Ethics? A) All four of the principles are considered equally important. B) Principle III is considered the most important of all four principles. C) The principles are ranked from most important to least important. D) It is up to the psychologist to determine which principles is important for him/her. E) The principles are ranked from least important to most important. Answer: C Diff: 1 Type: MC Skill: Conceptual
Page Ref: 473
41) Which of the following professionals is not qualified to determine whether a person meets the criteria for civil commitment into a psychiatric hospital? A) psychologist B) anaesthesiologist C) psychiatrist D) dermatologist E) physician Answer: A Diff: 1 Type: MC Skill: Factual
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42) Which of the following concerning the status of psychology in the legal system is true? A) psychologists can conduct court-ordered assessments of fitness to stand trial but not criminal responsibility. B) psychologists can conduct court-ordered assessments of criminal responsibility but not fitness to stand trial. C) in some jurisdictions psychologists have the legal authority to involuntarily hospitalize people. D) medical practitioners play a more dominant role in many areas in which mental health input is needed. E) psychologists are rarely, if ever, asked to give evidence before courts as professionals. Answer: D Diff: 2 Type: MC Skill: Factual
Page Ref: 473
43) The case of R. v. F. D. M. is important because A) it raised doubts about the ability of psychologists to diagnose mental disorders. B) it raised doubts about the ability of either psychologists or psychiatrists to diagnose mental disorders. C) it raised doubts about the validity of the psychoses diagnoses. D) it raised doubts about the ability of psychiatrists to diagnose mental disorders. E) it raised doubts about the validity of the schizophrenia diagnoses. Answer: A Diff: 2 Type: MC Skill: Factual
Page Ref: 474
44) In common law, the King (or Queen) was not obligated to protect and provide care for those who were incapable of caring for themselves. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
Page Ref: 460
45) Individuals with a mental disorder are protected by The Charter of Rights and Freedoms. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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46) The capable wishes principle does not grant any weight to a patient’s personal wishes even if they were competent at the time that they were expressed. A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
Page Ref: 464
47) Although the standard of insanity known as the M'Naghten standard became the accepted rule in England, in the United States and Canada it could not be labelled as a true cognitive test of insanity. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
Page Ref: 469
48) Legal arguments tend to focus on whether a person’s mental disorder is valid according to the law. A) True B) False Answer: B Diff: 2 Type: TF Skill: Factual
Page Ref: 469
49) Conditional discharge and detention in hospital are the two disposition options available to individuals found “not criminally responsible of a mental disorder” (NCRMD). A) True B) False Answer: B Diff: 1 Type: TF Skill: Factual
Page Ref: 469
50) Forensic psychologists are judged according to a higher standard of practice. A) True B) False Answer: A Diff: 1 Type: TF Skill: Factual
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51) The Canadian Criminal Code allows for general practitioners to make judgments in a court of law regarding a defendant’s sanity. A) True B) False Answer: A Diff: 2 Type: TF Skill: Factual
Page Ref: 474
52) Although Canadian involuntary civil commitment criteria vary from province to province, similar elements do exist. List these and indicate how involuntary civil commitment in Canada differs from the conviction for a criminal offence. Answer: Although legislation differs across provinces, involuntary civil commitment criteria have many similar elements across the country. First, an individual must be found to be mentally ill. Second, usually there must be a risk of “harm” or “danger” to the mentally ill person or to others. This assessment of an individual's risk can be determined using a “strict definition of danger” (i.e. Yukon, Alberta, North West Territories, Manitoba and Ontario). Here a person will likely be committed if his or her mental disorder likely will result in serious bodily harm to another person. Other provinces have a broader definition of danger. Here, for example individuals may be committed even without demonstrated danger if they need treatment, or if they will deteriorate mentally or physically if they are not held in hospital. Unlike criminal law (i.e. federally controlled), mental health acts are legislated by the provinces. People who are civilly committed lose their rights just as those convicted of criminal offences do. Civil commitment differs, however, in that its primary goal is to protect the individual patient. Involuntary hospitalized patients tend to have less protection of their rights than those dealt with by criminal law. Also, criminal acts are specifically defined whereas the terms relevant to civil commitment tend to be vague (e.g., “need for treatment”). Finally convicted felons face specific sentences, whereas civilly committed individuals face indeterminate sentences. Diff: 2 Type: TF Page Ref: 461-462 Skill: Conceptual 53) Describe the “typical” patient who is released by a review panel and discuss available research pertaining to the rate at which he/she faces rehospitalization. Answer: The “typical” patient released by a Review Panel was represented at the hearing by a lawyer, was unmarried, and was likely to have been deemed capable under the Patients' Estate Act. He/she had typically spent less time in hospital, and had been out of hospital longer since the last admission than patients who were not released by the panel. Patients who were released were also more likely to be on a waiting list for a boarding home, and were judged by their attending psychiatrist as being less dangerous to self than those who were not released. Finally, released patients typically had a history of drug abuse, but were judged as having less psychopathology than those patients who were not released. .. 14
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Although they are few in number, rehospitalization studies have produced variable results, partly due to the difference in the follow-up periods. Goering and Wasylenski (1980) followed 747 psychiatric patients discharged from a psychiatric hospital in Toronto. Patients were interviewed one month, three months, and two years after discharge. Discharged patients fared poorly; both social isolation and inadequate income persisted throughout the two-year follow-up period. Ledwidge et al. (1987), conducted a two-year follow-up study in British Columbia of 94 patients released by review panels or by an attending physician. There was no significant difference between the two groups. Forty-five percent were readmitted within one year, which is similar to rates reported by other researchers (e.g., Mortensen & Eaton, 1994). Two years after discharge, about 18% were in hospital (Ledwidge et al., 1987). Diff: 2 Type: ES Page Ref: 465-466 Skill: Factual 54) Describe the evolution of the insanity defence. Answer: James Hadfield was charged with high treason in the attempted murder of King George III. He pleaded insanity and was acquitted. This case led to implementation of the “not guilty by reason of insanity” defence and the passing of the Criminal Lunatics Act of 1800 which stated that people acquitted by reason of insanity could be confined to a mental hospital for an indeterminate period. Daniel M'Naghten's attempted murder of the Prime Minister of England, Sir Robert Peel also had an influence on the insanity defence. The M'Naghten standard, comprised of three elements, became the rule in England, the United States and Canada. First, the accused must be suffering from a defect of the mind (i.e., a mental disorder); second, the accused must not have known the “nature or quality of the act he was doing,” or third, the accused must not have known that “what he was doing was wrong”. The current language of section 16 of the Criminal Code permits a finding of what is currently called “not criminally responsible on account of mental disorder (NCRMD), which dates back to the 1800s. The M’Naghten standard has also formed the basis for the insanity provisions of the criminal codes in most common law jusrisdictions around the world, including the United States. Diff: 1 Type: ES Page Ref: 468-469 Skill: Factual 55) Why are certain individuals found unfit to stand trial? Which means are available to make this assessment in Canada? Answer: An accused is presumed fit to stand trial unless the court is satisfied on a balance of probabilities that the accused is unfit. The law is specifically concerned that mentally ill people may not be “fit” or competent to participate in the criminal justice system. Without this capacity, an individual may lack the necessary competencies that are called into question during a trial (i.e., competence to understand their Charter cautions, competence to confess, fitness to stand trial, and competence to be sentenced). In order to have this assessed, an examiner will assess the accused's present mental condition and
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