Abnormal Psychology The Problem of Maladaptive Behavior, 11E Irwin G Sarason Test Bank

Abnormal Psychology The Problem of Maladaptive Behavior, 11E Irwin G. Sarason

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Table of Contents Chapter 1: Introduction……………………………………………….……………………… 1 Chapter 2: Theoretical Perspectives on Maladaptive Behavior……..…………………..37 Chapter 3: The Therapeutic Enterprise: choices, Techniques, Evaluation……..…….. 71 Chapter 4: Classification and Assessment………………………………………..………..94 Chapter 5: Stress, Coping, and Maladaptive Behavior………………………………… 116 Chapter 6: Body Maladaptions: Eating, Sleeping, and Psychophysiological Disorders…………………………………………………………… 136 Chapter 7: Disorders of Bodily Preoccupation………………………………………….. 164 Chapter 8: Anxiety Disorders…………………………………………..…………………. 179 Chapter 9: Sexual Variants and Disorders……………………………………….……… 205 Chapter 10: Personality Disorders…………………………….…………………………... 232 Chapter 11: Mood Disorders………………………………….………………….………... 263 Chapter 12: Schizophrenia and Other Psychotic Disorders..………………….……… 293 Chapter 13: Cognitive Impairment Disorders….………………………………………. 318 Chapter 14: Substance-related Disorders………………………………………….……. 345 Chapter 15: Disorders of Childhood and Adolescence……………………………….. 373 Chapter 16: Pervasive Developmental Disorders and Mental Retardation….…..… 397 Chapter 17: Society’s Response to Maladaptive Behavior…………………………… 420

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Chapter 1 Introduction 1-1. Although Buford Furrow’s family recognized that there was something wrong with him, he was not institutionalized. What is the primary reason that he was not committed to a mental institution? a) He had not committed a crime. b) Physicians could not agree on a diagnosis. c) State law prohibits family members from committing a family member older than 13. d) A judge determined that he could receive the treatment he needed on an outpatient basis.

Answer: c Page: 3 Level: Medium Type: Conceptual 1-2. Harvard University psychiatrist, Alvin Poussaint, is going to debate a colleague who holds an opinion diametrically opposed to his on cases such as those of Buford Furrow. Which of the following would make for the best title for this debate? a) “Racial bigotry as a mental disorder: Yes or no” b) “Schizophrenia as a cause of violence: Yes or no” c) “The genetic basis for bigotry: In the genes or in the environment” d) “Should schools or parents be responsible for teaching racial tolerance?”

Answer: a Page: 4 Level: Difficult Type: Conceptual 1-3. What is the primary focus of the field of abnormal psychology? a) group processes b) prevention programs c) maladaptive behavior d) pharmacological treatments Answer: c Page: 5 Level: Easy Type: Factual 1-4. Which of the following are true of abnormal psychology? a) Examines how society deals with people whom it considers to be different from other people. b) Investigates how it feels for people to be different c) Deals with meanings that get attached to being different. d) All are true of abnormal psychology.

Answer: d Page: 5 Level: Easy Type: Factual

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1-5. The ability to think rationally, coping effectively, and showing stability and growth are factors of: a) mental illness b) a therapeutic relationship c) abnormal psychology d) None of the above.

Answer: c Page: 5 Level: Easy Type: Factual 1-6. Mental health problems account for what percentage of disabling conditions? a) 50% b) 30% c) 75% d) 25% Answer: a Page: 6 Level: Medium Type: Factual 1-7. What factors assist clinicians to both explain and treat problems? a) identifying internal factors b) techniques of proper diagnosis c) structured clinical interviews d) identifying external factors Answer: d Page: 7 Level: Medium Type: Factual 1-8. Stigmatization can: a) Increase self-esteem depending on if presenting factors are internal or external. b) Lead to diminished self-esteem and increased pathology, but does not retard recovery. c) Be either external, internal, or a combination of the two. d) Require extended hospitalization to deal with events that prevent recovery.

Answer: c Page: 7 Level: Medium Type: Factual 1-9. You walk into a classroom to find the word adaptation written on the board.

It appears that the instructor was using a diagram to show that adaptation involves a balance between two factors, one of which is what people do or want to do. What is the other factor? a) what people fail to do b) what the environment requires c) feelings of accomplishment related to what people are doing d) hereditary predispositions that lead people to act in certain ways Answer: b Page: 8 Level: Difficult Type: Factual

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1-10. A survey was conducted to determine what the general public views as the causes of abnormal behavior. What are two of the common erroneous problem the general population believes are responsible for abnormal behavior? a) demons and spirits b) diet and genetic factors c) lack of will power and poor nutrition d) emotional weakness and bad parenting Answer: d Page: 8 Level: Easy Type: Factual 1-11. Henry was hospitalized with a serious mental disorder. With treatment, he returned to his previous level of functioning and was released. When a psychiatrist conducted a follow-up interview, Henry said he felt “stigma.” What is the most likely reason for Henry’s feeling? a) He was taking medication. b) His neighbors avoided him. c) He feared that treatment would fail. d) He kept in touch with friends from the hospital.

Answer: b Page: 8 Level: Easy Type: Conceptual 1-12. Jane is a psychologist who has practiced psychology for many years.

People are intrigued by her work, and she has several offers for public appearances and lectures. However, she has become annoyed at questions regarding the public’s perception of abnormal behavior; especially the manner in which the media portrays the behavior. Jane has indicated that: a) There is little, if anything, she can do to correct the public’s perception of abnormal behavior. b) She must meet the challenge to the field of abnormal psychology to correct the public’s misperceptions regarding the nature of abnormal behavior. c) She should consider teaching at the university level to relieve her stress. d) Ethically she needs to work more with her patients to remove stigmas.

Answer: b Page: 8 Level: Medium Type: Factual 1-13. What term is used to describe people’s ability or inability to modify their behavior in response to changing environmental requirements? a) adoption b) adaptation c) acclimation d) accommodation Answer: b Page: 8 Level: Easy Type: Factual 3

1-14. Adaptation is the ability to a) master the environment. b) feel at peace with oneself. c) modify behavior in response to change. d) learn the expectations of one’s social group.

Answer: c Page: 8 Level: Easy Type: Factual 1-15. After switching careers from librarian to kindergarten teacher, John developed a greater tolerance for noise. This change in John is an example of a) stress. b) adaptation. c) vulnerability. d) social maladaptation.

Answer: b Page: 9 Level: Medium Type: Conceptual 1-16. Most of the behaviors studied by those with an interest in abnormal psychology are related to failures in a) adaptation. b) vulnerability. c) stigmatization. d) balancing hormone levels.

Answer: a Page: 9 Level: Medium Type: Factual 1-17. By definition, all maladaptive behavior is considered to be a) deviant. b) pathological. c) maladaptive. d) nonproductive.

Answer: a Page: 9 Level: Medium Type: Factual 1-18. When a psychologist describes behavior as maladaptive, this indicates that: a) A problem exists and the person has vulnerability which led to problems in living. b) A person may have a problem but coping strategies can still be implemented. c) A problem exists but the person can maintain the ability to deal with stress. d) A problem exists but the person is not a danger to others but may be a danger to self.

Answer: a Page: 9 Level: Difficult Type: Conceptual

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1-19. What does the study of the history of abnormal psychology reveal about theories of maladaptive behavior? a) They are usually short-lived. b) They have resurfaced over and over. c) They exist independently of social mores. d) They have become progressively more enlightened.

Answer: b Page: 9 Level: Easy Type: Factual 1-20. The technique called exorcism is based on the assumption that mental illness is caused by: a) infections. b) evil spirits. c) stigmatization. d) chromosomal abnormalities.

Answer: b Page: 9 Level: Medium Type: Conceptual 1-21. An expert on shamans is being interviewed on public radio. How will this expert respond when asked about the existence of shamans in this century? a) Shamans still treat the mentally ill in some countries. b) The treatment espoused by shamans has been banned in most countries. c) The treatment espoused by shamans has been replaced by a modern form of trephination. d) Shamans no longer treat mental illness because they have been replaced by modern medicine.

Answer: a Page: 10 Level: Difficult Type: Conceptual 1-22. What is trephination? a) using herbs b) conducting séances c) removing the spleen d) making a hole in the skull Answer: d Page: 11 Level: Medium Type: Factual 1-23. Which approach is evident in attempts to treat maladaptive behavior by removing part of the brain? a) organic b) mystical c) philosophical d) psychological Answer: a Page: 11 Level: Easy Type: Factual

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1-24. According to the psychological perspective, behavioral disturbances are caused by a) excessive attachment. b) harmful societal influences. c) inherited deficits in metabolism. d) inadequacies in thinking, feeling, or perceiving.

Answer: d Page: 12 Level: Medium Type: Factual 1-25. Who were the first people to write about psychological and organic approaches to deviance? a) Chinese elders b) ancient Greek philosophers c) leaders in the Reform Movement d) church leaders in the Middle Ages Answer: b Page: 12 Level: Easy Type: Factual 1-26. Which of the following is not a perspective that has occurred throughout the history of Western civilization? a) supernatural b) emotional c) organic d) psychological Answer: b Page: 12 Level: Easy Type: Factual 1-27. In ancient Greece a mentally ill individual sought treatment at one of the temples dedicated to Asclepius. Which of the following treatments would this person likely receive during his stay in the temple? a) trephination b) vegetable diet c) a potent combination of herbs d) healing messages delivered in dreams Answer: d Page: 12 Level: Medium Type: Conceptual 1-28. Hippocrates described epileptic seizures as a disease of the a) liver. b) heart. c) brain. d) lungs.

Answer: c Page: 12 Level: Easy Type: Factual

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1-29. Which of these treatments for abnormal behavior were recommended by Hippocrates? a) bathing, dieting, and rest b) meditation, prayer, and sleep c) bloodletting, exercise, and fasting d) dream interpretation, herbal remedies, and trephining Answer: a Page: 12 Level: Medium Type: Factual 1-30. Plato believed that disturbed behavior grew out of conflicts between a) emotion and reason. b) children and parents. c) individuals and the community. d) biological and psychological stressors.

Answer: a Page: 12 Level: Medium Type: Factual 1-31. What did Socrates view as the cornerstone of personal happiness and the good life? a) reasoning b) physical health c) appeasement of the gods d) freedom from internal conflict Answer: a Page: 12 Level: Easy Type: Factual 1-32. Which ancient philosopher believed that people who were mentally ill should be separated from society? a) Socrates b) Hippocrates c) Plato d) Aristotle Answer: c Page: 12 Level: Easy Type: Factual 1-33. How did ancient Greek philosophers lay the groundwork for the development of modern science? a) They equated mind with brain. b) They proposed natural causes of abnormal behavior. c) They determined normal amounts of humors in the body. d) They recommended asylums for the treatment of the mentally ill.

Answer: b Page: 12 Level: Difficult Type: Conceptual

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1-34. An ancient Greek citizen hears that Galen proposed that personality and abnormal behavior were determined by an imbalance of humors. When this man asks a friend to describe what Galen means by humors, what will he be told? a) The term describes body fluids. b) The term describes an individual’s spiritual life. c) Humors is a term used to describe basic mental capacities. d) An individual’s reason and emotion are summarized by this one word.

Answer: a Page: 13 Level: Medium Type: Conceptual 1-35. Which physician believed that mental illness was a result of imbalances in body fluids? a) Dix b) Pinel c) Galen d) Kraepelin Answer: c Page: 13 Level: Easy Type: Factual 1-36. The ancient Greek physician, Galen, is examining a patient and concludes that the patient has an excess of black bile. What term will Galen use to describe this patient’s condition? a) manic b) anxious c) melancholic d) schizophrenic Answer: c Page: 13 Level: Medium Type: Conceptual 1-37. What focus of St. Augustine’s writings led him to be described as a forerunner of modern psychodynamic theories? a) sexuality b) aggression c) introspection d) the unconscious Answer: c Page: 13 Level: Medium Type: Factual 1-38. What was a common explanation of the causes of mental illness during the Middle Ages in Europe? a) demonology b) mental retardation c) natural, biological causes d) imbalances in reason and emotion Answer: a Page: 13 Level: Easy Type: Factual 8

1-39. During what historical period in Europe was the role of reason deemphasized in the study of mental illness? a) Medieval era b) World War I c) Middle Ages d) Renaissance Answer: c Page: 13 Level: Easy Type: Factual 1-40. Outbreaks of group hysteria were especially prevalent during what historical period in Europe? a) the B.C. era b) the Renaissance c) the Middle Ages d) the Medieval period Answer: c Page: 14 Level: Medium Type: Factual 1-41. During the Middle Ages in Europe, people who did not show mental disorders at birth but did show disabilities later in life were called a) idiots. b) psychotic. c) natural fools. d) non compos mentis.

Answer: d Page: 14 Level: Easy Type: Factual 1-42. The 16th-century physician, Johann Weyer, explained paranoia, epilepsy, psychosis, and depression in terms of a) witchcraft. b) psychological conflict. c) possession by evil spirits. d) an imbalance of body fluids.

Answer: b Page: 15 Level: Medium Type: Factual 1-43. Why was Robert Burton’s Anatomy of Melancholy important in the study of depression? a) described the role of anger in depression b) proposed a theory of imbalanced humors c) based on the life history of King George III d) described autopsies of depressed persons’ brains Answer: a Page: 15 Level: Medium Type: Conceptual

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1-44. Whose psychotic episode provided a major stimulus for the movement toward humane treatment of the mentally ill? a) King George III b) Baruch Spinoza c) Franz Joseph Gall d) William Shakespeare Answer: a Page: 15 Level: Easy Type: Factual 1-45. Physiognomy is a method of judging character, personality, and feelings based on a) bodily fluids. b) skin temperature. c) form of the body. d) bumps on the head.

Answer: c Page: 15 Level: Medium Type: Factual 1-46. Franz Joseph Gall’s theory that various psychological “faculties” are located in specific areas of the brain and can be measured by examining bumps and indentations on the head is known as a) magnetism. b) phrenology. c) physiognomy. d) non compos mentis.

Answer: b Page: 15 Level: Medium Type: Factual 1-47. You spend some time rummaging through boxes in the attic, and come across a photograph of several people who posed in front of a storefront sign that had the word Phrenologist. If the people in the photograph were there to visit the phrenologist, what was most likely to occur during the visit? a) The phrenologist would examine their handwriting for help in gathering information to give vocational recommendations. b) The phrenologist would examine their skulls for bumps or indentations that were thought to indicate levels of various faculties. c) The individuals would gather in a circle and the phrenologist would try to reach the spirits of some of their deceased relatives. d) The individuals would try to persuade members of their group that he or she was in need of an operation called trephining that would remove evil spirits.

Answer: b Page: 15 Level: Difficult Type: Conceptual

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1-48. William Cullen, a Scottish physician in the 1700s, believed that neurotic behavior was caused by physical defects in the a) spleen. b) small intestine. c) nervous system. d) circulatory system.

Answer: c Page: 16 Level: Medium Type: Factual 1-49. Imagine that you seek treatment provided by William Cullen. Which of the following treatments are you likely to undergo while under his care? a) exorcism, exercise, and enemas b) bloodletting, cold dousing, and vomiting c) relaxation, massage, and vegetable diet d) lobotomy, electroconvulsive therapy, and restraints Answer: b Page: 16 Level: Difficult Type: Conceptual 1-50. A patient seeks the treatment advocated by Franz Anton Mesmer. What is this patient likely to experience as part of the treatment? a) group therapy followed by dream interpretation b) ingesting a variety of drugs to enhance responsiveness c) a technique similar to hypnosis that relies on suggestion d) stress-inducing techniques designed to shock the nervous system Answer: c Page: 16 Level: Difficult Type: Conceptual 1-51. The reform movement in the 19th century in Europe was marked by a) herbal remedies. b) increased compassion for the mentally ill. c) successful surgical treatments for mental illness. d) rejection of scientific explanations of mental illness.

Answer: b Page: 17 Level: Medium Type: Factual 1-52. Franz Anton Mesmer’s use of magnets and “animal magnetism” in the treatment of abnormal behavior was a forerunner of a) hypnosis. b) medication. c) phrenology. d) bloodletting.

Answer: a Page: 17 Level: Medium Type: Factual

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1-53. Who was responsible for the idea of sympathy for the deranged and humane care and treatment was a course for wellness? a) William Cullen b) Franz Joseph Gall c) Franz Anton Mesmer d) Philippe Pinel Answer: d Page: 17 Level: Medium Type: Factual 1-54. What treatment approach sought to control and rehabilitate patients through a fixed schedule that encouraged regular habits? a) phrenology b) Mesmerism c) moral treatment d) Rogerian therapy Answer: c Page: 17 Level: Medium Type: Factual 1-55. “Moral treatment” of the mentally ill during the reform movement involved a) exorcism. b) physical restraint. c) calm surroundings. d) forgiveness of sins.

Answer: c Page: 18 Level: Medium Type: Factual 1-56. In the American colonies, the mentally ill were associated with paupers and criminals because all three groups were seen as a) intolerant. b) possessed. c) needing special charity. d) a menace to the community.

Answer: d Page: 18 Level: Easy Type: Factual 1-57. What was the primary purpose of treatment techniques such as purging and bloodletting used by Benjamin Rush? a) to allow evil spirits to escape b) to reduce pressure on the brain’s blood vessels c) to separate the emotion centers from the higher brain centers d) to reduce the level of neurotransmitters in the nervous system Answer: b Page: 18 Level: Easy Type: Conceptual

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1-58. Who is credited with the founding of American psychiatry? a) Dorothea Dix b) Clifford Beers c) Benjamin Rush d) Albert Bandura Answer: c Page: 18 Level: Easy Type: Factual 1-59. What was Dorothea Dix’s major contribution to the treatment of the mentally ill? a) She encouraged the founding of mental hospitals. b) She classified the major symptoms of depression and mania. c) She developed the diagnostic system that is still used today. d) She insisted that the mentally ill would receive better care if allowed to live at home with their families.

Answer: a Page: 19 Level: Medium Type: Factual 1-60. Who wrote about personal experiences as a patient and founded the National Committee for Mental Hygiene? a) Clifford Beers b) Dorothea Dix c) Benjamin Rush d) Wilhelm Griesinger Answer: a Page: 19 Level: Medium Type: Factual 1-61. Who encouraged the construction of many new mental hospitals in the U.S.? a) Benjamin Rush b) Robert Burton c) Clifford Beers d) Dorothea Dix Answer: d Page: 19 Level: Medium Type: Factual 1-62. Who was responsible for founding the National Committee for Mental Hygiene (now known as the National Association for Mental Health)? a) a former mental patient b) several concerned physicians c) an agency of the federal government d) a committee of bishops of the Catholic Church Answer: a Page: 19 Level: Medium Type: Factual

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1-63. Perry Baird was hospitalized for a manic-depressive condition. One of the treatments was a prefrontal lobotomy. What type of treatment was this? a) removal of the spleen b) cutting nerve tracts that carry pain messages c) surgical intervention to provide a means of escape for evil spirits d) surgical separation of nerve fibers connecting the frontal lobe and the thalamus Answer: d Page: 19 Level: Medium Type: Factual 1-64. The year is 1949 and a patient at a mental hospital is being prepared for a lobotomy, which is a new surgical intervention for treating mental illnesses.

Many staff members are unfamiliar with the procedure so they are full of questions. When they inquire they are told that a lobotomy involves cutting the fibers that connect the a) frontal lobe and thalamus. b) left and right hemispheres. c) cerebellum and parietal lobe. d) limbic system and occipital lobe.

Answer: a Page: 19 Level: Medium Type: Factual 1-65. Why did the slogan “Mental diseases are brain diseases” become popular in the nineteenth century? a) Many theorists argued that mental disorders were caused by direct and indirect influence of disturbance in how the brain functioned. b) This was the age of “rational thinking” which emphasized personal achievement and social adjustment. c) More emphasis was being placed on emotions, motivations, and conflicts with the brain. d) Maladaptive behavior was being viewed from biological and psychological perspectives.

Answer: a Page: 21 Level: Medium Type: Factual 1-66. When considering the interactional approach to research, social, psychological, and________ variables play a significant role in causation and influence the outcome of several disorders. a) physiological b) emotional c) biological d) anatomical Answer: c Page: 21 Level: Medium Type: Factual 14

1-67. What term do we use to describe our reaction to situations that impose demands or constraints, or which offer opportunities? a) stress b) regression c) sublimation d) vulnerability Answer: a Page: 21 Level: Medium Type: Factual 1-68. Ted is trying to remember the key concepts of abnormal psychology and he is having difficulty remembering and understanding vulnerability and resilience.

One of his friends says it is easy, just remember that vulnerability and resilience are really a) risk and protective factors. b) primary and secondary factors. c) genetic and environmental factors. d) diagnostic and therapeutic factors.

Answer: a Page: 21 Level: Medium Type: Factual 1-69. What term is used for the likelihood of responding maladaptively to certain situations? a) coping b) resiliency c) vulnerability d) maladjustment Answer: c Page: 21 Level: Easy Type: Factual 1-70. As a young boy, Jamar saw another child killed in a car accident. As an adult, he witnessed a terrible multi-car pileup and fire and found himself frozen and unable to respond to the desperate cries for help from the occupants who were trapped in the burning wreckage. Jamar’s inability to respond in this case may be due to his unique a) resiliency. b) adaptation. c) vulnerability. d) adjustment.

Answer: c Page: 21 Level: Medium Type: Conceptual

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1-71. A researcher who has been studying the development of brain disorders was interviewed and described new research focused on a high-risk group. If Jan is a member of this high-risk group, what can we conclude about her? a) She has a high level of resilience. b) Her life conditions have led her to develop protective factors. c) She has experienced life conditions that increase her vulnerability. d) Her past life conditions have compensated for her maladjustment.

Answer: c Page: 21 Level: Difficult Type: Conceptual 1-72. Resilience is the ability to function effectively under what condition? a) in the face of adversity b) without using coping skills c) in the absence of stressors d) when adaptation is avoided Answer: a Page: 21 Level: Medium Type: Factual 1-73. Under what conditions is maladaptive behavior most likely to occur? a) low stress and low vulnerability b) low stress and high vulnerability c) high stress and low vulnerability d) high stress and high vulnerability Answer: d Page: 21 Level: Difficult Type: Conceptual 1-74. Clinical interventions are methods of helping distressed people deal with vulnerability and improve their: a) coping skills b) resilience c) communication skills d) intervention strategies Answer: b Page: 22 Level: Medium Type: Factual 1-75. What term describes techniques available to an individual in dealing with difficulties and overcoming them? a) adaptation b) vulnerability c) coping skills d) stress reactions Answer: c Page: 22 Level: Medium Type: Factual

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1-76. _________data examines the number of new cases of a condition while _________ data examines the frequency of occurrence of a condition. a) incidence; raw b) incidence; prevalence c) survey; incidence d) prevalence; incidence Answer: b Page: 23 Level: Difficult Type: Factual 1-77. Epidemiologists are primarily interested in the a) treatment of illnesses. b) use of experimental methods. c) occurrence of illnesses in a population. d) causes of stigmatization among mental patients.

Answer: c Page: 23 Level: Medium Type: Conceptual 1-78. During a class discussion at the local high school, one of the students says his father is an epidemiologist. Which of the following is most likely to be one of the tasks this man has been working on lately? a) studying rates of alcoholism on campuses of different sizes b) designing packaging to increase the sale of alcoholic beverages to the public c) investigating the effects of alcohol consumption on interpersonal communication d) determining how the type of music in a bar influences the amount of alcohol sold Answer: a Page: 23 Level: Difficult Type: Conceptual 1-79. Which of the following is the best example of the type of data that an epidemiologist might use? a) a community’s hospital records b) results of a person’s psychological testing c) surveys about attitudes toward mental illness d) changes in symptoms over the course of therapy Answer: a Page: 23 Level: Medium Type: Conceptual 1-80. A researcher uses interviews to determine the rate of alcoholism among African Americans, European Americans, and Native Americans. What type of research is this researcher using? a) a longitudinal study b) naturalistic observation c) an epidemiological study d) a quasi-experimental study Answer: c Page: 23 Level: Difficult Type: Conceptual 17

1-81. In the town of Passivity, three people had anxiety disorders in the past but not now. Four people developed anxiety disorders six years ago, and continue to have anxiety disorders now. Which of the following might an epidemiologist write in her report concerning the rate of anxiety disorders in this community during the last 12 months? a) incidence = 4 b) prevalence = 7 c) prevalence = 4 d) lifetime prevalence = 10 Answer: c Page: 23 Level: Difficult Type: Conceptual 1-82. What term do we use for data that describe the frequency of a disorder at a particular point in time? a) incidence b) prevalence c) longitudinal d) experimental Answer: b Page: 23 Level: Medium Type: Factual 1-83. Which of the following is not true with regard to risk factors? a) do not include a genetic defect b) includes circumstances that make an individual more likely to develop a disorder c) change with relation to a developmental phase d) serve as early warning signs Answer: a Page: 23 Level: Medium Type: Factual 1-84. What is the incidence of an illness? a) how deadly the illness is b) how contagious the illness is c) the number of new cases of the illness d) the number of people who have ever had the illness Answer: c Page: 23 Level: Medium Type: Factual

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1-85. An epidemiologist studied depression in a community of 100 people. At the beginning of the study, she found that 10 people already qualified for the diagnosis. By the end of the study, 10 new cases had developed. What is the incidence rate of depression in this community during the study? a) 100% b) 20% c) 10% d) 1% Answer: c Page: 23 Level: Difficult Type: Conceptual 1-86. A clinical psychologist is reviewing Ted’s case file. As she reads the file, she finds a notation concerning a “risk factor.” Based on this notation, which of the following is she likely to conclude? a) Ted engages in behavior that the staff considers to be risky. b) Ted has experienced a complication of his current mental illness. c) Ted is unable to make decisions for himself as a result of his mental illness. d) Ted has a characteristic that increases the likelihood of exhibiting symptoms of a disorder.

Answer: d Page: 24 Level: Difficult Type: Conceptual 1-87. A television health reporter focused her last segment on the finding that children of alcoholics exhibit a higher-than-average rate of alcoholism. What term was she likely to use to describe being the child of an alcoholic? a) cause b) stigma c) incidence d) risk factor Answer: d Page: 24 Level: Difficult Type: Conceptual 1-88. Which of these individuals exhibits a significant risk factor for violent behavior? a) Bob who is depressed b) Frank who has an anxiety disorder c) George who is dependent on alcohol d) Harry who has an adjustment disorder Answer: c Page: 24 Level: Difficult Type: Conceptual

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1-89. Which of the following factors is associated with higher rates of diagnosed mental disorders? a) older age b) higher income c) less education d) being widowed Answer: c Page: 24 Level: Medium Type: Conceptual 1-90. Personal unhappiness, concerns of others, and legal problems are: a) factors in epidemiological research b) factors for family intervention c) reasons people seek professional help d) factors researchers should consider studying the effects of psychosocial interventions Answer: c Page: 24 Level: Medium Type: Factual 1-91. Which of the following is the most significant influence on the increased use of community-based outpatient treatment for psychological disorders in recent years? a) use of antipsychotic drugs b) changes in health insurance c) lower incidence of schizophrenia d) concerns about the availability of housing Answer: a Page: 26 Level: Medium Type: Factual 1-92. What is deinstitutionalization? a) decreased use of medications b) elimination of involuntary commitment c) discharge of many hospitalized patients d) renovations to make hospitals more homelike Answer: c Page: 26 Level: Easy Type: Factual 1-93. What degree does a psychiatrist hold? a) M.D. b) Ph.D. c) Ed.D. d) Psy.D. Answer: a Page: 27 Level: Medium Type: Factual

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1-94. Frank described some symptoms of depression he has been experiencing during the past six months. He said his therapist had prescribed a medication to treat the symptoms. Based on this description, you conclude that Frank’s therapist is trained as a a) podiatrist. b) psychiatrist. c) social worker. d) clinical psychologist.

Answer: b Page: 27 Level: Medium Type: Conceptual 1-95. What is the primary difference between psychiatrists and clinical psychologists? a) Psychiatrists are physicians. b) Psychologists prescribe medication. c) Only psychologists have training in treating psychoses. d) Psychiatrists are mainly involved in research, not treatment.

Answer: a Page: 27 Level: Medium Type: Conceptual 1-96. Dan is excited because today is the day his mom visits class to tell the students about her job as a clinical psychologist. After Dan’s mom leaves, the teacher asks each of the students to summarize the responsibilities of a clinical psychologist. Which of the following responses is most accurate? a) to work as a hospital administrator b) to diagnose and treat personality disorders c) to prescribe medications and administer shock therapy d) to treat patients with somatic therapies and administer intelligence tests Answer: b Page: 27 Level: Difficult Type: Conceptual 1-97. What is the primary concern of psychiatric social workers? a) psychological testing b) pharmacological treatments c) influence of the home environment d) assisting patients to qualify for welfare Answer: c Page: 27 Level: Medium Type: Factual 1-98. Which clinician is most likely to address patients’ aptitudes and to help them prepare vocationally to return to the community? a) psychiatrist b) clinical psychologist c) clinical social worker d) counseling psychologist Answer: d Page: 27 Level: Medium Type: Conceptual

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1-99. All of the following are important steps in seeking help for mental illness except: a) recognition b) decision – making c) availability d) cost Answer: d Page: 28 Level: Medium Type: Factual 1-100. Which of the following was an important part of the foundation of abnormal psychology? a) mapping the human genome b) drug therapy outcome studies c) in-depth studies of deviant people d) physiological research on brain dysfunction Answer: c Page: 28 Level: Medium Type: Factual 1-101. What are the first steps in the scientific process? a) testing and application b) observing and describing c) interpreting and theorizing d) hypothesis generation and testing Answer: b Page: 28 Level: Medium Type: Factual 1-102. If Dr. Jones joins a punk-rock band to study the youth subculture, what type of research is he using? a) follow-up study b) cross-sectional study c) participant observation d) epidemiological research Answer: c Page: 29 Level: Medium Type: Factual 1-103. Under which condition is the reliability among several observers likely to be highest? a) the ratings are subjective b) each rater has a unique frame of reference c) different raters emphasize different behaviors d) the observations do not require the drawing of inferences Answer: d Page: 29 Level: Difficult Type: Conceptual

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1-104. Which of the following is an example of the type of observational data called consequences of a behavior? a) Staff members avoid contact with Juan when he is depressed. b) Juan is most likely to become depressed in the evening and at night. c) Juan reports that he is very angry when staff members do not talk with him. d) Staff members tend to spend most of their time in conversation with each other.

Answer: a Page: 29 Level: Difficult Type: Conceptual 1-105. Which of these is an example of participant observation? a) joining a group to see what it is like b) having one group observe another group c) having two people observe the same group d) asking group members to describe their own behavior Answer: a Page: 29 Level: Difficult Type: Conceptual 1-106. In which situation is the reliability of an observation likely to be greatest? a) The ratings require inference. b) A series of self-observations are used. c) The observation depends on experience. d) Explicit definitions of the observed behavior are used.

Answer: d Page: 29 Level: Difficult Type: Conceptual 1-107. In order for a theory to be useful, it must be a) correlated. b) testable and refutable. c) descriptive, not predictive. d) supported by experimental research.

Answer: b Page: 30 Level: Medium Type: Factual 1-108. In an experiment on the relationship between anxiety and eating behavior, some participants are induced to experience high anxiety and some participants are induced to experience low anxiety. The amount of food they eat is then measured. What is the independent variable in this study? a) amount of food eaten b) number of participants c) level of induced anxiety d) the participants’ weight Answer: c Page: 31 Level: Difficult Type: Conceptual

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1-109. One step in the scientific process is making an educated guess that states a predicted relationship between events or variables. What is this step called? a) conducting a study b) defining the variables c) developing a specific hypothesis d) specifying the topic as clearly as possible Answer: c Page: 31 Level: Medium Type: Factual 1-110. What is an educated guess that states a predicted relationship between events or variables? a) theory b) hypothesis c) inferential statistic d) independent variable Answer: b Page: 31 Level: Easy Type: Factual 1-111. What is the dependent variable in an experiment on the relationship between achievement motivation and persistence in problem-solving among 120 elementary-school children? a) number of participants b) achievement motivation c) the problem to be solved d) persistence in problem solving Answer: d Page: 31 Level: Medium Type: Conceptual 1-112. A researcher surveys the students in a university sorority and finds that 50% of them know someone with bulimia. What type of statistic is this researcher using? a) inferential b) significant c) descriptive d) correlational Answer: c Page: 31 Level: Medium Type: Conceptual

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1-113. The homework assignment in statistics involves determining if two scores are significantly different, by determining the statistical probability that the difference could be due to chance. When you describe the assignment to your friend who has already taken the course, she immediately recognizes it as one involving a) inferential statistics. b) descriptive statistics. c) correlational statistics. d) experimental statistics.

Answer: a Page: 31 Level: Difficult Type: Conceptual 1-114. A researcher finds more health problems among the poor, and fewer health problems among the rich. From these results, what could this researcher conclude with the most confidence? a) Poor health causes poverty. b) Poverty causes poor health. c) Poverty is an independent variable. d) Poor health and poverty are correlated.

Answer: d Page: 32 Level: Medium Type: Conceptual 1-115. The correlation between scores on a measure of tranquility and age at death is +.52. What could we conclude from this correlation coefficient? a) People with high tranquility scores live longer. b) People who have high tranquility scores die younger. c) People with who have low tranquility scores die older. d) People who have low tranquility scores die 52% sooner than those with high tranquility scores.

Answer: a Page: 32 Level: Difficult Type: Conceptual 1-116. What is the aim of an assessment study? a) to contrast several theory-generated hypotheses b) to vary experimental conditions to test the hypothesis c) to provide an objective account of behavior at a given time d) to gather information under standard, laboratory conditions Answer: c Page: 32 Level: Medium Type: Factual 1-117. In what type of study are participants observed at several time points? a) longitudinal study b) experimental study c) cross-sectional study d) epidemiological study Answer: a Page: 33 Level: Easy Type: Conceptual

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1-118. What are some of the limitations of longitudinal research? a) expensive and time-consuming b) relies on retrospective ratings and is correlational c) does not test a specific hypothesis and is subjective d) makes assessments at one point only and is correlational Answer: a Page: 33 Level: Difficult Type: Conceptual 1-119. What is one of the limitations of assessment studies? a) They are correlational. b) They rely on self-observations. c) They involve experimental manipulation. d) They provide no information about diagnosis.

Answer: a Page: 33 Level: Medium Type: Factual 1-120. Follow-up studies are most similar to a) longitudinal studies. b) assessment studies. c) experimental studies. d) cross-sectional studies.

Answer: a Page: 33 Level: Medium Type: Conceptual 1-121. A hospital clinician contacts persons who had been discharged from the hospital 5 years earlier, to see if they were re-hospitalized during that period.

What type of research study is represented by the clinician’s work? a) case study b) follow-up study c) longitudinal study d) correlational study Answer: b Page: 33 Level: Medium Type: Conceptual 1-122. A longitudinal study assesses people during what time frame? a) one time point only b) during lengthy testing sessions c) at several different time points d) after an experimental manipulation Answer: c Page: 33 Level: Medium Type: Conceptual 1-123. Which of these is an example of a cross-sectional study? a) a public opinion poll b) an experimental manipulation c) administering IQ tests to students every 3 years d) contacting people several years after the end of treatment Answer: a Page: 33 Level: Difficult Type: Conceptual 26

1-124. What additional ingredient sets experimental studies apart from assessment studies? a) use of animals b) use of retrospective data c) manipulation of variables d) observation and assessment of behavior Answer: c Page: 33 Level: Medium Type: Conceptual 1-125. Which scientific method involves the manipulation of variables? a) case study b) experiment c) follow-up study d) correlational study Answer: b Page: 33 Level: Difficult Type: Conceptual 1-126. Hypothesis-testing experiments involve a) intensive case studies. b) making predictions based on theory. c) manipulation of the dependent variable. d) development of practical treatment techniques.

Answer: b Page: 34 Level: Difficult Type: Conceptual 1-127. If Dr. Raymond designs a study to assess the effectiveness of social skills training for patients with schizophrenia, what type of research is he conducting? a) a correlational study b) an epidemiological study c) a behavior-change experiment d) a hypothesis-testing experiment Answer: c Page: 34 Level: Difficult Type: Conceptual 1-128. What is the most scientifically sound method of conducting a clinical trial? a) eliminating placebo conditions b) allowing subjects to volunteer for the control group c) conducting a case study of an experimental treatment d) randomly assigning participants to control and treatment groups Answer: d Page: 35 Level: Difficult Type: Conceptual 1-129. What is a clinical trial? a) an assessment battery b) a difficult therapy case c) a study of treatment effectiveness d) a licensing procedure for clinical psychologists Answer: c Page: 35 Level: Medium Type: Factual 27

1-130. A psychologist compares groups of patients who receive social skills training to similar groups of patients who do not receive social skills training.

Patients at several hospitals are studied. This research is an example of a a) correlation. b) case study. c) clinical trial. d) cross-sectional study.

Answer: c Page: 35 Level: Medium Type: Conceptual 1-131. What is one reason that animals are used in experiments to help answer questions about humans? a) Animals do not feel pain. b) Animals are easier to study because of shorter life spans. c) There is no risk that animals will become addicted to drugs. d) The brain chemistry of animals is almost identical to humans.

Answer: b Page: 35 Level: Medium Type: Conceptual 1-132. Why are clinical trials often held in more than one clinic at a time? a) to promote randomization b) to increase generalizability c) to eliminate placebo effects d) to control expectation effects Answer: b Page: 35 Level: Medium Type: Conceptual 1-133. Under what circumstances has animal research revealed that monkeys show the most disturbed behavior? a) when they are raised in isolation b) when they are raised by humans c) when they do not show innate fear d) when they do not have any siblings Answer: a Page: 35 Level: Medium Type: Conceptual 1-134. If young monkeys are raised in isolation until the age of 6 months, they are likely to show improvements in their disturbed behavior when they a) are reunited with their mothers. b) are reunited with same-age peers. c) spend time with younger, clingy infants. d) spend time with older, more aggressive peers.

Answer: c Page: 35 Level: Medium Type: Factual

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1-135. Young monkeys who are separated from their mothers often exhibit behaviors that are similar to those observed in humans diagnosed with a) psychosis. b) depression. c) identity confusion. d) personality disorder.

Answer: b Page: 35 Level: Medium Type: Factual 1-136. Double-blind studies are designed to reduce a) eye strain. b) side effects. c) animal research. d) expectation effects.

Answer: d Page: 37 Level: Easy Type: Factual 1-137. A television reporter wants to report on treatments for insomnia. After consulting with experts, she decides to discuss drug and behavioral treatments.

Which of the following statements is the most accurate conclusion on the effectiveness of these treatments? a) “Neither treatment is very effective in alleviating insomnia.” b) “Both treatments are equally effective in long-term studies of effectiveness.” c) “Both treatments are effective in the short term, but behavioral treatments are more effective in the long run.” d) “Both treatments are relatively ineffective in the short term, but drug treatments are effective with long-term use.”

Answer: c Page: 37 Level: Difficult Type: Conceptual 1-138. You are assigned the task of finding the root meaning of the word placebo.

When you look it up you find that the word derives from a) a Latin word meaning “I shall please.” b) a Greek word meaning to “assist in treatment.” c) an African word meaning “to alleviate suffering.” d) a Hebrew expression reflecting concern for healing.

Answer: a Page: 37 Level: Medium Type: Factual 1-139. What do we call the experimental prediction that groups do not really differ from one another? a) null hypothesis b) inferential hypothesis c) dependent hypothesis d) confounding hypothesis Answer: a Page: 38 Level: Difficult Type: Factual 29

1-140. You are a member of a research team that is beginning a study of the effectiveness of a new drug called Focus on the symptoms of attention deficit disorder. One of the researchers asked you to describe the null hypothesis for this study. What will you say? a) “The null hypothesis states that the drug’s effect will not differ from no treatment.” b) “The null hypothesis states that the dependent variable in this research must be objectively measured.” c) “The null hypothesis means the researchers must be blind to the identity of the individuals that are receiving the drug.” d) “The null hypothesis means there are no differences in demographic characteristics between the control and the experimental groups.”

Answer: a Page: 38 Level: Difficult Type: Conceptual 1-141. What is the arithmetic average of a group of scores? a) mean b) mode c) range d) median Answer: a Page: 38 Level: Easy Type: Factual 1-142. In a group of scores, the median is the score that is a) highest. b) in the middle. c) most common. d) the arithmetic average.

Answer: b Page: 38 Level: Easy Type: Factual 1-143. The effects of a placebo condition depend on a) expectations. b) the therapist’s training. c) the treatment drug’s chemical activity. d) whether or not there was random assignment.

Answer: a Page: 37 Level: Easy Type: Factual 1-144. Which of the following is likely to affect the internal validity of research? a) whether the subjects are debriefed b) whether the subjects are randomly assigned c) whether the hypothesis is relevant to the theory d) whether the results are generalizable to other groups Answer: b Page: 37 Level: Difficult Type: Conceptual 30

1-145. You are asked to evaluate a research study on a number of important issues, including external validity. When you read the research report to evaluate this particular issue, you will look for information that will help you decide which of the following? a) level of statistical significance used in the data analysis b) degree of objectivity evident in the measures used in the research c) whether the reported results can be generalized beyond this study d) presence of random assignment of participants to various conditions Answer: c Page: 37 Level: Difficult Type: Conceptual 1-146. The mean, median, and mode are all measures of a) inference. b) variability. c) clinical ratings. d) central tendency.

Answer: d Page: 38 Level: Medium Type: Factual 1-147. What is the most commonly used measure of variability? a) mode b) median c) frequency d) standard deviation Answer: d Page: 38 Level: Medium Type: Factual 1-148. Which of the following is a measure of how much a group of scores vary from their own mean? a) mode b) median c) central tendency d) standard deviation Answer: d Page: 38 Level: Medium Type: Factual 1-149. What is the basis for determining whether a statistical result is significant? a) likely level of external validity b) practical importance of the research findings c) probability that the results are due to chance d) judgment of the appropriateness of the statistical tests used Answer: c Page: 38 Level: Difficult Type: Factual

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1-150. Which correlation coefficient describes a situation in which there is no systematic relationship between two variables? a) .00 b) 0.5 c) -1.0 d) +1.0 Answer: a Page: 38 Level: Medium Type: Factual 1-151. A researcher observes the following pattern in a large sample of overweight people: the higher the person’s weight, the less physical activity they engage in. What type of relationship is this? a) causal b) null result c) negative correlation d) statistically significant Answer: c Page: 38 Level: Medium Type: Conceptual 1-152. A correlational study of weight and heart disease found that people with higher weight show higher rates of heart disease. Which of the following correlation coefficients might describe this relationship? a) .00 b) -.26 c) +.57 d) -.90 Answer: c Page: 38 Level: Medium Type: Conceptual 1-153. A confound is something that a) decreases sample size. b) increases internal validity. c) makes results clearer and easier to understand. d) obscures the relationship between two variables.

Answer: d Page: 38 Level: Medium Type: Factual 1-154. What do expectancy effects influence? a) random assignment b) what hypotheses are tested c) how an observer rates a participant d) how a participant behaves in the laboratory Answer: c Page: 38 Level: Medium Type: Factual 32

1-155. One threat to a study’s validity is the possibility of reactivity, which refers to the tendency for participant to change their behavior when they a) want to sabotage the study. b) realize they are being observed. c) are told the results are confidential. d) receive excessive compensation for their efforts.

Answer: b Page: 38 Level: Medium Type: Factual 1-156. Paul volunteers for a study on attitudes about dating. When he arrives at the laboratory, he notices a book on the researcher’s desk called Nonverbal Communication in Dating Couples. Paul concludes that the study is about nonverbal communication, and in his answers to questions he tries to be helpful by emphasizing his skills in this area. The way Paul responded to the questions is an example of a threat to validity called a) reactivity. b) expectancy effects. c) demand characteristics. d) nonrandom assignment.

Answer: b Page: 39 Level: Difficult Type: Conceptual 1-157. Professor Harrison has designed an experiment on memory for traumatic events. He must submit his research for approval by a university committee.

What question is the committee most likely to ask Professor Harrison concerning his proposed research? a) “Will this research provide practical benefits to society?” b) “Will you debrief the participants before the research has been conducted?” c) “What theoretical perspective formed the basis for this proposed research?” d) “Is there a potential for any physical or psychological harm to the participants?”

Answer: d Page: 39 Level: Difficult Type: Factual

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1-158. A group of college students volunteered to take part as participants in research conducted by members of the Psychology Department. The students did not know that the experiment would involve deception. What is most likely to happen after the experiment is completed? a) The students will be sworn to secrecy in order to continue the research. b) The researchers must explain the experimental procedures to the students. c) The students will be told that they have the right to file a civil lawsuit in the court. d) The researchers must compensate the students for the use of deception by offering them a financial reward.

Answer: b Page: 39 Level: Medium Type: Conceptual

Essay Questions 1-159. What occurred during the Reform Movement in the U.S. in the 1800s?

Answer: Benjamin Rush admitted mental patients to regular hospitals and wrote the first American textbook on psychiatry; he also recommended and used medical treatments for the mentally ill. Dorothea Dix argued for and oversaw the building of many new psychiatric hospitals. Clifford Beers wrote about his experiences as a mental patient to bring attention to inhumane treatment, and founded the National Committee on Mental Hygiene.

Pages: 17- 19 Level: Medium Type: Factual 1-160. Describe the three important determinants of resilience.

Answer: (1) Temperamental factors: activity level and responsiveness to others; (2) family factors: warmth, cohesion, and caring; (3) external support: neighbors, parents, friends, and clergy who are supportive and actively want to help.

Pages: 21 – 22 Level: Easy Type: Factual 1-161. What has epidemiological research found concerning the risk factors for committing violent acts by individuals with mental disorders?

Answer: Only a small minority of all people who commit violent acts have a psychotic disorder, and overall they are responsible for relatively little violent crime. However, a statistical connection exists between psychosis (particularly schizophrenia) and violence as well as between violence and drug and alcoholrelated disorders. Research shows that the presence of delusions and/or hallucinations may provide individuals with a rationale for violence because of the need to counterattack.

Pages: 22 – 24 Level: Medium Type: Factual

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1-162. What are some of the factors associated with rates of diagnosed mental disorder?

Answer: Age: younger people have higher rates; marital status: separated, divorced, and single people have higher rates than married and widowed people; education: less educated people have higher rates; personal income: the lower the income, the higher the rates; employment status: unemployed people have higher rates; contact with friends: lack of social contacts is associated with relatively higher rates; satisfaction with relationships with friends and relatives: the greater the satisfaction, the lower the rates of mental disorders; marital happiness: the greater the degree of marital happiness, the lower the rates.

Pages: 22 – 26 Level: Medium Type: Factual 1-163. What are the functions and characteristics of a good theory?

Answer: Good theories are able to incorporate many existing facts, observations, and relationships within a single, broad explanatory framework. Additional hypotheses may lead to new observations. In this way, theories provide a foundation on which to build knowledge. If new observations do not support the theory, it can be modified or discarded. However, it will still have served a valuable function by leading to the discovery of new knowledge and to the development of an even better and more inclusive theory. In order for a theory to be useful it must be capable of being tested and refuted. It should be able to specify the types of relationships that are not possible as well as those that are.

Pages: 29 – 31 Level: Medium Type: Factual 1-164. What are the limitations of a longitudinal design?

Answer: Can be costly and time-consuming; the researcher may not live to see the results; the methodology may be outdated by the end of the study; the sample may change in unpredictable ways over time.

Page: 33 Level: Medium Type: Factual 1-165. Compare demand characteristics and expectancy effects.

Answer: Both are threats to validity in research. Demand characteristics influence how a research participant responds; expectancy effects influence an observer’s ratings.

Pages: 38 – 39 Level: Medium Type: Factual

True/False 1-166. People who present with serious mental health issues can function in an adequate manner in some aspects of their lifestyle.

Answer: True Page: 5 Level: Medium Type: Factual 35

1-167. A person may be able to return to some level of normal functioning and a somewhat distress-free lifestyle is the cause if the cause of the problem can be identified.

Answer: True Page: 5 Level: Medium Type: Factual 1-168. Abnormal psychology examines the concept of “differentness.” The spectrum of “differentness” is narrow in scope when compared to other areas of psychology.

Answer: True Page: 5 Level: Easy Type: Factual 1-169. The text discussed Nancy Raines experience of being raped. Being able to identify external triggers can assist clinicians in explaining and treating mental health issues.

Answer: True Page: 7 Level: Easy Type: Factual 1-170. Adaptation is a person’s ability, or conversely, inability to modify behaviors in response to environmental requirements in many facets of life.

Answer: True Page: 8 Level: Easy Type: Factual 1-171. A recurring theme in the history of abnormal behavior is the belief that people behave strangely because their minds have an organic defect.

Answer: False Page: 11 Level: Medium Type: Factual 1-172. The Egyptians, Mesopotamians, and Hebrews believed the seat of the mind to be in the heart.

Answer: True Page: 12 Level: Easy Type: Factual 1-173. St. Augustine made an important contribution to abnormal psychology through introspective and emotional exploration.

Answer: True Page: 13 Level: Easy Type: Factual 1-174. Many literary developments sent to exemplify the long-standing conflict between psychological and physical explanations of abnormal behavior.

However, it was not until the 19th century that demons and the supernatural were rejected as the causes of abnormal behavior.

Answer: False Page: 15 Level: Medium Type: Factual 1-175. A major focus of the twentieth century was the recognition of research to identify causes of maladaptive behavior.

Answer: True Page: 19 Level: Easy Type: F/D

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Chapter 2 Theoretical Perspectives On Maladaptive Behavior 2-1. Which of the following is not true of theories? a) Theories are created to organize information and explain its meaning. b) Theories are complete because once a concept is explained, change in the concept is rare. c) Theories can explain why clinical disorders occur. d) Theories can assist in treatment of clinical disorders.

Answer: b Page: 45 Level: Medium Type: Factual 2-2. Two psychologists are set to debate their views on the causes of abnormal behavior. One of them describes his position as “emphasizing our uniqueness as individuals and our freedom to make our own decisions.” The other describes her view as “examining how the environment influences behavior.” Which two theories of abnormal psychology are represented by these two psychologists? a) cognitive and biological b) cognitive and behavioral c) community-cultural and cognitive d) humanistic-existential and behavioral Answer: d Page: 46 Level: Difficult Type: Conceptual 2-3. You are listening to a program in which several psychologists describe their theoretical viewpoints. One of them says she represents a theoretical approach that has led to therapeutic techniques for changing unrealistic ideas. Which theoretical approach does she represent? a) cognitive b) behavioral c) psychodynamic d) community-cultural Answer: a Page: 46 Level: Difficult Type: Conceptual

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2-4. Sara was in an automobile accident and sustained head trauma. In an effort to evaluate her condition, she will be given a Position Emission Tomography (PT) scan and a computerized tomography (CT) scan. The results of the scans will be used to initiate a treatment plan. The model used to understand her condition is the: a) community-cultural perspective b) humanistic-existential perspective c) cognitive perspective d) biological perspective Answer: d Page: 47 Level: Difficult Type: Conceptual 2-5. Sam had recently lost his job. As a result of losing his job, he did not eat or sleep well, and he was always ill. As a result, he had a high fever caused by an infection. He was hospitalized for several days. His maladaptive behavior can be understood through which perspective? a) community-cultural b) biological c) psychodynamic d) behavioral Answer: b Page: 47 Level: Medium Type: Conceptual 2-6. Which perspective looks at maladaptive behavior as a joint product of disordered processes in the body, in psychological functioning, and in the social environment? a) biological b) psychodynamic c) behavioral d) cognitive Answer: a Page: 48 Level: Easy Type: Factual 2-7. How many chromosomes are there in each cell of the human body? a) 10 b) 23 c) 46 d) 50 Answer: c Page: 48 Level: Easy Type: Factual 2-8. What is the chromosomal abnormality associated with Down syndrome? a) an extra Y chromosome b) a broken branch on the Y chromosome c) three #21 chromosomes instead of two d) 24 rather than 23 pairs of chromosomes Answer: c Page: 48 Level: Medium Type: Factual 38

2-9. What are the units that make up chromosomes? a) neurons b) genes c) loci d) karyotypes Answer: b Page: 48 Level: Easy Type: Factual 2-10. A karyotype is a map of a) genes b) chromosomes c) amino acids on DNA d) the double helix of DNA and RNA Answer: b Page: 48 Level: Medium Type: Factual 2-11. What is a genome? a) a very small gene b) a chromosomal karyotype c) a complete set of a person’s genes d) a mutated gene that has been replaced Answer: c Page: 48 Level: Easy Type: Factual 2-12. What is the basis for the action of the genes? a) DNA b) locus c) karyotype d) chromosome Answer: a Page: 49 Level: Easy Type: Factual 2-13. Elaine’s parents were both athletes in college as were her grandparents. Her parents have tried to convince her to participate in sports, and cannot understand why she has little interest. More specifically, they cannot understand why she is not more physically developed as a potential athlete since most members of the family are athletic. What term provides an explanation for this dilemma? a) penetrance b) heritability c) genetics d) hormones Answer: a Page: 49 Level: Difficult Type: Conceptual

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2-14. An expert was invited to campus to discuss current research on population genetics. During the question and answer period, he was asked to comment on the importance of population genetics. What is he likely to say? a) “It provides tools to control overpopulation.” b) “It allows researchers to map the karyotype.” c) “It is used to predict the occurrence of disorders.” d) “It is helpful in protecting species that are close to extinction.”

Answer: c Page: 49 Level: Medium Type: Conceptual 2-15. Which individuals are most susceptible to Tay-Sachs disease? a) Japanese b) North Africans c) Scandinavians d) European Jews Answer: d Page: 49 Level: Easy Type: Factual 2-16. Which technique is frequently used by behavioral geneticists? a) Mapping the human genome b) Microscopic examination of chromosomes c) Comparing monozygotic and dizygotic twins d) Treating genetically-caused behavior problems Answer: c Page: 49 Level: Medium Type: Factual 2-17. _________is the study of the effects of genetic inheritance on behavior which _____________accesses information used in predicting the incidence of certain genetically carried disorders a) population genetics; behavior genetics b) behavior genetics; medical genetics c) population genetics; penetrance d) behavior genetics; population genetics Answer: d Page: 49 Level: Difficult Type: Factual 2-18. Seth has Tay-Sachs disease. He wants to marry but is fearful of his children contracting the disease. Seth has volunteered for a research study. What field would be used? a) behavior genetics b) pedigree studies c) population genetics d) medical studies Answer: c Page: 49 Level: Medium Type: Conceptual 40

2-19. A researcher studies the rate of a rare blood disease among monozygotic and dizygotic twins. She finds a much higher rate of concordance in the monozygotic twins. What might she conclude? a) Both parents must be carriers of the disease. b) Genetic factors play a strong role in this disorder. c) The disorder is due to a chromosomal abnormality. d) There are few, if any, environmental influences on this disorder.

Answer: b Page: 50 Level: Medium Type: Conceptual 2-20. If only one twin has a certain disease, the twin pair is said to be a) fraternal. b) penetrant. c) karyotypic. d) discordant.

Answer: d Page: 50 Level: Medium Type: Factual 2-21. What do schizophrenia, Alzheimer’s disease, major affective disorder, and reading disability have in common? a) chromosomal abnormalities b) low twin concordance rates c) substantial genetic influence d) more common now than in the past Answer: c Page: 51 Level: Medium Type: Conceptual 2-22. After a class in developmental psychology, a student asked the professor a question concerning the effects of the environment on the student and her brother. When answering the question the professor said, “The research seems to indicate that nonshared environment plays a significant role in the development of siblings.” What was the professor suggesting in his answer to this student’s question? a) Siblings have to compete for space and resources. b) Siblings in a family do not share 100% of their genes. c) Each child has an environment that differs from his/her siblings. d) Children in a family share an environment different from other families.

Answer: c Page: 52 Level: Difficult Type: Conceptual

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2-23. Rose has been healthy her entire life. However, she has begun to experience changes in her behavior and through processes. She has noticed that, under stress, these changes occur. This is an example of: a) changes in the nervous system b) gene expression c) behavior genetics d) population genetics Answer: b Page: 52 Level: Medium Type: Conceptual 2-24. A researcher has been investigating difference in personality among family members. The difference among family members in regard to personality traits is accounted for by a combination of genetic differences among the children and the unique relationships of each child. The unique relationships among the children is an example of the: a) shared environment b) nature – nurture controversy c) nonshared environment d) None of the above.

Answer: c Page: 52 Level: Medium Type: Conceptual 2-25. The two major divisions of the nervous system are: a) central nervous system; autonomic system b) somatic system; anatomic system c) central nervous system; peripheral nervous system d) peripheral system; autonomic system Answer: c Page: 52 Level: Easy Type: Factual 2-26. Sam is experiencing difficulty with voluntary muscle movement. The system affected is: a) somatic system b) central nervous system c) autonomic system d) cerebral cortex Answer: a Page: 52 Level: Medium Type: Conceptual 2-27. The fundamental unit of the entire nervous system is the: a) axon b) dendrite c) synapse d) neuron Answer: d Page: 52 Level: Easy Type: Factual 42

2-28. The ___________is a long extension of a neuron while shorter extensions are called _______________. a) dendrites; axon b) axon; dendrites c) axon; neurotransmitters d) neurotransmitter; dendrites Answer: a Page: 52 Level: Easy Type: Factual 2-29. What are the main components of the central nervous system? a) brain and spinal cord b) chromosomes and genes c) glands and sensory receptors d) hormones and neurotransmitters Answer: a Page: 52 Level: Easy Type: Factual 2-30. The somatic system and the autonomic system are components of the a) limbic system. b) cerebral cortex. c) central nervous system. d) peripheral nervous system.

Answer: d Page: 52 Level: Medium Type: Factual 2-31. Which part of the nervous system is responsible for regulating glands and internal organs? a) limbic system b) central system c) somatic system d) autonomic system Answer: d Page: 52 Level: Easy Type: Factual 2-32. Which of the following is the best description of neurotransmitters? a) brain neurons b) psychoactive drugs c) electrical discharges d) chemicals that carry signals Answer: d Page: 52 Level: Easy Type: Factual

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2-33. Which of the following correctly matches a neurotransmitter with the disorder it influences? a) GABA - schizophrenia b) dopamine - schizophrenia c) acetylcholine - panic disorder d) serotonin - generalized anxiety disorder Answer: b Page: 52 Level: Difficult Type: Factual 2-34. What is the gap between two nerve cells? a) axon b) dendrite c) synapse d) neurotransmitter Answer: c Page: 52 Level: Easy Type: Factual 2-35. Chemicals that serve as messengers between neurons are called a) dendrites. b) synapses. c) hormones. d) neurotransmitters.

Answer: d Page: 52 Level: Easy Type: Factual 2-36. An explosion at an industrial plant caused a piece of metal to be shot through the skull of one of the workers who was immediately taken to the emergency room. He was in great pain, but awake and able to speak to the emergency room staff. Despite the severe nature of the injury, it is not life threatening. In fact, the injury is remarkably similar to injuries suffered by Phineas Gage. Based on this case, what would you tell the man’s family about the outcome they might expect? a) He will have difficulty with his sense of vision. b) He will have problems with short-term memory. c) He will exhibit a heightened degree of emotional instability. d) He will develop symptoms similar to those found in schizophrenia.

Answer: c Page: 53 Level: Medium Type: Conceptual

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2-37. What part of the brain controls the distinctly human behaviors and cognitive abilities? a) cerebellum b) limbic system c) cerebral cortex d) autonomic nervous system Answer: c Page: 54 Level: Medium Type: Factual 2-38. What does an electroencephalogram (EEG) measure? a) motor movement b) activity of brain cells c) size of the cerebral cortex d) neurotransmitters in the synapse Answer: b Page: 54 Level: Easy Type: Factual 2-39. An EEG technician is giving a lecture to students from the local university.

She points out several of the different brain waves, and shows a record with an abundance of delta waves. She asks the students what the person might be doing.

Which of the following is most likely to be correct? a) This person is in deep sleep. b) This person is either writing a letter or speaking to someone. c) This person is relaxing and not thinking of anything in particular. d) The person is in a coma and is completely unresponsive to the environment.

Answer: a Page: 54 Level: Difficult Type: Conceptual 2-40. What is the primitive part of the cerebral cortex that is associated with emotional and motivational functions? a) cerebellum b) limbic system c) pituitary gland d) corpus callosum Answer: b Page: 54 Level: Medium Type: Factual 2-41. Which of the following could be described as part of the primitive lower part of the cortex that is associated with emotional and motivational functions? a) cerebellum b) parietal lobe c) limbic system d) corpus callosum Answer: c Page: 54 Level: Medium Type: Factual

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2-42. A rat will continue to press a bar in order to receive stimulation to the reward center of the brain, even if it means going without food. What part of the brain is involved? a) cerebellum b) limbic system c) cerebral cortex d) corpus callosum Answer: b Page: 54 Level: Medium Type: Factual 2-43. What are the natural pain relievers produced by the brain? a) hormones b) endocrines c) endorphins d) neuropeptides Answer: c Page: 55 Level: Medium Type: Factual 2-44. The ability of the nervous system to change in response to stimulation is: a) brain plasticity b) neural plasticity c) endorphins d) neurogenesis Answer: b Page: 55 Level: Medium Type: Factual 2-45. You are paging through a journal on physiology and come across an article on the topic of neurogenesis. The term is new to you so you look it up and find that the article probably deals with a) production of new brain cells. b) genes responsible for brain development. c) the delicate balance between sleep and waking. d) hormonal imbalances that lead to brain degeneration.

Answer: a Page: 55 Level: Difficult Type: Conceptual 2-46. How do endocrine glands deliver their products to other parts of the body? a) through ducts b) in cerebral spinal fluid c) by way of neurotransmitters d) directly into the bloodstream Answer: d Page: 55 Level: Medium Type: Factual

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2-47. What chemical messengers are secreted by the endocrine glands? a) neurons b) synapses c) hormones d) neuropeptides Answer: c Page: 55 Level: Medium Type: Factual 2-48. Which of the following is one of the endocrine glands? a) tear b) lymph c) thyroid d) salivary Answer: c Page: 56 Level: Easy Type: Factual 2-49. How does the endocrine system affect the body’s response to stress? a) mobilizes physical resources b) increases likelihood of infection c) speeds delivery of cerebral spinal fluid d) increases electrical activity in the brain Answer: a Page: 56 Level: Medium Type: Factual 2-50. The chemicals corticotrophin – factor, adrenocorticotrophichormone, and adrenal corticosteroids are associated with the ___________during stress response. a) endocrine system b) neurogenesis c) hypothalamus d) cerebral cortex Answer: c Page: 56 Level: Difficult Type: Factual 2-51. Which of the following is a good indicator of the degree of stress experienced by an individual? a) serotonin levels b) cerebral spinal fluid c) brain electrical activity d) adrenal corticosteroids Answer: d Page: 56 Level: Medium Type: Factual

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2-52. The adrenal cortex is important for the a) stress response. b) DNA replication. c) regulation of brain cell activity. d) replacing the neurotransmitter serotonin.

Answer: a Page: 56 Level: Medium Type: Factual 2-53. What part of the brain releases corticotrophin-releasing factor (CRF) during the stress response? a) thyroid b) pituitary c) hypothalamus d) adrenal cortex Answer: c Page: 56 Level: Medium Type: Factual 2-54. During the stress response, the hypothalamus releases a substance that acts on what part of the brain? a) thyroid b) pituitary c) pancreas d) substantia nigra Answer: b Page: 56 Level: Medium Type: Factual 2-55. Researchers are looking for subjects to examine and participate in a study to understand the relationship between the structure and function of the brain and the subject’s thoughts, feelings, and behaviors. These researchers are from the filed of: a) neuropsychology b) neuroscience c) genetic medicine d) neuropathology Answer: b Page: 56 Level: Medium Type: Conceptual

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2-56. Which of the following are functions of the neurosciences? a) Protection of a healthy brain and to heal the brain when it is ill. b) Clarification of how the brain functions as a molecular-cellular machine. c) Understand and view the brain as a highly complex and flexible information system. d) All of the above are functions of the neurosciences.

Answer: d Page: 56 Level: Medium Type: Factual 2-57. Sixty-year-old Sam is part of a research program designed to predict future diseases and disorders from brain scans completed yearly. If researchers determine that the brain scans reveal a loss of cells in the substantia nigra, which disorder would they predict that Sam will develop? a) PKU b) Tay-Sachs c) Alzheimer’s disease d) Parkinson’s disease Answer: d Page: 56 Level: Difficult Type: Conceptual 2-58. “Shaking palsy” was another name for a) syphilis. b) schizophrenia. c) Alzheimer’s disease. d) Parkinson’s disease.

Answer: d Page: 56 Level: Medium Type: Factual 2-59. How does L-dopa help people with Parkinson’s disease? a) acts as a tranquilizer b) causes a genetic mutation c) corrects a neurochemical deficiency d) changes electrical activity in the brain Answer: c Page: 56 Level: Difficult Type: Factual 2-60. What was the first neuroimaging technique used to study abnormal behavior? a) magnetic resonance imaging (MRI) b) computerized axial tomography (CT) c) positron emission tomography (PET) d) magnetic resonance spectroscopy (MRS) Answer: b Page: 57 Level: Medium Type: Factual

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2-61. Which brain imaging technique has the capacity to examine brain anatomy visually and to measure it quantitatively? a) magnetic resonance imaging (MRI) b) computerized axial tomography (CT) c) positron emission tomography (PET) d) magnetic resonance spectroscopy (MRS) Answer: a Page: 57 Level: Medium Type: Factual 2-62. What is the most costly and complex neuroimaging technique? a) computed tomography (CT) b) magnetic resonance imaging (MRI) c) positron emission tomography (PT) d) magnetic resonance spectroscopy (MRS) Answer: c Page: 57 Level: Medium Type: Factual 2-63. Which neuroimaging technique measures cerebral blood flow? a) computed tomography (CT) b) magnetic resonance imaging (MRI) c) magnetic resonance spectroscopy (MRS) d) single photon emission computed tomography (SPECT) Answer: d Page: 57 Level: Medium Type: Factual 2-64. Which of the following are cells found in the immune system? a) neurons b) antigens c) lymphocytes d) adrenocorticoids Answer: c Page: 58 Level: Medium Type: Factual 2-65. The immune system must recognize and remove foreign materials called a) antigens. b) lymphocytes. c) adrenocorticoids. d) positron emissions.

Answer: a Page: 58 Level: Medium Type: Factual 2-66. How do stress and emotional factors suppress immunological responses? a) through hormonal changes b) by increasing endorphin levels c) by decreasing neuronal activity d) through damage to the cell walls Answer: a Page: 58 Level: Medium Type: Factual

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2-67. Which of the following disciplines simultaneously studies the nervous, endocrine, and immune systems? a) neuroscience b) neuropathology c) psychoneuroimmunology d) psychoneurophysiology Answer: c Page: 58 Level: Medium Type: Factual 2-68. If a drug acts as (an) _________________, it blocks a neurotransmitter’s action.

Similarly, an ______________ disrupts the action of a neurotransmitter. a) agonist; antagonist b) endocrine agent; action synapses c) antagonist; agonist d) agonist; endocrine agent Answer: a Page: 58 Level: Medium Type: Factual 2-69. Larry’s mother recently died of cancer. He became quite ill, and had difficulty getting better. What system would be affected by the loss of Larry’s mother? a) peripheral system b) endocrine system c) immune system d) autonomic system Answer: c Page: 58 Level: Medium Type: Conceptual 2-70. Which perspective examines thought and emotions as important causes of behavior? a) humanistic b) biological c) psychodynamic d) cognitive Answer: c Page: 59 Level: Medium Type: Factual 2-71. The psychodynamic approach assumes that all observable behavior is a function of a) free will. b) errors in logic. c) reinforcement history. d) intrapsychic processes.

Answer: d Page: 59 Level: Medium Type: Factual

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2-72. Before developing psychoanalysis, what technique did Sigmund Freud use to study emotional disorders? a) hypnosis b) desensitization c) free association d) dream interpretation Answer: a Page: 60 Level: Medium Type: Factual 2-73. What is the principle of psychic determinism? a) Neurosis leads to psychosis. b) Human beings have free will. c) Free association reveals the psyche. d) Behavior is caused by prior mental events.

Answer: d Page: 60 Level: Medium Type: Factual 2-74. When Maria looked at a picture of a carnival, she suddenly remembered a fair she had gone to as a child. Before she looked at the picture, her memory of the fair was a) conscious. b) unconscious. c) preconscious. d) conscientious.

Answer: c Page: 60 Level: Medium Type: Conceptual 2-75. Sigmund Freud believed that some things remain unconscious because they are associated with a) brain abnormalities. b) existential freedom. c) intrapsychic conflict. d) psychic determinism.

Answer: c Page: 60 Level: Medium Type: Factual 2-76. What term did Sigmund Freud use to refer to an individual’s quest for pleasure and gratification? a) sadism b) sexuality c) sublimation d) self-actualization Answer: b Page: 61 Level: Medium Type: Factual 52

2-77. According to Sigmund Freud, at about what age does a child go through the phallic stage of psychosexual development? a) during the first year b) about age 3 c) about age 10 d) during adolescence Answer: b Page: 61 Level: Medium Type: Factual 2-78. Which Freudian structure is described as an unorganized reservoir of psychic energy? a) id b) ego c) phallic d) superego Answer: a Page: 62 Level: Easy Type: Factual 2-79. What is the libido? a) psychic energy b) an erogenous zone c) a psychosexual stage d) a defense mechanism Answer: a Page: 61 Level: Medium Type: Factual 2-80. What is the correct sequence of Sigmund Freud’s psychosexual stages? a) anal, oral, genital, phallic b) phallic, genital, oral, anal c) oral, genital, phallic, anal d) oral, anal, phallic, genital Answer: d Page: 61 Level: Medium Type: Factual 2-81. Which of the following characterizes the phallic stage of psychosexual development? a) occurs only in males b) occurs during adolescence c) involves sexual impulses toward the parents d) accompanies a mature heterosexual relationship Answer: c Page: 61 Level: Medium Type: Factual

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2-82. Each of Sigmund Freud’s psychosexual stages is organized around a) a latency period. b) an erogenous zone. c) developing abilities for rational thought. d) the development of new psychic structures.

Answer: b Page: 62 Level: Medium Type: Factual 2-83. When does the latency period end? a) age 3 b) age 5 c) adolescence d) adulthood Answer: c Page: 62 Level: Medium Type: Factual 2-84. Failure to resolve a psychosexual conflict may cause a person to experience a) libido. b) fixation. c) latency. d) psychic determinism.

Answer: b Page: 62 Level: Medium Type: Factual 2-85. What is the role of the ego in Freudian theory? a) maximizing pleasure b) keeping the id in line c) realistic problem-solving d) primary process thinking Answer: c Page: 62 Level: Medium Type: Factual 2-86. Greg has always been taught that stealing is wrong. However, while shopping he sees a rock video that he wants, so he steals it. Later he feels guilty about what he has done. Greg’s guilt arises from his a) id. b) ego. c) superego. d) collective unconscious.

Answer: c Page: 62 Level: Medium Type: Conceptual

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2-87. Which of these individuals is engaged in an example of what Sigmund Freud would term primary process thinking? a) Alice who is daydreaming about a guy in her biology class b) Bill who is trying to get his car to start after he drove into a big puddle c) Dave who is outlining a term paper on the topic of the human sexual response in the elderly d) Teresa who is trying to determine whether she should go the library to study or go out with her friends Answer: a Page: 62 Level: Difficult Type: Conceptual 2-88. Which part of the psychic structure would make someone a conscientious objector to war? a) id b) ego c) superego d) collective unconscious Answer: c Page: 62 Level: Medium Type: Conceptual 2-89. Secondary process thinking describes the mature person’s ability to a) free associate. b) avoid repression. c) delay gratification. d) use the pleasure principle.

Answer: c Page: 62 Level: Medium Type: Conceptual 2-90. Staying home from the football game to work on a term paper is an example of a) repression. b) subconscious thinking. c) primary process thinking. d) secondary process thinking.

Answer: d Page: 62 Level: Medium Type: Conceptual 2-91. In adults, primary process thinking is most evident in a) guilt. b) dreams. c) delay of gratification. d) defense mechanisms.

Answer: b Page: 62 Level: Medium Type: Conceptual

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2-92. What is the primary purpose of the defense mechanisms? a) to protect psychic determinism b) to promote primary process thinking c) to make the unconscious conscious d) to ward off awareness of intrapsychic conflict Answer: d Page: 63 Level: Medium Type: Conceptual 2-93. Martha feels ambivalent about finding out the results of her pregnancy test.

What will happen if she uses the defense mechanism of repression to deal with her anxiety? a) She will act immaturely. b) She will forget the appointment. c) She will tell herself its better not to know. d) She will call the doctor and make an excuse.

Answer: b Page: 63 Level: Difficult Type: Conceptual 2-94. How does the defense mechanism of repression reduce anxiety? a) The person behaves immaturely. b) Anxiety-laden thoughts are forgotten. c) Feelings are directed to a new object. d) An impulse is transformed into its opposite.

Answer: b Page: 63 Level: Medium Type: Conceptual 2-95. In Freudian theory, defense mechanisms are strategies people use in order to a) protect the libido. b) insure that the id rules the ego. c) make unconscious material conscious. d) protect against unacceptable impulses.

Answer: d Page: 63 Level: Medium Type: Conceptual 2-96. What technique did Sigmund Freud develop to encourage patients to express their thoughts and feelings as openly as possible? a) desensitization b) free association c) relaxation training d) hypnotic induction Answer: b Page: 63 Level: Medium Type: Factual

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2-97. Painting a picture of a bloody war scene rather than acting on an aggressive impulse is an example of what defense mechanism? a) sublimation b) displacement c) reaction formation d) intellectualization Answer: a Page: 64 Level: Medium Type: Conceptual 2-98. Ann left work feeling very angry at her boss. When she got home she yelled at her roommate. Ann’s behavior is an example of which defense mechanism? a) denial b) displacement c) sublimation d) intellectualization Answer: b Page: 64 Level: Medium Type: Conceptual 2-99. When we are around someone we dislike intensely we often “bend over backward” to be nice to this individual. Which defense mechanism is illustrated here? a) denial b) projection c) sublimation d) reaction formation Answer: d Page: 64 Level: Medium Type: Conceptual 2-100. Compared to Sigmund Freud, the approaches offered by Carl Jung and Alfred Adler tended to a) address more spiritual issues. b) view human nature in a more optimistic way. c) focus on more biological issues in development. d) focus on early development of attachment to significant others.

Answer: b Page: 65 Level: Difficult Type: Conceptual

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2-101. As a child, Sammy felt inferior in comparison to his parents. A family counselor suggested parent training in child-rearing techniques. The theorist associated with this approach is: a) Alfred Adler b) Carl Jung c) Erik Erikson d) Sigmund Freud Answer: a Page: 65 Level: Difficult Type: Conceptual 2-102. Which of the following characterizes Erik Erikson’s view of psychological development? a) Development is a lifelong process. b) The ego is ineffective in solving problems. c) Reinforcement is the cornerstone of learning. d) The first five years of life are the most important.

Answer: a Page: 65 Level: Medium Type: Conceptual 2-103. Which theorist was interested in the capacity to achieve mastery, creativity, and developed ego psychology: a) Melanie Klien b) Heinz Kohut c) Carl Jung d) Erik Erikson Answer: d Page: 65 Level: Medium Type: Factual 2-104. The belief that self-concept played a key role in the organization of development is associated with: a) Heinz Kohut b) John Watson c) Carl Jung d) Melanie Klien Answer: a Page: 66 Level: Medium Type: Factual 2-105. What is one limitation of psychoanalytic theory? a) It is hard to evaluate scientifically. b) It is unable to explain normal behavior. c) It is more of a philosophy than a theory. d) It is better at prediction than description.

Answer: a Page: 66 Level: Medium Type: Factual

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2-106. John B. Watson was the founder of a) humanism. b) behaviorism. c) object relations. d) community psychology.

Answer: b Page: 66 Level: Easy Type: Factual 2-107. John B. Watson believed that personality was built out of a) the self-actualization process. b) conditioning and reinforcement. c) resolution of intrapsychic conflicts. d) progression through psychosocial stages.

Answer: b Page: 66 Level: Medium Type: Factual 2-108. What do the psychoanalytic and behavioral approaches have in common? a) idea of determinism b) assumption of free will c) focus on internal events d) stage model of development Answer: a Page: 67 Level: Medium Type: Conceptual 2-109. Which of the following key figures in the history of psychology was wellknown for describing classical conditioning? a) Ivan Pavlov b) B. F. Skinner c) Carl Rogers d) Alfred Adler Answer: a Page: 67 Level: Easy Type: Factual 2-110. Ivan Pavlov’s experiments with hungry dogs are examples of a) operant conditioning. b) classical conditioning. c) extinction conditioning. d) correlational conditioning.

Answer: b Page: 67 Level: Easy Type: Factual

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2-111. During a thunderstorm, Beth picked up the telephone to call her parents.

While dialing she received a painful shock. Now she reacts with fear whenever she sees a telephone. What is the telephone in this example? a) neutral stimulus b) reinforced stimulus c) conditioned stimulus d) unconditioned stimulus Answer: c Page: 67 Level: Medium Type: Conceptual 2-112. During a thunderstorm, Beth picked up the telephone to call her parents.

While dialing she received a painful shock. Now she reacts with fear whenever she sees a telephone. What is the unconditioned stimulus in her case? a) the shock b) Beth’s fear c) the telephone d) the thunderstorm Answer: a Page: 67 Level: Medium Type: Conceptual 2-113. As a child, Jane, was stung by a bee and years later she is afraid of all insects. In classical conditioning terms, what was the original bee sting? a) conditioned stimulus b) conditioned response c) unconditioned stimulus d) unconditioned response Answer: c Page: 67 Level: Medium Type: Conceptual 2-114. Which therapeutic technique uses a series of steps to break down the bond between a stimulus and an undesirable conditioned response? a) modeling b) hypnosis c) relaxation training d) systematic desensitization Answer: d Page: 67 Level: Medium Type: Factual 2-115. A scientist rings a bell just before giving meat to the dogs in his laboratory.

After several pairings, the dogs begin to salivate when the bell is rung, even when there is no meat. In this study, the bell represents the a) conditioned stimulus. b) conditioned response. c) unconditioned stimulus. d) unconditioned response.

Answer: a Page: 67 Level: Medium Type: Conceptual 60

2-116. A mother turns on the radio right before she feeds her toddler each evening. After a few days, the child begins to open his mouth and hold out his spoon as soon as the mother turns on the radio. What is the radio in this example? a) conditioned stimulus b) conditioned response c) unconditioned stimulus d) unconditioned response Answer: a Page: 67 Level: Medium Type: Conceptual 2-117. When the goal is to increase avoidance responses (like keeping an animal away from the road), what kind of unconditioned stimulus (UCS) is used? a) a novel UCS b) a rewarding UCS c) an unpleasant UCS d) an extinguished UCS Answer: c Page: 67 Level: Medium Type: Factual 2-118. Phil was given a failing grade on his paper because the professor discovered that it was plagiarized. The failing grade is an example of a) extinction. b) punishment. c) positive reinforcement. d) negative reinforcement.

Answer: b Page: 68 Level: Medium Type: Conceptual 2-119. How does a negative reinforcer increase the probability of a response? a) It punishes the respondent. b) It extinguishes the response. c) It provides a pleasant reward. d) It takes away something aversive.

Answer: d Page: 68 Level: Medium Type: Factual 2-120. What was the “Skinner box” used to study? a) operant conditioning b) classical conditioning c) social learning theory d) systematic desensitization Answer: a Page: 68 Level: Medium Type: Factual

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2-121. Obtaining a desired response by reinforcing successively closer approximations of the response is called a) shaping. b) modeling. c) operant conditioning. d) classical conditioning.

Answer: a Page: 68 Level: Medium Type: Factual 2-122. Fred gives his dog a treat each time the dog looks to the left. After a while, Fred only gives a treat when the dog takes a step to the left. Finally, Fred gives a treat only when the dog turns completely around. This situation is an example of a) shaping. b) extinction. c) classical conditioning. d) negative reinforcement.

Answer: a Page: 68 Level: Medium Type: Conceptual 2-123. According to modeling theorists, why would a young man want to join the military? a) He has passed through the latency stage. b) He has been positively reinforced for aggression. c) He has seen how military officers are well respected. d) He has experienced an unavoidable impulse for aggression.

Answer: c Page: 70 Level: Medium Type: Conceptual 2-124. Which psychologist is known for studying modeling? a) Ivan Pavlov b) B. F. Skinner c) Albert Bandura d) John B. Watson Answer: c Page: 70 Level: Medium Type: Factual 2-125. Modeling is a process of learning that can occur a) during hypnosis. b) through extinction. c) without reinforcement. d) through classical conditioning.

Answer: c Page: 70 Level: Medium Type: Factual

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2-126. Which perspective emphasizes how people acquire, interpret, and use information to solve problems? a) cognitive b) humanistic c) behavioral d) psychodynamic Answer: a Page: 72 Level: Medium Type: Factual 2-127. Which of the following enables a person to identify stimuli quickly, cluster information effectively, and make inferences? a) model b) schema c) memory d) conditioning Answer: b Page: 72 Level: Medium Type: Factual 2-128. Aaron Beck believes that the type of maladaptive behavior a person exhibits depends on a) modeling. b) idiosyncratic schemata. c) level of self-actualization. d) the stage at which conflict is unresolved.

Answer: b Page: 72 Level: Medium Type: Factual 2-129. Cognitive therapy involves helping the client to a) revise negative interpretations. b) use systematic desensitization. c) accept the inevitability of death. d) remember childhood experiences.

Answer: a Page: 73 Level: Easy Type: Factual 2-130. In rational-emotive therapy, the therapist’s role is primarily that of a a) teacher. b) conscience. c) substitute parent. d) superego reinforcer.

Answer: a Page: 74 Level: Medium Type: Factual 63

2-131. Rational-emotive therapy involves helping the client to a) express strong feelings. b) see things more realistically. c) use systematic desensitization. d) make unconscious memories conscious.

Answer: b Page: 74 Level: Medium Type: Factual 2-132. Emphasis on self-determinism, choice, and the responsibility of the individual to rise above environmental forces is most characteristic of which perspective? a) cognitive b) existentialist c) psychodynamic d) radical behaviorist Answer: b Page: 75 Level: Difficult Type: Factual 2-133. According to the humanist perspective, how does the process of selfactualization occur? a) It is a natural drive. b) It is reinforced by society. c) It is a learned personal construct. d) It is a byproduct of defense mechanisms.

Answer: a Page: 75 Level: Medium Type: Factual 2-134. Janet’s parents always encouraged her in life. Her life’s motto was to be “all that you can be”. This is an example of: a) social role b) self-actualization c) social causation d) self-efficacy Answer: b Page: 75 Level: Medium Type: Conceptual 2-135. Which theorist believed that anxiety is due to tension resulting from inconsistencies between self-perceptions and people’s ideas of what they would like to be? a) Sigmund Freud b) Carl Rogers c) Alfred Adler d) Carl Jung Answer: b Page: 75 Level: Medium Type: Factual 64

2-136. What do the humanist and psychoanalytic perspectives have in common? a) focus on the unconscious b) use of introspection in therapy c) assumption that people make rational decisions d) assumption that human nature is basically good Answer: b Page: 75 Level: Medium Type: Factual 2-137. According to the humanist perspective, anxiety results from inconsistencies between one’s self-perception and one’s a) ideal self. b) superego. c) reputation. d) self-efficacy.

Answer: a Page: 75 Level: Medium Type: Factual 2-138. From the humanist perspective, to act authentically means to a) make rational choices. b) eliminate defense mechanisms. c) act according to one’s own goals. d) be in touch with the collective unconscious.

Answer: c Page: 75 Level: Medium Type: Factual 2-139. Dr. Trevino is a therapist who describes her role as accepting her clients fully, communicating to them that she is listening, and respecting their worth and dignity despite their problems. What type of therapist is Dr. Trevino? a) humanistic b) psychoanalyst c) social-learning d) rational-emotive Answer: a Page: 75 Level: Medium Type: Conceptual 2-140. Tonya has been seeing a therapist who is attempting to convince her that she is free to choose among different courses of action. Her parents always dictated her goals in life. The goal of her therapy is to fulfill her own uniqueness.

Which theorist is associated with this approach? a) Carl Rogers b) Viktor Frankl c) John B. Watson d) Carl Jung Answer: b Page: 76 Level: Medium Type: Conceptual 65

2-141. You are assigned to write a term paper on the topic of the communitycultural perspective. The goal of the assignment is for you to delineate how this approach differs from other ways of viewing maladaptive behavior. Which of the following would make for a good title for your term paper? a) “Failure of social support, not diseases” b) “Combining psychodynamic and social approaches” c) “ How genetic factors are manifested in social environments” d) “Conscious not unconscious, dreams not daydreams as key sources” Answer: a Page: 76 Level: Difficult Type: Conceptual 2-142. Inadequate schools and housing, crime, and prejudice are associated with what theory regarding environment when discussing factors related to mental illness? a) community theory b) social causation theory c) cultural theory d) social selection theory Answer: b Page: 76 Level: Medium Type: Factual 2-143. Which perspective on maladaptive behavior places the most emphasis on prevention? a) humanist b) cognitive c) community d) psychodynamic Answer: c Page: 76 Level: Medium Type: Factual 2-144. Duwayne has been a strong activist in his community, and believes in the community cultural perspective. He is likely to support what theory? a) social selection theory b) cultural theory c) social-behavioral theory d) social causation theory Answer: d Page: 76 Level: Medium Type: Conceptual 2-145. All are true of “labeling” except it: a) occurs when people are placed in categories b) is destructive c) can be desirable d) is encouraged Answer: d Page: 78 Level: Medium Type: Factual 66

2-146. Which of the following best describes the interactional approach on the causes and treatment of maladaptive behavior? a) People’s behavior depends on interactions of factors which give direction to life. b) Behavior must interact with societal norms. c) Cognition is the basis for interaction with affect and behavior. d) None of the above.

Answer: a Page: 78 Level: Medium Type: Factual 2-147. Personal and environmental factors influence each other; stressful life events and a nonsupportive social network are associated with the following perspective? a) interactional b) cultural c) social-behavioral d) community-cultural Answer: a Page: 79 Level: Medium Type: Factual

Essay Questions 2-148. What are the major methods used by behavior geneticists to study the influence of genetics and environment on behavior?

Answer: Behavioral genetic research with humans usually takes the one of two forms: analysis of family histories or twin studies. Pedigree studies begin with an individual who manifests a particular trait. His or her relatives are assessed to see whether they have the same trait. Twin studies are a more direct way of studying the effects of heredity on behavior. Monozygotic (identical) twins have been compared to dizygotic (fraternal) twins with respect to a variety of behaviors.

Pages: 49 – 51 Level: Difficult Type: Factual 2-149. What do various patterns of concordance in monozygotic twins and in dizygotic twins suggest to researchers?

Answer: If the concordance rate in monozygotic twins were similar to that of dizygotic twins, the evidence would suggest a strong environmental influence on the disease or behavior. If the concordance rate for monozygotic twins were much higher than the rate for dizygotic twins, the evidence would suggest a strong role for the influence of heredity.

Page: 49 Level: Difficult Type: Factual

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2-150. Describe the major methods of brain imaging.

Answer: In the first brain imaging methods, computerized axial tomography (CT), the images of the brain are collected on X-ray film. These images are then processed by a computer to generate visually and physically meaningful images.

In magnetic resonance imaging (MRI) the image is derived from signals generated by changes in the levels of electromagnetic radiation from tissues under observation. Magnetic resonance spectroscopy (MRS) extends the capacity of the MRI to permit the study of tissue chemistry and metabolic function. Single photon emission computed tomography (SPECT) provides direct measurement of blood flow and several specific physiological and neurochemical features of the brain.

Page: 57 – 58 Level: Difficult Type: Factual 2-151. According to Freudian theory, how is fixation different from regression?

Answer: Fixation is an arrest in personal development caused by the unresolved difficulties experienced at a given stage. Regression is adopting some of the feelings or behaviors of earlier, more satisfying stages.

Page: 62 Level: Medium Type: Factual 2-152. What are the main differences between the Freud’s and Erikson’s perspectives?

Answer: Freud emphasized the id, described psychosexual stages, and emphasized development through age 18. Erikson emphasized the ego, described psychosocial stages, and emphasized development throughout the life span. In addition, Erikson was more optimistic about his view of human nature.

Pages: 65 – 66 Level: Medium Type: Factual 2-153. What are the differences between negative reinforcement, punishment, and extinction?

Answer: Negative reinforcement increases the frequency of a behavior (by taking away something aversive). Punishment and extinction both decrease the frequency of behavior: Punishment, through application of something aversive; extinction, through lack of reinforcement.

Page: 68 Level: Medium Type: Factual

True/False 2-154. A psychologist should commit to a specific theoretical position to explain all abnormal behavior.

Answer: False Page: 46 Level: Easy Type: Factual

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2-155. The theoretical positions discussed in the text are used and researched today, but each theory was a reaction to a situation existing at the time of its proposal.

Answer: True Page: 46 Level: Difficult Type: Factual 2-156. The biological view of abnormal psychology assumes that all maladaptive behavior is due to a disordered body function or structure.

Answer: True Page: 47 Level: Medium Type: Factual 2-157. Research has demonstrated that few dimensions of behavior are immune to the effects of genetic factors.

Answer: True Page: 48 Level: Medium Type: Factual 2-158. Obtaining information about genetic vulnerability will not significantly increase the number of psychological questions regarding this issue.

Answer: False Page: 48 Level: Medium Type: Factual 2-159. Pedigree studies are initiated when an individual presents a particular trait.

Relatives are then assessed to see if they have the same trait.

Answer: True Page: 49 Level: Medium Type: Factual 2-160. The autonomic system transmits information from sense organs to muscles responsible for voluntary movement.

Answer: False Page: 52 Level: Medium Type: Factual 2-161. Researchers have found there can be as many as a hundred or more variations of a given receptor protein.

Answer: True Page: 52 Level: Medium Type: Factual 2-162. The brain acquires experience as it interacts with the environment. This will influence which synapses remain active, and which are eliminated.

Answer: True Page: 54 Level: Medium Type: Factual 2-163. A correlation exists between plasticity and sensitive periods.

Answer: True Page: 55 Level: Medium Type: Factual 2-164. Neuroscientists try to clarify how the brain functions as a molecularphysiological machine.

Answer: False Page: 56 Level: Medium Type: Factual 2-165. Several forms of mental illness are due to different types of brain abnormalities.

Answer: True Page: 56 Level: Medium Type: Factual 69

2-166. A therapist using psychodynamic psychotherapy would attempt to bring the unconscious to conscious awareness.

Answer: True Page: 60 Level: Medium Type: Factual 2-167. Jung believed people had a genetic inheritance that contributed to our unconscious life.

Answer: True Page: 65 Level: Medium Type: Factual 2-168. Object-relations theorists believed the mind consists of external representations of significant others referred to as objects.

Answer: False Page: 66 Level: Medium Type: Factual 2-169. The community-cultural perspective has produced new approaches to maladaptive behavior, and has aided in reaching populations whose psychological needs were often ignored.

Answer: True Page: 78 Level: Medium Type: Factual

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Chapter 3 The Therapeutic Enterprise: Choices, Techniques, Evaluation 3-1. Six-year-old Kevin's therapy was described in the text. The therapist's conceptualization of the case revolved around what factors? a) the traumas of his father's overeagerness to get Kevin to play in the water and his sister's birth b) his congenital heart disorder and his perception that he was not as strong as other boys his age c) his small physical stature and the hidden abuse that he suffered for years at the hands of a neighbor d) inconsistent discipline at home coupled with aggressive peers who were more than willing to provide role models for his development Answer: a Page: 88 Level: Difficult Type: Conceptual 3-2. What was one of the ways that Garrett's therapist treated his posttraumatic disorder? a) Garrett was asked to practice relaxation exercises at home and to report his daily mood ratings for several months. b) Garrett was encouraged to spend more time out of the house and to pay more attention to the content of his daydreams. c) Garrett was given homework assignments, including writing an account of what happened when his wife was killed in an accident. d) Garrett was encouraged to think about his relationships with his parents and to discuss how that continues to impact his behavior now that he is an adult facing a trauma.

Answer: c Page: 90 Level: Difficult Type: Conceptual 3-3. What was one of the accidental features of the therapy that had a positive impact on the outcome of Garrett's treatment for PTSD? a) discussion of his decision to donate for a memorial to his wife b) a feature article in the newspaper focused on several people who had overcome PTSD c) the manufacturer of the car expressed a willingness to assist victims of car crashes like Garrett d) his employer began an Employee Assistance Program, which made various forms of therapy available at low cost Answer: a Page: 90 Level: Difficult Type: Conceptual

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3-4. Tom described what he perceived as a "dog-eat-dog" world. What was one of the ways his therapist tried to help Tom through his difficulties? a) He asked Tom to create a list of people he trusted. b) He asked Tom express appreciation whenever someone did something he appreciated. c) He asked Tom to take walks each day in order to "clear his head " before he sat down for dinner. d) He helped Tom to practice relaxation during therapy sessions while imagining situations that would typically upset him.

Answer: a Page: 93 Level: Difficult Type: Conceptual 3-5. What do the cases of Garret Cross and Tom Martin reflect about the nature of the clinical enterprise? a) Treatment is the strength of diagnoses. b) Some problems have no solutions. c) People have problems and clinicians attempt to transform maladaptation into adaptation. d) Family involvement is important for case management and proper treatment.

Answer: c Page: 94 Level: Medium Type: Factual 3-6. Which is not a task performed by psychotherapists? a) responding b) communicating c) listening d) understanding Answer: b Page: 95 Level: Medium Type: Factual 3-7. Expressing an uninhibited flow of thoughts and feelings is called a) flooding. b) transference. c) free association. d) countertransference.

Answer: c Page: 96 Level: Medium Type: Factual 3-8. Which treatment approach focuses on memories of early relationships with parents and significant others? a) behavioral b) existential c) client-centered d) psychodynamic Answer: d Page: 96 Level: Medium Type: Factual 72

3-9. Which of the following is an important element of psychoanalysis? a) flooding b) extinction c) transference d) negative reinforcement Answer: c Page: 96 Level: Medium Type: Factual 3-10. After a year in analysis, Mark realizes that his therapist reminds him of his older sister, who guided and protected him after his mother's death.

Mark's reaction is an example of a) clinical projection. b) countertransference. c) positive transference. d) negative transference.

Answer: c Page: 96 Level: Difficult Type: Conceptual 3-11. Miguel's therapist realizes she has been responding inappropriately to him because he reminds her of a former client. This reaction is an example of a) clinical projection. b) countertransference. c) positive transference. d) negative transference.

Answer: b Page: 96 Level: Difficult Type: Conceptual 3-12. Ann is talking to her therapist about her relationship with her mother. She and her mother have never gotten along with each other. Ann has never expressed her anger to her mother, and in the session, she begins to yell at the therapist and becomes hostile. Ann’s reaction is an example of: a) countertransference b) clinical projection c) positive transference d) negative transference Answer: d Page: 96 Level: Difficult Type: Conceptual 3-13. Recovered memories are: a) unconscious conflict b) repressed memories c) conscious conflict d) None of the above Answer: b Page: 97 Level: Medium Type: Factual

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3-14. A patient is about to begin psychotherapy and a counselor describes the various forms of therapy that are available. For each form of therapy, the counselor describes the major goal of the therapy. What does she say when describing psychodynamic therapy? a) to make the unconscious conscious, often by recovering repressed memories b) to analyze daydreams for clues as to the disparity between the real and the ideal selves c) to establish a dialogue with the "inner self" in order to see one's behavior in a new light d) to question and even attack some of the beliefs that are currently interfering with a more fulfilling life Answer: a Page: 97 Level: Difficult Type: Conceptual 3-15. Tom has repressed memories about the tragic death of his parents. Tom told his therapist it is too painful to talk of these memories. His therapist discussed a technique with Tom where he will be receptive to suggestions to explore these memories. The technique was: a) hypnosis b) free association c) positive transference d) negative transference Answer: a Page: 97 Level: Difficult Type: Conceptual 3-16. People who are susceptible to hypnosis typically have a) brain damage. b) frequent nightmares. c) attentional difficulties. d) heightened suggestibility.

Answer: d Page: 97 Level: Medium Type: Factual 3-17. Which therapeutic approach confronts the patient’s need to confront basic questions of existence? a) humanistic b) client centered c) existential d) rational-emotive Answer: c Page: 97 Level: Medium Type: Factual

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3-18. Client-centered therapy is an example of which approach to therapy? a) humanistic b) existential c) psychoanalytic d) cognitive-behavioral Answer: a Page: 97 Level: Medium Type: Factual 3-19. Yolanda has been successful in her career and relationships, but is disturbed by the nagging question, "Am I being true to myself?" Which type of therapy would most likely address this concern? a) cognitive b) existential c) behavioral d) psychodynamic Answer: b Page: 97 Level: Medium Type: Factual 3-20. Carl Rogers is known as the founder of which approach to therapy? a) cognitive b) existential c) neo-Freudian d) client-centered Answer: d Page: 97 Level: Medium Type: Factual 3-21. Humanistic therapies emphasize the individual's need to a) feel self-confidence. b) confront abusive parents. c) achieve success in a career. d) understand the strong fear of death.

Answer: a Page: 97 Level: Medium Type: Factual 3-22. Which of the following describes the role of the therapist in client-centered therapy? a) acts as a symbolic parent b) reflects the client's concerns c) interprets unconscious conflicts d) serves as an advocate with social services Answer: b Page: 97 Level: Medium Type: Factual

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3-23. Which type of therapist aims to provide unconditional positive regard for the client? a) cognitive b) psychodynamic c) neo-Freudian d) client-centered Answer: d Page: 98 Level: Medium Type: Factual 3-24. Client-centered therapists assume behavior change follows from a client's a) self-acceptance. b) relaxed defenses. c) decreased anxiety. d) formulation of specific goals.

Answer: a Page: 98 Level: Medium Type: Factual 3-25. What term is used for the client-centered therapist's empathic, non-judgmental listening? a) projection b) therapeutic insight c) countertransference d) unconditional positive regard Answer: d Page: 98 Level: Medium Type: Factual 3-26. Maria is a therapist who believes labels and diagnoses are not useful. She sees her role as one of accepting her clients unconditionally. Which approach to therapy does Maria seem to follow? a) cognitive b) behavioral c) psychoanalytic d) client-centered Answer: d Page: 98 Level: Difficult Type: Conceptual 3-27. Which type of therapist believes their main task is to frustrate their clients, to help clients express strong emotions, and fight out conflicts with authority? a) Gestalt b) existential c) neo-Freudian d) client-centered Answer: a Page: 98 Level: Medium Type: Factual

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3-28. Which type of therapist would purposefully anger a client? a) Gestalt b) humanistic c) existential d) cognitive-behavioral Answer: a Page: 98 Level: Medium Type: Factual 3-29. A therapist who suggests role-playing would be using a technique from: a) client-centered therapy b) psychoanalysis c) rational-emotive therapy d) gestalt therapy Answer: d Page: 98 Level: Medium Type: Factual 3-30. What is the primary method to seek change in cognitive psychotherapy? a) modeling b) conversation c) role-play d) unconditional positive regard Answer: b Page: 98 Level: Medium Type: Factual 3-31. What do Gestalt therapy and psychoanalysis have in common? a) use of hypnosis b) unconditional positive regard c) use of dreams as part of therapy d) a belief that the therapist should remain neutral Answer: c Page: 98 Level: Medium Type: Conceptual 3-32. Which approach to therapy emphasizes changing unrealistic or irrational thoughts? a) cognitive b) existential c) neo-Freudian d) psychoanalytic Answer: a Page: 98 Level: Medium Type: Factual

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3-33. Which thought reflects the type of thinking that rational-emotive therapy seeks to change? a) "Snakes can bite." b) "What is the point of life?" c) "I must stay on the Dean's list." d) "I just don't associate with that kind of person."

Answer: c Page: 98 Level: Difficult Type: Conceptual 3-34. Ann seeks a therapist to help her overcome her depression. Her therapist helps her see that she is often preoccupied with "musts" such as "I must never disappoint my parents;" and "I must always be successful." Her therapist actively disputes these irrational beliefs and helps her develop more adaptive ones. Ann's therapist seems to share a great deal in common with a) Fritz Perls. b) Aaron Beck. c) Carl Rogers. d) Sigmund Freud.

Answer: b Page: 98 Level: Difficult Type: Conceptual 3-35. During a therapy session, Aaron Beck's client says, "You know I think I am a good-for-nothing worthless idiot." What is Aaron Beck likely to say? a) "Who is it in your past that encouraged you to think in those terms?" b) "What evidence is there and how could it be interpreted in other ways?" c) "To the contrary, I see you as a genuinely honest, respectable individual." d) "Tell me about the dreams that you have related to how you feel about yourself."

Answer: b Page: 98 Level: Difficult Type: Conceptual 3-36. Bert seeks out a therapist to overcome his depression. His therapist suggests that the best way to solve emotional problems is to alter one's thinking, especially the "automatic thoughts" that are often learned as children. The therapist gently and persistently challenges the validity of Bert's beliefs about himself and the situation. Bert's therapist is most like a) Aaron Beck. b) Carl Rogers. c) Albert Bandura. d) Sigmund Freud.

Answer: a Page: 98 Level: Difficult Type: Conceptual

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3-37. Interpersonal therapy was originally designed for people suffering from a) anxiety. b) depression, c) schizophrenia. d) personality disorder.

Answer: b Page: 99 Level: Medium Type: Factual 3-38. A therapist has recommended a form of therapy for you that will consist of weekly 50-minute sessions for 12 to 16 weeks. The first step is a structured interview dealing with symptoms, family history, and current and recent events in your life. Which of the following is the most likely form of therapy that has been recommended? a) interpersonal b) client-centered c) psychodynamic d) cognitive-behavioral Answer: a Page: 99 Level: Difficult Type: Conceptual 3-39. John just began therapy sessions to deal with a variety of problems that have caused him problems for some time. His therapist uses a lot of cognitive therapy approaches. Which of the following would this therapist likely do during a typical therapy session? a) The therapist will role play the consequences of some of John's faulty and irrational beliefs. b) Tell John that he needs to "get real" and "grow up" before he can expect any change in his life. c) Ask John to share his earliest memories of his interactions with his parents and his siblings in order to track down the roots of his current difficulties. d) The therapist will encourage John to spend more time each day engaged in a series of relaxation exercises that will help him to develop some of the social skills he is lacking.

Answer: a Page: 99 Level: Difficult Type: Conceptual

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3-40. Alice has been experiencing a number of personal difficulties, which have finally led her to consider seeking help from a mental health professional. Her neighbor suggests that before she lets her "fingers do the walking through the Yellow Pages," she should read the Consumer Reports survey. What finding should be of special interest to her in selecting a therapist? a) Advanced degrees were rated highly in the survey. b) Drug treatments were superior to other treatments. c) Long-term treatment was associated with relatively poor outcomes. d) Outcome of therapy did not seem to be related to the form of the therapy.

Answer: d Page: 100 Level: Difficult Type: Conceptual 3-41. Your cousin is an intern at the local newspaper. Part of her responsibility is to write stories that have a psychological angle. The editor asked her for 1,000 words on the Consumer Reports survey on therapy. Which of the following would make for the best title for this article? a) "Psychotherapy: Consumer Fraud" b) "Psychotherapy v. Drugs: A Clear Winner" c) "Consumer Satisfaction with Therapy is High" d) "Advanced Degrees Make a Difference in Therapy" Answer: c Page: 100 Level: Medium Type: Conceptual 3-42. A mental health professional was asked to comment on the Consumer Reports survey of satisfaction with psychotherapy. Which of the following might be the most important criticism of the survey? a) Open-ended questions made it difficult to draw conclusions. b) Only a small proportion of the magazine's subscribers returned the survey. c) Most of the respondents were hospitalized at the time they completed the survey. d) The surveys had to be completed by the therapist who was treating the respondent.

Answer: b Page: 100 Level: Difficult Type: Conceptual

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3-43. A mental health professional was asked to comment on the Consumer Reports survey of satisfaction with psychotherapy. Which of the following might be an important criticism of the report? a) "The results were based only on the patients' perspective." b) "The therapists did not use drug treatments in any of their approaches." c) "The results involved treatments based primarily on psychodynamic therapy." d) "The therapists who were providing the therapy were primarily using behavioral techniques."

Answer: a Page: 100 Level: Difficult Type: Conceptual 3-44. Meta-analysis is a method of a) conducting longitudinal research. b) combining the results of many studies. c) quantifying the process of self-actualization. d) determining if a statistical result is significant.

Answer: b Page: 101 Level: Medium Type: Factual 3-45. Meta-analytic studies show that after treatment, the average psychotherapy client is better off than about what percentage of untreated control subjects? a) 25% b) 50% c) 75% d) 95% Answer: c Page: 101 Level: Medium Type: Factual 3-46. The Senate committee charged with the responsibility for funding used for various forms of treatment issues subpoenas "to get to the bottom of the questions surrounding psychotherapy." After several days of hearings, how would an objective reporter describe the case made by psychotherapy researchers? a) Psychoanalytic therapy is quite effective for most disorders. b) Psychotherapy plays a positive role in the lives of those who receive it. c) It is impossible to provide any evidence on the effectiveness of psychotherapy at this point. d) In order to be effective, psychotherapy must be combined with group therapy and drug treatments.

Answer: b Page: 102 Level: Difficult Type: Conceptual

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3-47. Researchers compared the effectiveness of medical treatment and psychotherapy for irritable bowel syndrome. What did they find? a) Psychotherapy was the superior treatment. b) Both forms of treatment are equally ineffective. c) There was no difference in the effectiveness of the two types of treatment d) The medical treatment was far superior; psychotherapy actually made the symptoms worse.

Answer: a Page: 102 Level: Medium Type: Conceptual 3-48. A study of the treatment effectiveness for substance-use disorders found that therapists showed widely different rates of effectiveness. Which of the following was a key factor that seemed important in accounting for the success of some of the therapists? a) adherence to specific techniques b) possession of strong interpersonal skills c) increased years of experience in therapy d) strong belief in a single theoretical orientation Answer: b Page: 102 Level: Difficult Type: Factual 3-49. Which of the following is most likely to be a concern for a researcher engaged in process research on psychotherapy? a) therapist-patient relationship b) spelling out therapy techniques in training manuals c) identifying efficient methods of hospital administration d) determining which theoretical orientation is most valid Answer: a Page: 102 Level: Medium Type: Factual 3-50. You are attending your first psychological convention and are overwhelmed by the number of paper presentations. As you thumb through the convention program you see the following category of presentations, Psychotherapy Process Research. Which of the following titles would best fit under this session category? a) "Therapeutic success: A focus on the elements" b) "Therapists' own therapy and success in therapy" c) "Uncovering the unconscious: Its role in therapeutic outcomes" d) "How to combine medication with psychotherapy for increased success" Answer: a Page: 102 Level: Difficult Type: Conceptual

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3-51. Token economies use the principles of a) covert sensitization. b) operant conditioning. c) aversive conditioning. d) classical conditioning.

Answer: b Page: 103 Level: Medium Type: Factual 3-52. After attending several sessions of therapy at the mental health center, your family members ask you to describe the treatment and you tell them it has included a graded program of activities, homework, and role playing along with efforts to identify and modify unrealistic beliefs. What form of therapy is the basis for your treatment? a) Gestalt b) client-centered c) psychodynamic d) cognitive-behavioral therapy Answer: d Page: 103 Level: Medium Type: Conceptual 3-53. Bev is a patient on the adolescent ward of a state hospital, where patients earn points for participation in different activities. When she has enough points saved, Bev plans to exchange them for a trip to a local restaurant with a hospital aide. What is the name of this type of program? a) fading b) biofeedback c) generalization d) token economy Answer: d Page: 103 Level: Medium Type: Conceptual 3-54. Shaping, fading, extinction, and punishment are all procedures used in a) behavior therapy. b) neo-Freudian therapy. c) assertiveness training. d) client-centered therapy.

Answer: a Page: 103 Level: Medium Type: Factual

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3-55. Sherri has an extremely high-pressure position that has caused minor health problems. She does not want to take medication. Her therapist has recommended a technique where she can learn to monitor and control internal processes. The technique is: a) biofeedback b) modeling c) fading d) cognitive re-thinking Answer: a Page: 103 Level: Medium Type: Conceptual 3-56. The use of homework, role-playing, programmed activities, and attempting to identify and modify unrealistic thoughts are techniques of: a) rational-emotive therapy b) client-centered therapy c) cognitive-behavioral therapy d) gestalt therapy Answer: c Page: 104 Level: Medium Type: Factual 3-57. Ted is learning a technique that requires him to concentrate on a thought, a sensation, a word, an object, or some mental state. Which technique is Ted learning? a) flooding b) meditation c) biofeedback d) systematic desensitization Answer: b Page: 104 Level: Medium Type: Conceptual 3-58. Sue was telling her friend about the treatment that was recommended when she saw a psychologist at the clinic. If the treatment involves muscular relaxation, which of the following is a likely problem that brought her to the clinic? a) panic disorder b) bipolar disorder c) tension headache d) somatization disorder Answer: c Page: 104 Level: Medium Type: Conceptual 3-59. In contrast to flooding, exposure therapy involves a) biofeedback. b) the client's consent. c) fantasized exposure. d) gradual approach to the feared stimulus.

Answer: d Page: 104 Level: Medium Type: Factual 84

3-60. Bill is terrified of snakes. However, he must attempt to deal with his fear of snakes because his job places him in high-risk areas to come in contact with multiple species of snakes. Which of the following techniques could assist Bill with his fear? a) meditation b) flooding c) relaxation d) fantasized exposure Answer: b Page: 104 Level: Medium Type: Conceptual 3-61. The technique of systematic desensitization is based on the theory that relaxation is a) more natural than fear. b) reinforced by attention. c) incompatible with previously learned anxiety. d) the ideal behavioral response to environmental situations.

Answer: c Page: 105 Level: Medium Type: Factual 3-62. You walk into a classroom in preparation for your next class and see the following words on the board: behavioral training and cognitive activity.

You can tell from other writings that the class that met previously was abnormal psychology. You ask your friend who is taking the course what the topic for the day had been. What will she say? a) biofeedback b) family therapy c) operant conditioning d) systematic desensitization Answer: d Page: 105 Level: Medium Type: Conceptual 3-63. Rick has been watching his father fib on his income tax form and has decided to lie to his parents about how much allowance his friends get. Rick's behavior is an example of a) exposure. b) live modeling. c) guided rehearsal. d) symbolic meaning.

Answer: b Page: 105 Level: Medium Type: Conceptual

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3-64. To treat Valerie's fear of cats, her therapist asks her to watch a home video of other children playing with cats. This technique is an example of a) covert modeling. b) guided rehearsal. c) symbolic modeling. d) participant modeling.

Answer: c Page: 105 Level: Medium Type: Conceptual 3-65. Cognitive-behavioral training can be especially effective for which of these clients? a) Bill who is seeking to overcome fears and inhibitions b) Carla who is disturbed by delusions and hallucinations c) Ted who has the diagnosis of antisocial personality disorder d) Iris who has been visiting doctor after doctor in search of one who will "truly understand" her physical symptoms Answer: a Page: 105 Level: Medium Type: Conceptual 3-66. Ellen's therapist gives her homework assignments. In one of them, she practiced standing up for herself by expressing her opinions and making some reasonable requests. What technique is Ellen's therapist using? a) modeling b) operant conditioning c) assertiveness training d) systematic desensitization Answer: c Page: 106 Level: Medium Type: Conceptual 3-67. What is the primary focus of cognitive-behavioral group therapy? a) increasing social skills b) providing social support for group members c) breaking entrenched habits, such as smoking d) expressing strong emotions in a nonjudgmental setting Answer: a Page: 108 Level: Medium Type: Factual 3-68. Which perspective was used as the basis for the first group therapy sessions? a) Gestalt b) cognitive c) psychodynamic d) client-centered Answer: c Page: 108 Level: Medium Type: Factual

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3-69. What does the family therapist encourage the family to do as part of the therapy? a) share unconscious feelings with each other b) avoid conflict in the interest of family harmony c) obtain a balance between being individuals and being a group d) be supportive of the family member whose behavior is the problem Answer: c Page: 109 Level: Medium Type: Conceptual 3-70. What is the guiding principle of family therapy? a) Family harmony is the most important goal. b) Our society is witnessing the destruction of the family unit. c) It is easier to change behavior patterns of a group than of an individual. d) The family itself is a system which has its own characteristics and disorders.

Answer: d Page: 110 Level: Medium Type: Factual 3-71. A secretary is transcribing the notes of a therapist who just finished a session. The notes include several references to "transactional patterns." What form of therapy was involved? a) family therapy b) Gestalt therapy c) psychodynamic d) client-centered Answer: a Page: 110 Level: Medium Type: Conceptual 3-72. Marital therapy is viewed as a subtype of a) family therapy. b) fixed-role therapy. c) behavior modification. d) assertiveness training.

Answer: a Page: 110 Level: Medium Type: Factual 3-73. Which of the following involves a group of patients working together in therapy? a) psychodrama b) Gestalt therapy c) fixed-role therapy d) existential therapy Answer: a Page: 111 Level: Medium Type: Factual

87 3-74. In contrast to behavioral therapy, psychodrama involves

a) less emotionality. b) more spontaneity. c) focus on one client at a time. d) more of a focus on assertiveness.

Answer: b Page: 111 Level: Medium Type: Factual 3-75. About how many different types of psychological therapy are currently in use for adult disorders? a) 25 b) 100 c) 400 d) 1000 Answer: c Page: 111 Level: Medium Type: Factual 3-76. When former therapy clients are asked to specify which aspects of therapy were most helpful to them, how did the answers of clients who had gone through behavior therapy compare to the answers of clients who had gone through psychodynamic therapy? a) Both groups emphasized the same factors. b) Clients' ratings depended on the specific techniques used in therapy. c) Only the behavioral group emphasized the development of confidence. d) Only the psychodynamic group emphasized the therapist-client relationship.

Answer: a Page: 111 Level: Difficult Type: Conceptual 3-77. Why are control groups used in therapy outcome studies? a) to increase the sample size of the study b) to supply a pool of stand-by subjects in case other subjects drop out c) to rule out the possibility of alternative explanations of positive outcomes d) to motivate the treatment subjects to change by creating competition between groups Answer: c Page: 112 Level: Medium Type: Conceptual 3-78. Researchers who conduct therapy outcome studies attempt to rule out alternative explanations for positive outcomes by making sure that their research involves a) control groups. b) large sample sizes. c) clear definitions of treatments. d) participants who are likely to benefit from therapy.

Answer: a Page: 112 Level: Medium Type: Factual 88

3-79. A psychiatrist is discussing the treatment options for your uncle who a court has determined to be unable to make treatment decisions. As his guardian you are charged with making such decisions. One of the options for treating your uncle's depression is electroconvulsive therapy; however, you want to know the side effects. What major side effect will the psychiatrist mention? a) insomnia b) memory problems c) delusional thinking d) heightened fear reactions Answer: b Page: 115 Level: Difficult Type: Conceptual 3-80. A Professor of Psychiatry at University School of Medicine is describing changes that have occurred in the administration of electroconvulsive therapy (ECT). Which of the following will be included in her discussion? a) Anesthetics and muscle relaxants are now used. b) Patients are placed on MAO inhibitors prior to receiving the ECT. c) The amount of electricity used has been increased to create a more powerful and more effective seizure. d) The number of treatments has been decreased because ECT appears to be effective in just a few sessions.

Answer: a Page: 115 Level: Difficult Type: Conceptual 3-81. Which of the following would be prescribed for a person diagnosed with bipolar disorder? a) Lithium b) MAO inhibitor c) Phenothiazine d) Benzodiazepine Answer: a Page: 116 Level: Medium Type: Factual 3-82. Which of the following is likely to be prescribed to treat anxiety disorders? a) antipsychotic b) MAO inhibitors c) antimanic d) benzodiazepines Answer: d Page: 116 Level: Medium Type: Factual

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3-83. Which of the following drug treatments is most likely to be prescribed for a person suffering from panic disorder? a) lithium b) clozapine c) anticonvulsants d) tricyclic antidepressants Answer: d Page: 116 Level: Medium Type: Factual 3-84. Which of the following would not be a reason to consider hospitalization? a) behavior that is a threat to self or others b) intolerable behavior c) continued loss of employment d) withdrawal from substance Answer: c Page: 119 Level: Medium Type: Factual 3-85. Which of the following is one of the mental hospital procedures suggested

by Gordon Paul? a) increase emphasis on social skills and interactions b) greater protection from disturbing "outside world" influences c) lower staff expectations for patient independence to raise confidence levels d) reduce opportunities to practice vocational skills to focus on developing insight Answer: a Page: 120 Level: Difficult Type: Factual 3-86. For which of these individuals would day hospitals provide an appropriate treatment alternative? a) Dan who has no insurance b) Edward who is able to live at home c) Jonathan who has been chronically hospitalized d) Steve who needs constant supervision and intensive therapy Answer: b Page: 120 Level: Medium Type: Factual

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Essay Questions 3-87. What problems arise in connection with efforts to examine recovered memories?

Answer: The most basic problem is concern about the memories' validity.

Trauma-linked material often pertains to early childhood, and it may not be possible to collect objective information to confirm that the recovered memories are true. Additionally, even non-traumatic memories show distortion over time.

Clients can fill in gaps in memory based on therapists' suggestions or leading questions.

A client's present life situation and the need to explain the past might distort a person's memories. A therapist's beliefs about the causes of a person's psychological problems might also distort the client's memories by directing a patient's thoughts in a particular direction.

Pages: 96 – 97 Level: Difficult Type: Factual 3-88. What is meta-analysis and what are the results of these analyses when applied to the effectiveness of psychotherapy?

Answer: It is difficult to determine because there is no objective measure of treatment effectiveness. Meta-analysis has an advantage of allowing researchers to combine a large number of studies in trying to address questions about the effectiveness of therapy. This research shows that the average patient receiving therapy was generally better off in a measurable way than 75% of people who received no treatment.

Pages: 101 – 102 Level: Difficult Type: Factual 3-89. What are the key factors in the successful use of relaxation training?

Answer: (1) The individual's problems do not have an organic basis. (2) The individual is not psychotic, depressed, or subject to panic attacks. (3) The individual is able to assume responsibility for active participation in treatment, with special emphasis on home practice. (4) Family members are cooperative with and supportive of the individual's treatment. (5) The individual has reasonable expectations of the training's effectiveness.

Page: 104 Level: Difficult Type: Factual

91 3-90. What are some of the key features of group therapy?

Answer: (1) Self-disclosure: the opportunity to tell the group about one's own problems and concerns. (2) Acceptance and support: feeling a sense of belongingness and being valued by the other group members. (3) Norm clarification: learning that one's problems are neither unique nor more serious than those of other group members. (4) Social learning: being able to relate constructively and adaptively within the group. (5) Vicarious learning: learning about oneself through the observations of other group members, including the therapist. (6) Self-understanding: finding out about one's behavior in the group setting and the motivations contributing to the behavior.

Pages: 107 – 109 Level: Difficult Type: Factual 3-91. What are some of the ways that Gordon Paul suggests that hospital patients can be resocialized to adjust to life in the community?

Answer: (1) Emphasize a "resident" rather than "patient" status through informal dress of staff, open channels of communication in all directions, and broad (but clear) authority structure. (2) Make clear, through a set of rules and attitudes, that the residents are responsible human beings; are expected to follow certain minimal rules of group living; and are expected to do their share in participating in self-care, work, recreational, and social activities. (3) Utilized step systems which gradually increase the expectations placed on residents in terms of their degree of independence and level of responsibility. (4) Encourage social interactions and skills and provide a range of activities as well as regular large and small group meetings. (5) Emphasize clarity of communication, with concrete instruction in appropriate behavior and focus on utilitarian "action" rather than "explanation."

Pages: 102 – 121 Level: Difficult Type: Factual

True/False 3-92. In therapeutic settings, it is important to describe, understand, and evaluate the process.

Answer: True Page: 94 Level: Easy Type: Factual 3-93. Recovered memories can be correct but lack both objective and subjects evidence regarding validity.

Answer: False Page: 97 Level: Medium Type: Factual 3-94. Hypnosis is an intense alertness in which the patient’s mind can screen out extraneous events and focus on particular details.

Answer: True Page: 97 Level: Easy Type: Factual

92 3-95. Humanistic therapies examine client’s desires for self-respect.

Answer: True Page: 97 Level: Easy Type: Factual 3-96. Albert Ellis is the founder of gestalt therapy.

Answer: False Page: 98 Level: Easy Type: Factual 3-97. The initial step in interpersonal therapy is a structured interview focusing on symptoms, family history, and current events in the client’s life.

Answer: True Page: 99 Level: Easy Type: Factual 3-98. Brief psychotherapies were developed in the 1980s to contain health care costs.

Answer: True Page: 99 Level: Easy Type: Factual 3-99. Fading and token economy are associated with behavior therapy.

Answer: True Page: 103 Level: Easy Type: Factual 3-100. A client may be unaware that certain habits are controlling his behavior.

Through modeling, the client can be shown there are other ways of doing things.

Answer: True Page: 105 Level: Easy Type: Factual 3-101 In regard to diversity, consideration of the cultural background and ethnic identification of clients is relevant to successful treatment.

Answer: True Page: 114 Level: Easy Type: Factual

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Chapter 4 Classification and Assessment 4-1. What was the most serious consequence of the misdiagnosis of Robert Bjorklund as suffering from schizophrenia? a) The treatment given to him was inappropriate. b) He was refused admission to colleges that feared his disorder. c) Family members were not allowed to see him for extensive periods of time. d) A prefrontal lobotomy performed to treat his illness left him with a permanent disability.

Answer: a Page: 127 Level: Medium Type: Factual 4-2. Why is the classification of abnormal behavior considered to be in an early stage of development? a) The process of attaching labels is arbitrary. b) Interest in the topic developed only recently. c) Current behavioral classification systems are hierarchical. d) Behavioral classification systems have not been very useful.

Answer: a Page: 128 Level: Medium Type: Factual 4-3. How are most classification systems in psychology similar to those in the natural sciences? a) dynamic b) explanatory c) hierarchical d) low reliability Answer: c Page: 128 Level: Medium Type: Factual 4-4. Which of the following illustrates the hierarchical nature of the classification system for maladaptive behaviors? a) Delusions and hallucinations are key symptoms of schizophrenia. b) Anxiety and depression are common symptoms in many disorders. c) Mental retardation and personality disorders are diagnosed on Axis II of DSM. d) A manic episode is a subdivision of bipolar disorders, which in turn is a subgroup of mood disorders.

Answer: d Page: 128 Level: Difficult Type: Conceptual

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4-5. Which of the following is not a criticism of clarifying maladaptive behaviors? a) Diagnosis labels a person. b) All patients are unique, and patients cannot be helped without reference to general principals. c) Some diagnoses are not useful because diagnostic categories are imperfect. d) A diagnosis may keep a person from gaining employment.

Answer: b Page: 129 Level: Medium Type: Factual 4-6. What are the two major sources of unreliability in diagnoses? a) deception by clients and clinician's theoretical orientation b) overreliance on intelligence testing and failure to use structured interviews c) clinical judgment and differences in the way different people present their symptoms d) reliance on insurance regulations and misunderstanding the language of ethnically diverse clients Answer: c Page: 129 Level: Medium Type: Factual 4-7. What is Sarason and Sarason’s implication for the process of classification? a) Abnormal behavior must be understood in the context of several factors, which include stress, vulnerability, and coping. b) Abnormal behavior has to be examined and understood in exact diagnostic terms. c) Classification is only one component in the diagnostic procedure. d) The context of a problem is essential in classification.

Answer: a Page: 129 Level: Medium Type: Factual 4-8. What is the root meaning of the term diagnostic? a) cause b) brain disorder c) to cure disorders d) thorough knowledge Answer: d Page: 130 Level: Easy Type: Factual 4-9. What were the two major disorders identified by Emil Kraepelin? a) agoraphobia and multiple personality b) dementia praecox and manic-depressive insanity c) antisocial personality disorder and schizophrenia d) dissociative fugue and obsessive-compulsive disorder Answer: b Page: 130 Level: Medium Type: Factual 95

4-10. Which group publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM)? a) American Psychiatric Association b) American Psychological Association c) U.S. Department of Health and Human Services d) World Health Organization of the United Nations Answer: a Page: 130 Level: Easy Type: Factual 4-11. What does it mean when we describe the current classification system for mental disorders as a multiaxial system? a) The system has high reliability. b) It uses ratings scales, not categories. c) The system focuses on neurological causes. d) It describes diverse information rather than a single label.

Answer: d Page: 130 Level: Medium Type: Factual 4-12. A criticism of DSM is it does not give sufficient attention to: a) physiology b) treatment c) exactness d) etiology Answer: d Page: 130 Level: Easy Type: Factual 4-13. Which of the following describes the multiaxial approach of DSM-IV-TR? a) five axes, two of which list specific mental disorders b) five axes, one of which lists specific mental disorders c) three axes, two of which list specific mental disorders d) three axes, one of which lists specific mental disorders Answer: a Page: 130 Level: Medium Type: Conceptual 4-14. During a lecture in abnormal psychology, the professor describes the DSMIV-TR as a multiaxial system of classification. Your friend missed the class and asks you for your notes. He is confused when he comes across the term multiaxial. How will you explain this term to your friend? a) DSM-IV-TR offers a variety of possible etiologies. b) Diverse information is required for each case. c) A diagnosis requires input from several clinicians. d) An individual must show all symptoms of a disorder in order to receive a diagnosis.

Answer: b Page: 130 Level: Difficult Type: Conceptual

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4-15. Psychosocial and environmental problems and a global assessment of functioning are noted on what axes of DSM-IV-TR? a) I and II b) II and III c) III and IV d) IV and V Answer: d Page: 130 Level: Medium Type: Factual 4-16. Ben has a social phobia as well as a heart condition. These conditions would be diagnosed on what axes of DSM-IV-TR? a) I and III b) I and II c) II and IV d) IV and V Answer: a Page: 130 Level: Medium Type: Conceptual 4-17. For more than 10 years, Ray has had an extreme fear of speaking in front of groups. As a result, he will not take classes that require class presentations, and he will not join groups that have meetings where he might be expected to speak. His family physician has determined that Ray also has a problem with his thyroid, which may exacerbate some of the symptoms he has experienced. Ray decides to seek psychotherapy at a mental health clinic. On which two axes of DSM-IV-TR will Ray's problems be listed? a) I and II b) I and III c) II and IV d) II and III Answer: b Page: 130 Level: Difficult Type: Conceptual 4-18. During a case conference presentation a client is described as having an Axis V rating of 30. A student intern asks what this means. What will you tell her? a) "The client's symptoms are not severe. " b) "The client has a 30% chance of a full recovery." c) "The client is likely to be a danger to himself or to others." d) "The client has shown 30% improvement since beginning therapy."

Answer: c Page: 130 Level: Difficult Type: Conceptual

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4-19. What are the first three axes of the DSM-IV-TR classification system used to describe? a) a disorder's etiology b) level of daily functioning c) diagnoses of a psychiatric or physical nature d) level of environmental stress and coping skills Answer: c Page: 131 Level: Medium Type: Factual 4-20. Most of the primary diagnoses in DSM-IV-TR, such as mood disorders and anxiety disorders, are listed on which axis? a) I b) II c) III d) IV Answer: a Page: 132 Level: Easy Type: Factual 4-21. From the time he was an adolescent, everyone knew Sid was excessively concerned about details and lacked a sense of humor. He decided to make an appointment at a mental health center. The therapist found that in addition to having a personality disorder, Sid also suffered from depression. On which axes of the DSM-IV-TR would these diagnoses be recorded? a) I and II b) I and III c) II and IV d) II and III Answer: a Pages: 132, 133 Level: Difficult Type: Conceptual 4-22. Why are the disorders listed in DSM-IV-TR Axes I and II separated rather than combined on one axis? a) The separation provides for evaluation of continuing characteristics that should be taken into consideration. b) Insurance companies will pay for treatment of only certain disorders, so these are separated out for ease of billing. c) One axis contains disorders that can be treated; the other axis contains disorders that currently have no available treatments. d) The two sets of disorders differ in the degree to which genetic and environmental factors play a significant role in etiology.

Answer: a Page: 133 Level: Difficult Type: Conceptual

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4-23. Why are personality disorders listed on a separate axis than are the primary psychiatric diagnoses in DSM-IV-TR? a) Personality disorders are not diagnoses. b) Personality disorders are not debilitating. c) Personality disorders are continuing problems. d) Personality disorders have no biological cause.

Answer: c Page: 133 Level: Medium Type: Factual 4-24. On what axis of DSM-IV-TR is mental retardation noted? a) I b) II c) III d) IV Answer: b Page: 133 Level: Medium Type: Factual 4-25. One reason for the revisions in later versions of DSM was to have the diagnostic categories correspond more closely to those in the a) Physician's Desk Reference. b) health care reform legislation. c) original works published by Freud. d) International Classification of Diseases.

Answer: d Page: 133 Level: Medium Type: Factual 4-26. One way that the DSM-IV-TR is superior to earlier classification systems is that its designers focused on a) psychodynamic theory b) descriptions of behavior c) available, affordable medications d) disorders that are covered by health insurance Answer: b Page: 133 Level: Medium Type: Factual 4-27. The developers of the DSM-IV-TR wanted to be specific with regard to the criteria for using the diagnostic categories. Which of the following is not a factor in achieving that goal? a) Extensive coverage of childhood disorders. b) Increased coverage of the range of disorders. c) Emphasizing theoretical ideas concerning causation. d) Emphasizing descriptions of behavior.

Answer: c Page: 134 Level: Medium Type: Factual

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4-28. What is one of the reasons for the increased reliability of diagnoses based on the DSM system? a) The system was built upon psychodynamic principles. b) The system has a greater reference to biological causes. c) There is a greater emphasis on descriptions of behaviors. d) The current system requires a greater reliance on inference.

Answer: c Page: 134 Level: Medium Type: Conceptual 4-29. A professor at the university is conducting research on the use of DSM. He asks groups of clinical psychologists to view videotaped interviews of several clients. After they view each videotape, they are to write down the most likely diagnoses for each case. Based on this description of the research, which of the following terms is most likely to appear in the title of the report the professor will write describing his research? a) utility b) validity c) reliability d) coverage Answer: c Page: 134 Level: Difficult Type: Conceptual 4-30. The reliability of a diagnosis usually refers to the a) chances of a full recovery. b) length of time it takes a treatment to work. c) clinician's knowledge about the cause of the disorder. d) level of agreement on the diagnosis offered by two clinicians.

Answer: d Page: 134 Level: Medium Type: Factual 4-31. A major noteworthy feature of DSM-IV-TR is: a) Giving attention to multiple aspects of a person’s life that play roles in clinical conditions. b) The expansion of diagnostic predictors. c) The correlation of clinical descriptions to treatment. d) Bridging the gap of varying opinions concerning diagnoses.

Answer: a Page: 134 Level: Medium Type: Factual 4-32. _________is concerned with appropriateness of the classification system, while ________is concerned with whether the classification system is reproducible. a) Validity; kappa statistic b) Validity; reliability c) Reliability; validity d) None of the above.

Answer: b Page: 134, 135 Level: Medium Type: Factual 100

4-33. How does the kappa statistic differ from other measures of reliability? a) requires more raters b) corrects for chance agreement c) based on percentage agreement d) can be used with categorical ratings Answer: b Page: 135 Level: Medium Type: Factual 4-34. The appropriateness of a classification system is called a) validity. b) kappa. c) reliability. d) criterion.

Answer: a Page: 135 Level: Medium Type: Factual 4-35. Which of the following is an essential first step in introducing order into discussions concerning the nature, causes, and treatment of maladaptive behavior? a) etiology b) diagnosis c) research d) classification Answer: d Page: 135 Level: Medium Type: Factual 4-36. Which group is likely to be given higher doses of anti-psychotic medication? a) African American men b) Hispanic American men c) European American men d) Asian American men Answer: a Page: 136 Level: Medium Type: Factual 4-37. Which group is diagnosed more frequently with major depression? a) Asian-Americans b) Hispanic-Americans c) African-Americans d) European-Americans Answer: b Page: 136 Level: Medium Type: Factual

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4-38. Chin Lee is a 45-year-old Asian American who is being evaluated by a physician who works for the company that employs Mr. Lee. Mr. Lee reports a number of medical complaints. What does the physician need to keep in mind when evaluating these symptoms? a) The symptoms are probably reflections of a need to establish contact with deceased relatives. b) Asian Americans have low levels of seeking help for mental health problems. c) Medical complaints are frequently found when individuals have experienced a break with reality and are searching for an explanation. d) The presentation of such symptoms by a person of Asian descent usually indicates that he believes he has committed an unpardonable offense.

Answer: b Page: 136 Level: Difficult Type: Conceptual 4-39. Ethnic identity: a) Involves belief and emotional styles. b) Involves descent and heritage. c) Influences a person’s self-concept and sense of belonging and willingness to seek help. d) Influences a person’s belief system and ability to seek treatment.

Answer: c Page: 136 Level: Medium Type: Factual 4-40. Which group tends to somaticize their mental health problems? a) African Americans b) Asian Americans c) European Americans d) Hispanic Americans Answer: b Page: 137 Level: Medium Type: Factual 4-41. What would not be considered a road block in racial and ethnic minority groups seeking treatment for mental health problems? a) availability of service b) overdiagnosis c) lack of insurance d) resistance Answer: a Page: 137 Level: Medium Type: Factual

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4-42. Which of the following is the most commonly used assessment tool? a) a clinical interview b) behavioral observation c) a projective personality test d) a test of intellectual functioning Answer: a Page: 137 Level: Medium Type: Factual 4-43. The interview that occurs after a preliminary assessment as been made is: a) diagnostic interview b) therapeutic interview c) structured interview d) None of the above.

Answer: b Page: 137 Level: Medium Type: Factual 4-44. Compared to the assessment interview, a therapeutic interview is more likely to focus on a) modifying maladaptive behavior b) using a structured format c) using objective personality tests d) yielding reliable diagnostic information Answer: a Page: 137 Level: Medium Type: Factual 4-45. What is the role of the interviewer? a) build trust and support b) develop a treatment plan c) gather background information for the psychiatric interview d) establish valid relationships between responses made during the interview and the client’s behavior in current life situations Answer: d Page: 139 Level: Medium Type: Factual 4-46. Which of the following is an indication of the mental status component of a clinical interview? a) The therapist observes the way the person is dressed. b) The client is asked what the major symptom has been over the last few months. c) The client is asked to trace a family tree and locate others with similar symptoms. d) The therapist determines whether the client has discussed any bizarre ideas during the interview.

Answer: d Page: 140 Level: Difficult Type: Conceptual

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4-47. A clinical psychologist is interviewing a client and asks a series of questions.

Later the same psychologist interviews a different client and asks the same series of questions in the same order. What type of interview is the psychologist using in both cases? a) primary interview b) objective interview c) projective interview d) structured interview Answer: d Page: 141 Level: Medium Type: Conceptual 4-48. What is the major use of structured interviews? a) to modify the client's behavior b) to allow self-administration of questionnaires c) to evaluate the client's motivation for therapy d) to determine whether specific symptoms are present Answer: d Page: 141 Level: Medium Type: Factual 4-49. Which of the following is the best description of the Diagnostic Interview Schedule? a) a therapeutic interview b) a standardized interview c) an unstructured interview d) a self-administered questionnaire Answer: b Page: 141 Level: Medium Type: Factual 4-50. How do ratings by lay professionals using the Diagnostic Interview Schedule compare to ratings by professionals using the same tool? a) Lay professionals and professionals agree. b) Lay professionals underestimate problems. c) Lay professionals are generally unreliable raters. d) Lay professionals tend to overestimate problems.

Answer: a Page: 142 Level: Difficult Type: Conceptual 4-51. What are interviewers encouraged to do when interviewing clients with the Structured Clinical Interview for DSM-IV-TR (SCID)? a) to use projective personality tests for diagnosis b) to contact family members for further information c) to share their own experiences to establish rapport d) to ask follow-up questions based on clinical judgment Answer: d Page: 142 Level: Difficult Type: Factual

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4-52. What perspective on intelligence did Alfred Binet use when he developed his method of assessing intelligence? a) intelligence grows with age b) intelligence is an inherited characteristic c) intelligence cannot be assessed in children d) intelligence requires keen perceptual ability Answer: a Page: 142 Level: Medium Type: Conceptual 4-53. What did Alfred Binet's tests of intelligence seek to measure? a) creativity and spatial reasoning b) long-term memory and attention c) reasoning and ability to understand and follow directions d) sensitivity to differences in tone of voice and understanding of nonverbal gestures Answer: c Page: 142 Level: Medium Type: Factual 4-54. What is one way that the Wechsler Adult Intelligence Scale improved on earlier versions of intelligence tests? a) self-administering format b) assessed several aspects of intelligence c) combined all items into one overall score d) tested physiology, not abstract problem-solving Answer: b Page: 143 Level: Medium Type: Conceptual 4-55. Vocabulary and Similarities are part of what subscale of the Wechsler intelligence tests? a) verbal b) nonverbal c) performance d) sequential processing Answer: a Page: 143 Level: Easy Type: Factual 4-56. What is an example of something a test-taker might do as part of the performance scale of the Wechsler intelligence tests? a) define a word b) solve a puzzle c) copy hand movements d) add a series of numbers Answer: b Page: 143 Level: Easy Type: Factual

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4-57. As part of the diagnostic testing done for all newly admitted patients, an intelligence test is administered. Before she administers the test, the clinical psychologist determines that the next patient is 45 years old. Which of the following would be the most likely test she will administer to evaluate this patient's intelligence? a) Visual Analogue Scale b) Thematic Apperception Test c) Kaufman Assessment Battery d) Wechsler Adult Intelligence Scale Answer: d Page: 143 Level: Difficult Type: Conceptual 4-58. Which children’s intelligence test includes recent advances in cognitive development, cognitive neuropsychology, and theories of intelligence? a) Stanford-Binet b) Kaufman Assessment Battery for Children c) Wechsler Preschool and Primary Scale of Intelligence d) Visual Analogue Scale Answer: c Page: 143 Level: Medium Type: Factual 4-59. A psychologist is concerned that a patient may have sustained brain damage. Which test would the psychologist administer? a) Visual Analogue Scale b) Thematic Apperception Test c) Bender Visual-Motor Gestalt Test d) Minnesota Multiphasic Personality Inventory Answer: c Page: 143 Level: Difficult Type: Conceptual 4-60. A newly admitted patient at a psychiatric hospital is being administered a battery of psychological tests. Before each test is administered, he wants a description of the activities he will be asked to engage in during the test. If the next test to be administered is the Bender Visual-Motor Gestalt Test, what is the psychologist likely to say? a) "You will be asked to look at some pictures and tell me what you see." b) "You will be asked to look at some drawings and use blocks to make similar figures." c) "You will be asked to look at some geometric figures and then draw what you have seen." d) "You will be asked to watch me as I illustrate some motor movements and then I will ask you to do what I just did."

Answer: c Page: 143 Level: Difficult Type: Conceptual

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4-61. Carol is asked to complete a 567-item questionnaire that consists of truefalse questions. What test is she taking? a) Visual Analogue Scale b) Wechsler Intelligence Scale c) Thematic Apperception Test d) Minnesota Multiphasic Personality Inventory Answer: d Page: 145 Level: Easy Type: Factual 4-62. Which of these is one of the most widely used personality inventories? a) Rorschach inkblots b) Thematic Apperception Test c) Wechsler Adult Intelligence Scale d) Minnesota Multiphasic Personality Inventory Answer: d Page: 145 Level: Easy Type: Factual 4-63. What is one way the MMPI-2 differs from the original version? a) more validity scales b) fewer clinical scales c) more projective items d) use a self-administration format Answer: a Page: 145 Level: Medium Type: Factual 4-64. A psychologist is reviewing the psychological tests administered to a client who was mandated by a judge to seek therapy. The psychologist is concerned that the client may not have answered the questions honestly. The first psychological test the psychologist examines is the MMPI-2. Which part of the MMPI-2 will be of special interest to the psychologist? a) validity scales b) special scales c) clinical scales d) projective scales Answer: a Page: 145 Level: Difficult Type: Conceptual 4-65. What is a primary purpose of the validity scales of the Minnesota Multiphasic Personality Inventory - 2? a) to double check patient identification b) to reflect the patient's test-taking consistency c) to compare observers' ratings with patient ratings d) to determine if previous diagnoses were accurate Answer: b Page: 145 Level: Medium Type: Factual

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4-66. What is one of the strengths of the Minnesota Multiphasic Personality Inventory-2? a) extensive norms b) open-ended format c) ability to assess brain damage d) based on the psychodynamic perspective Answer: a Page: 146 Level: Medium Type: Factual 4-67. What is one of the changes that occurred in the development of the MMPI-2? a) Three new validity scales were added. b) The reading level was lowered so the test could be used more widely. c) Inclusion of specific psychiatric symptoms made DSM diagnosis possible directly from test scores. d) Reliance on psychodynamic theory enabled the developers to incorporate scales to assess defense mechanisms.

Answer: a Page: 146 Level: Difficult Type: Factual 4-68. Friends describe Bob as "highly anxious," insecure, and experiencing great difficulty in making decisions. If administered the MMPI-2, Bob would most likely have an elevated score on the scale measuring a) paranoia. b) hypomania. c) schizophrenia. d) psychasthenia.

Answer: d Page: 146 Level: Difficult Type: Conceptual 4-69. People who know him well describe Bob as "setting unrealistic goals" and often engaged in excessive psychomotor activity. On which scale of the MMPI-2 would you expect Bob to obtain an elevated score? a) paranoia b) hypomania c) schizophrenia d) psychasthenia Answer: b Page: 146 Level: Difficult Type: Conceptual

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4-70. Ralph is extremely suspicious and firmly believes that agents of a foreign government follow him everywhere, intending to kill him. In addition, he resents anyone who doubts his beliefs. If administered the MMPI-2 you expect that Ralph would obtain a high score on the scale measuring a) hysteria. b) paranoia. c) hypomania. d) psychasthenia.

Answer: b Page: 146 Level: Difficult Type: Conceptual 4-71. After interviewing a new client for more than 2 hours, a psychologist decides to administer the Millon Clinical Multiaxial Inventory. What type of diagnosis is suggested by the selection of this test? a) psychasthenia b) mental retardation c) personality disorder d) organic brain dysfunction Answer: c Page: 147 Level: Difficult Type: Conceptual 4-72. Ted is administered a psychological test that contains questions about minor "faults," such as whether or not he sometimes gossips. Which test is Ted taking? a) Rorschach b) Thematic Apperception Test c) Structured Clinical Interview for DSM-IV-TR d) Minnesota Multiphasic Personality Inventory - 2 Answer: d Page: 145 Level: Difficult Type: Conceptual 4-73. What test is used to screen clients with serious psychological difficulties? a) MMPI-2 b) Rorschach c) Thematic Apperception Test d) Millon Clinical Multiaxial Inventory Answer: d Page: 147 Level: Medium Type: Factual 4-74. Karen is given a psychological test in which she is asked about emotional stability, extroversion, and agreeableness. What test is Karen taking? a) projective test b) Revised NEO Personality Inventory c) visual analogue scale d) behavioral rating scale Answer: b Page: 147 Level: Difficult Type: Conceptual 109

4-75. Which of the following are some of the basic elements of personality found in the five-factor model of personality? a) tolerance, dominance, and conscientiousness b) responsibility, sensation seeking, and sociability c) agreeableness, emotional stability, and extraversion d) achievement orientation, agreeableness, and flexibility Answer: c Page: 147 Level: Medium Type: Factual 4-76. A company is looking for some new employees who are gregarious, warm, assertive, thorough, reliable, and self-disciplined. The company personnel officer suggests that employees be screened for high scores on which of the following components of the five-factor model? a) Conscientiousness and Extraversion b) Agreeableness and Emotional Stability c) Agreeableness and Conscientiousness d) Openness to Experience and Extraversion Answer: a Page: 147 Level: Difficult Type: Conceptual 4-77. What is the halo effect? a) clients are conscientious about completing tests b) observers make positive ratings of people they like c) people tend to use ratings in the middle of the scale d) Answers at the beginning of a questionnaire are more honest Answer: b Page: 147 Level: Medium Type: Factual 4-78. Alice is told that a psychologist is going to administer a projective test to her. What type of material will the psychologist present while administering this test? a) ambiguous stimuli b) true-false questions c) analogue rating scales d) open-ended questions about emotions Answer: a Page: 148 Level: Difficult Type: Conceptual 4-79. What is one of the limitations of the Rorschach inkblot test as an indicator of personality? a) The art work is outdated. b) Research has not supported its validity. c) The client must have good reading skills. d) Most people have already seen the inkblots.

Answer: b Page: 148 Level: Medium Type: Factual 110

4-80. What is the name of the projective technique in which pictures are presented one at a time to a person who is asked to make up a story about the picture? a) Rorschach inkblot test b) sentence completion test c) Thematic Apperception Test d) Minnesota Multiphasic Personality Inventory-2 Answer: c Page: 149 Level: Medium Type: Factual 4-81. Mark is asked to create stories about different pictures. Which test is he taking? a) Rorschach inkblot test b) Visual Analogue Scales c) Thematic Apperception Test d) Kaufman Assessment Battery for Children Answer: c Page: 149 Level: Easy Type: Conceptual 4-82. What does the psychologist use as the basis when interpreting stories told by clients in response to the Thematic Apperception Test? a) evidence of creativity b) demonstrated verbal abilities c) evidence of emotional conflicts d) demonstrated abstract problem-solving ability Answer: c Page: 149 Level: Medium Type: Factual 4-83. What is the most likely reason for a clinician to administer the Thematic Apperception Test to a client? a) to assign a standard diagnostic label b) to uncover possible organic dysfunction c) to probe a client's unconscious processes d) to determine a client's level of intelligence Answer: c Page: 149 Level: Medium Type: Factual 4-84. What is something a clinician notes when analyzing a client's responses to a word-association test? a) the client's level of articulateness b) whether the words form a coherent story c) whether the words refer to feelings or objects d) how long the client takes to come up with words Answer: d Page: 150 Level: Medium Type: Factual

111 4-85. A clinical psychologist is asked to evaluate a child who is reported to be

disruptive at home and at school. The psychologist's assessment includes a wide variety of tools. Which of the following would be the most objective technique he uses? a) clinical interview b) projective testing c) visual analogue scale d) behavioral observation Answer: d Page: 150 Level: Medium Type: Conceptual 4-86. Sara, age 13, never seemed to have problems at home or at school until this year. Now, she seems angry with everyone and has been in several fights. What would you expect a behavioral assessment of Sara to address? a) internal conflicts about her identity b) her feelings about authority figures c) when the change in behavior occurred d) unconscious hostility toward her parents Answer: c Page: 150 Level: Difficult Type: Conceptual 4-87. What term is used to describe assessments made before any treatment has started? a) baseline b) premorbid c) validating d) symptomatic Answer: a Page: 150 Level: Medium Type: Factual 4-88. A psychologist decides to give his client a beeper that will signal him several times a day. What is the most likely type of assessment this psychologist is using? a) cognitive b) humanistic c) physiological d) psychodynamic Answer: a Page: 150 Level: Medium Type: Conceptual 4-89. Which of these is an example of a relational assessment tool? a) WAIS-R b) polygraph c) Family Environment Scale d) Diagnostic Interview Schedule Answer: c Page: 151 Level: Medium Type: Factual 112 4-90. Why is it sometimes difficult to obtain blood pressure measures that are

useful? a) Blood pressure changes very slowly. b) Blood pressure varies throughout the day. c) Blood pressure is unrelated to emotional states. d) Blood pressure is usually lower in the doctor's office.

Answer: b Page: 152 Level: Medium Type: Factual 4-91. What do polygraphs measure? a) guilt b) substance abuse c) emotional responses d) unconscious conflicts Answer: c Page: 153 Level: Medium Type: Factual 4-92. A Congressional committee is holding hearings on proposed legislation concerning polygraph use. Several experts on polygraphs have been asked to testify on various aspects of polygraphs, including their drawbacks. When the committee staff later summarizes this testimony on drawbacks what is the staff likely to write? a) Polygraphs are valid but not reliable. b) Polygraphs are very expensive to use. c) Very few people are trained to use polygraphs effectively. d) The use of polygraphs is associated with a high rate of false positives.

Answer: d Page: 153 Level: Difficult Type: Conceptual 4-93. What is the process in which the client receives continuous reports of the level of particular bodily functions in order to learn to control these functions? a) biofeedback b) self efficacy c) polygraphic assessment d) systematic desensitization Answer: a Page: 153 Level: Medium Type: Factual

Essay Questions

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4-94. Why is it important to have a widely recognized classification system for abnormal behavior?

Answer: A classification system eases communication among professionals; it allows collection of meaningful research data on effective treatment. A classification system also makes it possible to collect statistical records of rates of disorders in order to study incidence and prevention, and finally such a system can contribute to treatment planning.

Pages: 127 – 130 Level: Difficult Type: Factual 4-95. Describe what would typically occur in an assessment interview.

Answer: The interviewer would attempt to identify problems and determine the nature and extent of maladaptive behavior. The interview would begin by assessing how the client describes, understand, and interprets the problem. The history of the problem would be explored.

Pages: 137 – 138 Level: Medium Type: Factual 4-96. In what way is an objective personality test such as the MMPI-2 superior to a projective personality test such as the Rorschach?

Answer: The MMPI-2 was designed to have norms and a representative standardization sample; similar information on the Rorschach is a relatively recent development. Extensive research supports the validity of the MMPI's descriptions of personality; the research on the validity of the Rorschach as a personality test is less clear.

Pages: 144 – 149 Level: Difficult Type: Factual

True/False 4-97. Diagnosis is considered as an important step in identifying and classifying a condition. A correct diagnosis serves as a basis for effective treatment.

Answer: True Page: 127 Level: Easy Type: Factual 4-98. Classification is useful in the diagnostic and treatment process of disorders.

Still, there remains controversy in its process.

Answer: True Page: 128 Level: Easy Type: Factual 4-99. The manner in which people’s problems are classified can tell a clinician about their future and response to therapy.

Answer: True Page: 130 Level: Easy Type: Factual

114 4-100. The axes of DSM-IV-TR provide information about the psychological,

biological, and physiological aspects of a condition.

Answer: False Page: 130 Level: Easy Type: Factual 4-101. Maladaptive personality features and defense mechanisms can be noted on Axis I. Answer: False Page: 130 Level: Medium Type: Factual 4-102. A significant difference between DSM-IV and DSM-IV-TR is DSM-IV-TR provides criteria for coding objective factors of Axes IV and V. Answer: False Page: 131 Level: Medium Type: Factual 4-103. Among the limitations of the recent DSM is a continued reliance on impressionistic clinical judgments.

Answer: True Page: 133 Level: Easy Type: Factual 4-104. If cultural and social factors are controlled, ethnic and racial backgrounds should be considered in making diagnostic decisions but not necessarily treatment decisions.

Answer: False Page: 135 Level: Medium Type: Factual 4-105. A single test rarely can diagnose abnormal brain function.

Answer: True Page: 143 Level: Easy Type: Factual 4-106. Projective techniques have a high validity, but low reliability as perceptual indicators of personality.

Answer: False Page: 148 Level: Easy Type: Factual

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Chapter 5 Stress, Coping, and Maladaptive Behavior 5-1. You attend a convention on the topic of stress and one of the sessions catches your eye. It is a discussion of types of stress that have only recently begun to be the focus of research. Which of the following is likely to be the topic of the session? a) the stress of moving to a new school away from home b) the stress of the changing sex role expectations in modern society c) the stress of caregiving, especially those who care for people with Alzheimer's disease d) the stress that occurs when we become preoccupied with a long list of "do's and don'ts" concerning diet, dress, and relationships Answer: c Page: 157 Level: Medium Type: Factual 5-2. Which of the following types of stress have not received adequate research? a) chronic illness b) caregiving c) lifelong racial stigmatization d) both B and C Answer: d Page: 157 Level: Medium Type: Factual 5-3. Which of the following statements is accurate with regard to stress? a) Stress is a negative emotional experience with related psychochemical changes. b) Stress implied negative emotional experiences with behavioral, biochemical, and physiological changes. c) The ability to cope over time has a minimal effect on stress. d) While stress can be debilitating, it is not a central factor in most diagnoses.

Answer: a Page: 158 Level: Medium Type: Factual 5-4. Stress is a function of how people appraise situations and how they rate their a) resiliency. b) adjustment. c) temperament. d) ability to cope.

Answer: d Page: 158 Level: Medium Type: Factual

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5-5. Which of the following factors is most influential in determining whether an event is experienced as a stressor? a) duration of the event b) how sudden the onset is c) predictability of the event d) how the event is interpreted Answer: d Page: 158 Level: Medium Type: Factual 5-6. Which of the following increases the likelihood of a maladaptive response to stress? a) resiliency b) vulnerability c) temperament d) task-oriented coping Answer: b Page: 158 Level: Medium Type: Factual 5-7. Although researchers do not classify disorders as related or not, stress may play differing roles in different disorders. What is the role of stress in people who have lifelong tendencies toward anxiety and depression? a) In both cases, genetic factors play the dominant role with stress playing little or no role in the etiology of the disorders. b) People with these disorders tend to experience an intensification of their symptoms when they confront stress-arousing challenges. c) Most people with these disorders tend "to roll with the punches" when confronted with stress because their symptoms are the primary focus of their lives. d) The effect varies with the disorder; stress tends to play a primary role in causing depression and a primary role in intensifying the symptoms among those who suffer from anxiety disorders.

Answer: b Page: 158 Level: Difficult Type: Conceptual 5-8. A reporter is writing an article on insomnia and asks you to describe what victims of insomnia view as a cause of their insomnia. What will you say? a) stress b) delusions c) nightmares d) muscle spasms Answer: a Page: 158 Level: Medium Type: Factual

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5-9. Which of these individuals is at highest risk for a more serious reaction to a stressful situation? a) Ann who has low vulnerability and is confronted with several challenges b) Barbara who has low resiliency and is confronted with an expected challenge c) Chad who has high resiliency and confronted with an unexpected challenge d) David who has high vulnerability and confronted with an unexpected challenge Answer: d Page: 159 Level: Difficult Type: Conceptual 5-10. Which of these individuals has a lower than average probability of a maladaptive response to stress? a) Ann who uses denial off and on b) Tim who has a high level of resilience c) Sara who has a high degree of vulnerability d) Ted who has been described as high in several aspects of temperament Answer: b Page: 159 Level: Medium Type: Factual 5-11. Composure, experience, and self-confidence are important and necessary components because: a) These factors contribute to appraisals of and responses to stressful situations. b) These factors are part of family dynamics. c) Personality development will be hindered if these characteristics are not present. d) All of the above.

Answer: a Page: 159 Level: Medium Type: Factual 5-12. Approximately 80 to 90 percent of people who experience chest pain attribute the pain to indigestion rather than a heart attack. What type of response to stress does this example represent? a) angry b) anxious c) denial d) task-oriented Answer: c Page: 159 Level: Medium Type: Factual

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5-13. Research on patients undergoing surgery found that recovery was faster when patients were given realistic information about a) mortality rates. b) their doctors' qualifications. c) how pain medication works. d) post-operative physical therapy.

Answer: d Page: 160 Level: Medium Type: Factual 5-14. Which of the following is characteristic of people who generally cope successfully? a) They use situation-specific coping styles. b) They don't make fun of serious situations. c) They consistently rely on one coping strategy. d) They don't think about problems ahead of time.

Answer: a Page: 160 Level: Medium Type: Factual 5-15. People who are generally successful copers use each of the following approaches except a) seeking pertinent information. b) using humor to defuse a situation. c) forgetting a situation after it is over. d) redefining a situation to make it less threatening.

Answer: c Pages: 160, 162 Level: Medium Type: Factual 5-16. Bob has always demonstrated the ability to cope with stress. A reason for his ability is: a) Bob has learned to direct his thoughts to productive uses and anticipate problems that may create stress. b) Bob has learned about stress in readings. c) Bob takes medication. d) Bob avoids all stressful situations.

Answer: a Page: 160 Level: Medium Type: Conceptual 5-17. What does research reveal concerning the effects of strong family ties? a) They encourage self-reliance. b) They disrupt outside relationships. c) They tend to foster unhealthy dependency. d) They hinder the development of social skills.

Answer: a Page: 162 Level: Medium Type: Factual

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5-18. What is one of the differences between people with high and low levels of social support? a) the ways they use social support b) the number of stressful experiences they face c) the social skills needed to attract others' interest d) the level of arousal provoked by stressful situations Answer: c Page: 162 Level: Medium Type: Factual 5-19. An undergraduate student is designing a research project to investigate the effects of family background on the types of stress symptoms experienced during college. The project focuses on symptoms related to sleeping and eating. The student researcher must present the research proposal to a faculty committee for approval. What is the committee likely to recommend? a) Add more stress symptoms because people have different reactions to stress. b) Classify the eating-related symptoms as either related to anorexia or to bulimia. c) Quantify the stress levels students experience by counting the number of exams they took during the semester. d) Focus on students who have experienced stressful events quite some time ago, so the events will have had time to have an effect.

Answer: a Page: 162 Level: Difficult Type: C/A 5-20. What are the two broad types of stress-arousing conditions that might require adjustment? a) limited and chronic b) stress and distress c) primary and secondary d) developmental transition and situations that arise in life Answer: d Page: 162 Level: Medium Type: Factual 5-21. Sue’s mother recently died. In order to cope with the stress, Sue will have need for a ________. Her daughter has just been promoted, and will move to Chicago. Her daughter will need a ______________. a) transitional adjustment; situational adjustment b) situational adjustment; personal adjustment c) situational adjustment; transitional adjustment d) transitional adjustment; life-style adjustment Answer: c Page: 163 Level: Difficult Type: Conceptual

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5-22. Which of the following statements demonstrates a person’s reaction to extreme stressors? a) Extreme stressors contribute to prolonged maladaptive behavior unless medications are used for stabilization. b) Extreme stressors initiate a cycle of reactions for the purpose of equilibrium between self-concept and the new reality. c) Extreme stressors cause a person to withdraw from everyday life and contribute to elevated levels of anxiety. d) Extreme stressors cause more psychological harm than physiological harm.

Answer: b Page: 166 Level: Difficult Type: Factual 5-23. One night several years ago Barbara was raped at knife point on her way home from the library. Ever since, she has been afraid of the dark, of men similar to the rapist, and of knives. What concept would a behavioral psychologist find most helpful in explaining her current avoidance of these stimuli? a) social learning theory b) classical conditioning c) positive reinforcement d) systematic desensitization Answer: b Page: 166 Level: Difficult Type: Conceptual 5-24. About what percentage of women college students report having been raped by someone they knew or were dating? a) 1% b) 3% c) 15% d) 30% Answer: c Page: 166 Level: Medium Type: Factual 5-25. Which of the following factors have been implicated in date rape? a) drug use and depression b) alcohol and party-related activities c) prior depressive episodes and high stress levels d) family conflict and liberal attitudes toward sexuality Answer: b Page: 166 Level: Medium Type: Factual

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5-26. Which of the following is characteristic of college students who are more accepting of date rape? a) They know more about sex. b) They cannot tolerate alcohol. c) They are highly judgmental about pre-marital sex. d) They have more traditional attitudes toward women.

Answer: d Page: 166 Level: Medium Type: Factual 5-27. Which of the following individuals is most likely to be a victim of rape? a) Sally who is 38 years old b) Lena who is 60 years old c) Agnes who is 17 years old d) Kathleen who is 45 years old Answer: c Page: 166 Level: Medium Type: Conceptual 5-28. Which age group has the highest rape victimization rate? a) 30 – 35 year olds b) 25 – 30 year olds c) 20 – 24 year olds d) 16 – 19 year olds Answer: d Page: 166 Level: Medium Type: Factual 5-29. What is bereavement? a) pathological grieving b) feelings of sadness after a loss c) loss of a loved one through death d) self-reproach for not preventing someone's death Answer: c Page: 167 Level: Medium Type: Factual 5-30. Under which of the following conditions would a person receive a diagnosis of adjustment disorder after experiencing bereavement? a) Response style causes the person to become maladaptive b) Coping style and reaction to familiar people change c) Response style extends past the normal course of recovery and coping problems and emotional distress continue with little improvement. d) Person refuses to return to present life-style and suffers from depression Answer: c Page: 167 Level: Difficult Type: Factual

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5-31. A physician is describing some of the physiological changes that can occur in bereavement in adults. Which of the following will be on the list? a) excessive crying, hypomania and paresthesia b) hypervigilance, loss of appetite, and somatization c) difficulty breathing, heart palpitations, and la belle indifference d) decreased body weight, immunological changes, and sleep disturbance Answer: d Page: 167 Level: Medium Type: Factual 5-32. Which of the following could be considered as possible steps in the grieving process? a) shock; suggestibility, recovery b) shock; despair, avoiding reminders, self-reproach c) shock; nightmares, recovery d) None of the above.

Answer: b Page: 167 Level: Medium Type: Factual 5-33. Which of the following individuals is in a situation in which the outcome of bereavement is likely to be poorest? a) Lena who just lost her husband b) Martin who unexpectedly lost a memory of his family c) Nancy who had ambivalent feelings toward the deceased d) Otto who had a close and warm relationship with the deceased Answer: c Page: 167 Level: Medium Type: Conceptual 5-34. Based on past research, which of the following individuals has the most heightened risk for a poor outcome of bereavement? a) Mel whose wife was murdered b) Sara whose husband died of heart disease c) Lena whose husband died after a long battle with cancer d) Barbara who had a ambivalent relationship with her husband Answer: a Page: 167 Level: Medium Type: Conceptual 5-35. Which of the following is the most accurate characterization of abnormal responses to stress? a) unwanted, intrusive thoughts b) strong feelings of anger and fear c) extreme versions of normal responses d) qualitatively different from normal responses Answer: c Page: 169 Level: Medium Type: Factual

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5-36. Which of these is an example of the type of stressor that is most likely to be associated with an adjustment disorder? a) a spouse dying b) getting married c) chronic physical illness d) witnessing a mass murder Answer: b Page: 170 Level: Medium Type: Factual 5-37. Which of the following types of stressors is most often associated with adjustment disorders? a) highly unusual events b) life-threatening events c) chronic physical disease d) normal transitional experiences Answer: d Page: 170 Level: Medium Type: Factual 5-38. Virginia has been diagnosed as exhibiting an adjustment disorder. Which of the following sets of symptoms is most likely to occur? a) delusions, hallucinations, and loose associations b) depression, disrupted sleep patterns, and anxiety c) family conflict, memory disturbances, and depersonalization d) difficulty maintaining weight, suspiciousness, and nightmares Answer: b Page: 170 Level: Medium Type: Factual 5-39. Which of the following symptoms is most typical of an adjustment disorder? a) amnesia b) flashbacks c) dissociation d) depression Answer: d Page: 170 Level: Medium Type: Conceptual 5-40. How long do the symptoms of adjustment disorder typically last? a) about 1 week b) about 1 month c) about 6 months d) about 1 year Answer: c Page: 171 Level: Medium Type: Factual

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5-41. Diane has been diagnosed with acute stress disorder. Based on this diagnosis, you are quite certain that among her symptoms, the mental health professional found evidence of a) delusions. b) anhedonia. c) dissociation. d) hypersomnia.

Answer: c Page: 171 Level: Medium Type: Conceptual 5-42. Ted has been diagnosed as exhibiting acute stress disorder; Will has a diagnosis of posttraumatic stress disorder. Based on this description alone, what would you conclude about the two individuals? a) Ted is more vulnerable than is Will. b) Will has had symptoms that lasted longer than Ted's symptoms. c) Compared to Will, Ted was exposed to a more serious type of stressor. d) Compared to Will, Ted is experiencing more symptoms related to the fight or flight response.

Answer: b Page: 171 Level: Difficult Type: Conceptual 5-43. While driving home ten months ago, Al observed a devastating accident in which an 18-wheeler plowed into the back of a small car that exploded in flames, killing its driver. Since that time, Al has experienced a number of stress-related symptoms and constantly thinks about the accident. What is the most likely diagnosis in this case? a) dissociative fugue b) acute stress disorder c) dissociative amnesia d) posttraumatic stress disorder Answer: b Page: 171 Level: Difficult Type: Conceptual 5-44. Which of the following individuals exhibits symptoms that would be labeled dissociative? a) Al who feels numb, detached, and has amnesia b) David who has heart palpitations, difficulty breathing, and insomnia c) Eugene who has auditory hallucinations, flat affect, and sleeps excessively d) Frank who daydreams a lot, is hypervigilant, and complains of pain in his muscles Answer: a Page: 172 Level: Difficult Type: Conceptual

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5-45. A psychology professor is explaining the concept of dissociation. Which of the following students seems to have the best understanding of this concept? a) George who says, "Dissociation occurs among many normal individuals." b) Harry who says, "Dissociation is the root cause of most forms of pathology." c) Iris who says, "The pace of modern life has increased reliance on dissociation." d) Julia who says, "The use of dissociation is associated with a schizophrenic-like process."

Answer: a Page: 172 Level: Difficult Type: Conceptual 5-46. Which of the following disorders is likely to begin and end abruptly? a) panic disorder b) adjustment disorder c) dissociative disorder d) posttraumatic stress disorder Answer: c Page: 173 Level: Medium Type: Factual 5-47. Which disorders are characterized by disruptions of identity, consciousness, and memory? a) psychotic b) adjustment c) dissociative d) posttraumatic stress Answer: c Page: 173 Level: Medium Type: Factual 5-48. What is the most common pattern of onset and outcome in dissociative disorders? a) abrupt onset and abrupt recovery b) lengthy onset and lengthy recovery c) abrupt onset and lengthy recovery d) lengthy onset and, abrupt recovery Answer: a Page: 173 Level: Medium Type: Factual 5-49. Which of the following cases represents the most common onset and outcome of a dissociative disorder? a) Al's symptoms occurred suddenly and ended abruptly. b) Bianca's symptoms developed after years of abuse and ended abruptly. c) Dana's symptoms developed suddenly and ended after decades of extensive treatment. d) Ed's symptoms occurred suddenly and have never changed after years of treatment.

Answer: a Page: 173 Level: Medium Type: Conceptual 126

5-50. Which of the following is not true of dissociative disorders? a) large gaps in memory and dramatic changes in social roles b) geographic relocation is evident in all dissociative disorders c) identity may be temporarily forgotten or a new identity assumed d) sense of reality is lost Answer: b Page: 173 Level: Medium Type: Factual 5-51. Which of the following is the typical course of recovery when amnesia or fugue follows a traumatic event? a) rapid recovery b) lifetime symptoms c) recurrence is likely d) functioning rarely returns to normal Answer: a Page: 173 Level: Medium Type: Factual 5-52. If a patient has the diagnosis of dissociative amnesia, how will you answer questions from family members when they ask about the disorder's cause? a) There is no evidence of an organic cause. b) The disorder is most likely due to a tumor that can be dangerous. c) The disorder is due to a slow-growing tumor that can be treated with drugs. d) The disorder was probably caused by a blow to the head but it will not have long-lasting consequences.

Answer: a Page: 173 Level: Difficult Type: Factual 5-53. Ted seems to forget things more often now than in the past. He is worried, so he consults a physician. During the interview, Ted wonders if he might be suffering dissociative amnesia. Which of the following questions would prove most useful in assessing the cause of Ted's complaint? a) "Are you having difficulty sleeping?" b) "Have you had your eyes checked lately?" c) "Did you experience a head injury recently?" d) "Do you find that you spend more time daydreaming?"

Answer: c Page: 173 Level: Difficult Type: Conceptual 5-54. Which of the following individuals is the most likely victim of dissociative amnesia? a) Sara who is 16-years old b) Dana who is 45 years old c) Skip who is 23 years old d) Dearly who is 50 years old Answer: a Page: 173 Level: Medium Type: Conceptual 127

5-55. Which of the following individuals is suffering from the generalized type of dissociative amnesia? a) Steve cannot remember anything related to his life. b) Zach cannot remember anything related to the death of his grandparents. c) Ramona cannot remember anything related to an accident she caused last month. d) Tim cannot remember anything from one year ago up to and including the present.

Answer: a Page: 174 Level: Medium Type: Conceptual 5-56. Which of the following is an example of the kind of information forgotten in localized amnesia? a) one's identity b) memories relating to one's sister c) everything since being sent home from the Gulf War d) events surrounding the first few hours after a car crash Answer: d Page: 174 Level: Medium Type: Conceptual 5-57. If you suddenly cannot remember anything about one of your parents, but are able to remember all other aspects of your life, you are probably experiencing a) localized amnesia. b) selective amnesia. c) continuous amnesia. d) systematized amnesia.

Answer: b Page: 174 Level: Medium Type: Conceptual 5-58. Seth has been diagnosed with dissociative amnesia. He has difficulty remembering events associated with his post-graduate studies. Seth has: a) selective amnesia b) localized amnesia c) systematized amnesia d) generalized amnesia Answer: a Page: 174 Level: Medium Type: Conceptual 5-59. Rod is involved in a near-death collision. Afterwards he cannot remember any of the details of the collision. Rod's condition is known as a) dysphoria. b) localized amnesia. c) regressive amnesia. d) delusional forgetting.

Answer: b Page: 174 Level: Medium Type: Conceptual

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5-60. The professor who is teaching abnormal psychology wants students to recognize the various diagnostic categories, so he gives brief case presentations and asks students for the likely diagnosis. The current case involves an individual who cannot recall any aspect of his life. Various brain scans have ruled out brain damage. What is the most likely diagnosis? a) selective amnesia b) continuous amnesia c) generalized amnesia d) systematized amnesia Answer: c Page: 174 Level: Difficult Type: Conceptual 5-61. Joe has lost his sense of identity, wandered to another state and set up a new life, calling himself "Pete". What is the most likely diagnosis? a) depersonalization b) dissociative fugue c) dissociative amnesia d) an adjustment disorder Answer: b Page: 174 Level: Medium Type: Conceptual 5-62. Fugue states are characterized by a) delusions. b) cataplexy. c) brain injury. d) unexpected travel.

Answer: d Page: 174 Level: Medium Type: Factual 5-63. Ollie wakes up one morning and can't remember who he is, where he works, or where he lives. A physician does not find anything physically wrong, although his friends say Ollie has been under stress recently. He is probably suffering from a) depersonalization. b) dissociative fugue. c) generalized amnesia. d) an adjustment disorder.

Answer: b Page: 174 Level: Medium Type: Conceptual

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5-64. One of the teaching techniques used by the professor responsible for teaching abnormal psychology is an activity in which students act out disorders.

Each student receives a card with the name of a disorder. Another student provides direction to help the student act out the disorder. Which of the following might be the most helpful direction for a student portraying a person with dissociative fugue? a) Act normally. b) Look down and walk slowly. c) Babble and stare into space. d) Make aggressive moves toward those around you.

Answer: a Page: 174 Level: Difficult Type: Conceptual 5-65. Someone in a fugue state is likely to appear a) normal. b) clearly disoriented. c) moody and troubled. d) unable to learn new information.

Answer: a Page: 174 Level: Medium Type: Factual 5-66. Cecilia has three sets of clothing and three sets of friends. She sometimes experiences herself as being one age and with one self-concept, and at other times, another age with another self-concept and so on. She may be exhibiting signs of a) depersonalization. b) dissociative fugue. c) generalized amnesia. d) dissociative identity disorder.

Answer: d Page: 174 Level: Medium Type: Conceptual 5-67. What is another name for multiple personality disorder? a) fugue state b) depersonalization c) adjustment disorder d) dissociative identity disorder Answer: d Page: 174 Level: Medium Type: Factual

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5-68. After a great deal of preparation, researchers have developed a method to survey people to identify those with dissociative identity disorder. When the data have been collected, they find 500 cases that are likely to qualify for this diagnosis. What is the likely breakdown by sex--females to males? a) 200:300 b) 250:250 c) 500:300 d) 400:100 Answer: d Page: 174 Level: Difficult Type: Factual 5-69. A sample of people diagnosed with dissociative identity disorder is evaluated with extensive interviews and psychological tests. After examining the data, the researchers conclude that there are some important differences between people with this diagnosis and the general population. In what way are these people likely to be different from the general population? a) They are more likely to be extraverted. b) They are more prone to spontaneous hypnotic trances. c) Their demeanor and overt behavior tends to be hostile to others. d) They tend to speak in ways that are difficult for most people to understand.

Answer: b Page: 175 Level: Difficult Type: Conceptual 5-70. Which of the following is likely to be said by someone experiencing depersonalization? a) "I can't take it any more." b) "I don't remember my name." c) "I feel as though I'm in a dream." d) "I want to be treated more like a human being."

Answer: c Page: 175 Level: Medium Type: Conceptual 5-71. Millie feels as if she is a robot, watching herself from outside her body as she begins kissing her new boyfriend. This feeling of being in a dream or being separate from her physical body happens whenever she is extremely anxious.

Which disorder is Millie most likely experiencing? a) a fugue state b) depersonalization c) an adjustment disorder d) dissociative identity disorder Answer: b Page: 175 Level: Medium Type: Conceptual

131 5-72. During a case presentation, a clinical psychologist describes a client with dissociative disorder that does not involve memory loss. When she asks the most likely specific disorder, what will you say? a) depersonalization b) dissociative fugue c) continuous amnesia d) dissociative identity disorder Answer: a Page: 175 Level: Medium Type: Conceptual 5-73. Uncovering dissociated memories is helpful in treating dissociative disorders. Which of the following is not useful in the treatment of dissociative disorders? a) behavior therapy b) hypnosis c) antianxiety drugs d) sedative drugs Answer: c Page: 177 Level: Medium Type: Factual 5-74. John was recently diagnosed with dissociative amnesia. His family and friends have asked to be involved in his treatment. What therapeutic approach is appropriate? a) family therapy b) supportive therapy c) social interaction d) relaxation training Answer: b Page: 177 Level: Medium Type: Conceptual 5-75. After being attacked by a wolf, Maria develops a phobia of animals and seeks treatment. In her first session of systematic desensitization, she is asked to relax and to think about a) positive events in her life. b) an animal in the far-off distance. c) how she would cope if attacked again. d) something she fears, other than animals.

Answer: b Page: 178 Level: Medium Type: Conceptual 5-76. What technique pairs relaxation training with a hierarchy of anxietyproducing stimuli? a) Rogerian therapy b) supportive therapy c) cognitive modification d) systematic desensitization Answer: d Page: 178 Level: Medium Type: Conceptual

132 5-77. Which treatment approach involves learning new internal dialogues along with new ways of viewing situations and oneself? a) social intervention b) cognitive modification c) supportive psychotherapy d) systematic desensitization Answer: b Page: 178 Level: Medium Type: Conceptual 5-78. A recent report in the newspaper described the treatment called eye movement desensitization and reprocessing. If the reporter checked and evaluated the treatment carefully, what headline would she select for her article? a) "Clinicians divided on new therapy" b) "Promising treatment for depersonalization" c) "Finally, a replacement for electroconvulsive therapy" d) "Revision of a Freudian method holds great promise" Answer: a Page: 178 Level: Difficult Type: Conceptual 5-79. Dan is undergoing the newest form of therapy for a disorder related to serious trauma. Which of the following might occur during one of the therapy sessions? a) He is asked to sit in the fetal position and recall events from early in life. b) He will sit quietly and silently, while the therapist describes the details of the trauma that he experienced. c) He will focus his attention on a traumatic memory while visually tracking the therapist's finger as it is moved across his visual field. d) He will stare for long periods of time at photographs and pictures that are designed to remind him of the trauma that led to his disorder.

Answer: b Page: 178 Level: Difficult Type: Conceptual

Essay Questions 5-80. How can people prepare to deal with stressful situations?

Answer: Learn specific skills for that situation; be exposed to a range of situations that are graded from relatively low to relatively high in stress; observe your own thoughts, feelings, and behaviors in challenging situations in order to think constructively, solve problems, behave flexibly, and provide feedback to oneself about the tactics that work and those that do not.

Page: 159 Level: Difficult Type: Factual

133 5-81. What have researchers found concerning the relationship of social support and social skills?

Answer: Research indicates that individuals who have low levels of social support tend to have low social skills needed to attract the interest and help of others.

When engaging in conversations with strangers, people who are high in social support feel more competent, comfortable, and assured than people who report having little support. People who are low in social support tend to be perceived by others as less interesting, dependable, friendly, and considerate than people who are high in social support.

Page: 162 Level: Difficult Type: Factual 5-82. What are some of the behavioral and physiological changes that occur in bereavement in adults?

Answer: Behavioral changes: crying, agitation and restlessness; preoccupation with the image of the deceased; social withdrawal; decreased concentration and attention; depressed mood; anxiety. Physiological changes: muscular weakness; sighing; sleep disturbances; immunological changes; endocrine changes, cardiovascular changes; and decreased body weight.

Page: 167 Level: Difficult Type: Factual 5-83. What factors heighten the risk for a poor outcome of bereavement?: Answer: Sudden, unexpected death, such as suicide, murder, and stigmatized death (e.g., death due to AIDS); ambivalence toward and dependency on the deceased; death of a parent; perceived lack of social support; concurrent crises (e.g., illness in other family members); reduced material resources; gender of a surviving spouse (widowers are often at higher risk than widows).

Page: 167 Level: Difficult Type: Factual 5-84. What are the major symptoms observed in cases of acute stress disorder?

Answer: The key symptoms of acute stress disorder are a subjective sense of numbness, detachment, and absence of emotional responsiveness; feeling as if one were in a daze; a feeling of unreality about oneself or about what is happening in one's life; and inability to recall important aspects of the trauma.

Such symptoms last for a minimum of 2 days and a maximum of 4 weeks, emerge within 4 weeks of the traumatic event, and are not due to the effects of a substance.

Pages: 171 – 172 Level: Difficult Type: Factual

True/False

5-85. Stressors are events in a person’s life that stimulate behavioral, biochemical, and physiological change.

Answer: True Page: 138 Level: Easy Type: Factual 134 5-86. Rather than becoming angry or defensive, a task-oriented response to a difficult situation is a healthier reaction to stress.

Answer: True Page: 159 Level: Easy Type: Factual 5-87. A person’s assets, liabilities, and analysis of the situation is important for a behavioral coping response to stress.

Answer: True Pages: 159 – 160 Level: Easy Type: Factual 5-88. There is a negative correlation between coping with stress and a high level of arousal.

Answer: False Page: 160 Level: Easy Type: Factual 5-89. There is a positive correlation between the availability of social support and psychological health and well-being.

Answer: True Page: 162 Level: Easy Type: Factual 5-90. Vulnerability to both physical and psychological breakdown will increase if social support lessens.

Answer: True Page: 162 Level: Easy Type: Factual 5-91. Grief is an emotional response to loss, and is a sign of pathology.

Answer: True Page: 167 Level: Easy Type: Factual 5-92. When considering a diagnosis of acute stress disorder, what it is not clear is the link between dissociative symptoms and the traumatic experience.

Answer: False Page: 171 Level: Easy Type: Factual 5-93. Treatment of dissociative disorders is difficult but explanations for the disorders are much clearer.

Answer: False Page: 176 Level: Easy Type: Factual 5-94. With regard to life transitions, adolescence appears to be a time of particular stress because of the many changes that occur.

Answer: True Page: 179 Level: Easy Type: Factual

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Chapter 6 Bodily Maladaptions: Eating, Sleeping, and Psychophysiological Disorders 6-1. Research has shown that psychological and social factors possibly play an important role in health and fitness. Which of the following statements does not support this statement? a) Bodily complaints are a way of coping with stress for certain people. b) Social attitudes correlate positively with time of recovery. c) Vulnerability and resilience influence recovery from illness. d) Stressors are a factor in certain physical conditions.

Answer: b Page: 184 Level: Medium Type: Factual 6-2. What term describes the idea that bodily symptoms may be caused by the blocking of emotional expression? a) biopsychosocial model b) psychosomatic hypothesis c) general adaptation syndrome d) organ-susceptibility hypothesis Answer: b Page: 184 Level: Medium Type: Factual 6-3. Which system of the body plays a significant role in the “fight or flight” response? a) endocrine b) circulatory c) central d) voluntary Answer: a Page: 184 Level: Medium Type: Factual 6-4. Which part of the endocrine system releases hormones when the situation calls for “fight or flight”? a) thymus b) pancreas c) parathyroid d) adrenal medulla Answer: d Page: 184 Level: Medium Type: Factual 136

6-5. An expert on current theories of the relationship between psychological factors and physical symptoms has been invited to give a lecture next week.

Which of the following would be the best choice for the title of her lecture? a) “The psychodynamic perspective: Too rich to abandon” b) “Organic Causes: The search for major influence on symptoms” c) “Biological Emphasis: Let’s not turn away from decades of progress” d) “Perspective: On the interactions of factors in the development of symptoms” Answer: d Page: 184 Level: Difficult Type: Conceptual 6-6. Which of these is an interactional model? a) cognitive b) biological c) psychodynamic d) biopsychosocial Answer: d Page: 184 Level: Medium Type: Factual 6-7. The organism’s ability to mobilize and restore a dynamic equilibrium in the face of disruptions is called a) biofeedback. b) homeostasis. c) fight or flight. d) self-monitoring.

Answer: b Page: 185 Level: Medium Type: Factual 6-8. Irene has experienced physical problems because her life has been disrupted by environment changes and constraints in her life. She complains of headaches, sleep problems, and poor relationships. Her condition can best be explained by which model? a) biopsychosocial b) cognitive c) psychodynamic d) biological Answer: a Page: 185 Level: Difficult Type: Conceptual

137 6-9. From a research perspective, which model would find interest in HIV and AIDS because large members of people are affected and can be identified early in

the disease process? a) psychodynamic b) cognitive c) biological d) biopsychosocial Answer: d Page: 185 Level: Medium Type: Factual 6-10. Which field is concerned with improving diagnosis, treatment, and rehabilitation through the use of psychological techniques? a) health psychology b) physical wellness c) behavior medicine d) health nutrition Answer: c Page: 185 Level: Medium Type: Factual 6-11. Which of the following topics would be of greatest interest to a health psychologist? a) improving physicians’ “bedside manner” b) developing test reports that reassure patients c) helping a person prevent cancer by not smoking d) reinforcing a diabetic patient for taking her insulin Answer: c Page: 185 Level: Medium Type: Conceptual 6-12. What philosophy do the fields of behavioral medicine and health psychology have in common? a) a psychodynamic perspective b) focus on pharmacological treatments c) use of prevention/educational programs d) an emphasis on personal responsibility for health Answer: d Page: 188 Level: Medium Type: Conceptual

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6-13. Which of the following would not be a factor when examining the chance of onset of an illness? a) events in the person’s life b) age c) education d) form of the illness Answer: c Page: 188 Level: Medium Type: Factual 6-14. Which statement is not associated with stress? a) Stress plays a significant role in illness and health. b) Many systems within the body work overtime when a person experiences stress. c) Stress is best dealt with through therapeutic intervention. d) Stress can cause many physical changes.

Answer: c Page: 188 Level: Medium Type: Factual 6-15. A newspaper article described research on the relationship between stress and colds. Which of the following is the most likely summary? a) Stress increases the chances of infection. b) Stress is more likely after a cold than before. c) Stress makes the symptoms of a cold worse. d) There is no association between stress and infection.

Answer: a Page: 189 Level: Medium Type: Conceptual 6-16. Which of these individuals possesses a characteristic that tends to increase resistance to infection? a) Danny who has high levels of hostility b) Barry who has high levels of social support c) Frank who has a high level of personal responsibility in his job d) George who has a tendency to daydream a great deal during the day Answer: b Page: 189 Level: Medium Type: Factual

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6-17. Angela frequently engages in episodes of out-of-control eating, although she does not purge her body of the excess calories she consumes. When she decides to visit a physician, what diagnosis will be made? a) binge eating b) bulimia nervosa c) anorexia nervosa d) body dysmorphic disorder Answer: a Page: 190 Level: Medium Type: Conceptual 6-18. What do eating disorders and sleep disorders have in common? a) The disorders are not well understood, and the contributions of both psychosocial and biological factors are not well defined. b) Both disorders have had psychiatric classifications for many years. c) The disorders are rarely, if ever, fatal. d) The disorders originate from a social perspective.

Answer: a Page: 190 Level: Medium Type: Factual 6-19. Jill is depressed most of the day. She has low self-esteem, poor social skills, and has obsessive tendencies. She indicates her weight as a causal factor in her inability to keep friends. Jill is an example of: a) anxiety disorder b) pain disorder c) depressive disorder d) eating disorder Answer: d Page: 190 Level: Medium Type: Conceptual 6-20. Which of the following individuals is most likely to be afflicted with eating disorders? a) Sally who is 18 years old b) Thomas who is 35 years old c) Virginia who is 45 years old d) William who is 32 years old Answer: a Page: 190 Level: Medium Type: Conceptual

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6-21. What cutoff in DSM-IV-TR separates normal weights from those that suggest the presence of anorexia nervosa? a) 90% of normal weight b) 85% of normal weight c) 50% loss of bone density d) 75% loss of bone density Answer: b Page:190 Level: Medium Type: Factual 6-22. Which of the following is a criterion for the diagnosis of anorexia nervosa? a) weighing 10 pounds less than average b) losing more than 2 pounds of weight per week c) weighing less than 85% or less of normal weight d) being in the lowest 5% of one’s age group for weight Answer: d Page: 190 Level: Medium Type: Factual 6-23. What is the primary feature of anorexia nervosa? a) self-induced vomiting b) eating non-nutrient substances c) repeated episodes of binge eating d) obsessive preoccupation with losing weight Answer: d Page: 190 Level: Medium Type: Factual 6-24. Refusal to maintain even a minimally normal body weight is the central characteristic of a) pica. b) bulimia nervosa. c) anorexia nervosa. d) somatization disorder.

Answer: c Page: 190 Level: Medium Type: Factual 6-25. Individuals who are attempting to become extremely thin by refusing to eat suffer from a) obesity phobia. b) bulimia nervosa. c) anorexia nervosa. d) somatization disorder.

Answer: c Page: 190 Level: Medium Type: Factual 141

6-26. How is the reduced appetite observed in anorexia nervosa different from the reduced appetite seen in some forms of depression? a) People with depression view food symbolically. b) The people with anorexia feel out of control over their eating. c) There is a true loss of appetite among people with depression. d) The reactions of people with anorexia are based on delusions.

Answer: c Page: 191 Level: Medium Type: Conceptual 6-27. Anorexia nervosa can lead to cardiac arrest due to low levels of a) iron. b) glucose. c) potassium. d) white blood cells.

Answer: c Page: 191 Level: Medium Type: Factual 6-28. What are the two ages of highest risk for anorexia nervosa among females? a) ages 10 and 14 b) ages 14 and 18 c) ages 18 and 22 d) ages 22 and 26 Answer: b Page: 191 Level: Medium Type: Factual 6-29. Based on epidemiological research, which of the following individuals has the highest risk for anorexia nervosa? a) Iris, a 32-year-old African-American school teacher b) Carl, a 25-year-old Caucasian construction worker c) Helen, a 16-year-old Caucasian high school athlete d) David, a 35-year-old African-American data processor Answer: c Page: 191 Level: Medium Type: Conceptual

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6-30. A public relations company is asked to develop a public service announcement to spread the word on the mental health center’s treatments for anorexia nervosa. The center suspects that their services are underutilized by victims of anorexia. Which of the following might the company want to include in the public service announcements? a) Anorexia nervosa can lead to death. b) Be alert because this disorder is difficult to detect. c) Anorexia nervosa often leads to psychotic disorders. d) Severe weight loss is often the result of a brain tumor.

Answer: a Page: 191 Level: Difficult Type: Conceptual 6-31. Which strategy for keeping a low body weight is usually used by men with anorexia nervosa? a) vomiting b) exercise c) laxatives d) low-calorie diet Answer: b Page: 192 Level: Medium Type: Factual 6-32. Which treatment is associated with the most successful weight gain in patients diagnosed with anorexia nervosa? a) family therapy b) client-centered therapy c) antipsychotic medication d) systematic desensitization Answer: a Page: 192 Level: Medium Type: Factual 6-33. Darla is suffering from anorexia nervosa and currently weighs 70% of the weight that is average for her age and height. What treatment would be recommended in this case? a) family therapy b) antipsychotic medications c) electroconvulsive therapy d) inpatient hospital treatment Answer: d Page: 194 Level: Medium Type: Conceptual

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6-33. Bulimia nervosa is characterized by a) below-average body weight. b) eating non-nutrient materials. c) binge eating followed by purging. d) extreme control over daily caloric intake.

Answer: c Page: 194 Level: Medium Type: Factual 6-35. During an episode of binge eating, a person with bulimia nervosa typically consumes large quantities of a) high calorie foods. b) foods rich in protein. c) non-food substances. d) foods with diuretic effects.

Answer: a Page: 194 Level: Medium Type: Factual 6-36. Jane is making her annual visit to the dentist. As the dentist checks her mouth, he notices some changes that concern him. Based on his observations he suspects Jane may suffer from bulimia nervosa. What did the dentist see during the examination that led him to suspect this diagnosis? a) large gaps between teeth b) loss of enamel on the teeth c) teeth growing at awkward angles d) open sores at the base of the teeth Answer: b Page: 195 Level: Difficult Type: Conceptual 6-37. Which of these combined treatments seems to be the most effective in treating cases of bulimia nervosa? a) lithium and cognitive-behavioral therapy b) antipsychotic medication and family therapy c) family therapy and cognitive-behavioral therapy d) antidepressant medication and cognitive-behavioral therapy Answer: d Page: 198 Level: Medium Type: Factual

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6-38. Approximately how much of the sleep of an adult is spent in stage 2 sleep? a) 10% b) 25% c) 50% d) 75% Answer: c Page: 199 Level: Medium Type: Factual 6-39. An EEG technician is watching the record of the brain waves of a sleeping patient and notices that this person is producing primarily delta waves. What stage of sleep is this person in at this time? a) stage 1 b) stage 2 c) stage 4 d) REM sleep Answer: c Page: 199 Level: Medium Type: Conceptual 6-40. A volunteer is hooked up and observed in a sleep laboratory. The technician is giving a tour of the facility to a group of students and points out one volunteer whose breathing has become more rapid, irregular, and shallow. In addition his limbs have become paralyzed and his eyes jerk rapidly in various directions. What stage of sleep is this volunteer in at the moment? a) stage 1 b) stage 2 c) stage 4 d) REM sleep Answer: d Page: 199 Level: Medium Type: Conceptual 6-41. A neurologist and an endocrinologist are working together on a very difficult case. They have found that among other problems, the patient has difficulty with his melatonin levels. Which of the following is most likely to be impacted by this difficulty? a) sleep b) heart rate c) overall growth d) long-term memory Answer: a Page: 201 Level: Medium Type: Conceptual 145

6-42. Neuroscientists are interested in sleep because: a) it is a direct link to depression. b) it is a process influenced by bodily systems and life styles. c) more research is needed to study the effect of neurotransmitters. d) All the above Answer: b Page: 201 Level: Medium Type: Factual 6-43. Your grandfather is undergoing a series of tests at the local hospital. During his last visit, he asked the physician to write the names of the tests because he wanted to ask you about them. One of the tests is a polysomnography. What your grandfather expect to happen during this test? a) A number of physiological indicators will be recorded while he sleeps. b) Using radio waves, the hospital will record his heart beat throughout a typical day. c) He will be asked a number of verbal and quantitative questions while his brains waves are recorded. d) His stress reactions will be assessed by taking small amounts of blood throughout the day, which will reveal his level of stress hormones.

Answer: a Page: 201 Level: Difficult Type: Conceptual 6-44. Polysomnography is a technique used to monitor bodily parameters during a) sleep. b) stress. c) an MRI. d) an epileptic seizure.

Answer: a Page: 201 Level: Medium Type: Factual 6-45. Why did Nathaniel Kleitman and his students and other volunteers spend over a month in a cave? a) He wanted to see if people could adapt to a 28-hour day. b) He wanted to see how the lack of natural light would affect levels of depression. c) He was interested in how the cold in the cave would impact the functioning of the immune system. d) He was interested in how groups would form when everyone was in a potentially dangerous situation.

Answer: a Page: 201 Level: Difficult Type: Conceptual 146

6-46. Which of the following is an example of a parasomnia? a) insomnia b) dyssomnia c) a nightmare d) substance-induced sleep disorder Answer: c Page: 201 Level: Medium Type: Conceptual 6-47. _________ involve abnormalities in the amount, quality, or timing of sleep while _________ are marked by unusual behavior in association with sleep. a) Sleepwalking disorder; parasomnias b) Dyssomnias; parasomnias c) Parasomnias; narcolepsy d) Dyssomnias; narcolepsy Answer: b Page: 201 Level: Difficult Type: Factual 6-48. What have researchers found concerning the possible etiology of the sleep disorder narcolepsy? a) The disorder is sex-linked but only occurs when there is a viral infection early in life. b) The disorder seems to be related to ingestion of toxins that alter the brain’s sleep mechanism. c) Brain imaging scans have identified tumors in the limbic system that seem responsible for the disorder. d) The disorder has a strong genetic component, most likely related to a cluster of genes on chromosome 6.

Answer: d Page: 202 Level: Difficult Type: Factual 6-49. Rich is a senior in high school. Although he has maintained good grades, he struggles each day to stay awake. Several of his teachers found that he frequently nods off during class for short periods of time. The family physician could find no obvious cause for this sleepiness; however, he does recommend an evaluation at a sleep clinic. Which of the following disorders might the physician suspect is the root cause of Rich’s problem? a) enuresis b) narcolepsy c) Tay-Sachs disease d) sleep terror disorder Answer: b Page: 202 Level: Difficult Type: Conceptual 147

6-50. The diagnosis of a patient at the sleep clinic reads sleep apnea. What can we conclude about this patient? a) His sleep is interrupted by breathing disruptions. b) He begins his sleep by entering REM sleep immediately. c) During the night, he will awaken abrupt and scream, cry, and fidget. d) He will grind his teeth while he sleeps, which reduces his sleep as well as the sleep of others.

Answer: a Page: 202 Level: Medium Type: Conceptual 6-51. Kay has difficulty sleeping. She awakes partially, has confusion, and disorientation. Kay sits up abruptly and screams and is unresponsive to effort to awaken her. Kay has: a) sleep terror disorder b) sleep apnea c) narcolepsy c) insomnia Answer: a Page: 203 Level: Medium Type: Conceptual 6-52. Which of these terms describes physical conditions in which psychologically meaningful events are closely related to bodily symptoms? a) factitious b) somatoform c) psychophysiological d) gastrointestinal Answer: c Page: 203 Level: Medium Type: Factual 6-53. Which of these describes a disorder that could be called “psychophysiological?” a) a disorder caused by brain tumors b) a disorder that is symbolically related to physiological events c) a disorder that is untreatable with traditional medical techniques d) a disorder that is closely related to psychologically meaningful events Answer: d Page: 203 Level: Medium Type: Conceptual

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6-54. Joan has repeated episodes of complex motor behavior. She rises from her bed and walks around the house. Joan has: a) sleep terror disorder b) sleep apnea c) sleepwalking disorder d) nightmare disorder Answer: c Page: 203 Level: Medium Type: Factual 6-55. What is the function of the arteries? a) to remove carbon dioxide b) to sort plasma from blood c) to carry blood to the brain d) to provide oxygen to the cells Answer: d Page: 204 Level: Medium Type: Factual 6-56. What is the leading cause of death and disability in the United States? a) angina pectoris b) stress c) coronary hearth disease d) cancer Answer: c Page: 204 Level: Medium Type: Factual 6-57. What are plaques? a) diseased blood cells b) deposits that thicken arteries c) changes in coronary electrical activity d) evidence of damage to coronary ventricles Answer: b Page: 204 Level: Medium Type: Factual 6-58. What is atherosclerosis? a) plaque deposits b) myocardial infarction c) excess oxygen in blood cells d) deficiency of catecholamines Answer: a Page: 204 Level: Medium Type: Factual

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6-59. A posted announcement at a psychology convention indicates the guest speaker will not be able to attend because he has had a myocardial infarction.

You overhear the reactions and comments of others as they read the announcement. Which of the following statements indicates the speaker understands what has happened? a) “The speaker suffered a heart attack.” b) “The speaker has had an anxiety attack.” c) “The speaker had an artery in the brain burst.” d) “The speaker fainted as a result of low blood pressure.”

Answer: a Page: 204 Level: Difficult Type: Conceptual 6-60. What produces coronary heart disease? a) deterioration of veins b) lesions of the arteries c) reduced catecholamines d) changes in blood plasma Answer: b Page: 204 Level: Medium Type: Factual 6-61. Which of these individuals died as a result of the leading cause of death and disability in the United States? a) James who died of cancer b) John who died of coronary heart disease c) Kevin who died in a motor vehicle accident d) Ken who died as a result of Alzheimer’s disease Answer: b Page: 204 Level: Medium Type: Conceptual 6-62. Which of these people is suffering the major symptom of angina pectoris? a) Ed who has stomach ulcers b) Dave who has periodic chest pains c) Felicia who has migraine headaches d) Georgia who has a low level of immune system functioning Answer: b Page: 204 Level: Medium Type: Conceptual

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6-63. What is the leading cause of death in women after age 66? a) cancer b) suicide c) accidents d) heart disease Answer: d Page: 204 Level: Medium Type: Factual 6-64. An expert on heart attacks was invited by the local news to be a guest on their health segment. When the reporter asks questions about the common symptoms of myocardial infarction, the expert is quick to point out that there are differences in the symptoms experienced by men and women. Which of the following is one of those differences? a) Men typically have more plaques. b) Women have chest pains for a longer period. c) Women typically have higher blood pressure. d) Men have their first heart attack at a later age.

Answer: b Page: 204 Level: Difficult Type: Conceptual 6-65. What is one effect of epinephrine and norepinephrine on coronary functioning? a) accelerate arterial damage b) protects against myocardial infarction c) increases oxygen supply to blood cells d) re-establishes normal rhythms after a heart attack Answer: a Page: 205 Level: Medium Type: Factual 6-66. Barry has been depressed for some time. How will his depression affect the likelihood that he will have a heart attack? a) The disorders are very different and do not affect on one another. b) The depression actually reduces the chances because it tends to control eating and exertion. c) For reasons that are not yet clear, the depression tends to raise the chances that he will suffer a heart attack. d) The depression will increase the risk for a heart attack because it will lower his immune system functioning.

Answer: c Page: 205 Level: Difficult Type: Conceptual 151 6-67. What changes have occurred in the mortality rate due to coronary heart disease in the past 40 years?

a) leveled off b) decreased c) increased d) decreased only in women Answer: b Page: 205 Level: Medium Type: Conceptual 6-68. Which characteristics are typical of someone labeled as Type A? a) hostile and hurried b) reliable and trusting c) irresponsible and dominant d) frequently exercises and takes time to relax Answer: a Page: 205 Level: Medium Type: Factual 6-69. The new employee arrives today; the manager has described him as a Type A. Because you are not sure what this means, you ask a fellow worker. She tells you to expect the new employee to be a) dependent and shy. b) competitive and hurried. c) responsible and sociable. d) humorless and unassertive.

Answer: b Page: 205 Level: Medium Type: Conceptual 6-70. Which element of the Type A personality is thought to be the most active ingredient in leading to heart disease? a) hostility b) worrying c) competitiveness d) high activity level Answer: a Page: 205 Level: Medium Type: Factual

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6-71. Your friend is cynical, mistrustful, and perceives other peoples’ hostilities as aimed at him. Which description most likely fits your friend? a) Type A with low risk of heart disease b) Type B with low risk of heart disease c) Type B with high risk of heart disease d) Type A with high risk of heart disease Answer: d Page: 205 Level: Medium Type: Conceptual 6-72. What was the statistical association between Type A/Type B personality and heart disease in the original research on this topic? a) twice as common in Type B b) twice as common in Type A c) four times as common in Type B d) equally common in Type A and Type B Answer: b Page: 205 Level: Medium Type: Factual 6-73. For your term paper in Abnormal Psychology you have decided to review the history of the concept of Type A. Based on your understanding of this history, which of the following titles would be most appropriate? a) “Type A: The revised version” b) “Type A: Right from the start” c) “Type A: A risk factor but not for heart disease” d) “Type A: How it actually reduces risk of heart disease” Answer: a Page: 205 Level: Difficult Type: Conceptual 6-74. A researcher reviewed the research on physiological reactivity of people who are most susceptible to coronary disease. Which of the following is the best summary of that research? a) These people exhibit low physiological reactivity. b) These people exhibit high physiological reactivity. c) During sleep, they exhibit more variable physiological reactivity. d) During periods of frustration, they exhibit more overt behaviors of their feelings.

Answer: b Page: 206 Level: Difficult Type: Conceptual

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6-75. Researchers studied men who had survived myocardial infarctions, in order to identify factors associated with increased risk for early death. In addition to life stress, what was another important risk factor for early death? a) religiosity b) social isolation c) low-level of education d) lack of cultural identity Answer: b Page: 206 Level: Medium Type: Factual 6-76. Which country has an especially low rate of coronary heart disease? a) Japan b) France c) Canada d) United States Answer: a Page: 207 Level: Medium Type: Factual 6-77. What community characteristic has been associated with higher rates of coronary heart disease? a) fast pace of life b) unpredictable weather c) strong cultural identity d) high rate of Type B behavior Answer: a Page: 207 Level: Medium Type: Factual 6-78. What was one of the ways that researchers measured the general pace of life in cities across the United States? a) They checked the size of the email files in offices. b) They measured the speed with which bank tellers worked. c) They measured the density of people in a given geographic area. d) The measured the size of the phone book used in various locations.

Answer: b Page: 207 Level: Medium Type: Conceptual

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6-79. In years past, the town of Roseto, Pennsylvania, had a remarkably low death rate, especially from heart disease. What characteristic did the townspeople have in common? a) vegetarian diet b) low rates of smoking c) close family relationships d) high involvement in sports Answer: c Page: 207 Level: Medium Type: Factual 6-80. Which of the following is probably the best therapy for a Type A person who experienced a first heart attack? a) psychodynamic therapy aimed at uncovering repressed memories b) cognitive behavior therapy to increase awareness of hostility and reduce these reactions c) a regimen of heavy physical exercise as a means of reducing the build up of stress levels d) listening to music as a means of reducing very high tension levels and increased amount of sleep Answer: b Page: 207 Level: Difficult Type: Conceptual 6-81. Which of these individuals has the greatest risk for developing hypertension? a) Amy, a 20-year-old Caucasian b) Steve, a 65-year-old Caucasian c) Julia, a 40-year-old African American d) William, a 35-year-old African American Answer: d Page: 208 Level: Medium Type: Conceptual 6-82. Hypertension is indicative of a) resistance to blood flow. b) an inability to remain calm. c) dangerously low blood pressure. d) one or more previous heart attacks.

Answer: a Page: 208 Level: Medium Type: Factual

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6-83. Hypertension has been linked to a) chronic anger. b) high assertiveness. c) high social competence. d) chronic levels of depression.

Answer: a Page: 208 Level: Medium Type: Factual 6-84. Which person is most likely to have hypertension? a) an older man b) a young woman c) an African-American d) a European-American Answer: c Page: 208 Level: Medium Type: Conceptual 6-85. Your physician suggests you try to treat your hypertension by using Herbert Benson’s method or relaxing. Which of the following regimens should you follow? a) adopt a passive attitude, sit quietly, and repeat a sound over and over b) go through each and every muscle in the body and alternatively tense it and then relax it c) hook up electrodes from a biofeedback machine to your forehead and try to use the feedback to relax d) engage in strenuous physical activity because it has a tendency to lower the blood pressure in the long run Answer: a Page: 209 Level: Difficult Type: Conceptual 6-86. Which of the following skills is associated with lowering of blood pressure? a) creativity b) assertiveness c) anger suppression d) taking responsibility for problems Answer: b Page: 209 Level: Medium Type: Factual

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6-87. Which type of work environment is associated with the most problems related to high blood pressure? a) low psychological demands, low control b) low psychological demands, high control c) high psychological demands, high control d) high psychological demands, low control Answer: d Page: 209 Level: Medium Type: Factual 6-88. A group of medical students whose psychological profiles indicated that they had a relatively restricted capacity for close interpersonal relationships were followed for 20-25 years. These people were found to be especially prone to develop a) insomnia. b) ulcers. c) cancer. d) heart disease.

Answer: c Page: 210 Level: Medium Type: Factual 6-89. A researcher divides a group of animals into four groups in order to investigate the effects of stressors on tumor growth. Based on the results of past research, which group is likely to experience the most rapid tumor growth? a) animals exposed to acute stressors b) animals exposed to controllable stressors c) animals exposed to uncontrollable stressors d) animals exposed to stressors early in their lives Answer: c Page: 211 Level: Medium Type: Factual 6-90. According to research by D. Spiegel and colleagues, what effect does participation in group psychotherapy have on women with breast cancer? a) lengthens life b) reduces T cell counts c) increases depression d) stigmatizes the patients Answer: a Page: 211 Level: Medium Type: Factual

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6-91. Neurasthenia is a term from the late 1800s that shares some common properties with a) narcolepsy. b) anorexia nervosa. c) chronic fatigue syndrome. d) body dysmorphic disorder.

Answer: c Page: 212 Level: Medium Type: Factual 6-92. What is the current status of chronic fatigue syndrome? a) It is not yet an official diagnostic category. b) It is listed as a somatoform disorder in DSM. c) It is listed as a provisional disorder in the current DSM. d) It is listed as a psychophysiological disorder in most diagnostic classifications.

Answer: a Page: 212 Level: Medium Type: Factual 6-93. What are the criteria used to define chronic fatigue syndrome at the current time? a) A patient must have at last 10 of 12 listed symptoms. b) The current definition combines inclusion and exclusion criteria. c) There must be positive results on a list of specified medical tests. d) There must be evidence of a past psychological condition that is actually responsible for the symptoms.

Answer: b Page: 212 Level: Medium Type: Factual 6-94. Which type of headache is localized on one side of the head or at the front of the head and is often accompanied by nausea or vomiting? a) cluster b) tension c) migraine d) muscle-contraction Answer: c Page: 213 Level: Medium Type: Factual

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6-95. Which of these people is suffering from the most common form of head pain? a) Peter who has a sinus infection b) Roberta who has migraine headaches c) Steve who suffers from tension headaches d) Theresa who suffers from a cluster headaches Answer: c Page: 213 Level: Medium Type: Factual 6-96. A television health reporter is conducting interviews for an upcoming segment on headaches. When she asks experts for the most frequent cause of headaches, what is she likely to be told? a) Infection is the major cause of headaches. b) Allergic reactions are the most frequent cause of headaches. c) Headaches result primarily from altered electrical brain activity. d) The most frequent cause of headaches are factors other than organic disease.

Answer: d Page: 213 Level: Medium Type: Factual 6-97. According to Stephanie’s medical chart she reports an aura accompanying the symptoms that have led her to seek medical treatment. What is Stephanie’s most likely diagnosis? a) hypertension b) dissociative fugue c) migraine headaches d) myocardial infarction Answer: c Page: 213 Level: Medium Type: Conceptual 6-98. Ringing in the ears, numbness, tingling, extreme sensitivity to light, and nausea are all experiences that may accompany a) an aura. b) conversion disorders. c) coronary heart disease. d) a muscle-contraction headache.

Answer: a Page: 213 Level: Medium Type: Factual

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6-99. What type of headache is more common among women than among men? a) cluster b) tension c) migraine d) muscle-contraction Answer: c Page: 213 Level: Medium Type: Factual 6-100. Which of these is a headache that causes pain that is described as “bandlike pressure” or “tightness?” a) cluster b) tension c) migraine d) aura Answer: b Page: 213 Level: Medium Type: Conceptual 6-101. What type of headache is more common in men than in women? a) tension b) cluster c) migraine d) muscle-contraction Answer: b Page: 214 Level: Medium Type: Factual 6-102. A patient’s chart indicates that his headache pain is described as “piercing” and “excruciating.” The pain comes on abruptly, and the use of alcohol or lying down can bring on the pain. Which type of headache is described here? a) cluster b) tension c) migraine d) muscle contraction Answer: a Page: 214 Level: Medium Type: Factual 6-103. Migraine headaches often respond to drugs that a) relax muscles. b) treat infection. c) constrict arteries in the scalp. d) increase cerebral electrical activity.

Answer: c Page: 214 Level: Medium Type: Factual 160

6-104. Which of the following conditions are very likely to occur along with cases of irritable bowel syndrome? a) depression and anxiety disorders b) anorexia nervosa and bulimia nervosa c) schizophrenia and obsessive-compulsive disorder d) narcissistic personality disorder and panic disorder Answer: a Page: 215 Level: Medium Type: Factual

Essay Questions 6-105. What are the three most studied eating disorders?

Answer: Anorexia nervosa: individuals have a distorted body image that causes them to see themselves as overweight even when they are dangerously thin.

They often refuse to eat, exercise compulsively, and develop unusual habits such as refusing to eat in front of others. Anorectics lose large amounts of weight and may starve to death. Bulimia nervosa: individuals eat excessive quantities of food, then purge their bodies of the food and calories they fear by using laxatives, enemas, or diuretics; vomiting; and/or exercising. They often act in secrecy. They feel disgusted and ashamed as they binge, yet they are relieved of tension and negative emotions once their stomachs are empty again. Binge eating: like bulimia, there are frequent episodes of out-of-control eating. The difference is that binge eaters do not purge their bodies of the excess calories.

Page: 190 Level: Medium Type: Factual 6-106. What are some of the key triggers for binge eating?

Answer: (1) Particular stressful situations; (2) Particular upsetting thoughts; (3) Feeling guilt about something one has done; (4) Feeling socially isolated or excluded; (5) Worries about responsibilities, problems or the future; (6) Boredom.

Page: 194 Level: Medium Type: Factual 6-107. What is the biological process by which stress can contribute to coronary disease?

Answer: Under stress, the body secretes more hormonal substances called catecholamines. Two of these, epinephrine and norepinephrine, accelerate damage to arteries in the heart. Plaque buildup in the arteries restricts blood flow.

Page: 205 Level: Medium Type: Factual 161

6-108. Describe the four types of coronary heart disease risk factors.

Answer: Bodily characteristics: age, hypertension, cholesterol, obesity, heredity.

Health habits: smoking, alcohol use; Community life-style and cultural factors: socioeconomic status, education; Personality: anxiety, hostility, life goals.

Page: 205 Level: Medium Type: Factual 6-109. What community life style and cultural factors have researchers found to be related to CHD? Answer: The general pace of life in a community (as indicated by speed of walking and talking, speed with which bank tellers work, and proportion of individuals wearing watches) is related to deaths from CHD. A fast pace of life is associated with higher rates of CHD. In addition, rates of CHD are lower in parts of the world where tradition and family ties are strong. The low rate of CHD in Japan and the high rate in the U.S. suggest the role of these cultural factors. The change in the CHD rate in Roseto, Pennsylvania is cited as an example of how changes in culture can affect heart disease rates.

Page: 207 Level: Medium Type: Factual 6-110. What is our current understanding of the cause of migraine headaches?

Answer: In the past, it was believed the migraines were caused by narrowing followed by dilation of blood vessels. This idea is now being replaced by the idea that a wave of cerebral electrical activity may cause the aura (or warning sensation), and that headaches develop when the wave reaches pain-sensitive blood vessels. The wave may be triggered by stress, hunger, hormone fluctuations, foods, alcohol, too much sleep, caffeine withdrawal, or noise. It has recently been shown that the neurotransmitter serotonin becomes depleted in the brain during a migraine attack.

Page: 213 Level: Medium Type: Factual

True/False 6-111. Asthma is a chronic respiratory disease, and is characterized by airway irritability and obstruction due, in part, to allergies and irritants.

Answer: True Page: 183 Level: Easy Type: Factual 6-112. People’s reaction to stress involves interactions between personal variables and situational variables.

Answer: True Page: 184 Level: Easy Type: Factual 162

6-113. Most illnesses are simply due to the influences of external agents.

Answer: False Page: 185 Level: Easy Type: Factual 6-114. The biopsychosocial view examines the causes of illnesses, but is also concerned with prevention and treatment.

Answer: True Page: 185 Level: Easy Type: Factual 6-115. Health psychology deals with the prevention of disease.

Answer: True Page: 185 Level: Easy Type: Factual 6-116. Behavioral medicine and health psychology are concerned with reducing the stress of illness but not necessarily preventing the stress.

Answer: False Page: 185 Level: Easy Type: Factual 6-117. Stress stimulates hormonal secretions from the pituitary and adrenal glands.

Answer: True Page: 188 Level: Easy Type: Factual 6-118. Research indicates that having a clinical diagnosis of depression in adolescence is not associated with eating disorders.

Answer: False Page: 190 Level: Easy Type: Factual 6-119. Insomnia is the most common type of sleep disorder.

Answer: True Page: 201 Level: Easy Type: Factual 6-120. In sleepwalking disorders, there are episodes of complex motor behavior which are repeated.

Answer: True Page: 203 Level: Easy Type: Factual 6-121. Chronic fatigue syndrome is a clinical condition with symptoms that are readily explainable.

Answer: False Page: 212 Level: Easy Type: Factual 6-122. Headaches are associated with significant organic disease and can be debilitating.

Answer: False Page: 213 Level: Easy Type: Factual 6-123. Irritable bowel syndrome is responsible for absenteeism from work.

Answer: True Page: 215 Level: Easy Type: Factual 163

Chapter 7 Disorders of Bodily Preoccupation 7-1. Somatization, conversion disorder, pain disorder, and hypochondriasis are all classified by DSM-IV-TR as a) anxiety disorders. b) factitious disorders. c) somatoform disorders. d) psychophysiological disorders.

Answer: c Page: 219 Level: Medium Type: Factual 7-2. Which term describes physical symptoms and disability in the absence of physical disease? a) factitious b) somatoform c) psychosomatic d) gastrointestinal Answer: b Page: 220 Level: Medium Type: Factual 7-3. Clients with medically unexplained symptoms account for what percent of problems confronted daily? a) 15% to 45% b) 35% to 70% c) 40% to 605 d) 25% to 50% Answer: d Page: 220 Level: Medium Type: Factual 7-4. All of the following are symptoms of pain disorder except: a) some form of bodily injury must be present b) client can present with or without organic symptoms c) severe, prolonged pain d) complaints can be used for attention Answer: a Page: 220 Level: Medium Type: Factual

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7-5. Shelly has seen her physician nine times in three months complaining of a variety of physical symptoms. Each time the physician has been unable to find a physical cause for her symptoms. What category of psychological disorder is the physician likely to suspect Shelly exhibits? a) anxiety disorder b) somatoform disorder c) dissociative disorder d) psychophysiological disorder Answer: b Page: 220 Level: Difficult Type: Conceptual 7-6. What are the two categories of pain disorder listed in DSM-IV-TR? a) acute and chronic b) primary and secondary c) generalized and specific d) autonomic and voluntary Answer: a Page: 220 Level: Medium Type: Factual 7-7. Which of the following is one of the criteria for the diagnosis of pain disorder? a) The pain must be described as piercing and unbearable. b) Reported pain symptoms must occur in at least four parts of the body. c) The pain and deficits related to it are not intentionally produced or feigned. d) There must be a clear precipitating incident that led to the reported pain symptoms.

Answer: c Page: 220 Level: Medium Type: Factual 7-8. What analogy did Descartes use in order to help in conceptualizing pain? a) a herd of animals walking slowly over a person b) the slow dripping of water from a leaky bucket c) blades of grass in a lawn that move with every breeze d) an individual pulling the rope at the bottom of a tower causing the bell in the belfry to ring Answer: d Page: 221 Level: Medium Type: Conceptual

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7-9. For several years, Ted has had back pain that is sufficiently severe that he has not been able to work. Nevertheless, physicians do not believe that the pain is as severe as one would believe from Ted's reaction. They have come to believe that Ted's presentation of his pain symptoms is related to his family's response.

What term do physicians use for this phenomenon? a) secondary gain b) family somatization c) dysfunctional family d) unconscious manifestation Answer: a Page: 221 Level: Difficult Type: Conceptual 7-10. Tomas has been given a diagnosis of pain disorder. His therapist wants to focus on pain behaviors and that conditions have a positive or negative effect on the behaviors. What approach will the therapist implement? a) behavioral therapy b) operant conditioning c) biofeedback d) psychotherapy Answer: b Page: 221 Level: Difficult Type: Conceptual 7 – 11. Frank has learned from his father that if he displays pain-like symptoms, he will receive attention. Frank has recently married and wants his wife to help manage his pain. She has refused to accept this responsibility. What approach could help Frank? a) psychodrama b) cognitive therapy c) biofeedback d) cognitive-behavior therapy Answer: d Page: 221 Level: Medium Type: Conceptual 7-12. What have studies of the Yogi practitioner, Swami Rama, revealed concerning his claimed abilities to control bodily functions? a) His claims of controlling bodily functions were false. b) There are limits to the effectiveness of biofeedback. c) "Involuntary" physical processes can be consciously controlled. d) Yoga produces the same body control as other forms of exercise.

Answer: c Page: 224 Level: Medium Type: Factual

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7-13. While reading an interview with Swami Rama, you are struck by some of his claims. You tell a friend about the Swami and when asked for an example of one of the claims, what will you say? a) He can slow up and speed up his heart beat. b) He can change his brain waves on command. c) He can walk over hot coals for a distance greater than a football field. d) He can support the weight of a fully loaded truck on his chest with no injury.

Answer: a Page: 224 Level: Medium Type: Factual 7-14. Your friend tells you about a news report on a form of therapy in which people are given information about their physiological state in the form of electronic signals. What is the likely topic of this report? a) biofeedback b) behavior modification c) pharmacological therapy d) systematic desensitization Answer: a Page: 224 Level: Medium Type: Conceptual 7-15. What is one of the limitations of biofeedback? a) high cost b) alters brain electrical activity c) takes years of training to be effective d) effectiveness tends to drop after training stops Answer: d Page: 224 Level: Medium Type: Factual 7-16. Phil would like to learn to control his heart rate and blood pressure. After carefully reading the literature, what has he determined he will need to accomplish his goal? a) electrical or chemical stimulation b) external reinforcement such as food c) years of discipline, as in the practice of yoga d) information about the state of the target system Answer: d Page: 225 Level: Medium Type: Factual

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7-17. Michael is always complaining of a long list of aches, pains, and other symptoms. He focuses on slight changes in his heartbeat, is convinced he always has a fever, and frequently sees a physician. What is Michael's most likely diagnosis? a) fugue b) conversion disorder c) somatization disorder d) Munchausen syndrome Answer: c Page: 225 Level: Medium Type: Conceptual 7-18. What is another name for Briquet's syndrome? a) hypochondriasis b) conversion disorder c) somatization disorder d) depersonalization disorder Answer: c Page: 225 Level: Medium Type: Factual 7-19. Which disorder is often associated with unnecessary surgeries? a) fugue b) bipolar disorder c) conversion disorder d) somatization disorder Answer: d Page: 225 Level: Medium Type: Factual 7-20. Jessica constantly complains of a long list of physical symptoms that do not center around one particular ailment. After finding no medical explanation for her symptoms, a physician suspects Jessica suffers from a) depersonalization. b) dissociative fugue. c) conversion disorder. d) somatization disorder.

Answer: d Page: 225 Level: Difficult Type: Conceptual 7-21. Multiple somatic symptoms that are chronic and presented in a very dramatic and vague fashion are found in a) conversion disorder. b) somatization disorder. c) depersonalization disorder. d) psychophysiological disorder.

Answer: b Page: 226 Level: Medium Type: Factual

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7-22. Alice has the diagnosis of somatization disorder; Mary has the diagnosis of hypochondriasis. What is the major difference in the symptoms of their disorders? a) Mary's symptoms have lasted longer than Alice's. b) Mary's symptoms involve a break with reality; Alice maintains good contact with reality. c) Alice has multiple symptoms; Mary's symptoms focus on her fear of a specific disease. d) Alice has some real impairment from her disorder; Mary is actually malingering to increase attention.

Answer: c Page: 226 Level: Difficult Type: Conceptual 7-23. Patients with somatization disorder exhibit many of the same personality characteristics as patients with a) schizoid personality disorder. b) avoidant personality disorder. c) histrionic personality disorder. d) obsessive-compulsive personality disorder.

Answer: c Page: 226 Level: Medium Type: Factual 7-24. How many people in a sample of 10,000 are likely to meet the criteria for somatization disorder? a) 50 b) 100 c) 250 d) 500 Answer: b Page: 227 Level: Medium Type: Factual 7-25. Glove anesthesia is an example of what disorder? a) factitious disorder b) conversion disorder c) somatization disorder d) histrionic personality disorder Answer: b Page: 227 Level: Medium Type: Factual

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7-26. After witnessing a car accident that killed his wife, Dan says he cannot see.

However, medical specialists found nothing wrong with the structure or function of his eyes, and brain scans reveal no evidence of any structural damage to the brain. After holding a case conference, a team of professionals suggests that Dan should be evaluated for the possible diagnosis of a) hypochondriasis. b) conversion disorder. c) somatization disorder. d) psychophysiological disorder.

Answer: b Page: 227 Level: Difficult Type: Conceptual 7-27. La belle indifference, a nonchalant attitude that communicates little concern about seemingly serious symptoms, tends to occur with which disorder? a) hypochondriasis b) conversion disorder c) somatization disorder d) Munchausen syndrome Answer: b Page: 227 Level: Medium Type: Factual 7-28. A psychologist has just finished analyzing a client who is believed to have a conversion disorder. The psychologist asks the family to meet with him as part of the process of planning treatment. The psychologist is especially concerned about what he calls secondary gain. When one of the family members asks for an explanation, what will the psychologist say? a) "Clients with this disorder tend to develop a second disorder after the first is treated. " b) "The client is attempting to control the family's interaction patterns by producing the symptoms." c) "The family's attention and affection can actually have the effect of reinforcing the symptoms." d) "The symptoms exhibited by the client are actually related to a second and previously undiagnosed disorder."

Answer: c Page: 227 Level: Difficult Type: Conceptual 7-29. Paul has been under a lot of stress at work. One morning he wakes up and finds himself blind. Although his physician can find nothing physically wrong, Paul is not faking. Which disorder is most consistent with Paul's symptoms? a) hypochondriasis b) conversion disorder c) somatization disorder d) Munchausen syndrome Answer: b Page: 227 Level: Difficult Type: Conceptual 170

7-30. What is the origin of the concept of conversion disorder? a) Its roots are in psychotic disorders such as schizophrenia. b) Ancient philosophers developed the concept to show how mind and body were separate. c) The origin is traced the category of hysteria, which was thought to be a disorder of the uterus. d) Ancient physicians used the concept to describe disorders that began with one set of symptoms and evolved into a different set of symptoms.

Answer: c Page: 227 Level: Difficult Type: Conceptual 7-31. Robert is unable to hear. A thorough physical examination reveals no medical findings that could account for this reported inability to hear. Which of the following diagnoses is a clinician likely to consider at this point? a) hypochondriasis b) depersonalization c) conversion disorder d) psychophysiological disorder Answer: c Page: 227 Level: Medium Type: Conceptual 7-32. Jessica constantly complains of a large number of physical complaints that do not center around one particular ailment. After finding no medical explanation for her symptoms, a physician suspects she sufferers from conversion disorder.

If Jessica lived several hundred years ago, what diagnosis would be made? a) hysteria b) depersonalization c) dementia praecox d) manic-depressive psychosis Answer: a Page: 227 Level: Medium Type: Conceptual 7-33. How long must a person have the persistent belief that he or she has a serious illness despite medical reassurance in order to meet the criteria for hypochondriasis? a) two months b) six months c) one year d) two years ANS: b Page: 228 Level: Medium Type: Factual

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7-34. Tammy is convinced that a pain in her leg is the first sign of bone cancer.

During a physical examination, her family physician finds no evidence of cancer.

To be sure the physician orders X-rays that confirm the original findings.

Nevertheless, Tammy sought the opinions of other physicians who agreed that there was no evidence of cancer. Tammy's behavior is most consistent with which disorder? a) bipolar disorder b) hypochondriasis c) dissociative fugue d) conversion disorder Answer: b Page: 229 Level: Difficult Type: Conceptual 7-35. Omar’s statement that “I immediately get upset if something is wrong with me”, and he drives to the doctor’s office is associated with: a) hypocondriasis b) somatization disorder c) conversion disorder d) malingering Answer: a Page: 229 Level: Medium Type: Conceptual 7-36. Someone with body dysmorphic disorder is likely to be concerned about a) cancer. b) vague pains. c) excessive facial hair. d) sudden loss of sight.

Answer: c Page: 229 Level: Medium Type: Factual 7-37. Which of the following individuals exhibits behavior that is consistent with the diagnosis of body dysmorphic disorder? a) Al who believes his intestines have turned to dust b) Linda who reports difficulty with her sense of vision c) Iris who thinks her eyebrows are too large for her face d) George who thinks his dental fillings can receive radio waves Answer: c Page: 229 Level: Medium Type: Conceptual 7-38. Which of the following would not be especially helpful in treating hypocondriasis? a) cognitive-behavior therapy b) support therapy c) existential therapy d) reassurance Answer: c Page: 229 Level: Medium Type: Factual 172

7-39. Alice believes that she has excessive facial hair and wrinkles on her face, despite the fact that no one sees these "defects." After thinking about this for months, she finally decides to see a mental health professional. What is likely to happen in the first few sessions? a) She will seek reassurance that she is not psychotic. b) Alice will talk about her depression and not mention her bodily preoccupation. c) Alice will complain that other people will not "level" with her about her "true" appearance. d) She will insist that the therapist keep the lights down so her features will not be noticed during the sessions.

Answer: b Page: 230 Level: Difficult Type: Conceptual 7-40. Which part of the body is the usual focus of preoccupation in body dysmorphic disorder? a) head b) hands c) feet d) genitals Answer: a Page: 230 Level: Medium Type: Factual 7-41. What is the primary basis for distinguishing between malingering and factitious disorder? a) symptom severity b) goal of the behavior c) specific disease chosen d) presence of actual physical damage Answer: b Page: 231 Level: Medium Type: Factual 7-42. Amy has been diagnosed with factitious disorder; Sally has been diagnosed with somatization disorder. What is the major difference between these two individuals? a) Amy is seeking attention from medical personnel; Sally really believes she is ill. b) Amy is more likely to have experienced child abuse; Sally is more likely to have brain damage. c) Amy is capable of altering her bodily functions at will; Sally feels that she no control over her bodily functions. d) Amy is actually suffering from delusions; Sally probably has a genetically caused disorder.

Answer: a Page: 231 Level: Difficult Type: Conceptual 173

7-43. At the local hospital a patient with a long and complicated case was observed putting some of his own blood into his urine sample. At the staff conference, there is a great deal of discussion concerning this case, and much of the discussion revolves around two likely diagnoses. When the group leader summarizes the discussion, which two diagnoses will be under active consideration? a) factitious and malingering b) bipolar disorder and schizophrenia c) depersonalization and Munchausen d) hypochondriasis and somatization disorder Answer: a Page: 231 Level: Difficult Type: Conceptual 7-44. Amber craves attention and has a high need to be cared for. Amber has ______. Annette seeks SSI disability and seeks medical care and hospitalization.

Annette’s diagnosis is _____________. a) malingering; somatization disorder b) facticious disorder; malingering c) malingerling; facticious disorder d) malingering; hypocondriasis Answer: b Page: 231 Level: Difficult Type: Conceptual 7-45. Ann often goes to the Emergency Room describing a number of bizarre symptoms. Sometimes she actually makes herself sick so she can be seen by a physician. Her behavior appears to be solely for the purpose of getting the attention of health care providers. What diagnosis is she likely to receive? a) hypochondriasis b) conversion disorder c) somatization disorder d) Munchausen syndrome Answer: d Page: 232 Level: Medium Type: Conceptual 7-46. What term is used for repeated, conscious simulation of disease for the sole purpose of assuming the role of a patient? a) malingering b) dissociation c) hypochondriasis d) Munchausen syndrome Answer: d Page: 232 Level: Medium Type: Factual

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7-47. Munchausen syndrome derives its name from Baron Von Munchausen.

What characteristic of this man was a reason for using his name for this disorder? a) He told elaborate lies. b) He frequently drank to excess. c) He would create physical symptoms to avoid having to fight. d) He was capable altering his heart rate by simply willing that it occur.

Answer: a Page: 232 Level: Medium Type: Conceptual 7-48. A patient at the local hospital was discovered exhibiting Munchausen syndrome. When the hospital staff collects the patient's records over the last 5 years, what are they likely to discover? a) a history of felony arrests b) prior, unnecessary surgeries c) a past history of childhood abuse d) a difficult birth resulting in brain damage Answer: b Page: 232 Level: Difficult Type: Conceptual 7-49. You are given an assignment to search the web for a case of factitious disorder by proxy. Which of the following cases is likely to fit this description? a) a husband and wife mimic each other's symptoms in order to confuse a therapist b) a mother causes physical symptoms in her child for the purpose of seeking treatment c) the more time they spend in group therapy, the more clients tend to exhibit each other's symptoms d) a client reports the symptoms that he sees exhibited on television shows because he "lives through the lives of others" Answer: a Page: 232 Level: Difficult Type: Conceptual 7-50. Martin is wanted by the police as a suspected bank robber. In order to avoid legal charges, he goes to an Emergency Room and says he cannot remember who he is or anything about his life. Martin may have amnesia, but clinicians will also have to rule out a) malingering. b) factitious disorder. c) conversion disorder. d) somatization disorder.

Answer: a Page: 232 Level: Difficult Type: Conceptual

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7-51. When a mother produces symptoms of diseases in her child and presents the child for treatment, this is called: a) malingering by proxy b) facticious disorder c) malingering d) facticious disorder by proxy Answer: d Page: 232 Level: Medium Type: Factual

Essay Questions 7-52. What are some of the major coping strategies people use to deal with pain?

Answer: 1) Ignoring pain can help a person lead a more active, satisfying life.

2) Distraction and diverted attention (e.g., reading a magazine or book) helps some people attend less to pain or disability. 3) Positive self-statements such as "I won't let it bother me" are often associated with lower levels of self-reported pain severity. 4) Catastrophizing, use of excessive or exaggerated negative selfstatements, such as "My condition is going to get progressively worse" is negatively correlated with adjustment to pain.

Page: 221 Level: Difficult Type: Factual 7-53. What are some reasons that people tend to engage in somatization?

Answer: 1) Illness allows a socially isolated person to receive nurturance and support from family, friends, and physicians. 2) The sick role can be used as a rationalization for occupational, social, and sexual failures. 3) Illness can be used to manipulate other people or social situations. 4) Because physical illness is less stigmatizing than having a psychological disorder, many individuals prefer to attribute psychological symptoms to physical causes. 5) Somatic symptoms may represent behavior learned in childhood (e.g., parents may provide more attention during illnesses).

Page: 226 Level: Difficult Type: Factual

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7-54. What are the three major characteristics found in hypochondriacal patients and what are the consequences of the characteristics?

Answer: Hypochondriacal individuals exhibit physiological arousal, which often is reflected in tension, anxiety, and sleep disturbances. They also have a bodily focus, which is illustrated in close monitoring of bodily features, attention to information that is consistent with worries about illness, and preoccupation and rumination about physical complaints, Finally, they engage in behaviors designed to avoid or check for physical illness: these include repeated self-inspection, repeated medical consultation and reassurance-seeking, rigid views and behavior regarding diet or lifestyle, and efforts to avoid physical exertion or contact with people who seem to have a disease.

Page: 229 Level: Difficult Type: Factual 7-55. What are the key points to keep in mind when trying to distinguish factitious disorder from malingering?

Answer: The judgment that a particular symptom is under voluntary control occasionally is made by excluding all other possible causes. However, this is not a foolproof method. When the clinician is not fully aware of the particular purpose for which the malingerer manufactures symptoms, the chances of a misdiagnosis increase. An act of malingering might, under certain circumstances, be considered adaptive (e.g., when prisoners fake illness), but factitious disorders are almost always seen in people with severe, lifelong personality disturbances.

Page: 231 Level: Difficult Type: Factual

True/False 7-56. When considering disorders of bodily preoccupation, if the clinician finds no organic disease this does not mean the client’s suffering is not real.

Answer: True Page: 219 Level: Easy Type: Factual 7-57. Participation in regular activities is an important consideration in recovery from pain disorder.

Answer: True Page: 220 Level: Easy Type: Factual 7-58. A biopsychological model is the approved and accepted approach in examining pain other than in the context of examining physical etiology of pain.

Answer: False Page: 221 Level: Easy Type: Factual 7-59. A barrier to pain treatment is finding objective indicators.

Answer: True Page: 221 Level: Easy Type: Factual

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7-60. Since pain disorders are a biobehavioral phenomena, the focus of attention should be on how the patient is responding to physical trauma and the social environment.

Answer: True Page: 225 Level: Easy Type: Factual 7-61. Several somatic complaints that are recurrent and/or chronic describe somatization disorders.

Answer: True Page: 225 Level: Easy Type: Factual 7-62. A conversion disorder is a disturbance that does not appear to be under the client’s voluntary control.

Answer: True Page: 227 Level: Easy Type: Factual 7-63. The term “hypochondriac” is associated with a conversion disorder.

Answer: False Page: 227 Level: Easy Type: Factual 7-64. Cognitive-behavioral therapy is a promising approach for treating body dysmorphic disorder.

Answer: True Page: 231 Level: Easy Type: Factual 7-65. Factitious disorders are more common in men than women.

Answer: False Page: 231 Level: Easy Type: Factual

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Chapter 8 Anxiety Disorders 8-1. The beginning of the chapter has Philip Manhards description of his experience in these words: "I dwelt on the good things. I refused to succumb to self-pity. I'd go back and relive the happiest moments." He was describing how he coped with a) learning he had cancer. b) undergoing delicate heart surgery. c) the death of his wife in a car accident. d) solitary confinement as a prisoner in Vietnam.

Answer: d Page: 238 Level: Medium Type: Factual 8-2. Which of the following is the best description of anxiety? a) vague, diffuse apprehension b) fear about something specific c) a cognitive, not physiological event d) physiological responses different from fear Answer: a Page: 238 Level: Medium Type: Factual 8-3. Erin has intense feeling of discomfort. She is described by friends as always waiting for terrible things to happen to her. Erin can’t seem to enjoy her personal life because of fear. These symptoms describe: a) depression b) apprehension c) anxiety d) worry Answer: c Page: 238 Level: Medium Type: Conceptual 8-4. Fear differs from anxiety in that fearful people can a) calm themselves more easily. b) identify the source of their fears. c) effectively repress their feelings. d) approach objects, but not social situations.

Answer: b Page: 238 Level: Medium Type: Factual

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8-5. Rapid heart beat, shortness of breath, diarrhea, loss of appetite, dizziness, sweating, sleeplessness, and tremors accompany a) fear and anxiety. b) fear, but not anxiety. c) anxiety, but not fear. d) neither fear nor anxiety.

Answer: a Page: 238 Level: Medium Type: Factual 8-6. Which of the following is not an anxiety disorder? a) generalized anxiety disorder b) obsessive-compulsive personality disorder c) panic disorder d) phobic disorder Answer: b Page: 239 Level: Medium Type: Factual 8-7. For the past year Dale has been experiencing intense anxiety and worry over minor things, even though there have been no obvious stressors during that time. Dale may be suffering from a) phobia. b) panic disorder. c) generalized anxiety disorder. d) obsessive-compulsive disorder.

Answer: c Page: 239 Level: Medium Type: Conceptual 8-8. In the DSM-II, the word "neurosis" was used to describe disorders marked by anxiety, personal dissatisfaction, and inappropriate (but not psychotic) behavior. Why were these disorders grouped together? a) They involve similar physiological symptoms. b) They respond to the same types of medications. c) They were the result of damage to the nervous system. d) They were thought to be related to similar unconscious processes.

Answer: d Page: 239 Level: Difficult Type: Factual

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8-9. How long must anxiety and worry last before someone can be diagnosed as having generalized anxiety disorder? a) 1 week b) 1 month c) 6 months d) 1 year Answer: c Page: 239 Level: Medium Type: Factual 8-10. Marie describes recurrent, sudden anxiety attacks where she experiences terror and dread. Her sister presents with anxiety but she can identify the cause of the anxiety. Maria has a ________, while her sister would be diagnosed with a ___________. a) panic disorder; phobic disorder b) phobic disorder; generalized anxiety disorder c) panic disorder; obsessive-compulsive disorder d) generalized anxiety disorder; obsessive-compulsive disorder Answer: a Page: 239 Level: Difficult Type: Conceptual 8-11. A survey of the general population was conducted to determine the prevalence of any of the anxiety disorders. If the sample consisted of 1,000, how many people were likely to have reported symptoms meeting the criteria for any anxiety disorder? a) 25 b) 50 c) 125 d) 250 Answer: c Page: 240 Level: Medium Type: Conceptual 8-12. For several weeks, Tony's heart has been beating faster and his breathing has been more difficult. He seems shaky and "on edge", although he is unable to put his finger on his apprehension. Tony consults a psychologist who suggests he is suffering from a) acrophobia. b) dissociative fugue. c) unipolar depression. d) generalized anxiety disorder.

Answer: d Page: 240 Level: difficult Type: Conceptual

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8-13. John has had persistent anxiety for about 8 months. He has also suffered from a racing heart, insomnia, and dizziness. He might meet the criteria for a) panic disorder. b) specific phobia. c) generalized anxiety disorder. d) obsessive-compulsive disorder.

Answer: c Page: 240 Level: Medium Type: Conceptual 8-14. Which of these is a symptom of generalized anxiety disorder? a) flashbacks b) compulsions c) dissociation d) hypervigilance Answer: d Page: 241 Level: Medium Type: Factual 8-15. Allen was recently diagnosed as suffering from generalized anxiety disorder. The psychologist noted that Allen's symptoms were predominantly in a group called autonomic reactivity. Which of the following symptoms are most likely affecting Allen? a) angina, hyperactivity, and insomnia b) dizziness, racing heart, and upset stomach c) amnesia, depersonalization, and nightmares d) delusions, hallucinations, and suicidal ideation Answer: b Page: 241 Level: Difficult Type: Conceptual 8-16. Kirk has been diagnosed with generalized anxiety disorder. He is unable to relax, appears tense, and easily startled. His friend Dick also is diagnosed with generalized anxiety disorder. However, Dick experiences sweating, dizziness, and a high pulse rate. Kirk has symptoms of ____, while Dick has symptoms of______. a) hypervigilance; motor tension b) autonomic reactivity; hypervigilance c) panic; motor tension d) motor tension; autonomic reactivity Answer: d Page: 241 Level: Difficult Type: Conceptual

182 8-17. Which anxiety disorder can be described this way: symptoms that are similar to those of generalized anxiety disorder but more severe and of

quicker onset? a) social phobia b) panic disorder c) specific phobia d) obsessive-compulsive disorder Answer: b Page: 241 Level: Medium Type: Conceptual 8-18. While waiting for his car to be fixed, John was suddenly overcome by an intense fear he has never experienced before. His heart was racing so fast he wondered if he was having a heart attack. John's symptoms are most consistent with a diagnosis of a) fugue. b) dysthymia. c) panic disorder. d) depersonalization.

Answer: c Page: 241 Level: Difficult Type: Conceptual 8-19. Panic disorders differ from generalized anxiety disorders in terms of the a) objects of the fear. b) suddenness of onset. c) type of physical symptoms. d) type of intrapsychic conflict.

Answer: b Page: 241 Level: Medium Type: Factual 8-20. Which of these individuals is most likely to be diagnosed with panic disorder for the first time? a) Agnes who is 20 years old b) Carla who is 45 years old c) Daniel who is 20 years old d) Robert who is 45 years old Answer: a Page: 241 Level: Medium Type: Conceptual

183 8-21. One key to understanding the development of panic disorder involves a psychological approach. For example, when a patient with the diagnosis of panic disorder experiences heart palpitations, she is likely to a) develop depression over the symptom.

b) misinterpret it as a signal of an impending heart attack c) repress thoughts related to physical well being to maintain coping. d) turn attention away from the symptoms by daydreaming or keeping busy on a task.

Answer: b Page: 242 Level: Difficult Type: Conceptual 8-22. Becky has recently been promoted. However, she will have to move to Seattle. Suddenly, she has an abrupt surge of anxiety. Becky has a a) panic attack b) phobic disorder c) generalized anxiety disorder d) psychotic reaction Answer: a Page: 242 Level: Medium Type: Conceptual 8-23. Fear of a panic attack is called a) flooding. b) compulsion. c) obsessive behavior. d) anticipatory anxiety.

Answer: d Page: 243 Level: Medium Type: Factual 8-24. Research on the effectiveness of imipramine has provided evidence that which two conditions might have different sources? a) depression and anxiety b) specific phobias and social phobias c) panic disorder and anticipatory anxiety d) generalized anxiety disorder and obsessive compulsive disorder Answer: c Page: 244 Level: Medium Type: Factual

184 8-25. Which of the following symptoms is more likely to occur in persons with panic disorder than in members of the general population? a) delusions b) brain injury c) hallucinations

d) suicidal thoughts Answer: d Page: 244 Level: Medium Type: Factual 8-26. Generalized anxiety disorders and panic disorders differ most clearly in: a) causal effects b) etiology c) diffuseness and focused intensity of anxiety d) treatment of the anxiety Answer: c Page: 244 Level: Medium Type: Factual 8-27. Which of these individuals is most likely to have a panic attack triggered by an intravenous injection of sodium lactate? a) Barbara who is lactose intolerant b) Alice who suffers from panic disorder c) Denise who has frequent bouts of the flu d) Karin who suffers from generalized anxiety disorder Answer: b Page: 244 Level: Medium Type: Conceptual 8-28. Tim is being given an injection of sodium lactate. He is most likely taking part in research dealing with the causes of a) depression. b) panic disorder. c) generalized anxiety disorder. d) obsessive-compulsive disorder.

Answer: b Page: 244 Level: Medium Type: Conceptual 8-29. What is the origin of the word phobos? a) Phobos is the Greek god of fear. b) Phobos is a Latin word meaning avoidance. c) It is derived from a Latin word meaning anxiety. d) It is a Greek word meaning "to experience queasiness."

Answer: a Page: 245 Level: Medium Type: Factual 185 8-30. What are involuntary, seemingly inexplicable fears that are out of proportion to reality? a) phobias b) obsessions c) compulsions d) anticipatory anxiety Answer: a Page: 245 Level: Medium Type: Factual

8-31. What do most fear-arousing stimuli have in common? a) They are determined by cultural factors. b) They are rarely encountered in day-to-day life. c) They are parts of the modern technological era. d) They were real threats earlier in human evolution.

Answer: d Page: 245 Level: Medium Type: Conceptual 8-32. Which of the following objects is most likely to evoke a phobia? a) a wolf b) a train c) an electrical outlet d) a nuclear power plant Answer: a Page: 245 Level: Medium Type: Conceptual 8-33. All are true of phobias except: a) phobias may start with a generalized anxiety attack b) phobias interfere with normal living c) phobias occur in isolation d) phobias grow broader Answer: c Page: 246 Level: Medium Type: Factual 8-34. Fear of heights is also known as: a) xenophobia b) acrophobia c) agoraphobia d) claustrophobia Answer: b Page: 246 Level: Medium Type: Factual

186 8-35. Dan has been diagnosed as suffering from acrophobia. Which of the following occupations would be a really bad choice for him? a) typist b) bridge painter c) computer technician d) grade-school teacher Answer: b Page: 246 Level: Medium Type: Conceptual 8-36. What is xenophobia?

a) fear of heights b) fear of strangers c) fear of open places d) fear of physical attacks Answer: b Page: 246 Level: Medium Type: Factual 8-37. Ted is thinking about the types of occupations he might enter when he finishes school. There is just one problem, he has claustrophobia and acrophobia. Which of the following occupations would be an especially bad choice for Ted? a) astronaut b) sales clerk c) accountant d) civil engineer Answer: a Page: 246 Level: Medium Type: Conceptual 8-38. Which of the following is the most common type of phobia? a) social phobia b) claustrophobia c) specific phobia d) fear of public speaking Answer: c Page: 246 Level: Medium Type: Factual 8-39. Dennis is terrified of dogs and is claustrophobic. Dennis would have a diagnosis of: a) anxiety b) specific phobia c) agoraphobia d) social phobia Answer: b Page: 246 Level: Medium Type: Factual 187

8-40. The three general categories of phobias in DSM-IV-TR are specific phobias, social phobias, and a) xenophobia. b) acrophobia. c) agoraphobia. d) claustrophobia.

Answer: c Page: 247 Level: Medium Type: Factual 8-41 Sal avoids talking to people because he is afraid they will hear the quivering in his voice and know how terrified he is. He seems to be experiencing a) agoraphobia. b) a panic attack. c) a social phobia. d) a simple phobia.

Answer: c Page: 247 Level: Medium Type: Conceptual 8-42 What type of phobia does someone exhibit if they have a fear of public speaking? a) xenophobia b) agoraphobia c) social phobia d) specific phobia Answer: c Page: 247 Level: Medium Type: Factual 8-43 Why do social phobics avoid contact with other people? a) They fear crowds. b) They aren't interested in relationships. c) They fear making a mistake and being criticized. d) They are afraid of having a panic attack in public.

Answer: c Page: 247 Level: Medium Type: Factual

188 8-44 Danielle has been diagnosed as suffering from social phobia. Her psychologist describes some of the key elements of the disorder and what

she says are the two particularly stubborn features which are a) fears of blushing and of eating. b) daydreaming and hypervigilance. c) fears of vomiting and going "crazy." d) suicidal ideation and auditory hallucinations.

Answer: a Page: 248 Level: Medium Type: Factual 8-45. Agoraphobia involves fear of a) water. b) heights. c) public speaking. d) unfamiliar situations.

Answer d Page: 251 Level: Medium Type: Factual 8-46. Fear of open spaces, traveling, and being in crowds is called a) xenophobia. b) agoraphobia. c) claustrophobia. d) specific phobia.

Answer: b Page: 251 Level: Medium Type: Factual 8-47. Mary is afraid to leave her house. She is terrified that if she goes out, something terrible will happen to her. Mary most likely meets the diagnostic criteria for a) agoraphobia. b) claustrophobia. c) a social phobia. d) a specific phobia.

Answer: a Page: 251 Level: Medium Type: Conceptual 8-48. Agoraphobia is commonly classified as occurring with or without a) panic attacks. b) social phobia. c) specific phobia. d) generalized anxiety disorder.

Answer: a Page: 251 Level: Medium Type: Factual

189 8-49. Research has shown a possible link between agoraphobia and what disorder of childhood? a) specific phobias

b) separation anxiety c) posttraumatic stress disorder d) obsessive-compulsive disorder Answer: b Page: 252 Level: Medium Type: Factual 8-50. In contrast to compulsions, obsessions concern a) rituals. b) people. c) objects. d) thoughts.

Answer: d Page: 252 Level: Medium Type: Factual 8-51. What is the irresistible urge to perform a particular act over and over again? a) psychosis b) obsession c) compulsion d) separation anxiety Answer: c Page: 252 Level: Medium Type: Factual 8-52. Repeated counting, checking, touching or washing as a means of warding off anxiety are examples of a) generalized anxiety. b) obsessive behavior. c) posttraumatic stress. d) compulsive behavior.

Answer: d Page: 252 Level: Medium Type: Factual

190 8-53. For months Al is plagued by worries that he forgot to lock the door, close the windows, or turn off the stove when he leaves for work. His worrying distracts him from his work and is highly upsetting to him. His worries might be an example of a) delusions.

b) obsessions. c) compulsions. d) hallucinations.

Answer: b Page: 252 Level: Medium Type: Conceptual 8-54. Before Larry leaves for work, he spends an hour checking and rechecking to see if he has shut off all the appliances and locked the windows and doors. Larry's behavior represents a) delusion. b) compulsion. c) obsession. d) abreaction.

Answer: b Page: 252 Level: Medium Type: Conceptual 8-55. Sherri constantly thinks of ways to improve her computer. Her husband complains her constant thinking takes time from their marriage.

This is an example of: a) generalized anxiety b) obsessive behavior c) specific phobia d) compulsive behavior Answer: b Page: 252 Level: Medium Type: Conceptual 8-56. Holiday walks home from work everyday. In three years she has worked at the hospital, she will not step on a crack in the sidewalk. This is an example of: a) compulsive behavior b) specific phobia c) agoraphobia d) obsessive behavior Answer: a Page: 252 Level: Medium Type: Conceptual

191 8-57. Based on epidemiological research, which of the following groups experiences obsessive-compulsive disorder at a rate that is higher than the general population? a) young females b) upper-income individuals c) individuals with low socioeconomic status d) individuals with less than a high school education

Answer: b Page: 252 Level: Difficult Type: Conceptual 8-58. Which anxiety disorder is equally common among men as among women and men in the U.S.? a) social phobia b) specific phobia c) generalized anxiety disorder d) obsessive-compulsive disorder Answer: d Page: 252 Level: Medium Type: Factual 8-59. Based on the demographic correlates of obsessive-compulsive disorder, which of these individuals fits the pattern of the most likely person to exhibit the disorder? a) Brian, a high school student, who is African American b) Juan, a teenager who recently immigrated from Mexico c) Andrea, a high school dropout, who lives in a poor inner city neighborhood d) Ken, a graduate of a prestigious university, who lives in an expensive neighborhood Answer: d Page: 252 Level: Difficult Type: Conceptual 8-60. All of the following are features of obsessive-compulsive disorder except: a) recognizing the absurdity and irrationality b) a feeling of dread c) intrusion into the person’s awareness d) being unable to function Answer: d Page: 254 Level: Medium Type: Factual

192 8-61. Obsessional thoughts generally involve a) surreal fantasies. b) unrealistic desires. c) sexual experiences. d) acts the thinker finds distasteful.

Answer: d Page: 255 Level: Medium Type: Factual 8-62. Mary tells her best friend that she always does tasks very carefully, but she does not feel she does these tasks right. Mary is exhibiting the

preoccupation of: a) doubting and conscientiousness b) cleaning c) slowness d) checking Answer: a Page: 255 Level: Medium Type: Conceptual 8-63. Alice has received the diagnosis of obsessive-compulsive disorder.

She believes that this diagnosis means she is psychotic. What can her psychologist tell her concerning her belief that people with this disorder may be psychotic? a) People with this disorder do not harm others. b) The symptoms of this disorder tend to be very brief. c) These people believe they are in control of their behavior. d) People with OCD are aware that their behavior is irrational.

Answer: d Page: 255 Level: Difficult Type: Factual 8-64. When symptoms of one disorder overlap with symptoms of other disorders, a decision is made as to which of several diagnoses is appropriate. This is called a: a) clinical diagnosis b) consult c) differential diagnosis d) working diagnosis Answer: c Page: 255 Level: Medium Type: Factual

193 8-65. A patient at the mental health center has an anxiety disorder and is being treated with a drug that affects serotonin levels. Which of the following disorders is most likely one that will respond to this treatment? a) social phobia b) agoraphobia c) generalized anxiety disorder d) obsessive-compulsive disorder Answer: d Page: 256 Level: Difficult Type: Conceptual 8-66. Under which condition is recovery from posttraumatic stress disorder likely to be most complete?

a) person able to forget the incident b) another stressor distracts the victim c) person already in psychiatric treatment d) symptoms appear soon after the trauma Answer: d Page: 256 Level: Medium Type: Factual 8-67. A United Nations Peacekeeper witnesses extensive shelling and the abuse of prisoners. When he returns to France, he has difficulty concentrating, has recurring nightmares about the war, and cries easily.

What is the most likely diagnosis of the symptoms of his distress? a) narcolepsy b) a dissociative disorder c) an adjustment disorder d) a posttraumatic stress disorder Answer: d Page: 256 Level: Medium Type: Conceptual 8-68. Which of these is a typical feature of posttraumatic stress disorder? a) lethargy b) delusions c) increased arousal d) blocked startle response Answer: c Page: 256 Level: Medium Type: Factual

194 8-69. Which of the following is not an essential characteristic of posttraumatic stress disorder? a) reexperience b) extreme anxiety c) hyperarousal d) avoidance Answer: b Page: 257 Level: Medium Type: Factual 8-70. What are the two major types of posttraumatic stress disorder listed in DSM-IV-TR? a) acute and delayed b) severe and transitory c) primary and secondary

d) social and environmental Answer: a Page: 257 Level: Medium Type: Factual 8-71. Which diagnosis describes symptoms that appear in the first few weeks after a trauma? a) adjustment disorder b) dissociative disorder c) acute stress disorder d) posttraumatic disorder Answer: c Page: 257 Level: Medium Type: Factual 8-72. Which disorders have been found to occur at elevated rates among people who develop posttraumatic stress disorder? a) amnesia and psychosis b) alcohol abuse and depression c) depersonalization and dissociative fugue d) personality disorders and somatoform disorders Answer: b Page: 257 Level: Medium Type: Factual 8-73. Some victims of the effects of PTSD exhibit maladaptive reactions to the trauma that may involve alterations between a) intrusive thinking and denial. b) delusions and hallucinations. c) withdrawal and excessive social activity. d) sleep disturbance and changes in appetite.

Answer: a Page: 257 Level: Medium Type: Conceptual 195 8-74. Al witnessed a mass murder spree involving 12 people. Hidden behind some boxes, he managed to keep out of the killer's line of sight. After several months of suffering with his symptoms, he seeks help. When he asked about possible treatments and their success, what is he likely to be told? a) Antidepressant drugs have the greatest success in treating PTSD symptoms. b) Antianxiety drugs have been the most successful in treating these symptoms. c) Compared to drug treatments, psychological treatments are generally more successful. d) Because the symptoms are very resistant to traditional techniques, hypnosis is widely used and with increasing success.

Answer: c Page: 257 Level: Difficult Type: Conceptual

8-75. How do psychodynamic theorists view clinical anxiety? a) an alarm indicating a threat b) the equivalent of obsessions and compulsions c) a symbolic equivalent of unconscious conflicts d) an alarm sounded in the absence of consciously recognized dangers Answer: a Page: 259 Level: Medium Type: Factual 8-76. What happens in the defense mechanism of isolation? a) a phobic avoids the feared stimulus b) a social phobic avoids other people c) an agoraphobic refuses to leave home d) a person with OCD tends to separate thought from emotion Answer: d Page: 261 Level: Medium Type: Conceptual 8-77. Amy checks her children's rooms’ dozens of times while they are asleep, yet she is quite resentful toward them. Psychologists would describe Amy as exhibiting the defense mechanism of a) undoing. b) denial. c) isolation. d) reaction formation.

Answer: d Page: 261 Level: Medium Type: Factual

196 8-78. Compulsively behaving opposite to one's true thoughts and feelings is called a) undoing. b) isolation. c) flooding. d) reaction formation.

Answer: d Page: 261 Level: Medium Type: Factual 8-79. For which of the anxiety disorders are exposure therapies particularly effective? a) panic disorder and social phobia b) agoraphobia and panic disorder c) phobias and generalized anxiety disorder d) obsessive-compulsive disorder and phobias Answer: d Page: 261 Level: Medium Type: Factual 8-80. What is the most successful treatment for obsessive compulsive

disorder? a) flooding b) implosive therapy c) systematic desensitization d) exposure and response prevention Answer: d Page: 261 Level: Medium Type: Factual 8-81. Zelda sees a psychologist for the treatment of anxiety. The psychologist teaches her to relax on a couch while imagining a series of situations that are more and more anxiety-provoking. What procedure is the psychologist using? a) in-vivo exposure b) implosive therapy c) response prevention d) systematic desensitization Answer: d Page: 261 Level: Difficult Type: Conceptual

197 8-82. In which type of treatment might the psychologist ask the patient to imagine every detail of a feared situation, perhaps in the first session of therapy? a) cognitive restructuring b) in-vivo exposure c) implosive therapy d) systematic desensitization Answer: c Page: 261 Level: Medium Type: Conceptual 8-83. What is the most effective behavioral technique for treating compulsive rituals? a) group therapy b) implosive therapy c) systematic desensitization d) exposure and response prevention Answer: d Page: 261 Level: Medium Type: Factual 8-84. A client is listening to a number of possible treatments for her phobia.

The current treatment being described is implosive therapy. Which of the

following would most likely be the description given? a) "The therapist will recreate the original situation that caused the phobia so it can be re-experienced without pain." b) "You will wear a helmet that will allows you to see a virtual image of the scene that usually causes you to be quite anxious." c) "The therapist will have you practice a series of relaxation exercises and then imagine the feared object while completely relaxed." d) "You will be asked to keep track of the dream themes that occur during the course of therapy for signs that indicate you are overcoming your fears."

Answer: a Page: 261 Level: Difficult Type: Conceptual

198 8-85. Monica has a fear of heights. She consults a psychologist who treats phobias with in-vivo exposure. What is Monica's treatment likely to involve? a) visiting a tall building b) talking with a support group c) imagining being on the top floor of a tall building d) using a computer to simulate visiting a tall building Answer: a Page: 261 Level: Medium Type: Conceptual 8-86. The cognitive perspective on anxiety disorders emphasizes the importance of a) defense mechanisms. b) unconscious motivations. c) unrealistic appraisal of situations. d) behavior as symbolic of underlying conflicts.

Answer: c Page: 262 Level: Medium Type: Factual 8-87. Cognitive restructuring helps clients to a) understand childhood fears. b) develop more realistic self-appraisals. c) learn to approach a feared object in a gradual manner.

d) develop insight into the symbolic meaning of symptoms.

Answer: b Page: 264 Level: Medium Type: Factual 8-88. Which of the following is something that a therapist following Aaron Beck's cognitive therapy would most likely say to a patient suffering a phobia? a) "What are you thinking just as you begin to give a talk?" b) "What dreams related to this phobia have you had recently?" c) "The only way for you to overcome your fear is to trace it back to its origins." d) "Let's examine the symbolic representations in the symptoms that you are presenting."

Answer: a Page: 264 Level: Difficult Type: Conceptual

199

8-89. Gail has an unrealistic thought that if she does not complete medical school she will be a failure. This thought has caused her behavior to become maladaptive. Which therapeutic technique would be helpful? a) modeling b) group therapy c) cognitive restructuring d) exposure prevention Answer: c Page: 264 Level: Medium Type: Conceptual 8-90. Researchers have investigated the biological underpinnings of anxiety disorders and found certain characteristics in people who are prone to severe anxiety disorders. Which of these is one of those characteristics? a) They are prone to epilepsy. b) They tend to be lactose intolerant. c) They are overly sensitive to stimulation. d) They do not respond to antipsychotic medication.

Answer: c Page: 266 Level: Difficult Type: Conceptual 8-91. An experimental human participant is wired so that researchers can obtain quick indications of which areas of the brain are active at any given time. When the research participant is shown stimuli known to cause strong fear responses, the researchers notice activation of the a) pons. b) amygdala. c) cerebellum. d) basal ganglia.

Answer: b Page: 266 Level: Difficult Type: Conceptual 8-92. A group of researchers exposed experimental animals to severe trauma over a course of several months. The animals were sacrificed so that the researchers could examine the animals for evidence of any changes in the brain. What are they likely to find? a) enlarged pons b) enlarged basal ganglia c) reduced size of the frontal lobes d) reduced size of the hippocampus Answer: d Page: 266 Level: Difficult Type: Conceptual

200 8-93. What types of drugs are benzodiazepines? a) stabilizers

b) tranquilizer c) antipsychotic d) antidepressant Answer: b Page: 266 Level: Medium Type: Factual 8-94. In treating anxiety disorders, which drugs are most likely to lead to psychological and physiological dependence? a) antipsychotics b) benzodiazepines c) monoamine oxidase inhibitors d) selective serotonin reuptake inhibitors Answer: b Page: 266 Level: Medium Type: Factual 8-95. A patient suffering from obsessive-compulsive disorder is given a prescription for a tricyclic antidepressant. When the patient asks about possible side effects, which of the following would the physician list? a) amnesia, delusions, and dry mouth b) drowsiness, dry mouth, and seizures c) cataplexy, muscle spasm, and weight loss d) amnesia, depersonalization, and insomnia Answer: b Page: 266 Level: Medium Type: Factual 8-96. What are some of the side effects of benzodiazepine drugs? a) amnesia, hives, and weight gain b) anorexia, delusions, and hallucinations c) depression, nightmares, and weight gain d) drowsiness, lethargy, and reduced ability to concentrate Answer: d Page: 266 Level: Medium Type: Conceptual 8-97. Which drug is approved by the U.S. Food and Drug Administration for the treatment of panic disorder? a) valium b) alprazolam c) imipramine d) thorazine Answer: b Page: 266 Level: Medium Type: Factual

201

8-98. Your sister is being treated by a psychiatrist who has prescribed alprazolam. Which of these disorders is the most likely one for which this drug would be prescribed? a) agoraphobia b) panic disorder c) hypochondriasis d) generalized anxiety disorder Answer: b Page: 266 Level: Medium Type: Conceptual

Essay Questions 8-99. Describe the differences and similarities between fear and anxiety?

Answer: Fear occurs in the presence of an easily identifiable threat. When the threat is not apparent, the fear subsides. Anxiety is a vague sense of apprehension that occurs even in the absence of any easily identifiable threat. Both fear and anxiety have the same physiological manifestations.

Page: 236 Level: Difficult Type: Factual 8-100. Describe the feeling of anxiety.

Answer: The person waits for the worst to happen and cannot enjoy a personal life. The person will have the following: fear, apprehension, rapid heart rate, shortness of breath, loss of appetite, and tremors.

Page: 238 Level: Difficult Type: Factual 8-101. Explain why a social phobic and an agoraphobic might avoid some of the same situations, but for different reasons.

Answer: Both might avoid going to a social event like a party. The social phobic would avoid this situation out of fear of being scrutinized or criticized. The agoraphobic would avoid this situation out of fear of internal cues, especially the possibility of having a panic attack in public.

Pages: 247 – 251 Level: Difficult Type: Factual

202 8-102. What are the most common rituals seen in obsessive-compulsive disorder?

Answer: Checking ("I frequently have to check things like gas or water taps or doors several times."); Cleaning ("I avoid using public telephones because of possible contamination."); Slowness ("I am often late because I can't seem to get through everything on time."); Doubting and conscientiousness ("Even when I do something very carefully, I often feel that it is not quite right.")

Page: 255 Level: Difficult Type: Factual 8-103. What have epidemiological surveys revealed about the lifetime prevalence of posttraumatic disorder?

Answer: Surveys reveal the lifetime prevalence ranges between 1% and 14%; however, more recent surveys suggest that the prevalence is actually higher than past research indicates. About 20% of wounded Vietnam veterans showed symptoms of PTSD. In a study of people who had been present at a mass murder in a cafeteria, 20% of the men and 36% of the women later met the criteria for PTSD. Pages: 256 – 257 Level: Difficult Type: Factual

True/False 8-104. People who have anxiety are aware of the reasons for their fear.

Answer: False Page: 238 Level: Easy Type: Factual 8-105. People who have fear can discuss their fears.

Answer: True Page: 238 Level: Easy Type: Factual 8-106. Neurosis was used in DSM-II to describe disorders marked by anxiety and inappropriate behavior.

Answer: True Page: 239 Level: Easy Type: Factual 8-107. In a phobic disorder, a client’s tension level is low even if the stimulus is present.

Answer: False Page: 245 Level: Easy Type: Factual

203 8-108. Anxiety disorders include varying degrees of maladaptive behavior.

A consideration in diagnosing anxiety disorders includes the client experiencing anxiety, worry, and apprehension for a longer duration and more intensely than the average person.

Answer: True Page: 240 Level: Medium Type: Factual 8-109. John presents with a history of anxiety. However, he is abusing drugs and alcohol. John can be diagnosed with generalized anxiety disorder.

Answer: False Page: 240 Level: Easy Type: Conceptual 8-110. A symptom of generalized anxiety disorder is autonomic reactivity.

A client with this symptom would have the sympathetic and parasympathetic nervous systems affected.

Answer: True Page: 241 Level: Easy Type: Factual 8-111. Agoraphobia is a frequent complication of people diagnosed with panic disorder.

Answer: True Page: 243 Level: Easy Type: Factual 8-112. Stimuli that evoke phobias are random.

Answer: False Page: 245 Level: Easy Type: Factual 8-113. People with specific phobias are usually symptom-free when the probability of the feared stimulus is low.

Answer: True Page: 247 Level: Easy Type: Factual 8-114. “Hoarding” is a dramatic symptom of obsessive-compulsive disorder.

Answer: True Page: 254 Level: Easy Type: Factual

204

Chapter 9 Sexual Variations and Disorders 9-1. The four major groups of problems related to human sexuality are: sexual dysfunction, gender identity problems, paraphilias, and a) bisexuality. b) sexual victimization. c) cross-gender disorders. d) culturally-specific disorders.

Answer: b Page: 271 Level: Medium Type: Factual 9-2. How did the ancient Greeks view homosexuality? a) Homosexuality was viewed as an accepted, pleasurable part of nature. b) Homosexuality was thought to result from conflict between emotion and reason. c) The general view was homosexuality was a sin caused by encounters with the devil. d) In general, homosexuality was thought to occur only in uncivilized societies, so it was actively discouraged.

Answer: a Page: 272 Level: Medium Type: Factual 9-3. In the Middle Ages, why did many women deny they had any sexual thoughts? a) to remain unmarried b) to practice birth control c) to avoid being killed by religious zealots d) to be accepted as members of the military Answer: c Page: 272 Level: Medium Type: Factual 9-4. What was Sigmund Freud's view on bisexuality? a) He believed that people are innately bisexual. b) He believed that bisexuality is caused by repression. c) Based on his clinical cases, he determined that bisexuality was normal for women, but not for men. d) Based on his clinical cases, he decided that people who think they are bisexual are actually delusional.

Answer: a Page: 272 Level: Medium Type: Factual 205 9-5. What contribution did Havelock Ellis make to the study of sexuality? a) He conducted extensive, objective surveys.

b) He described a range of normal sexual behavior. c) He developed the treatment called sensate focus. d) He introduced the idea of repression of sexual urges.

Answer: a Page: 272 Level: Medium Type: Factual 9-6. What type of sample did Alfred Kinsey use in his surveys of sexual behavior? a) randomly selected b) self-selected volunteers c) men enlisted in the military d) patients in clinics for sexual problems Answer: b Page: 272 Level: Medium Type: Factual 9-7. Which of these individuals fits the most common pattern of sexual behavior in the last year as described in the National Opinion Research Center's survey? a) Bret who had one sex partner b) Cara who had five sex partners c) William who is heterosexual, with multiple partners d) Silvia who had a mixed pattern of homosexual and heterosexual activity Answer: a Page: 272 Level: Medium Type: Conceptual 9-8. In what way did the National Opinion Research Center's study of sexual behavior differ from earlier research on the topic? a) They surveyed women as well as men. b) They used a randomly selected sample. c) Children and adolescents were interviewed. d) Cross cultural attitudes in the media were examined.

Answer: b Page: 272 Level: Medium Type: Factual

206 9-9. How often does the average American between the ages of 18 and 59 engage in sex? a) once a day b) once a month

c) six times a year d) a few times a month Answer: d Page: 272 Level: Medium Type: Factual 9-10. What is the median number of sexual partners over a lifetime for American men? a) 2 b) 6 c) 10 d) 15 Answer: b Page: 272 Level: Medium Type: Factual 9-11. Imagine that you are asked to help the researchers who conducted the National Opinion Research Center sex survey. Which of the following might make for a good and accurate title for the version of the findings intended for the general public? a) "Sexual Behavior: More Deviant by the Day" b) "Want to be Happy and Have More Sex? Try Monogamy" c) "Hidden Perversions: How Middle-America is Changing its Sexual Habits" d) "Still Uptight After All These Years: Americans Are Talking More About Sex and Having Less" Answer: b Page: 272 Level: Difficult Type: Conceptual 9-12. What are the two major reasons that younger women have sex for the first time according to the National Opinion Research Center Survey? a) peer pressure and affection for their partner b) drug-induced decision-making and peer pressure c) rebellion against parents and drug-induced decision-making d) personal pleasure and imitating behavior seen on television Answer: a Page: 272 Level: Medium Type: Factual

207 9-13. What is the median number of sexual partners over a lifetime for adult American women? a) 2 b) 6 c) 10 d) 15

Answer: a Page: 273 Level: Medium Type: Factual 9-14. Which of the following individuals represents the modal individual in terms of sexual activity in the past year? a) Andy who had one sexual partner b) Barry who had four sexual partners c) Sam who had relied on oral sexual exclusively d) Thomas who has had sex with both men and women Answer: a Page: 273 Level: Medium Type: Conceptual 9-15. Two anonymous surveys with similar response rates yield two very different estimates of the percent of the population that identifies as homosexual. A professor uses the examples to teach students in a research class. What is the lesson that is most likely to be learned from this finding? a) The geography of the samples can influence results. b) The wording of questions can determine the response rate. c) Most people will not admit their homosexuality even in anonymous surveys. d) Topics such as sexual behavior lead to very low response rates, that make the surveys not interpretable.

Answer: a Page: 273 Level: Difficult Type: Conceptual 9-16. What change in sexual practices has occurred over the last several decades in the United States? a) first intercourse occurs later b) higher reported rates of homosexuality c) males responding less to peer pressure d) oral sex more widely accepted by college students Answer: d Page: 274 Level: Medium Type: Factual

208 9-17. Why do homosexuals used the term “gay” to describe their lifestyle? a) The term refers to the ancient Greek god of homosexuality. b) The term has fewer negative implications than homosexual. c) Surveys reveal the term is preferred by the majority of the general population. d) The term gay was the first term used to describe their lifestyle more than 200 years ago.

Answer: b Page: 275 Level: Medium Type: Conceptual

9-18. What are the views of the American Psychological Association and the American Psychiatric Association concerning homosexuality? a) The two organizations have no formal position on homosexuality. b) The two organizations currently hold opposed views of homosexuality. c) The two organizations have voted to remove homosexuality from the list of mental illnesses. d) The two organizations maintain homosexuality as a mental illness, but only in cases of severe psychological discomfort.

Answer: c Page: 275 Level: Medium Type: Factual 9-19. Which of the following has had a major impact on the sexual behaviors of people? a) sexually transmitted diseases b) Viagra c) AIDS and HIV virus d) fulfilling sexual fantasies Answer: c Page: 276 Level: Medium Type: Factual 9-20. Society’s labeling and stigmatizing of homosexuals can be: a) harmful, cause anxiety, and lead to self-doubt b) a source of frustration c) a psychosocial factor in acceptance to certain groups d) hurtful and create confusion with regard to sexual orientation Answer: a Page: 276 Level: Medium Type: Factual

209 9-21. Which of the following statements is not associated with empirically based evidence regarding homosexuality? a) Lesbians and gay men differ in their adjustment to sexual orientation. b) A majority of children identified themselves as heterosexual even though they were raised in lesbian families. c) Adjustment of children from heterosexual parents and gay or lesbian parents is about the same. d) Lesbians and gay men do not differ in psychological adjustment from heterosexual men and women.

Answer: a Page: 276 Level: Difficult Type: Factual 9-22. Why might homosexual males be at higher risk for psychological disorders? a) Homosexuality is a mental illness. b) The AIDS crisis causes increased stress. c) They are biologically predisposed to mental disorders. d) They are probably unaware of resources available to them.

Answer: b Page: 276 Level: Medium Type: Conceptual 9-23. Which part of the brain has been the focus of research on possible anatomical differences between homosexual and heterosexual men? a) cortex b) hippocampus c) hypothalamus d) medulla oblongata Answer: c Page: 276 Level: Medium Type: Factual 9-24. What is an important limitation of research showing differences in the hypothalamus of heterosexual and homosexual men? a) no control for brain size b) inappropriate statistical tests c) The homosexual men had died of AIDS. d) The heterosexual men had brain injuries.

Answer: c Page: 276 Level: Medium Type: Factual

210 9-25. Angela is bisexual. What would be a mental health concern that should be addressed? a) psychosocial factors regarding adjustment b) psychobiological factors regarding gender c) conflict over her “true” sexual identity d) stressors encountered with this lifestyle Answer: c Page: 276 Level: Medium Type: Conceptual 9-26. What do all of the sexual dysfunctions covered by DSM-IV-TR have in common? a) They cause distress or interpersonal difficulty. b) They are symbolically related to early childhood conflicts.

c) Each of them has a different and specific genetic cause. d) Each of them can occur at each of the stages of the sexual response cycle.

Answer: a Page: 277 Level: Medium Type: Conceptual 9-27. A review of the concordance rates for homosexuality among twin brothers indicates the rate of homosexuality in fraternal twins was 22%.

How have researchers interpreted this finding? a) The rate points to the influence of genetic factors. b) The finding confirms previous results indicating homosexuality does not have a genetic basis. c) This rate is above the rate for non-twin brothers and thus points to environmental influences. d) The finding indicates the key factor in homosexuality is having a same-sex sibling in the household.

Answer: c Page: 277 Level: Difficult Type: C/A 9-28. Ed’s wife reports he has lost interest in sexual activity. He is not responsive, and she is considering divorce. Ed has a: a) sexual aversion b) problem specific to arousal c) sexual dysfunction d) None of the above.

Answer: c Page: 277 Level: Medium Type: Conceptual

211 9-29. Predisposing factors to sexual dysfunction include: a) child-rearing factors b) sexual trauma c) anticipation of failure d) All of the above.

Answer: d Page: 277 Level: Medium Type: Factual 9-30. Which statement is true regarding sexual dysfunctions? a) Most sexual dysfunctions have an array of causal factors. These factors can range from psychological to organic. b) Most causal factors for sexual dysfunction are specific with relation to psychological areas. c) Psychological factors and preexisting biological factors should be

the focus of the clinical interview. d) Interpersonal factors are important with regard to sexual dysfunctions with psychological predispositions being the main focus of the clinical interview.

Answer: a Page: 277 Level: Difficult Type: Factual 9-31. ________involves components shaped by development and cultural influences while _________ involves excitement and pleasure. a) Sexual arousal; orgasm b) Sexual desire; orgasm c) Sexual desire; sexual arousal d) Sexual arousal; sexual desire Answer: c Page: 277 Level: Medium Type: Factual 9-32. What are the three major categories of sexual dysfunctions in DSM-IVTR? a) desire, arousal, orgasm b) primary, secondary, tertiary c) homosexual, heterosexual, bisexual d) environmental, genetic, interactional Answer: a Page: 277 Level: Medium Type: Factual

212 9-33. Which of the following involves inability to attain an erection? a) erectile dysfunction b) retarded ejaculation c) premature ejaculation d) nocturnal penile tumescence Answer: a Page: 278 Level: Medium Type: Factual 9-34. At what stage of the sexual response cycle does erectile dysfunction occur? a) desire b) orgasm c) arousal d) resolution Answer: c Page: 278 Level: Medium Type: Factual

9-35. What is the most common sexual problem for which men seek treatment? a) erectile dysfunction b) retarded ejaculation c) inhibited sexual desire d) nocturnal penile tumescence Answer: a Page: 278 Level: Medium Type: Factual 9-36. Which of the following describes a case of erectile dysfunction? a) a man does not keep an erection throughout intercourse b) a woman sometimes loses the ability to achieve orgasm c) a woman who for the past year has had no interest in achieving orgasm d) a man who has never been able to sustain an erection long enough for coitus Answer: d Page: 278 Level: Medium Type: Conceptual 9-37. Which disorder could possibly lead to a panic attack with feelings of terror? a) erectile dysfunction b) inhibited sexual arousal c) hypoactive sexual desire disorder d) sexual aversion disorder Answer: d Page: 278 Level: Medium Type: Factual 213 9-38. Erectile dysfunction occurs in men at the arousal stage. In women, a problem at this stage is called: a) sexual aversion disorder b) inhibited sexual arousal c) hypoactive sexual desire disorder d) sexual dysfunction Answer: b Page: 278 Level: Medium Type: Factual 9-39. In which disorder will the participant possibly suppress sexual desire? a) erectile disorder b) inhibited sexual arousal c) sexual aversion disorder d) hypoactive sexual desire disorder Answer: d Page: 278 Level: Medium Type: Factual 9-40. Which of these is a common physical cause of erectile dysfunction? a) diabetes

b) cirrhosis c) Grave's disease d) sickle cell anemia Answer: a Page: 278 Level: Medium Type: Factual 9-41. What is nocturnal penile tumescence (NPT)? a) changes in penis size during sleep b) male timidity about being seen naked c) increased frequency of intercourse at night d) a biological problem associated with bedwetting Answer: a Page: 279 Level: Medium Type: Factual

214 9-42. After years of anxiety concerning his sexual performance, Sam decides to see a specialist. Part of the evaluation involves observation of Sam during sleep. After the evaluation, the specialist concludes that Sam's problem is psychological, not physiological. On what basis could the specialist have drawn this conclusion? a) Sam had a penile erection during sleep. b) Sam's dreams were normal for a healthy male. c) The tight clothing Sam wears during the day accounted for his sexual difficulties. d) Sam spent so much time preparing for bed that he was too tired to engage in sexual behaviors.

Answer: a Page: 279 Level: Difficult Type: Conceptual 9-43. Roger has recently experienced several episodes of impotence and has become so worried about it that the frequency of the impotence is increasing. What is the likely cause of this difficulty? a) frigidity b) hormonal imbalance c) performance anxiety

d) functional dyspareunia Answer: c Page: 279 Level: Medium Type: Factual 9-44. How does retarded ejaculation differ from premature ejaculation? a) The response to sexual stimuli is with erotic feelings but ejaculation does not occur. b) The failure to control orgasm results from feelings of sexual inadequacy. c) Anxiety occurs from conflict with partners. d) Orgasm occurs but is insufficient for pleasure.

Answer: a Pages: 279, 281 Level: Medium Type: Factual 9-45. What is the most common form of male sexual dysfunction? a) dyspareunia b) premature ejaculation c) inhibited sexual desire d) nocturnal penile tumescence Answer: b Page: 279 Level: Medium Type: Factual

215 9-46. Richard is having difficulty with his sex life because he climaxes as soon as his penis enters his partner. Sometimes he climaxes even before penetration. What is the likely diagnosis? a) dyspareunia b) premature ejaculation c) nocturnal penile tumescence d) inhibited sexual desire disorder Answer: b Page: 279 Level: Medium Type: Conceptual 9-47. Vaginismus is characterized by a) chronic vaginal infections. b) inability to maintain lubrication. c) lack of interest in or fantasy about sex. d) involuntary spasms of the outer portion of the vagina.

Answer: d Page: 281 Level: Medium Type: Factual 9-48. Over the last several months, every time Marla has attempted sexual intercourse she has experienced spasms of the muscles surrounding the vagina, which made intercourse impossible. What is the most likely diagnosis in this case? a) vaginismus

b) dyspareunia c) sexual aversion disorder d) female sexual arousal disorder Answer: a Page: 281 Level: Medium Type: Conceptual 9-49. Which of these sexual disorders can occur in both men and women? a) vaginismus b) anorgasmia c) dyspareunia d) erectile disorder Answer: c Page: 281 Level: Medium Type: Factual

216 9-50. What was the major contribution of William Masters and Virginia Johnson to the study of sexuality? a) They treated sexual disorders with psychoanalysis. b) They developed objective surveys of attitudes about sex. c) They explored the role of repression in sexual dysfunction. d) They conducted laboratory studies of human sexual behavior.

Answer: d Page: 282 Level: Medium Type: Factual 9-51. What does the technique of sensate focus involve? a) reducing aggressive fantasies b) open discussion about sexual problems c) focusing on pleasures of tactile contact d) emphasis on vaginal orgasms for women Answer: c Page: 282 Level: Medium Type: Factual 9-52. What are couples encouraged to do in the early stages of sensate focus? a) explore each others' bodies b) try intercourse in a new setting c) argue openly about past incidents d) focus on the woman having an orgasm Answer: a Page: 282 Level: Medium Type: Conceptual

9-53. Why is the squeeze technique used in sex therapy? a) to eliminate ejaculation b) to sexually arouse a male's partner c) to recondition the ejaculatory reflex d) to encourage exploration of the partner's body Answer: c Page: 282 Level: Medium Type: Factual 9-54. The Masters and Johnson technique of sensate focus is most similar to a) flooding. b) psychotherapy. c) cognitive restructuring. d) systematic desensitization.

Answer: d Page: 282 Level: Medium Type: Conceptual

217 9-55. Which of the following is the most accurate characterization of Helen Singer Kaplan's technique for treating sexual dysfunction? a) medical b) existential c) humanistic d) psychodynamic Answer: d Page: 284 Level: Medium Type: Factual 9-56. Which behavior is characteristic of gender-identity disorder of childhood? a) being mistaken for the opposite sex b) sexual play with members of same sex c) difficulty identifying others as male or female d) expressing a vehement desire to be of the opposite sex Answer: d Page: 285 Level: Medium Type: Conceptual 9-57. Gender identity refers to a person's a) biological sex. b) sense of being male or female. c) attitudes about sex-typed behaviors. d) willingness to conform to sex-role stereotypes.

Answer: b Page: 285 Level: Medium Type: Factual 9-58. What is the difference between gender identity and sexual preference? a) Gender identity refers to basically homosexual relationships;

sexual preference refers to heterosexual relationships. b) Gender identity involves choice of sexual partners; sexual preference involves one's view as being either male or female. c) Gender refers to behaviors that are psychological in nature; sexual preference refers to behaviors that are genetically caused. d) Gender identity involves whether a person views themselves as male or female; sexual preference involves attraction to either a male or a female.

Answer: d Page: 285 Level: Difficult Type: Conceptual

218 9-59. A newspaper story described a 26-year-old man who has an intense desire to change his physical sex. In the account, the reporter wrote that she asked a physician for the appropriate term to describe this man. What term was used? a) transsexual b) transvestite c) homosexual d) pseudohermaphrodite Answer: a Page: 287 Level: Medium Type: Conceptual 9-60. Several times a week Vince dresses and acts as a woman. He does not cross dress to get sexual gratification, but because he wishes he could be a woman. He does not want to have surgery or otherwise change his secondary sex characteristics. What diagnosis would a psychologist suggest as the most appropriate one in this case? a) exhibitionism b) transvestism c) transsexualism d) a dressing fetish Answer: c Page: 287 Level: Difficult Type: Conceptual 9-61. Which of the individuals exhibits behavior that seems to fit with the diagnosis of nontranssexual gender identity disorder? a) Bob who is homosexual b) Dan who has experienced temporary, pre-pubertal distress concerning his sexual orientation c) Eileen who feels discomfort concerning her biological sex and is preoccupied with getting rid of her sex characteristics

d) Felicia who feels discomfort about her assigned sex, although she is not preoccupied with getting rid of her sex characteristics Answer: d Page: 287 Level: Difficult Type: Conceptual 9-62. What are the two types of gender identity disorder in adults according to DSM-IV-TR? a) primary and secondary b) sexual and bisexual transsexualism c) transvestic fetishism and bisexuality d) transsexualism and nontransexual gender identity disorder Answer: d Page: 287 Level: Medium Type: Factual 219 9-63. Al has been diagnosed as a transsexual; Bob has the diagnosis of nontranssexual gender identity disorder. What is the most significant difference between these two individuals? a) Al is likely to be delusional; Bob has no evidence of delusions. b) Al is preoccupied with getting rid of his sexual characteristics, Bob is not. c) Al is likely to have genetic and hormonal defects; Bob has no genetic or hormonal defects. d) Al is likely to have been sexually abused as a child; Bob is more likely to have been sexually abused in his adolescent years.

Answer: b Page: 287 Level: Difficult Type: Conceptual 9-64. The approximate rate of transsexualism in the United States is 1 in every a) 10,000. b) 50,000. c) 100,000. d) 250,000.

Answer: c Page: 287 Level: Medium Type: Factual 9-65. How long are candidates for sex-change operations usually required to live in the community as a member of the opposite sex? a) 1 or 2 weeks b) 1 or 2 months c) 1 or 2 years d) 10 to 12 years Answer: c Page: 287 Level: Medium Type: Factual

220 9-66. Andy is a transsexual who has been accepted for sex reassignment surgery. What is likely to happen in the 1 to 2 years he will wait for the surgery? a) He will be given hormone injections to alter secondary sex characteristics. b) He will undergo covert sensitization in insure that he really wants to change his sex organs. c) He will undergo psychoanalytic treatment in order to align his unconscious with the changes that will take place. d) He will have his chromosomes checked to insure that he has not suffered damage from all of the testing required prior to being accepted for surgery.

Answer: a Page: 287 Level: Difficult Type: Factual 9-67. Why do clinicians stress the need for careful evaluation of candidates for sex-change operations? a) The surgery has a high fatality rate. b) There is a high rate of psychological disturbances. c) Many candidates for the surgery are fugitives from the law. d) Candidates for the surgery often have genetic abnormalities.

Answer: b Page: 287 Level: Medium Type: Conceptual 9-68. In contrast to transvestites, transsexuals are characterized by a) chronic exhibitionism. b) a concurrent paraphilia. c) sexual arousal when cross-dressing. d) a desire to live as a member of the opposite sex.

Answer: d Page: 287 Level: Medium Type: Conceptual 9-69. What is a paraphilia? a) an extra-marital relationship b) a philosophy of sexual responsibility

c) a vibrator used for sexual gratification d) sexual attraction to something deviant Answer: d Page: 289 Level: Medium Type: Factual

221 9-70. An individual spends part of his typical night peeking into windows in order to watch people as they undress; the rest of the night he kisses and fondles a black boot. What two paraphilias does this person exhibit? a) voyeurism and fetishism b) pedophilia and fetishism c) exhibitionism and sadism d) pedophilia and voyeurism Answer: a Page: 289 Level: Medium Type: Conceptual 9-71. What term do we use for sexual attraction to a nonliving object? a) fetishism b) transvestism c) exhibitionism d) transsexualism Answer: a Page: 289 Level: Medium Type: Factual 9-72. Dean finds it impossible to reach orgasm unless he is holding and kissing a woman's shoe. This problem is an example of the paraphilia known as a) fetishism. b) voyeurism. c) pedophilia. d) transvestic fetishism.

Answer: a Page: 289 Level: Medium Type: Conceptual 9-73. What is the primary source of sexual arousal in cases of fetishism? a) children b) humiliation c) inanimate objects d) nonconsenting partners Answer: c Page: 289 Level: Medium Type: Factual 9-74. Which of the following is the most typical fetishist? a) Amy who loves to dress in silk clothing

b) Robert who loves to expose his genitals to strangers c) Roberta who works as an exotic dancer at a local club d) Andy who masturbates while wearing rubber garments Answer: d Page: 290 Level: Medium Type: Conceptual

222 9-75. Tom has decided to seek therapy for his fetishism. Which of the following treatments is most likely to be recommended? a) Gestalt therapy b) aversion therapy c) client-centered therapy d) systematic desensitization Answer: b Page: 292 Level: Medium Type: Conceptual 9-76. Why is transvestic fetishism generally limited to men? a) It is motivated by a desire to be dependent. b) It is caused by a need to imitate one's mother. c) Male clothing styles are not attractive to women. d) Society is more accepting of women in masculine clothing.

Answer: d Page: 292 Level: Medium Type: Conceptual 9-77. Why is the case of Billy Tipton, the jazz musician from the 1930s, important? a) It was a case of undetected female cross-dressing. b) Tipton underwent the first successful sex-change operation. c) Tipton was involved in pre-1960s "drag" show for entertainment. d) It was a rare case in which pedophilia was accepted by a community.

Answer: a Page: 292 Level: Medium Type: Conceptual 9-78. What have studies of the personality characteristics of transvestites revealed? a) They are often fearful and ill-at-ease among women. b) They do not differ in many areas of personality from nontransvestites. c) They are generally more outgoing than members of the general population. d) They have repressed sexual abuse in childhood that haunts them in their adulthood lives.

Answer: b Page: 292 Level: Medium Type: Factual

223 9-79. Although studies of the personality of transvestites have found that they do not differ in many areas of personality, there are some differences such as a tendency for transvestites to be a) less responsible. b) more independent. c) less conscientious. d) more achievement oriented.

Answer: b Page: 292 Level: Medium Type: Factual 9-80. In covert sensitization, individuals who want to eliminate their transvestism create vivid mental images of cross-dressing and pair them with a) shocks. b) aversive images. c) positive self-statements. d) sexually-arousing stimuli.

Answer: b Page: 293 Level: Medium Type: Factual 9-81. Which of these individuals is engaging in behavior that would be described as sadistic sexual behavior? a) George who is aroused by a fetish b) Harry who is aroused when being hurt c) John who is aroused when cross-dressing d) Kevin who is aroused by humiliating someone Answer: d Page: 294 Level: Medium Type: Conceptual 9-82. Which of the following individuals fits the typical pattern of someone involved in masochistic sexual behavior? a) Ted who enjoys being slapped during sex b) Barbara who dresses in men's clothing during sex c) Veronica who likes to humiliate her partner during sex d) Ray who cannot achieve orgasm unless he is holding something made of rubber Answer: a Page: 294 Level: Medium Type: Conceptual

224 9-83. Roger has recurrent, sexual urges and related fantasies about torturing his sexual partner. He acts out these fantasies with a prostitute.

Which of the following is the best description of Roger's disorder? a) sadism b) masochism c) scatologia d) sadomasochism Answer: a Page: 294 Level: Medium Type: Factual 9-84. At a cocktail party, you become involved in a conversation involving sexual behavior. As you learn, some of the guests are sadomasochists.

Your curiosity gets the better of you and you ask one of them to describe his views on his sexual interests. Which of the following are you likely to hear in response to your question? a) "My sexual interests are natural and have been present since I was a child." b) "I recognize that genetic factors are responsible for my sexual interests and I do resist them." c) "As a result of sexual abuse early in my life I now seek sexual outlets that involve pain and suffering because it is all I know." d) "My confusion over sexual orientation has led me to investigate a wide variety of sexual outlets until I find that one that fits me best."

Answer: a Page: 294 Level: Difficult Type: Conceptual 9-85. What is the root of the sexual disorder called voyeurism? a) It is derived from a Latin word meaning deviant. b) It is derived from a French word meaning watcher. c) The root is a combination of two Greek words meaning sexual disorder. d) The root is a combination of two Latin words meaning aggressive encounter.

Answer: b Page: 295 Level: Medium Type: Factual

225 9-86. What disorder is associated with men and involves exposing their genitals? a) voyeurism b) exhibitionism c) fetishism d) masochism Answer: b Page: 295 Level: Medium Type: Factual 9-87. Robert has intense and recurrent sexual urges regarding children.

What is Robert’s diagnosis? a) exhibitionism b) voyeurism c) pedophilia d) fetishism Answer: c Page: 296 Level: Medium Type: Conceptual 9-88. The state police are analyzing data on arrests in order to advise a legislative body responsible for funding. When the look at sex offenders they find that one offense accounts for one third of all sex offenses. Which one is this? a) fetishism b) voyeurism c) masochism d) exhibitionism Answer: d Page: 296 Level: Difficult Type: Factual 9-89. Al has been arrested several times in the past and has been diagnosed as an exhibitionist. Which of the following individuals is most likely to be someone to whom Al would expose his genitals? a) a member of his family b) a woman he sees on the street c) fellow workers at the manufacturing plant d) one of the owners of the plant where he works Answer: b Page: 296 Level: Difficult Type: Conceptual

226 9-90. Lonnie repeatedly acts on recurrent, powerful urges to expose his

genitals to unsuspecting women, in hopes of shocking and arousing them.

What is Lonnie's disorder? a) fetishism b) voyeurism c) masochism d) exhibitionism Answer: d Page: 296 Level: Medium Type: Factual 9-91. How is exhibitionism similar to other compulsions? a) begins in old age b) involves little guilt c) is associated with intense anxiety d) is rarely detected by the legal system Answer: c Page: 296 Level: Medium Type: Conceptual 9-92. Eight-year-old Danny was molested by a pedophile. Based on police reports, which of these individuals is the most likely pedophile? a) a 13-year-old girl friend b) Danny's 20-year-old neighbor c) another boy in Danny's elementary school d) a 45-year-old stranger who abducted Danny from the street Answer: a Page: 296 Level: Medium Type: Conceptual 9-93. To be classified as a pedophile, a person must have acted on urges to engage in sexual activity with a child OR a) possess child pornography. b) have been accused of doing so. c) be very distressed by the urges. d) have been sexually abused as a child.

Answer: c Page: 296 Level: Medium Type: Factual

227 9-94. Which of the following represents the most common victim of a pedophile? a) a child who has known the perpetrator for several years

b) a child who is a complete stranger and is abducted at random c) a young child who is a close member of the pedophile's family d) a young hitchhiker who was abducted as she walked home on a lonely road late at night Answer: a Page: 296 Level: Medium Type: Conceptual 9-95. Sexual harassment: a) occurs in the workplace. b) may not involve physical assault. c) involves unwanted sexual attention. d) All of the above.

Answer: d Page: 298 Level: Medium Type: Factual 9-96. A judge is hearing a case in which a person is charged with a crime of sexual victimization. After the individual is convicted, the judge decides that he wants to hear about options for treatment. Which of the following will mental health professionals tell the judge has shown promise for sexual victimizers? a) Gestalt therapy b) Rogerian therapy c) electroconvulsive therapy d) cognitive behavior therapy Answer: d Page: 298 Level: Difficult Type: Factual

Essay Questions 9-97. What are the limitations of survey research in the study of sexuality?

Answer: Likely to contain bias or intentional misreporting (under- or overreporting); incomplete recall; misunderstanding of survey questions; selective participation in a survey. These problems plague all survey research, but may be especially problematic when the topic is a sensitive one like sexuality.

Page: 272 Level: Difficult Type: Factual

228 9-98. What research evidence contributed to the decisions by the American Psychiatric Association and the American Psychological Association to remove homosexuality from the list of mental illnesses?

Answer: Homosexuals do not differ from heterosexuals in terms of psychological adjustment, and the adjustment of children of lesbian or gay

parents does not differ from that of children with heterosexual parents.

Page: 275 Level: Difficult Type: Factual 9-99. What are the three general goals for a couple in sex therapy?

Answer: The three general goals are 1) to engender an atmosphere of mutual communication; 2) to decrease fear of failure; and 3) to shift in attention away from the fear of failure to the experience of sensory pleasure.

Page: 281 Level: Difficult Type: Factual 9-100. What are the major differences between tranvestism and transsexualism?

Answer: Transsexuals wish to change their genitals and live as members of the opposite sex. They do not experience sexual arousal when crossdressing. Transvestites, on the other hand, may become sexually aroused when cross-dressing but continue to identify themselves as members of their biological sex.

Pages:. 287, 292 Level: Difficult Type: Factual 9-101. What are the three general classes of paraphilia?

Answer: Preference for use of nonhuman objects for sexual arousal; repetitive sexual activity with humans that involves real or simulated suffering or humiliation; repetitive sexual activity with nonconsenting partners.

Page: 289 Level: Difficult Type: Factual 9-102. What are the five major features of sadomasochism?

Answer: 1) Agreement as to which partner is to be dominant and which one submissive; 2) awareness by both partners that are they are role-playing; 3) the consent of both participants; 4) a sexual context; 5) a shared understanding by both participants that their behavior is sadomasochistic.

Page: 294 Level: Difficult Type: Factual

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True/False 9-103. In his discussion of sexuality, Freud stated that all people are initially bisexual.

Answer: True Page: 272 Level: Easy Type: Factual 9-104. Little if any information is known concerning where people acquire their ideas about sex.

Answer: True Page: 274 Level: Easy Type: Factual 9-105. Homosexuality is still on the list of mental illnesses.

Answer: True Page: 275 Level: Easy Type: Factual 9-106. Mary’s belief that she is homosexual is dependent on her actual behavior.

Answer: False Page: 275 Level: Easy Type: Factual 9-107. Sexual orientation is a strong developmental process during adolescence. Adolescents whose identity may be gay or lesbian have a high level of suicide attempts during this time period.

Answer: True Page: 276 Level: Easy Type: Factual 9-108. A diagnosis of sexual dysfunction can be given even if the problem is entirely due to organic factors.

Answer: False Page: 277 Level: Easy Type: Factual 9-109. Over 50% of men requesting treatment for sexual disorders have erectile dysfunction.

Answer: True Page: 278 Level: Easy Type: Factual 9-110. Viagra has stimulated little interest in whether medication may be useful in treating sexual dysfunction in women.

Answer: False Page: 284 Level: Easy Type: Factual 9-111. Sexual preference, in part, refers to a person’s sexual self-concept.

Answer: False Page: 285 Level: Easy Type: Factual

230 9-112. Characteristics of paraphilias are specialized sexual fantasies, sexual props, and masturbation.

Answer: True Page: 289 Level: Easy Type: Factual

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Chapter 10 Personality Disorders 10-1. Which of the following is not a dimension of personality? a) cognitive b) social c) behavioral d) emotional Answer: b Page: 303 Level: Medium Type: Factual 10-2. Steven always responds to people with warmth and affection. He listens to people and cares what happens to others. He is task-oriented, and will not miss work even if he is ill. This description of Steven is his: a) standard of behavior b) personality c) maladaptive way of dealing with people d) style of interaction Answer: b Page: 304 Level: Medium Type: Conceptual 10-3. Dr. B., whose case was described in the text, rushed back to the hospital, despite the fact that he was going to attend his son's final high school basketball game. After arriving at the hospital, he decided to stay until his patient delivered.

Why did Dr. B make this decision? a) He felt he was the only one who should deliver the baby, which reflected his narcissism. b) His dedication to every detail imaginable led him to insist on delivering the baby, which reflects his obsessive-compulsive personality. c) Although he said he wanted to attend his son's game, his schizoid tendencies led him to select an activity with fewer people present. d) Although he knew his partner was capable of handling the delivery, he did not trust his partner and was suspicious of his every activity.

Answer: a Page: 304 Level: Difficult Type: Factual

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10-4. Which of these is an example of a maladaptive personality style? a) using multiple coping mechanisms b) exhibiting different behaviors in different situations c) demonstrating changes in personality style over the life span d) using one coping mechanism for many types of problems Answer: d Page: 304 Level; Medium Type: Conceptual 10-5. Which disorders are characterized by longstanding, maladaptive, inflexible ways of relating to the environment? a) mood b) psychotic c) personality d) somatoform Answer: c Page: 304 Level: Medium Type: Factual 10-6. What is the estimated prevalence of personality disorders in the general population? a) 2% b) 6% c) 12% d) 24% Answer: c Page: 304 Level: Medium Type: Factual 10-7. According to DSM-IV-TR, when are the characteristics of a personality disorder evident? a) infancy b) early childhood c) adolescent years d) middle adulthood Answer: c Page: 304 Level: Medium Type: Factual 10-8. Why has so little research been done on the personality disorders? a) Personality disorders are not easily recognized. b) Personality disorders are rare in the general population. c) Few people with personality disorders are in treatment. d) People with personality disorders exhibit very peculiar behaviors.

Answer: c Page: 304 Level: Medium Type: Factual 233

10-9. When is a personality style considered maladaptive? a) When it affects the person’s functioning in important situations b) flexibility occurs, but not in every situation c) if the person will not change d) The person is unable to modify behavior when the environment changes.

Answer: c Page: 305 Level: Medium Type: Factual 10-10 What is the major difference between Axis I and Axis II disorders? a) Axis I disorders are symptom disorders, and have some flexibility with regard to prognosis which Axis II disorders are near-permanent. b) Axis I disorders are almost always organic in nature of onset, while Axis II disorders are triggered by environmental factors. c) Axis I disorders are genetic, while Axis II disorders are psychological. d) Axis I disorders involve family dynamics, and Axis II disorders involve family dynamics as a predisposing cause.

Answer: a Page: 305 Level: Medium Type: Factual 10-11. Personality disorders are listed on Axis II of DSM-IV-TR, along with what other type of disorder? a) psychosis b) mood disorders c) medical problems d) mental retardation Answer: d Page: 305 Level: Medium Type: Factual 10-12. Why are personality disorders and mental retardation listed on the same diagnostic axis of DSM-IV-TR? a) They are lifetime conditions. b) They are inherited disorders. c) They do not respond to medication. d) They are less serious than other disorders.

Answer: a Page: 305 Level: Medium Type: Factual

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10-13. What characterizes the disorders listed on Axis I of the DSM-IV-TR diagnostic system? a) They have a chronic course, without remittance. b) They are temporary and cause personal distress. c) They have medical conditions that are associated with them. d) They are the result of failures in the use of defense mechanisms.

Answer: a Page: 305 Level: Medium Type: Factual 10-14. Don's co-workers perceive him to be very suspicious and family members have described him as "constantly angry." Many of his neighbors have moved because they have gotten tired of his frequent angry outbursts, which often result from his belief that something is wrong in the neighborhood. After years of coaxing, his family prevails upon him to seek help at the mental health clinic.

On which Axis of DSM-IV-TR would his condition be diagnosed? a) II b) III c) IV d) V Answer: a Page: 305 Level: Difficult Type: Conceptual 10-15. Which of the following personality disorders falls within the anxious or fearful category? a) histrionic b) borderline c) schizotypal d) obsessive-compulsive Answer: d Page: 306 Level: Medium Type: Factual

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10-16. A client is being evaluated at the mental health center. The clinical psychology intern assigned to the case proposes a diagnosis of antisocial personality disorder. When the supervising psychologist reviews the case, he wonders if there might be a second diagnosis. Which of these disorders should be the focus of the intern's re-evaluation of this case? a) alcohol abuse b) schizophrenia c) major depression d) dissociative fugue Answer: a Page: 306 Level: Difficult Type: Conceptual 10-17. According to the theory that personality disorders are a form of vulnerability to Axis I disorders, which personality disorder is thought to be a predisposition to depression? a) schizoid personality disorder b) histrionic personality disorder c) antisocial personality disorder d) dependent personality disorder Answer: d Page: 306 Level: Medium Type: Factual 10-18. Which of these pairs correctly associates a personality disorder with the Axis I disorder that it predisposes an individual to develop? a) histrionic personality disorder and schizophrenia b) antisocial personality disorder and alcohol abuse c) borderline personality disorder and bipolar disorder d) dependent personality disorder and depersonalization Answer: b Page: 306 Level: Medium Type: Factual

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10-19. Alice's teenage son was referred to the mental health center because of problems in high school. After complete psychological and medical examinations, several members of the staff ask Alice to come in for a discussion of what they have found. Because you are a psychology major, she asks you to come along.

During the discussion, a psychiatrist uses the term premorbid. Alice's facial expression indicates she is puzzled. Which of the following is the psychiatrist likely to say? a) "The symptoms are serious but not life threatening." b) "Your son probably had a personality disorder that existed for several years, now he has developed another disorder." c) "We have found that your son had a relatively normal life prior to the divorce; however, symptoms developed thereafter." d) "Unfortunately, what we found is more serious anticipated. We doubt your son will live very long as a result of a brain tumor."

Answer: b Page: 306 Level: Difficult Type: Conceptual 10-20. When is a condition or personality disorder described as "premorbid"? a) It involves depression. b) It is associated with suicide risk. c) It is diagnosable without autopsy. d) It already exists when another problem develops.

Answer: d Page: 306 Level: Medium Type: Factual 10-21. Anna has a diagnosis of an anxiety disorder on Axis I and a Histrionic personality disorder on Axis II. However, in her report, the term “premorbid” is typed after the diagnosis on Axis II. What does the term “premorbid” indicate? a) The clinician should evaluate for other disorders. b) Before the anxiety symptoms developed, the personality disorder already existed. c) The anxiety symptoms were evident before the personality disorder developed. d) The personality disorder should be re-examined.

Answer: b Page: 306 Level: Difficult Type: Conceptual

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10-22. What is a limitation of the personality disorder diagnoses in DSM-IV? a) failure to establish a biological basis b) lower reliability than other diagnoses c) seen as more temporary than other disorders d) can only be made if there is no Axis I diagnosis Answer: b Page: 306 Level: Medium Type: Conceptual 10-23. Which of the following contributes to low reliability in diagnosing personality disorders? a) reliance on structured interviews b) personality disorders are temporary conditions c) overlap in behaviors that characterize these disorders d) behaviors involved in personality disorders are hard to detect Answer: c Page: 306 Level: Medium Type: Conceptual 10-24. A patient who cannot stand to be alone; exhibits intense, unstable moods and interpersonal relationships; and is chronically angry is most likely to receive the diagnosis of a) borderline. b) dependent. c) schizotypal. d) narcissistic.

Answer: a Page: 306 Level: Medium Type: Factual 10-25. Which clinician would have the higher interrater reliability? a) clinician relying on family and significant others b) clinician using a standardized interview c) clinician who relies on testing results d) clinician who conducts a freewheeling interview Answer: b Page: 306 Level: Medium Type: Factual

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10-26. The theory that personality disorders are a form of vulnerability to symptom disorders suggests that a person with avoidant personality disorder may be at higher risk for a) schizophrenia. b) alcohol abuse. c) social phobia. d) bipolar disorder.

Answer: c Page: 306 Level: Medium Type: Factual 10-27. What is the basis for identifying members of a category using the prototypal approach found in the DSM-IV-TR diagnostic system? a) They must share all of the same symptoms. b) They will share some of the same symptoms. c) They exhibit the same degree of symptom severity. d) They exhibit none of the symptoms found in other categories.

Answer: b Page: 307 Level: Difficult Type: Conceptual 10-28. Diagnoses in the DSM-IV-TR system are made when a person shows a certain number of symptoms from a list of symptoms. What term is used to describe this approach to diagnosis? a) clustered b) axis-driven c) prototypal d) dimensional Answer: c Page: 307 Level: Medium Type: Factual 10-29. Which of the following is not a difficulty in deciding the appropriateness of an Axis II diagnosis? a) Unclear boundary between normal and disordered behavior b) Overlapping of categories c) Overlapping with AXIS I categories d) treatment options and approaches Answer: d Page: 307 Level: Medium Type: Factual 239

10-30. The three types of personality disorders are (1) anxious or fearful behavior; (2) dramatic, emotional, or erratic behavior; and (3) a) dissociative behavior. b) odd or eccentric behavior. c) neurotic or mood-disordered behavior. d) psychotic or schizophreniform behavior.

Answer: b Page: 307 Level: Medium Type: Factual 10-31. Which personality disorder is characterized by unwarranted feelings of suspiciousness, mistrust of other people, and hypersensitivity? a) paranoid b) histrionic c) antisocial d) borderline Answer: a Page: 307 Level: Medium Type: Factual 10-32. In which job would a person with schizoid personality disorder probably be most comfortable? a) file clerk b) air-traffic controller c) kindergarten teacher d) insurance salesperson Answer: a Page: 308 Level: Medium Type: Conceptual 10-33. Withdrawal from social contact is characteristic of a) schizoid personality disorder. b) histrionic personality disorder. c) antisocial personality disorder. d) narcissistic personality disorder.

Answer: a Page: 308 Level: Medium Type: Factual

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10-34. Which personality disorder is Joan Didion describing when she uses the phrase "only marginally engaged in the dailiness of life" in her novel The White Album? a) schizoid b) paranoid c) antisocial d) narcissistic Answer: a Page: 308 Level: Difficult Type: Factual 10-35. Why do people with schizoid personality disorder have few relationships? a) They manipulate and exploit others. b) They fear rejection and disapproval. c) They are not interested in other people. d) They have hallucinations and delusions.

Answer: c Page: 309 Level: Medium Type: Factual 10-36. Which personality disorder is characterized by little interest in social relationships, poor social skills, a lack of humor, and seem detached from the environment? a) schizoid b) histrionic c) borderline d) narcissistic Answer: a Page: 309 Level: Medium Type: Factual 10-37. Why are people with schizoid personality disorder poor candidates for psychotherapy? a) They are psychotic. b) They tend to manipulate others. c) They have a very low level of verbal intelligence. d) They are not bothered by their lack of interpersonal relationships.

Answer: d Page: 309 Level: Medium Type: Conceptual

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10-38. The staff of a mental health center is reviewing the diagnostic criteria for personality disorders. Schizoid and schizotypal personality disorders are causing them difficulty because they are so similar. In order to differentiate the two, they list symptoms that the disorders share and do not share. What symptoms will they have listed as occurring in schizotypal personality disorder but not schizoid personality disorder? a) poor social skills b) shallow emotions c) oddities of speech d) lack of close relationships Answer: c Page: 309 Level: Difficult Type: Conceptual 10-39. A 15-year-long longitudinal study suggests that schizotypal personality disorder may be a a) learned behavior pattern. b) disorder that ends after childhood. c) more severe form of borderline personality. d) borderline between schizophrenia and health.

Answer: d Page: 309 Level: Medium Type: Factual 10-40. A character in a play demonstrates odd beliefs, thinking, behavior, and appearance. However, there is no evidence of delusions or hallucinations.

The professor of an English literature class knows you are a psychology major, so he asks you what the likely diagnosis might be. What will you answer? a) histrionic personality disorder b) paranoid personality disorder c) borderline personality disorder d) schizotypal personality disorder Answer: d Page: 310 Level: Difficult Type: Conceptual 10-41. Schizotypal individuals have an elevated risk for what disorder? a) social phobia b) schizophrenia c) multiple personality disorder d) histrionic personality disorder Answer: b Page: 310 Level: Medium Type: Conceptual

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10-42. Stacey often feels as if deceased relatives are in the room with her. She talks to herself, often speaks to others in a meandering yet not totally incoherent manner, and believes she possesses a sixth sense that enables her to read peoples' minds. She might be diagnosed as having what type of personality disorder? a) schizoid b) antisocial c) avoidant d) schizotypal Answer: d Page: 310 Level: Difficult Type: Conceptual 10-43. Which of the following is one of the characteristics seen in histrionic individuals? a) amnesia b) nightmares c) excessive attention to details d) frequent complaints of poor health Answer: d Page: 311 Level: Medium Type: Factual 10-44. Which of the following represents behaviors that are likely to occur in someone with histrionic personality disorder? a) Arlene thinks other people are making fun of the way she dresses. b) Alice carefully catalogs every item of clothing she owns and hangs them by size and color. c) Angela dresses in drab clothing because she is really not interested in interpersonal relationships. d) Andrea dresses as seductively as possible although she does not really desire intimate sexual activity.

Answer: d Page: 311 Level: Difficult Type: Factual 10-45. On what basis is a person with histrionic personality disorder likely to make important decisions? a) hunches b) overly detached, rational analysis c) obsessive attention to details d) meek requests that someone else decide Answer: a Page: 311 Level: Medium Type: Conceptual 243

10-46. Which diagnosis is given more frequently to women than to men? a) schizoid personality disorder b) histrionic personality disorder c) antisocial personality disorder d) schizotypal personality disorder Answer: b Page: 311 Level: Medium Type: Factual 10-47. Which of the following is characteristic of narcissistic personality disorder? a) lack of empathy b) sleep disturbances c) oddities of speech d) moralistic attitudes about right and wrong Answer: a Page: 312 Level: Medium Type: Conceptual 10-48. Greg, a successful actor, contacted a therapist because he was having trouble playing a character who was grieving. Greg could not understand how someone could be so wrapped up in someone else, nor could he understand why someone as gifted as himself was having any difficulty with the role. Which personality disorder is most consistent with the symptoms Greg exhibits? a) schizoid b) dependent c) antisocial d) narcissistic Answer: d Page: 312 Level: Difficult Type: Conceptual 10-49. Which personality disorder is characterized by a sense of self-importance accompanied by fragile self-esteem? a) schizoid b) paranoid c) narcissistic d) schizotypal Answer: c Page: 312 Level: Medium Type: Factual

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10-50. Which personality disorder is characterized by grandiose sense of selfimportance, exaggerating personal achievements, and a preoccupation with fantasies of unlimited success? a) antisocial b) borderline c) schizotypal d) narcissistic Answer: d Page: 312 Level: Medium Type: Factual 10-51. Cheryl loves to brag about her accomplishments. She enjoys being the center of attention, is self-absorbed, and lacks empathy. She is exhibiting characteristics of which personality disorder? a) antisocial b) dependent c) narcissistic d) borderline Answer: c Page: 312 Level: Medium Type: Conceptual 10-52. As part of an in-class activity you are given a card with the following: grandiose sense of self-importance, not able to empathize, preoccupied with own achievements. The description also suggests the individual is in need of therapy.

Your job is to act out this individual. What diagnosis are you being asked to portray? a) dependent personality disorder b) borderline personality disorder c) schizotypal personality disorder d) narcissistic personality disorder Answer: d Page: 312 Level: Difficult Type: Conceptual 10-53. Approximately what percentage of psychiatric patients are given the diagnosis of borderline personality disorder? a) 1% b) 12% c) 20% d) 40% Answer: c Page: 313 Level: Medium Type: Factual 245 10-54. A person diagnosed with borderline personality disorder would likely show self-destructive behavior in reaction to which situation?

a) sleep deprivation b) impending separation c) disruption of anxiety-reducing rituals d) having to talk to a group of people at a party Answer: b Page: 313 Level: Medium Type: Conceptual 10-55. A therapist is going to make a presentation to other professionals on the topic of borderline personality disorder. Which of the following would make the best title for this presentation? a) "Self destructive behavior: A behavioral specialty" b) "The delusions and hallucinations might as well be real" c) "Forget the borderline: Recognize the psychotic symptoms" d) "Too much affection and too many calories: The end result" Answer: a Page: 313 Level: Difficult Type: Conceptual 10-56. Mary is uncertain about her goals, values, loyalties, career, and friends. She feels bored and empty and clings to her friends because of a fear of abandonment. She is extremely sensitive to any sign of rejection and generally considered to be quite self destructive. Mary is showing some characteristics of which personality disorder? a) avoidant b) borderline c) schizotypal d) self-defeating Answer: b Page: 313 Level: Difficult Type: Factual 10-57. You are reading for a part in a play. The character is described as exhibiting a pervasive pattern of intense and unstable interpersonal relationships, an unstable self-image, and repeated suicidal gestures. You conclude that you are being asked to play the role of a person who would meet the criteria for a) schizoid personality disorder. b) antisocial personality disorder. c) borderline personality disorder. d) dependent personality disorder.

Answer: c Page: 313 Level: Difficult Type: Conceptual 246 10-58. A co-worker has described Helen as engaging in unstable and intense interpersonal relationships and promiscuous sexual activity. In addition, she appears to be emotionally unstable and frequently loses her temper. What is the most likely diagnosis?

a) borderline personality disorder b) dependent personality disorder c) schizotypal personality disorder d) obsessive-compulsive personality disorder Answer: a Page: 313 Level: Difficult Type: Conceptual 10-59. People with which personality disorder are often compulsively social? a) schizoid b) borderline c) schizotypal d) obsessive-compulsive Answer: b Page: 314 Level: Medium Type: Factual 10-60. A psychologist is evaluating a client believed to be suffering from borderline personality disorder. In order to be sure about the diagnosis, what other personality disorders should be considered? a) histrionic and antisocial b) narcissistic and schizoid c) dependent and avoidant d) antisocial and schizotypal Answer: a Page: 314 Level: Difficult Type: Conceptual 10-61. Which personality disorder is associated with an especially high risk for suicide? a) schizoid b) antisocial c) narcissistic d) borderline Answer: d Page: 314 Level: Medium Type: Factual

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10-62. Originally, the term "borderline" was used to describe a milder form of a) schizophrenia. b) mental retardation. c) dissociative disorder. d) obsessive-compulsive disorder.

Answer: a Page: 315 Level: Medium Type: Factual 10-63. Some researchers have suggested that borderline personality disorder may be a boundary category between a) neurosis and psychosis. b) health and the other personality disorders. c) schizoid and schizotypal personality disorders. d) other personality disorders and mood disorders.

Answer: d Page: 315 Level: Medium Type: Factual 10-64. Borderline personality disorder differs from schizotypal personality disorder in that the borderline category emphasizes a) dependence rather than arrogance. b) arrogance rather than dependence. c) affective rather than cognitive symptoms. d) cognitive rather than affective symptoms.

Answer: c Page: 315 Level: Medium Type: Factual 10-65. Of the following personality disorders, which has been the most researched? a) avoidant b) borderline c) narcissistic d) obsessive-compulsive Answer: b Page: 315 Level: Medium Type: Factual

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10-66. Which of the following is frequently seen as the core problem of borderline personality disorder? a) intolerance of being alone b) inability to obtain pleasure from any activity c) extreme depression bordering on catatonia d) obsessive attention to details of their lives and the lives of their friends Answer: a Page: 316 Level: Medium Type: Factual 10-67. What do borderline personality disorder and histrionic personality disorder have in common? a) peculiar thoughts b) attention seeking behaviors c) avoidance of strong emotions d) disinterest in personal relationships Answer: b Page: 316 Level: Medium Type: Conceptual 10-68. What characteristic occurs in both borderline personality disorder and antisocial personality disorder? a) impulsive b) sensitivity to criticism c) excessive attention to detail d) discomfort with strong emotions Answer: a Page: 317 Level: Medium Type: Conceptual 10-69. Although there are some similarities between borderline and schizotypal, there are also some major differences. An intern is asked to summarize one way to distinguish the two disorders. He decides that compared to schizotypal people, people with borderline personality disorder are a) unlikely to want to be alone. b) overwhelmed with their sense of loss. c) more likely to exhibit shallow emotions. d) more likely to be perceived as faking symptoms.

Answer: a Page: 315 Level: Difficult Type: Conceptual

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10-70. Which term is used to describe the failure to integrate positive and negative interpersonal experiences? a) autism b) delusion c) splitting d) primary process Answer: c Page: 316 Level: Medium Type: Factual 10-71. Otto Kernberg has suggested that splitting, or failing to integrate positive and negative experiences, is an explanation for a) antisocial behavior. b) compulsive behavior. c) histrionic personality disorder. d) borderline personality disorder.

Answer d Page: 316 Level: Medium Type: Factual 10-72. Amy is about to begin dialectical behavior therapy for the treatment of borderline personality disorder. Which of the following is likely to characterize this form of therapy? a) The therapist will try to establish transference. b) The client will be treated with a combination of medication and psychotherapy. c) The goal of the therapy will to be undercover unconscious causes of the symptoms. d) The sessions will aim to develop the client's reasonable expectations concerning other people.

Answer: d Page: 316 Level: Difficult Type: Factual 10-73. Chronic behavior that violates the rights of others and is associated with little expression of remorse or guilt is characteristic of a) schizoid personality disorder. b) histrionic personality disorder. c) antisocial personality disorder. d) narcissistic personality disorder.

Answer: c Page: 317 Level: Medium Type: Factual

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10-74. What have recent revelations about Gary Gilmore indicated about his early life? a) His childhood was filled with violence and child abuse. b) His parents were schizophrenic and unable to care for him. c) An accident during childhood may have caused brain damage. d) He actually had a soft side that was hidden during his adult years.

Answer: a Page: 317 Level: Medium Type: Factual 10-75. Which of the following is NOT necessary in the diagnostic criteria for antisocial personality? a) history of arrests b) irresponsible behavior c) current age of 18 or older d) history of antisocial behavior before age 15 Answer: a Page: 317 Level: Medium Type: Factual 10-76. To people who know her casually, Marcia is charming. She is quite intelligent but uses this quality to manipulate and exploit others. She expresses little remorse when she hurts someone. These characteristics are typical of which personality disorder? a) paranoid b) avoidant c) antisocial d) schizotypal Answer: c Page: 317 Level: Difficult Type: Factual 10-77. Low levels of which neurotransmitter has been implicated in the development of antisocial personality disorder? a) GABA b) dopamine c) serotonin d) norepinephrine Answer: c Page: 319 Level: Medium Type: Factual

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10-78. Evidence that antisocial personality disorder may be related to a need for higher stimulation levels in order to be aroused comes from research on a) serotonin levels. b) electrical brain activity. c) self-reported depression. d) response to drugs for hyperactivity.

Answer: b Page: 319 Level: Medium Type: Factual 10-79. A neurologist just finished reviewing the EEG records of an individual. The records reveal a pattern of slower than expected alpha rhythms. If the neurologist suspects the presence of a personality disorder, which one should he consider first? a) schizoid b) borderline c) antisocial d) dependent Answer: c Page: 319 Level: Medium Type: Conceptual 10-80. A person with the diagnosis of antisocial personality disorder volunteered to be a subject in research involving brain waves. After the technicians studied this individual for a few days, they were surprised that he had high levels of a) beta waves. b) theta waves. c) slow alpha waves. d) slow delta waves.

Answer: c Page: 319 Level: Medium Type: Factual 10-81. An expert on antisocial personality disorder was asked to describe the anxiety responses of men with this disorder. How would he respond? a) Their anxiety lacks a component of cognitive worry. b) There are no signs of physiological or cognitive anxiety. c) Their anxiety has an unusually high level of cognitive worry. d) There is little physiological arousal associated with their anxiety.

Answer: a Page: 319 Level: Difficult Type: Factual

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10-82. A cognitive psychologist interested in studying antisocial behavior would probably focus on a) moral development. b) brain wave patterns. c) physiological arousal levels. d) conditioning of self-defeating behavior.

Answer: a Page: 320 Level: Difficult Type: Conceptual 10-83. Which of the following characteristics of antisocial personality disorder usually interferes with successful psychotherapy? a) hallucinations b) lack of empathy c) fear of separation d) extreme social anxiety Answer: b Page: 321 Level: Medium Type: Conceptual 10-84. Avoidant, dependent, and obsessive-compulsive personality disorders constitute the cluster of disorders characterized by a) anxious behaviors. b) dramatic behaviors. c) eccentric behaviors. d) self-defeating behaviors.

Answer: a Page: 322 Level: Medium Type: Factual 10-85. The desire for affection and close personal relationships distinguishes a diagnosis of avoidant personality disorder from a) schizoid personality disorder. b) histrionic personality disorder. c) borderline personality disorder. d) dependent personality disorder.

Answer: a Page: 322 Level: Difficult Type: Conceptual

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10-86. Avoidant personality disorder is characterized by all of the following except a) low self-esteem. b) few personal attachments. c) lack of interest in relationships. d) extreme sensitivity to rejection.

Answer: c Page: 322 Level: Medium Type: Factual 10-87. What type of hypervigilance is likely to be part of avoidant personality disorder? a) paranoia b) anticipation of rejection c) obsessiveness with details d) making sure one is the center of attention Answer: b Page: 323 Level: Medium Type: Factual 10-88. Ellen longs to have friends and to be popular, but she feels she has nothing to offer anyone as a friend. She sees herself as boring and incompetent and is afraid to be with people unless she knows they like her. Ellen's traits are consistent with a diagnosis of a) avoidant personality disorder. b) antisocial personality disorder. c) borderline personality disorder. d) schizotypal personality disorder.

Answer: a Page: 323 Level: Difficult Type: Conceptual 10-89. During a case conference, the assembled professionals are discussing several cases, including some that seem to meet some of the criteria for avoidant personality disorder and social phobia. What is a good guideline for distinguishing these two disorders? a) Those with avoidant personality disorder have poorer social skills. b) There is a greater level of anxiety among those with social phobias. c) Those with social phobias tend to experience more frequent panic attacks. d) There are more frequent anxious thoughts among those with social phobias.

Answer: a Page: 323 Level: Difficult Type: Conceptual

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10-90. Which personality disorder is characterized by a fear of separating from others looked to for advice and reassurance? a) paranoid b) borderline c) dependent d) schizotypal Answer: c Page: 323 Level: Medium Type: Factual 10-91. What do dependent personality disorder and borderline personality disorder have in common? a) hypervigilance b) peculiar thoughts c) difficulty being alone d) lack of strong emotions Answer: c Page: 323 Level: Medium Type: Conceptual 10-92. Jenny allows her husband to make all important decisions about things affecting her, and conforms all aspects of her own life to suit his interests. What's more, she is fearful that her husband may die and leave her alone. These traits are consistent with the diagnosis of a) avoidant personality disorder. b) borderline personality disorder. c) dependent personality disorder. d) schizotypal personality disorder.

Answer: c Page: 324 Level: Difficult Type: Conceptual

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10-93. Raymond is 46 years old and lives at home with his 70-year-old mother and father. At Raymond's request, his mother balances his checkbook; his father is asked to give his opinion on every decision Raymond makes. From the moment Raymond wakes up until he goes to sleep, he rarely makes a move without asking for his parents' guidance. When co-workers ask about this situation, Raymond says he wouldn't have it any other way. If Raymond received a diagnosis of a personality disorder, which one would it be? a) schizoid b) dependent c) borderline d) narcissistic Answer: b Page: 324 Level: Difficult Type: Conceptual 10-94. Inability to function autonomously and a tendency to subordinate one's own needs to others' needs are characteristics of a) avoidant personality disorder. b) paranoid personality disorder. c) dependent personality disorder. d) obsessive-compulsive personality disorder.

Answer: c Page: 324 Level: Medium Type: Conceptual 10-95. Individuals with which personality disorder are most likely to have several close personal friends? a) schizoid personality disorder b) avoidant personality disorder c) paranoid personality disorder d) dependent personality disorder Answer: d Page: 324 Level: Medium Type: Factual 10-96. In contrast to obsessive-compulsive personality disorder, obsessivecompulsive anxiety disorder is characterized by a) rigidity. b) interest in rules. c) focus on details. d) intrusive thoughts.

Answer: d Page: 325 Level: Medium Type: Factual

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10-97. An inability to grasp the "big picture" due to a preoccupation with rules and details is characteristic of which personality disorder? a) histrionic b) antisocial c) schizotypal d) obsessive-compulsive Answer: d Page: 325 Level: Medium Type: Conceptual 10-98. Sandra is so preoccupied with perfection that she almost never gets things done on time. Socially, she rarely goes out because she is usually working. She is rigid about her daily schedule. Sandra may qualify for a diagnosis of a) avoidant personality disorder. b) histrionic personality disorder. c) borderline personality disorder. d) obsessive-compulsive personality disorder.

Answer: d Page: 325 Level: Difficult Type: Conceptual 10-99. Sherry is having problems at work because she refuses to make any decisions or to start work on a project until she has gone over the assignment with a fine-toothed comb. She becomes bogged down in the preliminary details of the project, seemingly unable to grasp the "big picture." These behaviors are characteristic of which personality disorder? a) schizoid b) dependent c) schizotypal d) obsessive-compulsive Answer: d Page: 325 Level: Difficult Type: Conceptual

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10-100. What is the general consensus at this time concerning drug therapy for personality disorders? a) The same drugs that work for the Axis I related disorders are effective with these disorders. b) Although under careful investigation, there are generally no clearly successful drug therapies at this time. c) Drug therapies can enhance the effectiveness of psychological forms of therapy for the majority of personality disorders. d) Due to the overlapping symptoms, a combination of drugs is probably appropriate although research has been unable to find the best combinations.

Answer: b Page: 326 Level: Difficult Type: Conceptual 10-101. What is the major advantage of a dimensional approach to assessing personality disorders? a) This approach results in a profile of the persona being classified. b) The etiology can be more easily classified using this approach. c) Treatment decisions are easier because areas in need of therapy are highlighted. d) Clients find such an approach more acceptable and understanding and therefore are more willing to accept therapist's recommendations.

Answer: a Page: 327 Level: Difficult Type: Factual 10-102. Which type of diagnostic system rates the prominence of personality features, not just their presence or absence? a) axial b) medical c) categorical d) dimensional Answer: d Page: 327 Level: Easy Type: Factual

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10-103. People with personality disorders may not initiate therapeutic help because of the following rationale? a) Issues in the environment are the predisposing factor for the problem. b) Medications will be used. c) High cost of treatment. d) Others have problems; they do not have problems.

Answer: a Page: 327 Level: Medium Type: Factual

Essay Questions 10-104. What is the rationale for diagnosing personality disorders on Axis II with mental retardation?

Answer: These two conditions have in common a lifetime or near-lifetime duration and stability, there are not likely to be periods of improvement or change.

Page: 305 Level: Difficult Type: Factual 10-105. What are some of the reasons for the low reliability of personality disorders?

Answer: 1) unclear boundary between normal and abnormal personality characteristics; (2) overlap among the personality disorders; (3) overlap between the personality disorders and Axis I disorders; (4) prototypal approach used

by DSM-IV does not require each person with the diagnosis to share the same symptoms.

Page: 306 Level: Difficult Type: Factual 10-106. What are the similarities and differences between schizoid personality disorder and schizotypal personality disorder?

Answer: Both are characterized by shallow emotions, few close relationships, and poor social skills. Schizotypal behavior is also characterized by perceptual and cognitive peculiarities and oddities of speech.

Pages: 308 – 309 Level: Difficult Type: Factual

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10-107. What is the evidence for and against viewing borderline personality disorder (BPD) as a distinct disorder?

Answer: The idea that borderline personality disorder is distinct is based in part on evidence that it "breeds true"--relatives of those with borderline personality disorder are more likely to share this diagnosis than are family members of those with other personality disorders. Also, people with borderline personality disorder tend to keep the diagnosis throughout life, without developing a different or more serious condition such as schizophrenia. However, there is also evidence suggesting that borderline personality disorder is not distinct. About half of those with BPD also have a mood disorder, along with a family history of mood disorder. Diagnostic reliability is low because the characteristics of BPD overlap with other personality disorders. For example, some researchers have been unable to distinguish borderline personality disorder from histrionic personality disorder and antisocial personality disorder.

Pages: 315 – 316 Level: Difficult Type: Factual 10-108. What are the three important problems in borderline personality disorder?

Answer: (1) Identity disturbances, reflected in borderline individuals chronic feeling of emptiness or boredom and their intolerance of being alone. These people have a strong need for involvement with others and a reliance on external support for self-definition. (2) Affective disturbance reflected in their intense, inappropriate anger, emotional instability, and unstable interpersonal relationships. Borderline patients often lead stormy, dramatic lives. (3) Impulse disturbance, reflected in their self-damaging acts and impulsive behaviors.

Page: 316 Level: Difficult Type: Factual 10-109. What are the key features of antisocial personality disorder?

Answer: According to the diagnostic criteria, a person must have at least three of the following characteristics: (1) failure to conform to social norms; (2) deceitfulness, manipulativeness; (3) impulsivity, failure to plan ahead; (4) irritability, aggressiveness; (5) reckless disregard for the safety of self or others; (6) consistent irresponsibility; (7) lack or remorse after having, hurt, mistreated, or stolen from another person.

Page: 317 Level: Difficult Type: Factual

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10-110. What is the difference between obsessive-compulsive anxiety disorder and obsessive-compulsive personality disorder?

Answer: The anxiety disorder involves intrusive, obsessive thoughts. The personality disorder involves similar rigid and unadaptive behaviors, but the behaviors feel under control. People with the personality disorder do not show obsessional thinking that seems to force itself into consciousness, nor do they engage in the kinds of irrational rituals performed by people with obsessivecompulsive anxiety disorder.

Page: 324 Level: Difficult Type: Factual

True/False 10-111. A transient condition can be considered for a personality disorder diagnosis.

Answer: False Page: 304 Level: Easy Type: Factual 10-112. Personality disorders are not noticed during childhood.

Answer: False Page: 304 Level: Easy Type: Factual 10-113. Personality disorders affect interpersonal relationships but do not directly elicit certain patterns of behavior from family and friends.

Answer: False Page: 304 Level: Easy Type: Factual 10-114. A person can have both a personality disorder and a symptom disorder.

Answer: True Page: 305 Level: Easy Type: Factual 10-115. The prototypal approach used in DSM-IV-TR indicates that it is not necessary that any single characteristic listed for the personality disorders be shared by all who would receive this diagnosis.

Answer: True Page: 307 Level: Easy Type: Factual 10-116. Axis II would appear to represent a novel step toward a classification system applicable to the whole person.

Answer: True Page: 307 Level: Easy Type: Factual

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10-117. Recognition of the multiplicity of causes will assist in the treatment of personality disorders.

Answer: True Page: 307 Level: Easy Type: Factual 10-118. In Joan Didion’s book, “The White Album”, she could be describing the schizoid personality.

Answer: True Page: 308 Level: Easy Type: Factual 10-119. Joanne has been diagnosed with a personality disorder. Even with this diagnosis, she behaved appropriately some of the time in her life.

Answer: True Page: 326 Level: Easy Type: Factual 10-120. Clients with personality disorders form good therapeutic relationships with their therapists.

Answer: False Page: 326 Level: Easy Type: Factual

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Chapter 11 Mood Disorders and Suicide 11-1. For several months, Jack tells his friends that he feels depressed.

When questioned by his friends, he states that he feels “down” most of the time. Jack has: a) clinical depression b) mood disorders c) depressed mood d) depression Answer: c Page: 332 Level: Medium Type: Conceptual 11-2. Dysthymia, major depressive disorder, cyclothymic disorder, and the bipolar disorders are classified as a) neuroses. b) mood disorders. c) anxiety disorders. d) personality disorders.

Answer: b Page: 333 Level: Medium Type: Factual 11-3. Approximately what percentage of people have met the criteria for a mood disorder in the past? a) 2% b) 10% c) 16% d) 32% Answer: b Page: 332 Level: Medium Type: Factual 11-4. An expert on depression has been asked to testify before a committee of the United States Senate that is investigating the treatment of depression. Which of the following points is this expert likely to include in the testimony? a) Depression is often misdiagnosed as schizophrenia. b) Health care providers often fail to recognize depression. c) Gene therapy is the major hope in the fight against depression. d) A lack of will power is a major reason for the epidemic of depression.

Answer: b Page: 332 Level: Difficult Type: Conceptual

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11-5. DSM-IV-TR divides mood disorders into three general categories.

These categories are depressive disorders, bipolar disorders, and: a) clinically related mood disorders b) medically related mood disorders c) major depressive disorders with psychotic features d) recurrent depressive disorders Answer: b Page: 332 Level: Medium Type: Factual 11-6. Which of the following is not a reason why people do not seek treatment for mood disorders? a) lack of awareness of effective treatment b) being socially stigmatized c) high cost related to treatment d) health care providers not recognizing the disorder Answer: c Page: 332 Level: Medium Type: Factual 11-7. An epidemiologist is preparing a report on the rates of depression among people of different races and ethnic groups in the United States.

What is the best title of the presentation? a) "Ethnicity, but not race, matters in depression rates" b) "Depression: Rates not affected by race and ethnicity" c) "Why the symptoms of depression vary with ethnicity and race" d) "Social support in some racial and ethnic groups makes depression rates" Answer: b Page: 332 Level: Difficult Type: Conceptual 11-8. Which disorder occurs at a much higher rate among women than men? a) bipolar I disorder b) bipolar II disorder c) cyclothymic disorder d) major depressive disorder Answer: d Page: 333 Level: Medium Type: Factual 11-9. Which of the following disorders tends to occur with approximately equal frequency in men and women?

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a) bipolar disorder b) unipolar disorder c) dysthymic disorder d) dissociative identity disorder Answer: a Page: 333 Level: Medium Type: Factual

11-10. People who have experienced one or more episodes of major depression, but no episodes of mania or hypomania, are classified as having a) dysthymia. b) cyclothymia. c) bipolar II disorder. d) unipolar depression.

Answer: d Page: 334 Level: Medium Type: Factual 11-11. Which of the following is not a risk factor affecting depression? a) lack of social support b) heredity c) education d) gender Answer: c Page: 334 Level: Medium Type: Factual 11-12. Which of the following cases of depression is most representative of those for which genetic factors seem to play an especially great role? a) Alan who sleeps more than average b) Cara whose depression began early in life c) Agnes whose diagnosis is of a less severe form of depression d) Dave whose depressive symptoms do not respond to medication Answer: b Page: 334 Level: Difficult Type: Conceptual 11-13. Which aspect of a depressive disorder is most closely associated with stressful life experiences (rather than genetic predisposition)? a) severity b) early onset c) number of recurrences d) response to medication Answer: c Page: 334 Level: Medium Type: Factual 11-14. Which of these individuals falls within the age range of women who 265

are at highest risk for a first episode of depression? a) Sally, who is 15 years old b) Mary, who is 24 years old c) Barbara, who is 45 years old d) Theresa, who is 55 years old Answer: b Page: 334 Level: Medium Type: Conceptual

11-15. Which of these individuals falls within the age range of men who are at greatest risk for a first episode of depression? a) Al, who is 21 years old b) Edward, who is 29 years old c) Randolph, who is 45 years old d) Salvatore, who is 65 years old Answer: c Page: 334 Level: Medium Type: Conceptual 11-16. During a case conference, a psychiatrist described several hospitalized patients as exhibiting "negative symptoms" of depression.

What does this description tell us about these patients? a) They had refused all forms of therapy. b) They were experiencing troubling delusions. c) They had been difficult to treat during therapy sessions. d) They were experiencing appetite, weight, and sleep problems.

Answer: d Page: 335 Level: Difficult Type: Conceptual 11-17. What is a birth cohort? a) a genetic predisposition to a disorder b) a group of people born around the same time c) a risk factor related to problems during pregnancy d) the number of children born to mentally ill parents Answer: b Page: 335 Level: Medium Type: Factual 11-18. Which birth cohort has the highest rate of depression? a) larger cohorts b) earlier cohorts c) more recent cohorts d) smaller birth cohorts 266

Answer: c Page: 335 Level: Medium Type: Factual 11-19. Which of these persons is a member of a cohort that has a higher than average risk of developing depression? a) Bob who was born in 1975 b) Steve who fought in World War II c) Frank who earned a doctoral degree in 1940 d) Dan who is the oldest member of the plumber's union Answer: a Page: 335 Level: Medium Type: Conceptual

11-20. One explanation for the higher rates of depression among women is that women experience more stress associated with a) poor nutrition. b) alcohol abuse. c) providing social support. d) lack of physical strength.

Answer: c Page: 336 Level: Medium Type: Factual 11-21. Which person has the greatest risk for developing depression? a) a father with young children b) a mother with young children c) a working man with no children d) a working woman with no children Answer: b Page: 336 Level: Medium Type: Factual 11-22. Which aspect of intimate relationships is most clearly associated with increased risk for depression? a) criticism b) interference from in-laws c) spending a lot of time apart d) lack of support for career choices Answer: a Page: 336 Level: Medium Type: Factual 11-23. Which of these individuals is most likely to experience depression? a) Al, who is 35-years old and single b) Carl, who is 54-years old and married 267

c) Bob, who is 69-years old and widowed d) Darla, who is 29-years old and has two young children Answer: d Page: 336 Level: Medium Type: Conceptual 11-24. Which of the following is not a factor in why women experience more depression than men? a) Women receive more social support and become involved in the lives of others. b) Coping strategies are different. c) Women are expected to offer more social support. d) Women are more involved in problems and stressors experienced by others.

Answer: b Page: 336 Level: Medium Type: Factual

11-25. Which of the following groups are at a higher risk for depression than others? a) Poor young women who are African American and Hispanic b) White women between the ages of 22 – 42 c) Women who are middle-class d) None of the above.

Answer: a Page: 336 Level; Medium Type: Factual 11-26. How do men and women differ in coping with depression? a) Men are reactive and women are proactive. b) Men have an action-oriented style, while women have a cognitive style. c) Men repress depression, while women openly discuss depression. d) Women’s coping styles are better adapted to deal with depression than men’s.

Answer: b Page: 336 Level: Medium Type: Factual 11-27. Which of the following is not true regarding stressful life situations and depression? a) Some people seem to be vulnerable genetically to recurrent episodes of depression. b) Many stressful situations in life are associated with relationships in the social network of the person. c) How people interact with those close to them can create stressful 268

situations. d) People’s behavioral-interactive style can contribute to depression.

Answer: d Page: 336 Level: Medium Type: Factual 11-28. For the past two years, Ed has experienced poor appetite, insomnia, fatigue, and several other symptoms. These symptoms have kept him from feeling happy, although they do not indicate a depressive episode. When assessing Ed, what disorder is a psychologist likely to consider? a) bipolar I disorder b) dysthymic disorder c) cyclothymic disorder d) schizoaffective disorder Answer: b Page: 337 Level: Difficult Type: Conceptual 11-29. What is the prevalence of dysthymia in the general population? a) .5% b) 1% c) 6% d) 8% Answer: c Page: 337 Level: Medium Type: Factual 11-30. Which mood disorder has sometimes been considered a personality disorder? a) dysthymia b) bipolar I disorder c) major depression d) bipolar II disorder Answer: a Page: 337 Level: Medium Type: Factual 11-31. Maria has experienced chronic sadness, poor appetite, and insomnia nearly every day over the last 2 years. What is her most likely diagnosis? a) dysthymia b) cyclothymia c) bipolar I disorder d) major depressive disorder Answer: a Page: 337 Level: Difficult Type: Conceptual 11-32. Marsha was seen last year at the Mental Health Center where she was diagnosed as having a major depressive episode. During the last six months, she has had five additional episodes. What is her present diagnosis? a) major depressive disorder with psychotic features 269

b) bipolar I disorder c) dysthymia d) recurrent major depressive disorder Answer: c Page: 337 Level: Difficult Type: Conceptual 11-33. Which disorder is most likely to occur with dysthymic disorder? a) cyclothymia b) bipolar I disorder c) bipolar II disorder d) major depressive disorder Answer: d Page: 338 Level: Medium Type: Factual 11-34. A psychiatrist wrote the following note on a patient's chart, "Classic case of double depression." A secretary was transcribing the psychiatrist's notes and asked what the term meant. What will the secretary be told? a) The patient actually has an underlying schizophrenic disorder. b) The patient has both dysthymic disorder and major depression. c) The presenting symptoms look like a mirror image of depression. d) The patient's depression is more than twice as serious as other forms of depression.

Answer: b Page: 338 Level: Difficult Type: Conceptual

11-35. What is "double depression"? a) bipolar mood disorder b) two episodes of depression c) helplessness and hopelessness d) comorbid dysthymia and major depression Answer: d Page: 338 Level: Medium Type: Factual 11-36. How does dysthymia differ from major depression? a) In major depression rates increases in certain age groups but in dysthymia, the rates of increase is stable from age 18 to 64.

Dysthymia tends to be chronic while major depression is timelimited. b) Major depression increases with age due to life stressors and situational factors. Dysthymia seems to decrease in intensity with age. c) Men seem to be more vulnerable to dysthymia and women are 270

more vulnerable to major depression. d) Dysthymia tends to be acute and pervasive, while major depression is chronic and developmental.

Answer: a Page: 338 Level: Difficult Type: Factual 11-37. What characteristic must a person's symptoms exhibit in order to meet the criteria for major depressive disorder? a) worse in the morning b) present for two weeks or more c) chronically present for over 2 years d) alternates with mania in a cyclical pattern Answer: b Page: 339 Level: Medium Type: Factual 11-38. How does age affect the severity of dysthymia? a) Dysthymia is stable throughout adulthood. b) Dysthymic periods are more brief with age. c) Dysthymic periods occur more frequently with age. d) Dysthymia lessens over time, even without treatment.

Answer: a Page: 339 Level: Medium Type: Conceptual 11-39. Loraine describes the following symptoms to her therapist: depression, loss of interest, weight gain, sleep problems, feelings of worthlessness and suicidal ideation. The symptoms have been present for at least 3 weeks. Loraine’s diagnosis is: a) dysthymia b) major depressive episode c) cyclothymia d) major depressive disorder Answer: b Page: 340 Level: Difficult Type: Conceptual

11-40. Which of the following is the most typical course of recurrent major depressive disorder? a) a single episode of mania b) a single episode of major depression c) several episodes of major depression d) cycling episodes of depression and mania Answer: c Page: 341 Level: Medium Type: Factual 11-41. What is the most appropriate description for a person who loses a loved one to death and who shows depressive symptoms for two months? a) bereavement 271

b) dysthymic disorder c) major depressive episode d) adjustment disorder with depressed mood Answer: a Page: 340 Level: Medium Type: Factual 11-42. Which psychotic symptom often occurs with severe depression? a) delusions b) hallucinations c) incoherent affect d) incongruent affect Answer: a Page: 341 Level: Medium Type: Factual 11-43. What is the most likely biological basis for depression? a) lesions in the limbic system b) loss of neurons in the frontal lobes c) irregular electrical activity in the brain d) abnormal levels of neurotransmitters in the brain Answer: d Page: 341 Level: Medium Type: Conceptual 11-44. Dopamine, epinephrine, and norepinephrine are classified as a) indolamines. b) catecholamines. c) reuptake inhibitors. d) gamma aminobutyric acids.

Answer: b Pages: 341, 342 Level: Medium Type: Factual

11-45. When a neuron is stimulated, it releases chemicals from storage areas called a) vesicles. b) receptors. c) synapses. d) dendritic clefts.

Answer: a Page: 342 Level: Medium Type: Factual 11-46. What is the synaptic cleft?

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a) the space between two neurons b) a pattern of brain waves seen on an EEG c) a specialized receptor protein on a neuron d) the amount of neurotransmitter a neuron produces Answer: a Page: 342 Level: Medium Type: Factual 11-47. The monoamine hypothesis of the development of depression focuses on insufficient activity of several neurotransmitters. Although this hypothesis has influenced treatment, it is not without shortcomings as an explanation for depression. What is one of the problems of this hypothesis? a) In some cases, high levels of these neurotransmitters are the actual cause of depression. b) Not all people who suffer depression have all the neurotransmitters thought to be involved in depression. c) Other neurotransmitters such as GABA and acetylcholine appear to be involved in some cases of depression. d) The neurotransmitter levels thought to be involved in depression are actually responding to changes in diet that often accompany depression.

Answer: c Page: 342 Level: Difficult Type: Conceptual 11-48. What is the purpose of the enzyme monoamine oxidase? a) speeding up release of serotonin into synapses b) deactivating serotonin by chemically altering it into another form c) directing various neurotransmitters to their appropriate synapses d) protecting synapses from interference from drugs that might have an unfavorable effect on the body Answer: b Page: 342 Level: Medium Type: Conceptual 11-49. What effect does monoamine oxidase have on serotonin levels? a) increases serotonin production b) keeps serotonin in the synapse longer c) speeds serotonin's delivery to receptors d) decreases amount of serotonin in the synapse Answer: d Page: 342 Level: Medium Type: Factual 11-50. How does monoamine oxidase decrease the availability of serotonin in the synapse? a) It promotes reuptake. b) It slows production of serotonin.

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c) It changes serotonin into another form. d) It speeds delivery of serotonin to the receptors.

Answer: c Page: 342 Level: Medium Type: Factual 11-51. Suppose a new technique is developed that can accurately and quickly measure monoamine oxidase levels in the brain. Using this technique, a scientist finds a very low level of monamine oxidase in the brain of a research participant. What will the scientist conclude about this person's current level of serotonin? a) The serotonin level is normal. b) The serotonin level is likely to be very high. c) The level of serotonin is at such low levels that it may cause death. d) The level of serotonin is not related to monoamine oxidase, so no conclusion could be reached.

Answer: b Page: 342 Level: Difficult Type: Conceptual 11-52. What is the biological effect of MAO inhibitors? a) increases availability of serotonin b) decreases availability of serotonin c) increases availability of acetylcholine d) decreases availability of acetylcholine Answer: a Page: 342 Level: Medium Type: Factual 11-53. Agnes has been depressed for the last six months. She finally decides to seek help at the mental health center where a psychiatrist prescribes a tricyclic antidepressant. Before she leaves, the psychiatrist advises her to be aware of several possible side effects. Which side effects will the psychiatrist include on the list? a) constipation, dry mouth, and headaches b) delusions, hallucinations, and sleepiness c) depersonalization, memory loss, and tremors d) joint pain, loss of appetite, and upper body rash Answer: a Page: 342 Level: Difficult Type: Factual 11-54. Why do serotonin reuptake inhibitors have fewer side effects than other antidepressants? a) They block acetylcholine. b) Their effect is more specific. c) They are taken for a shorter period. d) They affect more neurotransmitters.

Answer: b Page: 342 Level: Medium Type: Factual 274

11-55. Based on criteria ranging from effectiveness to cost, which drug would be the likely first choice for treating a depressed patient? a) a benzodiazepine b) an MAO inhibitor c) a tricyclic antidepressant d) a selective serotonin reuptake inhibitor Answer: d Page: 342 Level: Difficult Type: Conceptual 11-56. What is the biological effect of the tricyclic antidepressants? a) They chemically alter serotonin. b) They block reuptake of serotonin. c) They speed production of serotonin. d) They inhibit MAO from altering serotonin.

Answer: b Page: 343 Level: Medium Type: Factual 11-57. Why do the tricyclic antidepressants have so many side effects? a) They are addictive. b) They cause drops in serotonin levels. c) They cause toxic reactions with some foods. d) They block reuptake of norepinephrine and dopamine.

Answer: d Page: 343 Level: Medium Type: Factual 11-58. Dysphoric mood, inability to experience pleasure, helplessness, and feelings of sadness are associated with decreased metabolism in what part of the brain? a) thalamus b) cerebellum c) corpus callosum d) frontal-temporal cortex Answer: d Page: 343 Level: Medium Type: Factual 11-59. In what part of the world are seasonal affective disorders most prevalent? a) near the poles b) near the equator c) industrialized countries d) non-industrialized countries Answer: a Page: 343 Level: Medium Type: Factual

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11-60. For someone living in the United States, when is seasonal affective disorder likely to start? a) February b) April c) July d) November Answer: d Page: 343 Level: Medium Type: Factual 11-61. What changes in sleep may be associated with lowered levels of serotonin in depressed people? a) increased REM sleep b) decreased REM sleep c) REM period ending later in the sleep cycle d) REM sleep beginning later in the sleep cycle Answer: a Page: 343 Level: Medium Type: Factual 11-62. What are the major factors that are related to the prevalence of seasonal affective disorder around the world? a) Prevalence is tied directly to latitude. b) The prevalence varies quite a bit depending on treatments available. c) In addition to latitude, other factors such as climate, appear to play a role. d) The rate of seasonal affective disorder is tied directly to the number of hours of daylight, regardless of geography.

Answer: c Page: 344 Level: Difficult Type: Conceptual 11-63. A survey of the effectiveness of antidepressant medications reveals that not all depressed people respond full to these medications.

Approximately what percentage respond fully? a) 10% b) 20% c) 35% d) 70% Answer: c Page: 343 Level: Medium Type: Factual

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11-64. A physician is deciding whether to prescribe one of the older tricyclic antidepressant drugs or one of the newer, more recently developed ones.

Fortunately, a medical journal just published a review of the drugs. What is the likely conclusion? a) There are no difference other than cost between the two groups of drugs. b) The newer drugs are more effective, work faster, and have fewer side effects. c) The older drugs have a higher degree of effectiveness but they have some troubling side effects. d) The two types of drugs do not differ in effectiveness, although the newer ones have fewer side effects.

Answer: b Page: 343 Level: Difficult Type: Conceptual 11-65. Which treatment for depression requires careful restrictions in diet? a) tricyclic antidepressants b) electroconvulsive therapy c) monoamine oxidase inhibitors d) selective serotonin reuptake inhibitors Answer: c Page: 343 Level: Medium Type: Factual 11-66. A patient at the mental health clinic is given a list of foods he should not consume while taking a drug prescribed for depression. What type of drug has been prescribed for this patient? a) MAO inhibitor b) benzodiazepine c) tricyclic antidepressant d) selective serotonin reuptake inhibitor Answer: a Page: 343 Level: Medium Type: Conceptual 11-67. A severely depressed patient is brought to a hospital emergency room. He has tried to commit suicide, and he says he will try again. When the man's family members arrive, what treatment will physicians recommend? a) MAO inhibitors 277

b) electroconvulsive therapy c) selective serotonin reuptake inhibitors d) a double dose of a tricyclic antidepressant Answer: b Page: 346 Level: Difficult Type: Conceptual

11-68. Why is electroconvulsive therapy sometimes used instead of antidepressant medication in the treatment of severe depression? a) It is less expensive. b) It works more quickly. c) It has fewer side effects. d) It has a stronger theoretical rationale.

Answer: b Page: 346 Level: Medium Type: Factual 11-69. Among severely depressed patients who have not responded to antidepressant medications, what percentage show marked improvement after electroconvulsive therapy? a) 10% b) 30% c) 50% d) 70% Answer: c Page: 346 Level: Medium Type: Factual 11-70. Over the years several changes have occurred in electroconvulsive therapy. Because you have seen movies such as One Flew Over the Cuckoo's Nest you are reluctant to give consent for such treatment for your uncle who the court has declared unable to make the decision for himself.

You express your concerns to the chief psychiatrist. What will you be told that will allay your fears? a) The patient is under general anesthesia and the treatment is done to only one side of the head. b) Treatment now involves battery-powered shocks that are given only once, with no side effects. c) The electrical pulse is about one-third what it was in the past, and with bifrontal placement, there is little effect on memory. d) Prior to receiving the treatment, both antidepressants and anesthetics are given, so the treatment is safer and works more 278

quickly.

Answer: c Page: 346 Level: Difficult Type: Conceptual 11-71. Which of the following individuals is most likely to be treated and respond to treatment with electroconvulsive therapy? a) Ann who is suffering from dysthymia b) Barbara who is suffering from cyclothymia c) Carl whose diagnosis is major depression with delusions d) David whose diagnosis is adjustment disorder with depressed mood Answer: c Page: 347 Level: Difficult Type: Conceptual

11-72. Robert is severely depressed and suicidal. At a hastily called case conference, the staff recommends electroconvulsive therapy. What is the most likely series of treatment that Robert will receive? a) daily treatments for three weeks b) six to 12 sessions at about three sessions per week c) one treatment per week for approximately one month d) one massive ECT treatment followed by antidepressant medication Answer: b Page: 347 Level: Difficult Type: Conceptual 11-73. In 1972, George McGovern chose Thomas Eagleton for his presidential running mate. Thomas Eagleton was removed from the ticket because he had the following treatment for depression? a) drug therapy b) electroconvulsive therapy c) seizures resulting from medication d) psychotherapy Answer: b Page: 348 Level: Medium Type: Factual 11-74. What did Sigmund Freud believe characterized the psychic structure of a depressed person? a) a strong ego b) an unregulated id c) a strong, punishing superego d) diffuse boundaries between id, ego, and superego Answer: c Page: 349 Level: Medium Type: Factual 279

11-75. The psychoanalyst, John Bowlby, viewed depression as: a) a relationship between childhood loss and later development. b) the Oedipus complex. c) a strong and punitive superego. d) the ego's feeling of helplessness.

Answer: a Page: 349 Level: Medium Type: Factual 11-76. Interpersonal therapy is a variation of what form of therapy? a) cognitive b) biological c) behavioral d) psychodynamic Answer: d Page: 350 Level: Medium Type: Factual

11-77. What do existential theorists view as the central cause of depression? a) cognitive distortions b) significant loss of a loved object c) changes in self assessment following a loss d) repressed anger at others perceived to be intrusive Answer: c Page: 350 Level: Difficult Type: Conceptual 11-78. Which theoretical perspective holds that the higher rate of depression among women (compared to men) might be due to women's frustrations with not being able to perform multiple roles as well as they would like? a) cognitive b) behavioral c) humanistic d) psychodynamic Answer: c Page: 350 Level: Medium Type: Factual 11-79. According to the behavioral perspective, what characterizes depressed persons’ coping? a) delaying action b) impulsive actions c) use of irrational attributions d) unconscious anger at others 280

Answer: a Page: 351 Level: Medium Type: Factual 11-80. What is a schemata? a) a map of the brain b) attention-seeking behavior c) a way of interpreting behavior d) a treatment plan for changing behaviors Answer: c Page: 352 Level: Medium Type: Factual 11-81. According to Aaron Beck, the cognitive triad consists of negative thoughts about a) self, others, and society. b) past, present, and future. c) oneself, the situation, and the future. d) one's intelligence, looks, and personality.

Answer: c Page: 352 Level: Medium Type: Factual

11-82. What is the cognitive triad? a) major depression, dysphoria, and double depression b) unipolar mood disorder, bipolar I disorder, and bipolar II disorder c) attention to negative features of the self, the situation, and future d) behavioral, cognitive, and emotional changes that occur in depression Answer: c Page: 352 Level: Medium Type: Factual 11-83. According to Aaron Beck, which of the following is typical of the cognitions of persons with anxiety disorders? a) focus on negative aspects of the past b) worry about whether or not they can cope c) pessimistic view of what the future will bring d) belief that nothing can be done to change the future Answer: b Page: 352 Level: Medium Type: Conceptual 11-84. Which attributional style characterizes the depressed person's thinking? a) blaming others for one's faults 281

b) thinking that failure is due to bad luck c) believing that success is not due to good luck d) feeling responsible when something bad happens Answer: d Page: 352 Level: Medium Type: Conceptual 11-85. What is the hypothesized link between hopelessness and depression? a) hopelessness leads to depression b) depression leads to hopelessness c) hopelessness leads to helplessness, which leads to depression d) depression leads to helplessness, which leads to hopelessness Answer: a Page: 352 Level: Medium Type: Factual 11-86. Which of the following is an example of learned helplessness? a) being untrustworthy b) realizing you need professional help c) manipulating others to get attention d) feeling no control over what happens Answer: d Page: 352 Level: Medium Type: Conceptual 11-87. In what area are depressed persons' cognitions actually more accurate than those of nondepressed persons? a) descriptions of happy events b) evaluations of their own social skills c) ratings of others' depressed behaviors d) predictions about how well they will cope Answer: b Page: 353 Level: Medium Type: Factual 11-88. What is the primary emphasis of cognitive-behavior therapy for depression? a) uncovering repressed anger b) fostering close relationships c) changing automatic thoughts d) mobilizing the client to perform self-help tasks Answer: c Page: 353 Level: Medium Type: Factual 11-89. Elletta has a long history of depression. Her psychosocial history indicates both biological and personally related factors have combined to both increase and decrease her stressors for depression. Which perspective would be used as therapeutic explanation and intervention. a) behavioral b) cognitive-behavioral 282

c) vulnerability-resilience d) psychodynamic Answer: c Page: 353 Level: Medium Type: Conceptual 11-90. A historian is writing a biography of Abraham Lincoln. He describes the symptoms Lincoln suffered during his life and asks your opinion on the most likely diagnosis. What would you respond? a) depression b) cyclothymia c) schizophrenia d) avoidant personality disorder Answer: a Page: 354 Level: Difficult Type: Conceptual 11-91. What did the results of the National Institute of Mental Health's study of various psychotherapies and drug treatments for depression show about the effectiveness of these treatments? a) All were significantly better than the placebo. b) Cognitive therapy was more effective long-term. c) Drug treatment was the most effective form of treatment. d) There was little difference among the forms of treatment.

Answer: d Page: 355 Level: Difficult Type: Factual

11-92. What would be a rationale as to why the number of people affected during their early 20’s with bipolar disorder is underestimated. a) Early presenting symptoms are diagnosed as an attention disorder.

The initial symptom may also be depression but when mania is experienced, reclassification occurs from a unipolar to a bipolar disorder. b) Early presenting symptoms can present as a hyperactivity disorder, and later depression is diagnosed. c) Most people do not seek treatment during the early stages. d) Clinicians have difficulty differentiating unipolar disorder from bipolar disorder at this age.

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Answer: a Page: 356 Level: Difficult Type: Factual 11-93. Which of these individuals is most likely to develop the symptoms of bipolar disorder? a) Alice, who is 25 years old b) Carla, who is 45 years old c) Daniel, who is 10 years old d) Grant, who is 65 years old Answer: a Page: 356 Level: Medium Type: Conceptual 11-94. Why are estimates of the prevalence of bipolar disorder thought to underestimate the actual frequency of the disorder? a) The symptoms are hard to detect. b) Insurance does not cover the cost of therapy. c) Bipolar disorder is often mistaken for panic disorder. d) Some patients with mild symptoms are never diagnosed with this disorder.

Answer: d Page: 356 Level: Difficult Type: Conceptual 11-95. Which of the following is not a group of bipolar disorders in DSM-IVTR? a) bipolar II disorder b) miscellaneous disorder c) cyclothymic disorder d) dysthymic disorder Answer: d Page: 357 Level: Medium Type: Factual 11-96. Barbara just experienced an episode of mania. Which diagnosis describes her condition? a) dysthymic disorder b) bipolar I disorder c) unipolar mood disorder d) dysphoric mood disorder Answer: b Page: 357 Level: Difficult Type: Conceptual 11-97. Which of the following is a major feature of mania? a) criminality b) elevated mood c) dissociation d) blunted affect Answer: b Page: 358 Level: Medium Type: Factual 284

11-98. In which disorder is the most severe mania experienced? a) dysthymia b) cyclothymia c) bipolar I disorder d) bipolar II disorder Answer: c Page: 358 Level: Medium Type: Factual 11-99. Which psychiatric disorder was relatively common among famous American poets in the 1900s? a) dysthymia b) schizophrenia c) bipolar disorder d) adjustment disorder with depressed mood Answer: c Page: 358 Level: Medium Type: Factual 11-100. Jack suffered a serious episode of depression that is diagnosed as major depressive disorder. A year later he experiences an episode of mania.

What is his diagnosis after the manic episode? a) cyclothymia b) bipolar disorder c) dysthymic disorder d) major depressive disorder Answer: b Page: 358 Level: Difficult Type: Conceptual 11-101. Last year George experienced an episode of mania but had no episodes of major depression. A clinical psychologist has evaluated him using DSM-IV-TR criteria. Which disorder is the psychologist considering? a) hypomania b) bipolar I disorder c) bipolar II disorder d) atypical mood disorder Answer: b Page: 358 Level: Difficult Type: Conceptual

11-102. Elevated mood, psychomotor agitation, and flight of ideas are all characteristic of a) mania. b) dysthymia.

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c) schizophrenia. d) unipolar mood disorder.

Answer: a Page: 358 Level: Medium Type: Factual 11-103. Before making a diagnosis of bipolar disorder, a mental health professional needs to make sure that the symptoms are not the result of other causes such as a) diabetes. b) MAO inhibitors. c) Huntington's disease. d) elevated cholesterol level.

Answer: b Page: 359 Level: Difficult Type: Conceptual 11-104. A professor of psychiatry is giving a lecture on mood disorders.

Then he presents a case history and asks for the likely diagnosis. When the class suggests bipolar disorder, the professor points out that they should first eliminate the possibility that the symptoms are due to which of the following? a) steroids b) antibiotic drugs c) antipsychotic drugs d) immune suppressing drugs Answer: a Page: 359 Level: Difficult Type: Conceptual 11-105. Which of the following is not a causal factor of mania? a) biochemical factors b) infection c) tumors d) repressed depressive symptoms Answer: d Page: 359 Level: Medium Type: Factual 11-106. For several years, Ralph has experienced alternating episodes of very severe depression and milder episodes of mania. What is the most appropriate diagnosis? a) bipolar I disorder b) bipolar II disorder c) cyclothymic disorder d) manic-depressive psychosis Answer: b Page: 359 Level: Difficult Type: Conceptual

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11-107. How do bipolar I disorder and bipolar II disorder differ? a) Bipolar I involves hypomania. b) Bipolar II involves hypomania. c) Bipolar I involves no mania or hypomania. d) Bipolar II involves no mania or hypomania.

Answer: b Page: 359 Level: Medium Type: Conceptual 11-108. Bipolar II disorders differ from bipolar I disorders in that: a) medication diffuses the symptoms b) the client has a hypomanic episode c) psychotherapy provides a catharsis for energy d) clients are not as pathological in thought components Answer: b Page: 359 Level: Medium Type: Factual 11-109. A chronic but less severe form of bipolar disorder is a) dysthymia. b) dysphoria. c) cyclothymia. d) unipolar disorder.

Answer: c Page: 361 Level: Medium Type: Factual 11-110. In cyclothymic disorder: a) both hypomanic and depressive behavior occur b) only hypomanic behavior occurs c) the person has at least three major depressive episodes d) dysthymic disorder occurs prior to age 30 Answer: a Page: 361 Level: Medium Type: Factual 11-111. Which person is most likely to have a family member with bipolar disorder? a) someone with dysthymia b) someone with bipolar disorder c) someone with unipolar disorder d) someone without a mood disorder Answer: b Page: 361 Level: Medium Type: Conceptual

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11-112. A group of scientists has been asked to report on the efforts to identify the specific genes involved in bipolar disorder. What are they likely to conclude? a) The gene is located on the sex chromosomes. b) Current research suggests that a combination of dozens of genes is responsible for the disorder. c) The genes involved are likely to be different depending on the individual's sex and ethnic background. d) The search continues because several genes have been identified but few have been found in more than one study.

Answer: d Page: 361 Level: Difficult Type: Conceptual 11-113. An expert on the genetics of bipolar disorder is asked to describe the evidence collected so far relating genetic factors in the etiology of this disorder. What is she likely to say? a) "To date, evidence for a genetic etiology is weak at best." b) "The case for an inherited predisposition seems very strong." c) "The genetic etiology varies greatly with sex and ethnic group." d) "While there is some genetic involvement, the etiology is more strongly tied to environment factors.”

Answer: b Page: 361 Level: Difficult Type: Conceptual 11-114. What is the drug of choice in the treatment of bipolar disorder? a) lithium b) tricyclics c) monoamine oxidase inhibitors d) selective serotonin reuptake inhibitors Answer: a Page: 362 Level: Medium Type: Factual 11-115. An insurance company reviewer is examining the records of a patient who is being treated with lithium. The treating physician apparently forgot to fill in the line for the diagnosis. Before the reviewer calls the physician's office she is quite sure that the most likely diagnosis is a) dysthymia. b) schizophrenia. c) bipolar disorder. d) schizotypal personality disorder Answer: c Page: 362 Level: Difficult Type: Conceptual 288

11-116. Why does lithium intake have to be carefully monitored? a) Lithium is addictive. b) Lithium reacts negatively with tyrosine. c) Slight changes in lithium levels can be toxic. d) Monoamine oxidase inhibits lithium's impact.

Answer: c Page: 362 Level: Medium Type: Conceptual 11-117. What is one reason that many bipolar patients stop taking lithium? a) Lithium causes muscle spasms. b) Lithium reacts with certain foods. c) Patients do not understand the serious nature of their disease. d) Patients may be unwilling to give up the pleasant changes of their elevated mood.

Answer: d Page: 362 Level: Medium Type: Conceptual 11-118. According to a patient's chart at the mental health center, she has been prescribed divalproex. Based on these prescriptions, what might you conclude is the likely diagnosis? a) schizophrenia b) bipolar disorder c) major depressive disorder d) generalized anxiety disorder Answer: b Page: 362 Level: Difficult Type: Conceptual 11-119. What is one of the advantages of treating bipolar disorder with anticonvulsants rather than lithium? a) They work more quickly. b) They have fewer side effects. c) They do not require a prescription. d) They have a stronger effect on the more serious symptoms.

Answer: b Page: 362 Level: Medium Type: Conceptual 11-120. Approximately how many people kill themselves each year in the United States? a) 5,000 b) 15,000 c) 30,000 d) 100,000 Answer: c Page: 364 Level: Medium Type: Factual 289 11-121. Which mood disorder has the highest risk of suicide?

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a) bipolar II disorder b) bipolar I disorder c) unipolar disorder d) cyclothymic disorder Answer: a Page: 364 Level: Medium Type: Factual

11-122. “Parasuicide” describes: a) suicidal behavior as a result in a belief in parapsychology b) suicidal behavior due to a belief in the supernatural c) suicidal behavior that does not result in death d) cognitive thoughts of attempting suicide Answer: c Page: 364 Level: Medium Type: Factual 11-123. All of the following are risk factors for suicide except: a) age b) education c) marital status d) ethnicity Answer: b Page: 364 Level: Medium Type: Factual 11-124. What is the most common method used to commit suicide? a) drugs b) firearms c) wrist slitting d) jumping from buildings Answer: b Page: 364 Level: Medium Type: Factual 11-125. For which age group is suicide the third leading cause of death? a) 10 to 24 b) 35 to 45 c) 46 to 54 d) 60 to 75 Answer: a Page: 364 Level: Medium Type: Factual 11-126. Which of the following teenage groups are not at high risk of suicide? a) incarcerated youth b) gay, lesbian, and bisexuals 290

c) married teens d) homeless, runaways, and delinquents Answer: c Page: 364 Level: Medium Type: Factual 11-127. Which characteristic is highly predictive of suicide? a) anger b) sadness c) helplessness d) hopelessness Answer: d Page: 365 Level: Medium Type: Factual

11-128. Which of these individuals has an elevated risk for committing suicide? a) Larry who is a plumber b) Michael who is a mechanic c) John who is a police officer d) Kevin who is a high school teacher Answer: c Page: 366 Level: Medium Type: Conceptual 11-129. Suicide by contagion occurs when: a) a well-known person commits suicide b) people want to demonstrate their loyalty to a political cause c) more groups of people commit suicide d) a person’s successful Answer: a Page: 367 Level: Medium Type: Factual 11-130. What is postvention? a) intense treatment for suicidal patients b) training former patients as counselors c) counseling for those close to a suicide victim d) pairing treatments for alcoholism and depression Answer: c Page: 367 Level: Medium Type: Factual

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Essay Questions 11-131. What evidence suggests that gender differences in rates of depression cannot be explained wholly in terms of women's greater tendency to seek psychological help when distressed?

Answer: Surveys that have used a random community samples, found similar gender differences as those found among patient populations. Thus, more women than men suffer from depression, even among those who do not seek treatment.

Page: 336 Level: Difficult Type: Factual 11-132. What is "double depression?"

Answer: Double depression occurs when a person suffers from both dysthymic disorder and major depression. In one survey, almost half of the people who had dysthymic disorder also had at least one episode of major depression.

Page: 338 Level: Medium Type: Factual 11-133. What are the major classes of drugs used to treat depression?

Answer: (1) Older (first generation) tricyclic antidepressants like Elavil are slow acting, have many side effects, and can be dangerous in overdose. (2) MAO inhibitors like Nardil require a restricted diet because they can interact with certain food chemicals; they are also slow acting. (3) Selective serotonin reuptake inhibitors (SSRIs) like Prozac and Paxil have fewer side effects than other drugs used to treat depression. They are slow acting, safer in overdose, and expensive.

Pages: 343 – 344 Level: Difficult Type: Factual 11-134. What is the typical course and procedure for electroconvulsive treatment?

Answer: A typical ECT treatment involves 6 to 12 sessions at about three sessions per week. The electrical pulse used today is about one-third of the electrical power used in older methods. While one electrode has been used in the recent past, evidence suggests that this one electrode method is less effective than two electrodes. Two electrodes are again used, but a bifrontal placement is used.

Page: 346 Level: Difficult Type: Factual

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True/False 11-135. Jack is feeling depressed, therefore, he has a depressive disorder.

Answer: False Page: 331 Level: Easy Type: Conceptual 11-136. Research indicates that high educational and income levels correlate positively for feelings of depression, sadness, and hopelessness.

Answer: False Page: 332 Level: Easy Type: Factual 11-137. Medically-related mood disorders are caused by medical illness, prescribed medication, or abuse of substances.

Answer: True Page: 332 Level: Easy Type: Factual 11-138. Major depressive disorder is regarded as the second leading cause of disability.

Answer: True Page: 332 Level: Easy Type: Factual 11-139. A simple screening approach by a government task force found that between 25 and 40% of patients giving positive answers had treatable major depression.

Answer: True Page: 333 Level: Medium Type: Factual 11-140. There is a strong relationship between the percent of shared genes between two people and the likelihood that if one of them is diagnosed with a mood disorder, the biological relative will be diagnosed with the same disorder.

Answer: True Page: 335 Level: Medium Type: Factual 11-141. Family research has shown that if a person experiences the first major depressive episode at a young age, the more likely relatives will experience periods of depression.

Answer: True Page: 335 Level: Medium Type: Factual 11-142. Being “male” is one of the greatest risk factors of depression.

Answer: False Page: 335 Level: Easy Type: Factual 293

11-143. The correlation between life events that are stressful and the onset of major depression will decrease as the number of past depressive episodes increases.

Answer: True Page: 336 Level: Medium Type: Factual 11-144. A major protector from depression is social support.

Answer: True Page: 336 Level: Easy Type: Factual 11-145. Transcranial magnetic stimulation (TMS) is an alternative form of brain stimulation used for recovery from mood disorders.

Answer: True Page: 349 Level: Easy Type: Factual

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Chapter 12 Schizophrenia and Other Psychotic Disorders 12-1. At the beginning of the chapter, a woman who suffers from schizophrenia described her story in her own words. What analogy did she use to describe how this disorder affects her life? a) She says she lives in an invisible closet where the walls are imprisoning and the darkness is terrifying. b) She feels as if there is a dark cloud following her everywhere, and like rain clouds she never knows when it will rain on her. c) Every day she struggles to live her life as normally as she can but she feels like a car with a failing battery, never knowing when she can't get started. d) The overwhelming feeling of dread she feels is similar to riding a roller coaster every day; she never knows whether she is in for a slow ride up or a wild ride down.

Answer: a Page: 373 Level: Difficult Type: Factual 12-2. Schizophrenic disorders are part of the category of mental disorders known as a) mood disorders. b) autistic disorders. c) neurotic disorders. d) psychotic disorders.

Answer: d Page: 373 Level: Medium Type: Factual 12-3. What type of disorder does Harry have if he makes incorrect inferences about reality based on alterations in his perceptions, thoughts, or consciousness, and believes that these inferences are real? a) a mood disorder b) a neurotic disorder c) a psychotic disorder d) an adjustment disorder Answer: c Page: 373 Level: Medium Type: Factual 12-4. What term is used for behaviors that were formerly called "madness", "lunacy", or "insanity"? a) anxiety disorders b) neurotic disorders c) schizoid disorders d) psychotic disorders Answer: d Page: 373 Level: Medium Type: Factual 293

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12-5. All of the following are symptoms for psychotic disorder except: a) disorganized behavior b) hallucinations c) disorganized speech d) depression Answer: d Page: 373 Level: Medium Type: Factual 12-6. Delusions and hallucinations do not always indicate the presence of a psychotic disorder. Which of the following is not a condition where this would occur? a) effects of medication b) stress-induced inoculation c) reduced oxygen to the brain d) vitamin deficiencies Answer: b Page: 374 Level: Medium Type: Factual 12-7. People with schizophrenia who actually kill themselves have similar characteristics to people who do not have schizophrenia. However, they have additional characteristics. Which of the following would not be considered as an additional characteristic? a) college-educated b) fearful of further mental disintegration c) hallucinations are not visual d) nondelusional view of the future Answer: c Page: 374 Level: Medium Type: Factual 12-8. Why do schizophrenic disorders have such a large financial impact on the health care system? a) These disorders have a high prevalence rate. b) Antipsychotic medications are very expensive. c) The disorder often leads to severe and permanent disabilities. d) Diagnosing these disorders requires extensive diagnostic tests.

Answer: c Page: 374 Level: Medium Type: Factual

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12-9. In comparison to most people who commit suicide, people with schizophrenia have certain characteristics that do not occur as often in others.

Which of these people best represents someone with schizophrenia who is likely to commit suicide? a) Carl who is young, college-educated, and has a nondelusional negative view of his future b) Frank who is 65 years old, dropped out of high school, and has several bizarre delusions c) Vince who is 45 years old, never attended school, and has a non-chronic form of schizophrenia d) Alicia who is 40 years old, a high school graduate, and experiences auditory hallucinations almost every day Answer: a Page: 374 Level: Difficult Type: Conceptual 12-10. An epidemiologist is conducting research on patients with the diagnosis of schizophrenia. The research is designed to determine what problems occur at elevated rates among people with this diagnosis. When the data are analyzed, what will they show occurs at higher rates among people with schizophrenia compared to the general population? a) anorexia b) suicide attempts c) mental retardation d) loss of immunological functioning Answer: b Page: 374 Level: Difficult Type: Conceptual 12-11. Cecilia believes her thoughts are broadcast straight from her mind through electrical appliances so everyone around can hear them. This delusional belief is most likely part of which DSM-IV-TR diagnosis? a) schizophrenia b) mood disorder c) adjustment disorder d) personality disorder Answer: a Page: 375 Level: Medium Type: Conceptual 12-12. As part of a course in Abnormal Psychology, each student must play the role of a famous figure in the history of abnormal behavior. You have been given the name Eugene Bleuler. You must create a title for a brief presentation. Which of these titles would be best suited for this presentation? a) "The group of schizophrenias" b) "The genetic bases for schizophrenia" c) "The early, child-rearing roots of schizophrenia" d) "Brain damage as the root cause of schizophrenia" Answer: a Page: 375 Level: Difficult Type: Factual 296

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12-13. What types of symptoms distinguish the paranoid subtype of schizophrenia from other subtypes of schizophrenia? a) motor b) cognitive c) emotional d) neurological Answer: b Page: 375 Level: Medium Type: Factual 12-14. What diagnosis is most commonly given to patients with a schizophrenic disorder on their first admission to a psychiatric hospital? a) paranoid type b) catatonic type c) disorganized type d) undifferentiated type Answer: a Page: 375 Level: Medium Type: Factual 12-15. Which type of schizophrenia is characterized by psychomotor disturbances? a) residual b) paranoid c) catatonic d) disorganized Answer: c Page: 375 Level: Medium Type: Factual 12-16. What statement provides an explanation as to why the classification by subtype for schizophrenia is only moderately stable over the course of the illness because symptoms seem to shift from positive symptoms to negative symptoms. a) The changes may be associated with neurological impairment. b) The changes are associated in a build up of tolerance for the medication. c) The changes are a result in improvement in treatment technique. d) Deterioration in behavior is altered due to newer medications.

Answer: a Page: 375 Level: Difficult Type: Factual 12-17. Delusions, sustained suspiciousness, and delusional thinking are associated with: a) catatonic schizophrenia b) disorganized schizophrenia c) paranoid schizophrenia d) schizoaffective disorder Answer: c Page: 375 Level: Medium Type: Factual

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12-18. During Mike’s clinical interview, the psychologist found that his delusional thinking was well-defined and integrated through various systems. His behavior was not well-integrated. His diagnosis would be: a) paranoid schizophrenia b) catatonic schizophrenia c) delusional disorder d) disorganized schizophrenia Answer: c Page: 375 Level: Difficult Type: Conceptual 12-19. Which of the following can produce paranoid thinking even if no disorder is present? a) drugs b) aging c) brain damage d) All of the above can produce paranoid thinking even if no disorder is present.

Answer: d Page: 375 Level: Medium Type: Factual 12-20. Psychomotor disturbance, refusing to speak, and waxy flexibility are symptoms of: a) residual schizophrenia b) disorganized schizophrenia c) catatonic schizophrenia d) paranoid schizophrenia Answer: c Page: 375 Level: Medium Type: Factual 12-21. Waxy flexibility is characterized by a) disordered speech. b) extreme immobility. c) psychomotor agitation. d) emotional ambivalence.

Answer: b Page: 375 Level: Medium Type: Factual 12-22. A patient's medical history indicates that he has a diagnosis of catatonic schizophrenia. Which of the following symptoms is likely to occur in this patient? a) stupor b) narcolepsy c) nightmares d) dissociative fugue Answer: a Page: 375 Level: Medium Type: Conceptual

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12-23. Incoherence in expression, flat affect, aimless behavior, and childish disregard for social norms are symptoms of: a) paranoid schizophrenia b) disorganized schizophrenia c) catatonic schizophrenia d) None of the above.

Answer: b Page: 378 Level: Medium Type: Factual 12-24. Maria receives a diagnosis of schizophrenic disorder of the residual type.

What does this mean? a) Maria had previously met the criteria for schizophrenia but no longer has prominent positive symptoms. b) Maria had previously met the criteria for schizophrenia but no longer has prominent negative symptoms. c) Maria’s condition has worsened. d) Maria is in a transitory phase and needs re-evaluated.

Answer: a Page: 378 Level: Difficult Type: Conceptual 12-25. Seven years ago Alan was diagnosed as suffering from schizophrenia.

At the current time he is not exhibiting or reporting any signs of the disorder.

What is the likely diagnosis at this time? a) residual b) hebephrenic c) disorganized d) undifferentiated Answer: a Page: 378 Level: Difficult Type: Conceptual 12-26. Henry's behavior is active but aimless. He refuses to wear clothes, uses silly mannerisms, eats with his fingers, and urinates in public places. Henry's behaviors are most consistent with which type of schizophrenic disorder? a) residual b) catatonic c) disorganized d) undifferentiated Answer: c Page: 378 Level: Difficult Type: Conceptual

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12-27. Max's activity sometimes slows to a point that he appears frozen in bizarre, uncomfortable-looking postures. He maintains these positions for hours, says nothing, and stares straight ahead. These behaviors are most consistent with which type of schizophrenia? a) paranoid b) catatonic c) disorganized d) undifferentiated Answer: b Page: 378 Level: Difficult Type: Conceptual 12-28. What are "positive" symptoms of schizophrenia? a) socially valued symptoms b) genetic markers for the disease c) behaviors experienced as enjoyable d) distortions or excesses of normal functions Answer: d Page: 378 Level: Medium Type: Factual 12-29. Which of these is a positive symptom of schizophrenia? a) flat affect b) delusions c) loss of motivation d) poverty of speech Answer: b Page: 378 Level: Medium Type: Conceptual 12-30. What term is used for faulty interpretations of reality that cannot be shaken despite clear evidence to the contrary? a) delusions b) fantasies c) hallucinations d) defense mechanisms Answer: a Page: 378 Level: Medium Type: Factual 12-31. ________ occur in the early stages of schizophrenia while __________ are more prominent in the later stages of schizophrenia. a) Positive symptoms; hallucinations b) Positive symptoms; negative symptoms c) Negative symptoms; delusions d) Negative symptoms; positive symptoms Answer: b Page: 378 Level: Medium Type: Factual

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12-32. John believes there are special messages to him in the sports section of the daily newspaper. His friends and family notice nothing unusual about these columns, and John's belief is not shaken despite numerous calls to the newspaper editor about his concerns. How would a psychologist describe John's belief? a) delusion b) hallucination c) loose associations d) disorganized speech Answer: a Page: 378 Level: Difficult Type: Conceptual 12-33. Compared to delusions that occur in other disorders, delusions that occur in schizophrenia tend to a) contain bizarre content. b) involve stronger convictions. c) occur more frequently each day. d) respond more effectively to medication.

Answer: a Page: 379 Level: Medium Type: Conceptual 12-34. A client at the mental hospital believes certain gestures or comments, song lyrics, and passages in books are specifically intended for him. Based on this description, which of the following terms is likely to appear in the written description of the client's symptoms? a) bizarre b) negative c) referential d) hallucinatory Answer: c Page: 379 Level: Difficult Type: Conceptual 12-35. Which of these individuals presents evidence suggesting a bizarre delusion? a) Iris who believes people are persecuting her b) Harry who believes his food has been poisoned c) John who believes he is an extremely important person d) Karen who believes her thoughts are externally controlled Answer: d Page: 379 Level: Medium Type: Conceptual 12-36. Ray believes people are spying on him. What's more, he claims the CIA has put a microphone in his dog's stomach so they can listen to his private conversations. What type of delusion is Ray exhibiting? a) grandeur b) reference c) persecution d) unjustified guilt Answer: c Page: 379 Level: Difficult Type: Conceptual 302

12-37. Which of these individuals could be described as exhibiting a referential delusion? a) Alice who believes her food is being poisoned b) George who believes he is an extremely important person c) Harold who believes that newspaper headlines are about him d) John who believes that someone is inserting thoughts in his mind Answer: c Page: 379 Level: Medium Type: Conceptual 12-38. The delusions that sometimes accompany mania most typically involve the belief that the individual is a) persecuted. b) rotting away. c) loved by a celebrity. d) an extremely important person.

Answer: d Page: 379 Level: Medium Type: Factual 12-39. Which of the following is not a bizarre delusion? a) Others are removing thought from the person’s mind. b) Everyone can hear the person’s thoughts. c) A “voice” is telling the person what to do. d) An external force is controlling the person’s thoughts.

Answer: c Page: 379 Medium Type: Factual 12-40. What term describes projections of internal impulses or experiences onto perceptual images in the external world? a) delusion b) hallucination c) externalization d) negative symptom Answer: b Page: 380 Level: Medium Type: Factual 12-41. What characteristic of the experience of hallucinations in persons during a psychotic episode sets it apart from the experience of hallucinations during a high fever or under the influence of drugs? a) People with schizophrenia are experiencing dissociation. b) The experience of schizophrenia makes the person delirious. c) People with schizophrenia experience hallucinations in a clear, conscious state. d) The disorder of schizophrenia makes the experience pleasurable as a result of the lack of reality contact.

Answer: c Page: 380 Level: Difficult Type: Conceptual

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12-42. What is the most common type of hallucination that occurs in schizophrenia? a) visual b) tactile c) auditory d) olfactory Answer: c Page: 380 Level: Medium Type: Factual 12-43. Mark has a high fever, and he hears voices saying his brother is in danger and needs his help. What term would a psychiatrist use to describe Mark's symptom? a) delusion b) hallucination c) paranoid reaction d) catatonic response Answer: b Page: 380 Level: Medium Type: Conceptual 12-44. Ideas that shift from one topic to another in a seemingly unrelated way are often apparent in a type of disordered speech called a) delusional thinking. b) referential thinking. c) poverty of content. d) loosening of associations.

Answer: d Page: 380 Level: Medium Type: Factual 12-45. When asked to explain the meaning of the saying "strike while the iron is hot," a patient with the diagnosis of schizophrenia responds, "it means don't iron over your hands and don't strike anybody before you cast the first stone." This type of response is an example of a) delusional thinking. b) thought broadcasting. c) an olfactory hallucination. d) loosening of associations.

Answer: d Page: 380 Level: Difficult Type: Conceptual 12-46. Loosening of associations and perseverative speech are examples of a) delusions. b) hallucinations. c) disordered speech. d) attributional errors.

Answer: c Page: 380 Level: Medium Type: Factual

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12-47. The repetition of words or phrases by inserting them in subsequent statements is called: a) disordered speech b) perseverative speech c) disorganized speech d) incoherent speech Answer: b Page: 381 Level: Medium Type: Factual 12-48. A patient's chart indicates that he has exhibited a symptom called disorganized behavior. When you see this patient, what would you expect to observe? a) rambling, unconnected speech b) a high level of joy and happiness c) failure to respond to social stimuli d) unpredictable behavior not related to the surroundings Answer: d Page: 382 Level: Medium Type: Conceptual 12-49. Emil has been diagnosed with schizophrenia. He is prone to sudden, unpredictable, inexplicable outbursts of anger, which causes him to walk in a circle. This is an example of: a) catatonic behavior b) disorganized behavior c) bizarre behavior d) hallucinations Answer: b Page: 382 Level: Medium Type: Conceptual 12-50. What are negative symptoms of schizophrenia? a) behavior deficits b) signs of recovery c) delusions and hallucinations d) indications of a patient's bad attitude Answer: a Page: 382 Level: Medium Type: Factual 12-51. Which of the following is a negative symptom of schizophrenia? a) delusions b) flat affect c) hallucinations d) disorganized speech Answer: b Page: 382 Level: Medium Type: Conceptual

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12-52. Which set of symptoms of schizophrenia consists of negative symptoms? a) delusions, disordered thinking, flat effect b) flattened affect, poverty of speech, lack of directedness c) bizarre behavior, monotonous voice, slow speech d) flat affect, hallucinations, and slowed movements Answer: b Page: 382 Level: Medium Type: Conceptual 12-53. Compared to positive symptoms of schizophrenia, negative symptoms appear to be more closely associated with a) manipulation. b) delusional thinking. c) birth complications. d) genetic predisposition.

Answer: c Page: 382 Level: Medium Type: Factual 12-54. Which of the following is a schizophrenic spectrum disorder? a) paranoid personality disorder and schizoid personality disorder b) antisocial personality disorder and paranoid personality disorder c) histrionic personality disorder and schizotypal personality disorder d) dependent personality disorder and schizotypal personality disorder Answer: a Page: 383 Level: Difficult Type: Factual 12-55. Twenty years ago, Frank was diagnosed as suffering from schizophrenia.

Today he continues to suffer the symptoms of this disorder. Frank's diagnosis places his family members at higher risk for a) alcoholism. b) anxiety disorders. c) major depression. d) schizotypal personality disorder.

Answer: d Page: 383 Level: Difficult Type: Factual 12-56. Schizophrenia spectrum disorders: a) share some of the characteristics with schizophrenia but do not meet the full criteria for a diagnosis of schizophrenia. The spectrum disorders include specific personality disorders. b) share many symptoms and etiological factors with several other Axis I disorders. c) include genetic, environmental and social components. d) are the more serious schizophrenic disorders and have a poor prognosis.

Answer: a Page: 383 Level: Difficult Type: Factual

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12-57. Which of the following personality disorders would share some characteristics with schizophrenia and be included with schizophrenic spectrum disorders? a) schizoid, paranoid, borderline b) schizotypal, paranoid, schizoid c) borderline, schizotypal, schizoid d) borderline, paranoid, schizoid Answer: b Page: 383 Level: Medium Type: Factual 12-58. As part of a debate on the etiology of schizophrenia, two teams of students are preparing their sides by carefully checking the literature. You have been assigned to the side that will argue that genetic factors are not the only ones involved. Which of the following might you want to use during the debate? a) Dopamine is the neurotransmitter most often cited as playing a role in schizophrenia. b) The concordance rate for dizygotic twins is less than then the concordance rate for monozygotic twins. c) Most mental health professionals do not believe there is any cure for schizophrenia, although there might be some recovery. d) The risk of development of schizophrenia is correlated with the closeness of the genetic relationship.

Answer: d Page: 384 Level: Difficult Type: Conceptual 12-59. What is an index case in genetic studies? a) a person with the disorder under study b) a description of prototypical symptoms c) a family member of the person under study d) the ancestor to whom a disorder can be traced Answer: a Page: 384 Level: Medium Type: Factual 12-60. A Mendelian pattern of heredity is associated with which model of genetic transmission? a) polygenic b) monogenic c) diathesis-stress d) multifactorial polygenic Answer: b Page: 385 Level: Medium Type: Factual

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12-61. Which genetic model seems to be the best fit to the findings from genetic research on schizophrenia? a) polygenic b) Mendelian c) monogenic d) multifactorial polygenic Answer: d Page: 385 Level: Medium Type: Factual 12-62. The __________ model in schizophrenia is a model in which one gene pair is all that is needed to determine a particular characteristic. The _______ model assumes several gene pairs must interact to produce a trait. a) multifactorial; polygenic b) monogenic; polygenic c) monogenic; multifactorial d) polygenic; monogenic Answer: b Page: 385 Level: Difficult Type: Factual 12-63. Which of the following individuals has an elevated risk for developing schizophrenia? a) Ray who was born in March in an urban area b) Yul who was born in January in an urban area c) Sandra who was born in August in a rural area d) Brenna who was born in October in an urban area Answer: a Page: 385 Level: Medium Type: Factual 12-64.Why are babies born between January through March believed to have an elevated risk for developing schizophrenia? a) There is an increased risk for influenza and other viral diseases. b) Rapidly changing temperatures can adversely affect the developing fetus. c) The winter months are associated with an increase in the number of falls. d) The stress of weather and an increase in depression following the holiday season makes pregnant women more susceptible to dietary changes that affect their baby.

Answer: a Page: 385 Level: Difficult Type: Conceptual 12-65. You are going to a lecture on new data on the etiology of schizophrenia.

Which of the following is likely to be the specific topic of the presentation? a) "Dopamine is still the key" b) "The neurodevelopmental model" c) "Schizophrenia as a failure of the immune system" d) "How early stress impacts the development of schizophrenia" Answer: b Page: 389 Level: Difficult Type: Conceptual 309

12-66. Some researchers now believe that one of the keys to the development of schizophrenia lies in the process of synaptic pruning? Which of the following illustrates this term? a) High levels of dopamine reduce the number of dendrites in the brain. b) Neurons selectively reduce the number of branches of their dendrites. c) Antipsychotic drugs may reduce schizophrenic symptoms but they also adversely affect the number of dendrites. d) Destruction of certain neural pathways make it possible for the brain to experience hallucinations that occurs in schizophrenia.

Answer: b Page: 389 Level: Difficult Type: Conceptual 12-67. Why do scientists believe that the process of synaptic pruning occurs? a) In order for the brain cells to fit within the skull cavity, some neurons must be sacrificed. b) This process aids the brain in handling the explosive growth of information to which children are exposed. c) The only way for the brain to stay young is to discard some of the older neurons that have developed over time. d) As a child is exposed to stimuli, he or she becomes overwhelmed and the brain compensates by reducing the total number of brain connections.

Answer: b Page: 389 Level: Difficult Type: Conceptual 12-68. The possibility that something goes wrong with prenatal development is supported by the findings that compared to people without schizophrenia, those with schizophrenia are more likely to have a) slanted and crossed eyes. b) a very small tongue and a very large forehead. c) excessive ridges in the forehand and widely spaced eyes. d) unusual spacing of tear ducts and a highly arched palate.

Answer: d Page: 389 Level: Difficult Type: Conceptual 12-69. What is the single best piece of evidence to illustrate the likelihood that schizophrenia is not entirely due to heredity? a) Antipsychotic drugs work by blocking dopamine receptors in the brain. b) The major symptoms of schizophrenia are delusions and hallucinations. c) Disorders such as schizoaffective disorder suggest that this disorder does breed pure. d) Half of the co-twins of monozygotic twins with schizophrenia do not develop schizophrenia.

Answer: d Page: 390 Level: Difficult Type: Conceptual

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12-70. Scanning techniques have shown that some people with schizophrenic disorders have significantly larger a) cerebellums. b) corpus collosums. c) cerebral ventricles. d) frontal cortex areas.

Answer: c Page: 390 Level: Medium Type: Factual 12-71. A group of psychologists has collected a series of videotapes of young children, some of which grew up to be normal and others were diagnosed as suffering from schizophrenia. They give the tapes to a group of professionals and ask them to identify the ones who develop schizophrenia. Which of the following signs would be helpful in making this distinction? a) aggressive movements and tics b) muscular twitches and poor posture c) total number of words used and physical size d) responsiveness to others and amount of eye contact Answer: d Page: 391 Level: Difficult Type: Conceptual 12-72. Why are antipsychotic drugs effective in the treatment of schizophrenia? a) They block dopamine receptors. b) They increase reuptake of dopamine. c) They decrease production of dopamine. d) They change the chemical makeup of dopamine.

Answer: a Page: 391 Level: Medium Type: Factual 12-73. Schizophrenia has been hypothesized to be related to an excess of a) GABA. b) serotonin. c) dopamine. d) acetylcholine.

Answer: c Page: 391 Level: Medium Type: Factual 12-74. What is assortative mating? a) genetic pairing on the locus b) Mendelian patterns of inheritance c) tendency to marry someone similar to oneself d) tendency for recessive genes to disappear over several generations Answer: c Page: 392 Level: Medium Type: Factual

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12-75. What type of people are studied in high-risk research on schizophrenia? a) young adults in stressful inner-city environments b) chronically hospitalized patients with the disorder c) schizophrenics who do not respond to medication d) children with a strong family history of the disorder Answer: d Page: 392 Level: Medium Type: Conceptual 12-76. Prospective studies of children at high risk for schizophrenia show that compared to children who do not develop the disorder, children who develop the disorder show greater problems with a) verbal fluency. b) impaired attention. c) visual-spatial mapping. d) coordination and balance.

Answer: b Page: 392 Level: Medium Type: Factual 12-76. Why have so many studies of schizophrenia been conducted in Denmark? a) Denmark maintains excellent national records. b) The Danes have an exceptionally high rate of the disorder. c) The people of Denmark are especially aware of environmental risks. d) The country has a connection to the disorder due to Hamlet's illness.

Answer: a Page: 394 Level: Medium Type: Factual 12-77. An attentional error that is observed both in people diagnosed with schizophrenia and in the undiagnosed relatives of these patients is probably a a) positive symptom. b) negative symptom. c) trait-linked deficiency. d) state-linked deficiency.

Answer: c Page: 396 Level: Medium Type: Factual 12-78. The deficiencies in information processing exhibited by individuals with schizophrenia are most evident when engaged in a challenging task in the presence of a) music. b) distracters. c) other patients. d) evidence of expressed emotion.

Answer: b Page: 396 Level: Medium Type: Factual

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12-79. What is the focus of current psychophysiological research on schizophrenia? a) delusions b) flat affect c) social withdrawal d) attentional deficits Answer: d Page: 397 Level: Medium Type: Factual 12-81. The Continuous Performance Test is a measure of a) motor skills. b) social aptitude. c) visual attention. d) verbal intelligence.

Answer: c Page: 397 Level: Medium Type: Factual 12-82. What is an example of something a research participant would be asked to do in a study using the Continuous Performance Task? a) visually follow a slow-swinging pendulum b) identify the color ink in which a word is presented c) press a button only when a certain picture appears d) put a mark on a line to indicate strength of an emotion Answer: c Page: 397 Level: Medium Type: Conceptual 12-83. What is the greatest limitation in doing ordinary prospective research on the development of schizophrenia? a) reliance on hospital records b) low incidence of schizophrenia c) difficulty in diagnosing schizophrenia d) biased ratings of schizophrenic behaviors Answer: b Page: 397 Level: Medium Type: Factual 12-84. Which task might a research participant be asked to perform in a study of smooth-pursuit eye movements? a) watch a movie b) watch a pendulum swing c) read a nonsensical sentence d) make eye contact with another person Answer: b Page: 397 Level: Medium Type: Factual

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12-85. Persons who show abnormal patterns of smooth-pursuit eye movement are also likely to exhibit a) aphasia and impaired intelligence. b) mood swings and sleep problems. . c) auditory deficits and excessive skin sensitivity. d) interpersonal difficulties and neurological impairments.

Answer: d Page: 398 Level: Medium Type: Conceptual 12-86. What is the major limitation of the idea that smooth-pursuit eye movement is a trait marker of schizophrenia? a) It also appears in other disorders. b) It is not apparent in close relatives. c) It only appears during acute psychosis. d) It appears as a side effect of medications.

Answer: a Page: 398 Level: Medium Type: Factual 12-87. Which of the following is a disadvantage associated with the use of antipsychotic medications in the treatment of schizophrenia? a) The drugs are extremely expensive. b) There is an elevated risk of addiction. c) The positive symptoms are often exacerbated. d) The drugs have a negative impact on a person's motivation.

Answer: d Page: 400 Level: Medium Type: Factual 12-88. Tim was diagnosed as suffering from schizophrenia and he has been prescribed antipsychotic medication, which he has been taking for a few months.

What is the most likely effect of these drugs on Tim's symptoms? a) Tim's positive symptoms will improve dramatically but his negative symptoms will become worse. b) Tim's negative symptoms will improve dramatically but his positive symptoms will remain at the level before he began taking the drug. c) Tim's positive symptoms will show a temporary improvement but there will be little effect on his attention and cognitive functioning. d) Tim's positive and negative symptoms will both improve dramatically, after the proper level of the drug has been identified, which usually takes a few weeks.

Answer: c Page: 400 Level: Difficult Type: Conceptual

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12-89. What is tardive dyskinesia? a) cognitive worry b) perceptual distortion c) numbing of the senses d) involuntary movements Answer: d Page: 400 Level: Medium Type: Factual 12-90. Tardive dyskinesia is associated with a) electroconvulsive therapy. b) use of antipsychotic drugs. c) certain personality disorders. d) withdrawal from addictive drugs.

Answer: b Page: 400 Level: Medium Type: Factual 12-91. Which of the following was the first of a new type of antipsychotic drugs that were developed to overcome some of the negative aspects of traditional antipsychotic drugs? a) Clozapine b) Lithium c) Elavil d) Prozac Answer: a Page: 400 Level: Difficult Type: Factual 12-92. Virginia's psychiatrist prescribed clozapine to treat the symptoms of schizophrenia. What will Virginia have to do in order to keep taking this drug? a) She will have regular blood tests to monitor the effects of the drug. b) She will modify her diet so she does not eat foods that react with this drug. c) She will reduce her exposure to sunlight to reduce the changes of bad reactions to the drug. d) She will increase her intake of water to compensate for the effects of the drugs on thirst.

Answer: a Page: 400 Level: Difficult Type: Conceptual 12-93. Which drug is not an atypical antipsychotic drug? a) olanzapine b) risperidone c) quetiapine d) prozac Answer: d Page: 400 Level: Medium Type: Conceptual

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12-94. Dan has been hospitalized for more than three years with the diagnosis of schizophrenia. Fortunately, his symptoms have responded to drug treatment and he is about to be released. What is likely to happen to Dan when he is released? a) He will be given the drug in long lasting injectable form. b) He will be given the drug in color-coded form to help him remember to take the proper doses. c) He will undergo periodic electroconvulsive therapy sessions because the combined therapy is more effective than one therapy by itself. d) He will have his diet monitored to insure that he is not consuming any foods that could interact with the drug and reduce its effectiveness.

Answer: a Page: 400 Level: Difficult Type: Factual 12-95. Cognitive therapy helps people with schizophrenia to understand that their hallucinations are a) upsetting to others. b) treatable with medication. c) internal, not external, stimuli. d) caused by delusional thinking.

Answer: c Page: 402 Level: Medium Type: Factual 12-96. Cognitive behavior therapy helps people suffering from schizophrenia to a) recognize internal cues. b) use self-reinforcing statements. c) express themselves with pictures. d) interpret ambiguous stimuli less negatively.

Answer: a Page: 402 Level: Medium Type: Factual 12-97. What is expressed emotion? a) flat affect in people with schizophrenia b) a diagnostic criterion for schizoaffective disorder c) a goal of insight-oriented therapy for people suffering from schizophrenia d) family members' attitudes toward a member whose behavior is disturbed Answer: d Page: 405 Level: Medium Type: Factual 12-98. Which of the following is a component of negative expressed emotion? a) emotional overinvolvement b) improper use of nonverbal skills c) deliberate refusal to follow commands d) excessive patient warmth that is annoying to family members Answer: a Page: 405 Level: Medium Type: Factual 317

12-99. What aspect of family life has been found to be most related to relapse among patients with schizophrenia? a) religiosity b) family size c) expectations for autonomy d) negative attitudes about the patient Answer: d Page: 405 Level: Medium Type: Factual 12-100. The amount of negative expressed emotion in a family has been shown to be correlated with what aspect of a schizophrenic member's psychiatric treatment? a) quicker relapse b) shorter hospitalization c) shorter time on medication d) increased insight in the patient Answer: a Page: 405 Level: Medium Type: Factual 12-101. Among which groups do families show higher levels of negative expressed emotion toward schizophrenic family members? a) Anglo-American b) Mexican-Americans c) families living in India d) families from India living in the U.S. Answer: a Page: 405 Level: Medium Type: Factual 12-102. All of the following individuals suffer from schizophrenia. Which of them would be most likely to show relapse? a) Cara who has been living for a short time with a family that is high in negative expressed emotion b) David who has been living for a long time with a family that is high in negative expressed emotion c) Ann who has been living for a long time with a family that is low in negative expressed emotion d) Brad who has been living for a short time with a family that is low in negative expressed emotion Answer: b Page: 405 Level: Difficult Type: Factual 12-103. Studies on expressed emotion indicate that re-hospitalization occurs more quickly for people with schizophrenia whose families do which of the following? a) provide little stimulation b) are uninvolved in treatment 318

c) see the symptoms as voluntary d) express high criticism and hostility Answer: d Page: 405 Level: Medium Type: Factual 12-104. What is one of the typical first signs of relapse in a person diagnosed as suffering from schizophrenia? a) dysphoria b) hallucinations c) visits to the clinic d) disordered speech Answer: a Page: 405 Level: Medium Type: Factual 12-105. A person with significant depression or manic symptoms along with the development of a thought disorder would be classified as having a) organic brain disorder. b) schizoaffective disorder. c) schizoid personality disorder. d) schizotypal personality disorder.

Answer: b Page: 407 Level: Medium Type: Factual 12-106. Which of the following is not true of schizoaffective disorder? a) deals with behaviors and symptoms that do not fit the categories of major mood disorder or schizophrenia b) Combines characteristics of psychosis with those of major mood disorder c) delusions or hallucinations occur even when symptoms of depressed or manic mood are not present d) mood must be predominantly negative and behavior is destructive Answer: d Page: 407 Level: Difficult Type: Factual 12-107. All are true of delusional disorders except: a) most experience delusions of persecution and ideas of reference b) includes paranoia but is not limited to delusions with paranoid or accusatory elements c) delusions reflect situations that could occur in everyday life d) person must never have met the full criteria for schizophrenia Answer: a Page: 408 Level: Medium Type: Factual

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Essay Questions 12-108. What are the prenatal factors that may be involved in the development of schizophrenia?

Answer: Infants born from January through March, in urban, but not rural, areas have been found in some studies to have a higher risk of developing schizophrenia. One possible explanation is the increased prevalence of influenza and other viral diseases during the winter and spring. Some studies have found that if the mother had influenza while pregnant, the child born of that pregnancy had an increased risk for schizophrenia.

Pages: 385, 388 Level: Difficult Type: Factual 12-109. What are high-risk studies in research on the development of schizophrenia? What is the major benefit and the major drawback of this type of research?

Answer: High-risk research studies a group of people who are thought to have greater-than-average vulnerability to develop a disorder. In schizophrenia research, children with a strong family history of schizophrenia are studied throughout their development, to assess which children develop the disorder and which factors may be associated with this development. Because of the extremely low base rate of schizophrenia, such high-risk research allows a more efficient use of resources.

Pages: 395, 396 Level: Difficult Type: Factual 12-110. Discuss the psychosocial approaches to treat schizophrenia.

Answer: Social Skills: Clients need work in social interactions, self-care, and coping with stress. Also, training in basic skills, social problem-solving, and cognitive effectiveness. Cognitive Skills: Clients need help in memory, attention, and planning. Self-Care Skills: Clients need basic skills in caring for themselves.

Skills for dealing with stress.

Page: 401 Level: Difficult Type: Factual 12-111. Discuss the optimal treatment program for schizophrenia.

Answer: At present, there is no real optimal treatment program. However, preferred treatment should include medication and interventions. Treatment should focus on improving client’s skills, parent and family education, and provide a social safety net.

Page: 406 Level: Difficult Type: Factual

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True/False 12-112. All hallucinations and delusions reflect a psychological disorder.

Answer: False Page: 373 Level: Easy Type: Factual 12-113. Hallucinations and delusions are the defining aspects for psychotic disorders.

Answer: True Page: 373 Level: Easy Type: Factual 12-114. People with schizophrenia have a relatively low rate of suicide attempts.

Answer: False Page: 374 Level: Easy Type: Factual 12-115. Paranoid thinking is a cognitive style that can be expressed from every day fleeting thoughts to delusional thinking.

Answer: True Page: 375 Level: Easy Type: Factual 12-116. Patients diagnosed with catatonic schizophrenia and experience prolonged catatonic excitement can be violent.

Answer: True Page: 375 Level: Easy Type: Factual 12-117. Patients with disorganized schizophrenia have a positive long-term prognosis.

Answer: False Page: 378 Level: Easy Type: Factual 12-118. In the early stages of schizophrenia, positive and negative symptoms fluctuate in severity and may respond to treatment.

Answer: True Page: 378 Level: Easy Type: Factual 12-119. Negative symptoms dominate the later stages of schizophrenia.

Answer: True Page: 378 Level: Easy Type: Factual 12-120. It is within the realm of possibility that some behavior based on delusional thinking can be organized and logical.

Answer: True Page: 379 Level: Easy Type: Factual 12-121. Research with brain activity during hallucinations indicates that blood flow in the Broca’s area was significantly greater during the time the hallucination was 321

occurring than when it was not.

Answer: True Page: 380 Level: Easy Type: Factual 12-122. The causes of schizophrenia are well known and documented.

Answer: False Page: 383 Level: Easy Type: Factual 12-123. In shared psychotic disorder, delusions appear to have been transferred from one person to another.

Answer: True Page: 408 Level: Easy Type: Factual

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Chapter 13 Cognitive Impairment Disorders 13-1. Bob Oxley, whose case was described in the text, suffered a severe headache that led him to seek medical attention. A CT scan revealed areas of swollen brain tissue. Later, Bob referred to his doctor as "blotcher" and when asked to name 10 animals he could utter only two. What happened to Bob? a) Bob had aphasia resulting from damage to the left frontal lobe. b) Bob had apraxia resulting from damage to the right frontal lobe. c) A CT scan revealed evidence of Huntington's disease, which affects his motor movement. d) A CT scan revealed evidence of Parkinson's disease, which affected his motor movement.

Answer: a Page: 413 Level: Difficult Type: Conceptual 13-2. How do cognitive impairment disorders differ from most other DSM-IV-TR categories? a) They are irreversible conditions. b) They are generally present from birth. c) They are usually treated with surgery. d) They are due to known medical conditions or substances.

Answer: d Page: 413 Level: Medium Type: Conceptual 13-3. Which of the following is not a type of the cognitive impairment disorders? a) delirium b) amnestic disorders c) agnosia d) dementia Answer: c Page: 413 Level: Medium Type: Factual 13-4. A psychology professor is lecturing to a class on Physiological Psychology.

She routinely uses overheads to outline the topic and begins with a one line summary of the topic under discussion. How might she summarize the topic of how the brain ages? a) The brain stops growing after childhood. b) The brain actually begins to deteriorate at birth. c) Different parts of the brain ages at different rates. d) In most people the brain stops growing in middle age.

Answer: c Page: 414 Level: Difficult Type: Conceptual

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13-5. Which of the following is not an area of brain research pertinent to the understanding of normal and abnormal behaviors? a) examining the effects of medications on brain interaction b) clearly defining the role of the brain in regulating and monitoring internal bodily processes c) examining how the brain grows and maintains itself d) identifying memory systems used by the brain at the cellular and module levels Answer: a Page: 414 Level: Medium Type: Factual 13-6. Which of the following is not a causal factor in the unusual behavior in relation to the brain? a) damage to the brain b) diseases to the brain c) strokes d) psychobiological stressors Answer: d Page: 415 Level: Medium Type: Factual 13-7. All of the following are factors influencing vulnerability to brain disorders except: a) stress b) medications c) physical condition d) personality factors Answer: b Pages: 414, 415 Level: Medium Type: Factual 13-8. What is the association between age and vulnerability to brain damage and brain disorders? a) Infants are less vulnerable. b) The elderly are most vulnerable. c) Young adults are most vulnerable. d) The association depends on the disorder.

Answer: d Page: 414 Level: Medium Type: Factual 13-9. In general, how does healthy psychological and social functioning at the onset of an organic condition influence the impact of the condition on behavior? a) hinders adjustment b) unpredictable effect c) promotes adjustment d) increases risk for depression Answer: c Page: 415 Level: Medium Type: Conceptual

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13-10. For an assignment in your abnormal class, you are to compare brain injuries, epilepsy, and acute cerebrovascular diseases with schizophrenia and panic disorders. What will you find when you compare the two groups of disorders? a) The two groups occur with equal frequency. b) Both sets of disorders occur at lower rates now than they did in the past. c) There are large and significant sex differences in the two sets of disorders. d) The group of brain disorders occurs more frequently than schizophrenia and panic disorder.

Answer: d Page: 416 Level: Difficult Type: Factual 13-11. A physician suspects that a patient has a subtle form of brain damage that has not shown up on brain scans. The symptoms include apathy, overeating, reduced capacity to use language, and loss of orientation to time and place.

A referral is made to a neuropsychologist. Which part of the brain might the neuropsychologist suspect has been damaged? a) parietal lobes b) corpus callosum c) cerebellum d) frontal lobes Answer: d Page: 416 Level: Difficult Type: Conceptual 13-12. Which of the following is a possible sign of changes that occur in patients with frontal lobe malfunctions? a) delusions of grandeur and odd postures b) auditory hallucinations and depersonalization c) dissociative amnesia and migraine headaches d) diminished ability to concentrate and loss of orientation to time or place Answer: d Page: 416 Level: Medium Type: Factual 13-13. What is the primary purpose of the mental status examination? a) to make a psychiatric diagnosis b) to describe current behavior and thought c) to draw inferences about the cause of a disorder d) to record direct observation of brain abnormalities Answer: b Page: 416 Level: Medium Type: Factual

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13-14. Alan is scheduled for a mental status examination tomorrow. What can he expect to happen? a) He will undergo PET and CT scans. b) A clinical interview will be conducted. c) A complete blood analysis will be done. d) He will take a battery of psychological tests.

Answer: b Page: 416 Level: Medium Type: Factual 13-15. All of the following are considered for evaluation in a mental status examination except: a) stream of thought b) long-term memory c) mood d) appearance Answer: b Page: 416 Level: Medium Type: Factual 13-16. The mental status examination is supplemented by: a) psychological testing; neurological exam b) neurological exam; educational testing c) neurological exam; medical exam d) psychological testing; CT scan Answer: a Page: 417 Level: Medium Type: Factual 13-17. Clinical neuropsychologists are particularly interested in understanding changes in behavior due to a) anxiety. b) brain lesions. c) hormonal imbalances. d) intrapsychic conflicts.

Answer: b Page: 417 Level: Medium Type: Factual 13-18. Steve was involved in a serious auto accident last week. A team of surgeons worked on him for 8 hours and saved his life. However, the extensive damage to his head raised the possibility that he suffered brain damage.

In addition to the use of brain scans, which of the following professionals is likely to be consulted in order to determine if Steve suffered brain damage? a) neuropsychologist b) clinical psychologist c) forensic psychologist d) counseling psychologist Answer: a Page: 417 Level: Difficult Type: Conceptual 321

13-19. A positron emission tomography (PT) scan provides information about a) structural damage to the brain. b) biochemical changes in the brain. c) interneuronal electrical activity in the limbic system. d) extent of neuronal connections across the hemispheres.

Answer: b Page: 417 Level: Medium Type: Conceptual 13-20. Which brain imaging technique shows patterns of glucose metabolism in areas of the brain? a) computer tomography (CT) b) electroencephalography (EEG) c) brain electrical activity mapping d) positron emission tomography (PT) Answer: d Page: 417 Level: Medium Type: Conceptual 13-21. Which brain imaging technique illustrates anatomical structures in only one plane? a) computer tomography b) magnetic resonance imaging c) positron emission tomography d) brain electrical activity mapping Answer: a Page: 417 Level: Medium Type: Conceptual 13-22. Which brain imaging technique provides a three-dimensional image of the anatomical structures of the brain? a) computer tomography b) magnetic resonance imaging c) positron emission tomography d) brain electrical activity mapping Answer: b Page: 418 Level: Medium Type: Conceptual 13-23. Computer tomography and magnetic resonance imaging are similar in that they both provide information about a) electrical activity in the brain. b) glucose utilization in the brain. c) infections in cerebrospinal fluid. d) anatomical structures in the brain.

Answer: d Page: 418 Level: Medium Type: Conceptual

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13-24. Carl has a high fever and appears disoriented. He has difficulty following his nurse's instructions to sit up and drink some water. He yells things to people who are not there, and he is difficult to understand. When his fever subsides, he no longer exhibits these symptoms. Carl's behavior is consistent with a diagnosis of a) delirium. b) Parkinson's disease. c) Alzheimer's disease. d) multi-infarct dementia.

Answer: a Page: 418 Level: Difficult Type: Conceptual 13-25. Which of the following is characteristic of cases involving delirium? a) disorientation b) motor disturbances c) atrophy of brain tissue d) progressive loss of intellectual ability Answer: a Page: 418 Level: Medium Type: Factual 13-26. Denzel is disoriented and confused. He has difficulty focusing and shifting attention. What is Denzel’s diagnosis? a) dementia b) attention disorder c) delirium d) Korsakoff’s syndrome Answer: c Page: 418 Level: Medium Type: Conceptual 13-27. Which of the following conditions is not an organic cause of delirium? a) withdrawal from drugs b) tumor c) intoxication d) confabulation Answer: d Page: 419 Level: Medium Type: Factual 13-28. A group of medical students is learning the criteria used to diagnose cognitive disorders. The professor is discussing evidence of disturbances of consciousness along with cognitive deficits such as memory deficits. What type of disorder is being discussed? a) delirium b) dementia c) amnestic disorder d) depersonalization Answer: a Page: 419 Level: Difficult Type: Conceptual 323

13-29. Last year, Bob was admitted and released from the hospital within two days. The diagnosis was a cognitive disorder. Since that time he has held down a job as an engineer. Which of the following disorders is most likely to have caused Bob's hospitalization? a) delirium b) dementia c) Parkinson's disease d) Huntington's disease Answer: a Page: 419 Level: Difficult Type: Conceptual 13-30. Which disorder develops over a short period of time and is marked by relatively global cognitive impairment, disorientation, and confusion? a) delirium b) dementia c) Parkinson's disease d) Alzheimer's disease Answer: a Page: 419 Level: Medium Type: Conceptual 13-31. Which of these individuals is at greatest risk for experiencing delirium? a) Steve who drinks lots of water every day b) Ray who sleeps more than eight hours each night c) Ted who eats a lot of chocolate on break each day d) William who is hospitalized after undergoing heart surgery Answer: d Page: 419 Level: Medium Type: Conceptual 13-32. Which of the following is a primary cause of delirium? a) dopamine deficit b) brain deterioration c) lack of oxygen to the brain d) excess glucose in the brain Answer: c Page: 419 Level: Medium Type: Factual 13-33. Which of these people represents the group of individuals with the highest incidence of delirium? a) Alice who is 5 years old b) George who is 15 years old c) Nancy who is 25 years old d) Margaret who is 65 years old Answer: d Page: 419 Level: Medium Type: Factual

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13-34. Which of these people is most likely to experience the effects of delirium tremors? a) Zach who prefers to drink wine b) Tom who drinks alcoholic beverages very slowly c) Oz who eats lots of high calorie foods when he drinks d) Rob who suddenly stopped drinking after drinking heavily for years Answer: d Page: 419 Level: Medium Type: Conceptual 13-35. Frank is rushed to the emergency room where a physician quickly determines he is experiencing delirium tremors. Which of the following class of drugs is likely to be administered? a) antibiotics b) tranquilizers c) antipsychotic d) antidepressant Answer: b Page: 419 Level: Difficult Type: Factual 13-36. Which condition is associated with the cessation of heavy drinking? a) dementia b) general paresis c) delirium tremors d) Parkinson's disease Answer: c Page: 419 Level: Medium Type: Factual 13-37. About what percentage of alcoholics experience delirium tremors? a) 1% b) 5% c) 15% d) 25% Answer: b Page: 419 Level: Medium Type: Factual 13-38. What is the effect of delirium tremens on brain wave activity? a) more rapid firing of neurons b) slowing of brain wave patterns c) more erratic brain wave patterns d) increased risk of epileptic seizure Answer: b Page: 419 Level: Medium Type: Factual

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13-39. Which acute brain condition is characterized by terrifying visual hallucinations? a) dementia b) Pick's disease c) delirium tremens d) Parkinson's disease Answer: c Page: 419 Level: Medium Type: Factual 13-40. Dementia is primarily characterized by loss of a) hearing. b) peripheral vision. c) fine motor control. d) intellectual abilities.

Answer: d Page: 420 Level: Medium Type: Factual 13-41. Over a period of several years, Lena has shown a gradual decline in cognitive abilities, although physically she remains healthy. She may be exhibiting a) delirium. b) dementia. c) delirium tremors. d) general paresis.

Answer: b Page: 420 Level: Medium Type: Factual 13-42. Typically, the onset of dementia is a) sudden. b) gradual. c) induced by head injury. d) associated with infection.

Answer: b Page: 420 Level: Medium Type: Factual 13-43. All are symptoms of dementia except: a) confusion b) loss of self-control c) difficulty focusing attention d) language problems Answer: c Page: 420 Level: Medium Type: Factual

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13-44. Beyonce just celebrated her 68th birthday. Her daughter describes her as being confused with language difficulties. She has loss of self-control and changes in personality. Her diagnosis is: a) dementia b) delirium c) senile dementia d) Korsakoff’s syndrome Answer: c Page: 420 Level: Medium Type: Conceptual 13-45. Which of the following individuals is most likely to suffer from senile dementia? a) Sam who is 68 years old b) Alice who suffered from delirium c) Alex who is withdrawing from alcohol d) Steve who is recovering from a head injury Answer: a Page: 420 Level: Medium Type: Conceptual 13-46. What term is used to designate degeneration of brain tissue? a) infarct b) plaque c) atrophy d) tremens Answer: c Page: 420 Level: Medium Type: Factual 13-47. When Mr. Bolden is asked about something he cannot remember, he gives a detailed, but inaccurate, answer. His responses often make it difficult for others to realize he has memory lapses. Mr. Bolden's behavior is called a) delirium. b) malingering. c) confabulation. d) amnestic disorder.

Answer: c Page: 420 Level: Medium Type: Conceptual

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13-48. As part of a routine interview of a patient in a psychiatric hospital, a psychologist asked, "What did you have for dinner?" The patient described a dinner of Beef Wellington and all the trimmings. After determining that Beef Wellington had not been served, the psychologist checked the patient's records and found he had been admitted for severe alcohol problems. With that information, the psychologist concluded the answer was most likely an example of a) repression. b) confabulation. b) delusional thinking. d) dissociative amnesia.

Answer: b Page: 420 Level: Difficult Type: Conceptual 13-49. The staff of the mental health center is discussing guidelines they can use to distinguish depression from dementia. Which of the following is likely to occur in cases of dementia but not in cases of depression? a) The patient exaggerates any disability. b) The patient attempts to hide memory loss. c) Abuse of alcohol is the actual presenting problem. d) Symptoms severity is greatest in the morning hours.

Answer: b Page: 420 Level: Difficult Type: Conceptual 13-50. Which symptom must be present in order to meet the criteria for a diagnosis of dementia? a) memory impairment b) vague or empty speech c) disturbances in planning ability d) disturbance in the ability to abstract Answer: a Page: 420 Level: Medium Type: Factual 13-51. Treatment of dementia focuses on: a) reducing patient distress b) improving behavior and cognitive function c) reducing family distress d) All of the above.

Answer: d Page: 421 Level: Medium Type: Factual 13-52. Which of the following questions and responses would provide the most 328

useful information in assessing a patient suspected of suffering Alzheimer's disease? a) "Can you point to your eye?" b) "How are you feeling today?" c) "Spell the word 'chair' backwards." d) "Walk a straight line from here to the wall."

Answer: c Page: 421 Level: Difficult Type: Conceptual 13-53. What are the two major types of Alzheimer's disease? a) sporadic and familial b) psychotic and neurotic c) delirious and demented d) primary and secondary Answer: a Page: 422 Level: Medium Type: Factual 13-54. What is the most common form of presenile dementia? a) delirium b) Pick's disease c) Alzheimer's disease d) multi-infarct dementia Answer: c Page: 422 Level: Medium Type: Factual 13-55. An epidemiologist from the U.S. Department of Health and Human Services wrote a report on the current and future prevalence of Alzheimer's disease. Which of the following titles would be most suitable for that report? a) "Rates to rise" b) "Predicting the unpredictable" c) "Genetic breakthroughs have cut the toll" d) "Surgery will reverse the effects of Alzheimer's disease" Answer: a Page: 422 Level: Difficult Type: Conceptual 13-56. What is the average time between the diagnosis of Alzheimer's disease and the person's death? a) 6 months b) 3 years c) 8 years d) 15 years Answer: c Page: 422 Level: Medium Type: Factual 13-57. Which disorder constitutes 50% to 60% of the 1.3 million people in nursing homes? a) Pick’s disease b) Alzheimer’s disease c) Korsakoff’s syndrome 329

d) Huntington’s disease Answer: b Page: 422 Level: Medium Type: Factual

13-58. What are plaques? a) epileptic seizures b) stroke-causing tumors c) periods of oxygen deprivation d) disintegrated nerve cell branches Answer: d Page: 423 Level: Medium Type: Factual 13-59. Which of the following is one of the most distinctive characteristics of Alzheimer's disease? a) tangled clumps of nerve cells in the brain b) insufficient levels of dopamine in the brain c) abnormal electrical activity in the cerebellum d) abnormal glucose metabolism in the limbic system Answer: a Page: 423 Level: Medium Type: Factual 13-60. Alzheimer's disease is associated with lowered amounts of what substance in the brain? a) serotonin b) thiamine c) dopamine d) acetylcholine Answer: d Page: 423 Level: Medium Type: Factual 13-61. What is beta amyloid? a) a protein found in Alzheimer's plaques b) a vitamin whose deficiency causes pellagra c) an experimental drug for Parkinson's disease d) a messenger chemical produced by cholinergic cells Answer: a Page: 424 Level: Medium Type: Factual 13-62. Which of the following is being investigated as a risk factor for Alzheimer's disease? a) history of syphilis b) thiamine deficiency c) dopamine deficiency d) presence of apolipoprotein E 330

Answer: d Page: 424 Level: Medium Type: Factual

13-63. Darcia’s family has noticed very subtle signs of intellectual decline, most notably in executive functions. Her family is concerned even though this factor has not interfered with daily life. What is her diagnosis? a) dementia b) delirium c) mild cognitive impairment d) persenile dementia Answer: c Page: 424 Level: Medium Type: Factual 13-64. Which of the following is a strategy recommended for the caregivers of Alzheimer's patients? a) write only in large letters b) color code rooms in the house c) speak very slowly and deliberately d) increase the amount of protein in the diet Answer: b Page: 426 Level: Medium Type: Factual 13-65. Research on stress for caregivers of Alzheimer’s victims has shown that which of the following is of the greatest importance? a) Will I inherit this disorder? b) Is the medication working? c) Will they get better? d) What will happen next?

Answer: d Page: 426 Level: Medium Type: Factual 13-66. Former President Ronald Reagan suffered from a) Parkinson's disease. b) Alzheimer's disease. c) Huntington's disease. d) Korsakoff's syndrome.

Answer: b Page: 426 Level: Easy Type: Factual 13-67. What is one way of diagnosing Alzheimer's disease? a) use chromosomal analysis b) use brain imaging techniques c) administer psychological tests 331

d) There is a characteristic pattern of decrease in metabolic function in certain areas of the brain.

Answer: d Page: 426 Level: Medium Type: Factual

13-68. What do Alzheimer's disease and Pick's diseases have in common? a) They are both caused by toxins. b) They are distinguishable only after an autopsy. c) They are more common in women than in men. d) They are examples of the normal consequences of aging.

Answer: b Page: 428 Level: Medium Type: Conceptual 13-69. Pick's disease is most likely to develop between the ages of a) 20 and 30. b) 40 and 50. c) 60 and 70. d) 80 and 90.

Answer: c Page: 428 Level: Medium Type: Factual 13-70. Which of the following individuals is most likely to develop Pick's disease? a) Ken who is 65 years old b) Jane who is 40 years old c) 40-year-old Vickie who has syphilis d) 33-year-old Terry who abuses alcohol Answer: a Page: 428 Level: Medium Type: Conceptual 13-71. Jamar has been diagnosed with a less common form of Alzheimer’s disease. His diagnosis would be: a) Huntington’s disease b) Crone’s disease c) Pick’s disease d) Parkinson’s disease Answer: c Page: 428 Level: Medium Type: Conceptual 13-72. What is the cause of Huntington's disease? a) viral infection b) a dominant gene c) bacterial infection d) chromosomal mutation Answer: b Page: 428 Level: Medium Type: Factual 332

13-73. Chorea is a symptom of a) vascular disease. b) Alzheimer's disease. c) Parkinson's disease. d) Huntington's disease.

Answer: d Page: 428 Level: Medium Type: Factual 13-74. If one parent is affected with Huntington's disease, what are the odds that a child will inherit the disorder? a) 0% b) 50% c) 75% d) 100% Answer: b Page: 428 Level: Medium Type: Factual 13-75. Newly developed genetic tests make it possible to determine if individuals have the genes for diseases such as Huntington's disease. Because Marsha and Ray know that the disease runs in their families, they had their newborn daughter tested. If the genetic test reveals that the baby has the gene for Huntington's disease, what is the likely outcome? a) She will inevitably develop the disease. b) She can be treated with preventive medications. c) She will be a carrier, but may not develop the disease. d) She may develop the disease if she experiences stress.

Answer: a Page: 428 Level: Difficult Type: Conceptual 13-76. Which disorder is an autosomal dominant disorder? a) Pick’s disease b) Huntington’s disease c) Parkinson’s disease d) Alzheimer’s disease Answer: b Page: 428 Level: Medium Type: Factual 13-77. Which symptom is found in Huntington's disease? a) fugue b) mania c) cataplexy d) choreiform movements Answer: d Page: 428 Level: Medium Type: Factual 13-78. What are choreiform movements? a) changes in metabolism b) spasmodic jerking and twisting 333

c) tremor and chewing movements d) wandering associated with dementia Answer: b Page: 428 Level: Medium Type: Factual

13-79. Anthony suffers from involuntary, jerky movements of his face, neck, limbs, and trunk. His symptoms began in his 40s and have grown progressively worse.

He also shows progressive dementia. These symptoms are consistent with a diagnosis of a) Pick's disease. b) Parkinson's disease. c) Alzheimer's disease. d) Huntington's disease.

Answer: d Page: 428 Level: Medium Type: Conceptual 13-80. A neurologist diagnosed a patient as suffering from Huntington's disease.

The patient wants to know what other symptoms he can expect to develop as the disease progresses. Which symptoms will the neurologist list as likely to occur? a) anorexia, aphasia, and mania b) apraxia, apathy, and insomnia c) amnesia, delusions, and double vision d) dementia, depression, and hallucinations Answer: d Page: 428 Level: Difficult Type: Factual 13-81. Which psychological symptoms are often associated with Huntington's disease? a) flat affect, slurred speech, euphoria b) depression, obsessions, and compulsions c) restlessness, disorientation, and insomnia d) drowsiness, lack of attention, and memory loss Answer: b Page: 428 Level: Medium Type: Factual 13-82. Huntington's disease is associated with deficiencies in a) acetylcholine. b) beta amyloid. c) apolipoprotein E. d) gamma-amino-butyric-acid.

Answer: d Page: 429 Level: Medium Type: Factual 13-83. Folksinger Woody Guthrie suffered from a) Parkinson's disease.

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b) Alzheimer's disease. c) Huntington's disease d) Korsakoff's syndrome.

Answer: c Page: 429 Level: Easy Type: Factual

13-84. Parkinson's disease is thought to be caused by a deficiency of a) GABA. b) calcium. c) thiamine. d) dopamine.

Answer: c Page: 430 Level: Medium Type: Factual 13-85. Fifty-year-old Carl suffers from a tremor, rigidity, and loss of vocal power.

He looks expressionless, as if he were wearing a mask. These symptoms are consistent with a diagnosis of a) Pick's disease. b) Alzheimer's disease. c) Parkinson's disease. d) Huntington's disease.

Answer: c Page: 430 Level: Medium Type: Conceptual 13-86. Which of the following symptoms is characteristic of Parkinson's disease? a) chorea b) aphasia c) tremor d) cataplexy Answer: c Page: 430 Level: Medium Type: Factual 13-87. A new protein, glial-celline-derived neurotrophic factor counters the degeneration of what disorder? a) Parkinson’s disease b) Hungtington’s disease c) Pick’s disease d) Alzheimer’s disease Answer: a Page: 430 Level: Medium Type: Factual 13-88. L-dopa is a drug that has been used to treat a) Alzheimer's disease. b) Parkinson's disease.

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c) Huntington's disease. d) Korsakoff's syndrome.

Answer: b Page: 430 Level: Medium Type: Factual

13-89. Which of the following diseases has been treated with glial cell line-derived neurotrophic factor? a) Picks' disease b) Alzheimer's disease c) Parkinson's disease d) Huntington's disease Answer: c Page: 430 Level: Medium Type: Factual 13-90. Major tears or ruptures in brain tissue are called a) strokes. b) concussions. c) contusions. d) lacerations.

Answer: d Page: 430 Level: Medium Type: Factual 13-91. Brain injuries are classified into concussions, contusions, and: a) trauma b) apoxia c) lacerations d) cranial pressures Answer: c Page: 430 Level: Medium Type: Factual 13-92. Transient states that momentarily change the physical condition of the brain but do not cause structural damage are called a) lesions. b) contusions. c) concussions. d) lacerations.

Answer: c Page: 430 Level: Medium Type: Factual 13-93. Brain tumors produce a variety of physiological and psychological changes because their presence interferes with a) sensory input. b) blood supply to the brain.

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c) neurotransmitter production. d) electrical activity in the brain.

Answer: b Page: 430 Level: Medium Type: Factual

13-94. What important lesson about cognitive disorders can we learn from the story of George Gershwin? a) Headaches can be misinterpreted. b) Musical ability can slow the progression of dementia. c) A high level of extraversion is a key factor in coping with Alzheimer's disease. d) Music can be used to overcome the depression associated with brain pathology.

Answer: a Page: 431 Level: Medium Type: Conceptual 13-95. Martin is suffering from HIV-associated cognitive disorder. Until his condition is accurately diagnosed, Martin's symptoms may be confused with a) delirium tremens. b) major depression. c) personality disorder. d) post-traumatic stress disorder.

Answer: b Page: 431 Level: Medium Type: Conceptual 13-96. Why is HIV-associated cognitive impairment often misdiagnosed? a) It is less severe than other dementias. b) It is not a recognized, official diagnosis. c) It occurs in a younger population than other dementias. d) It does not appear until the symptoms of AIDS are full blown.

Answer: c Page: 431 Level: Medium Type: Conceptual 13-97. Penicillin is used to treat a) Pick's disease. b) general paresis. c) amnestic disorders. d) multi-infarct dementia.

Answer: b Page: 432 Level: Medium Type: Factual 13-98. Susan is diagnosed with general paresis. Her physician infers that earlier in life, Susan must have had an untreated case of 337

a) syphilis. b) pneumonia. c) alcoholism. d) schizophrenia.

Answer: a Page: 432 Level: Medium Type: Factual

13-99. Untreated general paresis results in a) death. b) temporary delirium. c) thiamine deficiency. d) elevated cholesterol levels.

Answer: a Page: 432 Level: Medium Type: Factual 12-100. Dementia paralytica is another name for a) general paresis. b) Huntington's disease. c) multi-infarct dementia. d) Korsakoff's syndrome.

Answer: a Page: 432 Level: Medium Type: Factual 13-101. Amnestic disorders are disturbances of a) mood. b) speech. c) memory. d) movement.

Answer: a Page: 433 Level: Medium Type: Factual 13-102. What is another name for a cerebrovascular accident? a) stroke b) epilepsy c) dementia d) heart attack Answer: a Page: 434 Level: Medium Type: Factual 13-103. How does a stroke produce behavioral and cognitive changes? a) changes electrical activity in the brain b) creates plaques and tangled nerve cells c) deprives oxygen and blood to the brain d) introduces infection into cerebrospinal fluid Answer: c Page: 434 Level: Medium Type: Factual 338

13-104. A patient's record indicates that he suffers from aphasia. Which of the following might prove difficult for this patient? a) eating with a fork b) watching television c) answering a question d) putting on his clothing Answer: c Page: 434 Level: Difficult Type: Conceptual 13-105. Dementia resulting from a series of minor strokes is called a) Pick's disease. b) vascular dementia. c) Huntington's disease. d) primary degenerative dementia.

Answer: b Page: 434 Level: Medium Type: Factual 13-106. Vascular dementia is also known as a) Pick's disease. b) general paresis. c) multi-infarct dementia. d) Korsakoff's syndrome.

Answer: c Page: 434 Level: Medium Type: Factual 13-107. Mr. Foster has abused alcohol for more than 20 years. His drinking has interfered with his eating and metabolism, causing serious nutritional deficiencies. Mr. Foster is likely to develop a) Pick's disease. b) vascular dementia. c) Huntington's disease. d) Korsakoff's syndrome.

Answer: d Page: 434 Level: Difficult Type: Conceptual 13-108. Korsakoff's syndrome is associated with a deficiency in a) thiamine. b) dopamine. c) acetylcholine. d) beta amyloid.

Answer: a Page: 434 Level: Medium Type: Factual 13-109. What causes an epileptic seizure? a) presenile plaques b) vitamin deficiencies c) lack of oxygen in the brain 339

d) excessive firing of brain cells Answer: d Page: 434 Level: Medium Type: Factual

13-110. Which of these people represent the group that has the highest prevalence of epileptic seizures? a) eight-old-year Alice b) Ray, a diagnosed alcoholic c) Sam who lives in an affluent country d) Tess who has no history of head injury Answer: a Page: 434 Level: Medium Type: Factual 13-111. The period preceding a grand mal seizure, which is characterized by a feeling of unreality and depersonalization, is called the a) aura. b) infarct. c) tonic phase. d) dissociation period.

Answer: a Page: 434 Level: Medium Type: Factual 13-112. A petit mal seizure is usually characterized by a) blank staring. b) manic behavior. c) sudden onset of deep sleep. d) convulsions that last from 2 to 5 minutes.

Answer: a Page: 434 Level: Medium Type: Factual 13-113. Phyllis experiences a psychomotor epilepsy. Which function or ability is she likely to lose during the seizure? a) ability to move b) good judgment c) short-term memory d) bowel and bladder control Answer: b Page: 435 Level: Medium Type: Factual 13-114. Dr. Harris helps people with Alzheimer's disease by teaching them to make lists. She is probably using which therapeutic approach? a) cognitive 340

b) behavioral c) community d) psychodynamic Answer: a Page: 436 Level: Medium Type: Factual

Essay Questions 13-115. What are the four general causes of delirium?

Answer: (1) Brain disease (e.g., infection or tumor), (2) A disease or infection in another part of the body that affects the brain (e.g., a metabolic condition), (3) Intoxication (e.g. with alcohol), (4) withdrawal from a substance to which an individual is addicted (e.g., drugs).

Page: 419 Level: Difficult Type: Factual 13-116. What signs and symptoms distinguish depression from dementia?

Answer: The progression of depression is uneven and occurs over a period of weeks; the progression of dementia is even and occurs over a period of months or years. A person with depression complains about memory loss; a person with dementia denies or hides memory loss. The symptoms of depression are often worse in the morning; those of dementia are worse later in the day or when fatigued. The depressed person is aware of his or her disability, whereas the demented person is not. Alcohol and drug abuse are common among people with depression, but rare among people with dementia.

Pages: 420 – 421 Level: Difficult Type: Factual 13-117. What has research shown concerning the possible causes of Alzheimer's disease?

Answer: On autopsy, the brains of persons with Alzheimer's disease show two distinctive characteristics: tangled clumps of nerve cells and patches of nerve-cell branches called plaques. The neurotransmitter, acetylcholine, is involved in learning and memory. Patients with Alzheimer's disease have dramatic reductions in the amount of acetylcholine produced in the brain. A strong correlation exists between the amount of loss of acetylcholine in the brain and the severity of dementia. The genetic basis for many cases of early-onset familial Alzheimer's disease is now established. Some studies have linked Alzheimer's disease to abnormalities on chromosome 21, which has been identified as the location for the gene for a protein called beta amyloid, which is found in the characteristic clumps and plaques of this disease. However, it is not clear if beta amyloid is the cause or the result of brain cell degeneration. The degeneration may be due to the 341

protein called apolipoprotein E (Apo E). A high percentage of Alzheimer's patients have at least one gene coding for this type of Apo E protein known as E4.

Page: 423 Level: Difficult Type: Factual

13-118. What has research shown about people's psychological reactions to genetic testing for Huntington's disease?

Answer: Huntington's disease is transmitted by a single dominant gene; a person who has inherited the gene will inevitably develop the disorder. Among people who volunteer to be tested for the gene, those who learn they will develop the disorder are quite distressed at first. However, six months later their psychological state was generally better than it had been prior to testing. People for whom the test indicated freedom from the disorder were elated at first but then seemed to go into a slump. Sometimes this was because they had already made irreversible decisions based on their possible genetic status, such as being sterilized. Other people were negatively affected because they had unrealistically high expectations about how the test results would change their lives. There were similar numbers of negative reactions in the groups that got good news and bad news. People who had experienced psychological problems prior to the test had the worst outcome regardless of the test outcome.

Page: 429 Level: Difficult Type: Factual 13-119. Why is HIV-associated cognitive impairment sometimes misdiagnosed?

Answer: This recently identified disorder is associated with the AIDS epidemic.

The symptoms include forgetfulness, concentration difficulties, mental slowness, mild motor difficulties, and apathetic, withdrawn behavior. These symptoms sometimes appear in an HIV-positive individual before the diagnosis of AIDS has been made. This type of dementia affects a disproportionate number of young adults, in contrast to the other dementias which usually have an onset after middle age. Finally, symptoms of AIDS dementia complex are sometimes difficult to distinguish from psychological and emotional reactions to the diagnosis of AIDS. Pages: 431 – 432 Level: Difficult Type: Factual 13-120. How can a community perspective be helpful in the study of cognitive impairment disorders?

Answer: Damage to the brain and central nervous system is more common among people of lowest socioeconomic status. Within this group, these problems are especially prevalent among African-American children. Factors such as 342

inadequate nutrition and inadequate prenatal care can lead to complications of pregnancy, which result in higher numbers of premature births and congenital defects. The community perspective emphasizes prevention of brain disorders through preventive medical care, especially good prenatal care.

Page: 436 Level: Difficult Type: Factual

True/False 13-121. A central factor in diagnosing cognitive impairment is establishing a link between behavioral symptoms and the medical condition or substance.

Answer: True Page: 413 Level: Easy Type: Factual 13-122. Research has indicated that all areas of the brain develop in unique ways and most brain cells will continue to form new connections.

Answer: True Page: 414 Level: Easy Type: Factual 13-123. After examining research studies, there appears to be no standard type of psychological effect for each type and degree of brain defect.

Answer: True Page: 414 Level: Easy Type: Factual 13-124. During the onset of an organic problem, a person’s psychological state and social relations will have an effect on the person’s behavior.

Answer: True Page: 415 Level: Easy Type: Factual 13-125. When assessing the impact of brain damage, the primary areas of evaluation are easy to determine.

Answer: False Page: 415 Level: Easy Type: Factual 13-126. Cultural factors are not an essential component when evaluating cognitive dysfunction and rehabilitation.

Answer: False Page: 416 Level: Easy Type: Factual 13-127. Brain imaging technology assists in clarifying the relationship between damage to specific areas of the brain and the effects of this damage on psychological functioning.

Answer: True Page: 417 Level: Easy Type: Factual 13-128. Delirium occurs as a result of an acute brain condition.

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Answer: False Page: 418 Level: Easy Type: Factual 13-129. People with dementia are vulnerable to physical, psychological, and social stressors.

Answer: True Page: 420 Level: Easy Type: Factual 13-130. Dementia causes people to live in the past most of the time.

Answer: True Page: 420 Level: Easy Type: Factual

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Chapter 14 Substance-Related Disorders 14-1. What is a consequence of heavy use of psychoactive substances? a) reduction in goal-directed behavior b) cognitive deficits c) physical symptoms d) All of the above are consequences.

Answer: d Page: 441 Level: Medium Type: Factual 14-2. What term, which is not used in DSM-IV-TR, describes the harmful effects of excessive reliance on drugs for pleasure and relief of tension? a) addiction b) tolerance c) withdrawal d) intoxication Answer: a Page: 441 Level: Medium Type: Factual 14-3. Why is the term “addiction” not used in DMS-IV-TR? a) Substances affect people in different ways that cannot be determined. b) Personal and social factors have a role in the manner in which substances interact. c) Addiction is not a diagnostic term. d) All the above.

Answer: b Page: 442 Level: Medium Type: Factual 14-4. The two categories of substance-related disorders in DSM-IV-TR are substance-use disorders and: a) substance-related disorders b) psychoactive-induced disorders c) substance-induced disorders d) substance-dependence Answer: c Page: 442 Level: Medium Type: Factual

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14-5. Alex has been drinking heavily for more than ten years. He says he would like to stop, but each time he tries his body's response to the cessation of alcohol draws him back. His family has pleaded with him to seek treatment because his drinking has created upheaval and led to a loss of his job. When he finally seeks professional treatment, what diagnosis is likely to be made? a) substance abuse b) substance intoxication c) substance dependence d) psychoactive psychosis Answer: c Page: 442 Level: Difficult Type: Conceptual 14-6. Dan is an alcoholic who has been drinking large amounts of alcohol for more than a decade. Ed, a social drinker, drinks moderately at parties and has never been "drunk." For a research study, each of these 150-pound men consume eight beers in a few hours. Dan does not seem to be affected, whereas Ed exhibits major effects. How can we explain this difference? a) The liver of an alcoholic breaks down alcohol into byproducts much faster because it has adjusted to high levels of alcohol and this rapid breakdown aids survival. b) As a protective device, the body of an alcoholic diverts most of the alcohol away from the brain so it does not have the effect it does in someone who is not an alcoholic. c) Over long periods of time, neurotransmitter levels in the brain adjusts to a relatively steady state of alcohol and remain constant, so the amount of alcohol has practically no effect. d) In someone who has been drinking excessively for a long time, less and less alcohol permeates brain cell membranes so he may have less alcohol in his brain than someone with the same BA level who is not an alcoholic.

Answer: d Page: 442 Level: Difficult Type: Conceptual 14-7. Tolerance, withdrawal, and compulsive use are associated with ________ while psychological problems and maladaptive behavior are associated with _____. a) substance abuse; substance dependence b) substance use disorders; substance abuse c) substance dependence; substance abuse d) substance-induced disorders; substance abuse Answer: c Pages: 442, 443 Level: Difficult Type: Factual

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14-8. Cognitive, physiological, and __________ symptoms are the factors which define it’s the condition of substance dependence. a) social b) behavioral c) physical d) biophysical Answer: b Page: 442 Level: Medium Type: Factual 14-9. LaToya’s doctor tells her she must stop drinking. She begins to experience physical symptoms. LaToya is experiencing: a) withdrawal b) excessive alcohol use c) tolerance d) intoxication Answer: a Page: 442 Level: Medium Type: Conceptual 14-10. The need for markedly increased amounts of a substance to achieve the desired effect is called a) addiction. b) tolerance. c) withdrawal. d) compulsion.

Answer: b Page: 442 Level: Medium Type: Factual 14-11. The three major criteria for the diagnosis of substance dependence are tolerance, withdrawal, and a) compulsive use. b) criminal activity. c) psychotic symptoms. d) altered brain wave activity.

Answer: a Page: 442 Level: Medium Type: Factual 14-12. Which psychoactive substance produces withdrawal symptoms that are less apparent than those produced by most other substances? a) heroin b) alcohol c) cocaine d) barbiturates Answer: c Page: 442 Level: Medium Type: Factual

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14-13. What is one of the keys to the diagnosis of substance intoxication? a) The drug used is illegal. b) The effects are reversible. c) Use of the drug results in criminal activity. d) Use of the drug affects the individual for more than one week.

Answer: b Page: 443 Level: Medium Type: Factual 14-14. Al has not been home for several days. His wife states he will not return until he is able to purchase his drug of choice. There are several bars and streets that Al will visit until he finds the substance he needs. The behavior is called: a) compulsive substance dependence b) compulsive substance use c) substance abuse d) substance dependence Answer: b Page: 443 Level: Difficult Type: Conceptual 14-15. Substance intoxication affects which nervous system? a) peripheral nervous system b) autonomic nervous system c) limbic system d) central nervous system Answer: d Page: 443 Level: Medium Type: Factual 14-16. Vince experienced a psychotic reaction the first time he ingested LSD. What is the most likely diagnosis he would have been given at this point? a) withdrawal b) substance abuse disorder c) substance-induced disorder d) substance dependence disorder Answer: c Page: 443 Level: Medium Type: Conceptual 14-17. Which of the following factors does not influence the level of intoxication? a) substance b) expectations c) tolerance d) level of abuse history Answer: d Page: 443 Level: Medium Type: Factual

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14-18. What is the major criteria for diagnosing substance abuse? a) tolerance b) harmful consequences c) withdrawal d) compulsive use Answer: b Page: 443 Level: Medium Type: Factual 14-19. Which of these individuals is exhibiting a symptom that commonly occurs in substance abuse but is not necessarily one that constitutes part of the diagnostic criteria for substance dependence? a) John whose symptoms include tolerance b) Larry who has had numerous legal problems c) Mike who engages in a compulsive pattern of use d) Harry who is experiencing withdrawal from a psychoactive substance Answer: b Page: 443 Level: Difficult Type: Conceptual 14-20. What are the primary characteristics that differentiate substance dependence from substance abuse? a) tolerance and withdrawal b) amount and frequency of drinking c) subjective intoxication and distress d) behavioral and social consequences Answer: a Page: 443 Level: Medium Type: Factual 14-21. Your friend misses work and has serious family difficulties because he uses drugs. However, he is not “addicted” to drugs. What DSM-IV-TR diagnosis would be made in this case? a) substance abuse b) substance craving c) substance dependence d) substance ingestion habit Answer: a Page: 443 Level: Medium Type: Conceptual 14-22. What do alcohol, tranquilizing drugs, amphetamines, and heroin have in common? a) Overdose can result in death. b) They cause delusional thinking. c) They can cause long-term coma. d) The abuser experiences hallucinations.

Answer: a Page: 444 Level: Medium Type: Conceptual

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14-23. Which form of alcohol is safe for humans to consume? a) ethanol b) wood alcohol c) methyl alcohol d) isopropyl alcohol Answer: a Page: 444 Level: Medium Type: Factual 14-24. Which part of the brain is affected first by alcohol consumption? a) medulla b) cerebellum c) frontal lobes d) occipital lobes Answer: c Page: 444 Level: Medium Type: Factual 14-25. The newspaper carried a story of a college student who was found dead in his dorm after ingesting a very large amount of alcohol last night. The death is most likely due to the effects of the alcohol on which part of the brain? a) medulla b) cerebellum c) frontal lobes d) limbic system Answer: a Page: 444 Level: Medium Type: Conceptual 14-26. What is “pathological use” of psychoactive substances? a) use beyond which any positive effects are outweighed by negative effects b) tolerance levels increase c) the “ultimate” high d) None of the above.

Answer: a Page: 444 Level: Medium Type: Factual 14-27. Which part of the brain is affected by continued consumption of alcohol? a) occipital lobes b) medulla c) cerebellum d) frontal lobes Answer: c Page: 444 Level: Medium Type: Factual

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14-28. Which of the following individuals is most likely to have had a bloodalcohol level of .50? a) Dan who is exhibiting a loss of motor control b) George who was pronounced dead at the emergency room c) Ed who is exhibiting an obvious loosening of inhibitions at a party d) Frank who was brought to the hospital with acute alcohol poisoning Answer b Page: 444 Level: Difficult Type: Conceptual 14-29. Which of the following terms is associated with the modification of beliefs of one culture on another culture, and is relevant to substance use? a) acculturation b) abstinence-violation c) cultural diversity d) All of the above.

Answer: a Page: 445 Level: Medium Type: Factual 14-30. The Surgeon General is examining data on the amount of alcohol consumed in the United States for a report to Congress. The purpose is to inform members of Congress so they can make prudent decisions concerning funding programs to deal with alcohol. What will the Surgeon General want to highlight about the use of alcohol in the United States? a) There is no sex difference in alcohol use. b) A minority of people consume the majority of alcohol. c) There is little difference between social drinkers and alcoholics. d) The amount of alcohol consumed continues to increase every year.

Answer: b Page: 445 Level: Difficult Type: Conceptual 14-31. Which of these individuals falls within the age range that has the highest prevalence of drinking? a) Al, who is 14 years old b) Dan, who is 24 years old c) Steve, who is 39 years old d) Richardo, who is 59 years old Answer: b Page: 445 Level: Medium Type: Factual 14-32. What was the effect of reducing the drinking age from 21 to 18 on alcoholrelated highway accidents? a) lowered the rate of accidents b) increased the rate of accidents c) had no effect on the accident rate d) an initial increase in accidents was followed by a decrease Answer: b Page: 445 Level: Medium Type: Factual 351

14-33. Which is the difference in descriptors between alcohol abuse and alcohol intoxication? a) behavioral indicators and psychological changes b) psychological change and social change c) behavioral indicators and social change d) social change and physiological response Answer: a Page: 445 Level: Medium Type: Factual 14-34. Which of these individuals is part of a group that has a relatively high rate of alcohol abuse? a) Dan who is a Native American b) Emily who is a French American c) Hans who is a German American d) Thuy who is an Asian American Answer: a Page: 445 Level: Medium Type: Factual 14-35. Of the total national expenditure for health, what percentage is estimated to be spent on alcohol-related problems? a) 2% b) 6% c) 14% d) 20% Answer: d Page: 446 Level: Medium Type: Factual 14-36. What do CT scans of young chronic alcoholics show? a) presenile plaques b) deterioration of the cerebellum c) increased levels of cerebrospinal fluid d) reduced density in the left hemisphere Answer: d Page: 446 Level: Medium Type: Factual 14-37. What are the primary risks to the infant if the child develops fetal alcohol syndrome? a) tumors and blood clots b) heart and kidney failure c) immunodeficiency and pneumonia d) mental retardation and physical malformations Answer: d Page: 446 Level: Medium Type: Factual

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14-38. Fetal alcohol syndrome refers to: a) development of physical malformations b) development of mental retardation c) damaging effects on the unborn child as a result of the mother’s alcohol consumption d) All of the above.

Answer: d Page: 446 Level: Medium Type: Factual 14-39. What percent of people with alcohol disorders have another diagnosable mental disorder? a) 17% b) 37% c) 27% d) 8% Answer: b Page: 446 Level: Medium Type: Factual 14-40. After reviewing the data on alcohol and its effects on health, one finding seems surprising to a panel of experts. There is evidence that moderate use of alcohol tends to reduce the chances of a) diabetes. b) heart attack. c) mood disorders. d) Parkinson's disease.

Answer: b Page: 446 Level: Medium Type: Factual 14-41. Which of the following disorders have a high rate of comorbidity with alcohol disorders? a) hypochondriasis and schizophrenia b) bipolar disorder and depersonalization c) borderline personality disorder and mental retardation d) affective disorders and antisocial personality disorders Answer: d Page: 447 Level: Medium Type: Factual 14-42. Al has been an alcoholic for more than 10 years. He is proud to tell you that he is no longer an alcoholic, and his boss and family can verify this to be the case.

When asked how he accomplished this change in his life, what will he say? a) He recovered on his own, without formal treatment. b) He began going to AA meetings three years ago and continues to attend. c) He entered a residential treatment program that used a variety of therapies. d) He was court ordered to undergo aversion therapy after he was involved in a series of drunk driving accidents.

Answer: a Page: 447 Level: Difficult Type: Conceptual 354

14-43. According to the text, which of the following, regardless of theoretical orientation, would be a possible progression of stages in treating alcoholism? a) detoxification, individual therapy, family therapy b) detoxification, acknowledgement, denial, obliviousness c) denial, detoxification, medical treatment, therapy d) denial, intervention, social support Answer: b Page: 447 Level: Medium Type: Factual 14-44. How did E. M. Jellinek, the founder of the modern study of alcoholism, view alcoholism? a) a sign of moral degeneracy b) a permanent, irreversible condition c) a psychological, not physical, addiction d) a long lasting, but not permanent condition Answer: b Page: 447 Level: Medium Type: Factual 14-45. Compared to other males, what is the risk of alcoholism among sons of alcoholics? a) lower b) similar c) twice as high d) four times as high Answer: d Page: 447 Level: Medium Type: Factual 14-46. What does research on sensitivity to alcohol suggest? a) Different races seem to vary in their sensitivity to alcohol. b) The apparent variation in individual levels of sensitivity to alcohol is psychological. c) The only system in the body that is affected directly by alcohol is the central nervous system. d) Facial flushing, raised body temperature, and rapid pulse are signs of an acquired allergic reaction to alcohol.

Answer: a Page: 447 Level: Difficult Type: Conceptual 14-47. Which ethnic group is especially sensitive to alcohol? a) Asians b) Africans c) Europeans d) Middle Eastern Answer: a Page: 449 Level: Medium Type: Factual

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14-48. Which system of the body is most affected by alcohol? a) central nervous system b) autonomic nervous system c) limbic system d) peripheral nervous system Answer: a Page: 449 Level: Medium Type: Factual 14-49. Albert and Abigail, who weigh the same, each consumed the same amount of alcohol. An hour later, Abigail has a higher blood alcohol level. How do researchers explain this difference in blood alcohol levels? a) Women tend to drink at a different rate than men. b) Women have less of the stomach enzyme alcohol hydrogenase. c) There are hormonal differences that directly influence the breakdown of alcohol. d) Despite the similar weights, women tend to have digestive organs that are somewhat smaller and thus alcohol moves through the system faster.

Answer: b Page: 449 Level: Difficult Type: Conceptual 14-50. Your friend Thuy turned 21 a few months ago. Over the last few months she has gone out to bars with friends and had the same bad experience each time she drank even a small amount. Because Thuy is of Asian descent, you recognize that she may have a sensitivity to alcohol that is manifested in which of these symptoms? a) headaches, nausea, and vomiting b) difficulty breathing, muscle spasms, and rapid pulse rate c) double vision, muscle spasms, and ringing sensations in the ears d) elevated skin temperature, increased pulse rate, and rapid facial flushing Answer: d Page: 449 Level: Difficult Type: Factual 14-51. Ray has been abusing alcohol for many years. His physical condition has become life-threatening and he finally seeks treatment at University Hospital. He is asked if he would take part in an experimental program involving a relatively new drug for treating alcohol, naltrexone. How is this drug likely to affect his alcohol problem? a) The drug alters the brain's electrical activity by inducing delta waves. b) The drug reduces relapse rates in people being treated for drinking problems. c) The drug increases dopamine and norepinephrine levels in the brain's reward centers. d) The drug induces an altered state of consciousness that makes it less likely that people will drink.

Answer: b Page: 449 Level: Difficult Type: Conceptual

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14-52. Rob takes the drug disulfiram every morning. One day at lunch he has a glass of scotch. What is he likely to experience subsequently? a) There will be no effect. b) He will become violently ill. c) He will feel intoxicated much more quickly. d) The alcohol will be quickly eliminated from his body.

Answer: b Page: 449 Level: Medium Type: Conceptual 14-53. What is disulfiram? a) a toxic form of alcohol b) a treatment for alcohol abuse c) a toxic by-product of alcohol abuse d) an enzyme that metabolizes alcohol Answer: b Page: 450 Level: Medium Type: Factual 14-54. According to longitudinal research, which pattern of personality development was found to characterize adult male problem drinkers? a) felt superior to others b) introverted as adolescents c) hostile and submissive as adults d) able to have satisfactory social relationships Answer: c Page: 450 Level: Medium Type: Factual 14-55. How does alcohol act as a positive reinforcer for drinking? a) reduces anxiety b) promotes tolerance c) staves off withdrawal d) produces pleasant sensations Answer: d Page: 450 Level: Medium Type: Factual 14-56. How does alcohol act as a negative reinforcer for drinking? a) reduces anxiety b) promotes tolerance c) produces pleasant sensations d) associated with social activities Answer: a Page: 450 Level: Medium Type: Conceptual

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14-57. Neuroscientists have found evidence suggesting that the reinforcing properties of alcohol are related to alterations in which of the following? a) dopamine, epinephrine, and serotonin b) acetylcholine, GABA, and norepinephrine c) acetylcholine, endorphins, and norepinephrine d) dopamine, norepinephrine, and opioid peptides Answer: d Page: 450 Level: Difficult Type: Factual 14-58. In Marlatt and others' study of the importance of expectations about the effects of alcohol, the people who drank the most were those who a) believed they were drinking tonic. b) believed they were drinking alcohol. c) thought they were not being observed. d) thought they could control their intake.

Answer: b Page: 451 Level: Medium Type: Factual 14-59. Helping people refrain from drinking by pairing alcohol with a stimulus such as electrical shock is an example of a) modeling. b) covert sensitization. c) operant conditioning. d) aversive conditioning.

Answer: d Page: 451 Level: Medium Type: Factual 14-60. As part of treatment for her alcohol problem, Jean is asked to take a drink of alcohol at the same time she takes a drug that induces nausea and vomiting.

What technique is her therapist using? a) modeling b) skills training c) covert sensitization d) aversive conditioning Answer: d Page: 451 Level: Medium Type: Factual 14-61. Covert sensitization is a technique that teaches patients to associate drinking with a) nausea and vomiting. b) social pressure to stop. c) public and social events. d) aversive images and fantasies.

Answer: d Page: 451 Level: Medium Type: Factual

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14-62. A group of cognitively oriented therapists is designing a program to address the problems of people who consume excessive amounts of alcohol. As you listen to their discussion, you conclude that a key factor that guides their development of a program is a focus on a) reversing addictions. b) overcoming an inherited disability. c) increasing the ability to cope with stress. d) finding ways for the clients to express repressed anger.

Answer: c Page: 451 Level: Medium Type: Factual 14-63. What is the primary goal of many cognitively based alcohol treatment programs? a) abstinence b) controlled drinking c) understanding of intrapsychic causes d) ability to seek social support from other alcoholics Answer: b Page: 451 Level: Medium Type: Factual 14-64. What is the “controlled drinking approach” to the treatment of alcoholism? a) emphasis is placed on positive social interaction b) emphasis is placed on building the client’s coping skills c) combines behavioral and medical approaches d) reinforces social drinking Answer: b Page: 451 Level: Medium Type: Factual 14-65. Melissa goes to a therapist for treatment of her alcohol abuse problem. Her therapist helps her to develop new skills and self-control strategies, so that Melissa can practice controlled drinking. Her therapist is probably working from which perspective? a) medical model b) humanistic model c) psychodynamic model d) cognitive-behavioral model Answer: d Page: 451 Level: Medium Type: Conceptual 14-66. Sam is an alcoholic who is currently in a treatment program. His therapist tells him about people who experience the abstinence-violation effect. In explaining this effect to Sam, what will the therapist say such people see as the cause of a drinking relapse? a) fate or luck b) conflict and guilt 359

c) situational factors d) peer pressure and competitive instincts Answer: b Page: 453 Level: Medium Type: Conceptual 14-67. A cognitive psychologist was interviewed by a television health reporter.

During the interview, the psychologist used the term abstinence-violation effect.

When the interviewer asked the psychologist for a definition, the psychologist described it as a) a patient's tendency to lie about concealed drinking. b) the fact that drinking in public is illegal in some states. c) a patient's belief that he or she is being controlled by the therapist. d) the pattern of falling back to chronic drinking if one slips up even a little.

Answer: d Page: 453 Level: Difficult Type: Factual 14-68. What do relapse prevention programs teach alcoholics to do in response to a drinking relapse? a) practice controlled drinking b) view it as a temporary lapse c) blame themselves, not the situation d) acknowledge their lack of will power Answer: b Page: 453 Level: Medium Type: Factual 14-69. How do proponents of Alcoholics Anonymous view alcoholism? a) a sin b) a habit c) a disease d) a reversible condition Answer: c Page: 454 Level: Medium Type: Factual 14-70. What is the cornerstone of Alcoholics Anonymous's success in helping some individuals to abstain from drinking? a) social support b) financial assistance c) drugs such as disulfiram d) intensive individual counseling Answer: a Page: 454 Level: Medium Type: Factual 4-71. What is one difficulty in interpreting the available evidence on alcohol treatment programs? a) about half of patients drop out of treatment b) most information is protected by the government c) measurements of blood alcohol level are imprecise d) no control groups, because most alcoholics seek treatment Answer: a Page: 456 Level: Medium Type: Conceptual 360

14-72. After reviewing the research on the causes of problems related to alcohol, a committee is about to issue its report. The focus of the report will be on what we know about the causes of alcoholism. Which of the following would make the best title for this report? a) "Toward an Interactional Approach: Personal, Social and Cultural Factors" b) "Rediscovering the Unconscious Roots of Alcoholism: Freud was More Right than Wrong" c) "Mapping the Human Genome: Major Advances in Identifying the Genes Responsible for Alcoholism" d) "The Real Key to Understanding Alcoholism Lies in Family-Induced Cognitive Factors That Are Often Overlooked" Answer: a Page: 456 Level: Difficult Type: Conceptual 14-73. A task force on problems of alcohol is investigating rates of alcohol problems among various cultural and ethnic groups. What are they likely to find when they issue their report? a) Overall, there have been sharp drops in the rates of alcohol problems across ethnic groups. b) Ethnic groups with high rates of problems in the past have even higher rates now due to social changes. c) There have been few changes in the rates of alcohol problems for each ethnic group over the past few decades. d) Ethnic groups with high rates in the past seem to have decreasing rates, whereas groups with low rates are now increasing.

Answer: d Page: 456 Level: Difficult Type: Conceptual 14-74. Which sociocultural conditions tend to minimize alcohol problems? a) condemnation of alcohol use as a sin b) social acceptance of occasional drunkenness c) considering alcohol a festive beverage, rather than a food d) exposing children to alcohol at an early age in a family or religious setting Answer: d Page: 456 Level: Medium Type: Factual 14-75. Which of the following has been shown to decrease a community's rate of serious alcohol abuse? a) outlawing alcohol b) raising taxes on alcohol c) limits on alcohol advertising 361

d) restrictions on alcohol use in TV shows Answer: b Page: 456 Level: Medium Type: Factual

14-76. What do barbiturates and tranquilizing drugs have in common? a) They cause insomnia. b) They are not physically addictive. c) They are central nervous system depressants. d) They cause psychotic symptoms at high doses.

Answer: c Page: 457 Level: Medium Type: Conceptual 14-77. Which of these is a common medical use for barbiturate drugs? a) fighting viral infections b) preventing convulsions c) reducing hallucinations d) decreasing blockages in arteries Answer: b Page: 459 Level: Medium Type: Factual 14-78. With regard to barbiturate abuse, __________ intoxication occurs when people obtain prescriptions, while __________intoxication occurs when people take barbiturates orally. a) episodic, chronic b) intravenous, chronic c) chronic, chronic d) episodic, intravenous Answer: c Page: 459 Level: Difficult Type: Factual 14-79. What type of drug is Valium? a) opioid b) barbiturate c) amphetamine d) benzodiazepine Answer: d Page: 459 Level: Medium Type: Factual 14-80. What is the most well-known synthetic opioid? a) LSD b) heroin c) Valium d) cocaine Answer: b Page: 459 Level: Medium Type: Factual 14-81. What do we call opioids that are manufactured by the brain?

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a) morphines b) endorphins c) psychedelics d) benzodiazepines Answer: b Page: 459 Level: Medium Type: Factual 14-82. Endorphins and enkephalins are both examples of a) barbiturates. b) tranquilizers. c) natural opioids. d) synthetic amphetamines.

Answer: c Page: 459 Level: Medium Type: Factual 14-83. Opium is the source of a) LSD. b) PCP. c) morphine. d) marijuana.

Answer: c Page: 460 Level: Medium Type: Factual 14-84. What is the mechanism by which morphine and similar drugs act as pain killers? a) distort pain signals b) fit into receptor sites for pain signals c) send signals to numb affected areas d) carry pain signals to the wrong part of the brain Answer: b Page: 459 Level: Medium Type: Factual 14-85. Why has Naloxone been helpful in research on opiates? a) It imitates the effects of morphine. b) It blocks the effects of endorphins. c) It stimulates production of endorphins. d) It reduces the symptoms of withdrawal from heroin.

Answer: b Page: 459 Level: Medium Type: Factual 14-86. Heroin was originally thought to be a safe substitute for a) LSD. b) valium. c) morphine. d) amphetamines.

Answer: c Page: 460 Level: Medium Type: Factual 14-87. Jane reported that first she felt intense pleasurable feelings and then a long period of relaxed contentment. What drug was she most likely using?

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a) heroin b) Valium c) alcohol d) amphetamines Answer: a Page: 460 Level: Medium Type: Conceptual 14-88. Heroin highs are characterized by a feeling of a) euphoria. b) mental clarity. c) disorientation. d) dissociation.

Answer: a Page: 460 Level: Medium Type: Factual 14-89. An overdose of opioids can lead to death due to a) seizure. b) heart attack. c) self-directed violence. d) cessation of breathing.

Answer: d Page: 460 Level: Medium Type: Factual 14-90. A group of researchers was commissioned by the U.S. Department of Health and Human Services to examine data on the outcomes of Vietnam era soldiers who used heroin during their tours of duty in Vietnam. After reviewing the information, which of the following titles would be the most appropriate for their written report? a) "Heroin: The downward slide is inevitable" b) "Changed environments lead to changes in heroin use" c) "Genetic predispositions to heroin cannot be overcome" d) "Violence and heroin use: A legacy of the Vietnam era that will not go" Answer: b Page: 460 Level: Difficult Type: Conceptual 14-91. What is the key to the exposure orientation that attempts to explain opioid addiction? a) Opioids lead to the development of plaques in the brain. b) Opioids lead to a breakdown in the synthesis of endorphins. c) The mere presence of opioids in the environment can have a toxic effect on predisposed individuals. d) The expectations associated with watching other drug abusers are what lead some people to problems related to opioids.

Answer: b Page: 461 Level: Difficult Type: Factual 14-92. Which condition often occurs with opioid addiction? a) mania 364

b) paranoia c) depression d) violent behavior Answer: c Page: 462 Level: Medium Type: Factual

14-93. Ted was arrested by the police for breaking and entering. During an interview at the police station, he reported that he needed money to buy heroin.

Ted's attorney asks the prosecutor to consider allowing Ted to enter a treatment program rather than go to jail. If the judge agrees to this arrangement, Ted is most likely to enter a treatment program that involves a) methadone. b) biofeedback. c) aversive conditioning. d) covert sensitization.

Answer: a Page: 462 Level: Difficult Type: Conceptual 14-94. Why would a heroin addict be prescribed methadone? a) It treats delirium tremens. b) It produces a safer "high." c) It stops the craving for heroin. d) It causes violent nausea if heroin is taken.

Answer: c Page: 462 Level: Medium Type: Factual 14-95. What effect does naltrexone have on a heroin abuser? a) It provides a safer "high." b) It treats delirium tremens. c) It stops the craving for heroin. d) It blocks the effects of heroin.

Answer: d Page: 462 Level: Medium Type: Factual 14-96. Why do the Indians of Peru and Bolivia use the leaves of the coca bush? a) to kill pain b) to induce sleep c) to increase endurance d) to produce hallucinations Answer c Page: 463 Level: Medium Type: Factual 14-97. If you want to look up information on cocaine you will find it listed under the category of a) psychedelic drugs. b) tranquilizing drugs.

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c) central nervous system stimulants. d) central nervous system depressants Answer: c Page: 463 Level: Medium Type: Factual

14-98. Which is the only drug to be a local anesthetic and a central nervous system stimulant? a) alcohol b) heroin c) marijuana d) cocaine Answer: d Page: 463 Level: Medium Type: Factual 14-99. What are the three major parts of the brain that are affected when someone takes cocaine? a) frontal lobes, medulla, and pons b) limbic system, medulla, and occipital lobes c) corpus callosum, limbic system, and thalamus d) cerebellum, cerebral cortex, and hypothalamus Answer: d Page: 463 Level: Medium Type: Factual 14-100. For a class assignment, you are asked to find information on cocaine. A reference book on drugs lists them by major category. Under which category will you find cocaine? a) opiates b) stimulants c) depressants d) hallucinogens Answer: b Page: 463 Level: Medium Type: Factual 14-101. How does crack differ from other forms of cocaine? a) less potent b) more expensive c) more rapid onset d) longer lasting effects Answer: c Page: 464 Level: Medium Type: Factual 14-102. What is one similarity shared by cocaine and heroin? a) They are physically addictive. b) They originally had a benign image. c) They were once ingredients in soda pop.

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d) They increase bodily activity and reactivity.

Answer: b Page: 464 Level: Medium Type: Conceptual

14-103. The news had a story of a young man who had been arrested for use what was called a "speedball." The reporter described this drug as a combination of a) LSD and PCP. b) alcohol and heroin. c) heroin and cocaine. d) marijuana and LSD. Answer: c Page: 464 Level: Medium Type: Factual 14-104. Withdrawal from cocaine typically involves a) fever, nausea, and vomiting. b) heavy sweating, headache, and indigestion. c) hallucinations, insomnia, and loss of appetite. d) dysphoric mood, fatigue, and sleep abnormalities.

Answer: d Page: 464 Level: Medium Type: Factual 14-105. Which characteristic is likely to occur in infants who were exposed to crack or cocaine in the womb? a) irritable b) withdrawn c) malformed limbs d) profound mental retardation Answer: a Page: 464 Level: Medium Type: Factual 14-106. “Crystal”, “beanies”, and “meth” are names for: a) amphetamies b) oriates c) steroids d) barbiturates Answer: a Page: 465 Level: Medium Type: Factual 14-107. Using amphetamines to alter performance on intellectual tasks typically leads to an increase in a) quality of work, but not quantity. b) quantity of work, but not quality. c) both quantity and quality of work. d) neither quantity nor quality of work.

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Answer: b Page: 465 Level: Medium Type: Conceptual

14-108. As a class assignment, you are told to use the web to determine how cocaine and amphetamines are similar. You find several sites that describe the two drugs. How do you answer the question? a) The drugs have similar chemical structures. b) Cocaine is derived from amphetamine substances. c) The drugs act by influencing both serotonin and GABA. d) The drugs act by influencing dopamine and norepinephrine.

Answer: d Page: 465 Level: Medium Type: Conceptual 14-109. What are the two key neurotransmitters that are affected when someone takes amphetamine drugs? a) GABA and serotonin b) dopamine and norepinephrine c) serotonin and norepinephrine d) acetylcholine and epinephrine Answer: b Page: 465 Level: Medium Type: Factual 14-110. The drug “Ecstasy” is a [an]: a) barbiturate b) amphetamine c) methamphetamine d) MAO Inhibitor Answer: c Page: 465 Level: Medium Type: Factual 14-111. Which of the following has been called the "poor man's cocaine?" a) Valium b) alcohol c) marijuana d) methamphetamine Answer: d Page: 465 Level: Medium Type: Factual 14-112. The term psychedelics is another name for which type of drug? a) anesthetics b) barbiturates c) hallucinogens d) amphetamines 368

Answer: c Page: 465 Level: Medium Type: Factual 14-113. Which substance is a natural hallucinogen? a) morphine b) mescaline c) methadone d) monoamine oxidase Answer: b Page: 466 Level: Medium Type: Factual 14-114. Which category of drug is sometimes used in religious ceremonies in a number of cultures? a) opioids b) barbiturates c) anesthetics d) psychedelics Answer: d Page: 466 Level: Medium Type: Factual 14-115. Which drug is associated with flashbacks? a) LSD b) heroin c) cocaine d) amphetamines Answer: a Page: 466 Level: Medium Type: Factual 14-116. Kurt is a chronic user of hallucinogens. Sometimes experiences of his drug-taking occur even when he has not consumed any hallucinogen. What term is used to describe this phenomenon? a) flashback b) intoxication c) time distortion d) retroactive psychedelia Answer: a Page: 466 Level: Medium Type: Conceptual 14-117. Max began to use LSD. After two weeks, he began to experience “flashbacks.” Max is experiencing: a) relapse b) post-hallucinogen perceptual disorder c) post-hallucinogen disorder d) withdrawal Answer: b Page: 466 Level: Medium Type: Conceptual 14-118. Dan decides to find more information about PCP and decides that since it is similar to hallucinogens that is where he should look. However, he does not find it listed there. Under which category will he find PCP listed?

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a) barbiturate b) depressant c) antipsychotic drug d) dissociative anesthetic Answer: d Page: 467 Level: Medium Type: Factual

14-119. PCP is classified as a [an]: a) dissociative amnesic disorder b) dissociative anesthetic c) anesthetic d) All of the above.

Answer: b Page: 467 Level: Medium Type: Factual 14-120. What is hashish? a) an amphetamine b) a form of cannabis c) a form of morphine d) a synthetic endorphin Answer: b Page: 467 Level: Medium Type: Factual 14-121. What drug is known to inhibit sperm production? a) heroin b) cocaine c) alcohol d) marijuana Answer: d Page: 467 Level: Medium Type: Factual 14-122. What is the active psychoactive ingredient in marijuana? a) PCP b) THC c) opium d) serotonin Answer: b Page: 467 Level: Medium Type: Factual 14-123. How does marijuana smoke compare to tobacco smoke? a) contains more nicotine b) contains more carcinogens c) causes development of diabetes d) causes development of neurological disorders Answer: b Page: 468 Level: Medium Type: Conceptual 14-124. Marijuana is useful in the treatment of 370

a) chronic pain b) lung disease c) heart disease d) high blood pressure Answer: a Page: 468 Level: Medium Type: Factual

14-125. Nicotine has powerful effects on the brain, spinal cord, peripheral nervous system, and heart by stimulating receptors that are sensitive to a) serotonin. b) dopamine. c) acetylcholine. d) norepinephrine.

Answer: c Page: 469 Level: Medium Type: Factual 14-126. Ben has decided to stop smoking, but each time he tries to quit he experiences withdrawal symptoms, which lead him right back to smoking. How might psychologists explain this phenomenon? a) discrimination b) classical conditioning c) positive reinforcement d) negative reinforcement Answer: d Page: 469 Level: Medium Type: Factual 14-127. How can "nicotine gum" help a person stop smoking? a) blocks the effects of smoking b) produces violent nausea if the person smokes c) breaks the psychological dependence on smoking d) provides the taste of cigarettes without the nicotine Answer: c Page: 470 Level: Medium Type: Factual 14-128. What is the world's most widely used mind-altering drug? a) heroin b) alcohol c) caffeine d) marijuana Answer: c Page: 471 Level: Medium Type: Factual 14-129. How was pathological gambling listed in DSM-III? a) anxiety disorder b) personality disorder c) pre-psychotic condition d) disorder of impulse control 371

Answer: d Page: 472 Level: Medium Type: Factual

Essay Questions 14-130. What are elements that define substance dependence?

Answer: Substance dependence is defined as a maladaptive pattern of substance use that leads to clinically significant impairment or distress. The key elements are tolerance (a need for markedly increased amounts of the substance to achieve the desired effect), withdrawal (physical symptoms that occur when a person stops or cuts down on the use of a psychoactive substance), and compulsive substance use (behavior directed toward obtaining the substance, frequently called drugseeking behavior).

Page: 442 Level: Difficult Type: Factual 14-131. What evidence suggests that a vulnerability to alcoholism may be transmitted genetically?

Answer: Different racial groups show different sensitivity to alcohol. Sons of alcoholic fathers have a greatly increased risk of alcoholism, even if they are reared by a nonalcoholic adoptive father.

Page: 445 Level: Difficult Type: Factual 14-132. What difficulties are associated with conducting research on treatment effectiveness for drug abuse and for programs such as Alcoholics Anonymous?

Answer: Many people drop out of drug treatment and A.A. programs, so the results are not representative. In addition, not all people with drug or alcohol problems present themselves for treatment. Finally, researchers often lump people with different types of drug or alcohol problems into one group, making interpretations difficult.

Page: 454 Level: Difficult Type: Factual 14-133. What are the three types of barbiturate abuse?

Answer: Chronic intoxication: in which people obtain prescriptions, often from more than one physician. Initially they use barbiturates to reduce insomnia and anxiety, and they may then become addicted to the drugs. Chronic use leads to slurred speech and decreased effectiveness on the job. Episodic intoxication: in which individuals take barbiturates to produce a "high", or state of well-being.

Intravenous injections: in which the drug is injected, often in combination with other drugs (such as heroin). Intravenous use produces a "rush" of pleasant, 372

warm, drowsy feelings.

Page: 459 Level: Difficult Type: Factual

True/False 14-134. Addiction is the term describing the harmful effects of excessive reliance on substances.

Answer: True Page: 441 Level: Easy Type: Factual 14-135. Individuals with substance dependence have an intense craving for the substance of choice.

Answer: True Page: 442 Level: Easy Type: Factual 14-136. The particular substance used is not a factor in the development of tolerance.

Answer: False Page: 442 Level: Easy Type: Factual 4-137. The tolerance for alcohol is far less severe than the tolerance for amphetamines.

Answer: True Page: 442 Level: Easy Type: Factual 14-138. Substance intoxication is associated with substance abuse, and refers to the development of reversible substance-specific symptoms.

Answer: False Page: 443 Level: Easy Type: Factual 14-139. Alcohol is the most frequently used brain depressant.

Answer: True Page: 444 Level: Easy Type: Factual 14-140. Acute alcohol poisoning results when involuntary functions shut down.

Answer: True Page: 444 Level: Easy Type: Factual 14-141. Tolerance and withdrawal symptoms are terms used to define physiological dependence on alcohol.

Answer: True Page: 445 Level: Easy Type: Factual 14-142. Chronic use of alcohol can result in decreased blood flow and metabolic rates in brain regions.

Answer: True Page: 446 Level: Easy Type: Factual 14-143. E. J. Jellinek is considered the father of the modern study of alcoholism.

Answer: True Page: 447 Level: Easy Type: Factual

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Chapter 15 Disorders of Childhood and Adolescence 15-1. Understanding maladaptive behavior in childhood is based on an understanding of physical, cognitive, and ________ developmental patterns. a) psychological b) biological c) physiological d) social-emotional Answer: d Page: 479 Level: Medium Type: Factual 15-2. About what percentage of children aged 2 to 5 tentatively meet the criteria for a DSM mental disorder? a) 1% b) 5% c) 20% d) 50% Answer: c Page: 480 Level: Medium Type: Factual 15-3. Which of the following categories has the highest prevalence rate among children between the ages of 9 to 17? a) minimum impairment b) mild impairment c) moderate impairment d) severe impairment Answer: a Page: 480 Level: Medium Type: Factual 15-4. What happens to the rates of internalizing and externalizing disorders between ages 5 and 17? a) Both increase. b) Both decrease. c) Internalizing disorders increase; externalizing disorders decrease. d) Externalizing disorders increase; internalizing disorders decrease.

Answer: c Page: 480 Level: Medium Type: Factual

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15-5. The Senate is holding hearings on the prevalence and treatment of disorders in children and adolescents. A large group of mental health professionals has been called to testify. What are they likely to tell the committee concerning child and adolescent disorders? a) Epidemiological research indicates that most of these disorders are self-limiting; they do not continue into adulthood. b) Most of the mental health disorders that occur in childhood are the result of genetic factors, which suggests we need programs on early intervention. c) We need to pay special attention to these disorders because they are generally untreated, and when treated they are often treated by people with little knowledge of children's mental health. d) As a result of yearly check-ups and school-related physicals, most children with disorders are currently receiving the mental health services they need, although their parents are less likely to receive services.

Answer: c Page: 481 Level: Difficult Type: Conceptual 15-6. Which childhood disorder shows a pattern of continuation through adulthood? a) pica b) tic disorder c) mood disordered d) separation anxiety Answer: c Page: 481 Level: Medium Type: Factual 15-7. Which of these is an externalizing disorder? a) anxiety b) phobia c) depression d) conduct disorder Answer: d Page: 481 Level: Medium Type: Factual 15-8. What evidence suggests that childhood disorders are distinct from adult disorders? a) different sex ratios b) different prognoses c) different levels of severity d) different modes of genetic transmission Answer: a Page: 481 Level: Medium Type: Factual

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15-9. Afric’s parents tell the clinician that she fights, is disobedient, and is destructive. Her parents are describing a (an): a) internalizing disorder b) psychiatric disorder c) externalizing disorder d) emotional disorder Answer: c Page: 481 Level: Medium Type: Conceptual 15-10. Kesia worries much of the time. Her parents describe her as anxious but withdrawn. Kesia is an example of a (an): a) internalizing disorder b) externalizing disorder c) emotional disorder d) anxiety disorder Answer: a Page: 481 Level: Medium Type: Conceptual 15-11. What are the three subtypes of attention-deficit/hyperactivity disorder? a) primary, secondary, tertiary b) school-limited, home-limited, combined c) genetically based, environmentally based, combined type d) problems of attention, overactive behavior, and combined Answer: d Page: 481 Level: Medium Type: Factual 15-12. Inattention, hyperactivity, and impulsivity are symptoms associated with: a) generalized anxiety disorder b) anxiety disorder c) Rett’s disorder d) attention-deficit/hyperactive disorder Answer: d Page: 481 Level: Medium Type: Factual 15-13. Which of the following disorders does not co-occur with ADHD? a) mental retardation b) learning disabilities c) conduct disorder d) depression Answer: a Page: 481 Level: Medium Type: Factual

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15-14. Which of the following is a DSM-IV-TR criterion used in diagnosing attention-deficit/hyperactivity disorder? a) The symptoms must be disturbing to the child. b) The child's behavior must have legal consequences. c) The child must be inattentive or hyperactive/impulsive. d) The behavior must be perceived as aggressive by others.

Answer: c Page: 481 Level: Medium Type: Factual 15-15. A specialist on Attention-Deficit/Hyperactivity Disorder has been invited to discuss the cause of the disorder. Which of the following titles would be the best one for this presentation? a) "Still searching for a cause" b) "No evidence of a genetic influence" c) "Alter the environment and you alter hyperactivity" d) "Focusing on key neurotransmitters in hyperactivity" Answer: a Page: 481 Level: Difficult Type: Conceptual 15-16. Which of the following disorders often occur with AttentionDeficit/Hyperactivity Disorder? a) separation anxiety and anorexia nervosa b) depression and obsessive-compulsive disorder c) conduct disorder and specific learning disabilities d) obsessive-compulsive disorder and social phobia Answer: c Page: 481 Level: Medium Type: Factual 15-17. A seven-year-old child was recently diagnosed as exhibiting ADHD. A clinical psychologist developed a treatment plan that included drug treatment prescribed by a physician. In the child's file, the psychologist suggested close monitoring of the child and reassessment for the possible development of which of the following? a) depression b) schizophrenia c) panic disorder d) learning difficulties Answer: d Page: 481 Level: Medium Type: Conceptual

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15-18. Michael was recently diagnosed as exhibiting attention-deficit/hyperactivity disorder. If he exhibits the least common subtype of this disorder, what specific form of ADHD does he have? a) aggressive b) combined c) inattentive type d) hyperactive-impulsive Answer: d Page: 482 Level: Medium Type: Conceptual 15-19. In what setting are children who are diagnosed with AttentionDeficit/Hyperactivity Disorder likely to have the most difficulties? a) in school b) at home watching television c) playing alone on the playground d) interacting one-to-one with an adult Answer: a Page: 483 Level: Medium Type: Conceptual 15-20. Why is Attention-Deficit/Hyperactivity Disorder (ADHD) difficult to diagnose in children younger than 4 or 5? a) Response to medication cannot be determined. b) These children cannot verbalize their difficulties. c) Many ADHD type behaviors are normal for this age. d) These children are often inattentive but rarely hyperactive.

Answer: c Page: 483 Level: Medium Type: Conceptual 15-21. Why is Attention-Deficit/Hyperactivity Disorder most often diagnosed during early school years? a) Its symptoms do not appear until then. b) Children are routinely tested in first grade. c) Children can verbalize their difficulties by this age. d) School presents new demands that make symptoms more obvious.

Answer: d Page: 483 Level: Medium Type: Conceptual 15-22. Using the more rigorous definition of Attention-Deficit/Hyperactivity Disorder, how many school-age children in a sample of 1,000 would be expected to meet the criteria for this disorder? a) 10 b) 25 c) 70 d) 150 Answer: c Page: 484 Level: Medium Type: Conceptual 377

15-23. What is the most frequently diagnosed behavioral disorder in childhood? a) social phobia b) conduct disorder c) obsessive-compulsive disorder d) attention deficit/hyperactivity disorder Answer: d Page: 484 Level: Medium Type: Factual 15-24. The Child Guidance Clinic completed its annual report on the number of children treated and their diagnoses. When a reporter is given a copy of the report, she notices several interesting findings, especially the sex difference in attention-deficit/hyperactivity disorder. What is the ratio of boys to girls? a) 90: 10 b) 75 : 25 c) 50 : 50 d) 30 : 70 Answer: a Page: 484 Level: Medium Type: Factual 15-25. What is the estimated prevalence of attention-deficit/hyperactivity disorder among school-age children in the general population? a) .50% b) 2.5% c) 7% d) 15% Answer: c Page: 484 Level: Medium Type: Factual 15-26. Why are girls less likely to be referred for ADHD than boys? a) Boys are more aggressive than girls. b) Boys have lower achievement test scores than girls. c) Boys consistently fail to follow instruction. d) Boys show aggressive-impulsive behavior where girls are primarily inattention.

Answer: d Page: 484 Level: Medium Type: Factual 15-27. A diagnosis of ADHD depends on: a) the frame of reference used in the evaluation of behavior. b) the testing used by the psychologist. c) the theoretical approach used to conceptualize the behavior. d) the type of medication prescribed.

Answer: a Page: 484 Level: Medium Type: Factual

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15-28. A group of psychologists is interested in evaluating the diagnosis of hyperactivity, so they ask parents and teachers to use questionnaires and make observations to assess the presence of the symptoms. What are they likely to find? a) Parents and teachers tend to agree on the presence of the symptoms. b) Parents tend to see more aggressiveness in the children than teachers see. c) There will be limited agreement across evaluators and methods of assessment. d) Agreement is much higher for behavioral observations by teachers than for parents' behavioral observations.

Answer: c Page: 484 Level: Difficult Type: Conceptual 15-29. What is one example of the effect of Attention-Deficit/Hyperactivity Disorder on social development? a) Children with ADHD are disliked and do not realize it. b) These children are often popular and in leadership positions. c) Children with ADHD elicit negative behaviors from other children. d) These children learn about social behaviors mostly through observation.

Answer: c Page: 485 Level: Medium Type: Conceptual 15-30. What do family and twins studies suggest about the potential genetic influences on ADHD? a) Genetic factors seem to play little role in the disorder. b) There appears to be a strong genetic influence, especially for girls. c) There appears to be a strong genetic influence, especially for boys. d) There appears be no genetic influence for girls but a strong genetic influence for boys.

Answer: b Page: 486 Level: Medium Type: Factual 15-31. Each of the subtypes of attention-deficit/hyperactivity disorder has a different pattern of comorbidity. What have researchers concluded from this observation? a) A variety of gene locations probably combine to produce the behaviors associated with ADHD. b) There seems to be one predominant type of ADHD that manifests itself differently, depending on the environmental circumstances. c) The various manifestations of ADHD suggest that it is not likely that genetic factors play a significant role in the development of this disorder. d) The multiple manifestations of this disorder suggest that various sites in the control centers of the brain are impacted early in life and do not 379

recover.

Answer: a Page: 486 Level: Difficult Type: Conceptual 15-32. What is the most common treatment for hyperactive children? a) play therapy and stimulant drugs b) stimulant drugs and behavior therapy c) behavior therapy d) tranquilizing drugs Answer: b Page: 487 Level: Medium Type: Factual 15-33. What percentage of children diagnosed with Attention-Deficit/Hyperactivity Disorder are treated with stimulant drugs? a) 5 - 10% b) 25 - 30% c) 55 - 60% d) 85 -90% Answer: d Page: 487 Level: Medium Type: Factual 15-34. A pediatrician has prescribed a trial of stimulant medication to deal with eight-year-old Sal's problems in paying attention in school. When his parents ask about the expected time frame for the effects, what will they be told? a) The drug will begin to have an effect within 30 minutes and it will wear off within 4 to 6 hours. b) It will take several hours before the drug has an initial observable effect, which will last for several more hours. c) The drug will have its initial effect within 24 hours and it will last for approximately 24 hours before another dose is needed. d) It will take several days for the drug to build in the system before it has an effect, which will last for several days after the initial doses.

Answer: a Page: 487 Level: Difficult Type: Factual 15-35. A pediatrician is reviewing treatment options for a child whose ADHD has not responded to stimulant medication. Before writing the prescription, what question will the pediatrician ask the parents of this child? a) "Is there any history of schizophrenia in your family?" b) "How many hours does your spend sleeping each day?" c) "Is there any history of mood disorders or suicide in your family?' d) "Does your child spend much time by himself, apparently daydreaming?"

Answer: c Page: 487 Level: Difficult Type: Conceptual

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15-36. Which of the following drugs has been used recently in the treatment of ADHD? a) Ritalin b) Dexedrine c) Cylert d) All of the above Answer: d Page: 487 Level: Medium Type: Factual 15-37. The use of stimulant medications in the treatment of AttentionDeficit/Hyperactivity Disorder is associated with improved academic performance because of its effect on a) memory. b) time on-task. c) reading speed. d) abstract reasoning.

Answer: b Page: 487 Level: Medium Type: Factual 15-38. What is the most prominent impact of stimulant medications on the social behaviors of children with Attention-Deficit/Hyperactivity Disorder? a) increases positive behaviors in social groups b) improves one-to-one play with other children c) improves one-to-one interactions with adults d) reduces in class disruption and increases on-task performance Answer: d Page: 487 Level: Medium Type: Conceptual 15-39. A group of children with ADHD were put on stimulant medication. After several months, physicians had teachers and independent observers check their progress. Which of the following is likely to be the most significant effect of the drug treatment? a) increasing self-esteem b) reducing daydreaming and aggressiveness c) improving academic accuracy and productivity d) improving the level of courtesy shown to other children Answer: c Page: 487 Level: Medium Type: Factual 15-40. Seven-year-old Mike was put on a behavior modification program for Attention-Deficit/Hyperactivity Disorder. In order to monitor the effectiveness of the program, an independent observer completes a questionnaire describing Mike's behavior. Which aspect of Mike's behavior would be expected to be most responsive to this program? a) time on-task 381

b) social behaviors c) academic accuracy d) academic productivity Answer: b Page: 487 Level: Difficult Type: Conceptual 15-41. A university team of child psychologists has just completed a longitudinal study of children who were diagnosed with Attention-Deficit/Hyperactivity Disorder. These children are now in their 20s. When they examine the data to determine what happens to the symptoms, what are they likely to find? a) The symptoms often decrease during the adolescent years. b) There is a rapid decrease in symptoms from childhood to adolescence. c) The symptoms increase and decrease in a random pattern across time. d) The symptoms tend to continue through adolescence, and into the adult years.

Answer: d Page: 488 Level: Difficult Type: Conceptual 15-42. The diagnosis of Attention-Deficit/Hyperactivity Disorder requires that at least some hyperactive or inattentive symptoms must have been observed before what age? a) 3 b) 5 c) 7 d) 15 Answer: c Page: 488 Level: Medium Type: Factual 15-43. Which two disorders in childhood would indicate ADHD will persist into adulthood? a) aggression/conduct problems b) conduct problems/learning disabilities c) aggression/tic disorder d) learning disabilities/mental retardation Answer: a Page: 488 Level: Medium Type: Factual 15-44. Carl is often disruptive in class. He is frequently negativistic, defiant, disobedient, and hostile toward authority figures. However, he has never violated any major societal norms or the basic rights of others. His behavior is most consistent with a diagnosis of a) overanxious disorder. b) oppositional defiant disorder. c) obsessive-compulsive disorder. d) attention-deficit hyperactivity disorder.

Answer: b Page: 489 Level: Difficult Type: Conceptual

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15-45. Twelve-year-old Tom often loses his temper, argues with adults, annoys anyone within earshot, and blames others for his mistakes. These symptoms have lasted for a year. Which of the following is the most likely diagnosis? a) reactive disorder b) separation anxiety c) oppositional defiant disorder d) obsessive-compulsive disorder Answer: c Page: 489 Level: Difficult Type: Conceptual 15-46. For which of the following disorders is the prevalence among boys and girls quite similar? a) conduct disorder b) anorexia nervosa c) oppositional defiant disorder d) attention-deficit/hyperactivity disorder Answer: c Page: 489 Level: Medium Type: Factual 15-47. Which of these factors tend to predict that oppositional defiant disorder will continue over time? a) parental divorce and physical anomalies b) a history of birth complications and inadequate diet c) negative parenting practices and mothers' psychiatric disorders d) fathers' psychiatric disorders and presence of more than two siblings Answer: c Page: 490 Level: Medium Type: Factual 15-48. Sergio has many of the symptoms of conduct disorder, however, he is 19 years old. What is the most likely disorder that will be considered? a) pica b) Tourette's disorder c) antisocial personality disorder d) obsessive-compulsive disorder Answer: c Page: 491 Level: Medium Type: Factual 15-49. Which childhood disorder is most similar to the adult category of antisocial personality disorder? a) conduct disorder b) overanxious disorder 383

c) oppositional-defiant disorder d) attention-deficit/hyperactivity disorder Answer: a Page: 491 Level: Medium Type: Factual

15-50. What has happened to the prevalence rate of conduct disorder over the last 50 years? a) increased in industrialized countries b) decreased in industrialized countries c) increased in virtually all countries across the world d) decreased in virtually all countries across the world Answer: a Page: 491 Level: Medium Type: Factual 15-51. Mark, a 10-year-old boy, is often in trouble for hurting his neighbor's pets, setting fires, and getting money with his parents' bank card. His behavior is consistent with what diagnosis? a) conduct disorder b) oppositional defiant disorder c) antisocial personality disorder d) attention-deficit/hyperactivity disorder Answer: a Page: 491 Level: Difficult Type: Conceptual 15-52. Which person is most likely to receive the diagnosis of conduct disorder? a) 14-year-old Ann b) 10-year-old Tom c) 10-year-old Virginia d) 17-year-old Raymond Answer: b Page: 491 Level: Medium Type: Conceptual 15-53. Young children who are diagnosed with conduct disorder are at high risk for the later development of: a) depression. b) panic disorder. c) schizophrenia. d) antisocial personality disorder.

Answer: d Page: 491 Level: Medium Type: Conceptual 15-54. A psychologist reviews the data on genetic factors in antisocial behavior in preparation for writing an article for a national publication. The publisher of this popular magazine prefers catchy titles that are also explanatory. Which of the following would be the best choice? a) "Not genetics, but modeling" 384

b) "Strong genetic ties when ADHD is present" c) "Environmental toxins: The missing piece of the puzzle" d) "How the environment keys development of this disorder" Answer: b Page: 491 Level: Difficult Type: Conceptual 15-55. Fred has been diagnosed with conduct disorder. A psychologist interviews several family members and finds evidence that other family members have had the same diagnosis as well as antisocial personality disorder. It is also determined that Fred has the diagnosis of ADHD. When the psychologist evaluates this case, what is he likely to view as the key to understanding this behavior? a) Fred probably exhibits a persistent form of conduct disorder that has a strong genetic link. b) Fred has a transient form of conduct disorder that will pass with time provided good parenting is provided. c) Fred's form of conduct disorder is probably the result of inadequate parenting and the influence of peers. d) Fred's background suggests there is a presence of some other disorders, which might reflect a psychotic process.

Answer: a Page: 491 Level: Difficult Type: Conceptual 15-56. Aggressive children are more likely than nonaggressive children to interpret the causes of ambiguous social situations as a) hostile. b) loving. c) playful. d) accidental.

Answer: a Page: 494 Level: Medium Type: Factual 15-57. Henry, who has been observed to be very aggressive, felt a kickball brush up against the back of his legs. Although he did not see how the kickball got there, he is likely to infer that someone was a) trying to invite him to play. b) purposely trying to hurt him. c) accidentally dropping the ball. d) trying to make friends with him.

Answer: b Page: 494 Level: Difficult Type: Conceptual 15-58. A cognitive-behavioral intervention might help an aggressive child to mentally review a) self-reinforcing statements. b) rules for appropriate behavior. c) questions and answers about a situation.

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d) polite statements he can make in any situation.

Answer: c Page: 494 Level: Medium Type: Factual

15-59. How are Gerald Patterson's parent training programs, based on the sociallearning approach, designed to help families? a) preventing coercive interactions b) involving more outsiders in the family c) providing education about medications d) providing respite care for difficult children Answer: a Page: 495 Level: Medium Type: Factual 15-60. A team of mental health professionals is given the responsibility and challenge of developing programs to prevent conduct disorder. Which of the following will be on their list to incorporate into their programs? a) relaxation training b) client-centered therapy c) increasing positive social support d) increasing the availability of medications Answer: c Page: 495 Level: Medium Type: Factual 15-61. A specialist on internalizing disorders is addressing a PTA. What is the message she will want to leave with these parents? a) These disorders are not easy to detect and can be overlooked. b) These disorders are responsible for the majority of problems in gradeschool classrooms. c) Most of these disorders can be treated effectively with drug treatments, provided they are identified early. d) Most of these disorders can lead to severely incapacitating problems that often require hospitalization later in life.

Answer: a Page: 495 Level: Difficult Type: Conceptual 15-62. Which of these is an internalizing disorder? a) anxiety b) aggression c) hyperactivity d) conduct disorder Answer: a Page: 495 Level: Medium Type: Factual 15-63. Which of these is an anxiety disorder that DSM-IV-TR classifies as unique to childhood?

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a) dysthymia b) separation anxiety disorder c) generalized anxiety d) overanxious disorder Answer: b Page: 495 Level: Medium Type: Factual 15-64. Separation anxiety disorder is diagnosed if a child expresses extreme distress at most separations from a caregiver over a period of at least a) 1 week. b) four weeks. c) 6 months. d) 1 year.

Answer: b Page: 496 Level: Medium Type: Factual 15-65. Which type of child is LEAST likely to develop separation anxiety disorder? a) a neglected child b) a sexually abused child c) a physically abused child d) a child from a close-knit family Answer: a Page: 496 Level: Medium Type: Factual 15-66. Little Darla has been diagnosed with separation anxiety disorder. She has been taken to a mental health center, where a therapist asks her why she is afraid.

What is she likely to say? a) She is afraid she will get lost and never find her parents again. b) She is afraid to sleep because she believes she may never wake up again. c) She believes that people look at her in odd ways that make her feel uncomfortable. d) She says she has begun to put on some weight and looks "ugly" so she refuses to be seen by others.

Answer: a Page: 496 Level: Difficult Type: Conceptual 15-67. Which of these children is most likely to be diagnosed as suffering from social phobias? a) Ken a 4-year-old Caucasian child b) Daniel a 5-year-old Hispanic child c) Joy a 12-year-old Asian adolescent d) Jasmine an 8-year-old African American child Answer: d Page: 497 Level: Medium Type: Conceptual 15-68. Denzel is nine years old. He has to present his school project to the entire fourth grade. He complains to his parents that he does not want to participate.

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His parents feel he does not want to be embarrassed. Denzel has a diagnosis of: a) separation anxiety disorder b) generalized anxiety disorder c) specific phobia d) social phobia Answer: d Page: 499 Level: Difficult Type: Conceptual 15-69. John’s parents describe him as always being a follower. He has always been drawn to peers who seen to dominate him. John is always eager to please his peers. These symptoms would indicate a diagnosis of: a) generalized anxiety disorder b) social phobia c) separation anxiety disorder d) obsessive-compulsive disorder Answer: a Page: 499 Level: Difficult Type: Conceptual 15-70. Which statement is true regarding mothers of children with generalized anxiety disorder? a) They tend to be domineering and will not allow the child to make decisions. b) They are very often over-involved and exercise high levels of control over behavior. c) They have an anxiety disorder diagnosis and perpetuate feelings of inadequacy. d) They are involved in all aspects of the child’s life but are not overcontrolling.

Answer: b Page: 499 Level: Difficult Type: Factual 15-71. Which statement is not related to school as a source of anxiety for children? a) The stress-related experience of school can be unbearable. b) School can cause some children strong feelings of anxiety in relation to physical symptoms. c) School can cause children to feel dread with certain aspects. d) School reinforces negative self-concept and academic deficiencies.

Answer: d Page: 499 Level: Medium Type: Factual 15-72. Re-experiencing the event, avoidance of the trauma-related stimuli, and increased arousal are symptoms of: a) separation anxiety disorder b) post traumatic stress disorder c) generalized anxiety disorder d) social phobia Answer: b Page: 500 Level: Medium Type: Factual 388

15-73. Nine-year-old Judy insists on checking several times to see if the windows are closed and the doors locked before she allows her family to leave home on even brief trips. Her insistence on checking could be a sign of a) a phobia. b) separation anxiety. c) attention-deficit disorder. d) obsessive-compulsive disorder.

Answer: d Page: 500 Level: Medium Type: Conceptual 15-74. What are the important sex differences among people who are diagnosed with obsessive-compulsive disorder? a) more common in boys; equal in adults b) more common in boys and adult males c) more common in girls and adult females d) equally common in males and females throughout the age range Answer: a Page: 500 Level: Medium Type: Conceptual 15-75. Which of the following is an especially poor prognostic feature that predicts a reduced chance of improvement with antidepressant treatment? a) insomnia b) presence of tics c) weight problems d) mental retardation Answer: b Page: 500 Level: Medium Type: Factual 15-76. The National Institute of Mental Health study of children with severe obsessive-compulsive disorder has shown that more than half of these children also are diagnosed with a) conduct disorder. b) psychotic thinking. c) major mood disorder. d) oppositional-defiant disorder.

Answer: c Page: 501 Level: Medium Type: Factual 15-77. What is the apparent purpose of the self injury that is found in children who suffer from obsessive-compulsive disorder? a) attempting to reach out for help 389

b) easing present emotional distress c) punishing oneself for creating family conflict d) attempting to "punish" parents for interference Answer: b Page: 501 Level: Medium Type: Factual 15-78. A psychologist who specializes in treating obsessive-compulsive disorder in children was invited by the school to discuss her work. The audience consists of parents of children who are either diagnosed or suspected of having obsessivecompulsive disorder. What will this psychologist tell the parents to be looking for as a possible symptom of this disorder in this age group? a) pica b) insomnia c) self-injury d) auditory hallucinations Answer: c Page: 501 Level: Difficult Type: Factual 15-79. What is the most typical type of treatment for childhood fears and phobias? a) play therapy b) antianxiety drugs c) psychodynamic techniques d) cognitive-behavioral therapy Answer: d Page: 502 Level: Medium Type: Factual 15-80. Which disorder of childhood is most likely to be treated, in part, with medication? a) conduct disorder b) separation anxiety disorder c) oppositional-defiant disorder d) obsessive-compulsive disorder Answer: d Page: 502 Level: Medium Type: Factual 15-81. What type of sleep-related changes are likely to occur among adolescents experiencing depression? a) nightmares b) restless leg syndrome c) getting up too early in the morning d) sleeping excessive amounts of time Answer: d Page: 502 Level: Medium Type: Factual 15-82. Compared to someone first diagnosed with depression during adulthood, individuals who are diagnosed with depression in childhood are more likely to a) develop bipolar disorder.

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b) develop schizophrenic symptoms. c) be committed to a mental institution. d) be symptom free for a long period of time.

Answer: a Page: 502 Level: Medium Type: Factual

15-83. In which of the following groups is depression most common? a) adolescents b) children under five years old c) children between five and eight years old d) children between eight and thirteen years old Answer: a Page: 502 Level: Medium Type: Factual 15-84. A psychologist compares the records of 100 individuals who received the diagnosis of depression when they were children with the records of 100 individuals who received the diagnosis when they were adults. What is the psychologist likely to find? a) There is little difference in the outcomes of the two forms of depression. b) Childhood depression predicts a faster recurrence of depression than does adult depression. c) Symptoms experienced during childhood are quite different compared to symptoms in adulthood. d) Depression in childhood is typically a reaction to the changes of adolescence; therefore, it is not as serious as adult depression.

Answer: b Page: 502 Level: Difficult Type: Conceptual 15-85. A professor in graduate school is reviewing techniques for treating children with mental health problems for clinical psychology graduate students. Which of the following might be the most essential point this professor would want to make to these students? a) Children are generally easier to treat than adults. b) Do not underestimate the effectiveness of drug treatments. c) Psychodynamic methods have proven to be effective with children. d) Remember that parents must have ongoing participation in the therapy.

Answer: d Page: 502 Level: Difficult Type: Conceptual 15-86. Which of the following are externalizing disorders? a) tic disorders and conduct disorder b) separation anxiety and Tourette's disorder c) obsessive-compulsive disorder and bulimia d) attention deficit/hyperactivity disorder and obsessive-compulsive disorder 391

Answer: a Page: 505 Level: Medium Type: Factual

15-87. Tic disorders and Tourette’s disorder often occur together with a) social phobia b) somatization disorder c) oppositional defiant disorder d) attention-deficit/hyperactivity disorder Answer: d Page: 505 Level: Medium Type: Factual 15-88. Andrea engaged in involuntary, sudden, recurrent, stereotyped motor movements and vocalizations that are rapid and not rhythmic. Although she can resist this behavior for short periods of time, they are nevertheless experienced as irresistible. What is her likely diagnosis? a) tic disorder b) panic disorder c) depersonalization d) body dysmorphic disorder Answer: a Page: 505 Level: Difficult Type: Conceptual 15-89. In which setting would you expect a person with Tourette's syndrome to experience the greatest difficulty? a) while alone in a church b) eating dinner in a quiet restaurant c) at home with close family members d) at a very loud football game with non-stop action Answer: b Page: 506 Level: Medium Type: Conceptual 15-90. The word coprolalia appears in a patient's records. Based on this description, you conclude this patient is likely to do which of the following? a) stare a lot b) utter obscenities c) impersonate police officers d) avoid cracks in the sidewalks Answer: b Page: 506 Level: Medium Type: Conceptual 15-91. Which of these people is most likely to receive the diagnosis of Tourette's disorder? a) 10-year-old Zach 392

b) 18-year-old Mary c) 45-year-old Abraham d) 65-year-old Wilson Answer: a Page: 506 Level: Medium Type: Conceptual

15-92. Fourteen-year-old Kyle has the diagnosis of Tourette's disorder. Which of the following types of drugs would be most suitable as a treatment for his symptoms? a) antibiotic b) antianxiety c) antipsychotic d) antidepressant Answer: d Page: 506 Level: Medium Type: Factual 15-93. Which methods are most often used to treat childhood disorders? a) play therapies b) drug therapies c) behavioral techniques d) cognitive-behavioral therapies Answer: d Page: 506 Level: Medium Type: Factual 15-94. A young child's parents have been through the parent training offered by Gerald Patterson. Last night the child was very aggressive and demanding. How would Patterson suggest they react? a) Maintain calm and ask the child why he is so angry. b) Refuse to comply and subject the child to a time-out. c) Help the child to understand how nightmares can cause daily outbursts. d) Allow the child to vent his anger and then instruct him to engage in some relaxation exercises.

Answer: b Page: 509 Level: Difficult Type: Conceptual 15-95. What is the basic premise of family therapy? a) parents can be trained as therapists b) unconscious conflicts must be exposed c) individuals can act out feelings through play d) the system of family interactions is disturbed Answer: d Page: 510 Level: Medium Type: Factual 15-96. Which of the following forms of therapy is closely related to family therapy? a) cognitive 393

b) behavioral c) humanistic d) psychodynamic Answer: d Page: 510 Level: Medium Type: Factual

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Essay Questions 15-97. Who is most likely to be diagnosed with Attention-Deficit/Hyperactivity Disorder?

Answer: ADHD is the most frequently diagnosed behavioral disorder of childhood and is very common in the school-age population. Even using the DSM-IV-TR criteria that specify that some impairment is necessary to give the diagnosis, it is estimated that 3% to 5% of school-age children meet the criteria for this diagnosis.

In both adolescents and children, the disorder is more common in boys than in girls; the ratio is about 4 boys to 1 girl in the general population, and 9 boys to 1girl in clinical studies. The difference between the figures for the general population and the figure for clinical cases suggests a bias in referral--girls with the disorder are less likely to be referred for treatment than are boys. Another sex difference is the change in the number of individuals who meet the diagnosis at different ages. The rate for girls decreases only slightly from age 10 to age 20; whereas the rate for boys exhibits a sharp drop over that period.

Pages: 483 – 484 Level: Difficult Type: Factual 15-98. How is the behavior of other people affected by interactions with a child with ADHD? Answer: Children diagnosed with ADHD may experience social roadblocks because they are not well liked, either by their classmates or their teachers.

Children categorized as having the inattentive subtype or the combined subtype of ADHD seem to be the least well liked by their peers and teachers. This interaction between a child’s behavior and the behavior of another person is frequently seen in family setting as well as in school. Problematic interpersonal interactions are often observed among family members in families that include a child with ADHD. Parents of children with this disorder often experience marital difficulties, high levels of stress, and conflict-laden parent-child interactions. A child who is playing with another child with ADHD is likely to show more frequent demands, commands, and negative responses than if he were playing with a nonADHD child. These negative behaviors may then serve to reinforce and escalate the behaviors in the ADHD child. Parents of children with ADHD experience more stress and fewer gratifications than most other parents do. These interpersonal problems are thought to be more a consequence of the child's problem behaviors than a cause of them, because improved child behavior (often associated with use of medication) leads to changes in others' reactions.

Pages: 484 – 485 Level: Difficult Type: Factual

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15-99. What are the major treatments for Attention-Deficit/Hyperactivity Disorder?

Answer: The most common treatment for this disorder is stimulant drugs; between 80% and 90% of all children diagnosed with ADHD are treated with these drugs. The drugs do seem to have positive effects, especially in the short-term.

They tend to have their greatest effect within 2 to 4 hours after the drug is taken.

Many children taking these drugs show improved classroom performance, with a reduction in class disruption, and increased on-task behavior. Because information on the long-term effects of medication is lacking, many experts recommend that a behavioral intervention be established. Such approaches can include classroom intervention and parent training.

Pages: 487 – 488 Level: Difficult Type: Factual 15-100. Discuss the effectiveness of therapy with children.

Answer: Evaluation is a key factor. A variety of therapeutic interventions is helpful. Play is helpful with young children. Cognitive-behavioral approaches using exposure and cognitive restructuring are also effective. Methylphenidate drugs are helpful with children with ADHD. However, research comparing the effectiveness of different techniques is just under way. No definitive conclusions are possible at this time.

Page: 506 Level: Difficult Type: Factual

True/False 15-101. Child and adolescent problems often predict problems in adulthood.

Answer: True Page: 479 Level: Easy Type: Factual 15-102. Society is addressing maladaptive behavior in children in an adequate manner.

Answer: False Page: 481 Level: Easy Type: Factual 15-103. The causes of ADHD are unknown but there are several basic causes for the disorder.

Answer: True Page: 481 Level: Easy Type: Factual 15-104. The diagnosis of ADHD is objective and the criteria is relatively similar in all cases.

Answer: False Page: 484 Level: Easy Type: Factual 15-105. Children with ADHD often come from families with interpersonal problems.

Answer: True Page: 485 Level: Easy Type: Factual 15-106. Research has suggested that some behavior checklists are discriminatory 396

with regard to ADHD. Answer: True Page: 486 Level: Easy Type: Factual 15-107. Families with conflict, poverty, and at least one parent having a psychotic disorder have a higher rate of conduct disorder than other families.

Answer: True Page: 493 Level: Easy Type: Factual 15-108. There appears to be a genetic component to conduct disorders.

Answer: True Page: 493 Level: Easy Type: Factual 15-109. Prevention is the most effective treatment for conduct disorder.

Answer: True Page: 494 Level: Easy Type: Factual 15-110. Jamar cannot stay in a room by himself. He clings to his parents and is terrified of getting lost. He has generalized anxiety disorder.

Answer: False Page: 498 Level: Medium Type: Conceptual

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Chapter 16 Pervasive Developmental Disorders and Mental Retardation 16-1. Which of the following is true regarding pervasive developmental disorders? a) are apparent early in the child’s development b) affects are social, language, and cognitive systems c) are a long-lasting impairment d) All are true.

Answer: d Page: 515 Level: Medium Type: Factual 16-2. Which of the following is not a pervasive developmental disorder? a) Rett’s disorder b) childhood disintegrative disorder c) Tourette’s disorder d) Asperger’s disorder Answer: c Page: 515 Level: Medium Type: Factual 16-3. On which axis of a DSM-IV-TR diagnosis is mental retardation listed? a) Axis I b) Axis II c) Axis III d) Axis IV Answer: b Page: 515 Level: Medium Type: Factual 16-4. On which axis of a DSM-IV diagnosis is autism listed? a) Axis I b) Axis II c) Axis III d) Axis IV Answer: a Page: 515 Level: Medium Type: Factual 16-5. Unusual patterns of social and cognitive development, difficulties in social interaction and communication, and restricted interests describe: a) Rett’s disorder b) Autistic disorder c) Asperger’s disorder d) Tourette’s disorder Answer: b Page: 516 Level: Medium Type: Factual

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16-6. What is the approximate prevalence of autistic disorder? a) 3 out of every 100 children b) 3 out of every 1,000 children c) 3 out of every 10,000 children d) 3 out of every 100,000 children Answer: c Page: 516 Level: Medium Type: Factual 16-7. Approximately what percentage of cases of autism involve mental retardation? a) 15% b) 25% c) 50% d) 70% Answer: d Page: 516 Level: Medium Type: Factual 16-8. Ann is conducting research on autism and its associated conditions. The research involves reviewing the case files of all children seen at a clinic over the last five years. During a meeting with her supervisor, she is asked to discuss a typical case. Which of the following would she select? a) Bill who is autistic and mentally retarded b) Ken who is autistic and has an IQ of 125 c) Agnes who is autistic and mentally retarded d) Harriet who is autistic and has an IQ of 170 Answer: a Page: 516 Level: Medium Type: Conceptual 16-9. Which of the following disorders tend to occur together? a) autistic disorder and schizophrenia b) mental retardation and autistic disorder c) hypochondriasis and mental retardation d) Rett's disorder and schizoid personality disorder Answer: b Page: 516 Level: Medium Type: Factual 16-10. What is the sex ratio in autistic disorder? a) twice as common in girls b) twice as common in boys c) four times as common in boys d) equally common in girls and boys Answer: c Page: 516 Level: Medium Type: Factual

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16-11. What is the most common way to categorize autistic individuals? a) those with social disturbances, and those without b) those with language disturbances, and those without c) those who inherited the disorder, and those who did not d) those of normal or near normal intelligence, and those who are mentally retarded Answer: d Page: 516 Level: Medium Type: Factual 16-12. What are the three major categories of the symptoms that define autistic disorder? a) activities, communication, and social interaction b) attention, imagination, and non-verbal expression c) communication, motor skills, and short-term memory d) intellectual development, motor movement, and symbolism Answer: a Page: 516 Level: Medium Type: Factual 16-13. Which of the following is a clinical feature of autism? a) rapid weight loss b) severe nightmares c) visual hallucinations d) avoidance of eye contact with people Answer: d Page: 517 Level: Medium Type: Factual 16-14. Which of these children exhibits a communication pattern that is common in autistic children? a) Barry who raises the pitch of his voice b) Carol who tends to use the past tense c) Daniel who simply will echo what is said to him d) Ann who uses words like "goed" instead of went Answer: c Page: 517 Level: Medium Type: Conceptual 16-15. Which of the following is an autistic child most likely to spend time doing? a) telling stories b) playing with siblings c) rocking their bodies d) worrying about his parents Answer: c Page: 517 Level: Medium Type: Conceptual

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16-16. As part of an Abnormal Child Psychology course, you are required to observe children at the Children's Psychiatric Hospital. The child you are observing has been diagnosed with autistic disorder. Which of the following are you most likely to observe? a) The child stares at you for long periods of time. b) The child uses words that rhyme with each other. c) The child clings to you and will not let go for even a minute. d) The child repeats every word from a television commercial over and over.

Answer: d Page: 517 Level: Medium Type: Conceptual 16-17. Which of the following is most likely to be distressing to an autistic child? a) watching television b) having no one to play with c) knowing someone's feelings were hurt d) moving a piece of furniture to a new place Answer: d Page: 517 Level: Medium Type: Conceptual 16-18. Which of the following is an explanation for the importance of sameness and routine to children with autism? a) It becomes a cognitive reality. b) This is an attempt to control exposure to over-stimulation. c) This limits the number of temper tantrums. d) This is an attempt to create more stimulation.

Answer: b Page: 517 Level: Medium Type: Factual 16-19. When she was young, Temple Grandin was diagnosed with autistic disorder. What aspect of her life has been of special interest to psychologists? a) She gave birth to children who show no signs of autism. b) She has managed to live longer than most individuals with autism. c) She used her experiences to develop a widely used sign language program for autistic children. d) She earned a Ph.D. in animal science and developed widely used techniques for animal management.

Answer: d Page: 518 Level: Difficult Type: Conceptual 16-20. In which of the following situations is Temple Grandin most likely to learn new things? a) The material can be visualized. b) The material is repeated ten times. c) The material is presented in large print form. d) The sound of the ocean is played in the background.

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Answer: a Page: 518 Level: Medium Type: Conceptual

16-21. What terms are used to describe underlying problems that account for the cognitive deficits exhibited by children with autistic disorder? a) visual and auditory imagery b) symbolic and meta-representations c) genetic and non-genetic explanations d) theory of the mind and executive functions Answer: d Page: 520 Level: Medium Type: Factual 16-22. What was the purpose of the "squeeze box" designed by Temple Grandin? a) It restricts the movement of autistic children to reduce potential injury. b) The padded side boards press tight against the occupant and lead to a reduction in anxiety. c) The box is a humane way of keeping autistic children safe while they receive various forms of behavioral treatments. d) It allows autistic children to roam about with some restrictions, yet keeps them safe from injury because it is padded on all sides.

Answer: b Page: 519 Level: Difficult Type: Conceptual 16-23. “Mindblindness” refers to: a) the autistic child’s deficiency and inability to use desire, knowledge, and belief in self as a way of explaining behavior. b) an inability to plan, and utilize working memory. c) the inability to transfer information to different stages of memory. d) the autistic child’s inability to problem-solve and use executive functioning.

Answer: a Page: 520 Level: Medium Type: Factual 16-24. The cognitive skills in autistic disorders are primarily in the area of: a) visual perception. b) factual memory. c) short-term memory. d) concrete problem solving.

Answer: b Page: 521 Level: Medium Type: Factual 16-25. Which of the following would be especially difficult for a child who suffers from autistic disorder? a) eating with a spoon b) rolling a marble across the floor c) pretending that a stick is a sword 401

d) repeating words heard on a television commercial Answer: c Page: 521 Level: Medium Type: Conceptual

16-26. Which of the following is an example of one of the savant abilities? a) recognizing dance routines b) recalling routes or timetables c) matching objects to similar objects d) turning toward the direction of a sound Answer: b Page: 521 Level: Medium Type: Factual 16-27. What is the most universal symptom of autistic disorder? a) rocking b) facial grimaces c) language disturbances d) excess responsiveness to stimuli Answer: c Page: 521 Level: Medium Type: Factual 16-28. At age nine Ted Hart could read and remember the spelling of five-syllable Greek names for dinosaurs but he could not tie his shoes or differentiate the fantasy on television or in books from reality. Despite his deficits, Ted demonstrates some remarkable abilities that are referred to by the term a) savant. b) eugenics. c) primary intelligence. d) multiple intelligence.

Answer: a Page: 521 Level: Medium Type: Factual 16-29. Robert is a 4-year-old boy with autistic disorder. His parents probably have a very hard time getting him to a) eat. b) go outside. c) play patty-cake. d) walk without help.

Answer: c Page: 521 Level: Medium Type: Conceptual 16-30. What aspect of development is the parent of an autistic child most likely to notice as being abnormal? a) facial features b) motor development c) amount of eye contact d) susceptibility to infection 402

Answer: c Page: 521 Level: Medium Type: Factual 16-31. Peter rarely makes eye contact, seldom smiles, and infrequently talks in response to other people. He seems indifferent to everyone, including his parents.

Which diagnosis is consistent with Peter's behavior? a) autistic disorder b) mental retardation c) childhood schizophrenia d) obsessive-compulsive disorder Answer: a Page: 521 Level: Difficult Type: Conceptual 16-32. Based on an examination of home videos of children's first birthdays, the frequency of which behavior is most predictive of a later diagnosis of autism? a) pointing to objects b) failing to look at other people c) responding to his/her own name d) showing an object to other people Answer: b Page: 521 Level: Medium Type: Conceptual 16-33. As a demonstration in your abnormal psychology class, your instructor shows a videotape of children taken at their first birthday parties. Half of the children were subsequently diagnosed with autistic disorder. The instructor asks the class to select the children they believe received this diagnosis. Which of the following indicators would be the best predictor of the diagnosis? a) imitating the movements of others b) infrequently looking at the face of another c) spending most of the time with eyes closed d) moving hands around in a seemingly random fashion Answer: b Page: 523 Level: Difficult Type: Conceptual 16-34. An expert on the neurobiology of autistic disorder was asked to present an overview of research aimed at identifying a cause of the disorder. Which of the following titles would most accurately represent the state of knowledge? a) "Brain wave patterns are the key" b) "Neurobiological causes: Likely, but which ones?" c) "Slow growing tumors in the frontal lobes have a wide impact" d) "The brain does not distinguish schizophrenia from autistic disorder" Answer: b Page: 523 Level: Difficult Type: Conceptual

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16-35. What have brain imaging studies shown about the brains of autistic individuals, compared to the brains of non-autistic individuals? a) smaller limbic systems b) larger lateral ventricles c) same level of neurological functioning d) larger temporal, parietal, and occipital lobes Answer: d Page: 523 Level: Medium Type: Factual 16-36. Folstein and Rutter studied sets of identical twins in which only one child was autistic. What did they find to be associated with autism of the affected child? a) inheritance of a recessive trait b) brain injury at or just after birth c) immunological rejection in utero d) infection that passed the placenta Answer: b Page: 524 Level: Medium Type: Factual 16-37. What has research shown concerning the tendency for autistic disorder to run in families? a) Autistic disorder does not run in families. b) The tendency for autistic disorder to occur in families seems related to environmental toxins. c) Families with an autistic child have an elevated risk of having another child with autistic disorder. d) Families with high rates of schizophrenia are at elevated risk for having children with autistic disorder.

Answer: c Page: 524 Level: Difficult Type: Conceptual 16-38. Which statement regarding autistic disorders and schizophrenia is true? a) Autistic disorder begins early in the life of the child while childhood schizophrenia does not occur until age 7. Still, childhood schizophrenia includes hallucinations and delusions. b) Autism is a spectrum disorder occurring early in life while schizophrenia is rarely observed before age 12. c) Research indicates a strong genetic link between schizophrenia and autism. d) Newer psychotropic medications have a positive correlation with autism but not schizophrenia.

Answer: a Page: 525 Level: Difficult Type: Factual

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16-39. Some research on possible genetic factors involved in autistic disorder has compared the parents of children with autistic disorder to parents of children with Down syndrome. In what way are the parents of autistic children different? a) They are more likely to be aloof and hypersensitive. b) They have an elevated rate of delusions and hallucinations. c) They tend to exhibit a number of minor neurological dysfunctions that do meet the diagnostic criteria for a disease. d) Parents of children with autistic disorder exhibit similar emotions and behavior to those found in parents of children with other serious disorders, although their responses are at a more extreme level.

Answer: a Page: 525 Level: Difficult Type: Conceptual 16-40. A child psychologist was asked to provide guidelines for distinguishing autistic disorder and childhood schizophrenia. Which of the following would be a helpful guideline for mental health professionals faced with making a differential diagnosis? a) Childhood schizophrenia is more likely to run in families. b) Childhood schizophrenia rarely occurs until age 7 or later. c) Childhood schizophrenia is more likely to involve disordered speech. d) Childhood schizophrenia tends to have a major impact on peer relationships.

Answer: b Page: 525 Level: Difficult Type: Conceptual 16-41. Which of the following is the most common form of treatment for autism? a) antidepressants and tranquilizers b) flooding and megavitamin therapy c) behavioral training and medication d) supportive therapy and behavior modification Answer: c Page: 526 Level: Medium Type: Factual 16-42. What is a key indicator of the outcome for autistic children? a) lack of self-stimulation b) fairly good language skills c) lack of facial abnormalities d) normal motor development Answer: b Page: 526 Level: Medium Type: Factual 16-43. Research by Lovaas on an intensive behavioral program for autism found that participants showed increased a) motor skills.

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b) language skills. c) ability for abstract reasoning. d) rates of regular classroom placement.

Answer: d Page: 527 Level: Medium Type: Factual 16-44. An expert on autistic disorder has been invited to give a presentation on the current status of drug treatments for this disorder. Which of the following is the best title for this presentation? a) "Antidepressants show great promise" b) "Drugs: Little evidence for effectiveness" c) "It looks like schizophrenia, so use antipsychotic drugs" d) "Stimulants: They work with hyperactivity; they should work with autism" Answer: b Page: 528 Level: Difficult Type: Conceptual 16-45. When five-year-old Aliens began elementary school the teachers noticed that compared to other children his interests and activities were restricted and he did not interact with other children. His motor behavior was often stereotyped and repetitive, and he appeared clumsy when he walked. A battery of psychological tests reveals no evidence of mental retardation. Based on his age and symptoms, which disorder would mental health professionals suspect in this case? a) Radios disorder b) autistic disorder c) Asperger's disorder d) childhood disintegrative disorder Answer: c Page: 529 Level: Difficult Type: Conceptual 16-46. What is one of the major differences between autistic disorder and Asperger's disorder? a) There are no significant delays in language in Asperger's disorder. b) There is a greater degree of memory impairment in autistic disorder. c) People with autistic disorder generally obtain higher intelligence scores. d) Asperger's disorder tends to develop much earlier than autistic disorder.

Answer: a Page: 529 Level: Medium Type: Conceptual 16-47. Problems with social use of language, motor clumsiness, and speech that is stilted and repetitive are symptoms of: a) autistic disorder b) Asperger’s disorder c) Rett’s disorder d) childhood disintegrative disorder Answer: b Page: 529 Level: Medium Type: Factual 406

16-48. Which of the following fits the typical pattern on an intelligence test administered to someone with Asperger's disorder? a) an average IQ score with significantly higher performance scores than verbal scores b) a below average IQ score with much higher verbal scores than performance scores c) an average IQ score with significantly higher verbal scores than performance scores d) a below average IQ score with much higher scores on the performance tests than verbal tests Answer: c Page: 529 Level: Difficult Type: Conceptual 16-49. Which of the following disorders is extremely rare; occurring only once in every million births? a) Rett’s disorder b) childhood disintegrative disorder c) Asperger’s disorder d) None of the above.

Answer: b Page: 530 Level: Medium Type: Factual 16-50. For the first five months of life, Jessica seemed to be developing normally.

Then, her head gradually began to stop growing; a pediatrician described her condition as microcephaly. She demonstrated impaired language development, poor coordination, and a loss of social interactions. What is the most likely diagnosis? a) Rett's disorder b) autistic disorder c) childhood schizophrenia d) childhood disintegrative disorder Answer: a Page: 530 Level: Medium Type: Conceptual 16-51. Which of these children is most likely to receive the diagnosis of Rett's disorder for the first time? a) Ann who is 2 years old b) Bill who is 11 years old c) Steve who is 6 years old d) Charlene who is 10 years old Answer: a Page: 530 Level: Medium Type: Conceptual 407

16-52. Luanne presented with a normal developmental history. However, at 6 months of age the development of her head slowed. Language development and social skills began to diminish. She began to tap her hands. She is in the early stages of: a) microcephaly b) childhood schizophrenia c) Rett’s disorder d) Mosanicism Answer: c Page: 530 Level: Medium Type: Conceptual 16-53. Which of the following pervasive developmental disorders typically occurs in females only? a) Rett’s disorder b) autistic disorder c) Asperger's disorder d) childhood disintegrative disorder Answer: a Page: 530 Level: Medium Type: Factual 16-54. You are asked to give a report on childhood disintegrative disorder and Rett's disorder. After reviewing information on both disorders, what similarity will you include in your report? a) Both disorders are inherited via a dominant gene. b) Both disorders occur more often in males than in females. c) Both disorders are associated with a shortened life expectancy. d) Both disorders develop after an initial period of normal development.

Answer: d Page: 531 Level: Difficult Type: Conceptual 16-55. A pediatrician and a psychologist are developing a treatment plan for a child who has been diagnosed with Rett's disorder. What caution will they discuss when they consider the use of antipsychotic drugs? a) The drugs can induce a childhood form of tardive dyskinesia that could lead to death. b) Antidepressants have shown great promise, although they may induce a rebound form of depression. c) The drugs may reduce stereotyped behaviors; however, they may also increase the frequency of seizures. d) Clozapine has shown great promise with difficult cases of schizophrenia, therefore, it should work with Rett's disorder.

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However, if the child is not carefully monitored, serious side effects could develop.

Answer: c Page: 531 Level: Difficult Type: Conceptual

16-56. Childhood autism, Rett’s disorder, and Asperger’s disorder are considered to be part of: a) childhood schizophrenia b) autistic spectrum disorders c) developmental disorders d) autistic disorder spectrum Answer: d Page: 531 Level: Medium Type: Factual 16-57. Which of the following would not be included in Lorna Wing’s grouping of autistic spectrum disorders? a) passives b) loners c) aloofs d) unusuals Answer: d Page: 531 Level: Medium Type: Factual 16-58. Epidemiological studies indicate that the number of individuals in the United States who meet the criteria for mental retardation is approximately 1 in every a) 10 b) 100 c) 250 d) 1,000 Answer: b Page: 532 Level: Medium Type: Factual 16-59. Which characteristics are associated with the diagnosis of mental retardation? a) brain damage and lack of responsibility b) below average intelligence and normal adaptive functioning c) normal intelligence and below average adaptive functioning d) below average intelligence and below average adaptive functioning Answer: d Page: 532 Level: Medium Type: Factual 16-60. Mental retardation is defined by a significantly below-average level of intelligence that accompanies a) chromosomal abnormality.

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b) impaired adaptive functioning. c) noticeable physical abnormalities. d) disinterest in human relationships.

Answer: b Page: 532 Level: Medium Type: Factual

16-61. Which of the following is one of the elements of the DSM-IV-TR criteria for identifying mental retardation? a) IQ below 50 b) occurrence prior to age 18 c) documented evidence of brain damage d) failure to develop age-appropriate social interaction skills Answer: b Page: 532 Level: Medium Type: Factual 16-62. Ted has been diagnosed as exhibiting autistic disorder and mental retardation. On which axes of the DSM-IV-TR, would these two diagnoses be entered? a) I and IV b) II and III c) I and III d) I and II Answer: d Page: 532 Level: Medium Type: Conceptual 16-63. What is the most common degree of mental retardation? a) mild b) moderate c) severe d) profound Answer: a Page: 532 Level: Medium Type: Factual 16-64. Roger and Jean's son was recently diagnosed as mentally retarded. What is his most likely degree of retardation? a) mild b) severe c) moderate d) profound Answer: a Page: 532 Level: Medium Type: Conceptual 16-65. What are the two general categories of the causes of mental retardation? a) accidental and genetic factors 410

b) autistic and nonautistic factors c) intentional and unintentional factors d) psychosocial and pathological factors Answer: d Page: 532 Level: Medium Type: Factual

16-66. About what percentage of all cases of mental retardation are classified as profound? a) 25% b) 15% c) 5% d) 1% Answer: d Page: 533 Level: Medium Type: Factual 16-67. Peggy has been slow in development since birth; her IQ is 30. She cannot feed or dress herself, and interacts with others only by laughing or giggling. In which category of mental retardation would Peggy be classified? a) mild retardation b) profound autism c) severe retardation d) moderate retardation Answer: c Page: 533 Level: Medium Type: Conceptual 16-68. A person with significantly impaired adaptive functioning and an IQ of 45 would be classified at which level of mental retardation? a) mild b) severe c) profound d) moderate Answer: d Page: 533 Level: Medium Type: Conceptual 16-69. Alice has been in special education classes since preschool. Although she can feed and dress herself well, she needs help selecting appropriate clothes. She can write simple letters and use the telephone, but does not seem aware of current events and is unable to write about abstractions. She is expected to complete the equivalent of the sixth grade. In what category of mental retardation would Alice be classified? a) mild b) severe 411

c) profound d) moderate Answer: a Page: 533 Level: Difficult Type: Conceptual 16-70. What grade level of academic functioning do people with mild mental retardation typically achieve? a) first b) third c) sixth d) eighth Answer: c Page: 533 Level: Medium Type: Factual 16-71. What is the cause of phenylketonuria? a) rubella virus b) air-borne toxins c) a gene mutation d) excess levels of neurotransmitters Answer: c Page: 534 Level: Medium Type: Factual 16-72. Sally's newborn was diagnosed with phenylketonuria. Which of the following is the most likely treatment suggested by her pediatrician? a) a restrictive diet b) cognitive stimulation c) surgery to reduce brain swelling d) antipsychotic drugs to reduce seizures Answer: a Page: 534 Level: Medium Type: Conceptual 16-73. A pediatrician is visiting the parents of a newborn in the hospital. The results of required tests reveal the infant has PKU. When the parents ask what this means, what is the pediatrician likely to tell them? a) "Your child has inherited a tendency to develop language at a slower rate than average." b) "Your child has an inherited metabolic disorder that can be treated by dietary restrictions." c) "A toxin has been found in your child's blood; however, we should be able flush it from his system and it will have no long term effects." d) "A brain scan has revealed a loss of cells in some key areas of the brain that often results from exposure to alcohol during pregnancy."

Answer: b Page: 534 Level: Difficult Type: Factual 16-74. Which person is most likely to show Fragile X syndrome? a) a girl whose father carries the gene for Fragile X b) a girl whose mother carries the gene for Fragile X c) a boy whose father carries the gene for Fragile X 412

d) a boy whose mother carries the gene for Fragile X Answer: d Page: 535 Level: Difficult Type: Factual 16-75. What is the most common form of inherited mental retardation? a) Fragile X syndrome b) tuberous sclerosis c) Tay-Sachs disease d) Parkinson's disease Answer: a Page: 535 Level: Medium Type: Factual 16-76. Down syndrome is caused by a) severe malnutrition. b) a chromosomal abnormality. c) oxygen deprivation before birth. d) an infection that passes the placenta.

Answer: b Page: 536 Level: Medium Type: Factual 16-77. What is the most common chromosomal abnormality that causes Down syndrome? a) one number 21 chromosome b) two number 21 chromosomes c) three number 21 chromosomes d) absence of number 21 chromosomes Answer: c Page: 536 Level: Medium Type: Factual 16-78. What physical characteristics are often found in Down syndrome? a) flat face, small nose, small ears b) long face, bulging eyes, and long fingers c) thin upper lip, flat cheeks, and low-set ears d) small eyes, large ears, and bulging forehead Answer: a Page: 536 Level: Medium Type: Factual 16-79. Trisomy 21 is another name for a) phenylketonuria. b) Down syndrome. c) Fragile X syndrome. d) fetal alcohol syndrome.

Answer: b Page: 536 Level: Medium Type: Factual 16-80. In addition to being mentally retarded, Down syndrome children often have a) heart problems. b) damaged kidneys.

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c) personality disorders. d) metabolic dysfunctions.

Answer: a Page: 536 Level: Medium Type: Factual 16-81. Trisomy 13, trisomy 18, and trisomy 21 are all causes of mental retardation associated with a) prenatal infections. b) metabolic dysfunctions. c) fragile areas on the X chromosome. d) more than the normal number of chromosomes.

Answer: d Page: 537 Level: Medium Type: Factual 16-82. Tim has a flat face, small nose, eyes that appear to slant upward because of small folds of skin at the inside corner, short arms and legs, and small squarish hands. These physical features are typical of a chromosomal disorder called a) phenylketonuria. b) Down syndrome. c) Tay-Sachs disease. d) Fragile X syndrome.

Answer: b Page: 537 Level: Medium Type: Conceptual 16-83. Which of these new mothers has an elevated risk of having a child with Down syndrome? a) Meg who is 45 years old b) Sally who has abused alcohol for years c) Phyllis who has untreated phenylketonuria d) Dana who has been diagnosed as mildly mentally retarded Answer: a Page: 537 Level: Medium Type: Conceptual 16-84. Nondisfunction, translacatim; and masaicism are types of chromosomal abnormalities occurring in: a) Down syndrome b) childhood disintegrative disorder c) childhood schizophrenia d) PKU Answer: a Page: 537 Level: Medium Type: Factual 16-85. Which of the following pairs of disorders have been shown on the basis of autopsy results to share similar characteristic brain damage? a) Tay-Sachs disease and autism b) Down syndrome and Alzheimer's disease c) Parkinson's disease and Alzheimer's disease d) Korsakoff's syndrome and Parkinson's disease 414

Answer: b Page: 538 Level: Medium Type: Factual 16-86. Abnormalities in the brain tissue of people with Down syndrome are similar to those observed in a) autism. b) Parkinson's disease. c) Alzheimer's disease. d) Huntington's disease.

Answer: c Page: 538 Level: Medium Type: Factual 16-87. A 35-year-old man was killed last week when he was hit by a car as he crossed the street near his group home. According to the staff at the group home, the man had Down syndrome. The man's relatives agree to an autopsy, which is likely to show brain pathology that is similar to that found in a) Parkinson's disease. b) Alzheimer's disease. c) Huntington's disease. d) Korsakoff's syndrome.

Answer: b Page: 538 Level: Medium Type: Factual 16-88. What is amniocentesis? a) a type of neurotransmitter b) a chromosomal abnormality c) a form of mental retardation d) a technique used to examine fetal cells Answer: d Page: 538 Level: Medium Type: Factual 16-89. The mother of a newborn contracted the rubella virus during the first three months of her pregnancy. In about half of such cases, the fetus is also infected, resulting in a variety of problems. Which of the following are the most likely consequences of this infection? a) brain damage, liver damage, and tics b) congenital heart disease, deafness, and mental retardation c) anomalies of the face and limbs, blindness, and learning disabilities d) breathing difficulties, delayed language development, and slowed motor movement Answer: b Page: 539 Level: Difficult Type: Conceptual 16-90. What physical characteristics are associated with fetal alcohol syndrome? a) short face, slanted eyes, thin upper lips b) long face, large ears, and drooping eyelids c) long arms and legs, large abdomen, and excessive scarring 415

d) upturned nose with a low bridge, small eyes, bulging forehead Answer: d Page: 539 Level: Medium Type: Factual 16-91. Which group of mentally retarded children is most likely to come from families with low socioeconomic status? a) mild b) severe c) profound d) moderate Answer: a Page: 540 Level: Medium Type: Factual 16-92. Which of the following is a form of primary prevention of mental retardation? a) school-based educational programs b) vocational and social training programs c) a campaign to reduce children's exposure to lead d) special classes for children diagnosed as mentally retarded Answer: c Page: 540 Level: Medium Type: Conceptual 16-93. School-based educational program, community living programs, and vocational skills programs are examples of: a) secondary prevention b) tertiary prevention c) primary prevention d) early prevention Answer: b Page: 541 Level: Medium Type: Factual 16-94. Which of these is an example of the secondary prevention of PKU? a) outline a special restricted diet b) school-based educational programs c) provision for genetic testing of mothers during pregnancy d) campaigns to inform expectant mothers of the importance of good prenatal care Answer: a Page: 541 Level: Difficult Type: Conceptual 16-95. What does the Disabilities Education Act of 1990 require in terms of education of disabled children? a) All disabled children must be mainstreamed. b) All disabled children must receive public education. c) Special education is provided only if physical handicaps are involved. d) Public schools are not responsible for children with profound disabilities.

Answer: b Page: 544 Level: Medium Type: Factual 416

16-96. What is one reason mentally retarded individuals are especially susceptible to exploitation? a) They do not feel shame. b) They tend to answer "yes" to all questions. c) They often have specific, remarkable talents. d) They are usually more physically fit than average.

Answer: b Page: 544 Level: Medium Type: Conceptual

16-97. The unmet needs of parents with a mentally retarded child seem to show a U-shaped pattern, with relatively fewer unmet needs occurring at which time point? a) at the time of diagnosis b) the child's 21st birthday c) the time for walking and talking d) enrollment in a school program Answer: d Page: 546 Level: Medium Type: Factual

Essay Questions 16-98. How have researchers used videotapes of children to help make the diagnosis of autistic disorder?

Answer: The most predictive behavior of autism is how seldom eye contact is made. Researchers wanted to determine if this behavioral characteristic would identify very young children who would later be diagnosed with autistic disorder.

They selected videotapes of the first birthday-party for a number of children who were later diagnosed as having autistic disorder and compared them to videotapes of the parties of normal children. Raters who were unaware of the childrens' diagnoses viewed the videotapes and coded the number of times each child exhibited certain behaviors. The absence of four behaviors--eye contact, showing an object to another person, pointing to objects, and responding to their own names--could identify children who were later diagnosed as autistic with 91% accuracy. A single behavior--the number of times a child looked at another person's face--correctly classified 77% of the children into either the autistic or the nonautistic groups.

Pages: 522 – 523 Level: Difficult Type: Factual 16-99. What is the distinction between autism and childhood schizophrenia?

Answer: Although some researchers view autism as a psychosis, it is now considered a pervasive developmental disorder distinct from childhood psychosis.

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Whereas autism is often evident from early infancy, childhood psychosis rarely appears before age 7 or 8. Like schizophrenia in adulthood, childhood schizophrenia includes hallucinations and/or delusions and seems to involve similarities in brain anatomy to those found in adult schizophrenia. Autism is often associated with mental retardation, whereas childhood psychosis is not.

Pages: 525 – 526 Level: Difficult Type: Factual

16-100. What are the major diagnostic criteria for mental retardation?

Amswer: A person must meet each of three criteria: (1) significantly belowaverage intellectual functioning, with an IQ of approximately 70 or below on an individually administered IQ test or, for infants, a clinically based judgment of significantly below-average intellectual functioning. (2) Deficits or impairments in the person's effectiveness in meeting the standards expected for his or her age by his or her cultural group in at least two of the following: communication, self-care, home living, social/interpersonal skills, use of community resources, selfdirection, functional academic skills, work, leisure, health, and safety. (3) These criteria must both be met before the age of 18 years.

Page: 532 Level: Difficult Type: Factual 16-101. What is phenylketonuria? What is its etiology and how can it be treated?

Answer: Phenylketonuria is a metabolic disorder produced by mutation of a gene that results in impaired functioning of a specific enzyme, phenylalanine hydroxylase. The impairments results in the inability of the person's body to oxidize the chemical phenylalanine, which therefore accumulates in the body. If this accumulation is allowed to continue, severe mental retardation may result. A special low-protein diet can prevent most of these changes. The sooner the treatment is begun the better the chances that mental retardation will not result.

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True/False 16-102. Children with pervasive developmental disorders lack skills for social interactions but cognitive behaviors are similar to most children their age.

Answer: False Page: 515 Level: Easy Type: Factual 418

16-103. Pervasive developmental disorders can occur together with some degree of mental retardation.

Answer: True Page: 515 Level: Easy Type: Factual 16-104. “Sameness” and routine are important to autistic children.

Answer: True Page: 517 Level: Easy Type: Factual 16-105. Unusual patterns of social and cognitive development, difficulties in social interaction and communication, and restricted interests are symptoms of Asperger’s disorder.

Answer: False Page: 529 Level: Easy Type: Factual 16-106. Children with autism have problems in planning, organization, and cognitive flexibility.

Answer: True Page: 520 Level: Easy Type: Factual 16-107. Symbolic play and functional play are rarely observed in autistic children.

Answer: False Page: 521 Level: Easy Type: Factual 16-108. The presence of savant abilities can give the impression of superior intelligence in retarded children with autism.

Answer: True Page: 521 Level: Easy Type: Factual 16-109. There appears to be agreement that autism is caused by a dysfunction in the central nervous system. However, there is disagreement with regard to the defining characteristics and the link between brain dysfunction and behavioral characteristics.

Answer: True Page: 523 Level: Easy Type: Factual 16-110. Asperger’s disorder is similar to autistic disorder because both are diagnosed prior to three years of age.

Answer: False Page: 529 Level: Easy Type: Factual 16-111. Specific treatments have been developed for Rett’s disorder, most notably behavioral methods.

Answer: False Page: 530 Level: Easy Type: Factual

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Chapter 17 Society's Response to Maladaptive Behavior 17-1. Primary prevention is concerned with a) reducing relapse rates. b) reducing new cases of a disorder. c) improving response to therapeutic interventions. d) protecting "at-risk" people from developing disorders.

Answer: b Page: 552 Level: Medium Type: Factual 17-2. Which of the following is an example of primary prevention? a) premarital counseling b) treating a hyperactive child with stimulant drugs c) providing social support for people who want to stop smoking d) sending juvenile delinquents to prison to meet with convicts to "scare them straight" Answer: a Page: 552 Level: Medium Type: Conceptual 17-3. Which of these is an example of primary prevention? a) taking iron pills to treat anemia b) group homes for juvenile offenders c) public campaigns about drinking and driving d) special classes for emotionally disturbed children Answer: c Page: 552 Level: Medium Type: Conceptual 17-4. Which of the following most accurately describes primary prevention? a) efforts to reduce the consequences of certain disorders or diseases once they have developed b) efforts aimed at a particular population to reduce the development of new cases of disorders or diseases c) efforts to reduce the chances that certain problems will develop in subgroups that are considered to have a high risk d) separation of cases of those who have certain diseases from those who do not in order to reduce the spread of such diseases Answer: b Page: 552 Level: Difficult Type: Factual 17-5. Which of the following is an example of secondary prevention of PKU? a) distribution of written materials describing PKU to expectant mothers b) analysis of genetic tests to determine if a child has the genes for PKU c) public service announcements describing the cause and the symptoms of PKU d) development of a special diet for a child who has been diagnosed as having PKU Answer: d Page: 552 Level: Difficult Type: Conceptual 420

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17-6. Which of the following is an example of secondary prevention? a) taking vitamins to prevent catching a cold b) discouraging young people from beginning to smoke c) putting warning labels on car seats to insure they are used properly d) providing social support groups for people who have experienced serious traumatic events Answer: d Page: 552 Level: Medium Type: Conceptual 17-7. Programs for men who have been violent toward their family members in which they receive support and counseling to change their behavior are examples of a) postvention. b) tertiary prevention. c) primary prevention. d) secondary prevention.

Answer: b Page: 552 Level: Medium Type: Conceptual 17-8. Secondary prevention is concerned with: a) reducing the potential disability of an existing abnormal condition b) educating couples on sexual diseases c) medical awareness of conditions d) All of the above.

Answer: a Page: 552 Level: Medium Type: Factual 17-9. Rehabilitation and resocialization are associated with: a) secondary prevention b) primary prevention c) tertiary prevention d) school-based programs for prevention Answer: c Page: 552 Level: Medium Type: Factual 17-10. Which of these is an example of tertiary prevention? a) taking vitamins every day b) speech therapy for stroke victims c) avoiding alcohol during pregnancy d) public campaigns against smoking Answer: b Page: 552 Level: Medium Type: Conceptual

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17-11. Which of the following is the best example of tertiary prevention for hyperactivity in children? a) evaluating all children in a school system for the possible diagnosis of hyperactivity b) training teachers in techniques used to detect cases of hyperactivity in the classroom c) instituting behavior therapy for a child diagnosed as hyperactive in order to improve attention skills d) distributing pamphlets describing the symptoms of hyperactivity to parents of children in a school district Answer: c Page: 552 Level: Difficult Type: Conceptual 17-12. What type of prevention focuses on people who have already developed a disorder? a) postvention b) tertiary prevention c) primary prevention d) secondary prevention Answer: b Page: 552 Level: Medium Type: Conceptual 17-13. Approximately what percentage of American teenagers are referred to courts each year for suspected offenses other than traffic offenses? a) 1% b) 4% c) 8% d) 12% Answer: b Page: 552 Level: Medium Type: Factual 17-14. Which of these is an example of primary prevention for juvenile delinquency? a) residential programs for delinquents b) therapy for families of serious offenders c) programs to provide safe, low-cost housing d) after-school activities for kids who have been to court Answer: c Page: 552 Level: Medium Type: Conceptual 7-15. Reducing or eliminating the environmental causes of disordered behavior is called a) tertiary prevention. b) secondary prevention. c) situation-focused prevention. d) competency-focused prevention.

Answer: c Page: 554 Level: Medium Type: Factual 422

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423 17-16. ________ prevention attempts to reduce environmental causes of maladaptive behavior. ___________ prevention enhances a community’s ability to cope with conditions leading to maladaptive behavior. a) Competency focused; primary b) Primary; situation-focused c) Tertiary; secondary d) Situation-focused, competency-focused Answer: d Page: 554 Level: Difficult Type: Factual 17-17. Robert and Evan are growing up in an area with a high number of very aggressive gangs. They are in a special school program to foster early development of job skills in hopes that these skills will keep them out of gangs.

This program is an example of a) tertiary prevention. b) primary prevention. c) situation-focused prevention. d) competency-focused prevention.

Answer: d Page: 554 Level: Difficult Type: Conceptual 17-18. About what percentage of all children in the U.S. can expect to experience their parents' divorce during childhood? a) 10% b) 25% c) 50% d) 75% Answer: c Page: 554 Level: Medium Type: Factual 17-19. Parental permissiveness and failures in monitoring are associated with increased risk for what child behavior or disorder? a) anxiety b) depression c) aggression d) attention deficit Answer: c Page: 554 Level: Medium Type: Factual 17-20. Children of psychotic parents have an increased risk for a) epilepsy. b) dysthymia. c) eating and sleeping problems. d) attention-deficit/hyperactivity and mental retardation.

Answer: c Page: 556 Level: Medium Type: Factual

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424 17-21. For a number of years Agnes has consumed large amounts of alcohol.

When she became pregnant, she did not alter her drinking habits. Her physician suspected she was a heavy drinker and warned her to stop. During their discussion, the physician pointed out that Agnes has increased the risk her child will develop which of the following problems? a) autism b) depression c) hyperactivity d) schizophrenia Answer: c Page: 556 Level: Difficult Type: Conceptual 17-22. Which of the following are characteristics of parents who abuse their children? a) impulsive and immature b) mood swings and auditory hallucinations c) high level of intelligence and low socioeconomic status d) overinflated sense of self-worth and doubts concerning ability Answer: a Page: 557 Level: Medium Type: Factual 17-23. Which of the following characterizes the family histories of parents who abuse their children? a) married later in life b) raised in small families c) experienced abuse as children d) showered with affection from parents Answer: c Page: 557 Level: Medium Type: Factual 17-24. Which of the following characterizes the parenting practices of abusive parents? a) psychological damage can be observed immediately b) excessive praise of children c) children are highly supervised d) few demands are placed on the child Answer: a Page: 557 Level: Medium Type: Factual 17-25. A psychologist was asked by the mental health department to create a program for abusive parents. After reviewing the literature on effective programs, what is she likely to include in the program she designs? a) existential therapy b) systematic desensitization c) group assertiveness training d) behavioral training in impulse control Answer: d Page: 557 Level: Difficult Type: Conceptual 424

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17-26. What is the primary focus of Parents Anonymous? a) helping single parents b) helping abusive parents c) assisting children who are abused d) assisting couples who are trying to conceive Answer: b Page: 557 Level: Medium Type: Factual 17-27. A group of citizens met recently because they were alarmed by the high rate of child abuse in their community. They invited an expert on child abuse prevention programs to outline some of the methods that could be used to reduce child abuse. Which of the following items is most likely to be on the list of techniques to be used in the prevention efforts? a) financial support for parents b) legal consequences for abuse c) monitoring of the home situation d) group therapy for family members Answer: c Page: 557 Level: Difficult Type: Factual 17-28. Approximately what percentage of women who are murdered in the U.S. are killed by a husband, ex-husband, or suitor? a) 8% b) 15% c) 30% d) 65% Answer: a Page: 557 Level: Medium Type: Factual 17-29. The state Department of Corrections and the Department of Mental Health are collaborating on a survey to determine the number of women who are killed by a husband, ex-husband, or suitor. They sampled 1,000 cases of murder of a woman. Based on past research, approximately what number would you expect to have been killed by a husband, ex-husband, or suitor? a) 10 b) 80 c) 300 d) 500 Answer: b Page: 557 Level: Medium Type: Conceptual 17-30. Which of these is a contributing factor to spouse abuse and murder? a) changing sex roles b) genetic abnormalities c) false reports of abuse 425

d) cultural acceptance of male dominance Answer: d Page: 558 Level: Medium Type: Factual 17-31. Compared to other husbands, husbands who abuse their wives are more likely to have a) legal difficulties. b) behaved violently in other situations. c) high levels of assertiveness in social situations. d) witnessed spouse abuse between their parents.

Answer: d Page: 558 Level: Medium Type: Conceptual 17-32. Which of the following is an example of a secondary prevention program for spouse abuse? a) premarital counseling b) marital counseling to reduce discord c) providing spouses with safety, shelter, and counseling d) psychological testing to determine whether a spouse is likely to become an abuser Answer: b Page: 558 Level: Medium Type: Factual 17-33. Premarital counseling designed to reduce spouse abuse is an example of a) postvention. b) tertiary prevention. c) primary prevention. d) secondary prevention.

Answer: c Page: 558 Level: Medium Type: Factual 17-34. Compared to other children, which of the following is more likely to occur among children of divorced parents? a) remain unmarried b) develop schizophrenia c) become spouse abusers d) receive mental health services Answer: d Page: 558 Level: Medium Type: Conceptual 17-35. Which of the following is an important guideline for helping children to adjust to a divorce? a) explain the reasons for the divorce b) delay telling them until it is absolutely necessary c) have only one of the parents continue frequent contact d) suggest that the parents will one day get back together Answer: a Page: 558 Level: Medium Type: Conceptual

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17-36. What are some of the techniques that can be used to teach parents to be effective behavior-change agents for their children and help to develop their social and cognitive skills? a) modeling and reinforcement b) milieu therapy and implosive therapy c) cognitive restructuring and group therapy d) existential therapy and aversive conditioning Answer: a Page: 558 Level: Medium Type: Factual 17-37. For many years, family members have been considered causal agents for the mental illnesses of other family members. How has this view changed? a) Family members are often so aloof from family members with mental illness that they play little role in the illness. b) The family member's mental illness is now viewed as a stressor, which can create a need to develop coping skills. c) Members of the family share common genes for mental illness, and members who have not developed an illness do not wish to be reminded of this possibility. d) Most of the maladaptive behavior seen in families with mental illness present results from genetic factors that should be addressed by genetic counseling.

Answer: b Page: 559 Level: Difficult Type: Conceptual 7-38. Jake has been identified as at risk for dropping out of school. What would be most helpful in preventing his dropout? a) placing him larger classes b) moving him to a new school c) not singling him out as needing help d) setting high but realistic expectations for achievement Answer: d Page: 560 Level: Medium Type: Factual 17-39. A group of social workers is monitoring programs in several poor neighborhoods. The data they have collected indicates that the neighborhood they are working in at the current time has a high degree of "collective efficacy."

What might they expect to find in this neighborhood based on this information? a) There is high level of fear of police intervention. b) Neighbors are more willing to keep quiet about crime. c) Adults are more likely to discipline children for missing school. d) Neighbors are more likely to be involved in political efforts to change their current situation.

Answer: c Page: 561 Level: Difficult Type: Conceptual 427

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17-40. Jack's neighborhood is described as trusting, sharing common values, and cohesive. Which term would researchers use to describe this set of characteristics? a) meshed b) collective efficacy c) communal effectiveness d) neighborhood solidarity Answer: b Page: 561 Level: Medium Type: Factual 17-41. What is the main focus of community psychology? a) diagnosis b) prevention c) treatment d) normal development Answer: b Page: 562 Level: Medium Type: Factual 17-42. Miguel is a community psychologist. What type of work is he likely to do? a) testing therapy clients b) developing prevention programs in the schools c) providing psychiatric treatment for hospitalized patients d) overseeing welfare payments in a social services center Answer: b Page: 562 Level: Medium Type: Conceptual 17-43. Under what set of circumstances can paraprofessionals be especially effective in providing mental health services? a) when they have religious training b) when their backgrounds are similar to their clients c) when they are recruited from well-educated populations d) when they are used primarily for statistical and clerical tasks Answer: b Page: 562 Level: Medium Type: Factual 17-44. Alcoholics Anonymous is an example of a) a self-help group. b) primary prevention. c) professional social support. d) situation-focused prevention.

Answer: a Page: 563 Level: Medium Type: Factual 17-45. When considering treatment in the community, a basic component of needed services is: a) hospitals 428

b) recreational centers c) affordable housing d) schools Answer: c Page: 564 Level: Medium Type: Factual 17-46. What is an example of alternative housing for the mentally ill? a) co-ops b) group homes c) personal care homes d) partial hospital programs Answer: b Page: 564 Level: Medium Type: Factual 17-47. What is an example of custodial housing for the mentally ill? a) co-ops b) group homes c) nursing homes d) halfway houses Answer: c Page: 564 Level: Medium Type: Factual 17-48. The public television station is going to air a program on the case of Sylvia Frumkin. Because you are a volunteer at the station and a psychology major, they ask you for suggestions for possible titles. Which of the following would be the best title for the program? a) "Falling through the mental health system" b) "Violence and mental illness: The dangerous connection" c) "Reason to hope: The effectiveness of new antipsychotic drugs" d) "Reversing the ravages of psychosis with diet and tender loving care" Answer: a Page: 564 Level: Medium Type: Conceptual 17-49. What is one of the clearest consequences of deinstitutionalization? a) There are now more re-admissions to hospitals. b) Patients now remain in hospitals for longer stays. c) There are more first-time admissions now than in the past. d) Rates of mental illness among the homeless have declined.

Answer: a Page: 568 Level: Medium Type: Conceptual 17-50. What is the process of placing a person in a psychiatric hospital without their consent? a) habeas corpus b) civil commitment c) deinstitutionalization d) declaration of insanity Answer: b Page: 568 Level: Medium Type: Factual 429

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17-51. Under what conditions can civil commitment proceedings occur? a) the individual is a risk to self or others b) a crime was the result of mental illness c) the patient voluntarily checks into the hospital d) with the assurance that no basic human rights are violated Answer: a Page: 568 Level: Medium Type: Factual 17-52. What is the most serious problem with forced institutionalization? a) Hospitalization is expensive. b) The process is time-consuming. c) The individual is deprived of basic human rights. d) There is little benefit unless the patient consents to treatment.

Answer: c Page: 568 Level: Medium Type: Factual 17-53. Under which set of circumstances is criminal commitment of an individual to a mental hospital most likely to occur? a) an individual is not adjusting well to prison b) the individual is judged to be dangerous to him/herself or to others c) he or she has committed a criminal act that is legally declared to be a result of insanity d) an individual convicted of a crime voluntarily decides to go to a hospital as opposed to a prison Answer: c Page: 568 Level: Medium Type: Conceptual 17-54. The legal concept of insanity refers to the person's state of mind at what point in time? a) at the time of trial b) before the crime occurred c) at the time the act was carried out d) while imprisoned for the conviction Answer: c Page: 568 Level: Medium Type: Factual 17-55. Ted is a lawyer who was assigned a criminal case by the senior partner in his firm. The senior partner hands Ted the client's file and tells him the client is incompetent. Which of the following is most likely to describe this client? a) The client is not able to understand the charges against him. b) The client was unable to complete a battery of psychological tests. c) When tested, the client was found to have only a sixth grade reading level. d) The client has had a court appointed person to make major decisions 430

for him.

Answer: a Page: 568 Level: Difficult Type: Conceptual

17-56. On the basis of all the evidence, a judge has decided that Steve did indeed carry out a murder with criminal intent, but that he is not capable of understanding the judicial proceedings. The judge declares Steve to be a) incompetent but not insane. b) insane but not incompetent. c) both insane and incompetent. d) neither insane nor incompetent.

Answer: a Page: 568 Level: Difficult Type: Conceptual 17-57. Which principle refers to a person's ability to distinguish right from wrong? a) Durham rule b) parens patriae c) M'Naghten rule d) irresistible impulse Answer: c Page: 569 Level: Medium Type: Factual 17-58. Which principle holds that a person is not criminally responsible if a criminal act was the product of mental disease or mental defect? a) Durham rule b) parens patriae c) M'Naghten rule d) irresistible impulse Answer: a Page: 568 Level: Medium Type: Factual 17-59. A judge is instructing a jury that is hearing a case in which the defendant pled insanity to the charge of murder. The trial is taking place in a state where the Durham rule is used to decide insanity cases. What will the judge say when instructing the jury on the basis for rendering their decision? a) "The defendant is insane if his crime was the product of a mental disease." b) "You cannot convict the defendant if he was incompetent at the time he committed the crime." c) "The defendant is insane if he could not tell right or wrong at the time the crime was committed." d) "The defendant is insane if he experienced an irresistible impulse at the time the crime was committed."

Answer: a Page: 569 Level: Difficult Type: Conceptual

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17-60. What did the Supreme Court decide in Jones v. the United States (1983) concerning people found not guilty by reason of insanity? a) They can still serve a jail term. b) They should be retried at a later date. c) They should be released to their families. d) They can be held indefinitely in a mental hospital.

Answer: d Page: 569 Level: Medium Type: Factual 17-61. Which of the following is the best description of the M'Naghten test for determining insanity? a) right-wrong b) irresistible impulse c) beyond moral control d) product of mental disease Answer: a Page: 569 Level: Medium Type: Factual 17-62. Harry pled "not guilty by reason of insanity." The state where Harry is being tried uses the M'Naghten test. What question will the judge use when instructing the jury on the basis of their decision in this case? a) "Did the defendant know right from wrong?" b) "Did the defendant experience an irresistible impulse?" c) "Does the defendant have the burden of proving insanity?" d) "Did the defendant show behavior that was the product of a mental illness?"

Answer: a Page: 569 Level: Difficult Type: Conceptual 17-63. In what proportion of criminal cases is the defendant declared not guilty by reason of insanity? a) very few b) about ¼ c) about 1/3 d) about half Answer: a Page: 569 Level: Medium Type: Factual 17-64. You are a member of a team of students that is investigating cases in which the defendant pled not guilty by reason of insanity. The team assembles 1,000 cases from all counties in the state. Based on past research, which of the following would you predict would be the approximate number of cases in which the individual was found to be insane?

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a) 5 b) 100 c) 300 d) 500 Answer: a Page: 569 Level: Medium Type: Conceptual 17-65. Assume that each of these individuals committed murder and was arrested for the crime. There is no doubt that the individuals committed the crime. The only question is whether the person will be held criminally responsible. If the position of the American Psychiatric Association is followed in these cases, which individual is most likely to be found not guilty by reason of insanity? a) Larry who was drunk at the time the crime was committed b) Al who was psychotic at the time the crime was committed c) Ed who was depressed at the time the crime was committed d) Mike who has been previously diagnosed as exhibiting antisocial personality disorder Answer: b Page: 570 Level: Difficult Type: Conceptual 17-66. A newspaper investigator is assigned to write a story on the insanity plea.

The editor tells the reporter to contrast what the general public believes about the insanity plea and people who use it with the facts. After collecting the data on the insanity plea, which of the following would make a good title for the story? a) "How criminals are getting away with murder: It is insane" b) "Accused use the insanity plea more than the public believes" c) "Most people who plead insanity are not accused of murder" d) "When the judge says 'not guilty by reason of insanity' it means you are free to go" Answer: c Page: 570 Level: Difficult Type: Conceptual 17-67. Why did John Hinckley attempt to assassinate President Ronald Reagan? a) He wanted to impress an actress. b) He was following the instructions of voices he heard. c) He wanted to engage in a behavior that would ensure that he received the treatment that he needed. d) He wanted to make a point concerning certain policies that restricted the rights of the mentally ill.

Answer: a Page: 570 Level: Easy Type: Factual

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17-68. Last year Ron was arrested for murder. He pled "not guilty by reason of insanity." Jurors in the state where Ron lives may find the defendant "guilty but mentally ill" and this was the verdict returned in Ron's case. What will happen to Ron? a) He will live the rest of his life in a mental hospital. b) He will serve time in prison and then be transferred to a mental hospital. c) He will receive treatment and then serve out his full sentence like other prisoners. d) Half of the time he will be in a mental hospital, and the rest of the time he will be in prison.

Answer: c Page: 570 Level: Difficult Type: Conceptual 17-69. How have the states of Montana, Idaho, and Utah addressed the controversies that surround the insanity plea? a) They abolished the insanity plea. b) They have forbidden the use of expert witnesses in insanity cases. c) They have limited the use of insanity pleas to murder cases without additional charges. d) They have limited the use of insanity pleas to cases in which the defendant has a prior diagnosed, serious mental illness.

Answer: a Page: 570 Level: Difficult Type: Factual 17-70. When a court appointed psychiatrist examined Ted Kaczynski, what conclusion was reached? a) Kaczynski was faking. b) Kaczynski was incompetent and insane. c) Kaczynski was diagnosed as paranoid schizophrenic. d) Kaczynski was diagnosed as suffering from bipolar disorder.

Answer: c Page: 570 Level: Medium Type: Factual 17-71. Ted Kaczynski, the "Unabomber" was arrested for mailing bombs to people he had identified as moving the culture toward a more highly technological era.

What was the outcome of his case? a) He was found "not guilty by reason of insanity" and will be treated in a mental hospital. b) He did not want mental health issues raised at trial, was diagnosed as paranoid schizophrenic, and agreed to plead guilty.

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c) He is still appealing his case on the grounds that his attorney did not follow his wishes in seeking psychiatric testimony. d) He was found "guilty but mentally ill" and will receive treatment for as long it takes to recover, and then be sent to a prison.

Answer: b Page: 571 Level: Difficult Type: Conceptual 17-72. According to what principle does the state act in what it considers to be the best interest of a child or incapacitated adult? a) Durham rule b) parens patriae c) habeas corpus d) insanity defense Answer: b Page: 571 Level: Medium Type: Factual 17-73. All civil commitment laws involve a judgment about whether an individual is suffering from a disabling mental illness and whether he or she is a) indigent. b) psychotic. c) dangerous. d) treatable.

Answer: c Page: 571 Level: Medium Type: Factual 17-74. A prosecutor is petitioning the court to commit an individual the state considers to require hospitalization. The prosecutor's supervisor instructs him to read the case of Addington v. Texas. What will he find when he reads this case that is essential to his presentation to a judge? a) The state cannot commit a person for more than one month. b) Decisions to institutionalize people are based on a psychological battery. c) The state must provide evidence that the individual is psychotic before it can institutionalize him. d) The state must prove the person needs hospitalization by a clear and convincing standard of proof.

Answer: d Page: 572 Level: Difficult Type: Conceptual 17-75. How accurate are clinicians' predictions of whether a given individual will do something dangerous in the future? a) often inaccurate b) usually accurate c) accurate in the short-term, but not the long-term d) accurate in the long-term, but not the short-term Answer: a Page: 573 Level: Medium Type: Factual 435

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17-76. A state commission is examining mental health predictions of dangerousness. The media is following the story and when the report is released they are likely to run stories under which of the following headlines? a) "Accuracy increases with time" b) "Highly accurate but unrecognized" c) "High accuracy based on psychological testing" d) "Inaccurate in the short-run and worse in the long-run" Answer: d Page: 573 Level: Difficult Type: Conceptual 17-77. A professor of psychiatry is lecturing to mental health professionals on the issue of predicting dangerousness. Which of the following points will he want to impress upon these people? a) Patients are more likely to be dangerous to others than themselves. b) When dangerous, patients are likely to be dangerous to themselves. c) Patients are equally likely to be dangerous to themselves and to others. d) The only reliable predictor of future dangerousness is the presence of brain damage.

Answer: b Page: 574 Level: Difficult Type: Conceptual 17-78. In the case of Wyatt v. Stickney (1971), what did the court rule about the state's responsibility for the mentally ill? a) must use involuntary commitment only in criminal cases b) must provide adequate treatment for involuntarily committed people c) must require informed consent for individuals undergoing drug therapy d) must deinstitutionalize all individuals who want to live in the community Answer: b Page: 575 Level: Medium Type: Factual 17-79. What right did the Supreme Court recognize in the case of O'Connor v. Donaldson for involuntarily committed patients who are not dangerous? a) right to treatment b) right to refuse medication c) right to have a voice in selecting a therapy d) right to communicate with people outside the institution Answer: a Page: 575 Level: Medium Type: Factual 17-80. What was the basis for the judgment of damages against two psychiatrists in the case of O'Connor v. Donaldson (1975)? a) They had given him a wrong diagnosis.

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b) They did not provide adequate treatment. c) They refused to provide services paid for by private insurance. d) They did not allow him grounds privileges while in the hospital.

Answer: b Page: 575 Level: Medium Type: Factual 17-81. What right was established for individuals who are involuntarily committed to psychiatric hospitals in the case of Rennie v. Klein (1978)? a) to have their files examined b) to refuse to take medication c) to refuse to participate in token economies d) to participate in the "least restrictive treatment possible" Answer: b Page: 575 Level: Medium Type: Factual 17-82. When is informed consent needed? a) for any therapeutic treatment b) only when drug treatment is involved c) only when patients are involuntarily hospitalized d) only when treatment involves high risk or negative side effects Answer: a Page: 575 Level: Medium Type: Factual 17-83. Under which of the following circumstances could parents commit a child to a state institution? a) They are willing to pay the cost of treatment. b) The child has a genetic disorder requiring treatment. c) A neutral fact-finder approves of the parents' decision. d) An Axis I diagnosis has been made by a licensed mental health professional.

Answer: c Page: 576 Level: Medium Type: Factual 17-84. What are the three essential elements of informed consent? a) etiology, diagnosis, and treatment b) competency, information, voluntariness c) privacy, freedom from harm, competency d) confidentiality, duty to warn, right to treatment Answer: b Page: 576 Level: Medium Type: Factual 17-85. A clinical psychologist is treating a young man who made several threats against his former girlfriend during therapy sessions. According to the Tarasoff decision, what is the psychologist's responsibility in this case? a) The psychologist must document the threat in session notes. b) The psychologist is bound by therapist-client privilege and may not divulge the content of the session. c) The psychologist is required to ask for immediate institutionalization in 437

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order to protect the threatened individual. d) The psychologist has a responsibility to the threatened person and must call the police or take other reasonable action.

Answer: d Page: 576 Level: Difficult Type: Conceptual

Essay Questions 17-86. What are the three major types of prevention programs?

Answer: Primary prevention - concerned with general reduction of new cases of disorders and is administered to everyone in a particular population. Secondary prevention - limited to a subgroup of the population that is at a higher-thanaverage risk for developing a mental disorder. Tertiary prevention - is intended for people who been diagnosed as having an illness or some behavioral disorder. It is aimed at reducing the impairment that has resulted from a given disorder or event.

Page: 562 Level: Difficult Type: Factual 17-87. What cultural and societal factors contribute to spouse abuse?

Answer: There is a societal acceptance of violence. Many people believe that violence between family members should have no legal repercussions. In many families, the wife and children are financially dependent on the husband, and so it is difficult for the wife to leave the relationship.

Page: 557 – 558 Level: Difficult Type: Factual 17-88. What are some of the major characteristics of self-help groups and how do self-help groups help their benefit their members?

Answer: The major characteristics are: avoidance of professional leadership and direction; a homogenous membership that has a common problem, affliction, or deviant status; meeting places outside such traditional therapy settings as hospitals and clinics; open-ended membership in which the group composition is rarely constant. Self-help groups benefit members in these ways: emotional support and understanding; an accepting reference group that reduces social isolation; information and advice; enhancement of member's awareness of alternatives available in dealing with problems.

Page: 563 Level: Difficult Type: Factual 17-89. What are the major tests of insanity?

Answer: M'Naghten rule (knowing right from wrong); irresistible impulse, a person could not control his or her behavior; Durham rule, a person is not criminally responsible if the criminal act was the product of mental disease or mental defect; American Law Institute, a person is not responsible for criminal conduct if at the time of such conduct as a result of mental disease or defect he lacks substantial capacity either to appreciate the criminality (wrongfulness) of his 438

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conduct or to conform his conduct to the requirement of the law.

Page: 569 Level: Difficult Type: Factual

17-90. What is informed consent and what are the three essential elements of informed consent?

Answer: Informed consent requires that patients receive adequate information about the nature of a planned treatment before they agree to submit to it. The three essential elements of informed consent are: competency, information, and voluntariness.

Page: 575 Level: Difficult Type: Factual

True/False 17-91. Society must assume a role in reducing vulnerability and fostering resilience in relation to maladaptive behavior.

Answer: True Page: 551 Level: Easy Type: Factual 17-92. The focus of prevention programs in society should be to reduce the occurrence of maladaptive behavior.

Answer: True Page: 552 Level: Easy Type: Factual 17-93. Juvenile delinquency is a legal term used to law breaking behaviors.

Answer: True Page: 552 Level: Easy Type: Factual 17-94. It appear that during the last five years mental health prevention programs are becoming ineffective.

Answer: False Page: 555 Level: Easy Type: Factual 17-95. Early education programs illustrate situation-focused prevention because the goal of the programs is to reduce problems in up-coming years.

Answer: False Page: 555 Level: Easy Type: Factual 17-96. There is a positive correlation between criminal behavior in parents and delinquent behavior in their children.

Answer: True Page: 556 Level: Easy Type: Factual 17-97. The type of person who is the abuser while the couple is together may actually become a stalker after the breakup.

Answer: True Page: 558 Level: Easy Type: Factual 439

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17-98. Tragically, many women who are abused remain in the relationship because she concludes her situation can become more dangerous if she leaves.

Answer: True Page: 558 Level: Easy Type: Factual 17-99. When families are in conflict, research indicates that girls are more vulnerable than boys and respond in more noticed ways.

Answer: False Page: 559 Level: Easy Type: Factual 17-100. It would appear that the major challenge of prevention is to identify all opportunities for growth and stability and provide opportunities for people in need of the opportunities.

Answer: True Page: 562 Level: Easy Type: Factual

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