Test Bank
for
Nietzel • Speltz
McCauley • Bernstein
Abnormal Psychology
Prepared by
Susan K. Fuhr
Weber State University
Allyn and Bacon
Boston • London • Toronto • Sydney • Tokyo • Singapore
Copyright © 1998 by Allyn & Bacon
A Viacom Company
160 Gould Street
Needham Heights, MA 02194
Internet: www.abacon.com
America Online: keyword: College Online
All rights reserved. The contents, or parts thereof, may be reproduced for use with Abnormal
Psychology by Michael T. Nietzel, Matthew L. Speltz, Elizabeth A. McCauley, and Douglas A.
Bernstein, provided such reproductions bear copyright notice, but may not be reproduced in any
form for any other purpose without written permission from the copyright owner.
ISBN 0-205-26283-X
Printed in the United States of America
10 9 8 7 6 5 4 3 2 1
02 01 00 99 98 97
TABLE OF CONTENTS
Preface
Chapter 1
ABNORMAL BEHAVIOR: PAST AND PRESENT PERSPECTIVES
1
Chapter 2
ASSESSMENT AND DIAGNOSIS
33
Chapter 3
DISORDERS OF INFANCY, CHILDHOOD, and ADOLESCENCE
58
Chapter 4
DEVELOPMENTAL DISORDERS AND LEARNING DISABILITIES
85
Chapter 5
STRESS, SLEEP, AND ADJUSTMENT DISORDERS
110
Chapter 6
PSYCHOLOGICAL FACTORS AND HEALTH
134
Chapter 7
ANXIETY DISORDERS
155
Chapter 8
DISSOCIATIVE AND SOMATOFORM DISORDERS
181
Chapter 9
MOOD DISORDERS AND SUICIDE
205
Chapter 10
SCHIZOPHRENIA
238
Chapter 11
COGNITIVE DISORDERS
263
Chapter 12
PERSONALITY DISORDERS
281
Chapter 13
SUBSTANCE-RELATED DISORDERS
309
Chapter 14
SEXUAL AND GENDER IDENTITY DISORDERS
339
Chapter 15
BIOLOGICAL TREATMENT OF MENTAL DISORDERS
365
Chapter 16
PSYCHOTHERAPY
385
Chapter 17
ALTERNATIVES TO INDIVIDUAL PSYCHOTHERAPY
410
Chapter 18
LEGAL AND ETHICAL ISSUES IN MENTAL DISORDERS
431
Preface
Given the popularity of the undergraduate course in abnormal psychology as well as the
exigencies imposed by large class sizes in most colleges and universities, many
instructors employ multiple choice exams as a primary means of evaluating student
learning. I have tried to produce a diverse array of such questions, along with a few
short answer/essay items at the end of each chapter. I hope you find them useful as you
create exams for your course.
Each item is presented with several descriptive qualifiers, listed just below the item
number. For instance, here is an item from Chapter 7:
7.
Ans. C
App
p. 217
E
*
7. 6
Ans. C
App
p. 217
E
*
6
>
>
>
>
>
Dr. Seshachari is treating a client who is diagnosed with one of the most common
anxiety disorders. Which of the following would this be?
a. generalized anxiety
b. panic disorder
c. social phobia
d. obsessive-compulsive disorder
chapter number. item number
correct answer
type of item: APPLIED (App), CONCEPTUAL (Con), FACTUAL (Fac)
page reference for answer
item difficulty: EASY (E), MODERATE (M), CHALLENGING (C)1
indicates item is found in the student Practice Tests (20 per chapter)
Each chapter has at least 65% Applied items and roughly 15% Conceptual and 15%
Factual. I would very much appreciate your feedback and suggestions as you use these
items. Please contact me by email: sfuhr@weber. edu.
I would like to express my thanks to the several individuals without whose aid and
support this project would not have come to fruition. To Doug Bernstein, thank you for
recommending me and providing all-important social support via the electronic highway.
And hearty thanks to Sue Gleason, my stalwart, always reassuring editor who's been a
pleasure to work with. About 250 items in this bank were written, and my own writing
reviewed, by some of Weber State University's brightest and best students: Danny May,
Bryce Warren, Shayne Palmer, Angie Wehr, and Todd Woodward. And Amanda
Allman, of Illinois, was a saving grace toward the end of the project, writing several
items for the last three chapters. Thanks Amanda. And now that I've written, rewritten,
and edited the last item, I can tell my long-neglected spouse that I'll soon be back to
normal (whatever that is!).
Susan K. Fuhr, Ph. D.
Weber State University
Ogden, Utah 84408-1202
I encourage you to bear in mind that because this is a new testbank for a new text, these difficulty levels
are rationally based and await empirical item analysis. Your own choices for class coverage and
emphases will affect the accuracy of these recommended levels.
Chapter 1
ABNORMAL BEHAVIOR: PAST AND PRESENT PERSPECTIVES
1.
1
Ans. D
Fac
p. 4
E
Which facet of your text's definition of "abnormal behavior" is universally
accepted?
a. individual disturbance of behavior or physical functioning
b. psychological distress or impaired functioning
c. a kind of disturbance that is unexpected in the culture
d. None of the above apply.
1.
2
Ans. C
App
p. 5
E
If you were a citizen of ancient Egypt, what would you be most likely to cite
as the cause of Nelson McGrath's behavior?
a. weakness of character
b. bodily illness
c. evil
d. irrational thoughts & perceptions
1.
3
Ans. D
Fac
p. 5
E
Evidence from cultures around 3500 to 3000 B. C. suggests that a
model would have been used to explain abnormal behavior.
a. medical
b. humanistic
c. rationalistic
d. demonological
1.
4
Ans. C
App
p. 5
M
How might an early Mesopotamian individual be treated if she or he
demonstrated bizarre actions, strange speech, and extremely unusual beliefs?
a. bloodletting with leeches
b. confinement to an asylum
c. trephining
d. a special diet to restore bodily imbalances
1.
5
Ans. B
Fac
p. 5
M
Ancient Chinese and Hebrew civilizations employed several methods in the
treatment of abnormal individuals. Which approach, however, was NOT
common?
a. exercise and special diet
b. special care in asylums
c. faith healing
d. concoctions to poison spirits and demons
1.
6
Ans. A
App
p. 5
E
The movie "An American Werewolf in London" reflects a belief in which of
the following?
a. lycanthropy
b. hysteria
c. tarantism
d. stigmata diaboli
1
1.
7
Ans. D
App
p. 5
E
In your historical review of early approaches to understanding abnormality, to
whom would you credit the birth of the medical tradition?
a. Roman philosophers
b. Islamic scholars
c. Egyptian healers
d. Greek physicians
1.
8
Ans. C
Con
p. 5
M
*
If you assert that humans are primarily rational beings who gain knowledge
through reasoning and recollection to discover universal truths, to whom do
you clearly owe an intellectual debt?
a. Hippocrates
b. Avicenna
c. Plato
d. Descartes
1.
9
Ans. C
Con
p. 5
M
Marc considers himself an empirical scientist of psychology, gathering and
evaluating information from perceptual experiences. Which Greek philosopher
set forth the intellectual foundation for Marc's perspective?
a. Plato
b. Hippocrates
c. Aristotle
d. Galen
1.
10
Ans. B
Fac
p. 5
E
Which humorous Greek is considered the father of medicine?
a. Galen
b. Hippocrates
c. Epictetus
d. Aristotle
1.
11
Ans. A
App
p. 5
E
An ancient Greek was diagnosed as suffering from melancholia. This
individual was probably given a special diet as well as purgatives in order to
treat an imbalance of
a. black bile.
b. phlegm.
c. yellow bile.
d. blood.
Which of the following descriptive terms would best reflect Hippocrates'
approach to abnormality?
a. madness
b. evil
c. illness
d. sinfulness
1.
12
Ans. C
Con
p. 5
E
1.
13
Ans. D
App
p. 6
M
You are Galen's medical assistant. What aspect of human psychology would
you be studying?
a. rational thinking processes
b. social behavior
c. intelligence
d. temperament
2
1.
14
Ans. A
Fac
p. 6
E
What sort of intervention would Epictetus most likely recommend for a
disordered individual?
a. a talking cure
b. laxatives and purgatives
c. prayer and faith healing
d. commitment to a restful asylum
1.
15
Ans. B
Con
p. 6
M
"It's not what your boyfriend said to you that's upset you; it's the way you
interpreted his comments that is bothering you. " Which of the following
philosophers would most heartily agree?
a. Aristotle
b. Epictetus
c. Avicenna
d. St. Vitus
1. 16
Ans. D
App
p. 6
M
Stacy is a graduate student in clinical psychology and is learning the tools and
techniques of psychotherapy. Her belief that these verbally-based methods will
help her future clients is most similar to the
view of the treatment
of disorders.
a. European Middle Ages'
b. ancient Hebrews'
c. ancient Egyptians'
d. classical Greek and Romans'
Aaron lives in a feudal society, marked by frequent wars and economic crises.
He also believes that abnormality is the work of the Devil. What is the most
likely year that Aaron is alive in Western Europe?
a. 120 B. C.
b. 410A. D.
c. 755A. D.
d. 1480 A. D.
1.
17
Ans. C
App
p. 6
C
1.
18
Ans. C
App
p. 6
M
A magical potion made up of eye of newt, heart of a cat, and the ovary of a
goat killed on a Saturday midnight would probably be offered to a psychotic
person during what historical age?
a. Renaissance
b. classical Greco-Roman
c. early European Middle Ages
d. late Islamic Middle Ages
1. 19
Ans. A
Con
p. 6
M
The text The Canon of Medicine provided a bridge between the philosophy of
and the
of the Renaissance.
a. Aristotle; science
*
b. Plato; rationalistic theology
c. Socrates; medical practices
d. Hippocrates; science
3
1.
20
Ans. D
Fac
p. 6
E
Although the rationalistic, naturalistic philosophy of the Greeks was lost during
the Dark Ages of Europe, where were their works preserved?
a. China
b. Spain
c. Indonesia
d. Islam
1.
21
Ans. B
Con
p. 6
C
What commonality exists between the work of Greek physicians, Islamic
physicians, and the monasteries of Europe?
a. They emphasized a supernatural approach to understanding causes of
abnormality.
b. They provided sanctuaries for disordered individuals.
c. They pioneered psychological treatment methods that spurred the
development of Renaissance asylums.
d. They combined magic, common sense, and herbal remedies to treat
disordered individuals.
1.
22
Ans. B
Fac
p. 6
E
When and to whom would you credit the first use of hospitals for the
specialized treatment of mental disorders?
a. 4th century Roman physicians
b. 8th century Islamic physicians
c. 12th century European monks
d. 16th century Renaissance physicians
1.
23
Ans. A
App
p. 7
E
Whether caused by naturalistic or demonic forces, if you joined a group of
people jumping and dancing, tearing off clothing, and frolicking in the streets,
what form of madness would you be displaying?
a. tarantism
b. Dance de Diaboli
c. folie en masse
d. lycanthropy
1.
24
Ans. B
App
p. 7
E
If you consulted the Malleus Maleficarum in the late 1400's, what was your
goal?
a. reconciliation of the teachings of the church and the values of humanism
b. the detection, exposure, and purging of witches
c. potions and incantations for the treatment of disordered individuals in
asylums
d. an understanding of the physical, mechanical workings of the human body
1.
25
Ans. D
Fac
p. 7
E
Which of the following represents a strong backlash to the increasing influence
of the secular world in the early years of the Renaissance?
a. The Canon of Faith
b. Paracelsus' study of abnormal behavior
c. greater value placed on humanism
d. Malleus Maleficarum
4
1.
26
Ans. A
Con
p. 7
C
Which item does not belong with the other three?
a. moral treatment
b. advent of humanism
c. advent of the printing press
d. Copernicus' cosmology
1.
27
Ans. D
App
p. 7
M
*
You live in a time in which books are becoming more readily available,
heretics are saying that the sun is the center of the universe, and humankind is
becoming a topic of study worthy in its own right. With whom are you living?
a. Plato and Hippocrates
b. Avicenna and Galen
c. Tuke and Pinel
d. Copernicus and Paracelsus
Which of the following represents the correct order of predominant themes
from the Greeks to the Middle Ages to the Renaissance?
a. theological > psychological > rational
b. psychological > rational > theological
c. rational > theological > psychological
d. supernatural > theological > psychological
1.
28
Ans. C
Con
p. 5-7
M
1.
29
Ans. A
Con
p. 7
M
"I think, therefore I am. " The author of this phrase asserted that human mental
activity could be thought of in mechanical, physical terms. Who was he?
a. Descartes
b. Epictetus
c. Copernicus
d. Chiarugi
1.
30
Ans. D
App
p. 7
M
You are a modem student in a field of study whose first member risked the
wrath of the church by condemning the practices in the Malleus Maleficarum.
In what field are you studying?
a. clinical psychology
b. family medicine
c. philosophy
d. psychiatry
1.
31
Ans. A
App
p. 7
M
If you were a mentally disordered person in the 16th century, to whom would
you mm for humane help?
a. Weyer
b. Tuke
c. Sprenger
d. Pinel
1.
32
Ans. B
Fac
p. 7
E
The word "bedlam" derives its meaning from
a. the strange "magical" treatments carried out in early monastery asylums.
b. the deplorable conditions found in prison-like Renaissance hospitals for the
insane
c. the name of the city in which the first mental hospital was founded.
d. the early bedrest treatment used for acutely disturbed patients in asylums.
5
1.
33
Ans. A
Con
p. 8
E
Which member of the moral treatment era and his country are mismatched?
a. Chiarugi: Spain
b. Rush: U. S.
c. Pinel: France
d. Tuke: England
1.
34
Ans. C
Con
p. 8
M
*
In your report on the background and outcomes of the moral treatment era,
which statement should you omit?
a. Bicetre Hospital in France was the site of the first unchaining of inmates in
1793.
b. The transformation of asylums into U. S. state hospitals resulted in
understaffing and eventual custodial care conditions.
c. Conditions in asylums of the early 1700's, while less than optimal, were
notably better than the conditions of such institutions in the Middle Ages.
d. The treatment approaches taken by the reformers shared the naturalistic
assumptions endorsed in the Enlightenment era.
1.
35
Ans. A
App
p. 8
E
Candide is one of Pinel's early patients. Which treatment would he be most
UNLIKELY to receive?
a. bloodletting or purgatives
b. a release from his chains
c. an expectation that he would find employment
d. exposure to fresh air, sunshine, and kindness
1.
36
Ans. B
Con
p. 9
M
A synopsis of the U. S. mental hygiene movement should include each of the
following statements EXCEPT
a. the movement was led by a former mental patient who helped form the
National Committee for Mental Hygiene.
b. it began an era of humane treatment in the U. S., lasting until the 1950's
and the discovery of drags.
c. as a result of Dorothea Dix's efforts, several large state hospitals were
constructed.
d. its underlying assumptions regarding abnormality were essentially those
held by Pinel, Tuke, and Rush.
1.
37
Ans. B
Con
p. 9
M
In your critique of the mental hygiene movement in the U. S., you would cite
each of the following factors for its decline EXCEPT
a. the increasing reliance on biological vs social approaches to understanding
abnormality.
b. the discovery of drags effective for treating mental disorders.
c. the shortage of staffing and resultant custodial care.
d. the ineffectiveness of moral treatment for severely disturbed patients.
1.
38
Ans. A
App
p. 9
M
Gregory is working for Dr. Emil Kraepelin in the late 1800's. What is likely
to be the focus of Gregory's efforts?
a. assisting with the development of a classification system for disorders
b. contributing to the discovery of the biological cause of general paresis
c. conducting studies of hypnosis for the cure of hysteria
d. treating patients with bloodletting and tranquilizing chairs
6
1.
39
Ans. B
Con
p. 9
M
Hypnosis has a history stretching back to the Enlightenment. Which of the
following reflects a correctly matched portion of that history?
a. Esdaile & magnetism
b. Breuer & the talking cure
c. Mesmer & hypnotic anesthesia
d. Charcot & treatments for anxiety
1.
40
Ans. D
Con
p. 9
M
Hysteria is to general paresis as
a. naturalistic; supernatural
b. biological; psychological
c. supernatural; medical
d. psychological; biological
1.
41
Ans. B
Fac
p. 9
E
After the successful discovery of the cause of general paresis, some physicians
were seeking the biological treatments for other mental disorders while Freud
was developing the first modern psychological approach, known as
a. hypnotherapy.
b. psychoanalysis.
c. psychical conflict therapy.
d. psychiatry.
1.
42
Ans. C
App
p. 10
E
Dr. Ramirez works in a local community mental health center, conducting
assessment of intelligence, personality, and other characteristics, and she also
provides psychotherapy. What type of professional is she?
a. psychiatrist
b. clinical social worker
c. clinical psychologist
d. psychiatric nurse
1.
43
Ans. D
App
p. 10
M
Dr. Dmg is a physician who has spent several years in a residency in which he
worked with individuals with mental disorders. What is his professional title?
a. clinical physician
b. clinical psychologist
c. psychiatric social worker
d. psychiatrist
1.
44
Ans. C
App
p. 11
E
Casandra was informed by her mental health professional that her anxiety
symptoms were caused by a disrupted pattern of neurochemical messages that
resulted in excessive motor activity, hyperalertness, and a sense of
apprehension. What is this health professional's model of abnormality?
a. psychoanalytic
b. cognitive
c. biological
d. mentalistic
is to
7
.
1.
45
Ans. D
App
p. 11
E
Hypervigilance, emotional numbing, flashbacks, and other characteristics go
together under the label "post traumatic stress disorder". Patterns of
characteristics such as this are also referred to as a(n)
a. symptom constellation.
b. etiology.
c. prognosis
d. syndrome.
1.
46
Ans. B
App
p. 11
E
Viktor is in a graduate program which involves several different disciplines
devoted to studying the structure, function, and chemistry of the nervous
system. What is the term for this area of study?
a. biocognitive psychology
b. neuroscience
c. biochemistry
d. neuroanatomy
1.
47
Ans. D
App
p. 11
E
Your peripheral nervous system (NS) contains each of the following branches
EXCEPT the
a. autonomic NS.
b. somatic NS.
c. sympathetic NS.
d. central NS.
1.
48
Ans. B
App
p. 11
E
Which specific portion of your nervous system is controlling the movements of
your hand as you write your answers to mis exam?
a. autonomic
b. somatic
c. sympathetic
d. peripheral
1.
49
Ans. C
App
p. 12
E
You are studying quietly in the library when your best friend sneaks up and
surprises you from behind. You let out an embarrassing shriek, your heart is
racing, and your adrenaline is pumping. What specific portion of your nervous
system is active at this point?
a. autonomic
b. somatic
c. sympathetic
d. parasympathetic
1.
50
Ans. C
App
p. 12
E
What portion of your brain automatically regulates breathing, heart rate, and
blood pressure so that the rest of your brain can concentrate on other things, like
this exam?
a. thalamus
b. reticular formation
c. medulla
d. midbrain
8
1.
51
Ans. A
App
p. 12
M
*
Narcolepsy is a sleep disorder in which an individual falls asleep without
warning, sometimes during emotionally arousing situations. Which brain
structure might be involved in such a disorder?
a. reticular formation
b. thalamus
c. cerebrum
d. occipital lobe
1.
52
Ans. C
App
p. 12
M
Kitar suffered damage to his cerebellum as a result of an automobile accident.
Which of Kitar's abilities is likely to be impaired?
a. ability to form and retrieve memories
b. responsiveness to rewarding environmental stimuli
c. his playing of the violin
d. maintenance of arousal and attention
1.
53
Ans. B
App
p. 12
E
It is true that you have "eyes in the back of your head". To which part of the
brain does this refer?
a. temporal lobe
b. occipital lobe.
c. parietal lobe,
d. central lobe.
1.
54
Ans. D
App
p. 13
M
The Four F's of motivation (fighting, fleeing, feeding, and mating) are
primarily controlled by the
a. cerebellum,
b. parietal lobe.
c. hindbrain.
d. hypothalamus
1.
55
Ans. B
App
p. 13
M
If information that was intended to be relayed to the visual cortex was
accidentally misrouted to the auditory cortex by this brain stmcture, you might
"see" noise. What structure would this be?
a. medulla
b. thalamus
c. midbrain
d. hypothalamus
1.
56
Ans. B
App
p. 13
E
*
Your best friend insists that she has a "sweet tooth" and often craves sugary
snacks. Which portion of her endocrine system is most directly involved in
the control of such substances?
a. adrenal cortex
b. pancreas
c. thyroid
d! adrenal medulla
1.
57
Ans. A
App
p. 13
E
Atypically short or tall people can probably attribute the distinctiveness of their
height to their
a. pituitary,
b. thyroid.
c. cerebellum.
d. adrenal medulla.
9
1.
58
Ans. B
App
p. 13
M
When you get home from your first day in abnormal psychology class and talk
to your roommate about "this really cool psych class I'm taking", what
distinctive part of your brain makes this conversation possible?
a. cerebellum
b. cerebrum
c. limbic system
d. midbrain
1.
59
For you to read this question, tens of thousands of neurons must fire in several
Ans. B
patterns. To create this, their chemical messages are carried via
App
from
one neuron to another.
p. 14
a. synapses
E
b. neurotransmitters
c. axons
d. dendrites
1.
60
Your study notes from your text reading should include only ONE of the
Ans. A
following statements about neuron structure and function. Which should it be?
Con
a. The binding of a neurotransmitter on a receptor makes the receiving neuron
p. 14
either more or less likely to fire.
M
b. Neurotransmitters are stored in dendrites and are released into the synaptic
cleft when the neuron fires.
c. Neurons are located only in the central nervous system, where bundles of
their axons form information pathways.
d. Little is known about the specific behavioral or cognitive effects of
identified neurotransmitters.
1.
61
Ans. A
App
p. 14
C
Imagine you were a neurotransmitter molecule. What is the correct order of
structures and events you would encounter during the firing of your neuron?
a. axon > synapse > receptor > dendrite's electrical change
b. synapse > receptor > dendrite > axon's electrical change
c. axon > receptor > synapse > dendrite's electrical change
d. dendrite > synapse > axon > receptor's electrical change
1.
62
Ans. C
App
p. 14
M
Some pesticides are extremely toxic to the human nervous system, causing
uncontrollable muscular tremors and convulsions. Which neurotransmitter is
involved in this reaction?
a. norepinephrine
b. GABA
c. acetylcholine
d, dopamine
1.
63
Ans. D
App
p. 14
M
*
Yvette was given an experimental drug that made it difficult for her to
concentrate and disrupted her sleep and arousal patterns. What
neurotransmitter was affected?
a. acetylcholine
b. dopamine
c. GABA
d. norepinephrine
10
164
Ans. D
Fac
p. 15
M
How are proteins, which form and direct the structure of cells, formed?
a. Nucleotides direct the production of DNA which assembles nitrogen bases
and proteins.
b. Heterozygous chromosomes produce amino acids which assemble the
proteins.
c. Amino acids direct the production of nitrogen bases which determine which
proteins are assembled.
d. DNA nucleotides direct the process in which amino acids are assembled
into proteins.
1.
65
Ans. C
App
p. 16
M
Blue eye color is a recessive genetic trait. This means that a blue-eyed
person's relevant alleles are
a. different,
b. polygenic.
c. alike.
d. monogenic.
1.
66
Ans. D
Fac
p. 16
E
Most human psychological characteristics are
a. genetically predetermined.
b. concordant,
c. recessive.
d. polygenic.
1.
67
Ans. D
Con
p. 16
C
A classmate has asked you to review her report on genetic influences on
behavior. Which statement would you recommend that she omit from that
paper?
a. "Genes have an indirect effect on behavior through the production of
proteins that give rise to various cells' development. "
b. "If an allele is dominant, it must also be a homozygous gene from the
mother and the father in order to be expressed. "
c. "Both internal and external events affect the expression of genes, and some
genes may never be expressed. "
d. "Genetic and environmental factors determine physical and behavioral
characteristics, both independently contributing to the phenotype. "
1.
68
Ans. D
App
p. 16
E
Diet sodas have a warning that states, "Attention phenylketonurics: Contains
phenylalanine". Which of the following is NOT true of this disorder?
a. It results in the failure to break down an amino acid found in many foods,
b. It is caused by a single dysfunctional gene.
c. It causes progressive mental deterioration.
d. It is a disorder that occurs in approximately one percent of the population.
1.
69
Ans. A
App
p. 16
E
Suppose that Dr. Palmer discovered that the impulse to bungee jump was related
to a single dominant gene (even though this is an unlikely scenario!). Which
family members would be most similar in this characteristic?
a. monozygotic twins
b. a parent and child
c. dizygotic twins
d. non-fraternal siblings
11
1.
70
Ans. A
Con
p. 17
E
Which of the following correctly reflects the progression from larger to smaller
elements of our genetics?
a. chromosome > DNA > gene > nucleotide
b. DNA > gene > chromosome > nucleotide
c. nucleotide > gene > chromosome > DNA
d. chromosome > nucleotide > DNA > gene
1.
71
Ans. A
Con
p. 17
M
Which of the following does not belong with the other three?
a. kum
b. PKU
c. Huntington's
d. children's temperament
1.
72
Dr. Wehr is investigating the role of genetic factors in schizophrenia. Which
Ans. A
research
approach would provide the most compelling evidence for that role?
Con
a. a study of individuals with the disorder who had been adopted, comparing
p. 18
them to both their biological and adoptive parents.
M
b. a study of monozygotic twins reared together, both of whom have the
*
disorder.
c. a study of the prevalence of schizophrenia in the immediate vs. distant
biological relatives of schizophrenic persons.
d. Any of the above approaches would be equally compelling.
1.
73
Ans. A
App
p. 18
C
Suppose researchers discovered the specific "comedy" gene that influences the
ability to tell jokes successfully. If Javier is an extremely successful stand-up
comedian, what can you conclude about his genetic make-up?
a. You cannot be certain whether his talent is due to genes or to the
environment.
b. If the comedy gene is a dominant allele, you can reasonably conclude his
ability is genetically determined.
c. If the comedy gene is a recessive allele, you cannot determine whether genes
and/or environment determined his ability.
d. Because behavior is affected by both nature and nurture, his ability is
necessarily determined by both factors equally.
1.
74
Ans. D
Fac
p. 18
E
Unconscious determinants of both normal and abnormal behaviors are the central
concern of
a. ego analysts,
b. behavioral theories.
c. cognitive theories,
d. psychoanalysis.
1.
75
Ans. B
App
p. 18
E
Who would see the misstatement "I loathe you" in place of "I love you" as an
indication of unconscious conflict?
a. Watson
b. Freud
c. Ellis
d. Rogers
12
.
76
Ans. D
Con
p. 19
E
Instinct is to
a. ego; id
b. id; ego
c. superego; ego
d. id; superego
1.
77
Ans. B
App
p. 19
E
While sitting through a dry lecture in class, your thoughts are far away on a
fabulous yacht, where you are surrounded by a bevy of attractive servants who
obey your every whim. What fuels your daydream?
a. ego introjection
b. libido
c. repression
d. the fantasy principle
1.
78
Ans. D
Fac
p. 19
M
Parents begin to shape appropriate personal and social behavior in the first three
years of a child's life. What is the fundamental effect of this influence on
her/his personality?
a. the superego's moral principle develops
b. primary defense mechanisms are developed
c. aggressive instincts develop
d. the ego begins to develop
*
as morality is to
.
1.
79
Ans. A
App
p. 19
E
You are debating whether to study for your upcoming psychology exam or go
out and gorge on pizza and beer with your friends. You decide to study for an
hour and then get a pizza delivered for you & your roommate. What portion of
your personality made this decision?
a. ego
b. superego
c. id
d. pleasure principle
1.
80
Ans. D
App
p. 19
M
Captain Janeway's
would love to spend hours frolicking with her new
bridge officer, Lt. Yalta. Her
instills guilt for thinking about anything
other than her official duties. In the end, Janeway's
decides to review
critical systems' maintenance plans with Lt. Yalta, followed by dinner in 10
Forward.
a. ego; superego; id
b. id; ego; superego
c. ego; id; superego
d. id; superego; ego
1.
81
Ans. A
App
p. 19
E
Any decent human being would attempt to find the owner of lost money. You
found a nickel near your desk in class. Which portion of your personality
insists you return it to its rightful owner?
a. superego
b. id
c. ego
d. ego ideal
13
1.
82
Ans. C
App
p. 19
M
Watching her dad take cookies out of the oven, two-year-old Andrea's id says,
"
", while her superego says "
".
a. "Gim'me, lots, now!!": "Could I please have a cookie?"
b. "Do I get some, Daddy? I'll share with you. ": "I'm a good girl & don't
need cookies. "
c. "All m i n e ! " : nothing - It has not formed yet.
d. Nothing - it has not formed y e t : "Sugar's not good for your teeth, Daddy. "
1.
83
Ans. D
App
p. 19
E
The childish mannerisms and simplistic language exhibited by some psychotic
adults represents
according to Freud.
a. repression
b. an inferiority complex
c. an id defense mechanism
d. regression
1.
84
Ans. A
Con
p. 20
M
In regard to Freud's conceptualization of disruptions in psychosexual
development, which statement is incorrect!
a. He abandoned the sexual "fantasy" theory to propose that adult disorders
were connected to experiences of molestation as a child.
b. He proposed that symptoms of mental disorders in adults are indirect
expressions of longterm sexual fantasies and conflicts.
c. The particular stage at which conflicts with parents and the larger social
world occur shapes the kinds of symptoms an adult displays.
d. Males and females have similar challenges in the first two stages of
development but then diverge in the third stage, seen as the core of all
neuroses.
1.
85
Ans. C
App
p. 20
E
Your best friend borrows your pens & pencils, and when you get them back the
tops look like they've substituted for chewing gum! According to the
psychoanalytic theory, how would you 'diagnose' your friend?
a. anal-retentive
b. unsuccessful in resolving the Oedipal conflict
c. orally fixated
d. unsuccessful in introjecting parental discipline
1.
86
Ans. B
App
p. 20
M
Danton drinks excessively when he is under pressure from his boss. Which of
the following descriptors does NOT apply to him?
a. oral fixation
b. absence of defense mechanisms
c. regression
d. unresolved Oedipal complex
1.
87
Ans. D
App
p. 20
E
On the television show Saturday Night Live, a chef character is known for his
obsessive cleanliness, orderliness, and perfectionism in the kitchen. In what
stage did this character become fixated?
a. phallic
b. oral
c. genital
d. anal
14
1.
88
Ans. B
App
p. 20
M
Marco is four years old and enjoys mimicking his Dad around the house when
he's working. Marco also wants to be "just like my Dad" when he grows up.
He is in which psychosexual stage?
a. anal
b. phallic
c. oral
d. latency
1.
89
Ans. A
Con
p. 20
C
Given that psychosexual stages affect adult behavior, which stage and "fixated"
adult occupation or activity are incorrectly matched?
a. genital: construction worker
b. oral: gossip columnist
c. anal: plumber
d. phallic: surrogate mother
1.
90
Two young children are changing into their swimsuits and the young male says
Ans. B to the young female, "No, you can't touch it; you already broke yours off. " This
App
Freudian-inspired joke implicitly refers to the young male's fear, known as
p. 20
a. the Electa complex.
E
b. castration anxiety.
*
c. penis fixation.
d. introjection.
1.
91
Ans. C
App
p. 20
M
According to Freud, young females feel inferior to and envious of males. How,
then, will young Tamara most fully resolve her Electa complex?
a. by identifying with her father
b. by identifying with her mother
c. by having a child
d. by marrying a virile, dominant male
1.
92
Ans. D
Fac
p. 20
E
What is the correct order of psychosexual development?
a. oral > anal > phallic > genital > latency
b. anal > oral > genital > latency > sexual
c. anal > phallic > latency > puberty > genital
d. oral > anal > phallic > latency > genital
1.
93
Ans. A
Con
p. 20
M
Contemporary psychoanalytic theorists have substantially disagreed with Freud
on each of the following issues EXCEPT
a. the importance of childhood experiences in shaping adult behaviors,
b. instincts as the primary motivation for behavior.
c. the centrality of unconscious processes.
d. an emphasis on internal vs social influences on behavior
1.
94
Ans. B
Con
p. 21
E
Which of the following concepts does not belong with the other three?
a. superiority strivings
b. psychosocial crisis
c. style of life
b. adaptive social interest
15
1.
95
Ans. C
App
p. 21
M
*
Than was bullied by several schoolmates when he was in elementary school. As
an adult, he has devoted a great deal of time to 'cutthroat' business tactics,
planning and instigating the downfall of his competitors. Which theory would
most clearly explain the origins of this lifestyle?
a. Jung's
b. Erikson's
c. Adler's
d. Mahler's
1.
96
Ans. D
App
p. 21
M
If you were to try to understand a client's difficulties by comparing her
experiences to the theory proposed by Erikson, which question might you ask?
a. "What sense of inferiority does she harbor from her childhood?"
b. "At what stage of psychosexual development did a possible fixation occur?"
c. "Does she have a healthy balance of connection and autonomy in her
relationships?"
d. "Did she develop a sense of trust in her earliest stage of social crisis?"
1.
97
Ans. A
Fac
p. 21
E
According to
theorists, adult psychopathology can be traced to
early disruptions in attachment to caregivers or a failure to achieve secure
independence.
a. object relations
b. social modeling
c. learning
d. cognitive
1.
98
Ans. B
App
p. 21
E
Dr. Eve, a psychoanalyst, would employ several techniques in her work, but
is not one of them.
a. interpreting dreams
b. challenging irrational beliefs
c. encouraging free association
d. exploring transference
1.
99
Ans. C
App
p. 21
M
Last week you had to cancel an appointment with your client. Today, the client
accuses you of not caring about her and abandoning her. You are aware that
these same feelings were often experienced in her interactions with her parents,
What is the term for your client's reaction?
a. introjection
b. projective identification
c. transference
d. fixated association
1. 100
Ans. D
Fac
p. 21
E
The therapeutic goal of "re-parenting" in order to help a client form healthy,
secure adult relationships is the primary focus of
therapy.
a. cognitive
b. ego analytic
c. behavioral
d. object relations
16
1.
101
The law of effect is most similar to which Freudian concept?
Ans. A
a. pleasure principle
Con
b. libido
p. 22, 19 c. reality principle
C
d. fixation
*
1.
102
Ans. B
App
p. 22
E
If you learn an abnormal behavior (e. g., helplessness) by associating your
actions with their environmental consequences (e. g., others take care of your
needs for you), what process accounts for this learning?
a. respondent
b. operant
c. classical
d. modeling
1.
103
Ans. C
Con
p. 22
M
The ABC's (antecedent, behavior, consequence) of learning are most clearly
outlined in the work of
a. Pavlov,
b. Watson.
c. Skinner.
d. Thorndike.
1.
104
Ans. D
Fac
p. 22
M
Positive reinforcement makes a behavior
likely to reoccur, and negative
reinforcement makes a behavior
likely to reoccur.
a. less; less
b. less; more
c. more; less
d. more; more
1.
105
Ans. A
App
p. 22
M
When you take out the kitchen trash in order to stop your spouse's angry glare,
what operant process is occurring for your behavior?
a. negative reinforcement
b. punishment
c. positive reinforcement
d. extinction
1.
106
Ans. D
App
p. 22
M
*
Martine was laid off from his job, was having a great deal of conflict in his
marriage, and his family was frequently trying to give him advice. When he
drank alcohol, he found he didn't think about these problems and his wife and
family left him alone, not wanting to be around him when he was intoxicated.
What learning process accounts for Martine's developing alcohol abuse?
a. classical conditioning
b. punishment
c. social modeling
d. negative reinforcement
17
1. 107
Ans. B
App
p. 22
E
Miranda's parents put gold stars on a chart on the refrigerator every time she
puts her toys neatly away. When she gets 10 stars, she gets to go to a movie.
What operant process is taking place?
a. law of consequence
b. positive reinforcement
c. negative punishment
d. negative reinforcement
1.
108
Ans. C
App
p. 22
C
A snack machine in the psychology building occasionally kept a professor's
money without dispensing any snack. After a while, she just went hungry.
What consequence occurred for her snack-buying behavior?
a. negative reinforcement
b. extinction
c. punishment
d. law of negative effect
1.
109
Ans. A
App
p. 22
M
A depressed client's negative statements (e. g., "I'm a hopeless case", "Nothing
will ever get better") are subjected to extinction by her therapist and family.
This means
a. her negative statements will be ignored and will tend to become less
frequent.
b. her irrational, negative statements will be challenged by her therapist and
family.
c. her therapist and family will positively reinforce optimistic statements and
punish the negative ones.
d. her classically conditioned responses will be modified by observing the
behaviors of her therapist and family.
1.
110
Ans. B
Fac
p. 22
E
In Pavlov's original studies of classical conditioning, what was the unconditioned
stimulus?
a. salivation
b. food
c. tone
d. alerting responses
1.
111
Ans. C
Con
p. 22
C
In classical conditioning, what is the crucial association upon which learning is
based?
a. the association of the unconditioned stimulus and unconditioned response
b. the association between the neutral stimulus and the conditioned stimulus
c. the association between the unconditioned stimulus and the conditioned
stimulus
d. the association between the conditioned stimulus and the conditioned
response
18
1.
112
Ans. B
App
p. 22
M
Close your eyes and imagine that you are sitting in a dentist's chair, and the
cavity she's drilling is in an area that isn't completely numb. If you find
yourself with an unpleasant reaction to this imagined scene, how would you
label that discomfort?
a. conditioned stimulus
b. conditioned response
c. unconditioned stimulus
d. unconditioned response
1.
113
Ans. A
Con
p. 22
M
Which of the following is an unconditioned stimulus?
a. a strong puff of air to the eye
b. shivering in cold weather
c. salivation to the thought of biting into a sour lemon
d. a telephone ring
*
1.
114
Ans. D
App
p. 22
E
Suppose a five-year-old child has a phobia of horses. Freud might interpret
this as an unconscious fear of the child's father, a common reaction during this
Oedipal stage. However, the work of Watson and Rayner indicated that
children's fears can be caused not by unconscious conflict but by
a. operant conditioning.
b. social modeling.
c. irrational cognitions.
d. classical conditioning
1.
115
Ans. C
Fac
p. 23
E
Mary Cover Jones provided an early example of the effective use of
a. cognitive therapy.
b. object relations therapy,
c. behavior therapy.
d. family therapy.
1.
116
Ans. B
Con
p. 24
M
In S-O-R terminology, the Stimulus, 0=organism, and R=response. Which
element distinguishes cognitive theories from learning theories?
a. S
b. O
c. R
d. All three elements apply to both kinds of theories.
1.
117
Ans. A
Con
p. 19-24
E
Historically speaking, what is the chronological order of the following
psychological theories?
a. psychoanalytic > behavioral > cognitive
b. behavioral > psychoanalytic > cognitive
c. psychoanalytic > cognitive > behavioral
d. cognitive > psychoanalytic > behavioral
1.
118
Ans. B
Fac
p. 24
E
An emphasis on the active information processing of internal and environmental
information is the primary concern of the
theories.
a. sociocultural
b. cognitive
c. behavioral
d. biological
19
1.
119
Ans. C
Con
p. 24
M
Observational learning could also be thought of as
a. direct conditioning.
b. expectancy conditioning,
c. vicarious conditioning.
d. trial-and-error learning.
1.
120
Ans. D
App
p. 24
E
Shandra has watched her sister express a great deal of fear whenever large,
noisy dogs come close to their yard. What process accounts for Shandra's
developing fear of such dogs?
a. operant conditioning
b. classical conditioning
c. cognitive-behavioral learning
d. observational learning
1.
121
Ans. A
App
p. 24
M
According to Bandura, if Cesar does not approach an attractive person and ask
for a date because he believes he will make a poor first impression, which of
Cesar's expectancies is impaired?
a. self-efficacy
b. internal attribution
c. self-appraisal
d. catastrophic
1.
122
Ans. B
App
p. 25
M
"You look very nice today!" A person who hears this and thinks to her/himself,
"Yeah, I do look pretty awful most other days" and then feels very despondent
is exhibiting a dysfunctional
a. attribution.
b. appraisal.
c. conditioned response.
d. global expectancy.
1.
123
Ans. C
App
p. 25
M
Which pattern of attribution is evident in the statement, "I can't leam chemistry
because the instructor covers too much material too fast"?
a. internal, stable, global
b. internal, temporary, specific
c. external, temporary, global
d. external, stable, global
1.
124
Ans. B
Con
p. 25
M
If the S-O-R model is defined as S=stimulus(environment),
0=organism(cognition), and R=response(behavior), which element is most
important to Albert Ellis?
a. S
b. O
c. R
d. All are equally relevant in his theory.
20
1.
125
Ans. D
App
p. 25
M
Your therapist is helping you explore the possibility that your belief that "my
family should always get along and be fully supportive of everyone" could be an
expectancy that is counterproductive. Which theorist's model is guiding your
therapist?
a. Julian Rotter
b. Aaron Beck
c. Carl Rogers
d. Albert Ellis
1.
126
Ans. A
Con
p. 25-6
M
What clear similarity is found between cognitive and phenomenological
theories?
a. an emphasis on the self
b. attention to environmental consequences for behavior
c. a belief in self-actualization
d. attention to styles of interpersonal interaction
1.
127
Ans. C
App
p. 26
E
You are a psychologist who conceptualizes depression as the result of frustrated
attempts to achieve one's potential for growth and congruence. What theory
guides your thinking?
a. cognitive
b. interpersonal
c. humanistic
d. sociocultural
1.
128
Ans. D
App
p. 26
M
1.
129
Ans. B
Fac
p. 26
M
A junior high female won an award for an improvisational dance in her 4-H
club at school. However, at the regional competition, her father encouraged her
to sing instead of dance. While the daughter was more talented and more
interested in dance, she acquiesced in order to gain his approval. In other
words, the father's suggestion was a
a. reflected appraisal.
b. negative reinforcer.
c. conditioned response.
d. condition of worth.
Which of the following concepts is INCORRECTLY paired?
a. superego: conditions of worth
b. id: self-actualization
c. defense mechanism: incongmence
d. ego: congruence
1.
130
Ans. B
Con
p. 26
E
Conditions of worth is to unmet needs as is to
a. Beck; Rogers
b. Rogers; Maslow
c. Sullivan; Ellis
d. Maslow; Perls
21
,
1.
131
Ans. C
App
p. 26
M
*
You are a therapist who believes that it is your role to provide unconditional
acceptance, to permit your clients the freedom to explore their full range of
possibilities. In other words, you intend to help your clients achieve
a. positive self-appraisal.
b. conditions of self-worth.
c. self-actualization,
d. phenomenology.
1. 132
Ans. D
Fac
p. 26
E
Harry Stack Sullivan would provide a theoretical framework most useful in
working with people who exhibit
a. clinical depression,
b. paranoid schizophrenia.
c. generalized anxiety disorder.
d. dependent personality disorder.
1.
133
Ans. A
App
p. 27
M
Adrian wants to take care of someone and be her sole source of emotional
support, and his girlfriend wants someone who will look out for her and save
her from her abusive family. While both have become miserable in this
relationship and are mostly unaware of the needs of the other person, they are
unwilling to end the relationship. What term applies to this situation?
a. reciprocity
b. congruence
c. interpersonal equity
d. counter-transference
In regard to the origins of disturbed behavior, which theory does NOT belong
with the other three?
a. psychoanalytic
b. sociocultural
c. behavioral
d. interpersonal
1. 134
Ans. B
Fac
p. 27
E
1.
135
Ans. C
App
p. 27
M
Duretha is a sociocultural psychologist. In explaining the origin of anxiety
disorders, she might emphasize
a. distorted perception and memory processes,
b. operant contingencies.
c. rapid technological change,
d. interpersonal styles.
1. 136
Ans. D
App
p. 27
E
Epidemiological researchers have discovered that acting-out behaviors and poor
impulse control are more common in cultures that tolerate and reward
aggression. This finding most clearly supports the
explanation of
disordered behavior.
a. behavioral drift
b. social selection
c. social relativism
d. social causation
22
1.
137
Ans. A
App
p. 28
M
If a social policy analyst believes that the mentally ill are overrepresented in the
homeless population because of their inability to maintain adequate employment
due to their symptoms, what explanation is this person endorsing?
a. social drift
b. social relativism
c. social inequity
d. social causation
1.
138
Ans. B
Con
p. 28
M
*
The criterion by which "abnormality" is defined as "not culturally expected"
would be most sharply criticized by sociocultural psychologists who emphasize
social
a. causation.
b. relativism.
c. selectivity.
d. differentiation.
1.
139
Ans. C
Con
p. 28
E
Which of the following disorders is least likely to be used by sociocultural
psychologists in order to support their perspective on the causes of mental
disorders?
a. windigo
b. anorexia nervosa
c. schizophrenia
d. alcohol abuse
1.
140
Ans. D
Fac
p. 28
E
There is a stigma associated with many of the diagnostic labels used by
psychiatrists and psychologists. Which outspoken advocate of the sociocultural
perspective asserts mat these labels turn "problems in living" into illnesses
needing professional treatment?
a. Rosenhan
b. Helzer
c. Sullivan
d. Szasz
A person who lives in a country marked by political upheaval, a shortage of
jobs, and inadequate health care may become depressed or anxious. According
to Szasz, what is the most appropriate description for this person's difficulties?
a. problems in living
b. mental disorder but not mental illness
c. incongruence
d. environmental pathology
1.
141
Ans. A
App
p. 28
M
1. 142
Ans. B
Con
p. 28-9
C
You could criticize the social labeling perspective for each of the following
reasons EXCEPT
a. a lack of explanation for the origin of problematic behaviors.
b. its irrelevance for an understanding of the impact of psychiatric diagnosis.
c. its essential rejection of the biological model.
d. ongoing and sometimes worsening difficulties experienced by people who
have never been labeled.
23
1.
143
Ans. C
App
p. 29
E
A group of psychologists is discussing ways in which juvenile delinquency can
be prevented before it starts. What kind of psychologists are these?
a. epidemiological
b. social
c. community
d. interventionist
1.
144
Ans. D
App this lack
p. 29
M
A clinical researcher has developed a hypothesis that anxiety disorders occur in
individuals who are bom with a tendency to synthesize too little GABA and that
of GABA is most problematic when the person loses a sense of
control over their environment (e. g., victim of a violent attack). What model is
represented in this hypothesis?
a. vulnerability-event model
b. additive-factor model
c. exposure-response model
d. diathesis-stress model
Due to both biological and family influences, Rene has a tendency to respond to
unpleasant events with passivity and pessimism. What would you predict about
Rene's vulnerability to depression?
a. If relevant stressors occur in Rene's life, the combination of that tendency
and the stressors could cause depression.
b. Given this diathesis, it is likely that Rene will experience depression
regardless of life circumstances.
c. Either Rene's response to events or the events themselves will be sufficient to
cause depression.
d. Rene probably inherited depression from his parents.
1.
145
Ans. A
App
p. 30
M
1.
146
Ans. C
App
p. 31
M
Jerrod insists that his explanation for the psychological cause of depression is
based on the scientific method. If so, which of the following criteria is NOT
relevant to evaluating his explanation?
a. his collection of empirical data
b. the organization of his findings into a theory
c. the correlational evidence demonstrating the relationship between cause and
effect
d. the testing of specific hypotheses with operational definitions
1.
147
Ans. C
App
p. 31
E
Bryce, a clinical researcher, is developing her ideas about how parenting styles
influence children's development of oppositional defiant disorder. What is the
appropriate term for the set of ideas, predictions, and explanations that will
result from this work?
a. a hypothesis
b. operational definitions
c. a theory
d. an experimental design
24
1.
148
Ans. A
Con
p. 31-4
M
*
Which of the following statements does NOT characterize the scientific
method?
a. A single well-designed and appropriately conducted study provides
conclusive evidence for a given theory.
b. The collection of empirical data is common to both the correlational and
experimental methods.
c. The abstract concepts of a theory must be operationally defined before
being evaluated in a specific research study.
d. The progress in scientific understanding of abnormality is slow, evolving
from the interplay of theory and hypothesis-testing.
1.
149
Ans. C
App
p. 31
C
Which description below reflects an operational definition?
a. "Aggression was measured as a frequency of violent, harmful acts. "
b. "Participants in the study were observed for signs of anxiety and fear. "
c. "Depression was assessed by scores on the Minnesota Multiphasic
Personality Inventory. "
d. "Effectiveness of group therapy was evaluated for patients with severe
psychopathology. "
1.
150
Ans. B
App
p. 32
M
Passing federal laws mandating what states must include in their public school
curriculum in response to the AIDS crisis represents
prevention.
a. tertiary
b. primary
c. cautionary
d. secondary
*
1.
151
Ans. C
App
p. 32
M
The Head Start program for disadvantaged preschoolers is what form of
prevention?
a. anticipatory
b. tertiary
c. secondary
d. primary
1.
152
Ans. D
Con
p. 32
M
Which of the following pairs is INCORRECTLY matched in regard to
prevention?
a. tertiary: treatment impact
b. primary: universal impact
c. secondary: selective impact
d. tertiary: developmental impact
1.
153
Ans. B
App
p. 32
M
Dr. Moulding is a developmental psychopathologist. In his work, he attempts to
identify which children are at risk for developing conduct disorders and to
develop intervention methods in the family and at school to lessen their risk,
What kind of prevention does this represent?
a. intermediary
b. secondary
c. primary
d. tertiary
25
1.
154
Ans. A
App
p. 33
E
If Emilio wanted to measure the relationship between marital income and
marital dysfunction, what approach would he use?
a. correlational
b. hypothetical
c. experimental
d. quasi-experimental
1.
155
Ans. C
App
p. 33
M
If household income and anxiety were negatively correlated, how would you
characterize this relationship?
a. As household income increases, anxiety increases.
b. An increase in household income causes reductions in anxiety.
c. As household income increases, anxiety decreases.
d. Reductions in household income cause increases in anxiety.
1.
156
Ans. C
App
p. 33
M
As the neurotransmitter GABA increases, symptoms of anxiety (e. g., rapid
breathing, sweating, difficulties in concentration) decrease. What kind of
relationship is this?
a. positive correlation
b. independent-dependent correlation
c. negative correlation
d. quasi-correlation
1.
157
Ans. A
App
p. 33
M
There is a strong positive relationship between attention deficit hyperactivity
disorder (ADHD) symptoms and learning disabilities. What can you conclude
about these two variables?
a. Knowing that a child has ADHD allows you to predict something about her
difficulties in learning.
b. ADHD causes learning disabilities.
c. Learning disabilities lead to ADHD.
d. As ADHD symptoms increase, learning disabilities tend to decrease.
1.
158
Ans. B
Con
p. 33
E
Cause is to
as effect is to
a. measurement; manipulation
b. independent variable; dependent variable
c. dependent variable; manipulation
d. experiment; correlation
1.
159
Ans. C
App
p. 33
M
In an experiment measuring the effects of positive reinforcement on the
frequency of prosocial behaviors in conduct disordered adolescents, the IV is
and the DV is
.
a. the group of adolescents; positive reinforcement
b. positive reinforcement; the control group
c. positive reinforcement; prosocial behaviors
d. prosocial behaviors; conduct disordered behavior
1.
160
Ans. A
App
p. 34
E
Shandra is conducting an experiment on the effects of caffeine on anxiety
symptoms. By what process should she assign her participants to groups?
a. random assignment
b. control procedure
c. random sampling
d. non-manipulated assignment
*
26
.
1.
161
Ans. A
App
p. 34-5
M
*
1.
162
Ans. D
App
p. 33-6
M
1.
163
Ans. D
Fac
p. 34
E
Dr. Woodward is conducting an experiment to evaluate the effect of clozapine,
a new drug, as a treatment for schizophrenic symptoms. Which of the
following aspects will NOT be useful for this study?
a. measurement of the effect of the dependent variable
b. a placebo control group
c. double-blind condition
d. random assignment to groups
You are a researcher investigating coping styles and depressive disorders. You
would use a(n) _
approach to evaluate which styles are most closely
related to depression, and you would use a(n)
approach to evaluate
whether certain styles cause more severe depression.
a. quasi-experimental; experimental
b. correlational; correlational
c. experimental; operational
d. correlational; quasi-experimental
Controversies surrounding genetic explanations of behavior are related to each of
the following factors EXCEPT
a. a history of disturbing abuses of research used to eliminate "inferior"
individuals.
b. implications for discriminatory or racist practices.
c. the anticipated neglect of environmental and social factors.
d. the assertion on the part of behavioral geneticists that biological interventions
are sufficient.
1.
164
Ans. C
Con
p. 34-5
C
On average. African Americans' IQ is lower than that of European Americans,
who in turn have a lower IQ than do Asian Americans. For what central reason
should you NOT attribute these group differences to genetic influences?
a. The polygenic factors associated with intelligence have not yet been
identified and thus not yet compared across groups.
b. Adoption studies have shown that environmental factors are more important
than genetic factors in determining group differences.
c. Behavior genetics research estimates within-group nature/nurture influences
and cannot explain differences between groups.
d. Such an explanation would rule out social and environmental factors and
thus fuel fires of racism and discrimination.
1.
165
Ans. C
App
p. 35
M
In a study of the effect of alcohol on coordination and problem-solving, some
randomly-assigned participants receive a "mocktail", a beverage without
alcohol, and others receive a beverage with the alcohol taste disguised.
However, the "mocktail" group showed more errors on the dependent variable
compared to a group that received no beverage. What problem is present?
a. biased assignment to groups
b. a lack of a manipulated IV
c. placebo effect
d. lack of a control group
27
1.
166
Ans. B
App
p. 35-6
M
You might choose a quasi-experimental approach under each of the following
conditions EXCEPT
a. when participants cannot be assigned randomly to groups
b. when you have an insufficient number of participants for a study
c. when manipulation of the IV presents a serious ethical violation
d. when the IV cannot physically be manipulated
1. 167
Ans. B
Con
p. 36
C
It is not actually possible to conduct direct experimental studies of the causes
of psychological disorders in clinical research subjects. This is true for each of
the following reasons EXCEPT the
a. inability to employ random assignment.
b. inability to operationally define the relevant variables.
c. inability to ethically manipulate the hypothesized causes.
d. inability to rule out all possible confounds in a single study.
1.
168
Ans. A
Fac
p. 36
M
Because quasi-experimental designs cannot rule out
as powerfully as
true experiments can, the use of
increase(s) the confidence one can
have about the hypothesized effects of such studies.
a. confounds; replication
b. placebo effects; representative samples
c. confabulations; manipulated variables
d. confabulations; reiteration
Dr. Rohi is planning to conduct a study on eating disorders in the U. S. He
hypothesizes that European American females will be more likely to exhibit
this disorder than will African American females, given the preponderance of
excessively thin, Caucasian models in the popular media. What kind of sample
will he need?
a. normative
b. representative
c. diversified
d. responsive
1.
169
Ans. B
App
p. 36
E
SHORT ANSWER / ESSAY
1.
170
Explanations for the behavior of persons like Nelson, described in the chapter,
will depend importantly on several factors that stem from one's culture. Describe these and give
an example of how a contemporary student of psychology might employ them to understand
abnormality.
The importance one's society places on science and on religion affects views toward
abnormality. Cultures that value science tend to produce more compelling explanations for
disorders and more effective interventions. The discipline of psychology itself works within the
assumptions of science developed over the last 400 years. Somewhat more related to religious
beliefs are one's perceptions of personal responsibility for problems which determine whether
"blame" is merited and what sort of treatment should be made available. The growing
understanding of genetic factors will require thoughtful consideration of this factor. Most
28
generally, the time and place in which one lives out one's life will importantly influence which
model of abnormality (e. g., demonological, Freudian, behavioral) is most accepted, emphasizing
that final answers to questions of abnormality will not be found.
1.
171
Describe the historical contributions of four persons, prior to 1900, who were
significant figures in shaping attitudes toward and/or treatment of mental disorders.
Plato & Epictetus: stressed rationality & perception vs. supernatural causes of
abnormality.
Aristotle: emphasis on empirical method, collecting of environmentally-available
information to understand abnormality
Hippocrates: developed biological vs. supernatural approach to abnormality; provided
basis for Galen's synthesis of biology and psychological temperament
Avicenna: helped preserve the Greek scholarship during Europe's Dark Ages; helped
bridge Greek philosophy with Renaissance science, making eventual science of psychology
possible
Weyer: strong advocate of compassionate treatment for bodily illnesses, including
abnormal behavior; strongly criticized the persecution of witches
Descartes: Renaissance philosopher providing basis from which to study behavior and
mental processes and mechanical, predictable processes
Pinel: unchained inmates at La Bicetre in France, ushering in the moral treatment era
Rush, Chiarugi, Tuke, Dix: in their respective countries, implemented moral treatment
Kraepelin: establishing first formal diagnostic system for classifying mental disorders
1.
172
Despite its early promise in France, moral (or humane) treatment was, in
essence, fatally flawed. Who instigated this approach and when? Which person was
instrumental in its introduction to the U. S. ? For what reasons did this era end?
Philippe Pinel instigated moral treatment in France by unchaining his first "inmate" in
1793. The deplorable conditions in asylum at that time were significantly improved by Pinel's
encouragement of compassion, attention to work and productivity, and greater personal freedom.
Dorothea Dix was instrumental in convincing states to construct mental hospitals for the
specialized care of disordered individuals. Over time, however, it became clear that such
treatment was not sufficient to address the needs of severe mental illnesses. Too, the state
hospitals became overcrowded and understaffed, leading to a renewed tendency to offer only
custodial care for the mentally ill. Perhaps most importantly, the discovery of the biological
cause of general paresis sparked a strong movement toward the identification of the
biological/genetic causes of other disorders, drawing attention away from psychosocial
characteristics.
29
1.
173
List four areas of your brain that are involved in the reading of this question and
the writing of your response. For each, briefly indicate what each area contributes.
Cerebrum: thinking, planning; language comprehension & production; motor control
Occipital lobe: visual perception
Thalamus: relay of information from eyes to occipital lobe
Reticular formation: maintaining alertness in order to complete activity
Cerebellum: fine motor coordination of writing
1.
174
Imagine that you are a molecule of acetylcholine. Describe what happens to
you during neural communication, and indicate what kind of chemical message you would be
communicating if subsequent neurons sent the message to the somatic nervous system.
I begin in the end of an axon, where I am pushed into the synapse, which is the tiny
gap between two neurons. I cross the synapse toward a dendrite of the next neuron. If I bind
to a receptor on that neuron's dendrite, I will make it more likely to produce its own action
potential. If this chemical message makes it to the somatic NS through a network of tens of
thousands of neurons, a voluntary muscle movement will occur.
1.
175
Explain why it is misleading to ask whether "nature" or "nurture" is the cause of
a particular disorder.
It is a commonly-held misconception that genes and environment are separate influences
on human behavior and mental processes. Genes do not, in fact, control human characteristics
directly but indirectly through the 'programming' of amino acids are assembled into proteins that
form the basis of cell development. The action of genes is influenced by both internal and
external (environmental) triggers, with the result that one's phenotype is never identical with
one's genotype. Genetic inheritance and life experience combine interactively to ultimately
determine individual characteristics. Human psychological characteristics are also polygenic,
meaning that no one. gene controls their expression. In regard to any given disorder individual,
moreover, even if their disorder has been shown to be influenced by genetics, we cannot specify
the extent to which that factor was instrumental in this person's disorder.
1.
176
Suppose that thrill-seeking behavior (e. g., bungee jumping of the World Trade
Tower) is genetically influenced. What kind of supportive evidence would you expect from
adoption studies? from twin studies?
In an adoption study, one would expect that the thrill-seeking behavior of adopted
children would be more similar to that of their biological parents than of their adoptive parents.
In twin studies, monozygotic twins would show greater concordance for this characteristic than
would dizygotic twins or other siblings.
30
1.
177
How does each component of the personality develop, according to Freud, and
how might you describe each one's 'character'? What is the nature of the relationship among
those components?
The id is present at birth and is the source of the instinct, libido, which fuels behavior in
accord with the pleasure principle — if it feels good, do it (no matter what the consequence). In
the first few years of life, as a child encounters limitations and consequences by interacting with
the external world, the ego develops as an organized portion of the id which operates on the
reality principle — if it feels good, do it, but don't get in trouble. In about the fifth year of life,
in the phallic stage of psychosexual development, the superego develops. It is the psychological
residue of parental and cultural norms, inhibitions, and mores, and is often excessively rigid in
its demands for "proper" behavior. It is the task of the ego to balance the competing demands
of the id and superego with the requirements of the external world. When unable to cope
effectively, the ego makes use of defense mechanisms that prevent distressing unconscious
impulses from reaching consciousness. Failure to use defense mechanisms or their excessive
use results in disorder.
1.
178
Describe two behaviors that you have learned through the process of operant
conditioning. In one example, explain the process by which you learned a specific behavior
through the process of negative reinforcement, and in the other, describe an example of
punishment.
[no modal response predictable]
1.
179
Heard on a television commercial: "Did I review the clinical research? No. I
had a headache, and I tried Exceeding brand tablets. My headache was cured. That's proof
enough for me. " Explain how this approach violates the components of critical thinking.
The speaker uses only himself as a research subject and does not seek replication either
through others' experiences or at least another dose of the tablet for his next headache. More
importantly, however, he has failed to consider the possibility of alternative explanations for the
outcome of his action. He has not attempted to collect competing evidence in order to evaluate
its validity in comparison to his initial findings. This is a clear example of how NOT to gather
information.
31
1.
180
Dr. Landry theorizes that anxiety disorders are caused by distorted perceptual
processes in which an individual perceives threat in her/his environment when no objective
threat is present. Develop a correlational or an experimental hypothesis to test to evaluate this
theory, and indicate the general characteristics of the associated research design. Be sure to give
specific operational definitions for the variables in your hypothesis.
[No definitive response predictable: Correlation should specify direction of the
proposed relationship between two variables WITHOUT describing a causal relationship;
experiment should explicitly include random assignment to groups, a manipulated IV, & a
measured DV; either approach should describe variables in concrete, measurable terms. ]
32
Chapter 2
ASSESSMENT AND DIAGNOSIS
2.
1
Ans. A
App
p. 44
E
*
In the 1920's, had a young woman worn a bikini to a public beach, she might
have been labeled as "disordered". What definition applies in this case?
a. deviation
b. subjective distress
c. dysfunction
d. disruptive
2.
2
Ans. B
App
p. 44
M
What definition of abnormality would you most likely be using if you defined
all U. S. presidents as "mentally disordered"?
a. labeling
b. statistical
c. dysfunction
d. political
2.
3
Ans. C
App
p. 44
M
If a psychologist employed only the "statistical" definition of mental disorder,
which "disorder" would be omitted?
a. schizophrenia
b. autism
c. phobia
d. panic disorder
2.
4
Ans. D
App
p. 44
M
Some introductory psychology students decided to try a social psychology
experiment. They stood in a nearly empty elevator with their backs to the door,
staring at the other riders. By what definition would they be considered
"disordered"?
a. dysfunctional
b. subjectively distressing
c. what clinicians treat
d. deviance
2.
5
Ans. A
App
p. 45
M
Dolf is a 58-year-old male who just married for the first time and has decided to
go to medical school to become a neurosurgeon. The deviance definition of
abnormality would define Dolf as "disordered". What problem is reflected in
this definition?
a. Failure to conform to social norms does not necessarily reflect a mental
disorder.
b. It is unclear what level of personal distress Dolf is experiencing.
c. This definition would fit only if Dolf is experiencing difficulty in everyday
functioning.
d. There is no evidence that Dolf has sought treatment from a clinician.
2.
6
Ans. B
App
p. 45
E
"How can you have so many definitions of mental disorder?", a person said with
exasperation. "Why don't you just make it simple?" To accommodate them,
you would offer just the
definition.
a. disorder as dysfunction
b. disorder as what clinicians treat
c. disorder as statistical rarity
d. disorder as a label
33
2.
7
A clinician defines "mental disorder" according to the nature of the problems
Ans. C
experienced by clients in treatment. She will encounter several problems with
App this definition. Which of the following is NOT relevant?
p. 45
a. She will underestimate the presence of disorders among people of lower SES.
C
b. Some clients seek help in order to attain goals unrelated to symptoms of a
mental disorder.
c. She will ignore some problems by tending to focus on characteristics that are
rare.
d. She will fail to define differences in the severity of dysfunction and distress
in her clients.
2.
8
Ans. D
App
p. 45
E
2.
9
Ans. A
App
p. 45
M
2.
10
Ans. B
App
p. 45
M
It is unlikely that any person has lived a life free from sadness, occasional
anger, or feelings of fear. Thus, according to the
definition, EVERY
person could be considered mentally disordered at some point.
a. deviance
b. labeling
c. dysfunction
d. subjective distress
Ted B. has an antisocial personality disorder. He has victimized many people
and feels no remorse for any of his actions. He does, however, become
temporarily depressed when he is caught and put in jail. Which definition does
NOT apply?
a. subjective distress
b. dysfunction
c. deviance
d. harm
Some people have argued that children diagnosed with attention deficit
hyperactivity disorder are exhibiting the common, healthy exuberance and
rambunctiousness of childhood. It is further argued that these children will
ultimately be rejected by nondisordered peers, with this rejection causing harm.
What definition of disorder are such persons employing?
a. disorder as dysfunction
b. disorder as label
c. disorder as what clinicians treat
d. disorder as deviance
2.
11
Ans. C
App
p. 45
C
Which of the following would in fact be considered a disorder by the labeling
definition?
a. social phobia
b. dependent personality disorder
c. Alzheimer's
d. posttraumatic stress disorder,
2.
12
Ans. D
Fac
p. 46
E
The official diagnostic system used in North America relies most heavily on
which disorder definition?
a. deviance
b. distress
c. what clinicians treat
d. dysfunction
34
2.
13
Ans. B
Fac
p. 46
E
Which group publishes the official nosological guide used in North America?
a. the American Psychological Association
b. the American Psychiatric Association
c. the World Health Organization
d. the National Institute of Mental Health
2.
14
Ans. A
App
p. 46
M
You have labeled punk rock adolescents walking down the street as
"dysfunctional" and therefore disordered. Which of the following is NOT an
issue applicable to your chosen definition?
a. What is the actual level of personal distress experienced by the adolescents?
b. Are the adolescents' behaviors harmful to society, or are they annoying?
c. Might their characteristics be considered acceptable or common in another
social setting?
d. What individual costs are associated with the adolescents' demeanor and
behavior?
2.
15
Ans. B
App
p. 46
M
*
You are trying to decide what major you should choose in college. Thus, you
go to several departments, gather information about requirements, and compare
this information to your future goals in order to make a thoughtful decision. In
other words, you are engaging in the process of
a. diagnosis.
b. assessment.
c. content validity.
d. nosology.
2.
16
Ans. C
Fac
p. 46
M
In order to understand and treat clients, a clinician must engage in a three-step
process of
a. diagnosing, gathering test data, and planning interventions,
b. interviewing and testing, diagnosing, and providing therapy.
c. gathering information, organizing and interpreting it, and diagnosing,
d. obtaining personality and behavior tests, classifying a nosology, and
diagnosing.
2.
17
What do the DSM-IV and the ICD-10 have in common? They
Ans. C
a. were both developed by psychiatrists in the U. S. and Canada.
Con b. are both guides to the assessment of mental disorders.
p. 46
c. are both systems of nosology.
M
d. both primarily employ the deviance definition of disorders.
2.
18
Ans. A
App
p. 46
M
A bachelor's-level "psych technician" works in a community mental health
center, conducting preliminary intake interviews and administering and scoring
tests. This activity comprises
a. the first step of assessment only.
b. the first and second steps of assessment only.
c. the second step of assessment only.
d. all three steps of assessment.
35
2.
19
Ans. D
App
p. 46
M
You have conducted a structured interview with your new client and have
received the results of several psychological tests taken by the client. What is
your next assessment task?
a. compare test results to DSM nosology
b. evaluate the reliability and validity of the assessment instruments
c. arrive at a diagnosis
d. develop an organized understanding of the client
2.
20
Ans. B
Fac
p. 46
E
On which two dimensions are psychological assessments evaluated?
a. reliability and utility
b. validity and reliability
c. comprehensiveness and validity
d. internal structure and content
2.
21
Ans. C
App
p. 46
E
Moira took an IQ test last year and took it again last week. What form of
reliability is most important in this case?
a. interrater
b. content
c. test-retest
d. internal
2.
22
Ans. A
App
p. 47
C
Which of the following pieces of information would permit you to evaluate the
reliability of a pencil & paper test of paranoia?
a. a comparison of answers on one half of the test to answers on the other half
b. its association to scores on established tests of interpersonal suspiciousness
and distrust
c. whether the results from two persons who score the test are in agreement
d. whether it can predict interpersonal conflict in the future
2.
23
Ans. A
App
p. 47
M
*
In a study in which observers measure a child's prosocial behaviors in the
classroom, what sort of reliability would be most important to you?
a. interrater
b. internal
c. test-retest
d. concurrent
2.
24
Ans. A
App
p. 46-7
M
Dr. Wan met with Nena and diagnosed her with an anxiety disorder. Dr. Tu
met Nena and diagnosed her with a mood disorder. The clinicians have a
problem with
a. reliability.
b. concurrent validity.
c. standardization.
d. objectivity.
2.
25
Ans. D
Con
p. 47
M
When you are evaluating assessment data for a consistent picture about a client,
you are concerned with
; when you evaluate that data for its
meaningfulness, you are concerned with
.
a. internal reliability; content reliability
b. accuracy; reliability
c. content validity; construct validity
d. reliability; validity
36
2.
26
Ans. B
App
p. 47
C
The Beck Depression Inventory (BDI) is commonly used in studies of
depression. Developers of The Inventory to Diagnose Depression, however,
assert that their instrument covers DSM criteria more fully than does the BDI.
What sort of validity is at issue here?
a. concurrent
b. content
c. internal
d. construct
2.
27
If you believe that the test you are currently taking does not adequately
Ans. C
represent the material that has been covered in class, what element of validity
App
are
you addressing?
p. 47
a. construct
M
b. predictive
c. content
d. concurrent
2.
28
Ans. D
App
p. 47
M
*
A test of chronic anxiety can identify who is most likely to later develop cardiovascular disease. What type of validity does this test demonstrate?
a. concurrent
b. test-retest
c. construct
d. predictive
2.
29
Ans. A
App
p. 47
M
While it is difficult to assess future suicide potential, the Hopelessness Scale is
one of the most useful tests currently available for this assessment. Which of
the following validities is important here?
a. predictive
b. construct
c. content
d. internal
2.
30
Ans. D
App
p. 47
M
Results on the MMPI's Psychasthenia scale indicate that Amee is very anxious.
If Amee's friends also report that she is often edgy, fidgety, and apprehensive,
then this MMPI scale demonstrates
a. internal reliability.
b. construct reliability.
c. predictive validity.
d. concurrent validity.
231
Ans. A
App
p. 47
M
Observational ratings of schizophrenic behaviors are positively correlated with
the MMPI's Sc scale. This demonstrates the
validity of the
observational ratings,
a. concurrent
b. predictive
c. internal
d. content
37
2.
32
Ans. B
App
p. 47
M
Dr. Whiteley wants to develop a program to prevent domestic violence. To do
so, he will need assessment instruments that measure attitudes and behaviors that
are related to later violence. What type of validity must this assessment
demonstrate?
a. content
b. predictive
c. concurrent
d. descriptive
2.
33
Ans. B
App
p. 47
M
A psychologist is developing an assessment instrument for "optimism", which
she believes will predict effective coping under conditions of extreme life stress.
She is, therefore, conducting initial studies to determine the
validity of
this instrument.
a. internal
b. construct
c. concurrent
d. forecastive
Which of the following coefficients reflect the highest internal consistency?
a. +. 62
b. -. 75
c. +. 00
d. +. 88
2.
34
Ans. D
Con
p. 47
E
2.
35
Ans. A
App
a.
p. 47
C
*
If higher scores on a depression inventory are strongly associated with lower
scores on a measure of optimism, what validity coefficient would you find?
-.
62
b. +. 37
c. -1. 05
d. +. 70
2.
36
Ans. B
App
p. 47
M
One cannot predict intelligence from a person's shoe size because these variables
have little relationship. Which expression below MOST accurately describes
this relationship?
a. c = +. 20
b. r = -. 03
c. c = . 00
d. r = +. 14
2.
37
Ans. C
Fac
p. 47, 9
M
An assessment instrument can have
a. validity; reliability
b. consistency; reliability
c. reliability; validity
d. meaningfulness; validity
2.
38
Ans. D
App
p. 47, 9
M
*
You checked your watch an hour ago and it said 8: 15. Now, it still says 8: 15.
In other words, your watch has
but not
.
a. content validity; predictive validity
b. validity; consistency
c. consistency; internal validity
d. reliability; validity
38
without having
.
2.
39
Ans. C
App
p. 48
E
As a graduate student, you are working with elementary school children who are
at risk for juvenile delinquency. What assessment will be most useful to you?
a. level of family conflict
b. family ratings of children's temperament
c. peer ratings of children's aggressiveness
d. measurement of family socioeconomic status
2.
40
Ans. A
App
p. 49
M
Eleni, a schizophrenic patient, and Dorcha, her nondisordered sister, both took a
new test for schizophrenia. If the test has good , it will correctly
diagnose Eleni; if it has good
, Dorcha will not be diagnosed as
schizophrenic.
a. sensitivity; specificity
b. content validity; predictive validity
c. specificity; sensitivity
d. validity; sensitivity
Richard, a 70-year-old male, was diagnosed with Alzheimer's disease when in
fact he was experiencing major depression with melancholic features. In other
words, the test for Alzheimer's disease produced a result.
a. true positive
b. false positive
c. false negative
d. nonspecific
2.
41
Ans. B
App
p. 49
E
*
2.
42
Ans. D
Con
p. 49
M
Which of the following terms and outcomes are incorrectly matched?
a. true negative: correct decision that no diagnosis should be made
b. false negative: incorrect decision that no treatment is needed
c. diagnostic sensitivity: correct decision to assign a diagnosis
d. false positive: incorrect decision that no diagnosis should be made
2.
43
Ans. C
Con
p. 49
M
Which diagnostic decision outcome would support the arguments made by the
"disorder as a label" critics?
a. true positive
b. true negative
c. false positive
d. false negative
2.
44
Ans. A
App
p. 49
E
A clinician wants to obtain information about a client that is least likely to be
distorted by the client's attempts to create a certain impression. Which of the
following is the best candidate?
a. life record
b. unstructured interview
c. objective test
d. naturalistic observation
39
2.
45
Ans. B
App
p. 49
M
Dr. Bernstein plans to employ several different assessment methods to
understand his new client. If he begins with the most commonly used tool,
what will he do?
a. ask the client to complete a structured personality test like the MMPI
b. conduct an interview
c. carry out controlled and participant observations
d. conduct an intelligence test
2.
46
Ans. C
App
p. 50
C
Which structured interview would you use if you wanted to conduct a multi-site
epidemiological study and your research assistants were nonprofessionals?
a. Structured Clinical Interview for DSM
b. Structured Diagnostic Inventory
c. The Diagnostic Interview Schedule
d. The Schedule for Affective Disorders and Schizophrenia
2.
47
Ans. D
App
p. 50
M
As a prison psychologist, which of the following instruments would you choose
to conduct an initial screening of mental illness in inmates?
a. Psychopathology Checklist Revised
b. The Diagnostic Interview Schedule - Prison version
c. Rogers Psychopathology Screening Scale
d. The Referral Decision Scale
2.
48
Ans. A
Fac
p. 50
E
The mental status examination is a type of
a. structured interview.
b. intelligence test.
c. neuropsychological battery.
d. personality inventory.
2.
49
Ans. B
Con
p. 50-3
E
Which of the following assessments and classification are incorrectly matched?
a. Halstead-Reitan Battery: neuropsychological test
b. MMPI: projective personality test
c. WAIS-R: intelligence test
d. mental status examination: structured interview
2.
50
Ans. C
Con
p. 51
M
*
In a student's review of the strengths of the interview method of assessment,
which statement should be omitted?
a. Interrater and test-retest reliability tend to be. 70 or greater, an acceptable
level of consistency.
b. Several structured interviews are available for various populations, ages, and
diagnostic categories.
c. Clinicians usually prefer the greater reliability and breadth of information
provided by unstructured interviews.
d. Interviews are a relatively inexpensive and flexible means by which to gather
information.
2.
51
Ans. D
App
p. 51
M
To say that the procedures for administering and scoring the Graduate Record
Exam are consistent across all test-takers is to say that the test is
a. valid,
b. reliable.
c. norm referenced,
d. standardized.
40
2.
52
Ans. D
App
p. 51
E
Reggie took the Stanford Binet test, providing his counselor with a measure of
Reggie's
a. achievement and aptitudes,
b. attitude and interests.
c. personality,
d. intelligence.
2.
53
Ans. A
App
p. 51-2
E
Nora wants to evaluate the possibility that a client who sustained a head injury
in an automobile accident may have brain damage that is affecting his
psychological functioning. She could consider using any of the following tests
EXCEPT the
a. Doria-Kansas Battery.
b. WAIS-R.
c. Wide Range Achievement Test.
d. Halstead-Reitan Battery.
2.
54
Ans. A
App
p. 51-2
C
Clara is a patient in a geropsychiatry unit of a state hospital. Lately, she has
had memory difficulties, dysphoric mood, little or no appetite, and deficits in
language production and comprehension. In order to evaluate the possibility of
depression vs. brain dysfunction associated with some form of dementia, what
two tests would be most useful?
a. MMPI and Halstead-Reitan
b. WRAT and WAIS-R
c. Millon Clinical Multiaxial Inventory-II and the MSE
d. Luria-Nebraska and the Rorschach Inkblot test
2.
55
Ans. B
App
p. 52-3
M
An individual was referred for tests such as the categories test, trail making test,
sensory-perceptual exam, and the tactile perception test. Which potential
disorder might the examiner suspect?
a. a psychotic disorder, such as schizophrenia
b. a cognitive disorder, such as dementia
c. a disorder of childhood, such as mental retardation
d. an anxiety disorder, such as attention deficit disorder
2.
56
Ans. C
Fac
p. 52-3
M
Which Halstead-Reitan Battery test and its focus of assessment are incorrectly
matched?
a. Categories test ~ ability to form abstract concepts
b. Aphasia screening test -- accuracy of reproduction of forms and simple
spelling
c. Finger tapping test — kinesthetic perception and auditory attention
d. Tactual performance test -- motor speed and incidental memory
2.
57
Ans. A
Con
p. 53
M
Drawing from information presented in the text, which of the following
assessments would demonstrate the lowest reliability?
a. Incomplete Sentences
b. Rorschach Inkblot
c. MMPI-A
d. The Diagnostic Interview Schedule
41
2.
58
Ans. B
App
p. 54
E
Kevin's scores on the L, F, & K scales of the MMPI-2 were the first items his
therapist considered in her profile analysis. What information do these scales
provide?
a. inter-item reliability
b. test-taking attitude
c. clinical symptoms
d. severity of psychological distress
2.
59
Ans. C
App
p. 54
M
Reya answered several items on the MMPI-2 that were rarely endorsed by any
of the persons who comprised the test's original clinical sample. You could
interpret Reya's responses in several ways EXCEPT as
a. a sign of carelessness in her responding.
b. evidence of a severe psychological disorder.
c. a sign of defensiveness.
d. an attempt to exaggerate her distress.
2.
60
Ans. A
Con
p. 54
E
You could fairly criticize the MMPI-2 for
a. lacking a guiding theory of psychopathology.
c. lacking clear guidelines for profile interpretation,
b. demonstrating poor reliability and standardization.
d. demonstrating poor validity for the clinical scales.
2.
61
Ans. D
App
p. 54
M
You have been asked to provide expert testimony in court regarding the
psychological functioning of a serial killer. If you could choose only one
personality test, your concern for validity would lead you to choose the
a. Rorschach inkblot test.
b. Thematic Apperception Test.
c. California Personality Inventory.
d. Minnesota Multiphasic Personality Inventory.
2.
62
Ans. D
App
p. 54
M
To conduct an adequate assessment of a client, a clinician could choose
a. the MMPI-2.
b. a structured clinical interview,
c. observational assessments.
d. None of the above is adequate.
2.
63
Ans. C
App
p. 55
M
If Adrian answers items on the MMPI-2 that are associated with flagrant
disregard of social customs and difficulty in learning from punishment for his
actions, what scale would be elevated?
a. scale 1, Hs
b. scale 3, Hy
c. scale 4, Pd
d. scale 9, Ma
42
264
Ans. D
App
p. 55
M
*
2.
65
Ans. B
App
p. 55
M
A graduate student has just begun his first psychological training practicum.
One of his tasks is to administer and score the MMPI-2. Given that most of the
clients are experiencing moderate levels of anxiety, tension, and depression,
what two scales will he frequently see elevated?
a. 1 (Hs) and 8 (Sc)
b. 4 (Pd) and 7 (Pt)
c. 3 (Hy) and 9 (Ma)
d. 2(D)and 7 (Pt)
Marta is often overactive, tends to jump from one topic to another in her
conversations, and is easily emotionally excited. She would probably exhibit
elevated scores on the MMPI-2
scale.
a. psychasthenia
b. hypomania
c. conversion hysteria
d. social extroversion
2.
66
Ans. C
App
p. 55
E
*
As a behavioral psychologist, Dr. Akt would tend to prefer what assessment
approach?
a. unstructured interviews
b. objective personality tests
c. observational assessments
d. PET scan or MRI
2.
67
Ans. B
App
p. 56
E
Ms. Seshachari, a marriage and family therapist, conducted a family assessment
while having dinner with the family in their home. What type of observation is
this?
a. controlled
b. participant
c. naturalistic
d. contextual
2.
68
Ans. A
App
p. 57
M
Which client below is most likely to be assessed through naturalistic
observation?
a. Tiffany, a 10-year-old hyperactive female observed at school
b. Art, a 19-year-old phobic male observed in a college class
c. Glenda, a 50-year-old depressed female observed at work
d. Marcello, a 60-year-old alcoholic male observed at home
2.
69
Ans. B
App
p.
57
C
"How did your self-monitoring go this week?" This question from a clinician to
a depressed client most likely pertains to the client's
a. written notation of the frequency and duration of her/his activities with
friends.
b. attempts to cognitively monitor and replace negative self-statements with
positive ones.
c. careful daily tracking of medication compliance and side effects.
d. success in resisting compulsive coping behaviors such as smoking.
43
2.
70
A social psychologist is conducting a study of interpersonal aggression between
Ans. B
adolescents in public settings. In order to achieve meaningful observations, the
App psychologist should address each of the following components EXCEPT
p. 57
a. careful training of observers.
M
b. a procedure for conducting controlled observations.
c. a method for summarizing ratings that reliably represents the observed
behaviors.
d. collection of a sample of behaviors that is not reactive to the process of
being observed.
2.
71
Ans. C
Fac
p. 57
E
Monitoring endocrinological changes in schizophrenia and depression as well as
measuring changes in the immune system's response to stressors are examples of
a. the use of computerized tomography.
b. neuroimaging.
c. biological markers.
d. neuropsychological assessment.
2.
72
Ans. D
App
p. 57-8
M
Clinicians are aware that accurate assessment of sexually deviant individuals is
complicated by these persons' tendency to deny and distort their behaviors.
What "marker" approach might be useful?
a. objective personality tests focusing on aggression and impulsivity
b. structured clinical interview focusing on sexual beliefs and practices
c. neuropsychological tests for brain dysfunction and disinhibition of impulses
d. measurement of physiological arousal during exposure to selected stimuli
2.
73
Ans. A
Fac
p. 58
E
Physiological measures of blood pressure, muscle tension, and skin conductance
would be central to the assessment of
disorders.
a. anxiety
b. schizophrenic
c. dissociative
d. depressive
2.
74
Shelly has been asked to take a lie detector test, following the theft of money
Ans. B
from
the office in which she works. What new neurodiagnostic procedure might
App
become a better candidate than the current polygraph?
p. 58
a. electromyogram
M
b. evoked potential
c. computer-synthesized EEG
d. SPECTscan
2.
75
Ans. C
App
p. 58
M
*
Renaldo has been diagnosed with the a sleep disorder. Which neurodiagnostic
procedure, available for use at home, was involved in this assessment?
a. CT scans
b. PET
c. EEG
d. MRI
44
2.
76
Ans. D
App
p. 59
M
*
Dr. Subbiah received her patient's Halstead-Reitan results that indicated
significant brain dysfunction. If she suspected a tumor, what imaging technique
would she order?
a. PET scan
b. MRI
c. MRS scan
d. CT scan
2.
77
Ans. A
App
p. 59
E
Persons with schizophrenia show abnormal patterns of glucose activity in their
frontal lobes, possibly reflecting disruptions in higher order thought processes.
What imaging technique provided this information?
a. PET scan
b. CT scan
c. MRI
d. EEG
2.
78
Ans. B
App
p. 59
E
A radioactive chemical was injected into Cara's blood stream. Pictures of the
activity of her brain from several different angles were then obtained. What
technique is being used?
a. MRI
b. SPECT
c. PET
d. MRS
2.
79
Ans. C
App
p. 59
E
A neuroscientist is using MRI technology to evaluate the role of abnormal
limbic system functioning in generalized anxiety disorder. This means that
participants will be studied via
a. computer-enhanced three-dimensional x-rays.
b. the tracking of utilization of radioactive glucose.
c. the tracking of activity of atoms exposed to powerful magnets.
d. computer-enhanced mapping of varying electrical activity patterns.
2.
80
Ans. D
App
p. 59
M
Investigators have found connections between cerebral atrophy (the shrinking of
brain mass) and symptoms of schizophrenia in adults. For what reason should
they be cautious about concluding that atrophy represents a biological
contributor to the disorder?
a. the poor reliability of brain imaging techniques
b. insufficient resolution of computer images at this level of measurement
c. the probability that other psychosocial factors are more important in causing
this disorder
d. the possibility that longterm medication use may have altered brain structure
and function
2.
81
Ans. C
Con
p. 60
M
If you are working as a physician during the time that Griesinger and Kraepelin
are making their contributions to psychopathology, what era are you living in?
a. ancient Greece
b. the late European Renaissance
c. the 19th century
d. the early 20th century
45
2.
82
Ans. B
Fac
p. 60
E
Who proposed the first scientific classification system for mental disorders?
a. Kraepelin
b. Griesinger
c. Hippocrates
d. the American Psychiatric Association
2.
83
Ans. D
App
p. 60
M
If you agreed with the most influential classification system of the late 19th
century, you would place all disordered individuals into one of three categories.
These did NOT include
a. organic brain disorders.
b. dementia praecox.
c. manic-depressive psychosis.
d. melancholia.
What we now refer to as schizophrenia was termed
by Kraepelin.
a. dementia praecox
b. manic-depressive psychosis
c. involutional organic dementia
d. multiple personality disorder
*
2.
84
Ans. A
Fac
p. 60
E
2.
85
Ans. B
Con
p. 60
C
Dr. Warren is writing a history of the factors that influenced the modem
DSM-IV. Which aspect should he omit from that review?
a. military classifications for veterans' disorders
b. the publication of reliable and valid structured interview schedules
c. the WHO's ICD-6 and subsequent revisions
d. Griesinger and Kraepelin's work in the late 19th century
2.
86
Ans. C
Con
p. 60-1
C
Which of the following classification manuals are INCORRECTLY paired?
a. ICD-6 and DSM-I
b. ICD-8 and DSM-II
c. ICD-10 and DSM-III-R
d. All of the above are correctly paired.
2.
87
Ans. B
Con
p. 60-1
M
Which of the following problems was NOT associated with the first two
versions of the DSM?
a. failure to predict the treatment and course of disorders
b. listings of causal factors only, without description of symptoms
c. an exclusive focus of attention to a single clinical label
d. low reliability and a virtual lack of validity for several categories
2.
88
Ans. D
App
p. 61
M
It's 1980 and you just received your copy of the DSM-III. In it, you notice
several improvements over the previous editions. Which of the following,
however, does not belong?
a. a multiaxial diagnostic system
b. improvement in classification reliability across clinicians
c. combinations of clearly specified symptoms required for diagnosis
d. emphasis on differences in disorders according to age, ethnicity, and gender
46
2.
89
Ans. D
Con
p. 61
E
What form of reliability is most important for DSM diagnoses?
a. test-retest
b. internal
c. content
d. interrater
2.
90
Ans. C
Fac
p. 61
E
"It introduced multiaxial classification. " To which DSM does this apply?
a. DSM-I
b. DSM-II
c. DSM-III
d. DSM-III-R
2.
91
Ans. D
Con
p. 61
M
Clinicians following which model of psychopathology demonstrated greater
interrater reliability when they utilized DSM-III diagnostic criteria?
a. psychodynamic
b. cognitive
c. biological
d. Reliability improved regardless of model.
2.
92
Ans. A
Fac
p. 61
E
What is the primary focus of the DSM-III and DSM-IV?
a. description of signs and symptoms of disorders
b. psychological and biological treatment recommendations
c. description of the causal factors related to clinical syndromes
d. All of the above are addressed.
2.
93
Ans. B
App
p. 61
C
Attention deficit hyperactivity disorder has gone through several name changes
across the various editions of the DSM. If experts in this area believed that the
disorder should be called "attention deficit disorder, with or without
hyperactivity", what would the DSM-IV planning group do?
a. leave the decision to a vote of experts who have conducted research in this
area
b. conduct a field trial and have the final decision reviewed by outside advisors
c. include both diagnostic descriptions and permit clinicians to choose the one
more relevant to their client population
d. choose the label that is closest to the ICD-10 to adhere to treaty obligations
2.
94
Ans. A
App
p. 61
M
You are serving on the panel to develop the DSM-IV. Which of the following
is NOT among the justifications you cite for revising the DSM-III-R?
a. its lack of multiaxial classification
b. the lack of empirical validity support for some diagnostic categories
c. inadequate attention to age, cultural, and gender issues
d. the pending publication of the ICD-10
*
2.
95
Martina is preparing a report on the history of the "posttraumatic stress disorder"
Ans. C
first
introduced in the DSM-III in 1980. If she wants to find information about
App
field
trials and other activities related to this disorder's inclusion in the DSM-IV,
p. 61
where should she turn?
M
a. to the DSM-IV manual, Appendix A
b. to articles in relevant scholarly journals in the late 1980s and early 1990s
c. to the DSM-IV Sourcebook
d. to the Proceedings of the DSM-IV Work Groups
47
2.
96
Ans. A
App
p. 61
E
In Dr. Roediger's assessment report of her client, Mara, where would Mara's
diagnosis of "dissociative identity disorder" be noted?
a. Axis I
b. Axis II
c. Axis III
d. Axis IV
2.
97
Ans. C
App
p. 61-2
E
*
On which axis or axes of the DSM does a clinician list abnormal behaviors
relevant to her client?
a. Axis I only
b. Axis II only
c. Axes I and II
d. Axes I, II, and III
2.
98
Ans. B
Fac
p. 62
E
Which DSM axis is retained in the DSM-IV largely due to tradition and custom?
a. I
b. II
c. Ill
d. V
2.
99
Ans. A
App
p. 61-2
M
Mr. Evans, a patient at a VA hospital, has been diagnosed with major depression
coded on Axis
, and schizotypal personality disorder coded on Axis
.
a. I; II
b. I; I
c. HI; II
d. II; I
2. 100
Ans. D
App
p. 62
M
Gail was divorced six months ago and is in a custody battle for her two
children. How would this situation be reflected in her DSM diagnosis?
a. It would not necessarily be included but could be noted with an Axis I
disorder.
b. It would be listed on Axis II.
c. It would be taken into account when the clinician determines her Axis V
GAF.
d. It would be listed on Axis IV.
2. 101
Ans. B
Con
p. 62
M
*
If Axis III were not included in the DSM, which of the following diagnoses
could you NOT list?
a. mental retardation
b. HIV/AIDS
c. homelessness
d. bipolar disorder
2.
102
Ans. C
Fac
p. 63
E
On which axis might the following notation be found? — "GAF = 82"
a. Ill
b. IV
c. V
d. none of the above
48
2.
103
Ans. C
App
p. 64
E
A
a.
b.
c.
d.
client's diagnosis on Axis I reflects her/his
long-standing, relatively unchanging behavior style.
general medical condition(s) relevant to mental health treatment.
major clinical syndrome(s) associated with clinically significant dysfunction.
general level of psychosocial functioning at the time of diagnosis.
2.
104
Ans. D
Fac
p. 64
M
According to the DSM-IV, how is
"mental disorder"?
a. It refers to disorders caused by
b. It refers to disorders caused by
c. It refers to disorders that result
d. It refers to disorders caused by
2.
105
Ans. D
Con
p. 64
E
Based on the DSM's definition of "mental disorder, " which model of
psychopathology is most clearly omitted?
a. cognitive
b. biological
c. behavioral
d. sociocultural
2. 106
Ans. A
App
p. 64
E
Manny exhibits symptoms reflecting distorted perception and severe disturbances
in his thinking processes. He most likely has a diagnosis that falls in the
__ category.
a. Schizophrenic and Other Psychotic Disorders
b Delirium, Dementia, Amnestic and Other Cognitive Disorders
c. Dissociative Disorders
d. Anxiety Disorders
2. 107
Ans. C
App
p. 64
M
Ira has a disorder in which physical symptoms are caused by psychological
factors, and he is unaware of this underlying connection. What is the name for
the category in which this disorder is found?
a. Mood Disorders
b. Factitious Disorders
c. Somatoform Disorders
d. Schizophrenia and Other Psychotic Disorders
2.
108
Ans. D
Con
p. 65
M
The DSM-IV essentially provides a "menu" of symptoms from which certain
ones must be met for diagnosis. What approach to classification does this
represent?
a. multiaxial
b. classical
c. heterogeneous
d. polythetic
2.
109
Ans. B
App
p. 65
M
Ron did not display all DSM-IV criteria for posttraumatic stress disorder, but his
symptoms did meet the minimum criteria for the disorder. What classification
approach is being applied?
a. classical
b. polythetic
c. homogeneous
d. multiconditional
49
the term "mental" defined in reference to
psychological factors,
physical factors.
in harmful dysfunction in the individual,
either psychological or physical factors.
2.
110
Ans. A
App
p. 65
E
Trisha has a comorbid condition. This means that she has
a. two or more DSM-IV clinical disorders.
b. an Axis I and an Axis III disorder co-occurring.
c. a fatal medical diagnosis on Axis III.
d. the same disorder as one of her close family members.
2.
111
Ans. B
Con
p. 65
M
Not all participants in a study of dissociative identity disorder will exhibit the
exact same pattern of symptoms. This means that the research sample is
a. invalid.
b. heterogeneous.
c. homogeneous,
d. polythetic.
2.
112
Ans. C
App
p. 65
E
A counseling psychologist is working with a client who has both a somatoform
disorder and a depression disorder. This comorbidity could have occurred in
any of the following ways EXCEPT
a. overlapping criteria exist in the two sets of disorders.
b. both disorders could have been caused by a common life experience.
c. the classical approach was applied to the diagnoses.
d. the somatoform disorder could have led to the depression disorder.
2. 113
Ans. D
App
p. 66
E
When a clinician reads through the description of each disorder in the DSM-IV,
he would encounter each of the following sections EXCEPT
a. general medical or physical exam findings that could be associated,
b. gender, age, and cultural features.
c. operationally defined diagnostic criteria,
d. treatment recommendations.
2. 114
Ans. A
Con
p. 66
C
As critics point out in regard to Rosenhan's labeling study, it should be
recognized that the hospital staff was understandably motivated to avoid what
sort of diagnostic error?
a. false negative
b. false positive
c. lack of specificity
d. lack of reliability
2.
115
Ans. B
Fac
p. 66
E
Which of the following labels 'stuck' to Rosenhan and his seven accomplices?
a. bipolar disorder with psychotic features
b. schizophrenia
c. schizoid personality disorder
d. schizoaffective disorder
2.
116
Ans. D
App
p. 66
M
Erik is experiencing minor behavioral disturbances following his family's move
to a new state. A counselor diagnosed him with separation anxiety disorder,
which was a false positive diagnosis. If Erik's disturbance worsens as a result of
this diagnosis, this would be an example of
a. a stereotype.
b. a polythetic error.
c. overpathologizing.
d. the self-fulfilling prophecy.
50
2.
117
Ans. D
App
p. 67
M
*
Anorexia nervosa, an eating disorder, is much more frequently diagnosed in
females than in males. Based on text information, which explanation below
might best account for this difference?
a. gender-related bias in the symptoms comprising the anorexia nervosa
syndrome
b. an actual gender-related psychosocial or biological difference
c. gender-related diagnostic bias on the part of clinicians
d. b and c
2.
118
Ans. C
Fac
p. 67
M
A description of a client with histrionic personality disorder is being read by a
group of clinicians. If the client is described as a male, the clinicians using
DSM-IV criteria will probably
a. diagnose HPD as frequently as they would if the client were described as
a female.
b. diagnose HPD more frequently than they would if the client were described
as a female.
c. diagnose HPD less frequently than they would if the client were described
as a female.
d. show different patterns of diagnosis depending on the clinician's gender.
2.
119
Ans. C
App
p. 68
M
Two clinicians are debating the most useful approach to defining anxiety. One
favors the
approach, in which symptoms are evaluated on a
continuum; the other argues for the
approach in which a client either
does or does not meet criteria for an anxiety disorder.
a. categorical; dualistic
b. homogeneous; dimensional
c. dimensional; categorical
d. heterogeneous; homogeneous
A critic of the approach to classification of disorders might argue that
there is no identifiable dividing line between "normal" and "abnormal. "
a. categorical
b. homogeneous
c. dimensional
d. multiaxial
*
2.
120
Ans. A
Con
p. 68
E
2.
121
Ans. B
App
p. 68
M
The MMPI-2 produces a profile whose interpretation depends on the pattern of
scores on all of the clinical scales. This reflects classification.
a. categorical
b. dimensional
c. continuous
d. polythetic
2.
122
The categorical approach for the DSM has been preserved for several reasons.
Ans. C Which of the following is NOT one of these?
Fac
a. theoretical disagreement about the most relevant diagnostic dimensions
p. 68
b. compatibility with the approach taken by the medical profession
M
c. the inherent conceptual weakness of the dimensional approach
d. ease of use by clinicians
51
2.
123
Ans. A
Con
p. 66-8
M
In your argument for the usefulness of diagnostic classification, you could cite
each of the following benefits EXCEPT
a. the flexibility of the dimensional approach underlying diagnostic syndromes,
b. the ability to search for common causal factors among persons with similar
disorders.
c. an efficient and reliable method for shorthand communication between
clinicians.
d. important information on which to base treatment decisions for disordered
individuals.
2.
124
Ans. A
App
p. 68
M
If you wanted to be paid for your therapy services by your client's insurance
company, you could only use one of the following diagnoses, namely
a. major depression,
b. adjustment disorder.
c. bereavement subsequent to the loss of a spouse,
d. premarital counseling.
2. 125
Ans. B
App
p. 69
M
Donny was experiencing a panic attack but thought he was having a heart
attack. What is the most likely outcome of his emergency room visit?
a. The physician will probably refer him for psychological assessment.
b. The physician will probably treat him for some form of physical illness.
c. The physician will construe ambiguous diagnostic signs in a manner
compatible with her own treatment specialty,
d. The physician will probably refer him for psychiatric treatment with an
antianxiety drug.
2.
126
Ans. C
App
p. 69
M
*
Rheanna is undergoing a psychological assessment prior to starting therapy.
Which of the following factors is LEAST likely to influence the clinician's
diagnostic decision?
a. the type of treatment in which the clinician specializes
b. Rheanna's ethnic group, if different from that of the clinician
c. arbitrary DSM diagnostic decision rules
d. whether treatment for Rheanna's disorder is covered by health insurance.
2.
127
Ans. D
App
p. 69
M
Dr. Wardley is developing a new test for anorexia nervosa. Which issue below
reflects a concern that the test might be biased?
a. Does the test measure anorexia or does it measure some other form of
psychopathology?
b. Will scores on the test be consistent for clients who take the test at two
different points in time?
c. Should the test focus more on external, social factors or factors related to
individual pathology in determining the cause of the disorder?
d. Does the test identify anorexia in blacks as well as it does in whites?
2.
128
Ans. A
App
p. 70
E
Which person is least likely to use formal mental health services?
a. Ernie, a Hispanic male
b. Tomiko, an Asian female
c. Earl, a black male
d. Wendy, a white female
52
2.
129
Ans. B
App
p. 70
E
Dr. Froid interpreted Sung Li's avoidance of eye contact as a sign of shyness,
low self-esteem, and possible depression. However, the clinician should be
careful that this is not the result of
a. observational unreliability.
b. overpathologizing.
c. diagnostic prejudice.
d. overgeneralizing.
2.
130
Ans. C
App
p. 70
C
A clinician, trying to prove her cultural sensitivity, reaches a diagnosis that
undeipathologizes her client. In other words, what kind of diagnostic decision
has she made?
a. false positive
b. quasi-positive
c. false negative
d. quasi-negative
2.
131
Ans. D
Con
p. 71
M
The Kessler et al. (1994) National Comorbidity Survey reported that 48% of
their sample had at least one disorder during their life, and 29% had experienced
a disorder in the prior year. The first result is an estimate of
, and
the second, an estimate of
.
a. epidemiology; prevalence
b. morbidity; incidence
c. incidence; annual epidemiology
d. lifetime prevalence; incidence
Adjusting for differences in cognitive symptoms that are strongly related to
social class, the epidemiological studies reported in the text indicated that
prevalence rates for mood disorders and substance abuse for Black Americans
were
those for European Americans.
a. much higher than
b. somewhat higher
c. equal to
d. lower than
2.
132
Ans. D
Fac
p. 71
E
2.
133
Ans. C
Fac
p. 71
According to the ECA Project (Robins & Regier, 1991), what is the lifetime
prevalence of the 30 major disorders assessed in that study?
a. 19 percent
b. 25 percent
c. 32 percent
d. 48 percent
2.
134
Ans. B
App
p. 71
E
*
A new client at the Lakeshore Mental Health Clinic has a disorder that appears
with greatest frequency in epidemiological studies. It is a
a. schizoaffective disorder,
b. phobia.
c. major depressive episode.
d. alcohol dependency disorder.
53
2.
135
Ans. A
App
p. 72
M
Considering the demographic differences in epidemiological rates, which of the
following persons is most likely to be diagnosed with a mental disorder?
a. a 32-year-old white male with a 10th grade education
b. a 48-year-old Hispanic male with a high school education
c. a 67-year-old black female with one year of college
d. a 70-year-old white female with a 10th grade education
2.
136
Ans. B
Con
p. 72
M
In terms of lifetime prevalence, which of the following disorders is out of place?
a. panic disorder
b. generalized anxiety disorder
c. schizophrenia
d. obsessive-compulsive disorder
2.
137
Ans. A
Con
p. 72
M
Which of the following occurs with LOWEST frequency?
a. treatment by a mental health practitioner
b. incidence of disorders in any given 12-month period in the U. S.
c. comorbidity of lifetime diagnoses
d. lifetime prevalence of anxiety disorders
2.
138
Ans. C
App
p. 72
M
If your goal were to be the kind of practitioner that most people turn to when
they experience a mental disorder, epidemiological findings suggest you should
study to become a
a. counseling psychologist.
b. clinical social worker.
c. general family physician.
d. psychiatrist.
2.
139
Ans. B
App
p. 72
E
Deidre is exhibiting the first symptoms of an anxiety disorder. Based on the
EC A findings, what age would you predict Deidre to be?
a. 12
b. 16
c. 19
d. 22
2.
140
Ans. D
App
p. 73
E
You are entering a clinical psychology program this fell. According to Thomas
Widiger, you should receive more training in
man has typically
been offered in the past.
a. personality testing
b. epidemiology
c. intelligence testing
d. structured interviewing
According to Widiger, the Research Coordinator for the DSM-IV, which of the
following trends might one expect in the future?
a. increasing utilization of projective techniques for psychological assessment
b. a sixth DSM axis for assessment of family/genetic background factors
c. increasing acceptance of dimensional diagnostic approaches for Axis I
d. an increasing reliance on sociocultural models of mental disorders
2.
141
Ans. C
Fac
p. 73
E
54
SHORT ANSWER I ESSAY
2.
142
Doug has been hearing voices telling him to jump through his living room window
and at other times has experienced hallucinations of stepping on broken glass with bare feet. He
is quite fearful and upset but refuses to go with his sister to see a doctor. Using each of the
definitions from the text, determine whether this is a description of a "mental disorder. "
Deviation from social expectation: Yes; others would find his behavior disturbing, given
that his behavior is unpredictable and unsettling to observers. This also reflects a mental disorder
because it is rare that people have perceptual experiences like the ones Doug has had.
What clinicians treat: No; because Doug refuses to seek help from any sort of health
practitioner, this definition could not apply.
Subjective distress: Yes; Doug's hallucinations are causing him a great deal of distress,
compounded by his unwillingness to see someone who might be able to help him with his disorder.
Label: Probably not; even if no one has given a label to Doug's experiences, his distressing
symptoms are unlikely to go away without treatment. However, if diagnosed "schizophrenic, " mis
could lead to rejection and discrimination by others who interact with Doug, resulting in potentially
worsened symptoms.
Dysfunction that causes harm: Yes; clearly Doug is incapable of adaptive perception and
thinking on a day-to-day basis and cannot plan effectively for the future. Because of his fears, he
may engage in behaviors that cause harm to himself and, potentially, to others.
2.
143
Describe the relationship between reliability and validity in assessment.
Reliability is the extent to which an assessment procedure provides consistent outcomes
across items, across time, or across raters. Validity is the extent to which an assessment procedure
measures what it is intended to measure, or the meaningfulness of the outcomes. Both are assessed
with correlation coefficients. However, the reliability of a procedure sets the upper limit for
validity. Moreover, a test or other assessment device can be very consistent over time (or raters,
etc. ), thus demonstrating high reliability, but may be essentially meaningless, thus demonstrating
little or no validity.
2.
144
Lyndall has been assessed by a clinical psychologist who is attempting to decide
whether Lyndall has an obsessive-compulsive disorder (OCD). Describe the 4 possible diagnostic
decisions the psychologist could make and what they would mean.
True positive: Lyndall is diagnosed with OCD and actually has the disorder.
True negative: Lyndall is not diagnosed with OCD and actually does not have the disorder.
False positive: Lyndall is diagnosed with OCD when, in fact, she does not have the
disorder.
False negative: Lyndall is not diagnosed with OCD when, in fact, she does have the
disorder.
55
2.
145
Why do some clinicians prefer unstructured interviews to structured interviews?
What do they sacrifice by this choice?
Unstructured interviews are preferred due to ease of administration, increased flexibility,
and economy of time. However, these interviews are typically much less reliable and less
comprehensive in coverage than the published structured interviews. Current evidence also suggests
that structured interviews may be the most valid assessment tool available to clinicians.
2. 146
You have an appointment with a new adult client. If you could only employ two
specific assessment techniques to diagnose this person, which two would you choose and why?
Structured Clinical Interview for DSM: most reliable interview method, covers
comprehensive information, probably most valid single assessment method
Objective personality test - MMPI-2: superior to projective tests, standardized scoring &
computer-based normative interpretation, clearly documented reliability and good validity, does not
appear to be ethnically biased
(Could make an argument for an observational method, including self-monitoring but not
naturalistic observation)
2.
147
Who proposed the first systematic classification system in the late 19th century, and
what was his model of mental disorders? Who developed the most influential system of that era,
and what was his nosology?
Wilhelm Griesinger proposed the first classification system, based on the medical model
cf disorders. Emil Kraepelin developed the most influential nosology, including the syndromes of
dementia praecox, manic-depressive psychosis, and organic brain disorders.
2.
148
Compare and contrast the current classification system represented in the DSM-IV
to the DSM-III and III-R.
Like the DSM-III and III-R, the DSM-IV employs a multiaxial approach to diagnosis,
incorporating clinical syndromes, medical conditions, psychosocial stressors, and general level of
psychosocial functioning. The various diagnoses in each of the versions are determined by
following operationally defined lists of signs and symptoms collected through careful assessment.
These manuals are essentially descriptive of disorders and thus are not reflective of any one model
of psychopathology. The DSM-IV, in contrast to the earlier manuals, is based on substantially more
empirical field work in addition to expert advisory input. Moreover, it explicitly acknowledges how
the factors of age, gender, and culture are associated with various syndromes. Finally, it is more
congruent with the ICD-10, an important characteristic in light of the U. S. treaty obligation to
maintain a system consistent with WHO classification.
56
2.
149
Huerta has been diagnosed with major depression and a comorbid dependent
personality disorder. In the past year, she has lost her full-time job and is experiencing increasing
marital discord. She reports that it is increasingly difficult for her to manage her hypertension with
medication alone and is worried that she will end up in the hospital if she doesn't find better ways
to cope with stress. Her counselor estimated Huerta's overall level of functioning as a 59. Provide
the multiaxial DSM diagnosis for Huerta.
Axis I: Major depression
Axis II: Dependent personality disorder
Axis III: Hypertension
Axis IV: Loss of job, marital difficulties
Axis V: GAF = 59
2.
150
In simpler terms, ones that your high school neighbor would understand, what does
the following statement mean? "The DSM employs a polythetic classification approach that results
in heterogeneous categories of individuals. "
For each of the categories included in the DSM, the manual that mental health workers use
to determine the best description for their clients' problems, there are several characteristics listed.
Some are symptoms that the person tells you about (their feelings, thoughts) and some are
descriptions of their behaviors or actions. For someone to be described with a certain label, or
diagnosis, they have to show a certain number of those characteristics, but they do not have to have
all of them. As a result, a group of people who have the same general diagnosis, like depression,
will not all have the exact same symptoms and behaviors.
2.
151
What are the dangers or difficulties that can be associated with diagnostic labeling
as practiced in the DSM?
Overemphasis on reliability without sufficient evidence of validity
Arbitrary and inconsistent distinctions between mental and physical disorders
Labeling: stereotyping leading to rejection and discrimination; self-fulfilling prophecy
Potential gender-related bias in clinicians' application of diagnostic criteria
Overlooking the dimensional quality of disorders by creating artificial categories
Lack of attention to sociocultural factors as a cause of disorders
Insurance reimbursement pressure toward false positive diagnoses
Failure to consider cultural differences, leading to under- and overpathologizing as well as
varying definitions of "abnormality"
57
Chapter 3 DISORDERS OF INFANCY, CHILDHOOD, and ADOLESCENCE
3.
1
Ans. A
App
p. 78
E
Dr. Youngman is studying the development of self-reliance in a group of 30
children who were first observed at age 3 and have been followed twice yearly
for the past three years. What sort of design does this represent?
a. prospective
b. retrospective
c. cross-sectional
d. developmental
3.
2
Ans. B
App
p. 78
M
*
Dr. Oldman was conducting research on children's psychopathology in the late
1960s. Which of the following descriptions is LEAST applicable to Dr.
Oldman's work?
a. Dr. Oldman probably viewed children as having disorders that were less
intense versions of adult disorders.
b. Dr. Oldman probably relied on prospective research designs.
c. Dr. Oldman probably had not yet heard of the discipline of developmental
psychopathology.
d. Dr. Oldman probably used a diagnostic system based on a categorical
approach.
3.
3
Ans. A
Con
p. 78
M
If you served on a panel responsible for developing childhood disorder
categories for the DSM-II (1968), which of the following would be your
primary conceptual guide?
a. adult disorders
b. research in developmental psychopathology
c. deviations or delays in developmental tasks
d. attachment theory
3.
4
Ans. C
App
p. 78
E
Dr. Kistner is studying mental disorders in children and adolescents. If she
adopts the perspective outlined by Sroufe and Rutter, she will be working
within the discipline called
a. childhood pathology.
b. developmental psychology.
c. developmental psychopathology.
d. abnormal psychology.
3.
5
Ans. D
Fac
p. 78
E
According to Newman et al. (1996), one might expect nearly
% of a
sample of disordered adults will have disorders that began in childhood or
adolescence.
a. 25
b. 55
c. 70
d. 90
58
3.
6
Ans. A
Fac
p. 79
M
John Bowlby has theorized that forming an effective attachment relationship
with parents is an important
of the first year of life.
a. developmental task
b. psychological milestone
c. psychosocial requirement
d. psychomaturational task
3.
7
Ans. B
App
p. 79
E
Emma is a child facing the tasks of self-reliance, empathy, and establishment of
effective peer contacts. If Emma is average for these tasks, how old would you
expect her to be?
a. 2 years old
b. 4 years old
c. 7 years old
d. 10 years old
3.
8
Ans. C
Con
p. 79
M
Which of the following sequences of developmental tasks is CORRECTLY
ordered?
a. attachment > academic competence > self-reliance
b. empathy > emancipation > self-reliance
c. attachment > self-reliance > academic competence
d. academic competence > emancipation > autonomy
3.
9
Ans. D
App
p. 79
M
Tommy is learning how to develop autonomy while also responding to parental
control of impulses, and he is beginning to use language. Which of the
following is NOT related to the timing and nature of these achievements?
a. cultural practices
b. Tommy's age
c. earlier developmental tasks
d. none of the above
3.
10
Ans. B
Fac
p. 79
E
Developmental tasks are linked to psychopathology in that
a. developmental tasks cause psychopathology.
b. a child's failure to successfully handle an early developmental task can
adversely affect later coping capacities.
c. the genetic factors affecting the nature and timing of developmental tasks are
also influential in childhood disorders,
d. There is no evidence linking developmental tasks in childhood with
psychopathology.
3.
11
Ans. C
App
p. 79
M
Bonnie is 14 years old and has had a great deal of difficulty achieving a sense
of competence and industry in school. As she approaches the task of
emancipation from her family in the future, what prediction is MOST
defensible?
a. Bonnie will fail to achieve emancipation and will develop some form of
pathology as an adult.
b. Bonnie will be delayed in achieving emancipation but will successfully do so
by her mid 20's without special assistance.
c. Bonnie will need additional support from her environment in order to
achieve emancipation on par with her peers.
d. Provided that Bonnie's earlier crucial tasks of attachment and autonomy were
achieved, she will achieve emancipation without difficulty.
*
59
312
Ans. D
App
p. 80
M
Jane is a developmental psychologist conducting research on parent-infant
attachment. In her study, parents bring their infants into a room with a stranger.
After a few moments the parents depart, leaving the infant with the stranger,
The method Jane is using to assess attachment is the
a. Situational Attachment Protocol.
b. Separation Distress Appraisal.
c. Attachment Assessment.
d. Strange Situation.
3.
13
Ans. A
App
p. 81
M
Two infants are being observed in Ainsworth's laboratory. Sara is not visibly
upset when her mother leaves the room and is disinterested in her mother when
she returns. Mark is moderately distressed when his mother leaves and wants to
be held by her when she returns. Sara has a(n)
attachment, and Mark,
a(n)
attachment.
a. insecure; secure
b. resistant; insecure
c. secure; secure
d. insecure; excessive
3.
14
Ans. B
App
p. 81
M
Which of the following infants is MOST likely to have a resistant/insecure
attachment?
a. Leon, a Black American infant
b. Tani, a Japanese infant
c. Susana, a Mexican infant
d. Leah, a Caucasian American infant
3.
15
Ans. C
App
p. 81
E
If a pediatrician sees a group of mother-infant patients that is representative of
the larger population, which attachment pattern will he see most frequently?
a. insecure/avoidant
b. insecure/distressed
c. secure
d. nondistressed
3. 16
Ans. D
App
p. 81
M
Ali is an infant who showed a secure attachment pattern according to
Ainsworth's assessment. Ali would thus be expected to
a. have a reduced risk of developing childhood behavior problems compared to
infants with other patterns.
b. function about the same in adult life as will infants who show an insecure
attachment pattern.
c. function better in adult life than will children who show an insecure
attachment pattern.
d. both a and c
3.
17
Ans. A
Con
p. 81
M
Which of the following terms does not belong with the other three?
a. adult monkeys
b. Suomi
c. elevated stress-related chemicals
d. separation distress
60
3.
18
Ans. B
App
p. 81
M
If Suomi's research were found to be replicable with humans, which of the
following characteristics would most closely apply to Ricky who has an insecure
attachment to his mother?
a. a negative temperament
b. elevated levels of epinephrine, a stress-related chemical
c. a history of early, repeated separation from his mother
d. mild mental retardation
3.
19
Ans. C
App
p. 81
M
"All children at one time or another display some symptoms of abnormal
behavior. For some children, however, these symptoms are more severe and
chronic and thus warrant intervention. " What approach does this speaker
appear to take to classifying childhood disorders?
a. categorical
b. diagnostic
c. dimensional
d. classical
3.
20
Ans. D
Con
p. 81
M
Which of the following terms does not belong with the other three?
a. categorical approach
b. use of structured interviews
c. administration of formal psychological tests
d. statistical criteria
3.
21
Ans. A
App
p. 82
M
*
Dr. Lawr employs a dimensional approach in the assessment of her child
clients. As a result, on what sort of criteria will she probably rely in order to
group together her clients' various symptoms?
a. statistical
b. experiential
c. theoretical
d. DSM-IV symptom clusters
3.
22
Ans. B
App
p. 82
E
Dr. Strangeglove is using the CBCL to asses Tim, a seven-year-old male. Tim
is hyperactive, inattentive, and often aggressive. Dr. Strangeglove would
probably conclude that
a. Tim would have somatic problems such as nausea and headaches.
b. Tim would have high scores on the externalizing dimension of the CBCL.
c. Tim would have high scores on the internalizing dimension of the CBCL.
d. Tim would have high scores on the oppositional/defiant dimension of the
CBCL.
3.
23
Ans. C
App
p. 82
E
Trish is failing to interact with peers, due in part to her depressed mood. Trish
also complains about several somatic symptoms. Her symptoms are
characteristic of which dimension of the CBCL?
a. passive/overcontrolled
b. introverted
c. internalizing
d. undercontrolled
61
3.
24
Ans. D
App
p. 82
M
Doris is described by her counselor as exhibiting several "externalizing"
problem behaviors. Which of the following would NOT be included in this
description?
a. impulsivity
b. aggressiveness
c. delinquent, nuisance behaviors
d. somatic complaints
3.
25
Mr. Evanoff, a school counselor, is reviewing a student's CBCL. If the
Ans. A
counselor is most concerned with the student's overcontrolled behaviors, on
App which of the following scales would he concentrate?
p. 82
a. anxious/depressed
E
b. social problems
c. externalizing behaviors
d. thought problems
3.
26
Ans. D
App
p. 83
C
On the CBCL profile, Marty's two highest scores are found on the delinquent
and aggressive behavior scales. His scale scores are 64 and 60, respectively.
What description would you give Marty?
a. externalizing
b. internalizing
c. conduct disordered
d. normal
3.
27
Ans. C
Fac
p. 83
E
The two most common reasons children are referred to mental health clinics are
a. neglect and abuse by parents.
b. depression and anxiety.
c. disruptive behaviors and attention deficits.
d. delinquency and learning disorders.
3.
28
Ans. B
App
p. 84
M
Chad has been referred to a child guidance clinic for a disorder that occurs in
approximately 5 percent of the general U. S. population. What disorder is this?
a. ODD
b. ADHD
c. childhood anxiety
d. learning disability
3.
29
Ans. A
App
p. 84
E
Bobby is an eight-year-old male and Sally is a seven-year-old female. In regard
to the disorders most commonly seen in clinics, one could conclude that
a. Bobby is 2 to 3 times more likely than Sally to develop these disorders,
b. Sally is 5 to 6 times more likely than Bobby to develop these disorders.
c. Bobby is 5 to 6 times more likely than Sally to develop these disorders.
d. Sally and Bobby have about the same chance of developing these disorders.
3.
30
Ans. D
App
p. 84
E
*
Dalila is a fourth-grade student. Compared to the males in her school classes,
she is MORE likely to exhibit which of the following disorders?
a. ADHD
b. ODD
c. CD
d. none of the above
62
3.
31
Ans. B
App
p. 84
M
*
3.
32
Ans. C
App
p. 84
M
Keith has a DSM-IV disorder that is among those most commonly seen in
mental health clinics. His disorder is also most likely to occur without
comorbidity. What disorder is this?
a. an anxiety disorder
b. attention-deficit hyperactivity disorder
c. oppositional defiant disorder
d. a pervasive developmental disorder
Mrs. and Mr. Baez are at their wits' end with their 7-year-old son, Eddie. In
their first clinic session, they describe how difficult it is to get Eddie to come to
dinner, do his homework, or do the simplest tasks around the house without a
full-blown temper tantrum. What disorder is most likely for Eddie?
a. conduct disorder.
b. preadolescent hyperactivity disorder.
c. oppositional defiant disorder.
d. inattentive defiant disorder.
3.
33
Ans. B
App
p. 85
M
Dr. Yahoo is concerned that psychologists in his area may be over diagnosing
ODD. Dr. Yahoo's concern is probably based on which of the following?
a. the lack of clear DSM-IV criteria for ODD diagnosis
b. the fact that ODD symptoms occur at a very high base rate in the general
population
c. the failure of clinicians to verify that behaviors are actually potentially
harmful
d. an excessive reliance on the CBCL that has been shown to "overpatiiologize"
children's behaviors
3.
34
Ans. B
App
p. 85
M
Dr. Licht is conducting a treatment program for children with ODD. If he were
to follow his preschool children through third grade (about age 9), one could
predict that
will still have significant disruptions in adaptive functioning.
a. one half
b. one third
c. one quarter
d. one eighth
3.
35
As a clinician, you are speaking with a third-grade teacher who is concerned
Ans. C
about one of her students, Aaron, who has been diagnosed with ODD. Which
App of the following observations by the teacher is LEAST likely to predict
p. 85
continuing problems for Aaron?
E
a. Problems with ODD are seen in school and at home.
b. Aaron shows some aggression and hyperactivity.
c. Moderate levels of stress are present in Aaron's family.
d. Aaron engages in covert behaviors such as lying and stealing.
3.
36
Dr. Jones is a child psychologist attempting to make a DSM-IV diagnosis of a
Ans. D
9-year-old male's disruptive behavior. Which of the following would MOST
App likely lead Dr. Jones to make a diagnosis of conduct disorder?
p. 85
a. The child acts inappropriately at school, at home, and in public.
E
b. The child is verbally abusive to parents and teachers.
*
c. The child is hyperactive, inattentive, and impulsive.
d. The child exhibits behaviors that are harmful to others or to property.
63
3.
37
Ans. B
App
p. 86
M
If Masako has been diagnosed with CD, you would know that he has been
exhibiting his aggressive, destructive, and deceitful symptoms for at least
a. 2 years.
b. 12 months.
c. 6 months.
d. 3 months if ADHD has previously been diagnosed.
3.
38
Ans. A
App
p. 86
M
Jacques is a 10-year-old male whose disruptive, undercontrolled behavior is
being assessed by a school counselor. If CD is likely, which of the following
DSM-IV symptom categories is NOT relevant?
a. manipulation of others
b. destruction of property
c. aggression
d. serious violation of rules
3.
39
Ans. C
App
p. 86
E
Max's parents have refused to get a new pet after 11-year-old Max drowned the
family cat. His parents also insist that someone always be at home with Max,
fearing that he may start a fire if left to his own devices. What DSM-IV
disorder is MOST likely?
a. antisocial personality disorder, juvenile onset
b. ODD
c. CD
d. adolescent-onset disruptive disorder
3.
40
Ans. C
App
p. 86
M
Which of the following CD children is MOST likely to "grow out" of his
disorder by the end of his teenage years?
a. Reggie, with a childhood onset at age 8
b. Mark, with a childhood onset at age 10
c. Alvin, with an adolescent onset at age 12
d. none of the above; this disorder virtually always leads to adult disorders
3.
41
Ans. D
App
p. 86
E
According to several longitudinal studies on CD, whom of the following would
experience the greatest academic difficulty and be most likely to develop adult
antisocial problems?
a. Mike, a 15-year-old male diagnosed with CD
b. Gary, an 18-year-old college student prone to burning text books after each
term
c. Marsha, a 7-year-old female who is prone to physically aggressive behavior
d. Brandt, an 8-year-old male diagnosed with CD
3.
42
Ans. A
App
p. 86-7
M
Dr. Ogata has seen 100 clients in his specialized practice for the treatment of
conduct disorder. If all of them had met DSM criteria by age 13, how many are
likely to exhibit antisocial personality disorder as adults?
a. 25
b. 40
c. 55
d. 66
64
3.
43
Ans. B
Fac
p. 87
E
What is the central difference between a diagnosis of CD versus antisocial
personality disorder?
a. the severity of aggressive and destructive behaviors
b. the age of the diagnosed individual
c. the severity of parental criminal behavior
d. the presence of substance abuse
3.
44
Ans. C
Con
p. 87
C
For what reason has it been difficult to establish a causal relationship between
elevated testosterone levels and long-term antisocial behavior in males?
a. Both animal and human studies have produced very inconsistent results,
b. The comorbidity of substance abuse in disordered adolescents makes
accurate hormonal measurement difficult.
c. The direction of the causal relationship has not been determined through
prospective research.
d. Antisocial behaviors occur with almost equal frequency in females.
3.
45
Ans. D
App
p. 87
E
Daniel is a 14-year-old male with a disruptive behavior disorder that includes
aggressiveness and acts of property destruction. What neurotransmitter is
associated with these behaviors?
a. norepinephrine
b. dopamine
c. testosterone
d. serotonin
3.
46
Ans. C
App
p. 87
M
*
Which of the following adolescents is MOST likely to display symptoms of a
disruptive externalizing disorder?
a. Terrance, who has a high resting heart rate and quick startle response
b. Joshua, who has a high level of serotonin in his brain
c. Jackson, who has a very low skin conductance rate
d. Ramon, who has a low level of GABA in his brain
3.
47
Ans. D
Con any
p. 87-8
E
If you wished to predict which adolescents might be at greatest risk of CD and
later adult criminal behavior, you might conduct prospective research involving
of the following EXCEPT
a. the neurotransmitter dopamine.
b. skin conductance levels and heart rate.
c. a family adversity index.
d. comorbid depressive and anxious symptoms.
3.
48
Ans. B
App
p. 88
M
Which of the following children has the greatest chance of being diagnosed
with conduct disorder?
a. Janet, a three-year-old female in foster care with a lower SES family
b. Jim, a ten-year-old male with deficits in executive functioning
c. Akoni, a nine-year-old male with below average grades and few friends
d. Amee, a seven-year-old female whose parents have recently divorced and
who is prone to frequent temper tantrums
65
3.
49
Ans. A
Con
p. 88
M
Which of the following terms does not belong with the other three?
a. adolescent-onset CD
b. deficits in neuropsychological abilities
c. executive functioning
d. language processing
3.
50
Ans. A
App
p. 88
M
Brian wants the new Han Solo action figure set. When his mother refuses to
buy it for him, he complains loudly and becomes verbally abusive. His
mother eventually gives in and buys him the action figure set; Brian
immediately stops his aversive behavior. Brian and his mother's behaviors are
an example of
a. coercive cycles.
b. circular causality.
c. the parent/child exchange theory.
d. dyadic-aversive behavior patterns.
3.
51
Ans. A
App
p. 88
M
Cecil and his mother are engaged in a dispute. If Cecil is diagnosed with a
dismptive behavior disorder, you might expect to see each of the following
behaviors from his mother EXCEPT
a. close physical proximity.
b. frequent criticism of Cecil's actions.
c. issuance of commands to Cecil to stop talking back to her, stop yelling, etc.
d. eventual reinforcement of his aversive behaviors in a coercive cycle.
3.
52
Ans. B
App
p. 88
M
Deedee is the mother of a teenager, Roy, with CD. When Deedee interacts
with her best friend's teenage son, Derrick, who is NOT disordered, Deedee
will
a. be as reactive to Derrick's negative behaviors as she is toward Roy's.
b. be less critical of Derrick than she is of Roy.
c. be as "bossy" toward Derrick as she is with Roy.
d. readily establish a coercive cycle with Derrick as she has with Roy.
*
3.
53
Ans. C
App
p. 88
E
Dr. Bond is working with preschoolers who have been referred to her clinic
for ODD. She would expect that approximately
% of them demonstrate
insecure attachments.
a. 52
b. 66
c. 80
d. 94
3.
54
Ans. D
Con
p. 88
M
What do coercive cycles, a high family adversity index, and insecure
attachment have in common?
a. Each is a contributing factor to many internalizing disorders,
b. They describe the home environment of children with ADHD.
c. They each describe the primary causal factor in dismptive disorders,
d. Each is a contributing factor to CD.
66
3.
55
Ans. A
App
p. 89
M
When she was accidentally pushed by another student, Melanie fell against
Todd's desk and caused him to ruin a picture he was painting. If Todd has
CD, how will he interpret Melanie's action?
a. as a deliberate act of aggression
b. as an attempt to get his attention but not necessarily a sign of aggression
c. as a possible act of aggression that should be ignored
d. as an accident
3.
56
Ans. B
App
p. 89
M
Zuri is a female with CD. Her tendency toward aggressive behaviors may be
due to each of the following factors EXCEPT
a. low levels of serotonin,
b. low levels of estrogen.
c. deficits in attributional processing during conflicts,
d. inadequate executive functioning.
3.
57
Ans. C
App
p. 89
M
Which of the following children is at GREATEST risk for severe aggressive
behaviors?
a. Kito, a male with low neuropsychological test scores,
b. Mali, a male with high family adversity scores.
c. Charlie, a male with low neuropsychological test scores and high family
adversity scores,
d. Each of the children is at equal and high risk.
3.
58
Ans. C
App
p. 90
M
As Payat's clinician, you are employing the most effective and best studied
treatment intervention for Payat's CD. In other words, you are using
a. cognitive-behavioral individual therapy for Payat.
b. social skills training for Payat in a group therapy format.
c. training in specific parenting skills for Payat's parents,
d. Any of the above is possible.
3.
59
Ans. D
App
p. 90
M
A graduate student is working with Dr. Eyberg, treating disruptive behavior
disorders. Which therapy approach is the graduate student employing?
a. the FAST Track System
b. Behavioral Management Skill Training
c. Self-Instructional Therapy
d. Parent-Child Interaction Therapy
3.
60
Ans. A
App
p. 90
M
Kurt and his family have successfully completed Dr. Eyberg's parent training
program for Kurt's CD. Why might the long-term benefits of this therapy be
limited, according to available research?
a. The original training generalizes poorly to new settings.
b. Kurt has adolescent-onset CD.
c. Insufficient attention was given to Kurt's participation in the coercive
cycles.
d. Kurt's family had too low a family adversity score at the beginning of
treatment.
67
3.
61
Ans. B
Con
p. 90
M
Which of the following treatments is NOT commonly used to treat disruptive
behavior disorders?
a. skills training for parents
b. medication
c. cognitive restmcturing for children
d. problem-solving training and anger management for children
3.
62
Ans. D
Fac
p. 91
E
*
3.
63
Ans. A
Con
p. 91
C
What do PMHP and FAST Track have in common?
a. They are types of parent-training programs for children with externalizing
disorders.
b. They are school-based programs used to treat the academic and social
deficiencies of children with ADHD.
c. They are multifaceted, longterm intervention programs for children
diagnosed with disruptive behavior disorders,
d. They are school-based programs aimed at preventing CD in high-risk
elementary school children.
Which of the following descriptions does not belong with the other three?
a. documented improvements in social and academic functioning at age 14
b. 6-year nationwide prevention program
c. school-based social skills and reading skills training
d. home-based parenting training and stress management training
3.
64
Ans. B
App
p. 91
M
If Collette is in the FAST Track program, she is believed to be
a. in need of intensive treatment for ADHD and comorbid ODD.
b. at risk for developing later conduct disorder.
c. at risk for developing later internalizing disorders.
d. in need of early intervention for symptoms of an eating disorder.
3.
65
Ans. D
App
p. 92
E
A clinician is interviewing a child whom he suspects may have ADHD. In
order to make a DSM-IV diagnosis of ADHD the clinician must find which of
the following?
a. clinically significant impairment in two or more settings
b. excessive inattention or excessive hyperactivity/impulsivity
c. oppositional behavior toward adults
d. both a and b
3.
66
Ans. D
App
p. 92
M
Eric is extremely active when compared to his classmates, demonstrates more
inattention and impulsiveness, and his teacher has trouble keeping him under
control. Nonetheless, he usually completes his assignments on time and gets
along well with most of his peers. Eric would be diagnosed with
a. ADHD, combined type.
b. ADHD/hyperactive subtype.
c. ADHD/inattentive subtype.
d. nothing; his behavior does not merit a diagnosis of ADHD.
3.
67
Ans. C
App
p. 92
M
Which of the following children is MOST likely to be diagnosed with ADHD?
a. Emma, an 8-year-old from a lower-class family
b. Brian, a 9-year-old from an upper-middle-class family
c. Chuck, an 11-year-old from a lower-class family
d. Tammy, a 10-year-old from a middle-class family
68
3.
68
Ans. B
App
p. 92
E
As a new public school teacher, you have many challenges ahead of you.
Among them will be classroom discipline which will be made more difficult
by the presence of children with ADHD. Based on national prevalence data,
you could expect _____ percent of your students to meet DSM-IV criteria.
a. 10 to 12
b. 3 to 9
c. 2 to 5
d. 1 to 3
3.
69
Ans. B
App
p. 92
E
Monica and Rick are children with ADHD who come from lower SES
families. Each of the following are cited by the text as possible explanations
for such children's slightly higher ADHD prevalence EXCEPT
a. inadequate health care.
b. parental criminal behavior.
c. general family instability.
b. higher rates of pregnancy complications.
3.
70
Ans. A
Fac
p. 92
E
Which of the following is NOT one of the ADHD subtypes?
a. oppositional
b. hyperactive
c. inattentive
d. combined
3.
71
Ans. A
App
p. 92
M
John has ADHD, hyperactive subtype. He is MORE likely to demonstrate
which of the following, compared to ADHD children without hyperactivity?
a. low popularity among peers
b. comorbid sensory-motor problems and learning disorders
c. academic underachievement
d. anxiety
*
3.
72
Ans. B
App
p. 92
M
The local high school guidance counselor is reviewing the files of this year's
new students. Of the students who were diagnosed with ADHD as children,
she can expect that roughly
percent will still meet diagnostic criteria in
mid-adolescence, and about _
_ percent of those will also exhibit CD.
a. 75; 33
b. 70; 50
c. 66; 30
d. 50; 50
69
3.
73
Ans. C
App
p. 92
M
*
As a clinician, you are talking with the parents of a young child you diagnosed
with ADHD/inattentive type. The parents are concerned that the ADHD
behavior will persist as the child enters adolescence. What should you tell
these parents?
a. Children diagnosed with ADHD in early elementary school rarely show
persisting symptomatology in adolescence.
b. Children with the inattentive subtype usually develop hyperactive
symptoms during adolescence, though the impact can be lessened with
medication.
c. The child's primary symptoms are likely to persist but will probably
dissipate in early adulthood.
d. There is little chance the ADHD symptoms will persist beyond childhood
because the child's ADHD is not comorbid with a disruptive behavior
disorder.
3.
74
Ans. D
App
p. 93
M
If Katie has ADHD with the subtype suspected to be more common for
females, she could exhibit any of the following symptoms in that category
EXCEPT
a. difficulty organizing tasks and activities.
b. failure to give close attention to detail.
c. loss of items necessary for activities.
d. difficulty playing quietly.
3.
75
Ans. A
Con
p. 93
M
Which of the following subtype symptoms does not belong with the other
three?
a. often does not follow through on instructions
b. often fidgets with hand or feet
c. often talks excessively
d. often has difficulty awaiting turn
3.
76
Ans. B
App
p. 93
E
For which of the following persons would you be MOST skeptical of a DSMIV ADHD diagnosis?
a. Cassie, a 14-year-old female
b. Roscoe, a 25-year-old male
c. Katrina, a 7-year-old female
d. Ted, an 8-year-old male
3.
77
Ans. C
App
p. 93
M
Matt is 35 years old. He was diagnosed with ADHD when he was 6 years
old. If he is typical of adults with this history, which of the following
outcomes is MOST likely?
a. Matt will develop a substance abuse disorder.
b. Matt will develop a comorbid depression or anxiety disorder.
c. Matt will have residual difficulties but will no longer meet diagnostic
criteria.
d. None of the above is correct.
3.
78
Ans. D
Fac
p. 94
E
"Minimal brain dysfunction" is an earlier term for the disorder now called
a. ODD.
b. learning disability,
c. autism.
d. ADHD.
70
3.
79
Ans. A
App
p. 94
M
Palani is a 6 year-old child with a disorder that was formerly called "minimal
brain dysfunction. " Which of the following early life problems is probably
NOT associated with possible underlying brain dysfunction?
a. lead poisoning
b. his mother's alcohol consumption during pregnancy
c. low birth weight
d. prolonged oxygen deprivation at birth
3.
80
Ans. B
App
p. 94
E
Nine-year-old Toshio is taking a prescribed stimulant medication for his
childhood disorder. This medication will
the availability of
his brain.
a. increase; GABA
b. increase; catecholamines
c. decrease; norepinephrine
d. decrease; endorphins
3.
81
Ans. C
Con
p. 94
M
Which of the following terms does not belong with the other three?
a. thyroid disease
b. gene mutation
c. conduct disorder
d. metabolism acceleration
3.
82
Ans. D
Con
p. 94
E
*
If it were possible to regulate the hyperactivity and impulsivity of ADHD
children by implanting a neural impulse generator in a child's brain, what brain
structure would you target?
a. LGN of the thalamus
b. temporal lobes
c. cingulate gyrus
d. RAS
3.
83
Ans. A
Fac
p. 95
E
Preliminary MRI studies suggest that
may play a role in the
impaired planning and executing of goal-directed behavior in ADHD.
a. the frontal lobes
b. the RAS
c. prolonged oxygen deprivation at birth
d. maternal intrusiveness
3.
84
Ans. B
Fac
p. 94-5
E
Brain abnormalities have been linked to ADHD. Which of the following is
NOT a focus of such studies?
a. an ineffective thyroid
b. the presence of cerebral asymmetry
c. undeiarousal of the RAS
d. impaired frontal lobe activity
3.
85
Ans. C
App
p. 95
M
Stanley, a 42-month-old child, is interacting with his mother. If Jacobvitz and
Sroufe observe this interaction and make the prediction that Stanley is at risk
for later hyperactivity, how might his mother be described?
a. aloof and critical
b. overprotective
c. overstimulating
d. anxious and insecure
71
in
.
86
Ans. D
App
p. 95
M
Two-year-old Sven has an underaroused RAS, and his mother often wakes him
from his naps prematurely and tries to play games with him long after his
interest has waned. If he were to develop a childhood disorder, which of the
following is it likely to be?
a. oppositional defiant disorder
b. separation anxiety disorder
c. an eating disorder
d. attention-deficit/hyperactivity disorder
3.
87
Ans. A
App
p. 96
E
Dr. Yates is a psychiatrist specializing in pediatric psychiatry. Which of the
following would she NOT prescribe to a child with ADHD?
a. Benzedrine
b. Dexedrine
c. Cylert
d. Ritalin
3.
88
Ans. B
App
p. 96
M
Dr. Teramoto is a pediatrician who specializes in treating children with
ADHD. Of his 20 patients, how many are likely to show a positive response
to medication?
a. 17
b. 14
c. 10
d. 8
3.
89
Ans. C
App
p. 96
C
Dax, a fifth grade student, and Connelly, a four-year-old boy, have both been
diagnosed with ADHD. Dax and Conelly's respective physicians have
prescribed Dexedrine to treat their symptoms. It would be expected that
a. Both Dax and Connelly would respond equally well to medication.
b. Connelly would show a more consistent response to the medication than
would Dax.
c. Dax would show a more consistent response to the medication than would
Connelly.
d. Neither Dax nor Connelly would be expected to show a positive response.
3.
90
Ans. D
App
p. 96
M
As a parent of an ADHD child, you are concerned that the medication your
child is taking to treat the disorder may stunt his/her growth. According to the
text what would your child's clinician recommend to avoid this possibility?
a. a vegetarian diet
b. vigorous exercise to stimulate muscle development
c. reductions in dosage levels
d. periodic drug holidays
72
3.
91
Ans. A
App
p. 96
M
Forrest, a ten-year-old male, took his ADHD medication at breakfast around
7: 30 A. M. Forrest was in a hurry and forgot to take his midday dosage to
school. According to the text, Forrest will most likely experience
a. a rebound effect in the early afternoon with his ADHD symptoms returning
stronger than ever.
b. a decrease of arousal as the day progresses due to the fact that the
stimulant will wear off.
c. abdominal pains, headaches, and a loss of appetite four to five hours after
his last dosage.
d. normal levels of arousal throughout the day.
3.
92
Ans. B
Fac
p. 96
M
Which of the following outcomes is LEAST likely for children taking
stimulant medication?
a. improved social relationships
b. long-term academic gains
c. side effects of decreased appetite and physical discomfort
d. improved attention to relevant environmental stimuli
3.
93
Ans. C
App
p. 96
M
When Brandon, a child with ADHD, finishes his assigned school task and
stays in his seat during the reading period, all of the children in the class get
an additional 15 minutes to spend at recess. What is the name for this
intervention approach?
a. yoked control
b. classroom management
c. group contingency
d. conformity reinforcement
3.
94
Ans. A
Fac
p. 96
E
Which of the following treatment methods is MOST likely to effectively treat
the core symptoms of ADHD?
a. medication
b. home-school behavior management procedures
c. cognitive-behavioral interventions
d. All of the above are likely to be effective.
3.
95
Ans. C
App
p. 97
M
If Clara participates in an intensive educational program for ADHD and also
takes medication for her disorder, to what factor will Clara probably attribute
her growing self-confidence and sustained attention?
a. to the drug's effects
b. to the program's training
c. to her own efforts
d. either a or b
*
73
3.
96
Ans. D
Con
p. 97
M
In your report on the issues which should be carefully considered in regard to
the use of Ritalin, you could include each of the following statements
EXCEPT
a. The use of the drug has increased sharply in the past several years and may
still be increasing, perhaps without sufficient cause.
b. Doctors may give prescriptions based on parents' reports only and may fail
to communicate with teachers about proper drug use.
c. The history of impassioned controversy regarding the drug may create
misleading impressions of its usefulness.
d. Children who are given the drag typically develop later adult substance
abuse disorders.
3.
97
Ans. B
App
p. 98
E
Dr. Okamoto specializes in the treatment of childhood internalizing disorders.
Of the 10 children she is currently treating for anxiety disorders, how many
probably also exhibit diagnosable depression?
a. 8
b. 6
c. 4
d. 1
3.
98
Ans. D
App
p. 98
M
A child psychologist is assessing the presence and severity of anxiety in a
child who has been referred to him. In order to diagnosis some type of
disorder, what symptom(s) must be present?
a. nervousness and foreboding about common present and future events
b. insomnia combined with physical symptoms such as nausea, rapid heart
rate, and sweating
c. disruptive behavior and academic impairment lasting at least two weeks
d. persistent anxiety across several weeks or months, interfering significantly
with age-expected activities
3.
99
Ans. A
Con
p. 98
C
*
Until recently, childhood anxiety disorders received less attention from
clinicians and researchers than disruptive disorders for each of the following
reasons EXCEPT
a. disruptive disorders are more common than are anxiety disorders.
b. anxiety disorders have less impact on adults than do disruptive disorders.
c. assessment of internalizing disorders is more difficult than that for
externalizing disorders,
d. anxiety is a more normal facet of daily experience and potentially more
adaptive than disruptive behavior.
3. 100
Ans. C
App
p. 99
M
Anthony began to develop anxiety symptoms around age 11. His symptoms
have gradually worsened to the point where Anthony becomes inappropriately
apprehensive about numerous everyday occurrences, such as his father taking a
different route when he drives Anthony to school or a new teacher in his class
room. Anthony may suffer from
a. agoraphobic anxiety disorder.
b. undifferentiated anxiety disorder.
c. generalized anxiety disorder.
d. residual anxiety disorder.
74
3.
101
Ans. D
Con
p. 99
E
Which of the following is FALSE in regard to separation anxiety disorder?
a. Children are typically not diagnosed with this disorder until 8 or 9 years of
age.
b. Separation anxiety reflects a developmentally inappropriate fear of
separation from those to whom the child is most closely attached.
c. Symptoms of separation anxiety may be a sign of good adjustment in
infants and young children.
d. This anxiety disorder is associated with prominent behavioral and cognitive
symptoms but somatic symptoms are uncommon.
3.
102
Ans. B
App
p. 99
M
Alexi appears to need his parents' help to complete even the simplest of tasks,
including tying his shoes and deciding what lunch box to take to school. He is
very worried about his parents' well being and reports frequent nightmares in
which his parents are the victims of horrible accidents. Alexi most likely
suffers from which of the following?
a. specific phobia
b. separation anxiety disorder
c. dependent personality disorder of childhood
d. parental attachment disorder
Mr. and Mrs. Cliett are concerned about Billy's separation anxiety disorder and
its longterm consequences. Which of the following is probably of greatest
concern in Billy's case?
a. school refusal
b. chronic physical ailments, such as headaches and stomach cramps
c. the development of comorbid specific phobias or social phobia
d. the development of aggressive behaviors toward siblings and parents
3.
103
Ans. A
App
p. 100
E
*
3.
104
Ans. B
Con
p. 100
M
If Russell's separation anxiety symptoms increase because his parents let him
stay home from school, thereby reducing Russell's worrying and distress
temporarily, what operant process is at work?
a. positive reinforcement
b. negative reinforcement
c. punishment
d. extinction
3.
105
Ans. C
App
p. 100
E
If Erika has a high level of inhibition in infancy, she may later develop
symptoms of a(n)
disorder.
a. depression
b. externalizing
c. anxiety
d. eating
3.
106
Ans. D
Con
p. 100
C
For which of the following anxiety-disordered children is a comorbid
depression disorder MOST likely?
a. Julie, a preschooler
b. Benne, a kindergartner
c. Ulani, a second grader
d. Muriel, a fifth grader
75
3. 107
Ans. A
Con
p. 101
M
Which of the following diatheses does not belong with the other three?
a. cerebral asymmetry
b. exaggerated perceptions of threat
c. inhibition
d. excess physiological arousal
3. 108
Ans. D
App
p. 101
M
Majan is receiving treatment for his anxiety disorder which stems from fear of
social scrutiny. In therapy, Majan is taught anxiety-inhibiting techniques such
as deep breathing and muscle relaxation. Over the course of his two-hour
therapy session Majan is asked to envision increasingly intense scenes, such as
having to introduce a speaker in front of a large crowd. What treatment
method is this?
a. in vivo exposure
b. self-reinforcement
c. coping skills training
d. systematic desensitization
3. 109
Ans. D
App
p. 102
E
Ivan suffers from astraphobia (fear of storms, thunder, and lightning). Which
of the following is LEAST likely to be used in the treatment of this disorder?
a. peer modeling
b. systematic desensitization
c coping skills training
d. interpersonal therapy
3. 110
Ans. C
App
p. 102
M
You are a graduate student conducting research with Dr. Kendall, and you are
involved in his study of treatment for childhood anxiety disorders. This means
that you are offering
therapy to your participants.
a. group contingency reward
b. behavioral management
c. cognitive-behavioral
d. medication and interpersonal
3.
111
Ans. A
App
p. 102
E
Carlos was one of Dr. Kendall's participants in the first controlled study of the
treatment of childhood anxiety disorders. If Carlos exhibited characteristics
that are typical for children in the study, which of the following is LEAST
likely?
a. He exhibited short-term symptom improvement that dissipated six months
after treatment ended.
b. He became indistinguishable from normal peers in regard to symptom
severity at the end of treatment.
c. He maintained his gains on the CBCL internalizing scales one year after
treatment ended.
d. He received a combination of several cognitive-behavioral treatments.
3. 112
Ans. B
Con
p. 102
M
Medication is particularly useful for the treatment of
been established as an effective treatment for _ _ _ _ _ _
a. childhood depression; ADHD
b. ADHD; childhood anxiety disorders
c. CD; childhood depression
d. childhood anxiety disorders; eating disorders
*
76
but has not
3.
113
Ans. C
App
p. 103
E
If William experiences a persistent depressed mood in childhood, he is
a. unlikely to experience clinical depression as an adult.
b. twice as likely to experience depression as an adult.
c. four times as likely to experience depression as an adult.
d. likely to develop a comorbid conduct disorder as an adolescent.
3.
114
Ans. D
App
p. 103
M
Nine-year-old Leon has been referred to a psychiatric clinic by his physician
who has found no medical reason for Leon's stomach pains and headaches
which have lasted for a few months. During examination, Leon appears
irritable and lethargic and makes several self-deprecating remarks. What
disorder is likely?
a. posttraumatic stress disorder of childhood
b. negative affectivity
c. separation anxiety disorder
d. depression
3.
115
Ans. D
Fac
p. 103
E
Which of the following adult symptoms of depression is NOT exhibited by
children with depression?
a. hopelessness
b. low self-esteem
c. suicidal thoughts
d. none of the above
3.
116
Ans. A
Con
p. 103
E
What do children and adolescents' substance abuse, reckless play, and other
high-risk behaviors have in common?
a. They could be signs of suicidal feelings.
b. They are core symptoms of ADHD, impulsive type.
c. They could be signs of an underlying eating disorder.
d. They are behavioral signs of long-term insecure attachment patterns.
3.
117
Ans. B
Con
p. 104
M
Given Dr. Susan Campbell's discussion of the high rates of comorbidity among
childhood disorders, on which diagnostic approach is she MOST likely to rely?
a. DSM-IV criteria
b. CBCL scale elevations
c. ICD-10 criteria
d. either a or b
3.
118
Ans. C
App
p. 105
M
At age 8, Keenan is
likely than Dora to show significant depression.
By age 15, Keenan will be
likely than Dora to show such symptoms.
a. much less; somewhat less
b. somewhat less; more
c. somewhat more; less
d. more; somewhat more
3.
119
Ans. D
Fac
p. 105
M
According to the text,
is/are present in nearly half of all
depressed children and adolescents.
a. a high level of serotonin
b. suicidal thoughts
c. conduct disorder
d. separation anxiety disorder
77
3.
120
Ans. A
Con
p. 105
C
Which of the following childhood disorders and biological findings are
mismatched?
a. depression: RAS underarousal
b. ADHD: frontal lobe deficits
c. anxiety: heightened physiological arousal
d. enuresis: disruptions in arginine vasopression release
3.
121
Ans. B
App
p. 105
M
If Layton is depressed and he has a depressed parent, which of the following
characteristics is LEAST likely?
a. Layton's family is less cohesive and supportive than are other families,
b. Layton's family expresses high levels of both negative and positive affect.
c. Layton's depressed parent is overcontrolling and insensitive to Layton's
emotional needs,
d. Layton's parents exhibit marital conflict and may be hostile toward Layton.
3.
122
Ans. C
App
p. 105
E
*
A clinician specializing in the treatment of depressed children is asked by the
parents of a client why she is not using tricyclics to treat their child's
depression. The clinician would probably respond in which of the following
ways?
a. Tricyclics are only used to treat adult depression.
b. Tricyclics are used to treat anxiety disorders, not depression.
c. Tricyclics should be given only to severely depressed children who fail to
respond to other treatments.
d. That's a good idea; why haven't I thought of that?
3. 123
Ans. D
Con
p. 105
M
Which of the following medications and disorders is mismatched?
a. Prozac: bulimia
b. Dexedrine: ADHD
c. imipramine: enuresis
d. Tofranil: childhood anxiety
3. 124
Ans. D
App
p. 105
E
Which of the following treatment approaches would you consider for a child
with a mild to moderate depression disorder?
a. cognitive restructuring and coping skills training
b. a tricyclic antidepressant
c. cognitive-behavioral group therapy
d. either a or c
3.
125
Ans. C
Con
p. 106-7
M
Which of the following does not belong with the other three?
a. unreasonable fear of gaining weight
b. disturbed perception of body shape or size
c. recurrent inappropriate compensatory behaviors
d. restricting type
78
3.
126
Jennifer exercises more than a world class athlete. She believes she is
Ans. B
overweight at 96 pounds and a height of 5'5". Jennifer consumes, on the
App
average, less than 200 calories per day and has had amenorrhea for three
p. 106 months. Jennifer suffers from which of the following?
E
a. anorexia nervosa, obsessive-compulsive type
b. anorexia nervosa, restricting type
c. bulimia nervosa, compensatory type
d. bulimia nervosa, restricting type
3.
127
Ans. A
App
p. 106
M
*
Alaqua has an eating disorder in which she avoids gaining weight through
extreme dieting and excessive exercise. What attitude does she probably hold
about food?
a. She is obsessed with food and spends a great deal of time cooking
elaborate meals for her family.
b. She often spontaneously thinks about food and is extremely distressed by
her inability to control her thoughts.
c. She rarely thinks about food except when she gains even the smallest
amount of weight, at which point she detests the thought of food.
d. She goes out of her way to avoid food-related stimuli, such as grocery
stores, television commercials for food, and restaurants.
3.
128
Ans. A
App
p. 106
E
If 16-year-old Angie has anorexia, which strategy is she MOST likely to
employ?
a. outright refusal to eat
b. excessive exercise
c. misuse of laxatives or diuretics
d. bingeing and vomiting
3.
129
Ans. B
App
p. 108
E
If you were a betting person and had to bet on whether Angelica, a fifteenyear-old female, or Mike, a fifteen-year-old male, had anorexia, what would
you expect your odds to be?
a. 15 to 1 in favor of Angelica
b. 10 to 1 in favor of Angelica
c. 4 to 1 in favor of Angelica
d. 2 to 1 in favor of Mike, despite popular belief to the contrary
3.
130
Ans. C
App
p. 108
E
Based on current data, what prediction would you make about next year's Miss
America winner?
a. She will have a body weight of about 90% of average, but this does not
meet DSM-IV criterion for anorexia.
b. She will have a body weight of about 82% of average, but this does not
meet the DSM-IV criterion for anorexia.
c. She will have a body weight of about 82% of average, and this meets the
DSM-IV criterion for anorexia.
d. She will have a body weight that is close to the female ideal reported by
both females and males.
79
3. 131
Ans. D
Fac
p. 108
M
According to Fallon and Rozin's (1985) study of college students' perceptions
of actual and ideal body shapes for females, which of the following represents
a CORRECT ordering from thinnest to heaviest?
a. male's attractive: female's ideal: female's attractive
b. female's ideal: male's attractive: female's attractive
c. male's attractive: female's attractive: female's current
d. female's ideal: female's attractive: male's attractive
3.
132
Ans. A
App
p. 108
C
Ana's body shape is equivalent to that chosen by college males as "most
attractive. " Given this, her body shape is THINNER than what females
themselves described as
a. their current body shape.
b. the most attractive body shape to males.
c. their ideal body shape.
d. both a and b
3.
133
Ans. B
Fac
p. 108
M
Which of the following statements is CORRECT in regard to college males'
ratings of their body shapes?
a. What males rated as "attractive to females" was the same body shape
described as attractive by the females.
b. What males rated as their "current" and "attractive" shapes were essentially
the same.
c. What males rated as their "ideal" shape was substantially thinner than their
"current" shape.
d. What males rated as their "current" shape was substantially thinner than
their "attractive to females" shape.
3.
134
Ans. C
App
p. 108
M
Dr. Skinner believes that his adolescent clients are struggling with the
development of adult sexuality by avoiding forbidden sexual objects and
activities. What diagnosis has Dr. Skinner given such clients?
a. separation anxiety disorder
b. social phobia
c. anorexia
d. depression, adolescent onset
3.
135
Ans. D
Con
p. 109
E
Which of the following concepts does not belong with the other three?
a. control of feeding behavior
b. amenorrhea
c. hypothalamus
d. arginine hormone
3. 136
Ans. D
App
p. 109
M
Libby is an 18-year-old female who has experienced amenorrhea for the past
two months. What might be causing this?
a. hypothalamic dysfunction
b. emotional distress
c. a deficiency of corticosteroids
d. either a or b
80
3.
137
Ans. A
App
p. 109
E
*
Micah eats enormous amounts of food then induces vomiting to rid herself of
the excess calories. Micah is especially prone to this pattern when she is
under emotional distress. On average, she tends to go through this cycle five
times a week. Micah suffers from which of the following?
a. bulimia/purging subtype
b. bulimia/anorexic subtype
c. anorexia nervosa
d. uncontrolled eating disorder
3.
138
Ans. C
Fac
p. 109
E
Unlike anorexics, individuals with bulimia tend to
a. be less healthy and more concerned with thinness.
b. suffer from more severe emotional problems.
c, be of normal weight or even somewhat overweight.
d. exercise more in order to become extremely thin.
3.
139
Ans. B
App
p. 109
M
Andrea is anorexic. Her primary goal is to
primary goal is to
.
a. lose weight; lose weight
b. be extremely thin; avoid being fat
c. avoid being fat; lose weight
d. lose weight; be extremely thin
3.
140
Ans. D
Fac
p. 109
E
Which of the following causal factors has NOT been implicated in bulimia?
a. media portrayal of ideal female body types
b. pathogenic family interactions
c. operant conditioning
d. disruptions in serotonin production
3.
141
Ans. B
App
p. 110
E
Emily has just begun treatment for anorexia. What will her therapist's first
goal be?
a. exploration of dysfunctional family communication patterns
b. an increase in body weight
c. an increase in self-esteem
d. confrontation of distorted body images
3.
142
Ans. A
App
p. 110
M
Adelina's parents are seeking a treatment program for their daughter who has
bulimia. If they are primarily concerned with reducing Adelina's bingeing and
purging, what would you recommend to them?
a. group psychotherapy
b. imipramine
c. anticonvulsant medication
d. self-administered punishment conditioning
3.
143
Ans. D
App
p.
111
M
Alvin is three years old. His parents are distressed by the fact that he has wet
his bed at night several times in the past few months. What diagnosis is
appropriate?
a. encopresis
b. enuresis
c. developmental delay syndrome
d. none
81
. Stella is bulimic. Her
3.
144
Ans. B
App
p. 111
M
Dr. Mills is talking with the parents of a child who has just been diagnosed
with enuresis. What prognosis should Dr. Mills make?
a. The child will probably outgrow the disorder in about a year.
b. The child will probably outgrow the disorder in about three years.
c. The disorder is probably being caused by marital discord and other family
stress and will subside once these issues are addressed,
d. None of the above is correct.
3.
145
Ans.
C
Fac
p.
111
E
If a child has an irregular release of arginine vasopressin, what disorder may
result?
a. an eating disorder
b. encopresis
c. enuresis
d. bipolar disorder of childhood
3.
146
Ans. A
App
p. 112
E
Ned is participating in dry-bed training for his enuresis. Which of the
following components is NOT involved?
a. bell-and-pad warning system
b. remaking the bed himself and changing clothes after an accident
c. parental reinforcement for avoiding accidents
d. practicing getting out of bed and using the toilet
3.
147
Ans. D
Fac
p. 105, 111
E
Which of the following disorders is more common in females than in males?
a. enuresis
b. preadolescent depression
c. encopresis
d. none of the above
SHORT ANSWER I ESSAY
3.
148
Describe the three primary components of the CBCL and list their respective scales.
What sort of classification system does this assessment procedure represent?
1. Internalizing - overcontrolled behaviors; deficits in desired behaviors that usually
cause subjective distress in the child.
Three scales: withdrawn, somatic complaints,
anxious/depressed.
2. Externalizing — undercontrolled behaviors; excesses of undesirable or nuisance
behaviors. Two scales: aggressive behavior and delinquent behavior.
3. Additional scales that are not sufficiently closely related to the above dimensions,
according to statistical criteria, but are important in assessing children's problems. Three scales:
attention problems, thought problems, social problems.
This approach represents a dimensional approach to classification.
82
3.
149
What types of childhood problems are most likely to prompt referrals to mental
health services? What sort of gender difference is present in these circumstances? What other sort
of childhood problem is also common but less likely to prompt such referrals? Why might this
difference exist?
Disorders of undercontrolled behavior, such as ODD, CD, and ADHD. Males are 2 to 3
times more likely to exhibit and be diagnosed with these disorders. Childhood anxiety is also
common (about a 9% prevalence) but less likely to lead to a clinic referral.
Internalizing disorders such as anxiety and depression are less likely to demand as much
attention from adults to deal with the symptoms, and it is more difficult to draw the line between
normal and/or adaptive emotional reactions and abnormal reactions. Too, children may have
difficulty verbalizing their inner experience, making assessment and diagnosis more difficult.
3.
150
List four of the six risk factors that comprise the family adversity index. How are
these factors linked to the parenting characteristics that contribute to disruptive behavior disorders?
Severe marital discord; low SES; large family size; father's criminality; mother's mental
disorder; foster placement for the child. These factors make it difficult for parents to carry out
effective child-rearing skills and to foster secure attachment in the child. Because of the adversity
and strain, parents are probably more likely to resort to coercive cycles, to be critical, overreactive
to negative behavior, and more directive and "bossy. "
3.
151
List the three types of factors that may contribute to the development of conduct
disorder, and list two examples of specific risk factors associated with each type.
Biological factors: genetic risks, abnormal levels of testosterone and/or serotonin (related
to greater impulsivity and aggression), underaroused nervous system (e. g., low resting heart rate,
low skin conductance)
Cognitive factors: neuropsychological deficits (in memory, language, problem solving),
executive functioning deficits, impairment in social-cognitive skills associated with interpersonal
conflict (jumping to conclusions, poor communication skills, difficulty handling cognitive demands
of conflict)
Social/family factors: insecure attachment, coercive cycles, adverse family conditions
(family adversity index), poor parenting skills
3.
152
Briefly describe four of the biological factors proposed to be related to ADHD and
indicate why you might question each one's causal significance in the disorder.
Early life problems: low birth weight has not yet been empirically documented as specific
to ADHD; prolonged oxygen deprivation is also strongly related to major developmental
disabilities; and maternal gestational alcohol use is not unique to ADHD and usually involves the
larger FAS disorder.
Neurotransmitter deficits of the catecholamines, dopamine & norepinephrine, have not
replicated consistently, although stimulant medication does affect these transmitters.
The gene mutation causing disruption in thyroid functioning provides primarily conceptual
evidence but not empirical evidence at this time.
83
[3. 152 cont'd]
Underarousal of RAS is difficult to measure.
Evidence for frontal lobe deficits in executive functioning depend on neuropsych tests that
may be inappropriate to administer to children and on MRI data gathered on very small samples.
3.
153
List the three anxiety disorders that can contribute to school refusal and indicate the
primary motivation for that refusal for each disorder.
Separation anxiety disorder: fear of being away from parents (or other persons to whom
the child is closely attached)
Social phobia: fear of public scrutiny or humiliation or close personal contact
Specific phobia: fear and avoidance of a specific object or a situation in which that object
might be encountered (e. g., dogs)
3.
154
Describe the primary differences between anorexia and bulimia. What are their
central similarities?
Anorexics: 85% of expected body weight or thinner; primarily interested in being
extremely thin; amenorrhea present; do not binge; often preceeded by picky eating and digestive
problems
Bulimics: typically of average or slightly heavier weight; primarily interested in avoiding
being fat/wanting to lose some weight; engage in recurrent binge eating followed by purging or by
fasts or stringent exercising; more likely to be preceeded by pica and battles with parents over
eating
Similarities = distorted body image and self-evaluation; potential threat to health and life;
difficult to treat successfully
3.
155
disorders?
What three psychotherapy methods have shown success in the treatment of eating
Cognitive-behavioral — both individual and group, interpersonal, and family therapy based
on Minuchin's model
84
Chapter 4
DEVELOPMENTAL DISORDERS AND LEARNING DISABILITIES
4.
1
Ans. A
Fac
p. 118
E
To find the first use of the term "developmental disability, " one would need
a. Public Law 95-602.
b. ICD-6.
c. DSM-II.
d. American Association of Mental Retardation guidelines.
4.
2
Suppose Dr. Romero served on the committee charged with the development of
Ans. C
the criteria for defining a "developmental disability. " For what primary reason
App
are
he and his committee engaged in this work?
p. 118
a. to provide clearer DSM guidelines to distinguish developmental disorders
M
from other childhood disorders
b. to set the stage for research related to behavioral and biological treatments for
those disabilities
c. to identify which persons would be entitled to specialized treatment services
d. to specify the conditions under which persons with such a disability could be
legally committed for institutional treatment
4.
3
Ans. B
App
p. 118
E
Richard's parents have been told that their son has a developmental disability.
Which of the following is NOT a characteristic of such disabilities?
a. Day-to-day functioning and basic skills are significantly impaired,
b. Symptoms cannot be modified by treatment.
c. Long-term specialized care is needed.
d. Impairment is evident prior to adulthood and extends through adulthood.
4.
4
Ans. D
App
p. 118
M
Judith has a developmental disability. The most likely prognosis for her is
a. eventually overcoming the disorder through intensive counseling and family
involvement.
b. ability to live relatively independently with employment in a sheltered
workshop.
c. the ability to successfully accomplish basic daily living skills after intensive
weekly therapy sessions.
d. lifelong impairment with serious limitations in daily living skills and need for
specialized care.
4.
5
Ans. A
App
p. 118
E
Miguel is a 5-year-old who has a learning disability. He is most likely to need
a. interventions limited to his school years.
b. behavioral interventions to manage destructive or self-injurious behaviors,
c. intensive interventions to allow him to function relatively normally.
d. moderate supervision in his adult occupational activities.
4.
6
Amy is a normal child. She is often cooing or babbling and uses her hands to
Ans. B maintain balance when she sits. If she is average for these milestones, she is
App
a. 3 months old.
p. 119
b. 6 months old.
E
c. 1 year old.
d. 18 months old.
85
4.
7
Ans. C
App
p. 119
M
*
Bly says things like "banky" for 'blanket' and "dada" for 'daddy'. She has a
vocabulary of about 40 words like these. About how old is Bly?
a. 9 months
b. 15 months
c. 20 months
d. 2 years
4.
8
Ans. D
App
p. 119
M
Corey is two years, three months old and has not yet begun to use three words in
combination and very rarely uses functor words. His parents are worried. What
should you tell them, based on your knowledge of development?
a. Corey shows sign of a delay in normal language ability and should be
thoroughly evaluated for a possible developmental disability.
b. This sort of language milestone is not typically reached until children are two
and a half years old, and they shouldn't worry at all.
c. Unless there are disturbances in motor and other cognitive domains, no
developmental disability could possibly be present, so they shouldn't worry.
d. Corey is somewhat delayed in this ability, but because children are widely
different they should continue to monitor his skills and not yet worry.
4.
9
Ans. A
App
p. 119
E
Kylee has well developed gross motor abilities. This means she is capable of
a. controlling large muscle movements in a coordinated fashion.
b. good coordination between hand and eye movements,
c. telling where a body part is without seeing it.
d. displeasing, disruptive body motions.
4. 10
Ans. C
App
p. 119
M
Ella wants her little sister to play outside with her. Ella wants to play
hopscotch and jump-rope. Based on average developmental milestones, how
young could Ella's sister be and still play along successfully?
a. 2 years old
b. 3 years old
c. 4 years old
d. 5 years old
4.
11
Ans. A
App
p. 119
M
Which of the following is applicable to Lita's expressive language development?
a. She developed this ability after her development of receptive language.
b. She probably developed this ability faster than did same-age males.
c. She was probably about two years old when she attained this ability.
d. She developed this ability prior to her development of receptive language.
4.
12
Ans. B
Con
p. 120
C
*
For which infant below would you MOST confidently predict a low IQ in later
childhood?
a. a six-month-old infant with a short habituation time
b. a seven-month-old infant with a long habituation time
c. a one-year-old infant with an average habituation time
d. a seventeen-month-old infant with a long habituation time
86
4.
13
Ans. B
App
p. 120
M
Jamie, a six-month-old child, has a short habituation time. She is predicted to be
than are infants with a long habituation time.
a. less intelligent
b. more intelligent
c. slower to develop adaptive behavior skills
d. less likely to develop dyslexia
4.
14
Ans. D
Fac
p. 120
E
A psychologist wants to determine the habituation speed of an infant. How
would this be accomplished?
a. observing the infant during normal and REM sleep to compare neural activity
level
b. measuring the time the infant spends trying to learn a new sound in a
particular day
c. measuring the rate at which the infant's neurons fire in the occipital lobe
during visual stimulation
d. measuring the time lapsed from when a new object is repeatedly presented
until the infant loses interest
4.
15
Ans. D
App
p. 120
C
Dr. Carbonell is conducting a study to predict the kindergarten cognitive abilities
of children who are 2 years old. On what characteristic should she focus?
a. performance on fine visual-motor skills, such as puzzle completion
b. habituation speed
c. performance on a standardized intelligence test
d. family characteristics and abilities
4.
16
Ans. C
App
p. 120
M
Dr. Watson wants to determine the cognitive abilities of a 20-month-old child.
She will obtain the most accurate results by
a. administering the Stanford-Binet Intelligence Scale,
b. administering the Wechsler Intelligence Scale for Children.
c. obtaining information about the abilities of the child's family,
d. assessing the type of toys the child is most interested in.
4.
17
Ans. A
Con
p. 119-20
M
Which of the following skills is NOT included on a standardized intelligence
test?
a. gross motor skills
b. visual-motor skills
c. expressive language
d. receptive language
4.
18
Ans. D
App
p. 120
M
*
Paco, an eight-year-old child, correctly answered items on the Stanford-Binet test
that are answered by an average nine-year-old. In other words, Paco has
a. a below-average IQ.
b. a mental age of 8.
c. a deviation IQ of 110.
d. a mental age of 9.
87
4.
19
Ans. C
App
p. 120
E
Scores on the WISC-III indicate that Yoshi, a 12-year-old child, has an average
IQ. You could guess that his IQ is
a. 12.
b. 50.
c. 100.
d. 115.
4.
20
Ans. A
Con
p. 120
C
It could be agreed by most psychologists that IQ tests have
a. high reliability.
b. high validity.
c. both a and b.
d. neither a nor b.
4.
21
Ans. B
App
p. 121
E
During an interview with his therapist, Jeffrey was given the Vineland Scales and
the test created by the American Association of Mental Retardation. The
therapist is assessing Jeffrey's
a. intelligence.
b. adaptive behaviors.
c. learning disability.
d. language skills.
4.
22
Ans. A
Con
p. 121
C
Eve achieved a score of 73 on the Vineland. Each of the following issues
suggests caution in diagnosing this apparent impairment EXCEPT
a. a lack of normative data on which to base interpretations,
b. the tendency for this test to overclassify impairment.
c. the natural and common tendency for children to exhibit occasional
developmental delays.
d. differences in definitions established by the AAMR, DSM, and ICD.
4.
23
Ans. C
App
p. 121
E
For Mitch to be classified as mentally retarded, his impairment must begin
a. in infancy.
b. by the time he completes grade school.
c. before he turns 18.
d. at any age, as long as mental functioning and adaptive behaviors are
impaired.
4.
24
Ans. D
Fac
p. 120-1
E
Cultural norms and values are important in the definition of
a. intelligence.
b. adaptive behavior.
c. developmental milestones.
d. all of the above
4.
25
Ans. B
App
p. 121
E
*
Dave's IQ of 73 could be considered "mentally retarded" according to the
definition set by the
a. DSM-IV.
b. AAMR.
c. ICD-10.
d. all of the above
88
4.
26
Ans. D
App
p. 121
C
According to whose definition would Beth be considered mentally retarded if her
IQ is 69 and adaptive behavior tests reveal scores 84 or higher in all domains?
a. AAMR
b. DSM-IV
c. both a and b
d. neither a nor b
4.
27
Ans. B
App
p. 122
E
Jake is mentally retarded. He is part of
this disability.
a. . 01-. 05
b. 1-3
c. 3-5
d. 7-8
4.
28
Ans. C
App
p. 122
E
As a clinician responsible for assessing children exhibiting significant impairment
in academic and adaptive abilities, what classification system are you MOST likely
to use?
a. educable, remedial, trainable
b. organic, nonorganic, cultural-familial
c. mild, moderate, severe, profound
d. borderline, limited, moderate, pervasive
4.
29
Ans. A
App
p. 121-2
M
Of the following persons, who would meet DSM-IV criteria for mental
retardation?
a. Dora, whose IQ is 64, lives at home and requires minor assistance with dayto-day activities and works part-time in a laundry.
b. Reginald, whose IQ is 76, lives on the streets, is unable to hold a job and
barely manages to take care of his daily needs for food and shelter.
c. Naum, whose IQ is 90, dropped out of school in ninth grade, cannot hold a
job, has never married, and is unconcerned about his situation.
d. Ida, whose IQ is 68, lives in her own apartment, works full-time, and
supports herself and her child.
4.
30
Ans. A
App
p. 121-2
M
Clark is married, holds a groundskeeping job, and lives in his own apartment.
His WAIS-R IQ is 69. A clinician using the DSM-IV might not diagnose Clark
as mentally retarded because
a. his adaptive functioning is not sufficiently impaired.
b. his IQ is not low enough.
c. he does not live in a structured, supervised setting.
d. the IQ test was not given prior to age 18.
4.
31
Ans. B
App
p. 122
M
Nora has a dual diagnosis. This means she has
a. deficits in both IQ and adaptive functioning.
b. mental retardation and a substance dependence disorder.
c. mental retardation due to a genetic disorder and environmental deprivation.
d. a developmental disability and a separate physical disability.
*
89
% of the world population with
4.
32
Ans. A
Fac
p. 122
E
Mild mental retardation is defined by the DSM-IV by IQ's in the range of about
a. 50 - 70.
b. 45 - 60.
c. 30 - 50.
d. 20-40.
4.
33
Ans. C
Fac
p. 122
M
Although not immediately obvious, the cognitive impairments of children with
mild mental retardation become evident by
grade.
a. first
b. third
c. fifth
d. seventh
4.
34
Ans. D
App
p. 122
M
Jim has some adaptive behavioral deficits, and an IQ of 58. He would be
diagnosed as
a. moderately retarded,
b. trainably retarded.
c. minimally retarded,
d. mildly retarded.
4.
35
Ans. B
App
p. 122
M
Beth has been diagnosed as having the level of mental retardation exhibited by
85% of persons with this disability. Beth will probably
a. be confined to an institution for much of her life.
b. hold a semiskilled job.
c. be unable to have a family.
d. live in a group home with the assistance of others on a daily basis.
4.
36
Ans. C
App
p. 122
M
Ryan is diagnosed with moderate mental retardation. He could probably
accomplish each of the following EXCEPT
a. reading and simple math.
b. expressive language.
c. marriage.
d. performance of unskilled jobs with supervision.
4.
37
Ans. D
Con
p. 122
M
Which of the following does not belong with the other three?
a. need for supervised group home living
b. significant cognitive delays evident in early childhood
c. IQ of 45
d. lack of expressive language
4.
38
Ans. A
App
p. 122
M
Marguerite has been given a diagnosis of severe mental retardation. Which of the
following descriptions is MOST likely to apply to her?
a. She will have only simple speech, be unable to read, and require assistance in
taking care of basic living skills.
b. She will be unable to engage in any vocational activity, be unlikely to marry
and have children, and require daily, intensive self-care assistance.
c. She will be able to learn near-normal speech, read on a third-grade level, and
work with supervision.
d. She will have an IQ of 25 or less, have neurological damage, and require
constant supervision to survive.
*
90
4.
39
Ans. B
Con
p. 122
M
Which of the following does not belong with the other three?
a. IQ of 30
b. 10% of the mentally retarded population
c. simplistic, poorly articulated speech
d. common motor and visual-motor deficits
4.
40
Ans. C
App
p. 123
M
Theo has severe neurological damage, is wheelchair bound, and requires
assistance with even the simplest of needs. Theo has
a. moderate mental retardation.
b. autistic mental retardation.
c. profound mental retardation.
d. severe mental retardation.
4.
41
Ans. A
App
p. 123
M
Annette developed cerebral palsy as a result of cerebral injury in infancy. Her
motor impairment is the type most commonly exhibited, namely
a. hemiplegic spasticity.
b. hypoxia.
c. motoric dystonia.
d. quadriplegia.
4.
42
Ans. B
App
p. 123
M
If Greg has cerebral palsy, which of the following characteristics necessarily
applies?
a. He has mental retardation.
b. He has muscular impairment due to early cerebral injury.
c. He is incapable of advanced speech,
d. Both a and b apply.
4.
43
Ans. C
Fac
p. 123
E
One of 300 known biological causes is responsible for the mental retardation of
% of persons with this developmental disorder.
a. 5 to 10
b. 15 to 25
c. 25 to 50
d. 60 to 80
4.
44
Ans. B
App
p. 123
M
*
A client in your day treatment program has mild mental retardation. Knowing
nothing else except the findings from research, you would predict that
caused the client's disability.
a. a genetic disorder
b. a cultural-familial factor
c. a peri- or post-natal problem
d. Any of the above are equally plausible causes.
4.
45
Ans. D
App
p. 123
M
Marta is 42 years old and is having her first child. She is concerned about her
child's risk of mental retardation due to an abnormal, non-heritable chromosomal
addition known as
a. Williams syndrome.
b. fragile X syndrome.
c. PKU syndrome.
d. Down syndrome.
91
4.
46
Ans. B
Fac
p. 124
M
Which of the following disorders and chromosomal location are mismatched?
a. PKU: 12
b. Williams syndrome: 15
c. Down syndrome: 21
d. Fragile X syndrome: 23
4.
47
Ans. C
App
p. 125
E
*
Having been diagnosed with Down syndrome, Mary Ann will
a. have "language in the relative absence of thought".
b. have quasi-psychotic symptoms, heart defects, and a smaller-than-normal
cerebrum.
c. have upward slanted eyes, be short and stocky, and be moderately retarded.
d. have a long face with a broad flat nose, and be able to pass the defect on to
her children.
4.
48
Ans. A
App
p. 125
M
Brian's parents are learning to cope with their child's Down syndrome. Which of
the following characteristics are these parents least likely to observe?
a. expressive language skills that exceed overall IQ
b. a high level of sociability and relatively good mental health
c. premature aging and a risk of dementia by age 40
d. changing patterns in the speed of acquisition of academic and adaptive skills
4.
49
Ans. B
App
p. 125-6
M
Reya successfully puts simple pictures in sequential order but has difficulty
understanding what higher-order concept the pictures might represent; Rollo
cannot do either task and is often unwilling to comply with the test-giver's
requests. Reya probably has
, and Rollo probably has
.
a. PKU; Williams syndrome
b. Down syndrome; fragile X syndrome
c. fragile X syndrome; FAE
d. Williams syndrome; PKU
4.
50
Ans. D
App
p. 126
M
Wendy is diagnosed with fragile X syndrome. Which of the following
characteristics probably does NOT apply to her?
a. a likelihood of passing the defect in chromosome pair 23 to her offspring
b. less retardation than her twin brother with the same syndrome
c. oppositional and hyperactive behavior problems
d. an elfin appearance, with small hands and fingers, with mild retardation
4.
51
Ans. A
App
p. 127
C
A storytelling festival took place on a college campus, and children from local
hospitals and group homes were invited to attend. Which of the following
children will be most interested in this activity?
a. Ricardo, with Williams syndrome
b. Matthew, with fragile X syndrome
c. Vonetta, with PKU
d. Gina, with FAS
4.
52
Ans. B
App
p. 127
M
Dr. Andreas is treating a pediatric patient who has Williams syndrome. Which
observation will probably surprise Dr. Andreas?
a. daily living skills much better than expected, given the patient's IQ of 55
b. expressive language abilities that greatly exceed the patient's IQ
c. an absence of physical stigmata
d. an ability to accurately reproduce complex visual stimuli from memory
92
4.
53
Ans. C
Con
p. 127
M
Regarding organic causes of mental retardation, which item below does NOT
belong with the other three?
a. fragile X
b. Down syndrome
c. FAS
d. PKU
4.
54
Ans. C
App
p. 127
M
Willy's body is poisoning itself with a substance that in normal persons would
be the harmless substance, tyrosine. What condition does Willy have?
a. FAS
b. autoimmune disorder
c. PKU
d. Tay-Sachs disease
4.
55
Ans. D
App
p. 127
E
A newborn is found to have phenylketonuria. This means that the child
a. has a malfunctioning thymus gland that will lead to growth suppression.
b. will be retarded and require specialized care for most of her/his life.
c. has a deletion of a gene on chromosome 7.
d. can lead a normal life and have a near-normal IQ with a special diet.
4.
56
Ans. A
App
p. 127
M
Monique, a child with hearing and visual impairments, has moderate mental
retardation. She also exhibits microcephaly and cardiac dysfunction. What is the
most likely source of her disability?
a. exposure to rubella during the first trimester of her gestation
b. exposure to alcohol as a result of her mother's binge drinking during
pregnancy
c. exposure to maternal herpes during the birthing process
d. exposure to environmental deprivation in the first two years of life
4.
57
Ans. B
Fac
p. 127
E
Teratogens are
a. toxic amino acid byproducts found in the CNS of some retarded children.
b. substances which cross the placenta and damage a fetus,
c. environmental toxins that can produce mental retardation in young children.
d. substances produced as a result of head injury that lead to neural dysfunction.
4.
58
Ans. C
App
p. 127
M
A nurse in an infant ICU ward cares for several infants born to cocaineaddicted mothers. Based on available research, the nurse would anticipate
significant difficulties in
for these children.
a. cognitive development
b. social development
c. physical development
d. all of the above areas
4.
59
Ans. D
Con
p. 127
M
Which of the following teratogens is most damaging for an infant's development?
a. cocaine
b. marijuana
c. trisomy 21
d. alcohol
*
93
4.
60
Ans. C
App
p. 127
E
*
Rosa exhibits facial deformity and neurological dysfunction as a result of her
mother's binge drinking that occurred just prior to pregnancy. This disability is
called
a. developmental alcohol effect disorder.
b. gestational alcohol effect.
c. fetal alcohol syndrome.
d. minimal teratogenic syndrome.
4.
61
Ans. D
Fac
p. 127
E
How much alcohol is safe for a pregnant woman to ingest?
a. Occasional binge drinking is safe if it occurs in the third trimester.
b. One drink per day is safe after the first trimester.
c. Very infrequent, moderate social drinking is safe.
d. It is not proven that any drinking is safe during gestation.
4.
62
Ibriham's mother drank two glasses of wine several times a week after the first
Ans. B trimester of her pregnancy. What outcome for Ibriham is LEAST likely?
App
a. a reduction in IQ of about 7 points
p. 127
b. brain cell dysfunction and early-onset dementia
M
c. shortened eyelids, flattened jaw line, and thin upper lip
d. emotional and social impairments later in childhood
4.
63
Ans. C
Fac
p. 128
C
Which of the following interventions will decrease the common causes of mental
retardation?
a. medical and educational programs to prevent premature birth and low birth
weight
b. genetic screening, counseling, and family planning
c. seat belt and helmet use and pedestrian safety training
d. improved birth delivery methods that prevent hypoxia and other complications
4.
64
Ans. A
App
p. 128
E
Which of the following children is at greatest risk for nonorganic mental
retardation?
a. Garrett, a black male
b. Roxanne, a black female
c. Michael, a white male
d. Beverly, a white female
4.
65
Ans. B
App
p. 128
M
Kibur is living in a home marked by environmental deprivation. Which
description below is LEAST characteristic of his parents?
a. unlikely to provide educational toys, games, or books
b. likely to be authoritarian in their discipline style
c. likely to converse with Kibur infrequently and with little verbal elaboration
d. relatively inattentive and unresponsive to child's efforts and interests
4.
66
Ans. C
Fac
p. 129
E
Which of the following is not a method of detecting the possibility of retardation
in an unborn child?
a. a check of the family pedigree
b. blood analysis of parents' chromosomes
c. linkage analysis
d. amniocentesis analysis
94
4.
67
Ans. D
App
p. 129
M
Because her cousin has PKU and her husband's niece has Down syndrome,
Satinka is concerned about her developing baby's health. If she were faced with
a possibility of a first trimester abortion, why would amniocentesis not be
helpful?
a. While it could be used to detect these disorders, the results are too unreliable.
b. PKU and Down syndrome are not heritable disabilities and thus the procedure
would not be informative.
c. This procedure detects only physical defects and does not provide information
relevant to genetic disorders.
d. The procedure cannot be safely performed until the fourth month, too late to
be of help in this decision.
4.
68
Ans. A
App
p. 130
E
Kenesha's risk of mental retardation can be lessened or even eliminated by early
dietary controls. She has
a. phenylketonuria.
b. Williams syndrome.
c. sacrose intolerance syndrome,
d. FAS.
4.
69
Ans. B
App
p. 130
M
Miranda is a child participating in Project Head Start. Each of the following
services will be offered EXCEPT
a. Miranda will attend a preschool which provides an intellectually stimulating
environment.
b. Psychiatric assessment and treatment will be provided for both of Miranda's
parents.
c. Miranda's parents will be taught how to read effectively to her.
d. Support groups and psychoeducational programs on nutrition and behavior
management will be provided to Miranda's parents.
4.
70
Ans. D
Con
p. 130
M
*
In a report on the effectiveness of Project Head Start, which statement would you
OMIT?
a. Several longitudinal studies have been conducted at several sites across the
U. S.
b. Research findings have varied according to program quality and choice of
outcome measures.
c. Children in the program consistently outperform their peers on developmental
tasks in early grade school.
d. Long-term follow up shows that most of these children are no more likely to
graduate from high school than are comparison group children.
4.
71
Ans. B
Fac
p. 130
E
Which learning paradigm is most commonly employed for the treatment of
moderate to profound mental retardation?
a. classical conditioning
b. operant conditioning
c. social modeling
d. respondent conditioning
95
4.
72
Ans. D
App
p. 130
M
Naomi is working with mentally retarded children to teach them basic social
skills. In order to use an applied behavior analysis, Naomi will first have to
divide the skill into its component steps known as
a. shaping behaviors.
b. direct reinforcement strategies.
c. analysis units.
d. target behaviors.
4.
73
Ans. A
App
p. 130
E
Seymour has identified eye contact as the first target step in a behavior
modification program for social skills. If he initially reinforces quick glances by
a child and then reinforces longer glances, Seymour is engaging in
a. shaping.
b. applied behavior sequencing.
c. targeting.
d. DRO correction.
Kamuko, an autistic child, has learned to appropriately request a toy from her
therapist. It is hoped that this behavior will also occur when Kamuko has a
home visit, a process known as
a. differential maintenance.
b. generalization.
c. shaping.
d. overcorrection.
4.
74
Ans. B
App
p. 130
E
4.
75
Ans. C
Con
p. 130
E
Which of the following concepts does not belong with the other three?
a. behavior modification program
b. maintenance
c. normalization
d. operant conditioning
4.
76
Ans. C
Fac
p. 131
C
Project Head Start targets children on the basis of
, but its outcome
might be more clearly favorable if it targeted children on the basis of
.
a. the children's low IQ scores; family environment
b. family environment; family income
c. family income; parental IQ scores
d. environmental deprivation; children's low IQ scores
4.
77
Ans. C
App
p. 131
C
Trevor is in the intervention group of the Abecedarian Project. His mother has
an IQ of 65. As of age 3, what prediction would you make for Trevor's IQ?
a. His IQ is probably around 90 and is about 7 points higher than that for a
comparable child in the control group.
b. His IQ is probably around 82 and is slightly higher than that for a comparable
child in the control group.
c. His IQ is probably around 95 and is about 20 points higher than that for a
comparable child in the control group.
d. His IQ is probably around 69 and is similar to that for a comparable child in
the control group.
96
4.
78
Ans. A
App
p. 131
M
Abigail was a member of the control group in the Abecedarian project.
Compared to a child in the intervention group, Abigail at age 12
a. is more likely to have an IQ below 85.
b. has an IQ that is about 15 points lower.
c. has about an equal chance of having been retained in school,
d. shows gains in reading and math skills.
4.
79
Ans. B
Fac
p. 131
M
*
What is the primary obstacle to implementing more programs such as the
Abecedarian Project?
a. lack of documented long-term research success
b. availability of public funding
c. insufficient numbers of eligible children
d. use of unreliable treatment interventions
4.
80
Ans. C
App
p. 132
M
Mahala, an autistic child, frequently engages in moderate head banging when she
is by herself, and her behavior is unchanged when her caregivers attempt a DRO
modification program. What probably motivates Mahala's behavior?
a. escape from task demands
b. nonverbal communication opportunity
c. endogenous opiate release
d. social reinforcement
4.
81
Ans. D
App
p. 132
M
Marissa recently learned to decrease the frequency of temper tantrums as a result
of her staff caregivers' DRO strategy for appropriate play behaviors. What
prediction would you make about Marissa's play behavior in the future?
a. It will probably continue through the process of maintenance.
b. It will probably generalize to other social settings.
c. It will probably become overcorrected.
d. It will probably require ongoing reinforcement.
4.
82
Ans. A
App
p. 132-3
E
A profoundly mentally retarded adolescent engages in self-injurious behavior,
hitting herself severely on her head and face. Which of the following is the
LEAST likely reinforcer for this behavior?
a. somatomotor release of tension
b. release of endogenous opiates
c. escape from task demands
d. caregiver attention
4.
83
Ans. B
App
p. 133
C
When he is taken out of the activity room and placed in his chair for lunch,
Bayard becomes combative and self injurious. The staff spend several minutes
physically restraining him, calming him down, and encouraging him to eat.
What type of consequence do the staff behaviors represent?
a. nonaversive punishment
b. positive reinforcement
c. overcorrection
d. aversive punishment
*
97
4.
84
Ans. D
App
p. 133
M
Amid a great deal of debate, Dr. Ikeda and her staff decide to prescribe the drug
naltrexone to a severely mentally retarded patient. What are they treating?
a. positive psychotic symptoms
b. assaultive, unprovoked attacks on other patients and staff
c. mood dysfunction, similar to manic-depressive disorder
d. uncontrollable head-banging
4.
85
Ans. A
Con
p. 132-3
M
If you are ethically opposed to the use of aversive punishment for the control of
self-injurious behavior in persons with developmental disabilities, on which of
the following operant strategies would you rely?
a. DRO program
b. positive response maintenance and generalization
c. behavioral normalization
d. self-instructional training
4.
86
Ans. C
App
p. 133
E
Isabella is 20 years old and moderately mentally retarded. She lives in a
supervised group home in a residential neighborhood. What kind of approach to
care does this situation reflect?
a. residentialism
b. institutionalism
c. normalization
d. mainstreaming
Interviews with mentally retarded adults living in community vs. institutional
settings indicates that
adults are more satisfied with their personal
choice options and that
adults are generally positive about the living
arrangement.
a. community; community
b. institutional; institutional
c. both groups'; community
d. community; both groups'
It is 1978, and Dimitri is experiencing significant changes in his living situation
and educational opportunities as a result of the U. S. IDEA legislation. Which of
the following does NOT belong?
a. placement in special education according to IQ and adaptive behavior tests
b. a move from a state institution to a specialized foster home
c. guaranteed access to educational services provided by the local school system
d. determination of his formal individualized education program
4.
87
Ans. D
Fac
p. 133
M
4.
88
Ans. A
App
p. 133-4
C
4.
89
Ans. B
App
p. 134
M
*
Coretta has a daughter who has been placed in a self-contained special education
classroom. Coretta has approached the local school board with several concerns
about this practice. What issue is she not likely to address?
a. a disproportionate number of black children in the program
b. a lack of attention to individual educational needs for children in the program
c. an overemphasis on placement by a single IQ measurement
d. a possible development of stereotypes and prejudice on the part of
nondisabled students and community
98
4. 90
Ans. C
App
p. 134
M
A local school principal is implementing a program in which teachers move from
one classroom to another and in which both disabled and nondisabled students
are taught. There are no "special" classrooms. What kind of educational process
does this represent?
a. mainstreaming
b. normalization
c. inclusion
d. integration
4. 91
Ans. D
Con
p. 134
M
For which type of disabled student do educators encourage the use of selfcontained special education classrooms?
a. mildly mentally retarded students with severe physical stigmata
b. moderately, severely, and profoundly mentally retarded students
c. mentally retarded students who live in institutions rather than community
settings
d. mentally retarded students with self-injurious or other behavior disorders
4. 92
Ans. A
App
p. 135
M
Emilio is three years old. He has no expressive language skills, spends hours
repetitively rolling marbles along the floor, and seems uninterested in his parents
or siblings. What disorder appears to be evident?
a. autism
b. stereotypy disorder
c. Asperger's disorder
d. Kanner's disorder
4. 93
Ans. B
Con
p. 135
M
The majority of individuals with typical autism will have an IQ in the range of
a. 25 - 40.
b. 35 - 55.
4. 94
Ans. B
App
p. 135
E
If Yoshi has typical autism, she will exhibit each of the following EXCEPT
a. stereotypes.
b. uniformly low scores on standardized IQ tests.
c. severely impoverished or absent language skills.
d. lack of adaptive, reciprocal social relationships.
4. 95
Ans. C
Fac
p. 135
E
Who first used the term "autism" and identified its core characteristics?
a. E. Kraepelin
b. H. Asperger
c. L. Kanner
d. L. Down
4. 96
Ans. D
App
p. 135-6
M
Dr. Suh is treating a 4-year-old child who exhibits stereotypic behavior,
language deficits, and a relatively average interest in other people. What
diagnostic label would he choose from the DSM-IV?
a. autistic spectrum disorder
b. atypical autism
c. Asperger's disorder
d. pervasive developmental disorder- NOS
c. 60-70.
d. 8 0 - 9 5 .
99
4.
97
Ans. A
Fac
p. 136
E
For every 10, 000 children, approximately will have autism, and of these
disabled children,
% will also be mentally retarded.
a. 4; 75
b. 4; 50
c. 9; 65
d. 9; 45
4.
98
Ans. B
App
p. 136
M
Which of the following children is most likely to exhibit autism?
a. Michi, a Japanese female
b. Jiro, a Japanese male
c. Chang, a Chinese male
d. Thelma, an African American female
4.
99
Ans. C
App
p. 136
E
If Salim is being assessed for the possibility of an autistic disorder, in which of
the following areas must he exhibit abnormal functioning prior to age 3?
a. social interaction
b. language and communication
c. any 1 of the diagnostic areas
d. any 2 of the diagnostic areas
4.
100
Alexa, a 4-year-old, exhibits idiosyncratic and repetitive language use as well as
Ans. D
developmentally
retarded social play and a lack of spontaneous make-believe
App
play. These two symptoms fulfill the
DSM criteria of autism.
p. 136
a. qualitative impairment in social interaction
M
b. restricted, repetitive, and stereotyped patterns of behavior
*
c. perseverative behavior disturbance
d. qualitative impairment in communications
4.
101
Ans. A
App
p. 136
M
If a developmentally disabled child regards other children as "tools" in a game,
much as the child would regard crayons as tools for drawing, what disorder
would you suspect?
a. typical autism
b. PKU-related mental retardation
c. atypical autistic disorder
d. schizotypal developmental disorder
4.
102
Ans. B
App
p. 137
M
When his parents try to show him interesting objects, Erik exhibits a great deal
of difficulty coordinating his gestures and eye contact to mesh with his parents'.
In other words, Erik has difficulty with
a. receptivity.
b. joint attention.
c. facilitated communication.
d. expressive interactionism.
100
4.
103
Ans. C
App
p. 137
C
If Mariana has typical autism with some expressive language skills, she probably
has a vocabulary that is
a. substantially larger than would be expected based on her mental age.
b. made up primarily of nonsense words meaningful only to herself and those
who know her well.
c. comparable to that expected for her mental age but limited in day-to-day
usefulness.
d. extremely limited in size and utility even when compared to her mental age
expectations.
4.
104
Ans. D
App
p. 137
M
Which of the following descriptions does NOT reflect stereotypic behavior by an
autistic child?
a. Jaime's complete preoccupation and fascination with door locks of all kinds
b. Alani's insistence that every object in her room be left in the exact same place
every day
c. Adrian's self-injurious wall-hitting behavior
d. Ida's repetitive use of idiosyncratic phrases such as "up, ip, pip" and pronoun
reversals
4.
105
Ans. B
Fac
p. 137-8
M
In which of the three DSM diagnostic areas are mentally retarded children most
dissimilar to children with autism?
a. stereotypic behaviors
b. impairment in social interaction
c. impairments in language
d. impairments in nonverbal intellectual abilities
4.
106
Ans. A
App
p. 138
M
On Raphael's IQ test, his therapist sees the pattern common for autistic children,
which includes very low scores on each of the following subtests EXCEPT
a. block design.
b. vocabulary.
c. comprehension and reasoning,
d. fund of general knowledge.
4.
107
Ans. D
App
p. 138
M
Mrs. and Mr. Stamos have an autistic child. Compared to the parents of a
nondisordered child, Mrs. and Mr. Stamos are probably
a. critical and emotionally aloof,
b. overly emotionally expressive and smothering.
c. anxiety-prone and socially introverted,
d. not substantially different.
4.
108
Ans. A
App
p. 138
M
Dr. Rutter has found it difficult to employ twin studies in the search for
biological contributions to autistic disorder because
a. the disorder is rare among MZ and DZ twins.
b. diagnostic practices have changed substantially in the last two editions of the
DSM.
c. no specific genetic transmission for the disorder has yet been identified.
d. the parents of such children are not interested in participating in research.
101
4.
109
Ans. B
Fac
p. 138
M
According to information presented in the text, which research strategy has NOT
yet documented a biological contribution to autism?
a. brain imaging studies
b. linkage analysis studies
c. twin studies
d. family studies
4.
110
Ans. C
App
p. 138
M
Dr. Weinstein works in a neuropsychiatric facility which specializes in treating
autism. Her specialty involves the use of PET and MRI scans to identify cortical
abnormalities in these children. She has probably found evidence of
a. hyperfrontality and hemispheric lateralization.
b. neural degeneration in the temporal lobe and underlying limbic system.
c. below-average development in the frontal lobes and cerebellum.
d. disruptions in sensory-thalamic-cortical feedback mechanisms.
4.
111
Ans. D
App
p. 138
E
Samantha has autism. If a sample of Samantha's cerebrospinal fluid were
analyzed, which neurotransmitter might be expected to be abnormally elevated?
a. enkephalin
b. dopamine
c. acetylcholine
d. serotonin
4.
112
Ans. A
Con
p. 138-9
M
Of the psychological factors proposed to account for autism, which one has the
most empirical support at this time?
a. deficits in executive functioning
b. disruptions of attachment
c. inability to engage in social imitation
d. failure to understand or express emotions in interpersonal situations
4.
113
Ans. B
App
p. 139
C
If Leotie, an autistic child, has no coherent theory of mind, she will be unable to
do each of the following EXCEPT
a. tell a lie.
b. form an attachment in the Strange Situation task.
c. correctly answer the "M&M" problem.
d. retell a story from the perspective of a person besides herself.
4.
114
Ans. D
Fac
p. 139
E
Based on available theory and data, which paradigm is most clearly implicated in
understanding the etiology of autism?
a. sociocultural
b. cognitive
c. biological
d. None have been conclusively supported.
4.
115
Ans. C
Con
p. 137-40
C
In terms of prevalence, which developmental disorders are correctly portrayed
from LEAST to MOST common?
a. autism: Rett's disorder: moderate mental retardation
b. childhood disintegrative disorder: Asperger's disorder: Rett's disorder
c. Rett's disorder: Asperger's disorder: autism
d. Asperger's disorder: moderate mental retardation: autism
102
4.
116
Ans. A
Con
p. 140
C
The language characteristics displayed by children with Williams syndrome are
most similar to those of which other developmental disorder?
a. Asperger's disorder
b. typical autism
c. Rett's disorder
d. trisomy 21 syndrome
4. 117
Ans. B
App
p. 140
M
A graduate student is preparing for a practicum experience in a special education
classroom. If he were to meet a child with a form of atypical autism first
described as autistic psychopathy, he could expect to see each of the following
symptoms EXCEPT
a. an initial onset of symptoms at 28 months of age.
b. reasonably good nonverbal skills and joint attention.
c. relatively normal expressive language skills.
d. a tendency for the child to talk incessantly and informatively about her
favorite hobby.
4.
118
Ans. C
Con
p. 140
M
Which disorder does not belong with the other three?
a. childhood disintegrative disorder
b. Asperger's disorder
c. William's disorder
d. Rett's disorder
4.
119
Ans. A
Fac
p. 141
E
Which of the autistic spectrum disorders is known to be more common in
females than in males?
a. Rett's disorder
b. typical autism
c. Asperger's disorder
d. childhood disintegrative disorder
4.
120
Ans. D
App
p. 141
C
At age 15 months, Candice suddenly became extremely clumsy with her hands,
unable to hold or manipulate objects. Thereafter, she exhibited deficits in
expressive language and disinterest in her family members. What prediction
would you make for Candice?
a. She will probably be moderately mentally retarded but able to care for her
basic daily needs if behavioral treatment begins by age 3.
b. She will probably return to her previously normal level of functioning once
her diet is changed and closely controlled.
c. She will probably develop stereotypic behaviors, increased social indifference,
and other symptoms of typical autism.
d. She will probably become severely mentally retarded, lose her ability to walk,
and show later decreases in her stereotypic behaviors.
4.
121
Ans. B
App
p. 141
M
If Nahele, a 12-year-old male, has childhood disintegrative disorder and Oliana, a
12-year-old female, has typical autism, what is the central difference between
them?
a. Nahele has only minor deficits in expressive and receptive language skills.
b. Nahele's first three years of life were marked by normal developmental
patterns.
c. Oliana has substantially more severe impairments in executive functioning.
d. Oliana has a higher overall IQ and somewhat better joint attention skills.
103
4.
122
Ans. A
Con
p. 141
M
If you wanted to replicate the treatment approach of the most extensive and
well-documented program for autistic children, you would
a. conduct daily behavioral training sessions for two years, involving parents and
peers in multiple settings.
b. combine a weekly behavior modification program with medication over a twoto three-year period.
c. conduct daily training and support sessions with parents for one year to teach
them to reinforce their child's attention to social stimuli and emotional
expression.
d. combine daily at-home social skills training with educational mainstreaming
for preschoolers.
4.
123
Ans. C
App
p. 141
M
*
You are one of Dr. Lovaas' graduate student therapists. Whom will you include,
and in what setting, as part of the behavior modification program for Ben, an
autistic child?
a. Ben, whom you will see in Dr. Lovaas' university lab
b. Ben and his parents, whom you will see in their home
c. Ben, his parents, and his peers, whom you will see at home and at school
d. Ben, his parents, and his teachers, whom you will see at school
4.
124
Ans. D
App
p. 141
M
Ramon received an intensive treatment program designed by Ivar Lovaas. If
Ramon shows average gains from the program, by age 7 he will
a. no longer display clinical symptoms of a developmental disorder,
b. be substantially improved but still require medication for disruptive behavior.
c. exhibit normal peer interactions.
d. show a 20-point gain in IQ.
4.
125
Ans. B
App
p. 141
E
Ruth's parents are understandably desperate to find a treatment program for their
autistic daughter. To whom would you refer them for a method that shows
realistic promise?
a. Doman & Delacato
b. Lovaas
c. Crossley
d. Asperger
4.
126
Ans. A
App
p. 141-2
M
For what reason might a psychiatrist be hesitant to treat Jacob's highly aggressive
autistic behavior with an antipsychotic medication?
a. Long-term use of medication may cause permanent neurological side effects.
b. The medication decreases aggression but worsens remaining autistic symptoms.
c. Research has demonstrated the greater efficacy of naltrexone despite slightly
increased side effects.
d. Jacob shows no evidence of schizophrenia or any other formal thought
disorder.
4.
127
Ans. A
Fac
p. 142
E
According to Robert Hodapp, early intervention programs should focus on what
goal in the treatment of mental retardation?
a. helping mothers to be more effective parents
b. fostering gains in IQ, as in the Abecedarian project
c. elimination of self-injurious behavior and other disruptive behaviors that
interfere with social skill development
d. phonological awareness and joint attention skills
104
4.
128
Ans. C
Fac
p. 143-4
E
On what group of children did the concept of a learning disability have its most
direct effect?
a. mildly retarded, high functioning children
b. emotionally disturbed children from all SES groups
c. middle-class white children
d. lower- and middle-class black and Hispanic children
4. 129
Ans. C
Fac
p. 144
M
*
When researchers employed appropriate control groups, standardized outcome
measures, and an appropriate statistical approach to evaluate a method for
treating a developmental disability, they discovered that
a. facilitated communication was effective only for atypical autistic children.
b. motor patterning treatment decreased stereotypic behaviors but did not
improve intellectual functioning in mentally retarded children.
c. the Doman-Delacato method is scientifically worthless.
d. the Crossley-Biklen method resulted in only minor improvements in the
expressive language skills associated with typical autism.
4.
130
Ans. D
Fac
p. 144-5
E
Why is the growing interest in facilitated communication seen as a problem by
clinical scientists?
a. The method requires the involvement of highly-trained, and thus expensive,
mental health care workers; other equally effective methods are less costly.
b. Additional empirical research is needed before a conclusion can be reached
about the effectiveness of the method.
c. Its success brings into question the validity of the scientific method for
evaluating treatment claims.
d. It diverts attention from effective instructional methods and raises false hope
for parents.
4.
131
Ans. B
App
p. 144-5
C
A clinician is encouraging the parents of an 8-year-old autistic girl to bring legal
charges against the girl's uncle because facilitated communication revealed
evidence of the uncle's mistreatment of the child. What might you conclude
about this clinician's general perspective?
a. She endorses the behavioral approach to developmental disorders.
b. She does not value and/or is not trained in the scientific method.
c. She probably relies on standard IQ tests as a valid means of evaluating her
clients' abilities.
d. She would probably recommend a treatment program such as Lovaas' in order
to enhance verbal communication skills for such children.
4.
132
Ans. A
App
p. 145
M
If you take Coles' (1987) stance, what factors) do you identify as actually
responsible for a learning disability?
a. families and schools
b. CNS dysfunction
c. emotional disturbance and psychiatric disorders
d. inherited phonological encoding deficiencies
4.
133
Ans. D
Con
p. 146
E
What component is common to the various definitions of learning disability?
a. significant discrepancy between IQ and achievement
b. the presence of an intrinsic CNS dysfunction
c. exclusionary criteria based on emotional disturbance or cultural disadvantage
d. none of the above
105
4.
134
Ans. B
App
p. 146
C
*
4.
135
Ans. D
App
p. 146
M
Evian was doing well in all of his school subjects except math. Testing indicated
that Evian had an IQ of 115 and his achievement test scores, including that for
arithmetic, fell between 85 and 110. Are learning disability criteria met?
a. yes, for many school districts and for the DSM-IV
b. yes, for many school districts; no, not for the DSM-IV
c. yes, for the DSM-IV; no, not for many school districts
d. no, neither for school districts nor the DSM-IV
You are a new school teacher. Of the 100 students in your classes this year,
about how many will be receiving federally authorized services for a learning
disability?
a. 18
b. 11
c. 5
d. 2
4.
136
Ans. C
App
p. 146
M
As a special education reading instructor, for every female student in your class,
you will have
male students in the class.
a. 1 to 2
b. 2 to 4
c. 3 to 5
d. 6 to 7
4.
137
Ans. A
Fac
p. 146
M
Several more males are diagnosed as learning disabled than are females. Why
might this be?
a. Referring teachers are more likely to refer males in part because they tend to
be less attentive and more disruptive than girls.
b. Hemispheric asymmetries in various brain structures are associated with higher
levels of androgen hormones, putting males at increased risk for the most
common learning disability.
c. Parents are less likely to read to preschool sons and are somewhat more likely
to encourage girls to excel in school.
d. When females have achievement problems in school, they typically have lower
overall IQ's, and thus would not meet the IQ discrepancy criterion as frequently.
4.
138
Ans. A
App
p. 146
M
Testing has indicated that Linda has dyslexia. Compared to the average student,
she probably
a. has poor phonetic decoding,
b. transposes the order of letters and words.
c. engages in abnormal eye movements.
d. both a and b
4.
139
Ans. B
App
p. 146-7
C
Dr. Reed wants to identify preschool children who may be at risk for later
dyslexia. Research indicates that he should select children who
a. perceive the letters "b-u-s" as "s-u-b" or repeats the phrase "dog ran" as "ran
dog. "
b. have difficulty sounding out the phonemes in the word "cat. "
c. make abnormal eye tracking movements while watching cartoons or reading
picture books.
d. have unusual asymmetries in their planum frontalis.
106
The Redding family is participating in Dr. Hoien's dyslexia study. Which family
members are most likely to share a similar pattern of reading deficits?
a. Mrs. Redding and her daughter
b. the Redding's children, Toni and Rachel, who are two years apart in age
c. Mr. Redding and his son
d. Mr. Redding and his daughter
A student's report on proposed causes of learning disabilities could include each
of the following research findings EXCEPT
a. evidence of planum temporale symmetry or reversed asymmetry in the brain
of poor readers.
b. greater concordance of reading disabilities between MZ rather than DZ twins.
c. influence of insufficient school practice in oral reading and impaired learning
readiness.
d. evidence of genetic factors accounting for roughly 65% of the differences in
reading achievement in the population.
Stanley is an adult who is an above-average reader. Based on available research,
you would expect his planum temporale to be
a. of equal size in his left and right hemispheres.
b. larger in his left hemisphere.
c. larger in his right hemisphere.
d. less well developed than his medial geniculate nuclei.
Several times when Kamaria does homework, her parents sit down with her and
encourage her to show them what she's doing, and they praise not only her
successes but also her effort and interest in her work. Kamaria benefits from
a. learning readiness.
b. academic efficacy.
c. phonological awareness.
d. joint attention.
Anthony's planum temporale is smaller in his left hemisphere than his right, and
his father has a learning disability. Given this situation, which of the following
is the LEAST helpful compensatory strategy for Anthony?
a. parental reinforcement of Anthony's self-efficacy and academic motivation
b. decreased reliance on group-based reading instruction
c. intensive training in vocabulary and grammatical complexity
d. systematic instruction in phonological awareness
If you wanted to refer your dyslexic child client for the most effective treatment,
you would recommend a(n)
intervention.
a. group psychotherapy
b. dietary modification and stress reduction
c. medication and visual skills
d. sound-based reading program
107
SHORT ANSWER / ESSAY
4. 146
According to the DSM-IV, what criteria determine the diagnosis of mental
retardation? How are the AAMR criteria different?
DSM-IV criteria: a score below 70 on standardized IQ test along with impairment in at
least two areas of adaptive functioning (possibly measured with the Vineland Adaptive Behavior
Scales). The AAMR criteria define MR by a cutoff score between 70 and 75 on an IQ test but also
includes the two-area impairment criterion.
4.
147
What is the most common non-heritable form of biologically-caused mental
retardation, and what are some of its characteristic physical and psychological symptoms? What
is the most common heritable form of that disability and some of its characteristics?
The most common non-heritable form of MR is Down syndrome, usually caused by an extra
21st chromosome when that chromosome fails to split during maturation of the egg. Some of the
common characteristics seen in Down syndrome children are the following: eyes which tend to
slant upwards; stocky, shorter-than-average height; small hands with short fingers; premature aging,
including dementia by middle age; IQs of about 50, with worse-than-expected expressive language
skills but reasonably good rote learning and visual-motor skills; and sociability, relatively stable
emotions, and good mental health, in comparison to other MR individuals.
The most common heritable form is Fragile X syndrome, in which one tip of the X
chromosome has an excess of material, making it look thin and "fragile. " Children with this form
of MR show the following: moderate MR, with less severity in females; a long, thin face with a
broad, fiat nose and large ears.
4.
148
What change in the approach to the treatment and education of mentally retarded
individuals occurred in the 1970s? What have been some of the consequences of mis change?
In the 1970s, children who would have previously been placed in long-term institutional
care began to be placed in community-based residential care or supervised living units and were
educated in the public school system. The goal was to foster greater independence and more
"normalized" lifestyles.
The school systems were mandated by the 1975 Individuals with Disabilities Education Act
(IDEA) to provide special educational services to these children, conducted in the least restrictive
setting possible. Many schools chose self-contained special classrooms for disabled children.
However, many of these specialized classrooms have been situated in buildings physically
segregated from regular classrooms, and this practice may promote antidisability biases. Too, the
reliance on IQ tests for assessment has resulted in a disproportionate number of black children being
placed in these classes. To offset these problems, most school districts have turned to
mainstreaming (portions of the day spent in regular classrooms), although the actual implementation
of this practice appears to fall short of its goals.
4.
149
List the three DSM-IV symptom categories for typical autism.
Severe deficits in reciprocal social relationships; nonexistent or poor language skills; and
stereotyped or restricted, repetitive patterns of behavior, activities, or interests
108
4.
149
Mary Ann is an autistic child. Drawing on research described in the text, describe
some of the cognitive deficits she might exhibit.
pragmatic use of language absent or extremely limited; failure to attend to salient social
stimuli; deficit in theory of mind, or the ability to infer the mental states of other people; impaired
executive functioning, or general cognitive abilities in planning and problem solving related to goaldirected behavior (possibly a reflection of frontal lobe deficits)
4.
150
Troy, three years old, is participating in Dr. Lovaas' treatment program for autism.
Describe the kinds of interventions Troy receives and what outcomes could be reasonably predicted.
Troy will be involved in intensive training sessions every day for two years, taking place
at home and in other relevant environments and including Troy's parents and his peers. His
therapist, a psychology graduate student, will focus on Troy's language development and on
cooperative play with peers. Operant conditioning of stereotypy, tantrums, and aggression will also
be employed.
Troy should exhibit a substantial increase in IQ scores by age 7 (on average, 20 points), and
he has roughly a 50/50 chance of entering a regular first-grade class. Follow-up five years later
should show that Troy will have maintained most of his achievements.
4.
151
Yrina is at risk for dyslexia. What biological, educational, and familial factors
(non-biological) could be associated with this risk? What treatment would you recommend and
why?
Biological factors - difficulty with phonetic decoding (or, limited phonological awareness);
genetic factors (probably polygenetic in nature), possibly resulting in a lack of asymmetry or the
presence of reversed symmetry in the planum temporale (the back and upper regions of temporal
lobe) or an abnormal asymmetry in the structure of the medial geniculate nucleus of the thalamus.
Educational factors - exposure to ineffective group instruction with inadequate opportunity
for practice and feedback; lack of an individually tailored curriculum for Yrina
Family factors - insufficient learning readiness instilled by parents; lack of a secure
attachment between Yrina and her parents
Treatment - an educational intervention employing either the whole language or soundbased approach to reading instruction
109
Chapter 5 STRESS, SLEEP, AND ADJUSTMENT DISORDERS
5. 1
Ans. A
App
p. 154
E
What response would you give to a friend who wants to know how to avoid
stress?
a. It is not possible to avoid stress altogether.
b. Maintain an optimistic attitude toward life's challenges.
c. Deal immediately with daily hassles in order to avoid entering the resistance
phase of stress.
d. Develop more extensive social support.
5.
2
Ans. C
Fac
p. 154
M
Stress is
a. relatively unaffected by cultural norms.
b. caused by traumatic events and major life milestone changes.
c. subjectively perceived and defined.
d. primarily a psychological process.
5.
3
Ans. B
App
p. 154
E
Dr. Ruiz is conducting an assessment of a new client. In order to adequately
assess the client's stress, Dr. Ruiz should gather information in several areas.
Which of the following would be LEAST useful?
a. the nature of the client's interpretation of the stressors
b. the adequacy of her innate immune response
c. indices of the client's physiological functioning
d. evaluation of the client's coping strategies
*
5.
4
Ans. C
App
p. 154
M
Based on Resnick et al. 's (1993) phone survey findings, you could predict that
of adult women in your community have been a victim of a major
crime or a noncrime trauma.
a. one quarter
b. one half
c. two thirds
d. four fifths
5.
5
Ans. B
App
p. 154
M
A group of adolescents at the local high school is being asked about the
experience of traumatic events in their childhood. Which of the following is
LEAST likely to be reported?
a. sexual assault
b. attempted kidnapping
c. severe illness or death of loved ones
d. assault involving a weapon or physical injury
5.
6
Ans. C
App
p. 156
E
*
Elisa wants to avoid the possibility that she might be a victim of acquaintance
rape. You would encourage her to take each of the following actions EXCEPT
a. avoiding the use of alcohol or other drugs during the date.
b. refusing to spend the date in an isolated location.
c. dressing conservatively.
d. paying some of the expenses on the date.
110
Annette participated in a 9-week acquaintance rape prevention program offered
at her university. Which of the following outcomes is MOST likely?
a. Regardless of her personal history, she is less likely to report a sexual
victimization than is a student in a control group.
b. If she has no prior history of rape, she is just as likely as a control group
student to report a sexual victimization.
c. If she has a prior history of rape, she is less likely to report a sexual
victimization than is a student in a control group.
d. If she has a prior history of rape, she is just as likely as a control group
student to report a sexual victimization.
Which of the following women is MOST likely to be a victim of sexual assault
as an adult?
a. Margaret, who was a victim of sexual abuse as a child
b. Cyndee, who witnessed the murder of her father when she was 10 years old
c. Cocheta, who was seriously injured in a car accident at age 12
d. Each of these women is at high and equal risk of sexual victimization.
If an individual has poor social skills or other long-term psychological
handicaps, how might this influence the person's stress process?
a. The individual may unintentionally bring about some stressful events in
her/his life.
b. The individual may experience abnormalities in brain chemistry that could
exacerbate the stress responses.
c. An individual with either of these characteristics is more likely to be a
victim of bad luck.
d. Her/his perception and interpretation of stressors may be objectively
incorrect.
If Ferris & Delville's work with young hamsters were found to be applicable to
humans, what outcome would you predict for Jerod who has been repeatedly
bullied and physically assaulted by older brothers?
a. Jerod will be overly aggressive as an adult.
b. Jerod will be overly timid as an adult.
c. Jerod will be chronically ill and susceptible to premature death.
d. Either a or b is possible.
Which of the following stressors is MOST damaging to personal adjustment?
a. the divorce of one's parents
b. dropping out of college due to failing grades
c. being a victim of violent crime
d. The impact of each would depend on an individual's subjective perception.
Marta and Kelly are both inpatients being treated for clinical depression
stemming, in part, from family conflict. Marta's family visits twice a week
without advance notice, and Kelly's family visits twice a week on a regular
schedule. Other things being equal, which patient is under greater stress?
a. Kelly
b. Marta
c. Both are equally stressed by family visits.
d. There is no way to make a prediction in this case.
111
5.
13
Ans. B
Fac
p. 158
M
Which combination of stressor characteristics is likely to result in the greatest
perceived stress and problems in adjustment?
a. unexpected, controllable, caused by the person him/herself
b. unexpected, uncontrollable, caused by a malicious person
c. expected, controllable, caused by the person him/herself
d. frequent, minor, and uncontrollable
5.
14
Ans. D
App
p. 158
M
How do reactions to stress differ between Marcy, an optimistic person, and
Betty, a pessimistic person?
a. Marcy often ignores the symptoms of stress, whereas Betty is usually
oversensitive to changes associated with the alarm phase.
b. Their physiological reactions to stress are different, with Marcy showing
less HYPAC activity.
c. Marcy tends to feel more threatened by a stressful event compared to Betty,
who finds such events more expected and controllable.
d. Marcy is more likely to view the stressor as a challenge, whereas Betty may
see the same event as a threat.
5. 15
Ans. C
App
p. 158-9
E
A clinician works with group therapy clients who have lost their jobs due to
layoffs and who are also experiencing increased marital conflict as a result of
that job loss. Which of the following is the LEAST likely focus of the group's
work?
a. development of optimism and self-esteem
b. cognitive reappraisal of job and marital stressors
c. techniques for the avoidance of the alarm phase of stress
d. enhancement of social support
5.
16
Ans. A
App
p. 158
M
Dr. Williams wants to assess his client's level of stress, and his client is a
Hispanic female who came to the U. S. from Guatemala two years ago. Which
scale would probably be MOST sensitive to his client's experience of major
events?
a. the Life Experiences Survey
b. the Schedule of Recent Experience
c. Selye's General Adaptation Syndrome Interview
d. the Hassles Scale
5. 17
Ans. B
App
p. 158
E
Mitch is completing a survey where he rates whether he has experienced "too
many meetings, " "frequent misplacement of objects, " or "unexpected company. "
What is being assessed?
a. the positive or negative impact of an event
b. life change units
c. chronic procrastination
d. the cumulative effect of small stressors
5. 18
Ans. C
App
p. 158
M
In the last 12 months, Shara has experienced several health, family, and
financial difficulties. She would exhibit high
scores on the
*
a.
b.
c.
d.
major hassles; SRE
negative event; HS
life change units; SRE
life change units; LES
112
In an examination of different types of stressors, which example below could
be considered a significant stressor based upon accumulation?
a. predictable stressors that arise from life's milestones, like getting married,
having children, or starting college
b. unpredictable traumas - earthquakes, floods, or violent encounters
c. relatively minor events such as car trouble, getting stuck in traffic jams, or
losing your lecture notes the night before an exam
d. stressors that are linked to repetitive occupational demands
Roberta is a research assistant for Hans Selye. What is the most likely topic of
her work?
a. autonomic reactivity to sustained stressors
b. behavioral- and emotion-focused coping strategies
c. emotional changes associated with alarm and resistance
d. cognitive reappraisal and social support interventions in adjustment disorders
What is the primary function of physiological reactions to stress?
a. to defend against environmental threat
b. to create adaptation
c. to create conscious awareness of stressors
d. to enhance immune system functioning
Which of the following physiological reactions correctly reflects an example of
the three progressive stages of the GAS?
a. body expands its energy supplies; weight loss; HYPAC activation
b. sympathetic nervous system aroused; immunosuppression; physical energy
depleted
c. adrenal corticosteroids secreted; immune system weakens; weight loss
d. immune system weakened; catecholamines secreted; organ damage
Which of the following emotional reactions does NOT belong with the other
three?
a. fear
b. excitement
c. anger
d. depression
How does Selye describe the alarm stage of the general adaptation syndrome?
a. the stage in which physical and psychological coping mechanisms are used
to defend against the effects of stress
b. the stage marked by emotions such as fear and excitement as well as
heightened levels of attention and concentration
c. the stage in which a person's energy is finally depleted and the ability to
cope with stressors is impaired
d. the stage dominated by sympathetic nervous system activity
113
5.
25
Ans. B
App
p. 160
E
Leah was informed two days ago that her mother suffered a severe stroke. Leah
realizes she will need to take an extended leave from work, find adequate child
care, and spend several hours across many days in the hospital. She is entering
the
stage of stress.
a. prodromal
b. resistance
c. alarm
d. coping
5.
26
Ans. C
Con
p. 160
E
Health psychologists who wish to study the coping strategies of individuals
experiencing ongoing stressors should seek persons in the
stage of stress.
a. alarm
b. exhaustion
c. resistance
d. regulatory
5.
27
Ans. A
App
p. 160
E
Hector is experiencing "burnout" in his role as a probation officer in an
overcrowded, understaffed judicial system. He takes several doses of an
antacid each day and rarely gets a full night's sleep. According to Selye,
Hector is in the
a. stage of exhaustion.
b. stage of resistance.
c. ANS depletion stage.
d. alarm reaction stage.
5.
28
Ans. C
Fac
p. 160
C
Which alarm phase sequence of chemical releases is correctly ordered?
a. ACTH: CRH: epinephrine
b. CRH: HPAC: ACTH
c. CRH: ACTH: corticosteroids
d. HPAC: corticosteroids: CRH
5.
29
Ans. D
Fac
p. 160
M
Which of the following structures and substances are correctly paired?
a. adrenal cortex: endorphins
b. hypothalamus: ACTH
c. pituitary: CRH
d. adrenal medulla: catecholamines
5.
30
Ans. B
App
p. 160
M
Levi is learning to ski and has just lost control on a long slope and cannot stop
his descent. His hypothalamus is releasing
, followed by
.
a. adrenocorticotrophic hormone; the release of endogenous opiates
b. corticotropin-releasing hormone; the release of adrenal corticosteroids
c. catecholinergic hormone; the release of adrenal corticosteroids
d. adrenal-releasing corticosteroids; epinephrine and norepinephrine
5.
31
Ans. D
App
p. 161
E
You are alone on a dark street. Suddenly, you think someone is following you
and getting closer. Which of the following physiological responses would NOT
occur?
a. pupils dilate
b. blood rushes to muscles
c. heart rate increases
d. digestion is stimulated
*
114
5.
32
Ans. A
App
p. 161
C
Wynona tripped and nearly fell down a long staircase. Which of the following
descriptions does NOT apply to her returning state of calm?
a. release of adrenal corticosteroids to shut down the sympathetic system
b. diversion of blood to internal organs
c. decrease in vigilance and attention
d. conclusion of alarm phase
5.
33
Ans. B
App
p. 161
M
Suppose Ruza's adrenal medulla is overactive and frequently secretes a
substance into her bloodstream. What consequence would you observe?
a. profuse sweating and lethargy
b. anxiety and feelings of panic
c. insomnia and feelings of depression
d. You would not expect an overt change in behavior, although her
susceptibility to illness would increase.
5.
34
Ans. B
App
p. 161
M
Alexa finds that her regular exercise routine helps her cope with stressors.
What might best account for this exercise benefit?
a. Physical exercise may result in the release of stress hormones that intensify
the alarm phase and prepare her body to cope with stressors.
b. Physical exercise helps release extra endorphins that help regulate Alexa's
cardiovascular activity and facilitate her psychological coping.
c. Physical exercise promotes perceptual, cognitive, and behavioral adjustments
which all increase Alexa's immediate ability to cope with a stressor.
d. By increasing her heart rate and her body's production of glucose she is
reducing the production of corticosteroids that prolong stress reactions.
5.
35
Ans. C
App
p. 162
M
One day while you are driving to school, a child on a bike darts out in front of
your car. You quickly respond by hitting your brakes and swerving around the
child. You discover mat except for a few minor scrapes everything is fine.
When you get back in your car, your legs are shaking so badly you can't drive,
and the nausea you feel requires you to sit in the car for 15 minutes. What
causes this reaction?
a. The parasympathetic branch of the autonomic nervous system is conserving
the body's energy for answering the immediate threat.
b. You prematurely entered the resistance phase of coping, causing an
extended release of catecholamines.
c. All reactions are by-products of the sympathetic nervous system activity and
mobilization against threat.
d. The reactions were caused by the failure of the body to release epinephrine
and norepinephrine that would have restored ANS balance.
5.
36
Ans. A
App
p. 162
M
Connie notices that no matter what she's eaten recently, when her level of stress
increases, her stomach winds up in knots. What produces this effect?
a. sympathetic system activity which rapidly deactivates digestive processes
b. the release of corticosteroids which interact with stomach acids to create
distress
c. parasympathetic system activity which rapidly activates digestive processes
d. the increase in muscle tone throughout the body, which causes
gastrointestinal constriction
115
5.
37
Ans. C
App
p. 162
M
In his recollection of falling from the parallel bars and breaking an arm during
a gymnastic competition, Bart is LEAST likely to recall
a. his fall from the parallel bars as though it happened in slow motion.
b. the appearance and texture of the parallel bars on which he was
performing.
c. the gasps and cries that went up from the crowd who saw him fall.
d. the thoughts that went through his mind as he fell.
5.
38
Ans. D
App
p. 160, 3
M
*
Ramone was involved in a serious car accident on the way to work. He was
away from his job for one month, and upon returning to his job, he had to
take time off to keep medical and legal appointments for several more days,
creating more tension and anxiety. Which physiological outcome is LEAST
likely in this stage of Ramone's stress reaction?
a. Ramone's ability to continue healing at a normal rate is impaired.
b. Ramone may be developing chronic hypertension.
c. Ramone is increasingly vulnerable to disease.
d. Ramone is sustaining organ damage.
5.
39
Ans. A
App
p. 163
E
After four months of working 14 hours a day to try to keep her business
afloat, Rosa is 15 pounds underweight and now feels helpless to avoid
bankruptcy. What GAS stage does she appear to be in?
a. exhaustion
b. resistance
c. alarm
d. collapse
5.
40
Ans. B
Con
p. 163
E
What sort of innate immunity do physicians rely on for defense against
pathogens?
a. protective clothing
b. skin
c. T cells and B cells
d. antibiotics
5.
41
Ans. C
App
p. 163
E
The human immunodeficiency vims is a type of
a. microphage.
b. lymphocyte.
c. antigen.
d. interleukin.
5.
42
Ans. D
App
p. 163
E
If Bobbi is exposed to a cold vims which invades her body but she does not
become ill, her
immunity functioned effectively.
a. innate
b. pathogenic
c. acquired
d. specific
116
5.
43
Ans. A
App
p. 163
M
Mato's body is fighting a foreign pathogen. This pathogen has been identified
by
and will be destroyed by
.
a. macrophages; killer T cells
b. antigens; interleukins
c. helper T cells; B cells
d. macrophages; antigens
5.
44
Ans. D
App
p. 163
M
Yolanda had been under the weather for several days, but as of today she feels
back to normal. Why was her immune system slow to ward off what was
probably a minor pathogen?
a. Macrophage activity was probably slow to identify this mild pathogen.
b. B cells had to release several types of antibodies to effectively combat the
pathogen.
c. Interleukins failed to summon sufficient numbers of helper B cells.
d. The match between antigen and sufficient numbers of specific killer T cells
was slow.
5.
45
Ans. A
App
p. 163
M
*
First Mr. Danoi had the flu; then his wife caught it; then their two children
were home sick for several days, but Mr. Danoi was well again. Why should
he not worry about catching the flu again from his children?
a. Memory T cells are poised to quickly destroy the familiar pathogen.
b. Helper B cells will release antibodies specific to the pathogen.
c. Killer T cells will be more readily recruited by interleukins, destroying the
pathogen before it can cause symptoms,
d. Autoimmune macrophages will rapidly identify and destroy the familiar
pathogen.
5.
46
Ans. D
App
p. 163
M
Ronald received a bone marrow transplant from his brother in an effort to treat
cancer. One of the anticipated benefits of this transplant could be
a. increased killer T cell production,
b. decreased antigen production.
c. increased suppressor T cell production,
d. increased B cell production.
5.
47
Ans. B
App
p. 163
M
David has successfully overcome a respiratory infection. The fact that his
effective killer T cells have now stopped their activity is
a. likely to inhibit the creation of memory T cells.
b. the expected result of suppressor T cell activity.
c. a sign of an impending autoimmune disease.
d. related to the adaptive cessation of interleukin activity.
5.
48
Ans. C
Fac
p. 163-4
E
There are several T lymphocytes in the body, but
a. helper
b. memory
c. antibody
d. suppressor
117
is NOT one of them.
5.
49
Ans. D
App
p. 163-4
E
If Wyatt's body were found to be deficient in interleukins, what process in his
immune system would be directly affected?
a. Antigens could not be identified.
b. Pathogens could not be devoured.
c. Antibodies could not be released into the blood.
d. B and T cells could not be recruited to kill a pathogen.
5.
50
Ans. C
App
p. 163-4
E
*
Your healthy, competent immune system should include each of the following
EXCEPT
a. a high number of killer T cells.
b. a low number of antigens.
c. a high number of suppressor T cells.
d. a high number of B cells.
5.
51
Ans. D
App
p. 163-4
M
Dr. Lincoln is a health psychologist studying the relationship between stress
responses and immune functioning. Of me various substances secreted in the
body during times of stress, which one is of specific interest to Dr. Lincoln?
a. the catecholamines
b. serotonin
c. suppressor T cells
d. glucocorticoids
5.
52
Ans. A
Con
p. 160, 4
E
Which of the following physiological reactions does not belong with the other
three?
a. immune defense activation
b. fight-or-flight response
c. enhancement of energy production in muscles and brain
d. corticosteroid release
5.
53
Ans. C
App
p. 164
E
Bertrand is trying to learn how to tolerate the stressors in his life, such as his
neighbor who mows his lawn at 7: 30 on Saturday mornings. In other words,
he is
a. adapting.
b. suppressing.
c. coping.
d. managing.
5.
54
Ans. D
App
p. 164
E
For several days, Francine has been ill with the flu and is getting further and
further behind in her classwork. She's been dealing with this situation by
calling her classmates and asking them to make copies of their notes and to
bring these to her dorm room. She is engaged primarily in
a. cognitive reappraisal.
b. emotion-focused coping.
c. defensive support.
d. problem-focused coping.
118
If Ishi were experiencing stress due to the actions of a new and incompetent
coworker and she chose a problem-focused coping approach, Ishi would
a. request a meeting with the coworker and their supervisor to discuss the
situation.
b. seek out colleagues at work who will understand and sympathize with her
experience.
c. think about the new worker's lack of experience and the likelihood that this
person's abilities will improve in the future.
d. make a voodoo doll of the person and displace her frustration onto the doll
by jabbing it with pins and putting curses on it.
When Miriam lost her job, she said to herself, "Well, I've been wanting to go
back to school for my master's degree. I guess this is a sign that it's time to
do that!" What coping strategy is she employing?
a. inner-focused coping
b. cognitive reappraisal
c. defense mechanism
d. problem-focused coping
Kristos and his cousin, Victor, get away from the pressures of their jobs by
going fishing together for several hours twice a month. Which coping
approach is NOT applicable in this situation?
a. social support
b. problem-focused coping
c. emotion-focused coping
d. distraction
A husband is worried about his wife's excessive weight and her poor health
habits, which have led to cardiovascular problems. Which type of coping
strategy would he be using if he made a comment in front of some friends
about his wife's idea of physical exercise being "shop 'til you drop"?
a. a defense mechanism, because he is using humor to indirectly express his
feelings and avoid conflict
b. social support strategy, because he is venting his frustration to some friends
who understand his concerns
c. emotion-focused coping, because he is trying to eliminate the stressor of
her shopping by changing his emotional response
d. problem-focused coping, because he is directly trying to solve the problem
of his wife's lack of exercise
Which of the following coping strategies does not belong with the other three?
a. problem-focused
b. social support
c. defense mechanisms
d. emotion-focused
119
5.
60
Ans. D
App
p. 165
M
*
Gina has just finalized her divorce. Which characteristic of her social support
network is most important in helping her cope with this experience?
a. the number of friends and family members with whom she interacts
regularly
b. objective measures of the quantity and quality of the support given by
people around her
c. her reliance on social support as a problem-focused rather than emotionfocused coping strategy
d. her own perception about her friends and family's level of care for her and
her value to them
5.
61
Ans. C
Fac
p. 165
E
Based on information from Stone and Neale (1984), females are somewhat less
likely to use
than males are.
a. defense mechanisms,
b. social support as a means of coping.
c. problem-focused coping.
d. emotion-focused coping.
5.
62
Ans. D
App
p. 165
C
*
Which of the following persons might MOST effectively make use of a
defense mechanism coping approach?
a. Vondra, who just learned that her mother has lung cancer
b. Mike, who just lost his job as an advertising executive due to his lack of
productivity
c. Emilio, who has been arrested on a false charge of cocaine possession
d. Marissa, who was just in an automobile accident and sustained minor
injuries
5.
63
Ans. A
Fac
p. 165
E
The MOST effective coping strategy is
a. one which fits a given stressor and its context.
b. either problem- or emotion-focused coping.
c. cognitive reappraisal.
d. social support.
5.
64
Ans. B
App
p. 165
C
For several years Jillian has had chronic migraine headaches that are usually
unresponsive to medication. What coping approach might be MOST helpful?
a. a denial defense mechanism
b. learning as much as she can about her condition in order to anticipate its
course and effects
c. increasing the number of people she spends time with in order to enhance
her social competence
d. changing her emotional reaction to her headaches by employing humor
5.
65
Ans. A
App
p. 164-5
C
After the Oklahoma City federal building bombing, security was noticeably
heightened for many federal offices. Based on evidence presented in the text,
which coping approach would you be LEAST likely to recommend to
employees trying to cope with their fears of another bombing?
a. problem-focused coping
b. emotion-focused coping
c. social support
d. defense mechanisms
120
5.
66
Ans. C
App
p. 166
M
Jahi has a young child with moderate mental retardation. He deals with this
stressor by volunteering for lengthy out-of-town business trips and shutting
himself in his study at home to work on the computer. If his friends and
family encourage him to seek family counseling to reduce this denial
mechanism, what kind of effect would this social support have?
a. a direct effect
b. a competence effect
c. a buffering effect
d. a minimizing effect
5.
67
Ans. A
Fac
p. 166
E
What variable has been hypothesized to account for the stress/social support
connection?
a. social competence
b. intelligence
c. gender
d. Type A personality
5.
68
Ans. D
Fac
p. 166
M
It seems clear that a lack of social support generally puts people at higher risk
for both physical and psychological disorders. However, when might social
support worsen rather than help a person's coping efforts?
a. when an individual is utilizing problem-focused or defense mechanism
coping approaches
b. when the support occurs indirectly instead of directly, lessening its value
c. when it is not associated with increases in the recipient's social competence
d. when helpers take full responsibility for directing the recipient's coping
response
5.
69
Ans. C
App
p. 167
M
Vicente's home was burglarized twice in the past year and he lost several
valued family heirlooms. If his hypertension is more severe as a result of
these events, how would this condition be described in the DSM-IV?
a. somatoform disorder
b. psychosomatic disorder, with associated medical condition
c. psychological factors affecting medical condition
d. adjustment disorder
5.
70
Ans. B
Fac
p. 167
E
What psychological disorder occurs when an individual experiences an
unusually severe stressor and subsequently exhibits distinct symptoms of
disturbance that last for at least 1 month?
a. somatoform disorder
b. posttraumatic stress disorder
c. adjustment disorder
d. stress-induced anxiety disorder
5.
71
Ans. D
App
p. 167
M
*
A clinician is writing an assessment report. How would a client's recent
marital separation and arrest for attempted assault be noted in that report?
a. They would be specified on Axis I along with the client's clinical diagnosis.
b. They would only be noted if they have exacerbated a previous mental
disorder.
c. They would be described in the "Background" section of the report only.
d. They would be noted on Axis IV.
121
5.
72
Ans. A
App
p. 167
E
Kauli is a 73-year-old male. If his sleep duration is average for his age group,
a. he sleeps about 6 hours a night.
b. he sleeps about 10 hours a night.
c. he sleeps longer than the average 45-year-old.
d. he sleeps about as long as a typical 9-month-old infant.
5.
73
Ans. C
App
p. 168
M
A therapist wants to enhance her clients' coping resources. In a therapy group
for adults who were sexually abused as children, she asked each of them to
talk about their experiences and their feelings. For whom might the therapist
predict the most improved functioning, based on Pennebaker et al. 's findings?
a. clients who relied almost exclusively on problem-focused coping
b. clients who expressed mild feelings of anger, disappointment, and other
negative emotions
c. clients who expressed very strong feelings of rage, betrayal, and other
negative emotions
d. clients who engaged in cognitive reappraisal in order to reestablish family
social support networks
5.
74
Ans. D
App
p. 168
M
If Jen experiences "stressor offset" following finals week of her last semester
of college, she will
a. reduce the effect of academic stress by pursuing sources of social support.
b. engage in emotion-focused coping and thereby reduce her risk of physical
illness.
c. use cognitive reappraisal to justify the stress she has just endured.
d. become ill after the stress of school has ended.
5.
75
Ans. A
Con
p. 168
M
According to Pennebaker, which of the following research questions may be
most productive for future researchers in the area of stress and coping?
a. "What aspects of interpersonal stressors are most important in adversely
affecting individual adaptation?"
b. "What similarities are found across cultures regarding individuals' approach
to emotion-focused coping?"
c. "Why are natural disasters more psychologically harmful to their victims
than technological disasters are?"
d. "Why is the process of talking about feelings more productive than the
process of writing those feelings on paper?"
5.
76
Ans. B
App
p. 169
M
*
Ariel has insomnia. Recent evidence suggests that she
a. will probably develop a mental disorder.
b. has a biological disturbance that is also common in many mental disorders.
c. had a preexisting depressive or anxiety disorder that is causing the sleep
disturbance.
d. actually experiences fewer major stressors than do persons without
insomnia.
122
5.
77
Ans. C
App
p. 169
M
Dr. Eisenstein is conducting a polysomnographic assessment. This means that
she is
a. conducting a multifaceted, structured clinical interview regarding a client's
sleep characteristics.
b. studying the effects of varying levels of sleep deprivation on cognitive
processes such as memory and attention.
c. observing several physiological patterns during a client's sleep.
d. graphing a sleep client's responses to various medications for insomnia.
5.
78
Ans. D
App
p. 169
E
In order to monitor Angela's transition from stage 2 to stage 3 sleep, you
would use an
a. EMG.
b. EKG.
c. EOG.
d. EEG.
5.
79
Ans. A
App
p. 169
E
Doris, a research assistant in a sleep lab, forgot to turn on the monitor that
tracks eye movements. What stage of sleep will be difficult to discern?
a. REM
b. stage 4
c. stage 2
d. stage 1
5.
80
Ans. B
App
p. 169
E
If he has a typical night's sleep, Bruno will spend most of his time in
a. stage 1.
b. stage 2.
c. stages 3 and 4.
d. REM.
5.
81
Ans. C
Con
p. 169
M
Which characteristic below does NOT belong with the other three?
a. immune system replenishment
b. delta waves
c. learning consolidation
d. NREM sleep
5.
82
Ans. A
App
p. 169
M
Zachary's EEG shows a preponderance of delta wave activity. If interrupted in
this stage,
a. he would be very difficult to awaken,
b. he would probably report he had been dreaming.
c. he would probably be aware that he is experiencing an erection.
d. he would be in the stage he spends the most time in each night.
5.
83
Ans. D
App
p. 169
E
Lisa has just begun to dream. Her PSG activity will be MOST similar to that
of
a. deep sleep.
b. circadian sleep.
c. stage 2.
d. stage 1.
123
5.
84
Ans. A
App
p. 169
M
If Loni is in REM sleep, she will exhibit each of the following EXCEPT
a. increased muscle activity.
b. increased heart rate and respiration.
c. rapid eye movements.
d. brain wave activity similar to stage 1.
5.
85
Ans. B
App
p. 169
C
Alex is seeking help from a counselor for impotence, being unable to
experience an erection. If the counselor wants to determine whether there is
an underlying physical problem, what sleep stage will the counselor monitor?
a. stage 1
b. REM
c. stage 3
d. This would not be an effective means of obtaining relevant information.
This week, Dara has gotten very little sleep while studying for final exams in
college. Subsequently, when she gets a full night's sleep she will
a. spend more time in stage 1 & 2 sleep and less time in REM sleep.
b. spend more time in stage 3 & 4 sleep and less time in REM sleep.
c. enter REM sleep sooner than usual and spend more time in it.
d. enter deep sleep sooner than usual and spend about half the night in it.
5.
86
Ans. C
App
p. 169-70
E
*
5.
87
Ans. D
Fac
p. 170
E
The inactivity of the locus coemleus during REM sleep suggests that this stage
is important for the regulation of
a. the circadian rhythm.
b. serotonin.
c. the endocrine system.
d. norepinephrine.
5.
88
Ans. B
Con
p. 169-70
M
A student's report on characteristics of sleep could include each of the
following EXCEPT
a. sleepers go through four to six 90-minute sleep stage cycles each night.
b. deprivation of NREM sleep interferes with consolidation of learning.
c. in the last half of a night's sleep, stage 3 and 4 decrease and REM
increases.
d. both NREM and REM sleep stages decline substantially across the lifespan.
5.
89
Ans. C
Con
p. 170
M
In the same way that the alarm clock next to your bed lets you know when it's
time to get up, your
acts as a circadian alarm clock.
a. hippocampus
b. pineal gland
c. suprachiasmatic nucleus
d. superior colliculus
5.
90
Ans. A
App
p. 170
E
Although its validity as a treatment for sleep disturbance has been strongly
challenged,
is an important hormone in the sleep/wake cycle.
a. melatonin
b. corticotrophin
c. serotonin
d. suprachiasmatin
124
5.
91
Ans. C
App
p. 170
M
*
5.
92
Ans. D
Fac
p. 171
E
Sleepy is one of the Seven Dwarfs, named for the mental state he exhibits
throughout the day. It is likely that his
is functioning abnormally.
a. locus coemleus
b. amygdala
c. hypothalamus
d. medulla
Which sleep disorder category will you NOT find in the DSM-IV?
a. primary sleep disorders
b. substance-induced sleep disorders
c. sleep disorders related to another mental disorder
d. secondary sleep disorders
5.
93
Ans. A
App
p. 171
E
Roland has a substance-induced sleep disorder. If it is caused by the substance
most frequently associated with this sleep disorder, its etiology is
a. alcohol intoxication or withdrawal.
b. caffeine intoxication.
c. sedative withdrawal.
d. cocaine intoxication or withdrawal.
5.
94
Ans. B
App
p. 171
M
It is very likely that you have at some point experienced some of the
symptoms of a dyssomnia. This means you could have experienced a
disturbance in any of the following EXCEPT
a. the quality of your sleep.
b. unusual behaviors during sleep.
c. the timing of your sleeping and waking.
d. the amount you sleep.
5.
95
Ans. C
Fac
p. 171
E
According to the DSM-IV, which category of disorders involve unusual
behaviors or abnormal physiological events during sleep?
a. sleep disorders due to a general medical condition
b. substance-induced sleep disorders
c. parasomnias
d. dyssomnias
5.
96
Ans. C
App
p. 171
M
Janet has just been informed by her physician that she suffers from the most
common form of dyssomnia. Which characteristic does NOT apply to Janet?
a. She suffers significant unhappiness or dysfunction because she has
difficulty staying asleep.
b. Her disorder probably has biological, behavioral, and cognitive causes.
c. She probably has a substantial delay in sleep onset and sleeps fewer than
five hours.
d. She is bothered by sleepiness during the day but engages in worry and
rumination before bedtime.
125
5.
97
Ans. D
App
p. 171
M
Based on epidemiological data, which of the following persons is most likely
to have a dyssomnia?
a. Reggie, who consumes alcohol before bedtime and sleeps about 7 hours
b. Cassandra, who sleepwalks and has occasional nightmares
c. Marlon, whose three-year-old daughter wakes him about once a month
when she has a night terror
d. Delia, whose job requires her to change from day to evening to graveyard
shifts every three months
5.
98
Ans. C
Fac
p. 171
E
Most adults report getting about
hours of sleep per night; self-identified
adults with primary insomnia get about
hours.
a. 9; 6
b. 8; 5
c. 7; 7
d. 7; 5
5.
99
Ans. A
App
p. 171-2
E
One of your friends is complaining that she feels sleepy during the day
because she has trouble falling asleep and wakes up often during the night.
You could give her several suggestions that might help her get a better night's
sleep. Which of the following would be LEAST useful?
a. Read or watch TV in bed in order to relax.
b. Avoid drinking caffeine or alcohol for a few hours before bedtime.
c. Develop cognitive reappraisal coping strategies that reduce rumination.
d. Try to develop a reasonably consistent bedtime and try to get up about the
same time each morning.
5.
100
Ans. B
Con
p. 171
E
Dr. Dreme is studying sleep disorders in adults. If he wants to assure himself
of an adequate sample size, on which disorder should he focus?
a. nightmare disorder
b. primary insomnia
c. narcolepsy
d. primary hypersomnia
5.
101
Seven-month-old Tabitha is waking Samantha and Damn several times a night,
Ans. A
and their pediatrician indicates that Tabitha has ISD. This dyssomnia could be
App caused by any of the following factors EXCEPT
p. 172
a. the use of Tabitha's crib for activities other than sleep.
M
b. the presence of parental discord or conflict.
c. cultural pressure for American children to go to bed before the parents do.
d. Tabitha's overactive temperament.
5.
102
Ans. B
App
p. 172
E
In the middle of an afternoon meeting, Shane was suddenly overcome by REM
sleep and cataplexy for several minutes. What probably accounts for this
event?
a. REM sleep rebound
b. narcolepsy
c. Orcadian sleep disorder
d. secondary hypersomnia
126
If high-speed aircraft, such as the Concorde, come to be routinely used for
international travel, which disorder might passengers exhibit?
a. delta sleep disorder
b. ultradian sleep stage disorder
c. circadian rhythm sleep disorder
d. environment-induced sleep disorder
Children are more likely than adults to suffer several sleep disorders, but this
is NOT true for
a. sleep terror disorder.
b. nightmare disorder.
c. sleepwalking disorder.
d. primary insomnia.
Barbara is a 4-year-old child experiencing a parasomnia that occurs in REM
sleep. This means she has
a. nightmare disorder.
b. sleep terror disorder.
c. sleep apnea.
d. either a or b.
As had happened several nights before, Bobby woke up at 2 a. m. screaming
and was agitated and panicked when his parents rushed to see what the
problem was. In the morning, Bobby's parents asked him about his bad dream,
but he recalled nothing about it and seemed unaffected by his ordeal. What
disorder is present?
a. nightmare disorder
b. sleep terror disorder
c. nocturnal fear disorder
d. childhood sleep disturbance
Sammy was found sitting in front of a blank TV screen at 2 o'clock in the
morning, apparently after sleepwalking from his bedroom. His parents were
unable to wake him as they put him back in bed. During what stage of sleep
did this behavior probably occur?
a. stage 1
b. stage 2
c. stage 4
d. REM
Which of the following sleep disorders and medical treatments are
mismatched?
a. hypersomnia: stimulant medication
b. primary insomnia: sedative medication
c. narcolepsy: antidepressant medication
d. All of the above are correctly matched.
127
5.
109
Ans. A
App
p. 173
M
Tess is relieved to have "cured" her insomnia by obtaining a prescription for
Halcion, which is helping her sleep through the night. Unfortunately, there are
several cautions to bear in mind about this approach. Which of the following
is NOT one of those concerns?
a. The drug may cause hypomanic symptoms during the day.
b. She may experience a side effect of daytime drowsiness.
c. The drug will probably cause both tolerance and dependence effects.
d. She may have increased insomnia when she stops taking the drug.
5.
110
Ans. C
Fac
p. 173
E
What would you recommend as an effective treatment for an individual with
primary insomnia?
a. prescription drugs such as Halcion or Dalmane
b. individual psychotherapy
c. sleep hygiene counseling
d. cognitive reappraisal therapy, including assessment in a sleep laboratory to
demonstrate that the person really does not differ in sleep onset or duration
compared to most adults
5. 111
Ans. B
Fac
p. 173
M
What factors must be present in order to diagnose as an adjustment disorder
according to the DSM-IV?
a. The stressor must be severe (such as the death of a loved one) and the
person must report adequate coping skills and moderate distress.
b. Behavioral or psychological symptoms must occur within 3 months after
the stressor's appearance and last no longer than 6 months after the stressor
or its consequences have ended.
c. The symptoms should not exceed what would normally be expected from
exposure to an extreme stressor and can last 3 to 12 months.
d. The person's symptoms are severe, likely to last a long time, fit Axis I
criteria, but have lasted for only 2 months.
5.
112
Ans. D
App
p. 173
E
Dr. Southwick is a full-time counselor at a university counseling center and
sees many students with an adjustment disorder. In order to specify the type
of disorder each student exhibits, he will need to assess each of the following
EXCEPT
a. the nature of the stressor.
b. behavioral difficulties.
c. depressed mood.
d. anxiety symptoms.
5. 113
Ans. A
App
p. 173-4
M
A graduate student in clinical psychology is working with a client who feels
tense, nervous, and restless following several stressful experiences. In order to
decide whether this reflects an adjustment disorder or if it reflects PTSD, the
student should consider each of the following EXCEPT
a. Are the stressors interpersonal, environmental, or technological?
b. Are the stressors unusually severe?
c. Are specific behavioral and autonomic nervous system symptoms present?
d. Are the symptoms mild and likely to be of short duration?
128
5. 114
A health insurance auditor is inspecting the reimbursement claims made by
Ans. B
clients for psychotherapy services they have received for adjustment disorders.
App If the auditor has taken this abnormal psychology class, she will have which
p. 173-4
question in mind during this process?
C
a. Why are substantially more females given this diagnosis than are males?
*
b. How many of these clients might actually have an Axis I disorder?
c. Why have therapists provided treatment when this disorder is not associated
with significant distress or functional impairment?
d. Why are so few clients in outpatient settings given this diagnosis?
5.
115
Why might adjustment disorder diagnoses be unreliable?
Ans. C
a. This disorder, used primarily for males, contains negative stereotypes that
Fac
are
often associated with mental illnesses.
p. 174
b. Someone with this disorder has symptoms that range widely in form but
M are typically mild and of limited duration.
c. This diagnosis does not take into account any of the behavioral symptoms
which may be present as a direct response to a stressor.
d. The diagnosis is often made to avoid using a more serious diagnosis and
when symptoms do not fit well into other DSM-IV categories.
5.
116
Ans. D
App
p. 174
E
If Ned has an adjustment disorder with mixed anxiety and depressed mood,
what sort of stressor has he probably endured?
a. a one-time event of moderate severity
b. multiple hassles or repeated failures
c. a minor or moderate stressor of extensive duration
d. Any of the above are equally possible.
5.
117
Ans. A
App
p. 174-6
M
Many residents of the southeastern U. S. have been inundated by rain which
has caused repeated and severe floods. Crisis intervention teams should assess
several characteristics of individuals subjected to this disaster, but
is probably LEAST important in this initial assessment.
a. the number of other flood victims in close proximity to the individual
b. the depth to which a person was physically submerged during the flood
c. the degree of control the person felt s/he had during the crisis
d. the length of time the person spent in flood waters
Dr. Parrilla has been recruited by the American Red Cross and the American
Psychological Association as a member of the , a team that
responds to the immediate mental health needs of groups affected by disasters,
a. Emergency Mobilization Unit
b. Disaster Response Network
c. Immediate Intervention Team
d. Quick-Response Disaster Specialists
5.
118
Ans. B
App
p. 176
E
129
5.
119
Ans. A
App
p. 176-7
M
The U. S. government recently disclosed that military personnel were exposed
to high doses of radiation during nuclear tests in the 1940s and 50s. Why
might the stress of this exposure be particularly damaging to its victims?
a. It is expected that the tests should have been carefully controlled by
government and military leaders.
b. The physiological effects will far outweigh individuals' psychological
ability to cope successfully.
c. The nuclear tests occurred with advance notice, giving victims time to
ruminate.
d. Victims are not likely to blame the government for their exposure, despite
evidence to the contrary.
5.
120
Ans. B
App
p. 176-7
M
According to the hypothesis set forth in the chapter, which of the following
disasters would cause greatest psychological harm for its victims?
a. an earthquake that occurred without warning
b. a massive release of toxic gases from a chemical manufacturing plant
c. a passenger train derailment with numerous fatalities caused by a tornado
d. loss of property and lives in a lightning-sparked forest fire exacerbated by
several months of drought
5.
121
Ans. C
Con
p. 177
E
Clients who report one of the three most upsetting life events on Holmes &
Rahe's Social Readjustment Rating Questionnaire are experiencing
a. some sort of disaster stressor,
b. an occupational or social stressor.
c. an interpersonal stressor.
d. a medical or interpersonal stressor.
5.
122
Ans. D
App
p. 177
E
Louise has been separated from her husband for 7 months, following 22 years
of marriage. She feels depressed, has missed work for several days, has
frequent headaches, and spends a great deal of time blaming herself for all the
imperfections in me marriage. Which of the following is NOT relevant to her
situation?
a. The separation is probably not an isolated relationship stressor but a
reflection of longer-term marital discord.
b. Her emotion-focused coping interferes with her ability to employ problemfocused and cognitive reappraisal strategies.
c. She is less able to make use of her social support network and may begin
to alienate remaining support.
d. All of the above apply to her situation.
*
5.
123
Jasud's soccer coach is helping him use effective problem-solving to deal with
Ans. A his failure to win a sports scholarship to the college of his choice, a goal Jasud
App
had worked toward for three years. After encouraging Jasud to brainstorm
p. 178
several possible solutions for this situation, the coach should next recommend
M
a. evaluating the short-and long-term consequences of each of those options.
b. clarifying Jasud's primary goal and the obstacles to that goal.
c. selecting a general strategy that might remove the obstacles to the goal.
d. talking with a mental health professional, the type of person most able to
enhance Jasud's coping resources.
130
5.
124
Ans. B
App
p. 178
M
A group of introductory psychology students has been asked by their instructor
to spend 20 minutes a day writing about traumatic events in their lives. Based
on the information presented in the text, what outcome is anticipated for the
students?
a. an increase in effective problem-focused coping
b. better immune system functioning and lower levels of psychological
distress
c. increased recognition of and commitment to social support networks
d. an opportunity to reflect on the lower level of stress the students are
presently experiencing, resulting in enhanced optimism
SHORT ANSWER / ESSAY
5.
125
Given that stressors depend upon individual differences, situational
characteristics, and cultural differences, list the characteristics of stressors that tend to create
heightened perceptions of harm.
Lack of social competence, cumulative stressors, long-term stressors, unexpected
stressors, coping alone rather than with the support of others/lack of social support, a sense of
helplessness or lack of control, intentional or careless behavior by others that creates stressors,
pessimism/introversion, technological disaster, inflexible coping strategy.
5.
126
Jenna has just discovered that she failed her first biochemistry exam. She
must pass this class and other science classes with a grade of at least a B to be considered for
the school's pre-med program. Describe how the GAS might apply to Jenna's stress response.
Jenna will first experience the alarm reaction. In this stage, her sympathetic nervous
system will be activated, creating sensations of a racing heart, shortness of breath, and literal (as
well as figurative) knots in her stomach. She will be faced with the decision to flee the whole
situation or to choose a means by which to fight back. Her emotions will probably include
panic, fear, and possibly anger or frustration.
If her performance improves in the class, she will at least momentarily reestablish
equilibrium. If the next exam, however, also reflects a poor grade, she may move into the stage
of resistance. She no longer expends acute physiological energy but begins to engage in more
deliberate coping efforts, which could take many forms (e. g., emotion-focused, social support).
She may experience feelings of tension and anxiety, and may make use of defense mechanisms
to deal with additional temporary stressors.
If Jenna spends the next semester struggling to "make the grade" to get into the premed program and she finds she must spend endless hours studying to the exclusion of her
friends and leisure activities, she may begin to show some signs of the exhaustion stage. If she
enters this stage, she will experience weight loss, increased vulnerability to illness due to
immunosuppression, and physical fatigue. Her studies will become ineffective due to impaired
attention and concentration, impaired coping efforts, disorganized thinking, and insomnia. She
will probably feel hopeless, helpless, and desperate.
131
5.
127
List the components of the HYPAC & SAM axes response during the alarm
stage of the GAS.
Hypothalamus secretes CRH - corticotropin-releasing hormone > CRH signals pituitary
to secrete ACTH - adrenocorticotrophic hormone > ACTH directs release of adrenal cortex
secretion of adrenal corticosteroids - "stress hormones" which prepare body to fight or flee
Hypothalamus stimulates the sympathetic NS > sympathetic NS stimulates adrenal
medulla's catecholamine production > activity in parasympathetic NS shuts down which prepares
body to fight or flee
[Optional - students may not think to include the following, though it is applicable:
HYPAC & SAM also activate endogenous opioids/endorphins]
5.
128
Micki has mononucleosis. Describe the process by which her immune system
will fight this illness, including attention to the various "soldiers" in this battle.
Specific immunity will be involved:
a. macrophages will identify pathogen by locating antigens on its surface and will
then devour and produce a digested form of the pathogen;
b. macrophages will then summon interleukin-1 which will summon various killer T
cells to destroy the remaining pathogen and helper T cells;
c. helper T cells secrete interleukin-2, which, in turn, will summon additional T and B
cells; B cells release antibodies;
d. a sufficient number of correctly matched killer T cells must be recruited to fully
destroy the virus;
e. suppressor T cells stop the activity of killer T cells before they begin to destroy
healthy body elements;
f. interleukins marshal memory T cells which will destroy the mononucleosis
pathogen if it enters Micki's body again in the next few days after she is well
5. 129 Joe's home was destroyed by an earthquake in central Oregon. Give an example of
how he might utilize each of the coping approaches described in the chapter.
No modal response reliably predicted. Answer should include a concrete example of
each of the following:
problem-focused coping aimed at changing the stressor itself;
defense mechanism of denial, projection, or humor;
emotion-focused coping aimed at altering his emotional reaction but not the stressor;
search for or use of social support — can include any of the above components also;
cognitive reappraisal to alter perception and meaning of the stressor.
5.
130
Imagine you have just gone to bed for a typical night's sleep. Describe in
detail the stages you will go through as well as the general pattern of your night's sleep.
Stage 1 — 30-second to 10-minute duration, muscles begin to relax, body temperature
begins to drop, easily awakened
Stage 2 — 30- to 45-minute duration, marked by significant EEG shifts
Stage 3 & 4 - 10 to 20% of night's sleep, deep sleep marked by delta waves,
restorative/immune replenishing sleep, very difficult to be awakened
132
[5. 130 cont'd]
REM — much like stage 1, rapid eye movements, increased sympathetic NS activity,
virtual body paralysis except for penile erections, likely to be dreaming, activity of
norepinephrine suppressed in locus coeruleus, possible consolidation of learning
Will spend about 90 minutes in NREM stages; 50% of night in stage 2; will sleep 7
hours on average, going through about 5 (4-6) stage cycles
5.
131
A woman seeks therapy because of insomnia. She states that before going to
bed she has a glass of wine to relax her. However, she indicates that when she goes to bed she
just cannot stop thinking about everything and now she thinks about how she is not sleeping.
She's tried such things like going to bed early and reading a book, increasing her intake of wine,
and going to bed at different times throughout the week. In the morning she is so tired that
coffee seems to have no effect, so she drinks several cups of coffee throughout the day and
evening. Identify the possible contributing factors to this woman's dyssomnia. Would you
recommend that she ask her doctor for a sedative or tranquilizer to help her sleep? Explain.
Use of alcohol disrupts sleep; ruminative cognitive process interferes with relaxation
and unwinding; nonsleep-related activity of reading a book distracts from perception of bed as a
place only for sleep (and sex); irregular bedtime disrupts sleep onset; use of caffeine also
distruptive.
A medication may cause daytime sleepiness, is likely to cause tolerance and
dependence, and may create more severe insomnia when it is discontinued.
5.
132
An adolescent male is brought into counseling by his parents because of
trouble in school and at home. The boy reports that he hates school since he broke up with his
girlfriend, doesn't really care about anything, has lost weight, and the counselor notes that he
appears to have low self-esteem. It is discovered that 3 months have elapsed since the break-up,
and while the teenager typically acts as though the event "was no big deal, " the interpersonal
stressor had obvious effects. When the police brought him home one evening because of curfew
violation and disruptive public behavior, his parents insisted on counseling. What diagnosis best
fits the adolescent in this case?
Adjustment disorder with mixed disturbance of emotions and conduct
5.
133
Describe the seven steps involved in effective problem-solving.
1. Clearly define the problem by identifying major goals and relevant obstacles.
2. Identify as many alternative solutions to the problem as possible.
3. Evaluate the short- and long-term consequences of each of those proposed
alternatives; then select one general strategy for solving the problem.
4. List several specific, concrete alternative approaches/tactics for implementing the
general strategy.
5. Evaluate the pro's and con's of those tactics, and then choose the one that looks
most feasible.
6. Take action to implement the chosen tactic.
7. Assess the effectiveness/usefulness of your actions; if the problem remains, return
to step 2 or 5 and carry out the process again through step 7.
133
Chapter 6 PSYCHOLOGICAL FACTORS AND HEALTH
6.
1
Ans. B
Fac
p. 184
E
What portion of patients who visit a physician do so because of physical
symptoms caused by psychological distress?
a. about one half
b. about one third
c. about one fifth
d. less than one tenth
6.
2
Ans. C
Fac
p. 184
E
What portion of patients who visit a physician do so because of physical
symptoms that have developed largely because of unhealthy behaviors such as
smoking and drinking?
a. about five percent
b. about ten percent
c. about thirty percent
d. about sixty percent
6.
3
Ans. C
App
p. 184
M
Imagine you are a health psychologist. Which activity below would be of
LEAST interest to you?
a. establishing relationships between negative affect in childhood and elevated
mortality rates in later life
b. evaluating the association between breast cancer and socioeconomic class
c. applying discoveries from biomedical research to develop a cure for AIDS
d. understanding cognitions associated with high risk behaviors such as
unprotected sex
6.
4
Ans. D
App
p. 184
M
Dr. Palmer is a health psychologist. Which activity below would probably not
interest him in regard to his research endeavors?
a. developing and evaluating techniques for promoting behaviors linked with
lower exposure to the HIV vims
b. evaluating programs to increase compliance with treatment for individuals
undergoing chemotherapy
c. developing psychological interventions that contribute to more effective
treatment of hypertension
d. designing safer treatments for cardiovascular disease and cancer
6.
5
Ans. C
Con
p. 184-5
E
Behavioral medicine is different from health psychology because behavioral
medicine
a. follows a biopsychosocial model.
b. focuses on the role of psychological and social factors in physical health.
c. is an interdisciplinary field incorporating biomedical research,
d. is interested in understanding, treating, and preventing illness.
6.
6
Ans. A
App
p. 185
E
If you were a proponent of the biopsychosocial model, you would NOT
a. place greatest emphasis on the biological causes and treatment of illness.
b. emphasize the contribution of social factors to the development of illness,
c. state that psychological processes play a role in illness and prevention.
d. view physical illness as partially dependent on biological vulnerabilities.
*
134
6.
7
Ans. D
Con
p. 185
M
The ancient Greeks held a view of the relationship between mind and body that
a. conflicted with the views later expressed by Freud.
b. was essentially the same as that popular during the Renaissance.
c. emphasized dualism.
d. is similar to the view taken by modem behavioral medicine scientists.
6.
8
Ans. D
Con
p. 185
M
If you emphasized the duality of mind and body, when and where might you be
living?
a. 12th century China
b. ancient Greece
c. late 19th century Vienna
d. Renaissance Europe
6.
9
Ans. B
Con
p. 185
M
*
In a report of the historical influences on the rise of behavioral medicine, a
student would include each of the following EXCEPT
a. the work of Sir William Osier in the early 1900s.
b. the Renaissance dualism preserved in Freud's psychoanalytic theory.
c. changes in the nature of disease in Western cultures,
d. the rise of psychiatry in the late 1800s.
6.
10
Ans. C
Fac
p. 185
E
According to your text, the father of modern behavioral medicine is
a. Sigmund Freud.
b. Aristotle.
c. Sir William Osier.
d. Franz Alexander.
6.
11
Ans. A
App
p. 185
M
If you agreed with Sir William Osier, you would hypothesize that
a. the symptoms of heart disease can be brought on by negative affect.
b. the symptoms of heart disease are brought on by carelessness.
c. heart disease is a natural, biological disease, with few links to psychology.
d. the heart is the center of the universe, and ills of the universe are reflected as
illness of the heart.
6.
12
Ans. B
App
p. 185
M
*
You were part of the group responsible for revising the category of
"psychosomatic disorders" for a new DSM. Why did you decide to change the
category?
a. Its title overemphasized the role of psychological factors in some illnesses.
b. Psychological factors are influential in virtually all diseases, not just a select
few.
c. "Psychophysiological disorders" was chosen instead because it more correctly
identified physiological contributions to these disorders.
d. It was changed to "somatoform disorders" to recognize the contribution of
psychological factors to most diseases.
If you were alive in the United States in the early twentieth century, which
illness below would you be least likely to fall prey to?
a. pneumonia
b. cancer
c. tuberculosis
d. influenza
6.
13
Ans. B
App
p. 186
E
135
6.
14
Ans. A
App
p. 186
M
As a health worker in recent years, what would you witness as the two leading
causes of death in the United States?
a. diseases of the heart and cancer
b. diseases of the heart and homicide
c. cancer and homicide
d. cerebrovascular diseases and unintentional injuries
6.
15
Ans. D
Con
p. 186-7
E
The DSM-IV tries to differentiate between mental and physical disorders in
three ways. Which item below is not one of them?
a. It provides special rules for classifying mental disorders caused by drugs and
medical conditions.
b. It directs clinicians to use multiple diagnoses to classify all the conditions
that might apply to a given patient.
c. It devotes one axis to general medical conditions that are related to a mental
disorder.
d. It explicitly and consistently specifies which disorders are medical and which
are mental.
6. 16
Ans. A
App
p. 186
M
One of your clients has major depression that is caused primarily by long-term
insulin-dependent diabetes. Using the DSM-IV, you would correctly diagnose
this client, in part, by including which of the following?
a. diabetes on Axis III
b. "medical illnesses affecting psychological condition" on Axis I
c. "endogenous major depression" on Axis II
d. "diabetes-related depression" on Axis III
6.
17
Ans. A
Fac
p. 187
M
In what way are somatoform disorders different from the "psychological factors
affecting medical condition" category? Somatoform disorders
a. appear to be caused exclusively by psychological factors with no physical
disease.
b. involve minor medical conditions associated with severe psychological
symptoms.
c. apply to persons who are intentionally exaggerating their physical illnesses.
d. are the former diagnoses that are now listed under "mental disorders due to a
general medical condition. "
6. 18
Ans. B
App
p. 187
E
Jerry likes to go to the hospital and tell the doctors he has something wrong
with him, even though he has nothing wrong. He likes the attention he receives.
What description best fits Jerry?
a. somatoform disorder
b. factitious disorder
c. malingering
d. fraud
6.
19
Ans. D
App
p. 187
E
In order to collect workman's compensation, Richard claims he has severely hurt
his back in a fall from a ladder although his back is not injured. What
description best fits Richard?
a. psychosomatic disorder
b. factitious disorder
c. somatoform disorder
d. malingering
136
6.
20
Ans. C
Con
p. 188
E
What was Franz Alexander's major contribution to health psychology?
a. He wrote a critique of the first DSM, leading to reform in later depictions of
the psychophysiological disorders.
b. He proposed a link between classical conditioning and certain stomach
disorders.
c. He proposed a link between emotional states and physical illness.
d. He helped identify and document the Type A behavior pattern and its
connection to CHD.
6.
21
Ans. D
App
p. 188
E
Bill has chronic obstructive pulmonary disease (COPD). Sometimes he becomes
depressed, and he begins to drink excessively. Which statement below does NOT
apply to this case?
a. Psychological and social influences associated with unhealthy behaviors may
indirectly lead to or aggravate Bill's COPD.
b. Bill's COPD itself can account for some changes in his psychological
functioning.
c. Bill's COPD and his drinking and depression could both be influenced by a
common, underlying biological process.
d. Biological and psychological factors independently influence the course of
Bill's COPD.
6.
22
Ans. C
App
p. 188
M
Jane is a very competitive individual. She likes gymnastic sports and is very
aggressive. What factor below is not likely to increase Jane's risk of illness?
a. the interactive relationship between Jane's aggressiveness and her
environment
b. frequent physiological arousal under conditions of stress
c. a tendency to view competitions as challenges rather than threats
d. decreased social support
6.
23
Ans. D
App
p. 189
E
Marvin was diagnosed with atherosclerosis. Which of the following is NOT a
likely consequence of his condition?
a. high blood pressure
b. an aneurysm
c. myocardial infarction
d. vasocongestion
6.
24
Luca has a form of CHD that results from inadequate removal of carbon dioxide
Ans. D
from
the blood in her heart and creates radiating pain; Matthew has a form of
App
CHD in which blood supply to his heart has been completely stopped, resulting
p. 189
in serious heart damage. Luca has
__, and Matthew has
M
a. angina pectoris; an aneurysm
*
b. an aneurysm; angina pectoris
c. myocardial infarction; myocardial infarction also
d. angina pectoris; myocardial infarction
6.
25
Ans. B
App
p. 189
E
Katrina was hospitalized after feeling as though her chest was being squeezed in
a vice, requiring her to gasp for every breath. She has experienced
a. a stroke.
b. a myocardial infarction.
c. an aneurysm.
d. a hypertensive induction.
137
.
26
Ans. A
App
p. 189
M
Which of the following persons is MOST likely to have CHD?
a. Tony, a 50-year-old white male
b. Ted, a 45-year-old Chinese American male
c. Mitch, a 37-year-old black male
d. Leslie, a 60-year-old black female
6.
27
Ans. B
App
p. 189
E
Sun Cho is a male of Mandarin Chinese heritage. What is his risk for
developing coronary heart disease compared to that for a male of European
descent?
a. one-fifth the risk
b. half the risk
c. two times the risk
d. the same risk
6.
28
Ans. C
App
p. 189
E
Mick, 35 years old, has average blood pressure. Which reading below probably
belongs to him?
a. 141/92
b. 132/87
c. 121/82
d. 113/74
6.
29
Ans. B
App
p. 189
E
If Shandra's hypertension is typical, which characteristic applies?
a. Her diastolic pressure is higher than her systolic pressure.
b. It is affected by levels of sodium in her body.
c. It could lead to diabetes or other pancreatic problems if untreated.
d. It has an identifiable organic cause.
6.
30
Ans. A
App
p. 190
E
Which of the following persons is most likely to have hypertension?
a. Bella, a 64-year-old black female
b. Sharon, a 70-year-old white female
c. Rodney, a 52-year-old black male
d. Tom, a 42-year-old white male
6.
31
Ans. D
App
p. 190
M
*
Hank has been diagnosed with high blood pressure. If he is like most people
with this disorder, his disease is caused by
a. excessive sodium intake.
b. chronic levels of stress.
c. atherosclerosis.
d. no identifiable physical condition.
6.
32
Ans. D
App
p. 190
E
A sample of 100 randomly selected black women over the age of 60 are
participating in a study of protective factors related to osteoporosis. How many
of these women would be expected to exhibit hypertension?
a. 25
b. 48
c. 60
d. 80
*
138
Samantha has been admitted to the hospital for a stroke. What has happened to
Samantha?
a. Blood vessels in her lungs have burst, causing unconsciousness.
b. Insufficient oxygen to her heart has caused severe pain in her chest.
c. A plaque-clogged artery has cut off blood flow in her heart.
d. A clot or an aneurysm has occurred in her brain, disrupting blood flow.
Andy, a high level supervisor, tends to be quite dominant in social settings.
With frequent employee turnover in his division, Andy feels pressured to let
each new employee know "who's boss" to assert his control and authority.
Based on Manuck et al. 's work, what would you predict about his heart function
compared to other people?
a. Due to the greater level of control he exercises in his environment, he will
have a lower risk for developing arterial plaque.
b. Due to the greater level of responsibility he carries in his environment, he
will have a higher risk for developing arterial plaque.
c. Due to the repeated disruptions in his work setting, he will have a higher risk
for developing arterial plaque.
d. If he has a genetic predisposition to CUD, he will have a higher risk for
developing arterial plaque regardless of social setting.
In Manuck et al. 's work with monkeys, which group demonstrated the least
arterial plaque?
a. submissive monkeys in an unstable social group
b. dominant monkeys in an unstable social group
c. submissive monkeys in a stable social group
d. dominant monkeys in a stable social group
In a study involving manipulations of the social hierarchies of monkeys,
researchers discovered that
a. life at the top was always related to lower levels of cardiovascular plaque
buildup.
b. unstable social hierarchies led to greater plaque buildup in submissive
monkeys compared to monkeys in the other groups.
c. unstable social hierarchies led to greater plaque buildup in dominant
monkeys compared to monkeys in the other groups.
d. stable hierarchies led to lower plaque levels for all the monkeys in that
group.
Mrs. Ogden has dragged her husband to the office of Drs. Friedman and
Rosenman. What are these physicians likely to look for in Mr. Ogden?
a. chronic essential hypertension
b. time urgency, aggressiveness, competitiveness
c. chronicity of environmental stressors
d. a family history of CHD and current levels of social support
139
6.
38
Ans. C
App
p. 192
E
You are often irritable, always seeking competitive activities, easily annoyed by
events that delay the attainment of your goals, and are rarely satisfied by your
achievements. What personality type would some health psychologists say you
exhibit?
a. Type B
b. Type C
c. Type A
d. Irritable-Competitive Type
6.
39
Ans. D
App
p. 192
M
You have been asked to conduct an assessment of a client's Type A personality.
What assessment instrument should you choose?
a. Jenkins Activity Schedule
b. Millon Personality Inventory
c. an unstructured clinical interview
d. a structured clinical interview
6.
40
Ans. B
Con
p. 193
M
*
What was the central finding from the Western Collaborative Group Study and
the Framingham Heart Study?
a. The majority of Type A individuals were to likely develop some form of CHD
when family history, diet, and smoking were controlled for.
b. Type A individuals were twice as likely as Type B individuals to develop some
form of CHD during each study.
c. The Western study found increased CHD in Type A individuals over an 8
1/2-year period while the 40-year Framingham study found little difference.
d. Contrary to expectations, there was a tendency in both studies for Type B
individuals to have a slightly higher risk for CHD.
6.
41
Ans. A
Con
p. 192-3
M
A student's report on the link between Type A personality and CHD could
include each of the following statements EXCEPT
a. About half of persons with Type A behaviors are likely to develop some
form of CHD if they are in situations involving chronic interpersonal conflict.
b. Varying measurements of Type A personality and cultural differences
probably account for some contradictory research findings about that link.
c. Hostility, anger, cynicism, and other negative emotions may be more
important in CHD than the "hurry sickness" behaviors.
d. Chronic physiological overarousal resulting in rapid hormonal changes could
account for the personality-CHD connection.
6.
42
Ans. B
App
p. 193
C
You are a graduate student working toward a Ph. D. in health psychology.
Which of the following topics would be LEAST productive for your dissertation
research, based on currently available information?
a. "What cognitive and social characteristics are associated with increased
cardiovascular reactivity to chronic stressors?"
b. "What psychological intervention is most effective for prevention of CHD in
hurried, impatient, 'workaholic' Type A persons?"
c. "How do unhealthy behavioral habits (e. g., poor nutrition) contribute to the
CHD risk associated with the Type A pattern?"
d. "What constellation of negative emotions are most strongly related to
physiological overarousal and CHD risk?"
140
6.
43
Ans. B
App
p. 193
M
are
Andy is a cynic and is usually hostile and suspicious towards others. Andy has
little patience with others and typically feels a very strong time urgency,
appearing edgy and nervous to others. In his work and personal life, Andy is
preoccupied with success and accomplishment. His only means of relaxation
smoking and occasional excessive alcohol use. Which component(s) of
Andy's behavior may be the MOST harmful to his cardiovascular health,
according to current research?
a. competitiveness and time urgency
b. negative emotions such as hostility and cynicism
c. substance use
d. excessive ambition and drive
6.
44
Beth has high blood pressure, is overweight, smokes a pack of cigarettes a day,
Ans. D
suffers from chronic headaches, and is often cynical in her attitude. What is the
App most likely cause of her health problems?
p. 194-6
a. smoking and lack of exercise
M
b. an unhealthy lifestyle
*
c. stress and negative affect
d. a reciprocal interaction between several factors
6.
45
Ans. C
Fac
p. 195
E
According to Dr. Karen Matthews, who should be the targeted population for
successful health psychology interventions?
a. young adults identified on the basis of family history and behavioral risk
factors
b. persons age 18 and older who exhibit high levels of negative emotions
c. children in middle school and younger, and their families
d. lower-SES families living in stressful urban environments
6.
46
Ans. D
Fac
p. 196
M
What changes in classical scientific thinking encouraged the development of
psychoneuroimmunology to become possible?
a. the development of new brain imaging systems
b. increased collaboration between psychologists and neurologists
c. changes in scientific funding from Congress
d. the realization that the brain and immune system are connected in important
ways
6.
47
Pavlov's dogs were instrumental in demonstrating the principles of classical
Ans. C
conditioning. Ader and Cohen's rats were instrumental in showing the
Con application of those principles to
p. 196
a. behavioral medicine.
M
b. creative novation therapy.
c. the biopsychosocial model.
d. psychoneuroimmunology.
6.
48
Ans. D
App
p. 196
E
George has cancer. He has been receiving chemotherapy for some time now for
his illness. Before George goes in for treatment he becomes nauseous. What is
the most likely cause of this nausea?
a. his cancer
b. cyclophosphamide, the chemotherapy drug
c. whatever he ate the prior night
d. classical conditioning
141
6.
49
Ans. A
App
p. 196
M
*
Mara has been treated with chemotherapy in a room with a strong antiseptic
smell by a nurse who wears shoes that make noisy squeaks when she walks.
Today at home, she was putting an antibiotic on a cut when she heard someone
squeaking across the wet kitchen floor. What is the term for Mara's resulting
nausea?
a. conditioned response
b. unconditioned response
c. conditioned stimulus
d. unconditioned stimulus
6.
50
Ans. C
Fac
p. 197
E
When was the first case of AIDS diagnosed in the U. S. ?
a. 1969
b. 1977
c. 1981
d. 1988
6.
51
Ans. D
App
p. 197
E
Myron contracted HIV-1 during a blood transfusion. What effect does this virus
have on Myron's body?
a. It changes the way in which DNA controls cell growth.
b. It alters the synthesis and action of several neurotransmitters in the brain.
c. It causes autotoxic reactions in the endocrine system.
d. It destroys T cells in the immune system.
6.
52
Ans. A
App
p. 197
M
Vondra has just been diagnosed with AIDS. Why will it be very difficult to
treat this disease effectively?
a. HIV can mutate into strains that are resistant to d r u g treatments.
b. No drugs have been developed that have a physiological effect on HIV.
c. Like most people with HIV, Vondra will probably have no symptoms and
thus will not pursue treatment,
d. The side effects of treatment cause such severe anticipatory nausea that she
will probably terminate treatment.
6.
53
Ans. C
App
p. 198
E
If current predictions are correct, when you are watching television news in the
year 2000, what number of people will be reported to have AIDS around the
world?
a. 20 million
b. 26 million
c. 30 million
d. 35 million
6.
54
As a health care worker in an African or Asian country, what two modes of
Ans. B
HIV
transmission would you be most concerned about?
App
a. homosexual contact and heterosexual contact
p. 198
b. heterosexual contact and mother-child transmission
M
c. intravenous drug sharing and mother-child transmission
*
d. homosexual contact and intravenous drug sharing
142
6.
55
Ans. D
App
p. 198
M.
6.
56
Ans. A
App cause
p. 198
E
A sociologist is studying the growing incidence of AIDS in the U. S. She
discovers that the number of AIDS cases is growing quickly in each of the
following groups EXCEPT
a. low-income blacks.
b. Hispanic adolescents.
c. young women.
d. Asian American males.
As a female between the ages of 18 and 44, Karen is most likely to die as a
result of cancer. By the year 2000, it is predicted that the second most likely
of her death will be
a. AIDS.
b. cardiovascular disease.
c. homicide.
d. cancer.
6.
57
Ans. B
App
p. 198
M
As a counselor at a local women's health clinic, you are aware that HIV
infection is growing at an alarming rate for women. Which of the following is
NOT among the factors that have been linked to that epidemic?
a. sexual victimization
b. homosexual contact
c. poverty
d. intravenous drug use
6.
58
Ans. C
App
p. 198
M
Which of the following persons is at greatest risk for HIV infection?
a. Martin, a gay male in a long-term monogamous relationship
b. Caryn, a lesbian female from a middle class SES
c. Erica, a 24-year-old IV heroin user
d. Jacobo, a 33-year-old heterosexual male
6.
59
Ans. D
App
p. 198
M
A psychologist is making a presentation about the central sexual problem
contributing to the AIDS epidemic. What would this problem be?
a. heterosexual contact
b. lack of effective birth control use
c. homosexual contact
d. risky sexual practices
6.
60
Ans. A
App
p. 198
M
Dr. Horst has conducted several psychological studies of HIV and AIDS.
Which of the following was probably NOT one of his research questions?
a. By what mechanism does cognitive restructuring prevent the development of
AIDS in HIV-positive individuals?
b. Have college students changed their "partying" activities (especially alcohol
use) in response to the AIDS epidemic?
c. What cognitive factors increase the likelihood of adolescent males' use of
condoms?
d. Do ruminative coping strategies predict decreased T cell counts in HIV
positive females?
143
6. 61
Ans. B
App
p. 198
E
Camille has a disease in which disrupted cells are creating a metastasized growth
in her body. In other words, she has a form of
a. HIV.
b. cancer.
c. CHD.
d. leukemia.
6.
62
Ans. C
Fac
p. 198
E
Cancer is directly caused by
a. psychological factors.
b. pollutants in the environment.
c. cell mutations that lead to metastasized growth.
d. genetic tendencies passed on from one's parents.
6.
63
Ans. B
Fac
p. 186, 198
E
Cancer is the
leading cause of death in the U. S., with 1 out of every
Americans developing cancer at some point in her/his lifetime.
a. first; 2
b. second; 3
c. second; 4
d. third; 5
6.
64
Ans. D
App
p. 199
M
Which of the following persons is somewhat more likely to develop cancer than
the other three?
a. Fumiko, a Japanese American female
b. Clara, a Hispanic female
c. Wang, a Chinese American male
d. Corey, a Black American male
6.
65
Ans. A
App
p.
198-9
E
Frederick is concerned about his risk for developing cancer. You could suggest
all of the following as effective measures EXCEPT
a. changing his overly conforming, emotionally blunted personality style.
b. quitting smoking.
c. increasing his level of social support.
d. avoiding radiation and other environmental hazards.
6.
66
Ans. C
App
p. 199
M
Andrea's mother has just been diagnosed with breast cancer, and her maternal
grandparents both died from cancer. Andrea is correct to be concerned about
her own risk for several reasons, although
is probably not one of them.
a. the high prevalence of cancer
b. the link between cancer and avoidable environmental hazards
c. her own tendency toward Type C personality traits
d. her smoking habit
6.
67
Ans. D
Con
p. 198-9
M
What argument can be made for the relationship between cancer and
psychological factors?
a. Neuropsychological factors are now known to be a primary cause of some
forms of cancer.
b. Type C personality has been shown to be highly correlated with cancer rates.
c. The relationship between psychology and cancer exists only in regard to
emotional reactions and adjustment after cancer develops.
d. Several psychosocial factors, such as unhealthy habits, have been implicated
in a higher risk for several forms of cancer.
144
6.
68
Ans. C
Con
p. 199
M
*
Empirical evidence is LEAST supportive of the link between the Type
personality and physical illness.
a. A
b. B
c. C
d. D
6.
69
Ans. B
Con
p. 199
M
Which statement below does not belong? Personality and social factors can
increase the risks of physical illness by
a. causing chronic changes in physiological reactivity.
b. directly causing illnesses such as hypertension and CHD.
c. causing changes in immune system functioning and resilience.
d. fostering maladaptive behaviors such as smoking, poor nutrition, and
treatment non-compliance.
6.
70
Ans. D
Fac
p. 199
E
Which component below is not included in the measurement of your SES?
a. education
b. occupation
c. income
d. geographic location
6.
71
Ans. B
Fac
p. 199
M
Standardized mortality ratios
a. have been found to be irrelevant for studies in health psychology.
b. are strongly negatively related to socioeconomic status.
c. are highly dependent on a given study's definition of "SES class. "
d. are a measurement of the average number of deaths due to poor health
habits.
6.
72
Ans. C
App
p. 200
M
Ms. Fuentes is a registered nurse working in a community health clinic for low
SES families. Which of the following appears to be most important for
understanding the frequency of health problems in her patients?
a. dysfunction in biochemical processes such as immune functioning
b. nutritional deficiencies and inadequate health care
c. stressors and unhealthy behaviors
d. lack of concern about health issues and greater physical risk-taking
6.
73
Ans. D
App
p. 200
C
Dr. Sheng is a health psychologist who wants to investigate factors that
contribute to the health problems of lower vs. middle SES patients. Which of
the following questions is LEAST likely to lead to a productive answer?
a. How do patients cope with chronic negative emotion?
b. How often do patients engage in physical exercise?
c. What negative life events have taken place in the last several months in the
patients' lives?
d. What signs of physiological reactivity are evident in patients?
145
6.
74
Ans. D
App
p. 200-1
M
Ms. Goldberg has found it extremely difficult to offer a smoking-cessation group
for low-income housing residents. Which of the following explanations is
probably NOT relevant?
a. Residents may be unaware of the health risks associated with smoking.
b. Residents may not have sufficient time to attend the group meetings.
c. Their friends and neighbors may not encourage healthy habits such as
smoking cessation.
d. Residents tend to be undereducated and thus would not adequately comprehend
information Ms. Goldberg provides in the group.
6.
75
Ans. A
Fac
p. 202
E
If you investigate the life experiences of "Termites, " you find that
predicts a lower risk of premature death.
a. conscientiousness
b. avoidance of smoking and drinking
c. Type B personality
d. highlQ
6.
76
Ans. B
App
p. 202-3
M
*
Alicia is one of the "Termites" followed in a longitudinal study between 1921
and the early 1990s. She was described as impulsive at age 11, and her parents
divorced when she was 17. Based on available data, what prediction would you
make about Alicia compared to other individuals in this study?
a. She has developed mild CHD and is unhappy in her marriage.
b. She is at a substantially elevated risk of premature death.
c. She has significant health problems associated with alcohol use and smoking.
d. She never married but is at lesser risk of hypertension and strokes.
6.
77
Ans. D
App
p. 202-3
M
Which of the following "Termite" persons is expected to have the greatest
longevity?
a. Tamara, who exhibits a moderate level of conscientiousness and whose
parents were never divorced
b. Ricardo, who is high in conscientiousness and whose parents were divorced
when he was 14 years old
c. Mark, who avoids smoking and drinking, whose parents were never divorced,
and who is widowed
d. Susan, who is high in conscientiousness and is happily married
6.
78
Ans. A
App
p. 202
C
Nara has just undergone triple coronary bypass surgery. She will respond MOST
favorably to an intervention program that includes
a. relaxation training, cognitive restructuring, and a support group,
b. meditation, behavioral modification, and coping skills training.
c. realistic recovery expectations, individual therapy, and dietary management.
d. nutritional counseling, cognitive restructuring, and biofeedback.
6.
79
Ans. C
App
p. 202
E
Derrick has been diagnosed with CHD. Effective treatment will probably
consist of a combination of each of the following techniques EXCEPT
a. meditation.
b. counseling focused on Derrick's sense of control over his life.
c. emphasis on the worst-case prognosis for his disease as a motivational tool.
d. opportunities for social reinforcement and social connectedness.
146
6.
80
Ans. C
App
p. 202
M
*
Jorge requires major surgery. Recovery will occur more quickly if his physician
a. assures him that he will have little or no pain and a rapid recovery.
b. tells him as little as possible about the postsurgical reactions so he will not
experience excessive anxiety and distress.
c. informs him about the course of the operation and is realistic about how he
will feel during recovery.
d. prepares him for the worst by emphasizing unfavorable surgery outcomes
and postoperative complications.
6.
81
Ans. D
App
p. 202
M
Dr. Arbuckle, the chief administrator of a regional hospital, wants to save
money by reducing a primary source of surgical costs. Research in behavioral
medicine indicates that she should consider
a. providing financial bonuses to her physicians for limiting postoperative stays.
b. encouraging physicians to communicate to patients only the most optimistic
prognoses for postoperative adjustment in order to foster optimism.
c. providing individual supportive therapy to postoperative patients for several
days to reduce risk of postoperative complications.
d. recommending that physicians provide realistic predictions for patients'
experience of pain and other surgical aftereffects.
6.
82
Ans. A
App
p. 204
M
Stephen and Elston have both had a heart attack, and both have exhibited
frequent Type A behavior throughout their lives. Both are receiving
cardiological counseling, and Stephen also receives Type A-modification
counseling. What outcome is likely?
a. Elston is almost twice as likely as Stephen to have another heart attack.
b. Both men exhibit improved cardiovascular functioning and a reduction in
Type A behavior patterns.
c. Both men exhibit improved cardiovascular functioning, but Stephen's Type A
behaviors are unaffected due to their ingrained, inflexible nature.
d. While Stephen is slightly less likely to have another heart attack than is
Elston, both have more than a 40% recurrence risk.
6.
83
Ans. B
Fac
p. 204
M
Which of the following interventions was not included in the attempts by Kelly
et al. (1989) to reduce gay men's high-risk behaviors associated with HIV/AIDS?
a. education and encouragement regarding condom use
b. visits to hospitals to talk to people with AIDS caused by risky sexual
practices
c. learning how to resist partners' pressure to engage in risky behaviors
d. behavioral rehearsal of self-control techniques to cope with risk-related
situations
6.
84
Ans. C
App
p. 204
M
Suppose Leon was in St. Lawrence et al. 's (1995) 8-week HIV/AIDS risk
reduction group. Compared to a teenager in the other educational group, Leon
is
a. less likely to use intravenous drugs.
b. slightly less likely to maintain sexual abstinence one year later.
c. less likely to engage in unprotected intercourse.
d. more likely to demonstrate improved immune system responsiveness.
147
6.
85
Ans. B
App
p. 204
C
Which of the following persons is LEAST likely to alter her/his behavior as a result
of HIV prevention programs in the community?
a. Reya, a middle-class lesbian female living in suburban Chicago
b. Rick, a heterosexual male living in the inner city of Detroit
c. Kendra, a higher-SES, heterosexual white female living in Seattle
d. Aaron, a gay male living in Philadelphia
6.
86
Ans. D
App
p. 205
M
Hadiya lives in Africa. She is among a group whose AIDS risk is growing at
an alarming rate. Each of the following might explain Hadiya's elevated risk
EXCEPT
a. her fear that a partner will accuse her of infidelity if she asks him to use a
condom.
b. her lack of knowledge about HIV or its transmission.
c. her lack of income which leaves her unable to exert control over her life,
including her sexual choices.
d. the unsanitary living conditions around her.
6.
87
Ans. C
App
p. 205
M
*
Naomi has just taken a blood test to determine the presence of HIV in her body.
She is meeting with a support group to prepare herself for the results. If she is
HIV positive, research described in the chapter suggests that she could increase
her immune response most importantly by
a. cognitive restructuring and assertiveness.
b. antidepressant medication and social support.
c. daily relaxation.
d. aerobic exercise.
6.
88
Ans. D
Fac
p. 205-6
E
According to the University of Miami study of HIV positive individuals, a
CBSM program creates reliable changes in participants'
a. postnotification depression scores,
b. HIV-specific measures of immune functioning.
c. safe sexual activities.
d. Both a and b.
6.
89
Ans. A
Con
p. 205
C
Which of the following correlations most closely approximates the relationship
between relaxation training and HIV-specific measures of immune competence?
a. +. 40
b. -. 55
c. +. 08
d . . 00
6.
90
Ans. D
Con
p. 204-6
M
*
Given the three components identified as crucial for a superior intervention in
illness and disease, which of the following programs included all three?
a. the year-long intervention for women with metastatic breast cancer
b. the counseling-plus-Type-A modification program for heart attack patients
c. the CBSM program for HIV positive gay men
d. all of the above
148
Melinda has metastatic breast cancer. If she participates in a behavioral
intervention program that includes training in self-hypnosis, which of the
following outcomes is LEAST likely?
a. She will report no increase in pain during the 12 months of treatment.
b. She will demonstrate greater antipathogen activity after 12 months of
treatment.
c. She will probably survive another three years after beginning the program.
d. She will report less emotional distress and a higher level of energy than will
women who are not in the program.
Whereas relaxation appears to be effective in improving immune system
functioning in HIV positive persons, self-hypnosis is important for reducing
in women with metastatic breast cancer.
a. pain
b. depression
c. antipathogen activity
d. maladaptive coping efforts
If Samuro is receiving therapy for his Type C personality, the therapist will help
him
a. lower his blood pressure via reductions in hostility, competitiveness, and
anger.
b. learn self-hypnosis for control of pain and to support more adaptive
problem-solving.
c. increase his assertiveness, reduce feelings of stress, and freely express
emotion.
d. decrease his risk-related behaviors such as overeating, smoking, drinking, and
unsafe sexual practices.
Of the 50 patients in Eysenck and Grossarth-Maticek's creative novation therapy
group, about how many had died from cancer 13 years after the experiment
began?
a. 0
b. 5
c. 12
d. 19
The results from research on creative novation therapy and other related
psychological interventions indicate that
a. Type C personality characteristics can be significantly changed, thus
increasing longevity and reducing recurrence of cancer.
b. multi-modal psychotherapy techniques can reduce or at least delay the
incidence of cancer.
c. weekly group therapy is required for individual adherence to the full
treatment regimen.
d. research replication is needed before any conclusions can be made about
their efficacy in treating or delaying cancer.
149
6.
96
Ans. B
Con
p. 204-7
M
A change in a patient's
appears to be the most common ingredient in
the various interventions discussed in this chapter.
a. depressed mood
b. sense of control
c. level of knowledge about a disease
d. problem-solving strategies
6.
97
Ans. C
App
p. 207
E
Duane does not completely follow the instructions given to him by his physician
about the medications he must take to manage AIDS. Duane is part of the
noncompliant group that comprises
% of medical patients.
a. 15
b. 38
c. 50
d. 62
6.
98
Ans. A
App
p. 207
E
Rudy uses "post-it" reminders and sets the alarm on his watch to remind him to
take his antihypertensive medication. Rudy uses
to increase compliance.
a. environmental cues
b. a contingency contract
c. a self-administered token economy
d. external incentives
6.
99
Ans. B
App
p. 207
M
Hannah's physician had her sign a written contract about her daily exercise
routine and dietary intake restrictions, in return for which she would be able to
schedule her appointments at times most convenient for her. This compliance
strategy is called a
a. token adherence agreement.
b. contingency contract.
c. formal mutual arrangement.
d. selective reward contract.
6. 100
Ans. D
App
p. 209
E
Dr. Cavaleri gives special coupons to Sally when she follows her prescribed diet
and maintains her weight. Sally can use the coupons to "buy" privileges and
toys in the hospital canteen. Her pediatrician is using a(n)
a. environmental cue contract.
b. contingency contract.
c. adherence monitoring.
d. token economy.
*
6.
101
Ans. C
Con
p. 209
M
For children whose medical illnesses require lengthy hospitalization and whose
compliance with treatment involves painful procedures or side effects, which
strategy would be most effective?
a. contingency contracting
b. environmental cues
c. a token economy
d. antiemetic drug therapy
150
6.
102
Ans. A
Fac
p. 209-10
E
Of the three techniques that comprise effective treatment interventions for
medical illnesses, which one is most effective for reducing the common side
effect of chemotherapy?
a. stress-reduction training
b. cognitive restructuring
c. social support
d. realistic expectations
6.
103
Ans. C
Fac
p. 210
E
Experts have estimated that changes in tobacco, alcohol, illegal drug use,
unhealthy eating, and other controllable behaviors could prevent
deaths each year in the U. S.
a. 350, 000
b. 625, 000
c. 1, 000, 000
d. 1, 425, 000
Which description below does NOT represent an example of one of the challenges
to health-promotion programs?
a. Jane's high-fat, high-cholesterol diet will not result in CUD symptoms for
several years.
b. Michael believes he is susceptible to HIV and is feeling pressured by friends
and magazine ads describing the plight of AIDS patients.
c. Michi smokes cigarettes, as did her parents, neither of whom developed lung
cancer even though they lived past age 70 and smoked for many years.
d. Tyree's new job and the birth of his first child have put his daily gym visit
low on his list of priorities.
6.
104
Ans. B
Con
p. 210
M
6.
105
Ans. D
Fac
p. 210
E
The most influential theory about why people do or do not engage in healthy
behaviors is the
a. risk/benefit cost model,
b. risk behavior model.
c. medical novation theory.
d. health belief model.
6.
106
Ans. A
App
p. 210
E
Under which condition below is a person MOST likely to alter an unhealthy
behavior habit according to the HBM?
a. A person is often pressured by family and friends to get regular checkups.
b. A person anticipates that if they become ill, the necessary treatment will be
effective and short term.
c. A person is diagnosed with a disease, such as hypertension, which produces
few noticeable or distressing symptoms.
d. A person understands the long-term effects of the unhealthy behaviors, such
as smoking or excessive eating.
6.
107
Ans. B
App
p. 210
M
For whom is the health belief model able to make the most accurate predictions?
a. Hans, a middle-SES man who completed a two-year technical college degree
b. Alameda, an upper-SES woman with an above-average understanding of
health issues
c. Adrian, a man living in poverty and dealing with CHD, whose father died of
a heart attack
d. Harriet, a middle-SES woman with a history of cancer in her family
151
6.
108
Ans. C
App
p. 211
C
If Dr. Subbiah wants to persuade his patient to adopt a weekly exercise regimen
to address the patient's CHD, Dr. Subbiah should
a. give the patient written literature regarding the pro's and con's of this
treatment recommendation and encourage an objective decision.
b. encourage the patient to engage in the regimen even if it has little chance of
affecting the patient's long-term prognosis.
c. be strongly convinced in his own mind that the regimen will have a positive
effect on the patient's functioning.
d. outline the worst-case scenario to the patient to create anxiety that will
motivate treatment compliance.
6.
109
Ans. A
Fac
p. 208
E
For at-risk residents of Watsonville, California, mass media and intensive oneon-one counseling were effective in leading to
a. reductions in cigarette smoking.
b. increases in regular physical exercise.
c. reductions in unhealthy eating habits.
d. increases in medication compliance.
6.
110
Ans. B
App
p. 208
M
It has been three years since Miguela participated in the Stanford Heart Disease
Prevention Program. If she received the dual-focus intervention, what would
you expect to discover about her?
a. She has returned to the level of risky behaviors she exhibited prior to the
program.
b. She has maintained a reduction in her cigarette smoking for the last 3 years.
c. She is similar to the average person from either of the other two cities in
regard to her level of knowledge and risk.
d. She is more likely to exercise on a regular basis and monitor her diet.
*
SHORT ANSWER
6.
111
Explain how the biopsychosocial model applies to health psychology's understanding
of illness, giving several examples of the latter two components of that model. Why does adoption
of this model encourage the deletion of "psychosomatic disorders" as a separate DSM category?
An illness does not have a sole cause but is affected by biological vulnerability,
psychological factors, and social conditions. These could include the following:
1) psychological factors -- risky behaviors such as cigarette smoking, alcohol & other drug
use, unsafe sexual behavior; lack of exercise; negative emotions (hostility, anger, competitiveness)
& lack of conscientiousness; poor diet; lack of a sense of control over environment (related to
interpretation of stressors); inadequate problem-solving skills.
2) social conditions -- unstable, stress-producing environments such as crowded, urban
areas; lack of education; racism and discrimination; inadequate access to health care; lack of social
support; gender-role related stresses.
The DSM deleted the psychosomatic disorders category because it is recognized that
psychological factors have a role to play in virtually all diseases and that most diseases can be
prevented or substantially ameliorated by psychological interventions.
152
6.
112
Why are Aristotle, Sir William Osier, Franz Alexander, and Friedman & Rosenman
important in the history of health psychology?
Aristotle: encouraged a monistic approach to understanding the relationship between mind
(soul) and body, supporting what would become the biopsychosocial model for the modem field.
Osier: considered the father of behavioral medicine, insisted that psychological factors were
important in understanding physical illness; 1910 lecture set forth ideas about heart disease that
have been supported by modem researchers.
Alexander: in his 1950 text, Psychosomatic Medicine, suggested that specific unconscious
conflicts caused certain illnesses; while his original ideas are not empirically supported, the role of
certain negative emotional states have been connected to various illnesses.
Friedman & Rosenman: identified the Type A behavior pattern that has become the most
extensively studied psychological risk factor for cardiovascular disease.
6.
113
When data regarding negative emotion is combined with research on the physiology
of Type A vs. Type B individuals, what pattern emerges?
When encountering a stressor, Type A's demonstrate physiological reactivity in terms of
faster heart rate and higher diastolic and systolic blood pressure than Type B's do. When these
stressors are related to interpersonal conflict, generate competitiveness, or involve criticism, this
reactivity is most evident. Given that these situations also tend to generate hostility and anger, a
chronic pattern of hostility can engender higher levels of cardiovascular reactivity; thus, a mutuallyreinforcing pattern of negative emotions and reactivity may account for some of the CHD risk
exhibited by Type A persons.
6.
114
In regard to the AIDS epidemic, a) which two groups have the highest risk of AIDS
in the U. S. ? b) which three groups in the U. S. have AIDS cases growing at a particularly fast pace?
c) what two modes of transmission are most common in African and Asian countries? d) what four
high-risk behaviors increase exposure to the disease?
a) gay males and intravenous d r u g users
b) low-income Black Americans, Hispanic adolescents, and heterosexual women
c) heterosexual contact and mother-child transmission
d) excessive use of alcohol/other drags prior to sexual activity; sex with multiple partners
and/or partners with unknown sexual histories; failure to use a condom; sharing of needles
6.
115
Given the alarming increase in the incidence of HIV and AIDS in heterosexual
women in many developing nations, what intervention strategies have been proposed to reduce their
risk?
Education regarding HIV, its transmission, and related risk behaviors; reduction in sexual
abuse victimization and support for women to take greater control over their sexual lives, including
greater access to female condoms and vaginal microbicides; support for greater economic
independence to reduce subjection to sexual coercion or commercialized sex
153
6.
116
Describe a hypothetical intervention for ovarian cancer that includes each of the
components necessary for a successful program. Give at least two examples of each of those
components.
No specific modal response predictable -- answer should address each of the three
components below, with at least two applications of the associated techniques:
1. stress-reduction: cognitive and/or muscle relaxation training, biofeedback, hypnosis
(including self-hypnosis), or meditation.
2. cognitive restructuring: training in effective problem-solving, development of a greater
sense of control over the disease as well as control related to treatment compliance, provision of
realistic information about prognosis and effects and side-effects of treatment, role modeling via
interaction with patients who have undergone prescribed treatment.
3. social support: offer 1 & 2 above in a group setting, provide tangible aid if needed,
encourage interactions with family and friends.
6.
117
What are the six behavioral risk factors that, if substantially changed, might prevent
half of the deaths in the U. S. each year?
use of tobacco, abuse of alcohol & other drugs, unhealthy eating habits, infrequent use of
seatbelts, failure to obtain or comply with necessary medical treatment, and risky sexual practices
6.
118
Dr. Bate is a new family practice physician. She was told in medical school that
patients would often be noncompliant with treatment, but she is surprised that so many of her
patients also seem uninterested in maintaining healthy behaviors. Offer her some ideas that might
help her understand her patients' apparent lack of concern.
Changes in lifestyle make long-term adherence difficult due to its inconvenience and to
changes in day-to-day priorities.
The delayed consequences for unhealthy behaviors are essentially meaningless to many
individuals; the longer the delays, the less the impact, and thus while outcomes may eventually be
extremely aversive, they are psychologically irrelevant in the present moment.
Many people with unhealthy behaviors do not develop a related disease or illness;
reductions in risky behaviors, then, only slightly affect a given individual's morbidity risk.
An individual's beliefs about their own susceptibility, the severity of a potential illness,
her/his view toward treatment, and level of discomfort caused by internal and external cues are also
factors in whether people change their risky behaviors [with these components comprising the health
belief model].
6.
119
In your life now or in the future, what unhealthy behaviors might increase your risk
of cardiovascular illness? How could you apply the health belief model to the probability that you
might change these behaviors?
No modal response available for the first question. The response to the second question
should demonstrate that the student has addressed the following issues:
degree to which they believe they personally are susceptible to the disease; how severe they
think the disease would be for them; what they think about the treatment for the disease, i. e., the
nature of its cost and effectiveness; whether they are bothered by internal cues; whether they are
motivated by external cues/pressures
154
Chapter 7 ANXIETY DISORDERS
7.
1
Ans. A
App
p. 216
E
Fear is a primitive, adaptive response to threat. Jason's level of fear, however, is
pervasive, uncontrollable, intense, and interferes with his day-to-day activities. In
other words, Jason has a(n)
disorder.
a. anxiety
b. neurotic
c. affective
d. maladaptive fear
7.
2
Ans. B
App
p. 216
E
Duretha has a kind of mental disorder that occurs with greatest frequency in the
U. S. population. Her disorder, then, would fall under the category of
a. mood disorders.
b. anxiety disorders.
c. somatoform disorders.
d. substance abuse and dependence disorders.
7.
3
Ans. B
App
p. 216
E
A random sample of 100 community residents has been asked to participate in an
epidemiological survey. If they are representative of the larger population,
approximately
are experiencing an anxiety disorder or have done so in the
past 12 months.
a. 12
b. 17
c. 25
d. 33
Ennis is in a situation causing him to experience both fear and anxiety. He will
express these emotions in several channels, but not necessarily
a. behaviorally.
b. interpersonally.
c. cognitively.
d. physiologically.
7.
4
Ans. B
App
p. 216
E
7.
5
Ans. D
App
p. 216
M
Stella has been diagnosed with generalized anxiety as well as panic disorder. This
reflects what characteristic of anxiety disorders?
a. Diagnostic criteria overlap so extensively that reliable diagnosis is difficult,
b. Many anxiety disorders begin as generalized anxiety and then develop more
specific symptomatology.
c. A commonly committed error is that of assigning two Axis I diagnoses to one
person.
d. There is a frequent occurrence of comorbidity among these disorders.
7.
6
Ans. C
App
p. 217
E
*
Dr. Seshachari is treating a client who is diagnosed with one of the most common
anxiety disorders. Which of the following would this be?
a. generalized anxiety
b. panic disorder
c. social phobia
d. obsessive-compulsive disorder
155
7.
7
Ans. D
App
p. 217
E
Lynette and Keith are fraternal twins. Based on prevalence data, Keith is more
likely than Lynette to experience
a. obsessive-compulsive disorder.
b. a specific phobia.
c. posttraumatic stress disorder.
d. none of the above.
7.
8
Ans. A
App
p. 217
C
Kale is seeking treatment for symptoms that his counselor describes as a type of
anxiety disorder. The counselor also told him that roughly 1 out of every 11 adult
males experiences this disorder at some point in their lives. What disorder is this?
a. social phobia
b. generalized anxiety
c. specific phobia
d. obsessive-compulsive disorder
7.
9
Ans. C
Fac
p. 217
M
Of the following, the two least commonly occurring anxiety disorders are
a. agoraphobia and generalized anxiety.
b. panic disorder and social phobia.
c. obsessive-compulsive disorder and panic disorder.
d. These differ depending on gender.
7.
10
Ans. A
App
p. 217
M
A vague sense of impending doom or catastrophe has been bothering Aaron for
several hours. How might you most accurately describe his emotional state?
a. anxious
b. fearful
c. neurotic
d. either a or b
7.
11
Ans. C
App
p. 217
E
When Natalie is feeling anxious what part of her life will she be most concerned
about, according to Barlow?
a. the past
b. the present
c. the future
d. all three equally
7.
12
Ans. D
App
p. 217
E
Because he never lived up to his parents' expectations, Edgar spends a great deal
of time feeling nervous, guilty, and unhappy. If you were Freud, you would
describe Edgar as
a. having generalized anxiety.
b. depressed.
c. comorbid.
d. neurotic.
7.
13
Ans. A
Con
p. 217
M
If fear is a signal that there is an external threat, anxiety, according to Freud, is a
signal of
a. internal, unconscious threat.
b. repressed unconscious conflict.
c. interpersonal conflict or threat.
d. future-oriented foreboding or apprehension.
156
7.
14
Ans. B
App
p. 217
M
7.
15
Ans. C
Con
p. 218
M
After several business failures, a divorce from his wife of 15 years, and
rejection by his best friend, Don is harboring a great deal of repressed anxiety.
According to Freud, Don will develop a(n)
disorder as a result of this
repression.
a. neurotic
b. somatoform
c. anxiety
d. depressive
Evolutionary theory hypothesizes that a 5-month-old infant should possess the
capacity for
a. anxiety.
b. somatization.
c. fear.
d. conditioning.
7.
16
Ans. D
Fac
p. 218
E
The text describes anxiety disorders as a fundamental disturbance in
is then shaped into particular patterns by
.
a. cognitive processing; learning and culture
b. learning experience; biology
c. behavioral responding; cognitive processes
d. biology; learning and culture
7.
17
Ans. A
Fac
p. 218
E
War is unquestionably a source of threat. It is fitting, then, that the term
comes from the name of a Greek deity, a son of the god of war.
a. phobia
b. anxiety
c. stress
d. trauma
7.
18
Ans. D
App
p. 217-8
M
One week after the crash of TWA flight 800, Monica had to fly overseas on
business. As she boarded her own flight, she felt her heart racing and her palms
were sweating, and she had vivid pictures in her mind of her plane going up in
flames. What label would you give this reaction?
a. material phobia
b. specific phobia
c. obsessive disorder
d. alarm reaction
7.
19
Ans. B
App
p. 218
M
Which of the following persons is most likely to be diagnosed with a phobia?
a. Lou, a white male
b. Ana, a Hispanic female
c. Trevor, a black male
d. Sara, a white female
7.
20
Ans. C
Con
p. 218
E
Which of the following disorders does not belong with the other three?
a. social phobia
b. agoraphobia
c. neurotic phobia
d. specific phobia
157
that
7.
21
Ans. A
Fac
p. 218
E
7.
22
Ans. C
App terrified
p. 218
M
*
Roughly what proportion of the population has either a true specific phobia or
intense, specific fears that fall short of diagnostic criteria?
a. one third
b. one quarter
c. one half
d. one fifth
Every time her parents take her for a checkup, Leanne becomes very agitated and
scared. She screams when the nurse tries to administer routine vaccinations,
by the sight of the needle. Her health is in jeopardy due to her
unwillingness to take the shots. What type of fear is this?
a. musophobia
b. nyctophobia
c. belonephobia
d. tonitrophobia
7.
23
Ans. B
App
p. 219
C
Tani, a 5-year-old male, has a phobia that is among the most commonly
occurring specific phobias. Which of the following is most likely?
a. hematophobia
b. ephidiophobia
c. brontophobia
d. claustrophobia
7.
24
Ans. D
App
p. 218, 9
M
Ms. Lok is a registered nurse working on a unit with HIV-positive patients. If she
has a fear of exposure to blood, she has
a. nyctophobia.
b. sangephobia.
c. hematophobia.
d. an adaptive fear.
7.
25
Ans. A
Con
p. 219
M
Many individuals with hematophobia, traumatophobia, belonephobia, and similar
phobias have each of the following characteristics EXCEPT
a. onset prior to age 16.
b. a tendency to faint when exposed to the stimulus.
c. impairment in health.
d. disruptions in daily functioning.
7.
26
Ans. B
App
p. 219
M
Yuan has an irrational fear which has prevented him from seeking employment in
any office that is more than one story above ground. According to the text, this
is probably MOST accurately described as a fear of
a. heights.
b. falling.
c. embarrassment.
d. enclosed spaces.
7.
27
Ans. C
App
p. 219
E
Tamar's irrational fears and avoidance of heights and of elevators are types of
a. social phobias.
b. agoraphobic symptoms.
c. specific phobias.
d. simple anxieties.
158
.
28
Ans. D
App
p. 220
E
7.
29
Ans. A
App
p. 220
E
A college senior, Naum has always avoided classes in which any kind of oral
presentation or class participation was required. However, his last class required
for graduation requires a 20-minute presentation. He is seriously reconsidering
whether he wants to complete his degree. What disorder does this reflect?
a. agoraphobia
b. situational specific phobia
c. acute stress reaction
d. social phobia
Micki's friends don't understand why Micki never goes out to dinner with them,
won't go to a movie, and doesn't like to meet new people. Inside, Micki is sure
that if she did any of these things, she would humiliate herself. What disorder
does she appear to have?
a. generalized social phobia
b. specific phobia
c. posttraumatic social disorder
d. agoraphobia
7.
30
Ans. B
Fac
p. 220
E
Which of the following statements regarding phobias is CORRECT?
a. Agoraphobia is a type of culture-specific disorder.
b. Social phobia is a type of culture-general disorder.
c. The symptoms associated with social phobia are culture-general.
d. The biological preparedness associated with specific phobias is culturespecific.
7.
31
Ans. C
App
p. 220
M
Minoru lives in Hiroshima, Japan. If he has symptoms of a social phobia, he is
probably MOST concerned about
a. being embarrassed by negative comments after making a public presentation.
b. revealing his own flaws and insecurities.
c. offending another person by his public behaviors.
d. leaving himself open to others' ridicule about his personal mannerisms.
7.
32
Ans. D
App
p. 220
E
Which of the following persons is most likely to exhibit TKS?
a. Dora, a Black American female
b. Umeko, a Japanese female
c. Frank, a White American male
d. Botan, a Japanese male
7.
33
Ans. A
App
p. 220
E
*
Dr. Nowital is working with a client with a social phobia including intense anxiety
when meeting members of the opposite sex. Dr. Nowital is convinced that the
client is afraid of her own unrecognized desire to have an incestuous relationship
with her father. What is Dr. Nowital's perspective?
a. psychoanalytic
b. cognitive
c. behavioral
d. social learning
*
159
7.
34
Ans. B
Con
p. 220
C
Deidre has an incapacitating snake phobia. According to Freud, Deidre has failed
to successfully resolve the
stage of psychosexual development.
a. oral
b. phallic
c. latency
d. castration
7.
35
Ans. C
App
p. 220
E
Deidre has an incapacitating snake phobia. What causal factor would John Watson
emphasize in understanding her fear?
a. unresolved unconscious conflicts
b. modeling
c. direct conditioning
d. inherited anxiety sensitivity
7.
36
Ans. A
Con
p. 221
C
Little Albert, a young infant, learned to fear and avoid white rabbits after the sight
of a rabbit was repeatedly paired with a loud, startling noise made behind him. In
classical conditioning terms, how would deconditioning be achieved?
a. by presenting the CS without the US
b. by presenting the NS without the CS
c. by presenting the UR without the CR
d. by removing the CS
7.
37
Ans. B
Con
p. 221
C
In the example from the previous question about Little Albert, which element of
the classical conditioning process represents Albert's rabbit phobia?
a. UR
b. CR
c. NS
d. CS
7.
38
Ans. D
Fac
p. 221
M
*
Several pieces of evidence have indicated that Watson's explanation for phobias is
incomplete. Which of the following is NOT one of those pieces?
a. the difficulty in extinguishing phobias by simple non-threatening exposure
b. the influence of vicarious conditioning and modeling
c. differences in "prepared" and "unprepared" stimuli as fear elicitors
d. the failure to document the generalization of traumatic fear reactions
7.
39
Ans. A
App
p. 220-1
E
Six year old Ekaterina has a phobia of large, noisy dogs. While
would
wonder about her relationship with her father,
would wonder how often
Ekaterina has seen such dogs on television and in the books her parents read to her.
a. Freud; Bandura
b. Watson; Freud
c. Kendler; Wolpe
d. Freud; Seligman
160
7.
40
Ans. C
App
p. 221
E
As a young child, Carlos watched his mother scream any time a spider was found
in the house or out in the yard. He vividly remembers her hysterical reaction when
she found one in her shoe while getting dressed one morning. What process
accounts for Carlos' phobia as an adult?
a. operant conditioning
b. direct conditioning
c. modeling
d. stimulus generalization
7.
41
Ans. D
App
p. 222
E
Martin and Melody are MZ twins. They are more likely to be concordant for
than are Evan and Emily, who are DZ twins.
a. specific phobias,
b. agoraphobia.
c. social phobias.
d. All of the above.
7.
42
Ans. B
App
p. 222
E
Which of the following twin pairs would probably be most concordant for a phobia?
a. MZ twins who have a relatively high level of GABA in their limbic systems.
b. MZ twins who have a relatively low level of GABA in their limbic systems.
c. DZ twins who have a relatively low level of GABA in their neocortexes.
d. DZ twins who have a relatively high level of GABA in their limbic systems.
7.
43
Ans. C
App
p. 222
M
Martin is a tightrope walker in the circus. If he nearly falls off the wire, which
neurological response is most likely to help him calm down?
a. The amygdala triggers activity in the adrenal gland.
b. Norepinephrine activity increases in his brain.
c. GABA activity increases in the brain.
d. Either a or c could apply.
7.
44
Ans. A
App
p. 222
E
Deidre has an incapacitating snake phobia. What neurotransmitter may be unusually
low in her brain, leading to excessive limbic system activity?
a. GABA
b. dopamine
c. serotonin
d. diazepine
7.
45
Ans. C
App
p. 222
M
Johnny just observed a traumatic incident with a schoolmate that will result in
Johnny's avoidance of needles for the next 12 years. What brain structure is MOST
clearly implicated in this early phobic response?
a. thalamus
b. hippocampus
c. amygdala
d. corpus callosum
7.
46
Ans. B
Fac
p. 222
M
Which of the following factors appears to be primarily responsible for triggering
most phobias in humans?
a. biological preparedness
b. environmental experiences
c. genetic makeup
d. Current research does not provide an answer to this question.
161
7.
47
Ans. D
Con
p. 222
E
Which of the following stimuli would most likely be included in the
preparedness theory of phobias?
a. elevators
b. subways
c. injections
d. darkness
7.
48
Ans. A
Fac
p. 222
E
The behavior of demonstrator and observer monkeys in Mineka and colleagues'
studies has provided clearest support for the
theory of phobias.
a. preparedness
b. direct conditioning
c. anxiety sensitivity
d. cognitive
7.
49
Ans. C
App
p. 222
M
A demonstrator monkey is displaying a fear reaction to a plastic toy car. Which
finding is MOST likely in regard to an observer monkey?
a. After one exposure, an observer monkey will develop a similar fear.
b. After many exposures, an observer monkey will develop a similar fear.
c. Despite repeated exposure, an observer monkey will not develop a similar fear.
d. It is not possible to make a prediction because this research has not been
replicated.
7.
50
Ans. B
App
p. 223
E
If Dr. Friere wants to maximize her chances of therapeutic success with a client,
she should treat someone with
a. posttraumatic stress disorder.
b. a phobic disorder.
c. obsessive-compulsive disorder.
d. generalized anxiety disorder.
7.
51
Ans. D
App
p. 223
E
In the past year, Dr. Bandura has treated 100 clients who suffered from a specific
phobia. Approximately how many clients responded well to treatment?
a. 45
b. 66
c. 83
d. 91
7.
52
Ans. B
Con
p. 223-4
E
Which of the following does not belong with the other three?
a. participant modeling
b. cognitive restructuring
c. systematic desensitization
d. graded exposure
7.
53
Ans. A
App
p. 223
M
*
Joseph Wolpe is your clinical supervisor. As a result, in your treatment plan for
a client with social phobia you would
a. construct an anxiety hierarchy.
b. provide unconditional positive regard and empathy.
c. combine in vivo exposure with modeling.
d. explore the unconscious origins of the client's social fears.
162
7.
54
Ans. C
App
p. 223
M
Luella's therapist has recommended that they employ systematic desensitization to
help Luella overcome her fear of flying. What is the first step to take?
a. Construct a fear hierarchy.
b. Enhance the client's self-efficacy.
c. Train Luella in muscle relaxation.
d. Expose Luella to nonfearful role models.
7.
55
Ans. D
App
p. 223
E
Sergei has a phobia of snakes. "A cartoon drawing of a snake" and "having a snake
wrapped around my shoulders" are the two extreme points on his
a. graded exposure scale.
b. systematic distress scale.
c. fear provocation hierarchy.
d. anxiety hierarchy.
7.
56
Ans. A
App
p. 224
M
*
Jules has successfully completed the process of systematic desensitization for his
phobia of cats. Which of the following descriptions is INCORRECT?
a. His treatment success will not generalize to in vivo situations without
additional exposure procedures.
b. He was able to maintain feelings of relaxation and calmness while imagining
the most threatening item on his hierarchy.
c. His treatment was relatively time consuming.
d. His underlying sense of self-efficacy has been enhanced.
Which psychological treatment technique is MOST likely to benefit from the
technological evolution of virtual reality?
a. systematic desensitization
b. graduated exposure
c. modeling
d. cognitive restructuring
7.
57
Ans. B
Fac
p. 224
E
7.
58
Ans. C
Con
p. 224
C
What classical conditioning process underlies graduated exposure therapy?
a. presentations of a US of decreasing intensity
b. repeated presentation of a moderately intense CS
c. presentations of a CS of increasing intensity
d. one presentation of an intense CS followed by gradual relaxation
7.
59
Ans. D
App
p. 224
M
Celine's sympathetic nervous system is sending her intense fear messages. She did
need to quickly overcome her fear of flying, but as she sits in her seat during
actual takeoff as part of her third therapy session, she wonders if she's made a
horrible mistake. Once her sympathetic nervous system becomes fatigued, however,
Celine begins to feel more calm; after two hours, her fear has subsided completely.
What process has she gone through?
a. sadistic psychotherapy with an unethical charlatan
b. covert desensitization
c. participant modeling
d. flooding
163
7.
60
Ans. A
Con
p. 224
E
Which of the following reflects an important difference between systematic
desensitization and graduated exposure?
a. imagined vs. in vivo exposure
b. immediate vs. gradual exposure
c. One includes modeling; the other does not.
d. One is clearly more effective than the other.
7.
61
Ans. C
App
p. 225
M
A therapist has decided to employ participant modeling to treat her client who has
apiphobia (fear of bees). Which of the following would be part of that treatment?
a. The client will be exposed to in vivo stimuli such as pictures of bees, sounds of
bees, etc.
b. The client will learn relaxation techniques modeled by the therapist and then
imagine pictures of bees, the sound of bees, etc.
c. The client will observe as the therapist watches a bee on a flower, helps collect
honey with a trained beekeeper, etc.
d. The client will imagine the therapist watching a bee on a flower, collecting
honey with a trained beekeeper, etc.
7.
62
Ans. B
App
p. 225
E
*
Antonia's therapist is helping her overcome her phobia of ants by letting the insects
crawl on the table near him and then letting them crawl over his hand, while
Antonia observes from a safe distance. Later, Antonia moves closer and ultimately
lets the ants crawl on her shoe. This is known as
a. graduated exposure.
b. participant modeling.
c. desensitized flooding.
d. in vivo modeling.
7.
63
Ans. D
Fac
p. 225
E
What the DSM-II referred to as anxiety neurosis is now divided into several
disorders. Which one does not belong?
a. agoraphobia
b. generalized anxiety
c. panic
d. phobia
7.
64
Ans. A
App
p. 225
E
Nashota had a terrifying experience today. She felt a choking sensation, was
dizzy and nauseous, had trouble breathing, and thought she was going absolutely
crazy. What has she experienced?
a. a panic attack
b. an anxiety neurosis
c. an agoraphobic reaction
d. a neurotic fear
7.
65
Ans. B
App
p. 225
M
Marco has an anxiety disorder that sometimes leaves him feeling out of touch with
reality and somehow detached from his sense of self. These experiences come on
rather suddenly and for no apparent reason. What disorder is likely?
a. generalized anxiety disorder
b. panic disorder
c. agoraphobia
d. obsessive-compulsive disorder
164
.
66
Ans. C
Con
p. 226
C
Dr. Tsukahara specializes in the treatment of the phobia most commonly seen by
clinicians. What is the central underlying fear in this disorder?
a. fear of public humiliation or embarrassment
b. fear of contamination (dirt, germs, etc. )
c. fear of a panic attack
d. fear of open spaces
7.
67
Ans. D
App
p. 226
M
Mrs. Gordeeva's neighbors think it very odd that she never leaves her house. The
neighbors have heard that there is nothing physically wrong with her, but rumor
has it that she had some kind of "attack" once when she was by herself at the mall
and has never been the same since. What disorder is most likely?
a. social phobia
b. obsessive-compulsive disorder
c. depersonalization
d. agoraphobia
7.
68
Ans. A
Fac
p. 226
E
Which of the following statements is best supported by research?
a. The majority of severe panic disorder cases include agoraphobia.
b. Panic disorder and agoraphobia are distinct, relatively independent disorders
that frequently occur together.
c. Agoraphobia virtually always occurs with a history of panic disorder.
d. Both panic disorder and agoraphobia are usually a result of substance abuse
disorders.
7.
69
Ans. B
App
p. 227
M
Gwenyth has agoraphobia with a history of panic attacks. In addition to the
psychosocial dysfunction posed by this disorder, Gwenyth is at risk for a comorbid
diagnosis of
a. schizoid personality disorder.
b. substance abuse.
c. obsessive-compulsive disorder.
d. bipolar disorder.
7.
70
Ans. D
Fac
p. 227
E
Estimates of the lifetime prevalence of panic disorder (with or without
agoraphobia) are as high as
percent in the U. S.
a. 2. 5
b. 4
c. 6. 8
d. 9
7.
71
Ans. D
App
p. 227
M
Which of the following persons is MOST likely to be diagnosed with panic
disorder?
a. Marcell, a male living in Italy
b. Su Lin, a female living in Hong Kong
c. Whitney, an Asian male living in the U. S.
d. Gretchen, a female living in Germany
7.
72
Ans. A
App
p. 227
M
For whom is sleep paralysis most likely to be a symptom of panic disorder?
a. Kenesha, a black female
b. Consuela, a Hispanic female
c. Rodrigo, a Hispanic male
d. Michelle, a white female
165
.
73
Ans. B
Fac
p. 228
E
Roughly what percentage of persons in the U. S. will experience agoraphobia at
some point in their lives?
a. 3. 5
b. 6
c. 9
d. 12. 5
7.
74
If parents do not adequately fulfill an infant or child's physical and emotional
Ans. D needs, later fears of abandonment and interpersonal losses may lead to an anxiety
Fac
disorder. This represents the
explanation of agoraphobia.
p. 228
a. Freudian
E
b. cognitive
c. interoceptive
d. object relations
7.
75
Ans. C
App
p. 228
M
Deanna's parents were emotionally distant during her childhood and
unresponsive to her needs and feelings, resulting in her chronic fears of
abandonment. One psychological theory predicts that she will develop
when she experiences later interpersonal loss.
a. a social phobia
b. posttraumatic stress disorder
c. agoraphobia
d. obsessive-compulsive disorder
7.
76
Ans. A
App
p. 228
M
Dr. Robinson is employing animal models in order to understand the physiology
of panic disorder. What area of the brain is she most likely to study?
a. locus coeruleus
b. amygdala
c. temporal lobe
d. hypothalamus
7.
77
Ans. B
App
p. 228
M
Dr. Danton has just stimulated the locus coeruleus of one of his rhesus
monkeys. What result is most likely?
a. aggressive behavior
b. a panic-like reaction
c. a decrease in sympathetic nervous system activity
d. compulsive motor behavior
7.
78
Ans. C
Fac
p. 229
M
Because actual intake of carbon dioxide and sodium lactate is often unrelated
to panic symptoms, researchers recognize that the role of
is also
critical in understanding this disorder.
a. LC hypersensitivity
b. interoceptive misperception
c. perception of control
d. GABA
*
166
7.
79
Ans. B
App
p. 229
E
An anxiety-disordered patient has been asked to hyperventilate as part of his
therapy to help him identify anxious apprehension states. What disorder is present?
a. agoraphobia
b. panic disorder
c. obsessive-compulsive disorder
d. posttraumatic stress disorder
7.
80
Ans. D
App
p. 229
M
Carmelita's autonomic nervous system is predisposed to overreact to environmental
threats such as major life stressors. Her experience of a panic attack under this
circumstance is referred to as a(n)
a. primary alarm.
b. learned alarm.
c. anxious apprehension.
d. false alarm.
7.
81
Ans. A
App
p. 229
M
Herb's counselor is helping him break the self-perpetuating cycle of somatic
misinterpretation that causes his anxiety disorder. In other words, the counselor
is trying to reduce Herb's
a. anxious apprehension.
b. false alarms.
c. somatic obsession.
d. autonomic hypersensitivity.
7.
82
Ans. B
App
p. 229
M
Mr. Nguyen is working at his desk. He is unaware that he is breathing rapidly and
is in danger of hyperventilating. Instead, he thinks he is beginning to experience
another panic attack. According to Barlow, what sort of alarm is this?
a. false
b. learned
c. primary
d. secondary
7.
83
Ans. C
Con
p. 230
E
Which of the following treatments is considered LEAST effective for panic disorder
and agoraphobia?
a. cognitive restructuring
b. medication
c. resolution of unconscious conflicts
d. relaxation and graded interoceptive exposure
7.
84
Ans. D
App
p. 231
M
Majel's counselor is using interoceptive exposure to reduce some symptoms
associated with Majel's anxiety disorder. What is the focus of this intervention?
a. the fear and physiological arousal associated with a specific phobia
b. intrusive thoughts that have been influenced by early family experiences that
cause obsessions
c. irrational anxiety-generating cognitions
d. benign physical sensations that trigger panic symptoms
7.
85
Ans. A
Fac
p. 231
E
Which of the following components is unique to panic control treatment?
a. education about overreacting to and catastrophizing physical sensations
b. graded interoceptive exposure
c. correction of chronic misinterpretation of benign bodily experiences
d. breathing retraining
*
167
7.
86
Ans. C
App
p. 231
M
Cora is taking a medication for an anxiety disorder that is causing drowsiness, poor
motor coordination, and may cause physical dependence. What d r u g might she be
taking?
a. imipramine
b. anafranil
c. alprazolam
d. Prozac
7.
87
Ans. D
Con
p. 231
M
Which drug and its biochemical action are incorrectly paired?
a. Valium: facilitates binding of GABA
b. Tofranil: blocks norepinephrine and serotonin reuptake
c. Prozac: blocks serotonin reuptake
d. Xanax: slows the decomposition of norepinephrine
*
7.
88
Ans. A
Con
p. 232
M
Toby is reviewing research that has evaluated various treatment approaches for
panic disorder. Based on your own reading, you would expect Toby to conclude
that
is most effective.
a. cognitive-behavioral therapy
b. anxiolytic drug treatment
c. antidepressant drug treatment
d. a combination of cognitive-behavioral therapy and medication
7.
89
Ans. D
App
p. 232
M
Anselmo and his family are on vacation. He finds himself worrying that he may
have left the coffee pot on and that the appliance could finally overheat and start
a fire. By the end of the day, he's convinced himself that he actually did turn the
pot off. Which of the following terms describes his concern?
a. compulsion
b. obsession
c. anxious apprehension
d. none of the above
7.
90
Ans. B
App
p. 232
M
Gerald is experiencing ego-dystonic images of standing up in public and shouting
profanity and obscenities at strangers. He is so worried about acting out this
behavior that he will not leave his house. What best describes his situation?
a. irresistible impulse
b. obsession
c. agoraphobia
d. compulsion
7.
91
Ans. B
Fac
p. 232
E
Approximately what percentage of persons with OCD engage in some sort of action
intended to neutralize or suppress their intrusive thoughts?
a. 100
b. 80
c. 65
d. 50
168
7.
92
Ans. C
App
p. 232
M
Sadie's mother is extremely worried about her daughter. Sadie spends several hours
each day meticulously rearranging the food in her cabinet according to size and
shape. Sadie is also distressed by her actions but cannot seem to stop. What term
best describes her action?
a. ego syntonic
b. obsessive
c. compulsive
d. impulsive
7.
93
Ans. A
App
p. 232
M
*
Emily is extremely afraid of coming in contact with germs so she always wears
two pairs of surgical-quality gloves when she leaves her house, and washes her
hands repetitively when she gets back. Her fear is a(n)
; wearing
gloves and handwashing
are
.
a. obsession; compulsions
b. compulsion; neutralizations
c. impulse; rituals
d. phobia; obsessions
Which of the following descriptions represents a compulsion?
a. persistent thoughts about harming someone
b. persistent doubts about turning off the clothes iron at home
c. persistent counting of streetlights while driving
d. persistent fear of being sexually assaulted
7.
94
Ans. C
Con
p. 232
M
7.
95
Ans. B
App
p. 232-3
C
Which of the following persons would NOT be described with an obsession?
a. Sandi, who is very upset about recurrent and persistent thoughts of hurting her
child
b. Roshma, who believes his father is putting frightening, repetitive thoughts into
his mind that he is infected with AIDS
c. Motega, who is afraid he will make a sexual advance toward his boss and cannot
get the thought out of his head
d. Veronica, who has not entered a store for over six months because she is afraid
she will be unable to control a distressing impulse to shoplift
7.
96
Ans. D
App
p. 233
C
Natasha is severely depressed. She is preoccupied with guilty ruminations that she
cannot get out of her mind and that cause her a great deal of distress. For what
reason does this obsessiveness not meet diagnostic criteria for OCD?
a. The thoughts are not ego-dystonic.
b. She no longer recognizes that the thoughts are excessive and unreasonable.
c. There is no evidence that she engages in compulsive behavior.
d. The thoughts are restricted to the depression disorder.
7.
97
Ans. A
App
p. 234
M
Dr. Aguilar is providing group therapy for persons with compulsive disorders such
as overeating and gambling. In what central way do these clients differ from his
clients with OCD?
a. The OCD clients do not derive short-term pleasure from their compulsive
activities.
b. The group clients do not describe their compulsions as being out of their control.
c. The OCD clients are more likely to describe their obsessions as ego-syntonic.
d. The group clients' compulsions are more responsive to medication treatment.
169
7.
98
Ans. C
App
p. 234
M
Blaine is a 19-year-old male who has a history of motor tics and who currently
exhibits repetitive vocalizations, compulsive shouting of obscene language, and
other impulsive social behavior. What disorder is most likely?
a. OCD, with coprolalia
b autistic OCD
c. Tourette's disorder, with coprolalia
d. OCD, Tourette's subtype
7.
99
Ans. D
App
p. 234
M
A true story: A student approached an abnormal psychology instructor to tell the
instructor about an acquaintance who has Tourette's disorder. The disorder became
known to the student one Sunday morning in church when the person stood up and
shouted a string of obscenities and curses! In other words, the student was
describing the acquaintance's
a. echolalia.
b. comorbid compulsive disorder.
c. cingulatomy.
d. coprolalia.
7.
100
Ans. A
Fac
p. 235
E
Epidemiological data indicates that
percent of children and adolescents suffer
OCD, and as many as
percent of OCD cases begin before age 18.
a. 1; 50
b. 3; 35
c. 1; 82
d. 3; 50
7.
101
Ans. B
Con
p. 235
C
Which of the following persons, according to Rapoport's studies, is MOST likely
to have had an onset of OCD in early childhood?
a. Susie, a young adult female
b. Stanley, a young adult male
c. an individual with a "washer" compulsion
d. Either b or c.
7.
102
Ans. D
App
p. 235
E
As a result of a thorough assessment completed this week, Melanie has been
diagnosed with OCD, with an onset in the last few months. Based on gender
prevalence data, how old would you expect Melanie to be?
a. 7
b. 15
C 29
d. either b or c
7.
103
Ans. C
Fac
p. 235
E
For which anxiety disorder are the MZ and DZ twin concordance rates
essentially equivalent?
a. specific phobias
b. panic disorder
c. OCD
d. agoraphobia
170
.
104
Ans. A
App
p. 235
M
A study of genetic factors in OCD is being conducted by Dr. Duit. What should
Dr. Duit expect to find among the relatives of his OCD probands?
a. a greater likelihood of some kind of anxiety disorder, but not OCD
b. a greater concordance between MZ versus DZ twins of those probands
c. a greater likelihood of OCD compared to relatives of control subjects
d. all of the above
7.
105
Ans. B
App
p. 235
C
Which of the following medications would be most effective for the treatment of
OCD?
a. Xanax
b. Anafranil
c. Tofranil
d. Lithium
7.
106
Ans. C
Fac
p. 235
E
Canine acral lick has offered a provocative animal model for understanding
a. the behavioral avoidance associated with specific phobias.
b. the physiological overreactivity of panic disorder.
c. the compulsive symptoms of OCD.
d. the autonomic conditioning of PTSD.
7.
107
Ans. D
Fac
p. 236
M
According to Rapoport et al. 's experiment involving dogs with acral lick, why
might a drug that affects serotonin be effective in treating OCD symptoms?
a. The drug may increase the level of serotonin in the brain.
b. The drug may slow the decomposition of serotonin.
c. The drug may decrease presynaptic production of serotonin.
d. The drug may increase the sensitivity of serotonin receptors.
7.
108
Ans. A
Con
p. 236
C
Which of the following brain regions does not belong with the other three?
a. amygdala
b. cingulate gyrus
c. orbitofrontal cortex
d. caudate nucleus
7.
109
Ans. C
App
p. 236
E
Using an MRI, Dr. Atkinson is looking for areas of abnormal metabolism in his
patients with OCD. What brain regions should he inspect most closely?
a. the amygdala and saggitotemporal cortex
b. the hypothalamus and somatosensory cortex
c. the caudate nucleus and cingulate gyrus
d. the locus coeruleus and prefrontal cortex
7.
110
Ans. B
App
p. 236
M
Emalia has undergone treatment for OCD. Based on the findings from brain
imaging studies of this disorder, you would expect to see orbitofrontal
activity as a result of Emalia's treatment.
a. decreased; drug
b. decreased; drag or behavioral
c. increased; behavioral
d. increased; drug or behavioral
*
171
7.
111
Ans. D
Con
p. 236
C
What sort of operant consequence is represented by an obsessive-compulsive
individual's ritualistic behaviors?
a. punishment
b. extinction
c. positive reinforcement
d. negative reinforcement
7.
112
Ans. A
Con
p. 236
E
Overreactive autonomic activity appears to be a common denominator in anxiety
disorders. Someone with this diathesis who believes mat "an act committed in
the heart" is equivalent to an actual, overt behavior may be at greatest risk for
a. OCD.
b. GAD.
c. social phobia.
d. PTSD.
7.
113
Ans. B
App
p. 236
M
Philippe is a young adult with OCD. When his therapist meets with his family for
counseling sessions, what will the therapist be MOST likely to observe in Philippe's
parents?
a. emotional aloofness and disinterest in Philippe's life
b. extremely high expectations for Philippe's behavior and strict rules for his
younger siblings
c. strong depressive tendencies and emotional overinvolvement in Philippe's life
d. one parent with OCD, given the strong genetic link in this disorder
7.
114
Ans. C
Con
p. 236
M
What process best accounts for the influence of parental characteristics on persons
with obsessive-compulsive disorder, according to Steketee & White?
a. genetics
b. unresolved childhood conflicts
c. modeling
d. classical conditioning
7.
115
Ans. D
Con
p. 236
M
In George Orwell's novel, 1984. citizens were legally punished for "thought crimes. "
Which anxiety disorder is characterized by such "crimes"?
a. GAD
b. panic disorder
c. social phobia
d. OCD
7.
116
Ans. B
App
p. 237
E
Mr. Burmenko has an anxiety disorder for which he is considering treatment
via psychosurgery. What disorder does he probably have?
a. panic disorder
b. obsessive-compulsive disorder
c. generalized anxiety disorder
d. Only psychotic persons are considered eligible for psychosurgery.
*
172
7.
117
Ans. A
Con
p. 237
M
A student's report on drug therapy for OCD could include each of the following
statements EXCEPT
a. Medications such as Xanax and Valium are effective in reducing OCD
symptoms.
b. Side effects of nausea, fatigue, and inhibited sexual desire are common.
c. OCD symptoms usually return quickly once medication treatment is
discontinued.
d. Drug therapy is useful for 50 to 75 percent of OCD patients.
7.118
Ans. B
Con
p. 237
E
Which disorder does not belong with the other three in terms of biochemistry and
drug therapy?
a. GAD
b. OCD
c. social phobia
d. panic disorder
7.119
Ans. C
App
p. 237
M
Nicolai has a strong compulsion to check every water tap he passes by. His
therapist and he are walking through a large restaurant kitchen, and the therapist
is helping him resist the temptation to touch the handle to make sure the tap is
completely shut off. During the hour session, Nicolai's anxiety becomes extremely
high but men subsides. What therapeutic processes are taking place?
a. flooding and negative reinforcement
b. response exposure and extinction
c. exposure and response prevention
d. graded exposure and behavioral deconditioning
Julie has an obsession about stabbing her roommate and engages in a checking
ritual to manage the anxiety generated by this intrusive image. What sort of
effective treatment might a clinician recommend?
a. Prozac
b. direct exposure and response prevention
c. imaginal exposure and response prevention
d. either a or c
7.120
Ans. D
App
p. 237
C
*
7.121
Ans. A
Fac
p. 237
E
Free-floating anxiety is described in the DSM-IV as
a. GAD.
b. OCD.
c. agoraphobia.
d. PTSD
7.122
Ans. B
App
p. 238
M
Salvador often experiences insomnia, has several minor aches and pains in his body,
worries excessively about his job and his family, and is tense and irritable. What
disorder is most likely?
a. adjustment disorder with behavioral disturbance
b. GAD
c. generalized phobia
d. panic disorder without agoraphobia
173
7.123
Ans. C
App
p. 238
M
Which of the following persons is MOST likely to be diagnosed with GAD?
a. Kevin, a 29-year-old Hispanic male
b. Shambrae, a 35-year-old black female
c. Marvin, a 21-year-old black male
d. Denise, a 19-year-old white female
7.124
Ans. D
Con
p. 238
E
Which anxiety disorder is MOST likely to be comorbid with another anxiety
disorder?
a. agoraphobia
b. specific phobia
c. panic disorder
d. generalized anxiety disorder
7.125
Ans. A
Con
p. 238
E
Which anxiety disorder would be most vulnerable to criticism by the sociocultural
perspective for reflecting social and economic deprivation rather than individual
psychopathology?
a. GAD
b. OCD
c. agoraphobia
d. panic disorder
7.126
Ans. B
Fac
p. 238-9
M
The worrying of an individual with GAD may actually be reinforcing in several
different ways. Which description below does NOT apply?
a. Worrying can serve as an attempt to maintain tight control over life, an attempt
to avoid mistakes and mishaps.
b. The frequent worrying puts the individual "on alert" and poised to cope more
quickly with stressors.
c. The cognitive preoccupation with possible threats may help a person avoid actual
emotional distress.
d. Excessive worrying may reduce physiological arousal when the person is faced
with a feared stimulus.
7.127
Ans. D
App
p. 239
C
Glenda experiences a DSM-IV disorder that some clinicians view as a basic anxiety
state rather than a discrete disorder. According to Barlow's findings, which
treatment method will be most effective for Glenda?
a. cognitive restmcturing
b. relaxation training
c. a combination of A and B
d. Any of the above is equally effective.
7.128
Ans. C
App
p. 239
C
Eva experiences a DSM-IV disorder that some clinicians view as a basic anxiety
state rather than a discrete disorder. If she is given the most common form of
treatment for this disorder, she will receive
a. relaxation training.
b. a combination of relaxation training and cognitive restmcturing.
c. an anxiolytic.
d. cognitive-behavioral control treatment.
*
174
7.129
Ans. A
App
p. 239
M
Ingeborg is taking a benzodiazepine for GAD. Which description is LEAST likely
to apply to Ingeborg's reaction?
a. GAD symptoms will begin to subside about 6 hours after beginning the drag,
b. Side effects such as drowsiness and physical dependence will occur.
c. Therapeutic effects may be no stronger than those obtained with a placebo,
d. Lasting reductions in chronic worry will not be obtained.
7.130
Paul and Patricia are fraternal twins. Several reasons have been put forth to explain
Ans. D
why Patricia is substantially more likely to experience an anxiety disorder than is
App Paul. These could include each of the following EXCEPT
p. 240-1
a. Paul's greater exposure to androgens during puberty.
M
b. Patricia's less frequent opportunities to extinguish fears of outdoor creatures such
*
as snakes, spiders, and the like.
c. Paul's socialized reluctance to admit or express fear.
d. Patricia's lower levels of GABA and smaller limbic system structures.
7.131
Ans. A
Fac
p. 240
E
7.132
Ans. B
Fac
p. 240
E
Based on differences in behaviors that are expected and encouraged in males versus
females, it would be anticipated that
would show significant gender
differences but that
would be more similar between genders.
a. specific phobia; social phobia
b. panic disorder; GAD
c. OCD; specific phobia
d. GAD; agoraphobia
As expected on the basis of gender role socialization, compulsions of
are
much more likely among females than among males.
a. checking
b. washing
c. counting
d. hoarding
7.133
Ans. C
Fac
p. 240-1
E
Utilizing a "lie detector," Pierce and Kirkpatrick (1992) provided support for the
hypothesis of gender differences in anxiety disorders.
a. hormonal
b. crosscultural
c. gender role socialization
d. limbic system reactivity
7.134
Ans. B
Con
p. 240
M
While
is usually treated with longterm success,
of a clearly successful treatment approach.
a. panic disorder; agoraphobia
b. specific phobia; GAD
c. OCD; panic disorder
d. PTSD; social phobia
175
is still in need
7.135
Ans. C
Con
p. 240
E
7.136
Ans. C
App
p. 241
M
*
In panic disorder, individuals respond to a stressor as though it posed a mortal
threat. Persons with
have actually been exposed to a life-threatening
situation,
a. OCD
b. GAD
c. PTSD
d. MDD
Rosalind was a victim of severe domestic violence two weeks ago. She is
experiencing nightmares, feels detached from and avoids friends who know about
the attack, and exhibits an exaggerated startle response. What diagnosis is
correct?
a. PTSD with delayed onset
b. chronic PTSD
c. acute stress disorder
d. GAD
7.137
Ans. C
Fac
p. 241
E
Resnick and colleagues reported a lifetime prevalence of PTSD for females of
a. 1.3 percent.
b. 5.4 percent,
c. 12 percent.
d. 19 percent.
7.138
Ans. D
Con
p. 242
E
Which of the following is NOT one of the three broad symptom classes of PTSD?
a. increased physiological arousal
b. frequent reexperiencing of the traumatic event
c. persistent avoidance of trauma-related stimuli
d. social isolation and emotional numbing
7.139
Ans. A
App
p. 242
M
7.140
Ans. B
App
p. 242
M
Dave is a police officer who nearly lost his life during the apprehension of a
robbery suspect. He stays away from the scene of the shootout, has stopped
attending his children's school activities, and feels detached from others. His
reactions
represent which PTSD symptom category or categories?
a. persistent avoidance and numbing of general responsiveness
b. frequent reexperiencing and persistent avoidance
c. increased physiological arousal and social isolation
d. numbing of general responsiveness and interpersonal withdrawal
Vietnam veterans with PTSD often refuse to sit with their back to a door, preferring
to monitor the activities of the people around them, watchful for threat. What
DSM-IV symptom category does this behavior represent?
a. persistent avoidance
b. increased arousal
c. persistent reexperiencing
d. social isolation
176
7. 141
Ans. D
App
p. 242
E
7.142
Ans. B
App
p. 243
M
Chris was a passenger in an automobile accident in which a close friend was killed.
Chris1 family was relieved that he seemed to cope well with the experience in the
weeks that followed. One year later, however, Chris developed symptoms of PTSD
that lasted for two months. How would these symptoms be diagnosed?
a. delayed stress adjustment disorder
b. PTSD, chronic
c. PTSD, latent onset
d. PTSD, acute, with delayed onset
Charles has returned from his tour of duty in Vietnam. He is met by protestors who
call him a "baby killer," and his friends who are against the war refuse to associate
with him. How might these experiences affect his risk for PTSD?
a. His physiological arousal will be heightened, and thus his general
unresponsiveness will be decreased and his risk actually lessened.
b. His social support will be decreased, and his risk will increase.
c. His resulting anger will motivate more adaptive problem-focused coping
strategies and decrease his risk.
d. His service in Vietnam will result in PTSD regardless of these posttrauma
events.
7.143
Ans. A
App
p. 244
M
Which of the following persons is most likely to develop PTSD?
a. Minh, a crime victim who was injured during the crime and believed his life was
in danger
b. Ruth, a non-injured victim of crime who believed her life was in danger
c. Pedro, a victim of a natural disaster who did not believe his life was in danger
but felt completely out of control of the event
d. Minh and Ruth, equally
7.144
Ans. D
Fac
p. 244
E
The lifetime prevalence of PTSD for victims of crimes in which bodily injury
occurred and the victim believed her/his life to be in danger is reported to be
a. 10 percent.
b. 18 percent.
c. 30 percent.
d. 45 percent.
7.145
Ans. B
Con
p. 244
M
Marko is a Vietnam veteran with PTSD. Which of the following prewar
characteristics is MOST likely to have increased his vulnerability to this disorder?
a. overconcern with bodily functions
b. social introversion
c. sensitivity to criticism and interpersonal suspiciousness
d. conduct disorder
7.146
Ans. C
Con
p. 244
E
*
Which PTSD diagnostic category contains symptoms that are best accounted for by
Mowrer's two-factor model?
a. persistent symptoms of increased arousal
b. persistent reexperiencing
c. persistent avoidance
d. persistent conditioning
177
7.147
Norma is a nurse who served in the Vietnam War. A few years ago, she moved
Ans. D
from Florida to North Dakota because when the weather was hot in Florida, she
App often found herself feeling extremely keyed up, as though she was preparing to
p. 244 see wounded soldiers, working in the oppressive heat of Vietnam. The two-factor
M
model identifies the
as the CS and the
as the reinforcer.
a. trauma of working with wounded soldiers; heat
b. physiological arousal of being keyed up; move to North Dakota
c. heat; physiological arousal of being keyed up
d. heat; move to North Dakota
7.148
Ans. A
App
p. 244
M
Paul has PTSD that developed as a result of his being violently assaulted while
riding to work on the subway. According to behaviorists, what two factors are most
important in understanding how his symptoms have developed?
a. classical conditioning and operant conditioning
b. operant conditioning and associative fear networks
c. the uncontrollability and physical danger of the event
d. social rejection and generalization of arousal
7.149
Ans. A
Fac
p. 245
M
According to Dr. Kaloupek, which of the following factors is most likely to reduce
the severity of PTSD symptoms?
a. persistent exposure to trauma-related stimuli
b. chronic depression
c. exposure to new but less severe stressors
d. prolonged avoidance of trauma-related stimuli
7.150
Ans. B
Fac
p. 246
E
Trauma-related stimuli and responses, the meaning assigned to an event, and escape
and avoidance programs comprise a(n)
a. associative memory node.
b. fear network.
c. cognitive trauma schema.
d. three-factor conditioning network.
7.151
Ans. D
App
p. 246
M
*
If Donna's memory of her sexual assault is stored as a fear network, which element
of that network is most likely to activate escape behavior?
a. trauma-related environmental stimuli
b. physiological responses similar to those experienced during the trauma
c. intrusive thoughts
d. any of the above
7.152
Ans. C
App
p. 246
E
Ron is seeking treatment for his PTSD. He should probably NOT choose
a. direct exposure treatment.
b. cognitive processing therapy.
c. object relations therapy.
d. cognitive-behavioral therapy.
7.153
Ans. A
Con
p. 246
C
Foa and colleagues' approach to the treatment of PTSD is most similar to
a. flooding.
b. covert desensitization.
c. interoceptive restructuring.
d. participant modeling.
178
7.154
Ans. B
App
p. 243,7
M
When a town in Pennsylvania lost several of its young adults in a TWA plane crash
in 1996, crisis intervention teams arrived to help residents cope with the trauma.
Each of the following factors was probably important in the attempt to prevent
posttraumatic stress disorder EXCEPT
a. encouraging interaction with family, friends, and counselors immediately after
the trauma.
b. endorsing perceptions that the world is a dangerous but predictable place.
c. reinforcing individuals' belief in their ability to cope effectively.
d. none of the above
7.155
Ans. C
App
p. 247
M
To reduce the possibility of PTSD subsequent to trauma, a university is offering
Foa's 4-session prevention course to students who have been raped. Of the ten
women who have participated in the course, how many would be predicted to meet
DSM criteria five and a half months later?
a. 8
b. 6
c. 3
d. 1
7.156
Ans. D
Fac
p. 246-7
M
Which of the following PTSD symptom categories and medications are mismatched?
a. flashbacks : anxiolytics
b. reexperiencing : antidepressants
c. heightened arousal : antiadrenergics
d. avoidance/numbing : SSRI's
SHORT ANSWER I ESSAY
7.157
Describe the conditions under which humans are most likely to develop a phobia.
Possession of a genetically inherited tendency to overreact physiologically and
experience anxiety (possibly a deficiency of GAB A); direct or vicarious exposure (modeling; vivid
information exposure) to a fear-producing stimulus or situation; stimulus or situation has
evolutionary importance that "prepares" development of the fear.
7.158
What brain structure appears to trigger the intense fear involved in phobias? What
neurotransmitter's activity might be disturbed, and what evidence supports this notion?
Amygdala. GABA, a primary inhibitory transmitter, may be insufficient or may
not adequately bind to receptors, leading to an increase in physiological arousal and anxiety; the
benzodiazepine drugs used to treat anxiety increase the activity of this transmitter.
7.159
Which procedures are commonly and successfully used in the treatment of phobias?
Systematic desensitization; exposure, including graduated exposure and flooding;
and modeling, including participant modeling.
179
7.160
Racine has developed a panic disorder. Using Barlow's model, describe the etiology
of her disorder.
1) Racine has an inherited predisposition toward autonomic overreactivity.
2) She experienced some form of a major life stressor that she interpreted as posing
an actual threat to her life. This prompted a "false alarm" of danger to which her sympathetic
nervous system responded with panic symptoms (e.g., racing heart, shaking, breathing difficulties,
dizziness, fear of dying).
3) The interoceptive cues associated with the first false alarm become early
warning signs for which Racine has become highly vigilant. In other words, she has developed
anxious apprehension.
4) Racine will then begin to misinterpret minor, benign somatic changes (such as
an increase in breathing or increase in lactic acid), and these misperceptions will in turn hasten the
development of full-blown panic symptoms in a sort of self-fulfilling prophecy.
7.161
In what way are the treatments for phobias and for panic disorder similar in focus?
All of the behavioral treatments for phobias as well as the cognitive-behavioral
treatments for panic have a similar goal: the enhancement of clients' sense of self-efficacy, or the
belief that they can approach and manage their reactions to feared objects, situations, or even their
own bodily states.
7.162
Do the findings of Black and colleagues (1992) and Torgersen (1983) indicate that
genetics are unimportant in OCD? Explain.
Black and colleagues found that there was no difference in OCD prevalence in
families of probands versus families of control subjects. Torgersen failed to find a difference in
concordance rates between MZ and DZ twins. However, both studies documented an increased
prevalence of various anxiety disorders in both proband families and MZ twins. Thus, while mere
appears to be no specific genetic diathesis for OCD, there does appear to be some sort of more
general vulnerability transmitted genetically.
7.163
What class of drugs is most effective for GAD? for OCD? for the frequent
reexperiencing of PTSD?
GAD: benzodiazepines; OCD: SSRI's; PTSD: antidepressants (not necessarily SSRI)
7.164
Kelli was a victim of a sexual assault while jogging through a public park.
Describe the posttrauma factors that may increase her risk of PTSD.
-- Kelli has an insufficient social support network prior to the assault, or that
network changes after the assault (e.g., her friends avoid her because they don't know how to help
or her father blames her for letting herself become a victim).
-- Kelli generalizes trauma danger signs (e.g., strangers approaching her, outdoor
public areas) to all situations and believes that the world is a dangerous place.
-- Kelli believes there is no one she can turn to for help who will listen to her fears.
— Kelli believes that she is incompetent to cope with her experience and feelings.
180
Chapter 8 DISSOCIATIVE AND SOMATOFORM DISORDERS
8.1
Ans. A
Fac
p. 252
E
Dissociative disorders are marked by disruptions in each of the following areas
EXCEPT
a. attention
b. memory
c. consciousness
d. identity
8.2
Ans. B
App
p. 252
M
A clinician is consulting the DSM-II for the correct classification of a client whose
symptoms include derealization and identity alteration. Which classification
below is appropriate?
a. repressive disorders
b. hysterical neuroses
c. dissociative psychoses
d. neurotic dissociation
8.3
Ans. C
App
p. 252
E
An ancient Egyptian healer was treating a patient who complained of paralysis in
her arms that seemed to have no physical cause. To what would the healer
attribute the symptoms?
a. conversion hysteria
b. somatization
c. wandering uterus
d. psychosis
8.4
Ans. D
Con
p. 252
M
Which of the following disorders is MOST similar to the meaning of "hysteria" as
used by the Greeks?
a. dissociative disorder
b. neurotic anxiety
c. posttraumatic stress reaction
d. somatoform disorder
8.5
Ans. A
App
p. 252
M
*
Janice has been complaining that she cannot feel her feet from her ankles down.
She has trouble walking because of this and is constantly injuring her feet.
Medical doctors have been able to find no physical cause for her symptoms.
How would Freud have described Janice's disorder?
a. conversion hysteria
b. somatoform disorder
c. repressive neurosis
d. hysterical disorder
8.6
Ans. B
Con
p. 252
E
Which of the following persons does not belong with the other three?
a. Anna 0.
b. Briquet
c. Breuer
d. Freud
181
8.7
Ans. C
App
p. 253
M
Dr. Asante specializes in the treatment of clients with dissociative or somatoform
disorders. Which of the following commonalties should he expect to find in their
personal histories?
a. childhood abuse
b. multiple visits to medical doctors prior to DSM-IV diagnosis
c. exposure to unusually stressful experiences
d. disruptions in memory and consciousness
8.8
Ans. C
Fac
p. 253
E
In which version of the DSM would you first see a separation of neuroses into
somatoform and dissociative disorders?
a. DSM-I
b. DSM-II
c. DSM-III
d. DSM-III-R
8.9
Ans. B
App
p. 253
M
Danton's therapist believes Danton was exposed to chronic child abuse and has
developed a subsequent mental disorder. Which of the following disorders is the
therapist LEAST likely to diagnose?
a. posttraumatic stress disorder
b. histrionic personality disorder
c. conversion disorder
d. dissociative identity disorder
8.10
Ans. D
App
p. 253
E
Tamara describes feeling completely detached from the events going on around
her and often forgets important experiences such as the death of her mother or
her sister's marriage. What psychological process is occurring?
a. splitting
b. splintering
c. division of consciousness
d. dissociation
8.11
Ans. A
App
p. 253
E
George's wife divorced him suddenly. After several weeks of poor job
performance following the divorce, George was fired. If he expresses his
emotional distress by developing headaches, joint pain, and other physical
symptoms, he is engaging in the process of
a. somatization.
b. dissociation.
c. somatoforming.
d. derealization.
182
8.12
Ans. B
App
p. 253
M
When Jachim meditates, he enters a trance-like state in which he is unaware of
the world about him. In this state, he can hear and feel events in the external
world, but they have no subjective meaning to him. Sometimes he feels
disconnected from his body, as if he were no longer himself. Spencer is a
veteran of WWII who was severely wounded twice in combat. Sometimes he
enters a state of mind in which the world has no subjective meaning to him and
he feels disconnected from his body, without an identity. His family finds these
episodes alarming as does his employer. Which of the following statements
correctly describes these two men?
a. Regardless of their culture, these would be considered pathological states due
to the complexity and infrequency of their experiences.
b. Jachim's experience is not pathological; Spencer's experience is pathological
and may represent PTSD or a dissociative disorder.
c. Because Jachim and Spencer experience a loss of identity and derealization,
the possibility of a dissociative disorder is likely for both.
d. Whether Jachim or Spencer is diagnosed as pathological depends on the
culture in which they live and the diagnostic practices of mental health
professionals.
8.13
Ans. C
Con
p. 254
M
What do "speaking in tongues" and Ataque de Nervios have in common?
a. They are considered pathological states in the DSM-FV.
b. They both involve some form of spirit possession.
c. They are forms of dissociation described as normal expressions in some
cultures.
d. They each involve characteristics of the mental processes described by Freud
as "conversion neuroses."
8.14
Ans. D
Fac
p. 254
M
When are dissociative states NOT considered pathological?
a. when they do not involve significant identity alteration
b. when they occur infrequently in an individual
c. when they occur within recognized cultural groups
d. when they do not produce personal distress
8.15
Ans. A
App
p. 254-5
M
Marguerite has a dissociative disorder. She might exhibit any of the following
key symptoms EXCEPT
a. hypnotizability.
b. derealization.
c. amnesia.
d. identity confusion.
8.16
Lucinda, a person with dissociative identity disorder, is exhibiting symptoms
Ans. B
similar to the perceptual hallucinations seen in psychotic disorders. This is an
App example of the key symptom of
p. 254
a. depersonalization.
M
b. derealization.
c. illusory imaging.
d. perceptual de-altering.
183
8.17
Ans. C
Fac
p. 255
E
Which of the following does NOT represent a DSM-IV dissociative disorder?
a. dissociative trance disorder
b. dissociative fugue disorder
c. dissociative memory disorder
d. depersonalization disorder
8.18
Ans. D
Fac
p. 255
M
If you were living in Germany in the late 1700s, you might have heard about the
first detailed report of
a. Briquet's syndrome,
b. Kraepelin's syndrome.
c. dissociative fugue,
d. multiple identities.
8.19
Ans. A
Con
p. 255
C
If you measured interest in spiritualism and the number of cases of multiple
personalities in the U.S. in the 1800s and 1900s, you would find
a. a positive correlation between those measures in both centuries,
b. a negative correlation between those measures in both centuries.
c. a positive correlation between those measures in the 1800s only.
d. a strong relationship between both measures and incidence of child abuse.
8.20
Ans. A
App
p. 255
E
For Lorraine to be diagnosed with dissociative personality disorder, how many
alters MUST be present?
a. 1
b. 2
c. 4
d. 7
8.21
A woman has dissociative identity disorder. Sara is the most outgoing and
Ans. B flamboyant identity but is unaware of the other identities. Madeline is inhibited and
App
shy but is in charge most of the time. Sara would be described as a(n) __
p. 256
and Madeline as a(n)
.
M
a. personality fragment; primary personality
*
b. alter; host personality
c. dominant personality; alter
d. alter; split identity
8.22
Ans. D
App
p. 255
E
Most of the time Marva appears to be a normal adult female, leading the life of a
typical middle-class American. Sometimes she suddenly changes her behavior,
acting like a child and claiming to be Toby, a poor minority child from the slums,
Her entire personality changes when this occurs. What is the term currently used
to describe Toby?
a. repressed memory complex
b. a split identity
c. guest personality
d. an alter
184
8.23
Ans. C
Fac
P. 256
E
Which identity of a person with dissociative identity disorder is most likely to
seek treatment?
a. the original personality
b. a suicidal alter
c. the host personality
d. the protective alter personality
8.24
Ans. C
App
p. 256
M
Which of the following identities of a female with dissociative identity disorder is
MOST likely to seek help from a therapist?
a. Tori, the angry personality fragment
b. Michelle, the powerful, protective alter
c. Juliet, the host personality
d. Joshua, her first male alter
8.25
Ans. B
App
p. 256
M
*
For Delsin, a 27-year-old male host personality, which of the following alters is
LEAST likely?
a. Ahmik, a 5-year-old male
b. Nodin, a 42-year-old physically disabled male
c. Ohen, an aggressive, alcoholic adult male
d. Meda, a suicidal adult female
8.26
Ans. D
Con
p. 256-7
M
Which statement about dissociative identity disorder is TRUE?
a. The number of alters present is proportional to the level of abuse suffered in
childhood and adolescence.
b. Personality fragments are more likely to occur than are complete alters.
c. Clinicians today are in agreement that this is a bona fide psychological
syndrome caused by early trauma,
d. The host personality usually does not represent the person's original
personality.
8.27
Ans. A
App
p. 256
M
Edmund has dissociative identity disorder. If Edmund were alive in the late
1800s, what difference would probably be observed between his disorder and the
same disorder diagnosed in the late 1900s?
a. Edmund would show more alters of the other gender.
b. Edmund would not have been considered disordered.
c. Edmund's personalities would be more clearly differentiated from each other.
d. Edmund would have only two personalities.
8.28
Ans. C
App
p. 256
E
If Erica is typical of clients diagnosed with dissociative identity disorder in 1990,
she has
alters.
a. 2
b. 8
c. 15
d. 32
185
8.29
Ans. B
App
p. 256
M
8.30
Ans. D
App
p. 256
M
When Marcia, a host personality, was approached by a man who looked a great
deal like her abusive father, she engaged in the process of
to enter the
identity of Rebecca, the protector identity.
a. altering
b. switching
c. displacing
d. cohosting
When Devorah changes from one identity to another as part of her dissociative
identity disorder, what is LEAST likely to prompt such changes?
a. flashbacks of memories
b. current stressful events
c. gradual recall of childhood traumas
d. voluntary switching
8.31
Ans. B
Con
p. 256-8
M
Certain evidence is commonly used to support the claim that dissociative identity
disorder is created by clinicians. Which finding below is NOT part of that
evidence?
a. the increase in alters exhibited over the past several decades in North America
b. the higher number of females diagnosed with dissociative identity disorder
c. the high use of hypnosis to discover alternate personalities
d. cases where malingering criminals and experimental subjects have been able to
effectively simulate dissociative identity disorder
8.32
Ans. C
App
p. 257
E
Of the dissociative identity disorder clients a therapist treats, there will be
female clients for each male client the therapist sees.
a. 15
b. 12
c. 9
d. 4
8.33
Ans. A
App
p. 257
M
Estrella is 28 years old. Previously she has been diagnosed with major depression
with psychotic features, hypochondriasis, PTSD, and, most commonly,
schizophrenia. If Estrella is now receiving another diagnosis, which of the
following DSM-IV labels is MOST likely?
a. somatization disorder
b. multiple personality disorder
c. conversion disorder
d. dissociative identity disorder
Which of the following females is LEAST likely to exhibit dissociative identity
disorder?
a. Penelope, from the U.S.
b. Yoko, from Japan
c. Eva, from Switzerland
d. Isabelle, from Canada
8.34
Ans. B
App
p. 258
E
186
8.35
Ans. C
Con
p. 258
M
*
Critics of the existence of dissociative identity disorder could cite each of the
following pieces of evidence to support their case EXCEPT
a. the failure to document the presence of a single case in Japan,
b. the extensive overlap of symptoms with several disorders that might better
account for clients' behaviors.
c. the implausibility of important ideas, emotions, and autobiographical memory
being dissociated from consciousness,
d. documentation of inappropriate use of hypnosis by overzealous therapists.
8.36
Ans. C
App
p. 258
M
Suppose each of the persons described below were participants in Coons et al.'s
study of EEG activity. Which of them would demonstrate the largest EEG changes
across personalities?
a. Henry, a male with dissociative identity disorder
b. Nanette, a female with dissociative identity disorder
c. Adrienne, a female who role-plays multiple identities
d. either a or b
8.37
Ans. D
Con
p. 258-9
M
If one of your friends asked you whether dissociative disorder really exists, what
answer would you give, based on information presented in the text?
a. yes
b. no
c. yes, as a severe manifestation of PTSD
d. none of the above
8.38
Ans. A
Con
p. 258,69
M
Which of the following statements BEST reflects your text's conclusion about the
validity of dissociative identity disorder?
a. Severe trauma probably can create splintering of consciousness, but these
characteristics are often exaggerated by some overzealous clinicians.
b. There is overwhelming evidence that dissociative identity disorder exists.
c. There is overwhelming evidence that dissociative identity disorder does not exist.
d. Cases of dissociative identity disorder are fabricated on the basis of leading
interviewing techniques and hypnosis by clinicians.
8.39
Ans. D
Fac
p. 259
E
For which DSM-IV disorders should a thorough medical assessment be included?
a. localized dissociative amnesia
b. generalized dissociative amnesia
c. somatoform pain disorder
d. all of the above
8.40
Ans. A
App
p. 259
M
Nathaniel has a dissociative amnesia in which he can remember nothing of his first
marriage. He can, however, remember the friends he had during that time. This
is an example of
amnesia.
a. systematized
b. selective
c. continuous
d. localized
187
8.41
Chris was a passenger in an automobile accident in which his young sister was
Ans. B killed. If he has dissociated his memories of the day following the accident, this
App
is a form of
amnesia.
p. 259
a. short-term
M
b. localized
c. discontinuous
d. systematized
8.42
Ans. A
App
p. 259
M
*
Alberto was a member of the first group of soldiers to reach the concentration camp
of Auschwitz during WWII. He can remember the weather on the day they arrived,
the names of soldiers who were with him, and the railroad cars outside the camp
but he cannot recall anything about the camp inhabitants he saw. This is a type of
a. selective dissociative amnesia.
b. repressed memory syndrome.
c. dissociative fugue.
d. localized dissociative amnesia.
8.43
Ans. C
App
p. 259
M
Dr. Wechsler is in charge of assessing the psychiatric casualties of American GI's
during WWII. What percentage of his patients will exhibit dissociative amnesia or
other dissociative episodes?
a. l t o 3
b. 4 to 7
c. 5 to 14
d. 12 to 19
8.44
Ans. D
App
p. 259
M
Which of the following persons is MOST likely to be diagnosed with a
dissociative amnesia?
a. Stephanie, a 23-year-old female
b. Marcus, a 13-year-old male
c. Carmen, a 30-year-old female
d. Alvin, a 25-year-old male
8.45
Ans. C
App
p. 259
E
If Dr. Arbuckle is treating young adult males who exhibit sudden losses of
memory for personally important information, she might expect these men to
have a history of
a. exposure to severe sexual abuse.
b. abnormal functioning in their hippocampus.
c. exposure to violent stressors such as combat.
d. opioid drug abuse that predisposes them to memory deficits.
8.46
Ans. B
App
p. 260-1
C
Hugh was recently involved in a violent crime for which he has been charged with
attempted murder. An initial assessment raises the possibility of a dissociative
amnesia because Hugh has no memory for the event. If Hugh is, in fact, a
malingerer, which of the following reactions is MOST likely from him?
a. He will be eager to participate in an interview under the influence of sodium
amytal.
b. He will exhibit a kind of "la belle indifference" in regard to his memory loss.
c. When assessed via EEG, he will be unable to simulate brain wave changes
when the interviewer begins to question him about the crime itself.
d. He will generalize his localized amnesia for the crime to a generalized amnesia
that will preclude further diagnostic testing.
188
8.47
Ans. B
Con
p. 258-61
M
It has been demonstrated that persons with dissociative identity disorder exhibit
differing EEG patterns as they switch alters. What conclusion can be drawn from
this?
a. Strong support for the existence of distinct alters is established.
b. No clear conclusion is possible; role-playing subjects also demonstrate these
changes.
c. The imaginative involvement and absorption common to persons with this
disorder are probably neurologically-based.
d. None of the above.
8.48
You have been asked to pretend that you are an accused murderer. The investigator
Ans. D
running the study then asks you to role-play responses to a hypnosis session much
App like the one Kenneth Bianchi underwent. Which of the following outcomes is
p. 260-1
LEAST likely?
M
a. You will describe an alternate personality but claim amnesia for this personality
*
after the session.
b. You will describe a childhood marked by abuse and familial discord.
c. You will perform quite differently on several psychological tests depending on
which personality is dominant.
d. You will probably resist the suggestive manipulation of the hypnotist and give
little or no evidence of an alter personality.
8.49
Ans. A
Con
p. 260-1
E
If Nicholas Spanos had been able to testify in Bianchi's trial, which diagnostic
conclusion would he probably offer?
a. malingering
b. dissociative amnesia
c. dissociative identity disorder
d. pseudotrance disorder
8.50
Ans. B
App
p. 261-2
E
Becky was in a cafe in Paris when a terrorist bomb went off outside; she was
traumatized by the horror she witnessed. Later, a woman calling herself Andrea
was identified by family members as Becky after she was picked up by the police
and found to match a missing person description. Andrea had no memory of her
life as Becky before the bombing. What was this woman suffering from?
a. dissociative amnesia
b. dissociative fugue
c. depersonalization disorder
d. dissociative identity disorder
8.51
Ans. C
App
p. 262
M
Which of the following risk factors might increase Victor's risk of dissociative
fugue following a traumatic life event?
a. a family history of schizoid personality disorder
b. somatization disorder
c. bipolar disorder
d. schizophrenia
189
8.52
Ans. D
App
p. 262
C
*
Which of the following persons is LEAST likely to display symptoms suggestive
of a mental disorder?
a. Frances, as she switches from an alter to her host personality
b. Martin, a person with generalized dissociative amnesia
c. Terrell, as he experiences an episode of derealization
d. Olga, a person in a fugue state
8.53
Ans. B
App
p. 262
M
If Keith is in a dissociative fugue, which prognosis is most accurate?
a. Once the fugue ends, he is at significantly increased risk of another episode
within the next five years.
b. The fugue will end in a few days and he will recover fully.
c. The fugue will end in a few weeks and he will remember most of the events
that happened during that time,
d. While he is unlikely to experience another fugue in the future, he is at
increased risk of developing a different dissociative disorder.
8.54
Ans. B
App
p. 262
E
Rosetta feels as though she were in a dream, hovering above her own body, and
the objects around her seem strangely unreal. Which of the following is most
likely?
a. fugue
b. depersonalization
c. trance disorder
d. dissociative psychotic disorder
8.55
Ans. C
App
p. 262
M
Miguel is a chronic substance abuser who vehemently denies his substance use.
If he has occasional "blackouts" due to drug intoxication, a naive clinician might
mistakenly diagnose Miguel's sudden departures from home and confusion about
his identity as
a. psychogenic flight disorder.
b. dissociative amnesia.
c. dissociative fugue.
d. dissociative identity disorder.
8.56
Ans. D
Con
p. 262
E
Which of the following disorders is/are more commonly diagnosed in females?
a. dissociative identity disorder
b. depersonalization disorder
c. dissociative fugue
d. both a and b
8.57
Ans. A
Fac
p. 262
E
Depersonalization occurs
a. as a symptom of several other physical and mental disorders.
b. more commonly in males than in females.
c. in isolation from the occurrence of derealization.
d. as a rare and dysfunctional reaction to severe stressors.
8.58
Ans. B
App
p. 263
E
Paula has a dissociative disorder. Which of the following characteristics is LEAST
likely to describe her?
a. high hypnotizability
b. schizotypal symptoms
c. fantasy proneness
d. a history of childhood abuse
190
8.59
Ans. C
App
p. 263
M
*
A game, popular in the late 1980s, known as "Dungeons and Dragons" required
that players create imaginative characters and engage in fantasy-based combat,
spell-casting, and other magical endeavors. Persons most involved in this game
were probably
a. low in absorption.
b. high in derealization.
c. high in absorption.
d. low in somatization.
8.60
Ans. D
Fac
p. 263
M
What have Steve Lynn and his colleagues found in regard to a person's vulnerability
to dissociative disorders?
a. There appears to be a relationship between child abuse and dissociative
symptoms.
b. There appears to be no relationship between creativity and dissociative
symptoms.
c. There is a high need for dependency among persons likely to develop
dissociative disorders.
d. There appears to be a relationship between fantasy proneness and dissociative
symptoms.
8.61
Ans. D
App
p. 263
M
Priscilla has completed a questionnaire that shows she is extremely high on
fantasy proneness. What prediction might you make about her?
a. She is likely to exhibit symptoms of dissociation,
b. She is likely to malinger a dissociative identity disorder.
c. She is likely to exhibit symptoms of clinical depression,
d. both a and c
8.62
Ans. C
Con
p. 263-4
E
The process of "dissociation" believed to underlie the dissociative disorders could
be reconceptualized to include each of the following EXCEPT
a. fantasy proneness.
b. self-hypnotizability.
c. creativity.
d. role-playing.
8.63
Ariel finds it easy to ignore everything around her in order to lose herself in a
Ans. B
novel. She is also quite suggestible, and her aunt reports that Ariel was abused by
App her parents in her first three years of life before being placed in a foster home.
p. 263-4
Which disorder is Ariel MOST likely to develop?
E
a. dissociative amnesia
b. dissociative identity disorder
c. somatization disorder
d. schizophrenia
8.64
Ans. B
Fac
p. 265
E
According to Frank Putnam and colleagues, what is the primary causal factor in
dissociative identity disorder?
a. high hypnotizability
b. severe childhood trauma
c. a personality marked by fantasy proneness and absorption
d. multiple identities role enactment
191
8.65
Ans. C
Con
p. 266-8
M
In your report evaluating the dissociation-trauma model of dissociative identity
disorder, you could cite each of the following problems EXCEPT
a. It is possible to implant false memories of abuse during therapy, particularly
with persons who score high on measures of hypnotizability.
b. Many individuals who have experienced childhood abuse do not develop this
disorder.
c. Childhood abuse occurs with less frequency than has previously been believed.
d. Documentation of childhood abuse is usually obtained through the adults'
retrospective and potentially inaccurate recall.
8.66
Ans. D
Fac
p. 267
M
According to Elizabeth Loftus, which of the following persons is able to
accurately discern a client's real memory from one that is a product of
imagination or suggestion?
a. a clinical therapist
b. a client her- or himself
c. either a or b
d. neither a nor b
8.67
Ans. A
App
p. 268
M
According to Dr. Loftus' discussion of Hyman's work in the area of memory
implantation, which of the following persons would be most susceptible to this
phenomenon?
a. Marion, who scores high on the Dissociative Experiences Scale
b. Carolyn, who scores low on a measure of hypnotizability
c. Isadora, who scores low on a measure of absorption
d. Terri, who has a history of severe, long-term sexual abuse as a child
8.68
Ans. B
App
p. 268
E
Cassie is an adult female with a diagnosis of dissociative identity disorder. Based
on recent MRI studies, you might predict that her
might be smaller
than that of most adults.
a. hypothalamus
b. hippocampus
c. cerebellum
d. frontal lobes
After several months of therapy for major depression, Mildred confides to her
therapist that she was repeatedly abused as a child and that her previous therapist
suspected a dissociative disorder. If her current therapist takes Spanos' approach
to understanding dissociative identity disorder, what will Mildred's therapist MOST
likely conclude?
a. Hypnosis-based assessment should be conducted soon in order to evaluate the
possibility of that disorder.
b. Because the depressive symptoms can increase the likelihood that Mildred will
be susceptible to memory implantation, assessment for the dissociative
disorder should be postponed until those symptoms are resolved.
c. It is entirely possible that Mildred was abused, but the presence of a
dissociative disorder is in essence an acceptable way to express her deep
frustrations, sense of failure, and distress.
d. Mildred was probably not abused as a child but may enact multiple identities
as a conscious means of manipulating others and gaining their attention and
concern.
8.69
Ans. C
App
p. 268
M
*
192
8.70
Ans. A
Con
p. 269
M
Which statement below is TRUE in regard to dissociative identity disorder?
a. The long-term prognosis for the disorder is not favorable, with clients
experiencing chronic impairments.
b. Ross' four-phase treatment approach is the one most commonly endorsed by
clinicians.
c. Cognitive-behavioral techniques are consistently more effective as a treatment
than are techniques that focus on the confrontation of past traumas through
hypnosis.
d. New drug treatments for dissociative identity disorder look promising.
8.71
Ans. B
App
p. 269
M
Dr. Hooper is helping her dissociative client recognize and cope with the
childhood traumas in her life. They are also developing more effective coping
strategies that do not rely on dissociative processes. What phase of Ross'
treatment are they in?
a. initial
b. second
c. third
d. final
8.72
Ans. C
App
p. 269
M
*
Erika is working through the grief caused by the severe abuse she suffered at the
hands of her parents. As she does so, her therapist is helping her build an
integrated personality that subsumes the former alters Erika has exhibited during
treatment. In which phase of Ross' structured therapy are they working?
a. initial
b. second
c. third
d. final
8.73
Ans. D
Con
p. 269-70
E
Which of the following therapeutic techniques does not belong with the other
three?
a. education about dissociation and trauma
b. identity fusion
c. hypnosis
d. cognitive-behavioral
8.74
Ans. D
App
p. 270
M
Dr. Peabody is treating a patient with dissociative identity disorder. When a
personality other than the patient's primary personality appears, Dr. Peabody
ignores him or her. What type of treatment is Dr. Peabody implementing?
a. cognitive-behavioral
b. interpersonal psychotherapy
c. personality fusion
d. behavioral
8.75
Ans. A
Fac
p. 270
E
Which of the following disorders is LEAST likely to remit spontaneously?
a. dissociative identity disorder
b. depersonalization
c. dissociative amnesia
d. dissociative fugue
193
8.76
Ans. B
App
p. 270
M
Which of the following persons is LEAST likely to be treated for their
dissociative disorder, being treated instead for commonly occurring comorbid
conditions?
a. Benito, with dissociative fugue
b. Assaf, with depersonalization disorder
c. Kimberly, with dissociative identity disorder
d. Anita, with hypochondriasis disorder
8.77
Ans. C
Con
p. 265-71
M
Which of the following persons is MOST likely to encourage educational
interventions for therapists as an approach to preventing dissociative identity
disorder?
a. Putnam
b. Ross
c. Ofshe
d. none of the above
8.78
Ans. D
Fac
p. 271
E
Which of the following is NOT one of the risk factors associated with abusive
parenting behaviors?
a. unrealistic expectations for children's behaviors and abilities
b. aggressive means of conflict resolution
c. disagreement between parents regarding childrearing and discipline styles
d. substantially below average intelligence in one or both parents
8.79
Ans. B
App
p. 271
M
*
A family has been referred by the court system to participate in Denicola and
Sandler's 12-session program. Which of the following outcomes is LEAST
likely?
a. The parents will substantially reduce their aversive behaviors and maintain
these gains for several months.
b. The parents will develop a larger social support network, including better
access to child care.
c. The parents will reduce their own stress and frustration levels through the use
of relaxation techniques.
d. The parents will increase the frequency of positive/approving interactions and
maintain these gains for several months.
8.80
Ans. D
Fac
p. 271
E
What factor is cited as the primary contributor to child abuse?
a. poor parenting
b. insufficient community resource support
c. temperamentally difficult and disabled children
d. both a and b
8.81
Ans. A
App
p. 271
E
Moira's therapist believes that Moira has an "iatrogenic" disorder. Which of the
following is MOST likely to fall in that category?
a. dissociative identity disorder
b. dissociative amnesia
c. hypochondriasis
d. somatoform pain disorder
194
8.82
Ans. A
App
p. 273
M
8.83
Ans. D
App
p. 273
E
Ruth experiences chronic cramping in her abdomen area. Physicians have
determined it is not related to her menstrual cycle and can find no other physical
cause for the cramping. Unknown to them, Ruth was sexually molested as a child,
What does your text call the process that appears to account for her symptoms?
a. somatization
b. projection
c. dissociation
d. denial
If Leif has a somatoform disorder, his symptoms are an expression of
a. disguised emotional conflict.
b. physical complaints that are not due to a medical illness,
c. dissociated memories of trauma.
d. either a or b
8.84
Ans. C
Con
p. 262,73
M
Which of the following psychological states is nearly always considered a
pathological condition?
a. somatization
b. derealization
c. dissociation
d. all of the above
8.85
Ans. B
App
p. 273
M
Corey is purposely exaggerating the frequency and intensity of his headaches,
muscle tension, and gastrointestinal distress for the purpose of getting attention from
his friends and family. What diagnostic label is MOST appropriate?
a. somatization disorder
b. factitious disorder
c. hypochondriasis
d. dissimulation disorder
8.86
Ans. C
Fac
p. 273
E
Somatoform disorders are often difficult to diagnose correctly for each of the
following reasons EXCEPT
a. Persons with these disorders experience real pain and discomfort, sometimes
stemming from an exaggeration of a past physical problem.
b. Medical illnesses are more acceptable, socially, than are mental illnesses,
leading to a reluctance to consider psychological factors.
c. In the past, clinicians have believed these disorders to be extremely rare and
have tended to underdiagnose them.
d. Physicians want to mle out all possible, if also unlikely, organic causes of such
symptoms, leading to extensive and time-consuming medical testing.
8.87
Ans. A
App
p. 274
E
Mariah has a somatoform disorder. Compared to the cost of treating the typical
medical patient, her treatment will cost about times as much.
a. 9
b. 7
c. 5
d. 3
195
8.88
Ans. D
App
p. 274
C
*
Dr. Feelgood is a general practice physician in a large health maintenance
organization. For the high-utilization patients he sees most frequently, what
undiagnosed condition(s) should he suspect?
a. a dissociative disorder
b. a somatoform disorder
c. a mood disorder
d. either b or c
8.89
Ans. B
Fac
p. 274
M
While psychiatric disorders are common in medical patients, one estimate
suggests that, patients with undiagnosed somatoform disorders may use
cents of every dollar spent for health care in the U.S.
a. 6
b. 10
c. 17
d. 21
8.90
Ans. A
App
p. 274
M
*
Reynelda has a history of multiple, chronic physical complaints that began when
she was 18. She has consulted dozens of physicians, none of whom have been
able to account for her pain and discomfort. In the past, her disorder would have
been labeled
a. Briquet's syndrome.
b. differentiated somatoform disorder.
c. factitious disorder.
d. hysteria.
8.91
Ans. C
App
p. 274
E
If Dr. Boddy's client is believed to have a somatization disorder, Dr. Boddy must
be able to confirm that his client's pattern of chronic physical complaints began
before the client
a. underwent multiple medical tests.
b. became unable to fulfill important social, occupational or other roles.
c. was 30 years old.
d. was 18 years old.
8.92
Ans. D
Fac
p. 274
M
According to the DSM-IV diagnosis for what was formerly called Briquet's
syndrome, which of the following criteria MUST be met?
a. a history of pain in at least four body areas
b. two gastrointestinal symptoms (other than pain)
c. one symptom suggesting a neurological condition (other than pain)
d. all of the above
8.93
Ans. A
App
p. 275
M
Lucinda has a mental disorder that has lasted ten months and is marked by six
specific complaints of pain and bodily dysfunction that are not caused by an
actual medical condition. What diagnosis is MOST likely?
a. undifferentiated somatoform disorder
b. hypochondriasis
c. body dysmorphic disorder
d. somatization disorder
196
8.94
Ans. B
App
p. 275
M
*
Which of the following persons is LEAST likely to be diagnosed with a
somatoform disorder?
a. Aristotle, a Greek male
b. Bryan, a U.S. male
c. Miguel, a Latin American male
d. Wanda, a U.S. female
8.95
Ans. C
Con
p. 275,9
M
What do "worms in the head" and dhat reveal about somatoform disorders?
a. Somatoform disorders are more commonly diagnosed in developing nations.
b. Conversion disorder tends to be associated with severe interpersonal stressors,
c. Symptoms of somatization are influenced by cultural norms.
d. Somatoform disorders have existed throughout history.
8.96
Spanos has suggested that the dissociative identity disorder is a socially acceptable
Ans. A means of expressing distress and frustrations. A similar explanation has been put
Con
forth by Samuels (1995) to understand
p. 275
a. somatization disorder.
M
b. dissociative amnesia.
c. body dysmorphic disorder.
d. derealization disorder.
8.97
Ans. B
App
p. 275
M
*
Theodore is attempting to understand the factors that might be causing his client's
somatization disorder. Which of the following is probably LEAST important in
this regard?
a. expression of social disenfranchisement and frustration
b. a history of primary gain for the expression of symptoms of illness
c. the utilization of medical personnel as a surrogate social support network
d. a lack of an adequate vocabulary with which to express emotional distress
8.98
You are a licensed clinical social worker employed by a health maintenance
Ans. C
organization. Several physicians have approached you to discuss their growing
App awareness of somatization in their patients. If they ask you to provide group
p. 275
therapy to patients, you should address not only the somatoform disorder but also
M
a. agoraphobia.
b. substance abuse problems.
c. depression.
d. underlying personality disorders.
8.99
Ans. D
App
p. 275-6
M
Kendall is convinced he is HIV positive, even though several doctors assure him
that his blood tests are negative for the vims. Kendall is very resentful that they
won't confirm the seriousness of his developing illness. What disorder is MOST
likely?
a. somatization disorder
b. Briquet's syndrome
c. somatoform disorder, with delusions
d. hypochondriasis
197
8.100
Ans. A
Con
p. 275
M
*
Assuming each of the following persons is preoccupied with having a dreaded
disease for which there is no medical basis, which of them could be diagnosed
with a type of somatoform disorder?
a. Opal, who realizes her fears are exaggerated but cannot control them despite
frequent medical reassurance
b. Bemie, who has had such symptoms for about 3 months and is missing work
frequently for medical appointments
c. Carla, who believes that the disease is caused by radiation emanating from
stoplights and streetlights in her neighborhood
d. all of the above
8.101
Ans. B
App
p. 276
C
A large medical facility wants to reduce health care costs by establishing
supportive group therapy for clients believed to have hypochondriasis. Based on
data from Barsky et al. (1990), you would expect that a group of about
clients would be formed if the facility serves an average of 200 patients.
a. 6
b. 11
c. 16
d. 20
8.102
Ans. C
App
p. 276
M
Wan has a disorder in which he is certain he has some sort of grave lung disease,
but extensive medical tests rule out any organic cause. Given the substantial
overlap between his symptoms and those of other DSM disorders, it has been
debated whether his disorder should be moved to the
disorders.
a. mood
b. dissociative
c. anxiety
d. delusional
8.103
Ans. D
App
p. 276
C
Dr. Wutz is treating a hypochondriasis client, Sue, who also has frequent panic
symptoms. It is likely that Sue will differ from persons with actual panic
disorder in each of the following ways EXCEPT
a. Sue's somatic complaints will be more extensive and severe.
b. Sue is less likely to exhibit comorbid depression or obsessive-compulsive
disorder.
c. Sue is more likely to visit several physicians in order to confirm her illness.
d. Sue is likely to exhibit more positive social and occupational functioning.
8.104
Ans. A
Fac
p. 277
E
Which of the following types of symptoms is LEAST common in conversion
disorder?
a. cognitive deficits
b. sensory deficits
c. motor deficits
d. seizurelike
8.105
Ans. D
App
p. 277
E
*
If Ned has a tme neurological disorder causing paralysis in his legs, he will
probably exhibit
a. la belle indifference.
b. a waxing and waning of symptoms depending on his activities.
c. an anatomically unusual pattern of physical impairment.
d. none of the above
198
8.106
Ans. C
App
p. 277
M
Tara has complained for several days that she has no feeling in her arm between
her elbow and her wrist. What condition should you suspect?
a. carpal tunnel syndrome
b. hysteria
c. conversion disorder
d. Without additional medical assessment, no conclusion is possible.
8.107
Ans. D
App
p. 277
M
A clinician suspects that her client with pseudoneurological symptoms may be
feigning her symptoms in order to avoid going to work. Which characteristic of
the possible somatoform disorder would MOST likely be absent in this case?
a. seizurelike symptoms
b. an anatomically unusual pattern of physical impairment
c. a lack of sophisticated medical knowledge
d. an indifferent, nonchalant attitude
8.108
Ans. C
Con
p. 277
E
Which of the following disorders is LEAST likely to exhibit a chronic course?
a. somatization disorder
b. hypochondriasis
c. conversion disorder
d. dissociative identity disorder
8.109
Ans. C
Con
p. 277
M
How would Anna O.'s disorder be classified in the DSM-IV?
a. neurosis
b. somatization disorder
c. conversion disorder
d. dissociative identity disorder
8.110
Ans. A
App
p. 278
E
Zahur has a type of disorder that has declined in prevalence over the past 100
years. Which disorder would this be?
a. conversion
b. dissociative identity
c. somatization
d. dissociative amnesia
8.111
Ans. B
App
p. 278
E
Amee is a graduate student who intends to specialize in the treatment of children.
Her graduate training should include particular attention to which of the following
disorders?
a. hypochondriasis
b. conversion
c. body dysmorphic
d. somatization
8.112
Ans. C
Con
p. 274,9
M
For which of the following somatoform disorders might a related medical
condition actually be contributing to a client's distress?
a. somatization
b. pain disorder
c. both a and b
d. neither a nor b
199
8.113
Ans. A
Con
p. 279
M
Which of the following disorders occurs MOST frequently?
a. pain disorder
b. hypochondriasis
c. body dysmorphic disorder
d. somatization disorder
8.114
Ans. A
Fac
p. 278-9
M
*
The perception of pain appears to be related to each of the following
characteristics EXCEPT
a. ethnicity.
b. perceived control over pain producing stimuli.
c. feelings of depression and anxiety.
d. whether or not the sufferer is pursuing an injury-related lawsuit.
8.115
Ans. B
App
p. 279
E
Which of the following persons is MOST likely to engage in alcohol and narcotic
abuse in relation to her/his somatoform disorder?
a. Art, diagnosed with hypochondriasis
b. Marsha, diagnosed with pain disorder
c. Theo, diagnosed with somatization disorder
d. Vera, diagnosed with body dysmorphic disorder
8.116
Ans. C
App
p. 279
E
Henri spends a great deal of time scrutinizing his appearance in a mirror,
wondering what he can do to get rid of the huge mole on the side of his neck. He
is certain his coworkers joke about his defect and wonders if his potential to be
promoted has been destroyed by this glaring imperfection. What disorder does
Henri appear to have?
a.
b.
c.
d.
8.117
Ans. D
App
p. 279
E
8.118
Ans. A
App
p. 279
C
,
obsessive somatoform disorder
somatization disorder
body dysmorphic disorder
somatophobic disorder
Dr. Priti is a plastic surgeon. She is MOST likely to encounter a patient with
which of the following disorders?
a. hypochondriasis
b. conversion
c. somatization
d. body dysmorphic
Gustav is hypersensitive to changes in his body's functioning, is high in private
self-consciousness and negative affectivity, and has been under chronic stress due
to estrangement from his wife for two years. What appears to be MOST
important in determining whether Gustav interprets his subsequent symptoms as
a sign of illness versus a mental disorder?
a. sociocultural conditions
b. the history of somatoform disorders in his family
c. the level of physiological arousal caused by his experiences
d. the severity of trauma in his earlier life
200
Based on available data, which of the following persons is MOST likely to
develop a somatoform disorder?
a. Okunu, whose biological mother has a somatization disorder
b. Myron, whose adoptive mother has a somatization disorder
c. Shirley, whose biological father has a pain disorder
d. none of the above
Which somatoform disorder may share a biological vulnerability similar to that
seen in persons with right hemisphere abnormalities?
a. hypochondriasis
b. conversion
c. pain
d. somatomorphic
Chronic self-absorption is to low threshold for physical discomfort as
is to
.
a. body dysmorphic disorder; pain disorder
b. hypochondriasis; somatization
c. private self-consciousness; somatosensory amplifiers
d. negative affectivity; sensory self-consciousness
What learning theory best accounts for the early family influence on persons who
later develop somatoform disorders?
a. modeling
b. operant conditioning
c. classical conditioning
d. both a and b
Glenda is 8 years old and has recurrent abdominal pain. Which factor most
clearly distinguishes her from children without this disorder?
a. negative affectivity
b. a family marked by multiple illnesses
c. somatosensory amplifiers
d. high absorption
Empirical research indicates that
could account for the connection
between early childhood trauma and later somatoform disorders.
a. the conversion of emotional trauma into physical symptoms
b. increased physiological reactivity
c. somatic dissociation
d. either a or b
Which of the following therapists is MOST likely to emphasize the role of
secondary gain in understanding and treating somatoform disorders?
a. Bemice, a psychodynamic therapist
b. Raoul, a humanistic therapist
c. Yusef, a behavioral therapist
d. Annette, a cognitive therapist
201
8.126
Ans. A
Con
p. 282
C
Primary gain is to secondary gain as
is to
a. conversion; reinforcement
b. positive reinforcement; negative reinforcement
c. dissociation; somatization
d. diathesis; stressor
8.127
Ans. B
App
p. 282
M
If you wanted to offer the most useful strategy for the treatment of persons with
somatoform disorders, you would
a. provide a combination of systematic desensitization and coping skills training,
b. design a training program for physicians to deal with such patients.
c. concentrate on the reduction of comorbid depression or negative affectivity.
d. any of the above
8.128
Ans. C
App
p. 283
C
For which of your somatoform clients would you MOST likely recommend
medication intervention?
a. Greg, diagnosed with conversion disorder
b. Natasha, diagnosed with somatization disorder
c. Carter, diagnosed with body dysmorphic disorder
d. Ophelia, diagnosed with hypochondriasis
*
.
8.129
Dr. Previn is considered a leading expert in the treatment in obsessive-compulsive
Ans. D
disorder. Which of the following clients is MOST likely to be referred to him for
App successful treatment of her/his somatoform disorder?
p. 283
a. Vivian, with conversion disorder
M
b. David, with hypochondriasis
c. Keisha, with pain disorder
d. Artie, with body dysmorphic disorder
8.130
Ans. A
Fac
p. 283
M
A multicomponent treatment program including antidepressant medication, biofeedback, and individual and family psychotherapy is MOST likely to be used for
a. pain disorder.
b. somatization disorder.
c. dissociative identity disorder,
d. body dysmorphic disorder.
SHORT ANSWER / ESSAY
8.131
List the types of alters commonly found in persons with dissociative identity
disorder. At the present time, how many are typically associated with the disorder?
An alter of the other gender, a child alter, an alter who acts out impulsive or forbidden
behaviors (e.g., promiscuity or substance abuse), a suicidal or self-injurious alter, and a powerful
and dominant alter protective of the host personality. 15 alters are commonly reported.
202
8.132
Describe how a person might develop dissociative identity disorder based on the
dissociation-trauma model.
The disorder almost always begins, according to Putnam and colleagues, with exposure to
severe childhood trauma, particularly in early to middle childhood. This trauma is most commonly
sexual abuse and may also be a combination of sexual and physical abuse. When a child
experiences such unrelenting trauma from which there is no physical escape, she/he must rely on
extreme psychological coping mechanisms, one of which may be imagining themselves as another
person—someone stronger or smarter. Children who possess high hypnotizability would be
particularly likely to engage in such a process. This spontaneous dissociation, repeatedly utilized,
becomes associated with the child's developing personality: during the dissociative states in
childhood, memories, feelings, and behaviors characteristic of that state form the basis for the later
identities in adulthood that are kept out of normal consciousness.
8.133
For what reasons are many clinicians skeptical of the validity and/or prevalence of
the dissociative identity disorder diagnosis?
It does not occur with similar prevalence across cultures, although childhood abuse is found
in virtually all cultures. There is a great deal of symptom overlap with other disorders, obscuring
the boundaries of this proposed syndrome. Symptoms may be the result of the therapeutic practices
of clinicians who misinterpret client reports and behaviors and/or subtly coach clients to assume
multiple roles; moreover, few clients begin therapy with this complaint, and some therapists see
such cases much more frequently than do other therapists. The apparent increased prevalence of
the disorder may also be due to a kind of hysteria created by mass media coverage in the past
several years, including sensationalized cases. Spanos, moreover, suggests that the disorder is in
essence a socially acceptable means of expressing distress, frustration, and disagreement but does
not actually involve mental dissociation.
Data pertaining to physiological differences across alters are not always replicated.
Persons asked to role-play alters are able to convincingly do so. For example, Bianchi's celebrated
case was eventually found to be fraudulent. Also, the work of Loftus, Hyman, and others indicates
that memories can be implanted and that such memories are not easily distinguished from memories
of actual events. Ofshe's involvement in Paul Ingram's case is a compelling example of this
phenomenon.
8.134
List five of the characteristics of parents who are abusive toward their children.
They possess little knowledge about normal child development, including unrealistic
expectations for children's behaviors and skills; become easily annoyed when stressed; choose
aggressive means of conflict resolution; have limited access to social support and child care;
disagree with each other about appropriate childrearing and discipline strategies; are poor; have a
history of abuse themselves; gave birth to children with congenital defects; are young (teenagers)
when they have children; are embroiled in marital conflict.
203
8.135
What distinguishes hypochondriasis from somatization disorder?
Hypochondriasis is marked by a focus on a few, select symptoms that may reflect any sort
of physical dysfunction, in contrast to the multiple complaints of somatization disorder that must
occur within 4 specific categories. Hypochondriasis, further, includes an explicit fear of having a
serious medical illness (or illnesses), whereas somatization disorder may be marked by more vague
complaints.
8.136
Maurice is high in private self-consciousness, negative affectivity, and impulsivity.
How might these factors combine to foster a somatoform disorder?
Private self-consciousness is the tendency to concentrate on internal sensations and private
thoughts. If Maurice chronically engages in this, he may become more acutely aware of his bodily
changes and minor discomforts. Because he is also likely to feel worried and pessimistic (and
possibly also guilty, tired, shy, and/or depressed), he may begin to attach feelings of concern about
those physical sensations, attaching more negative interpretations than are warranted. His tendency
to be impulsive may contribute to an urge to seek out repeated medical assessment and treatment
for his symptoms.
204
Chapter 9 MOOD DISORDERS AND SUICIDE
9.1
Ans. C
App
p. 288
E
The chapter's opening case study described Margaret's experiences of unipolar
depression. Individuals with this disorder could experience each of the
following symptoms EXCEPT
a. physical symptoms such as headaches and stomach aches.
b. feelings of hopelessness and guilt.
c. expansive euphoria.
d. difficulties concentrating.
9.2
Ans. D
App
p. 288
M
Juanita has an affective disorder. This means she has significant difficulty
a. sustaining an optimistic or positive outlook on life.
b. expressing her emotions effectively to other people.
c. understanding other persons' feelings and behaviors in important relationships.
d. maintaining balanced, productive emotional functioning.
9.3
Ans. C
Fac
p. 288
E
The most common mood disorder in Western cultures is
a. bipolar disorder.
b. dysthymia.
c. major depression.
d. anhedonic depression.
9.4
Ans. C
App
p. 288
M
Tito has episodes of both depression and mania that occur over time. This is
termed
a. double affective disorder,
b. hypomanic disorder.
c. bipolar disorder.
d. cyclothymic disorder.
9.5
Ans. B
Fac
p. 288
E
Another term for major depression is
a. double depression.
b. unipolar depression,
c. dysthymic disorder.
d. anhedonia.
9.6
Ans. B
Con
p. 288
C
What conclusion regarding mood disorders and creativity is most appropriate?
a. Prolonged creative efforts intensify artists' moods, often leading to a
depressive breakdown, as in the case of van Gogh or Ernest Hemingway,
b. Mood disorders and creativity are related, as found in Andreasen's study of
creative writers, but the causal direction is unclear.
c. The intensity and depth of emotional experience in mood disorders fuels the
artist's imagination, leading to innovative insights.
d. Studies of creative writers and other artists have helped document the role of
genetics in mood disorders.
*
205
9.7
Ans. D
Fac
p. 289
M
To differentiate them from common sad moods, depressive disorders
a. must last for at least 2 months and be associated with somatic, perceptual, and
memory impairments.
b. are typically caused by genetic or biological factors and should be treated with
medication.
c. require longterm psychotherapy in order to reduce emotional disturbance that,
if untreated, will lead to suicide.
d. include persistent physical and behavioral disturbances that significantly impair
relationship and work abilities.
9.8
Ans. C
Fac
p. 289
E
Approximately how many adults in the U.S. will experience at least one
significant episode of depression sometime in their lives?
a. 1 in 18
b. 1 in 10
c. 1 in 5
d. 1 in 3
9.9
Ans. C
App
p. 289
E
A person's likelihood of experiencing a depressive disorder is related to what
characteristic?
a. race and ethnicity
b. socioeconomic class
c. gender
d. culture
9.10
Ans. C
App
p. 289
M
Of the following, who is MOST likely to experience depression?
a. Stan, a 30-year-old successful bank president
b. James, a 17-year-old high school drop-out
c. Sarah, a 28-year-old geography graduate student
d. Raymond, a 50-year-old auto worker
9.11
Ans. A
Fac
p. 289-90
E
Cerise has been diagnosed with depression. Which of the following is least likely
to be a comorbid diagnosis for Cerise?
a. dissociative disorder
b. anxiety disorder
c. substance abuse
d. suicide
9.12
Ans. D
Con
p. 289-90
C
In regard to the comorbidity between substance abuse and depression, which
statement is accurate?
a. Most individuals who abuse alcohol or other drugs do so to relieve the
underlying distress of a mood disorder.
b. Studies of brain functioning reveal that the central neurotransmitters affected
by alcohol and other drugs are also the neurotransmitters that control mood
functioning.
c. Substance abuse and depression are two distinct categories of disorders that
overlap only when an individual uses drugs with depressant CNS effects, like
alcohol.
d. Long-term substance abuse can lead to legal and financial difficulties that
cause depression, while some people use drags to relieve depressive symptoms.
206
9.13
Ans. B
Fac
p. 290
M
The concept of"
" has been advanced to help explain the
substantial overlap between symptoms of depression and anxiety.
a. mixed mood disorder
b. negative affect
c. anxious depression
d. double depression disorder
9.14
Ans. A
Fac
p. 290
E
The two major categories of depressive disorders are
a. major depression and dysthymia.
b. unipolar depression and bipolar depression.
c. dysthymia and double depression.
d. endogenous depression and major depression.
9.15
Ans. A
App
p. 290
E
Chandra has been told by her therapist that she suffers from dysthymia. In
contrast to major depression, Chandra's dysthymia is
severe and
in its course.
a. less; chronic
b. more; chronic
c. less; episodic
d. more; episodic
Kathy has had a chronic and mild form of depression for several years and is
currently experiencing more severe symptoms of depressed mood, anhedonia,
insomnia, daily fatigue, and suicidal ideation. She is probably experiencing
a. major dysthymia.
b. double depression.
c. dysthymia with melancholic features.
d. episodic depression.
*
9.16
Ans. B
App
p. 290
M
9.17
Ans. D
App
p. 290
M
To diagnose an individual with major depression, each of the following criteria
must be met EXCEPT
a. symptoms must have continued for at least two weeks, present nearly every
day.
b. either depressed mood or anhedonia must be present.
c. physical or cognitive symptoms must be present.
d. a negative life event must have preceded the onset of symptoms.
9.18
Ans. B
Con
p. 291
E
Complete this analogy: Somatic symptom is to persistent fatigue as cognitive
symptom is to
a. impaired immune functioning,
b. hopelessness.
c. psychomotor retardation,
d. hypersomnia.
9.19
Ans. C
App
p. 291
C
A severely depressed female believed that she was being encouraged by the spirits
of her dead parents to commit suicide. This would be specified as a
a. mood incongruent psychotic symptom.
b. incongruent delusional symptom.
c. mood congruent psychotic symptom,
d. schizoaffective symptom.
207
9.20
Ans. A
Con
p. 291
M
Which of the following symptoms might be exhibited by a severely depressed
person in contrast to an individual with less severe depression?
a. delusions
b. panic attacks
c. schizophrenia
d. hypomania
9.21
Ans. A
Fac
p. 291
M
Where do many depressed people first mm for help for their distress?
a. primary care physicians
b. mental health counselors
c. psychiatrists
d. mental health telephone hotlines
9.22
Ans. A
App
p. 291
M
If Neila's episode of major depression is similar to the majority of people with this
disorder, her depression will be
and will last about
months.
a. untreated; nine
b. untreated; five
c. treated; five
d. treated; three
9.23
Ans. D
Fac
p. 291
E
In as many as
% of cases of major depression, individuals will experience
recurrent episodes.
a. 25
b. 48
c. 60
d. 75
9.24
Ans. C
App
p. 291-2
C
Which of the following items should be removed from a student's report on the
course and recurrence of major depression?
a. Most episodes subside without treatment, lasting about 8 to 10 months.
b. The first episode usually occurs in the mid-20's, with the average age of onset
decreasing in recent years.
c. Fewer than half of the adults with this disorder will experience a recurrence of
major depression during their lifetime.
d. One-quarter of these individuals also have dysthymic disorder and are much
more likely to relapse in the future.
9.25
Ans. B
Fac
p. 292
E
Which of the following is NOT one of the pattern specifiers for major depression?
a. with atypical features
b. with anxiety features
c. with seasonal pattern
d. chronic
9.26
Ans. A
App
p. 292
M
Dimitri, a 45-year-old male, exhibits symptoms of early morning wakening,
significant motor agitation or slowness, and substantial weight loss. What
specifier most clearly applies?
a. with melancholic features
b. with atypical features
c. with echopraxic features
d. with somatic features
208
.27
Ans. A
Fac
p. 292
M
Echopraxia and echolalia are examples of symptoms related to which specific
depressive features?
a. catatonic
b. endogenous
c. autistic
d. atypical
9.28
Ans. B
Fac
p. 292
E
When a depressed person automatically mimics another person's every movement,
this is called
. Automatic, parrot-like repetition of another's words is
called
.
a. waxy flexibility; echopraxia
b. echopraxia; echolalia
c. catatonia; parataxia
d. echolalia; catatonia
If Cheryl experiences a depressive episode shortly after giving birth, this is called
a. post-birth dysphoria.
b. major depression, postpartum onset.
c. labor-related mood disorder.
d. major depression, not otherwise specified.
9.29
Ans. B
App
p. 292-3
E
9.30
Ans. B
Con
p. 292-3
M
Which diagnostic specifier for major depressive symptoms is least well supported
as a special subdivision according to several research studies?
a. with seasonal pattern
b. with postpartum onset
c. with catatonic features
d. with atypical features
9.31
Ans. D
Fac
p. 293
E
Which of the following criteria applies correctly to dysthymic disorder?
a. Depressed mood in adults must last at least 1 year.
b. The individual's daily functioning is usually severely impaired.
c. Irritable or depressed mood in children must last at least 2 years.
d. Onset is typically slower and duration much longer than major depression.
9.32
Ans. A
Fac
p. 293
E
Hayes' wife died five months ago. The occurrence of depressed symptoms during
these several months is referred to as
a. bereavement.
b. adjustment disorder with depressed mood.
c. pathological grief reaction.
d. major depression, with bereavement symptoms.
9.33
Ans. D
Con
p. 295
E
Research evidence indicates that unipolar and bipolar mood disorders
a. are both strongly linked to genetic factors.
b. affect women and men in approximately equal proportions,
c. have an onset significantly linked to psychosocial stressors.
d. are two relatively distinct disorders.
209
9.34
Ans. A
App
p. 295
E
Teresa has been diagnosed with bipolar disorder. This means that her mood
alternates between
a. mania and depression,
b. anxiety and depression.
c. cyclothymia and dysthymia.
d. hypermania and hypomania.
9.35
Ans. C
Fac
p. 295
E
The lifetime risk of bipolar disorder in the population is
a. too rare to estimate.
b. about .25%.
c. about 1%.
d. about 5%.
9.36
Ans. C
Fac
p. 295
E
Major depression is more common in ;
a. men; more common in women
b. men; equally common between genders
c. women; equally common between genders
d. women; more common in men
9.37
Ans. A
App
p. 295
C
David is exhibiting a very irritable mood, inflated self-esteem, impulsivity, little
need for sleep, and frequent flight of ideas. With no history of major depression,
what is the most appropriate DSM-IV label for David's symptoms?
a. bipolar disorder.
b. cyclothymic disorder.
c. atypical depression with manic features.
d. manic disorder.
9.38
Ans. A
App
p. 295
M
A mental health clinic is preparing a pamphlet for their clients to provide
information about bipolar disorder. Which sentence should be OMITTED?
a. "Manic episodes are often triggered by life stress and will usually not occur
again in the future once the life stress is managed."
b. "It is common for a person in a manic episode to feel on top of the world and
invincible but his or her reasoning and judgment are usually poor."
c. "The depressive symptoms experienced as part of a bipolar disorder are
clinically the same as those of a major depressive disorder."
d. "Women and men are equally at risk for this disorder, and a family history of
the disorder increases this risk."
9.39
Ans. D
Fac
p. 295
E
*
Bipolar disorder has a(n)
onset than does major depression, and bipolar
episodes
are
affected by psychosocial stressors.
a. earlier; more
b. earlier; less
c. later; more
d. later; less
9.40
Ans. B
Fac
p. 295-6
M
Nikolai is experiencing a manic episode. This means he would exhibit one of the
following mood states EXCEPT
a. expansive,
b. impulsive.
c. elevated,
d. irritable.
210
bipolar
.
disorder
is
.
9.41
Ans. A
App
p. 295
M
Kalin, a young, struggling advertising executive, is spending 20 hours a day at
work developing "the $64 million dollar campaign" for a small, local shoe store.
Kalin is certain he will then move to New York and create similar winning ad
campaigns for every small business in the U.S. What manic disturbance does this
belief reflect?
a. grandiosity
b. flight of ideas
c. pressured thinking
d. psychosis
9.42
Ans. B
App
p. 296
M
If Enrique's bipolar disorder is typical, his episodes of mania will last up to
month(s) and occur with a median frequency of
episodes in his lifetime.
a. 1; 6
b. 3; 9
c. 3; 30
d. 5; 15
9.43
Ans. A
Con
p. 296
C
Of the following, which best explains why bipolar disorder may be mistaken for
schizophrenia?
a. Psychotic delusions of grandeur or other delusions can occur in both disorders,
b. Both disorders are marked by episodes of major depression.
c. Functioning can become so impaired as to require psychiatric hospitalization,
d. Such a mistake is unlikely; the two disorders are clearly different and have
virtually no symptom overlap.
9.44
Ans. C
App
p. 295-7
C
A student's report on bipolar disorder could include all of the following pieces of
information EXCEPT
a. more individuals are diagnosed as exhibiting Bipolar I vs. Bipolar II disorder,
b. the majority of bipolar individuals exhibit interepisode recovery.
c. women and men are equally likely to exhibit rapid cycling of episodes,
d. Bipolar II disorder signifies the presence of mild manic episodes that are
unlikely to require hospitalization.
9.45
Ans. B
App
p. 296
M
9.46
Ans. A
Fac
p. 296
M
Tasha was admitted to the hospital after she was arrested for writing thousands of
dollars in bad checks over the past two weeks. A psychological evaluation
requested
by her lawyer revealed clear manic symptoms, with a history of major
depression last year. What diagnostic category would best fit this description?
a. bipolar I
b. bipolar II
c. bipolar I with psychotic features
d. bipolar II with rapid cycling
Bipolar I and II are distinguished on the basis of the
a. duration of manic episodes.
b. presence or absence of psychotic features,
c. duration of interepisode recovery periods.
d. severity of depressive episodes.
211
9.47
Ans. D
Fac
p. 296-7
E
Which of the following accurately describes hypomania?
a. a form of mania that alternates rapidly with depression
b. a more severe form of mania
c. a type of mania occurring only in cyclothymia
d. a less severe form of mania
9.48
Ans. C
App
p. 297
E
Over the past few years, Katarina's moods have fluctuated between elevated and
depressed, but she has maintained adequate functioning on a day-to-day basis.
Like the other 3 to 4% of young adults like her, she is probably exhibiting
a. bipolar II disorder with full interepisode recovery.
b. atypical depression with manic features.
c. cyclothymic disorder.
d. hypomanic-depressive disorder.
9.49
Ans. D
App
p. 298
E
Benjamin is exhibiting a depressive disorder that is caused by severe dysfunction
of his thyroid gland. The best diagnosis for this depression would be
a. depression not otherwise specified.
b. atypical mood disorder with somatic features.
c. medically-induced mood disorder.
d. mood disorder due to a general medical condition.
9.50
Ans. B
Fac
p. 298
M
For what purpose do mood disorder researchers conduct a linkage analysis?
a. to evaluate the proportion of genetic influence by comparing MZ vs DZ twins.
b. to identify and trace a genetic marker for a disorder across generations.
c. to identify genetic overlap between unipolar and bipolar mood disorders
through family studies.
d. to determine the effectiveness of drug treatments for disorders linked to
biological causes.
9.51
Ans. A
Fac
p. 298
E
The mid 1980's studies of an Amish community in Pennsylvania claimed that
a. bipolar disorder was linked to genetic markers on the 11th chromosome.
b. unipolar disorder was linked to genetic markers on the X chromosome.
c. no consistent evidence could be found for genetic influences for mood
disorders.
d. bipolar disorders I and II were found substantially more frequently in MZ
twins than in DZ twins.
9.52
Ans. B
App
p. 298
E
Tim & Tom, monozygotic twins, are times more likely to both have major
depressive disorder than are Sue & Sam, dizygotic twins.
a. 2
b. 4
c. 7
d. 10
9.53
Ans. D
App
p. 298
M
Rick has been diagnosed with bipolar disorder. The most accurate prediction
regarding his identical twin, Martin, is that Martin will probably
a. also develop bipolar disorder.
b. develop a form of unipolar depression.
c. develop cyclothymia.
d. develop some kind of mood disorder.
*
212
9.54
Ans. B
Fac
p. 298
M
First-degree relatives of individuals diagnosed with bipolar disorder tend to show
high rates of
a. bipolar I disorder,
b. bipolar and unipolar mood disorders.
c. bipolar disorders with psychotic features,
d. major depression with rapid cycling.
9.55
Ans. A
Con
p. 299
C
Because MZ twins have both genetics and environment in common,
a. adoption studies are conducted to compare the frequency of disorders in
biological vs adoptive relatives.
b. it has been concluded that both factors contribute equally to the high
prevalence of mood disorders in these twins.
c. studies of families with common psycho-social characteristics are required in
order to hold this factor constant to measure genetic influences.
d. it is not scientifically possible, with current technologies, to estimate the
separate contribution of those factors in mood disorders.
9.56
Ans. C
Con
p. 298-9
C
If you hypothesized that genetic influences are important in mood disorders,
which of the following studies would best support your idea?
a. comparison of biological vs. adoptive relatives of individuals with major
depression
b. a linkage analysis of dysthymia in a close-knit population
c. a twin study of bipolar disorder
d. a family study of cyclothymic disorder
9.57
Ans. A
Con
p. 297-9
M
Which of the following summary statements is best supported by current
research?
a. Genetic factors are more influential in bipolar disorder than in unipolar
disorder.
b. Genetic factors are more influential in unipolar disorder than in bipolar
disorder.
c. Genetic factors appears to be equally influential in the development of both
unipolar and bipolar mood disorders.
d. While genetic factors may be influential in mood disorders, the failure to
replicate the findings of the Amish study cast doubt on the validity of such
research topics.
9.58
Ans. B
Con
p. 298-9
C
In regard to genetic influences on mood disorders, which of the following
statements is BEST supported by research?
a. Linkage analysis has demonstrated that bipolar disorder is most likely caused
by a defect on the 11th chromosome.
b. The genetic vulnerability to mood disorders could involve faulty
neurotransmitter functioning or endocrine system dysfunction.
c. Twin, adoption, and family studies suggest that genetic influences are equally
important in both unipolar and dysthymic depression.
d. While genetics are influential for some disordered individuals, environmental
factors explain the causes of most mood disorders.
*
213
9.59
Ans. A
Fac
p. 299
E
Which neurotransmitter has NOT yet been implicated in mood disorders?
a. acetylcholine
b. the catecholamines
c. dopamine
d. serotonin
9.60
Ans. D
Fac
p. 299
M
What occurred during the 1950s that led to the development of theories about
biological processes in depression?
a. The effectiveness of shock therapy for severe depression was discovered,
b. Twin studies documented the presence of depleted catecholamine levels in the
brains of depressed MZ twins.
c. Drag treatments for schizophrenia were found to also affect major depressive
disorder.
d. Patients given reserpine for high blood pressure developed symptoms of
depression.
9.61
Ans. C
App
p. 299
M
If the original catecholamine theory explains Rhonda's mood disorder, Rhonda's
depressed symptoms are the result of
levels of
.
a. high; norepinephrine
b. high; serotonin
c. low; norepinephrine
d. low; serotonin
9.62
Ans. B
Fac
p. 299-301 b.
C
Each of the following findings contributed to the original catecholamine theory
EXCEPT
a. Drugs that lower catecholamine levels increase symptoms of depression,
Low levels of the 5-F£LAA metabolite have been found in many depressed
individuals.
c. Medications for depression that increase catecholamine levels trigger mania in
some individuals.
d. Drag treatment for bipolar disorder lowers norepinephrine activity.
9.63
Ans. B
App
p. 300
C
Carlito has been exhibiting inattentiveness and poor concentration, decreased anxiety
and little inhibition of his actions. It is possible that the neurotransmitter
is
than usual.
a. serotonin; lower
b. norepinephrine; lower
c. serotonin; higher
d. norepinephrine; higher
According to the hypothesized influence of transmitters, what behaviors would
you expect if a person's dopamine level was abnormally high?
a. low aggression and good impulse control
b. aggressiveness and extroversion
c. poor impulse control and under-inhibited actions
d. good concentration and introverted
9.64
Ans. B
App
p. 300
C
214
9.65
Ans. D
Con
p. 300
M
MHPG is a metabolite of norepinephrine. You would expect MHPG levels to be
a. similar to levels of 5-HIAA in both unipolar and bipolar disordered
individuals,
b. elevated in depressed individuals.
c. higher in most mood disordered individuals than in non-disordered individuals,
d. low in depressed individuals and elevated in manic individuals.
9.66
Ans. D
Con
p. 300
M
Neural activity in mood disorders could be affected by each of the following
EXCEPT
a. interactive effects between 2 or more transmitters,
b. faulty reuptake or degradation of transmitters.
c. the number or receptivity of receptors.
d. D proteins' formation of first messenger chemicals.
9.67
Ans. C
Fac
p. 300
M
*
If serotonin "gives [biological] permission" for a mood disorder, the specific
disorder would be shaped primarily by
.
a. dopamine
b. whether serotonin is abnormally high or low
c. norepinephrine
d. Cortisol
9.68
Ans. B
App
p. 300
E
Dr. Wiatt ordered a brain scan that will measure his patient's level of glucose
metabolism in his auditory cortex. What imaging technique will be employed?
a. computerized axial tomography
b. positron emission tomography
c. functional x-ray topography
d. magnetic resonance imagery
9.69
Ans. B
Con
p. 299-301
C
Each of the following findings suggests that the neurotransmitter serotonin is a
factor in mood disorders EXCEPT
a. It is typically high when norepinephrine is low, contributing to bipolar mood
swings.
b. Indirect measures of serotonin indicate that it is sometimes relatively low in
bipolar patients.
c. Indirect measures of serotonin indicate that it is often relatively low in
depressed patients.
d. Prozac (fluoxetine) inhibits re-uptake of serotonin, contributing to a decrease
in depressive symptoms.
9.70
Ans. C
Fac
p. 301
M
In addition to specific neurotransmitter abnormalities, what other biological
disruption has been implicated by the chemical action of lithium?
a. lowered receptor sensitivity
b. "leaky" synaptic vesicles
c. disruptions in sodium ions
d. enlarged synaptic clefts
215
9.71
Ans. A
App
p. 301
E
Which portion of Anna's brain is primarily responsible for regulating her endocrine
system?
a. hypothalamus
b. medulla
c. cingulate gyms
d. thalamus
9.72
Ans. C
App
p. 301
E
*
Kevin is experiencing severe stress today, rushing to meet deadlines and managing
crises with supervisees. Which primary hormone is being produced in his situation?
a. adrenaline
b. CRH
c. Cortisol
d. ACTH
9.73
Ans. D
Con
p. 301
M
An argument for the role of the HPA axis in mood disorders should include all of
the following data EXCEPT
a. the importance of catecholamines as transmitters affecting the hypothalamus,
b. elevated levels of Cortisol and its metabolites in depressed patients.
c. depressed patients' "failure" on biological challenge tests,
d. evidence of growth suppression in depressed patients.
9.74
Ans. B
Con
p. 302
M
Each of the following is a correct depiction of psychological theories of mood
disorders EXCEPT
a. Such theories tend to focus on unipolar vs. bipolar disorders.
b. These theories compete with biological explanations and thus are essentially
incompatible with biological approaches.
c. Most of these theories address individuals' reactions to loss of control and
power.
d. These theories address several different domains, including interpersonal,
cognitive, and behavioral explanations.
9.75
Ans. D
App
p. 302
M
As a psychoanalyst, which psychosexual development stage is most important in
your explanation of depression?
a. genital
b. phallic
c. anal
d. oral
9.76
Ans. D
App
p. 302
C
Tanya's mother was extremely permissive and doting throughout Tanya's
childhood. Later, when close friends fail to meet Tanya's high expectations for
attention and approval, Tanya would react in what way, according to Freud?
a. turn her anger outward, reject her friends, and become depressed
b. give up her high standards, develop insecure attachments, and become
depressed
c. fail to engage in introjection, elevate her ego-ideal, and become depressed
d. turn her anger inward, harbor a sense of inadequacy, and become depressed
216
9.77
Ans. D
Fac
p. 302
E
What process do depression-prone people engage in following the loss of an
important person?
a. reaction formation
b. ego idealization
c. insecure attachment
d. introjection
9.78
Ans. A
Fac
p. 302
E
*
Which of the following psychological processes is de-emphasized in modem
psychoanalytic theories of depression?
a. anger turned inward
b. object relations
c. impaired self-esteem
d. early attachment
9.79
Ans. C
App
p. 302
M
Sara has developed an insecure attachment with her caregiver. According to
Bowlby, why might Sara be vulnerable to depression in the future?
a. She will develop interpersonal characteristics that elicit criticism and rejection
from significant others.
b. She will develop maladaptive cognitive beliefs about herself and the world.
c. She will fail to develop effective coping strategies for dealing with stressors.
d. She will fail to develop realistic standards for her own behavior.
9.80
Ans. C
Fac
p. 303
E
Which of the following researchers has provided support for the attachment theory
of depression based on studies with Rhesus monkeys?
a. John Bowlby
b. Peter Lewinsohn
c. Stephen Suomi
d. Martin Seligman
9.81
Ans. D
Con
p. 303
M
An interesting finding from research such as Coyne's which looks at the
interactions between depressed individuals and others in their life indicates that
a. distorted cognitive processing prevents depressed persons from accurately
recognizing the social support being offered by friends and family.
b. persons who interact with a depressed individual tend to feel better after the
interaction, which also improves the individual's mood temporarily.
c. decreased social support is primarily a cause, rather than a consequence, of a
depressive disorder.
d. the adverse change in others' mood and actions that follow such interactions
may contribute substantially to depressed functioning.
9.82
Ans. D
Con
p. 303
M
Regarding the role of social support in depression, what conclusion is unfounded?
a. A lack of social support can contribute to the onset of depression.
b. Depressed persons tend to elicit rejection and hostility in their interactions,
leading to reduced social support.
c. A depressed person's withdrawal and self-imposed isolation result in decreased
availability of social support,
d. Depression onset is most directly affected by a lack of social support from
family, while duration of depression is most directly affected by a lack of social
support from friends.
217
9.83
Ans. C
App
p. 303
M
For the last hour, Marcel has been talking to his roommate, Gary, who has been
very depressed for two weeks over the break-up of his engagement and often
wants Marcel's help and advice. According to Coyne and others' research, what
would you best predict about Marcel's mood after this interaction?
a. He is likely to feel good because he has been supportive of Gary.
b. He is likely to feel good because he has recognized his own more fortunate
situation.
c. He is likely to feel helpless and self-critical because he will over-empathize
with Gary's feelings.
d. He is likely to feel hostile and rejecting toward Gary because of Gary's
dependency and negativity.
9.84
Ans. C
App
p. 304
C
Melinda lives in a very small town that has been experiencing a severe economic
crisis. She only completed a fifth grade education and thus has few job skills.
Further, she tends to ignore suggestions from friends and family, insisting that
"things won't ever change for this town, and I can't go back to school". Whose
theory best accounts for Melinda's depression?
a. Beck's cognitive theory
b. Rehm's self-control theory
c. Lewinsohn's reinforcement theory
d. Pyszczynski & Greenberg's self-awareness theory
9.85
Ans. B
App
p. 304
C
When Marcia wanted to go back to college to finish her degree at age 40, she was
sure that instmctors would think she was too old and wouldn't give her a fair
chance. As a result, she decided to sit at the back of the class and avoid bringing
attention to herself. When she felt confused about assignments, she did not seek
the instructor's help because she was sure she'd be viewed as incompetent.
Finally, she dropped out after her first year and felt like a complete failure.
Which theory could best account for Marcia's developing depression?
a. learned helplessness
b. self-control
c. cognitive triad
d. self-awareness
9.86
Ans. A
App
p. 304
M
*
Ryan has always been very perfectionistic and rarely gives himself credit for
things he does well. He ends up thinking quite poorly of himself and has trouble
putting aside temporary setbacks in his long-term goals. Whose theory would
best explain why Ryan might become depressed?
a. Rhem's self-control theory
b. Beck's cognitive theory
c. Pyszczynski & Greenberg's self-awareness theory
d. Lewinsohn's reinforcement theory
9.87
Ans. B
Fac
p. 304
E
After being exposed to inescapable shock, some dogs failed to try to escape shock
when in fact they could do so. What theory of depression grew out of this work?
a. self-control theory
b. learned helplessness theory
c. conditioned amotivational theory
d. negative schema theory
218
9.88
Ans. A
App
p. 304
M
Toni got a promotion recently but thinks she was just lucky and that she doesn't
really have the skills for the new position. She made a small mistake on a memo
on the first day in her new position and concluded she really was stupid and
nothing would ever go right for her. What characteristic of depressed persons
does this most clearly represent?
a. negative attributional style
b. pessimism
c. learned helplessness
d. negative cognitive triad
9.89
Ans. D
App
p. 304
M
Kristen's therapist believes that Kristen is depressed because she approaches
conflicts in her life with a negative attributional style. If this were the case, how
would Kristen respond to an upsetting argument with her parents about her low
grades?
a. "We got in the fight because we were all tired and edgy that night; it's no big
deal and I don't really care anyway."
b. "I was lazy for the whole semester, but I'll probably bring my grades up next
semester if they'll just leave me alone for a while!"
c. "I was really dumb because I didn't study much, but my parents don't take the
time to hear my side of the story."
d. "I just can't handle college; my classes are only going to get harder and I won't
be able to keep up."
9.90
Ans. C
App
p. 305
M
Rich is experiencing several symptoms of depression after losing his job due to
management's 'down-sizing'. Which of the following statements would NOT
represent one of the factors that could contribute to Rich's hopelessness?
a. "I wouldn't have lost my job if I weren't so stupid."
b. "My family and friends are going to find out I'm completely useless to them and
they won't want to be around me."
c. "I can't stop thinking about that day my boss gave me my notice; every time,
I feel the shock all over again."
d. "Now that I've been let go', nobody will even think about hiring me for a
decent job."
9.91
Ans. C
Con
p. 306
E
Each of the following statements is correct in regard to the self-schema EXCEPT
a. The self-schema develops in childhood as a result of interactions with the
environment.
b. Activation of a negative self-schema leads to automatic thoughts and cognitive
distortions.
c. A negative self-schema develops largely through primitive thinking and
distortion of positive feedback.
d. One of two important themes, relationships or autonomy, often characterizes a
depressive self-schema.
219
9.92
Janice is very concerned about achieving success in law school without any help
Ans. B
from
other students. When she fails her first mid-term exam, what is the likely
App chain of events that could lead to depression, according to Beck?
p. 305-6
a. cognitive triad develops; automatic thoughts occur; negative self-schema
M
activates
b. negative self-schema activates; cognitive biases operate; cognitive triad
develops
c. automatic thoughts occur; negative self-schema activates; cognitive biases
operate
d. negative self-schema activates; cognitive triad develops; cognitive biases
operate
9.93
Ans. D
Con
p. 305-6
E
Which of the following characteristics does not belong with the other three?
a. negative cognitive triad
b. self-schema
c. thinking errors
d. hopelessness
*
9.94
Ans. D
Fac
p. 306
E
The cognitive triad in Beck's theory of depression refers to negative views of
a. past, present, and future experiences.
b. self, others, and goals.
c. personal life, work, and social relationships.
d. the self, the world, and the future.
9.95
Ans. D
App
p. 306
M
When Martine got an English term paper back with an "A" on it along with some
comments for improving her use of metaphors and similes, she was sure that the
whole paper needed to be completely rewritten to be any good. What thinking error
is she exhibiting?
a. magnification
b. personalization
c. arbitrary inference
d. selective abstraction
9.96
Ans. A
App
p. 306
E
A depressed client being treated with cognitive therapy came to her weekly
session. While discussing her progress in classes that week, she mentioned that
she had the highest grade in the class on the mid-term exam but insisted this was
only a "fluke" and that she's really "incompetent" in the course. Which of the
following thinking errors is she exhibiting?
a. minimization
b. personalization
c. arbitrary inference
d. overgeneralization
220
9.97
Ans. A
App
p. 306
M
"I will never be good enough for my father to love," Sam insisted. How could he
revise that primitive thinking to reflect reversible, mature thinking?
a. "If I try to see things from his point of view, maybe I'll understand why he's
so distant."
b. "I can be really difficult for my father to deal with and I'm often angry when
we interact."
c. "Sometimes my father seems to be distant and distracted and I don't know if he
even notices me."
d. "I don't think my father will ever deserve my love and concern."
9 98
Ans. D
Con
p. 306
E
Research conducted to evaluate Beck's theory of depression supports each of the
following statements EXCEPT
a. Depressed persons exhibit primitive and erroneous thinking,
b. Cognitive biases can be effectively treated through therapy.
c. Positive feedback tends to be distorted by depressed persons,
d. Cognitive biases cause depression.
9.99
Ricki wants to become the best skier in her class. At mid-semester, she is ranked
Ans. B third highest, and she decides to focus all of her time and energy toward improving
App
her standing. Three weeks later, she is still third and she is increasingly selfp. 307
critical and self-blaming. Even when she improves, she ignores that because it is
M
still not the best and she ends up feeling worthless. What theory most clearly
predicts that Ricki will become depressed?
a. Beck's cognitive theory
b. self-awareness theory
c. learned helplessness theory
d. self-control theory
9.100
Mitch is trying to help his friend, Marta, understand possible causes for her
Ans. D
depression. If he applies Pyszczynski and Greenberg's theory, what factors will
App
he ask Marta about?
p. 307
a. her views of herself, the world, and the future
E
b. her relationships and her tendency to be overly compliant and dependent
*
c. her excessively high standards for herself and her hopelessness about reaching
them
d. her tendency to engage in frequent self-reflection and to blame herself for not
reaching her goals
9.101
Ans. B
Fac
p. 308
E
What is most accurately predicted about a nondepressed ("normal") person's view
of her- or himself?
a. It tends to be very realistic, unlike the distorted self-attitudes of depressed
persons.
b. It is slightly distorted in a positive direction.
c. It is slightly distorted in a negative direction.
d. It is distorted slightly, though it could be in a positive or negative direction.
221
9.102
Ans. B
App
p. 308
M
Nan is not depressed. Which of the following cognitive characteristics would you
expect her to exhibit, based on comparisons with depressed persons?
a. a sense of personal invulnerability
b. slightly unrealistic optimism
c. low standards for goal-directed behavior
d. realistic self-evaluation
9.103
Ans. A
Con
p. 308
M
Why might "distortion" be a misleading representation of the cognitive processes
of individuals with depression?
a. Depressed people tend to be more realistic in evaluating themselves than are
nondepressed persons in some situations.
b. Depressed people usually perceive other people in terms of personal biases
that do not merit the term "distortion".
c. Depressed people usually develop their thinking patterns in childhood as a
result of early biasing experiences.
d. Depressed people recognize the errors in their thinking but cannot alter the
patterns without help.
9.104
Ans. D
App
p. 308
C
Who is most likely to experience depression, based on prevalence data?
a. Alice, bom in 1920
b. George, bom in 1945
c. Dorian, bom in 1952
d. Bemice, bom in 1955
9.105
Ans. B
Con
p. 308
E
According to your text, which paradigm best accounts for the decreasing age of
onset of depression in the last several decades?
a. biological
b. sociocultural
c. psychodynamic
d. attachment
9.106
Ans. D
Con
p. 308-9
C
Depression is increasingly common in younger cohorts, who are exposed to more
frequent and severe stressors. What conclusion about stressors and depression is
appropriate?
a. Increased social stress is causing higher rates of depression.
b. Increased incidence of depression is causing more frequent impairments in
social and occupational functioning, thus creating increased stress.
c. Increased social stress is causing both mental and physical health problems in
general but is not uniquely responsible for causing depression.
d. None of the above are appropriate.
9.107
Ans. C
App
p. 309
E
Based on Brown and Harris' (1978) work, who of the following is most
vulnerable to depression?
a. Marion, unemployed mother of three young children, who spends time with
her best friend, Margie
b. Candice, employed mother of two, who lost her mother two years ago
c. Rachel, unemployed mother of four young children, whose mother died when
Rachel was 3
d. Beth, employed with no children
222
9.108
Ans. A
App
p. 309
E
John has been released from the hospital following treatment for major
depression. Your prognosis would be MOST guarded if his family members exhibit
a. a great deal of criticism,
b. emotional overinvolvement with John.
c. symptoms of major depression,
d. disinterested detachment.
9.109
Ans. A
Fac
p. 309
M
Traumatic events do not cause depression for everyone. Brown and Harris (1978)
found that
was an important factor that increased the likelihood of
depression among women experiencing such events.
a. lack of social support
b. self-focused depressive style
c. insecure early attachment
d. cognitive biases
Which coping style described in the text is most similar to Pyszczynski &
Greenberg's self-focusing process?
a. internalizing
b. distracting
c. deliberating
d. ruminating
9.110
Ans. D
Con
p. 309
E
9.111
Ans. C
App
p. 309
M
Michael's friends want to help him cope with his feelings of depression following
the break-up of his engagement. Based on coping style research, what should
they recommend to him?
a. "Let's talk about what happened and how you're feeling about it."
b. "You should probably spend some time alone and collect your thoughts,
focusing on why the relationship ended."
c. "Let's go bowling. You're really good at it, and we'd like to spend some time
with you."
d. "Just try to get over it. You'll forget her soon enough."
9.112
Ans. A
App
p. 310
M
Tina and Mark have just finalized their divorce. Nolen-Hoeksema's work predicts
that
will be more likely to become depressed due to
.
a. Tina; socialization that emphasizes introspection and passivity
b. Tina; a lack of a supportive social network
c. Mark; socialization mat emphasizes rumination about failure and incompetence
d. Mark; a lack of emotional coping resources
9.113
Ans. B
App
p. 3i
E
Susan is often perfectionistic, self-critical, and feels very guilty when she tails to
meet her academic goals; this is known as the
personality. Ann is
very focused on others, worries about being abandoned, and is very uncomfortable
when she cannot find anyone to spend time with; this is known as the
personality.
a. sociotropic; dependent
b. autonomy-oriented; sociotropic
c. achievement; depressive
d. autotropic; dependency-oriented
10
223
9.114
Ans. A
App
p. 310
M
9.115
Ans. B
Con
p. 306-311
C
Drawing on socialization and personality style research, which person below is at
greatest risk for depression?
a. Nancy, who has a sociotropic personality and just moved away from home for
the first time
b. Tamara, who has an autonomy-oriented personality and just broke up with her
boyfriend
c. Stephen, who has a sociotropic personality and just lost his job
d. Norris, who has a sociotropic personality and just broke up with his girlfriend
You are writing a summary of the state of the field in regard to understanding
depressive disorders. You would include all of the following statements EXCEPT
a. Most models of unipolar depression include both a diathesis and a stress
component, both of which must be present for depression to occur.
b. Research has effectively eliminated the cognitive perspective in terms of
contributions to understanding depression onset.
c. Both biological and psychological predispositions are relevant to the
understanding of a depressive diathesis.
d. Individuals become depressed for many different reasons and no single cause
of this disorder will be isolated.
9.116
Ans. B
App
p. 311
M
Marvin has bipolar disorder. Which psychological theory has the most support
for explaining Marvin's disorder?
a. psychodynamic "flight from depression"
b. life stress disruptive of social or biological rhythms
c. achievement- and interpersonally-oriented stressors, especially for later episodes
d. self-control theory's "excessive self-reward"
9.117
Ans. D
App
p. 312
E
A group of depressed adults is being treated with antidepressant medication.
Drawing on available research, what percentage would you predict will show
improvement in their symptoms?
a. about 95%
b. about 80%
c. about 75%
d. about 65%
9.118
Ans. A
App
p. 312
E
To which of the following clients would you NOT recommend antidepressant
medication for their major depression?
a. Sabrina, 14 years old
b. Edgar, 21 years old
c. Maria, 45 years old
d. Timothy, 55 years old
9.119
Ans. C
App
p. 312
E
*
Rosalind has been given a drag that alleviates her depressive symptoms by
making neurotransmitters such as norepinephrine and serotonin more available at
the synapse; this is achieved by preventing the transmitters' chemical breakdown,
What kind of drug would she be taking?
a. a tricyclic
b. anSSRI
c. an MAO inhibitor
d. She could be taking A or C
224
9.120
Ans. A
App
p. 312
M
Antonio's depression is being treated with a medication that prevents the reuptake
of both norepinephrine and serotonin. Which drug might he be taking?
a. amitriptyline
b. phenelzine
c. sertraline
d. bupropion
9.121
Ans. A
Con
p. 312
E
Nardil is to Tofranil as
a. MAO inhibitor; tricyclic
b. SSRI; MAO inhibitor
c. tricyclic; SSRI
d. MAO inhibitor; SSRI
9.122
Ans. D
App
p. 312
E
Conchita's psychiatrist has recommended that she take Prozac to alleviate her
depressive symptoms. Which category of antidepressants does this drug fit?
a. MAO inhibitor
b. tricyclic
c. serotonergic
d. SSRI
9.123
Ans. C
App
p. 312
E
Martin's SSRI medication for depression will target the neurotransmitter
a. dopamine.
b. reserpine.
c. serotonin.
d. sertraline.
9.124
Ans. C
Con
p. 312-3
M
A student's report on antidepressant medications could include each of the
following statements EXCEPT
a. The various categories of medications are about equally effective in treating
symptoms.
b. MAO inhibitors are least likely to be used due to side-effect concerns.
c. Impact on neurotransmitter levels and amelioration of symptoms occur
simultaneously.
d. The specific mechanisms by which antidepressants affect symptoms are not
fully understood.
9.125
Ans. A
App
p. 313
M
Ron, a Vietnam veteran with severe depression, has developed cardiovascular
problems. What type of antidepressant medication should not be prescribed for
Ron?
a. imipramine
b. Fluoxetine
c. sertraline
d. buproprion
to
225
.126
Ans. B
App
p. 313
M
Paulette's depression is marked by psychomotor agitation; Marco, also suffering
unipolar depression, has a family history of bipolar disorder. Given the sideeffects of certain medications, Paulette might be a candidate for but
Marco should probably NOT receive
.
a. anSSRI; an SSRI
b. trazedone; a tricyclic
c. an MAO inhibitor; trazedone
d. a tricyclic; an MAO inhibitor
9.127
Ans. A
App
p. 313
M
If Gerardo takes an MAO inhibitor and does not adhere to dietary restrictions,
what side effect could result?
a. high blood pressure
b. mental retardation
c. epileptic seizures
d. cardiac dysfunction
9.128
Ans. C
App
p. 313
M
Your sister has begun taking an antidepressant medication. About how long
would you expect her to be treated with the drug?
a. about 6 weeks
b. 3 to 4 months
c. 4 to 6 months
d. about one year
9.129
Ans. B
App
p. 313
E
Dr. Moodi is prescribing an antidepressant for its prophylactic property. In other
words, she intends to prescribe the drug for
a. birth control.
b. longterm prevention of depression.
c. calming, sedative effects.
d. simultaneous treatment of depression and mania.
9.130
Ans. C
App
p. 313
E
Lithium has been prescribed for Sammi's mood disorder. What mood disorder is
most likely?
a. major depression
b. major depression with psychotic features
c. bipolar disorder
d. cyclothymia
9.131
Ans. A
Con
p. 313
M
*
Each of the following statements applies to the drug lithium EXCEPT
a. It is effective for approximately 80% of individuals with bipolar disorder.
b. It is often intended to be used prophylactically.
c. Because of concerns about toxicity and mood alterations, blood levels must be
monitored regularly.
d. The chemical mechanism by which it works in the brain is not known.
226
You are a psychiatric nurse responsible for monitoring prescribed treatment with
lithium. You would be concerned about the possibility of each of the following
side effects EXCEPT
a. kidney damage
b. thyroid damage
c. high blood pressure
d. tremors
If an individual responds poorly to lithium, what anticonvulsant medication might
be tried?
a. thorazine
b. valproate
c. carbamazepine
d. tegretin
Tiko has bipolar disorder with prominent depressive features. Lithium has not
been effective, and thus his physician has prescribed
a. carbamazepine
b. buproprion
c. ECT
d. valproate
Which antidepressant has stirred intense controversy, in part for its adherents'
claims that it makes you feel "better than well"?
a. Parnate
b. Elavil
c. Prozac
d. Paxil
If you listened carefully to the controversy around Prozac, which conclusion
would you, as a critical thinker, endorse?
a. Well-controlled studies indicate that suicidal behavior in persons taking Prozac
is no more likely than in persons taking other antidepressants.
b. While not conclusive, Prozac has demonstrated biochemical effects similar to
those linked to violently aggressive behavior.
c. Case studies, anecdotes, and media investigations provide compelling evidence
of the behavioral dangers of Prozac.
d. While side-effects associated with Prozac are less troublesome than those of
other drugs, its effectiveness as a treatment for depression is not yet reliably
demonstrated.
Martina is scheduled for ECT. Compared to the treatment she might have
received in the 1950s, she will benefit from each of the following improvements
EXCEPT
a. fewer treatment sessions without need for prophylactic follow-up.
b. unilateral vs bilateral administration.
c. administration of oxygen.
d. an anesthetic or other muscle relaxer.
227
9.138
Ans. A
Fac
p. 315
E
What side-effect of ECT is still relatively common today, though less severe than
in previous years?
a. memory loss
b. broken bones
c. oxygen deprivation in the brain
d. death
9.139
Ans. C
App
p. 315
M
Thirty patients have been treated with ECT at the state hospital and have
responded well. Due to a lack of resources, none of them will undergo
continuing treatment once they are released as outpatients. What is the best
prediction as to how many will experience a relapse of their depression?
a. fewer than 10
b. 10 to 15
c. more than 15
d. 25 to 30
9.140
Ans. C
App
p. 315
M
Greta has major depression, seasonal pattern. The effective treatment for her
depression would probably be
a. low-level ECT, during the winter months.
b. light therapy, consisting of several hours of bright light during the morning
and early afternoon.
c. light therapy, consisting of two hours of increasingly bright light in the
morning before waking.
d. an SSRI, for its effect on phase delays in the endocrine system.
9.141
You are a junior high school teacher who wants to refer a severely depressed
Ans. B
student to a psychotherapy group. Based on available research, you would be
App most confident with which of the following interventions?
p. 315
a. cognitive-behavioral restmcturing
M
b. Coping with Depression course
c. self-monitoring skills
d. interpersonal
9.142
Ans. B
App
p. 315
M
Dr. Froid is offering short-term dynamic psychotherapy to her depressed clients.
Compared to traditional psychodynamic therapy, her approach will NOT
a. include her playing a more active role in the therapy session,
b. work through unconscious conflicts to alter underlying personality structure.
c. focus on issues of self-esteem, sleep difficulties, and other specific current
symptoms,
d. be substantially shorter in length, despite its name.
9.143
Ans. A
App
p. 316
M
Olga's therapist is helping her leam how to relax, how to communicate her ideas
and feelings assertively, and how to develop and enjoy positive friendships. What
approach is Olga's therapist endorsing?
a. behavioral
b. short-term psychodynamic
c. supportive-expressive
d. cognitive
228
9.144
"You say you're depressed because your wife doesn't love you anymore. What
Ans. B
actions lead you to make this conclusion?... Can you think of other reasons why
App she might be acting that way? Might you feel differently if you considered a
p. 316
different explanation?" -- What therapeutic approach is this counselor using?
E
a. affective-expressive
b. cognitive
c. behavioral
d. interpersonal
9.145
Ans. D
App
p. 317
M
Tawny was comparing some of the therapy modalities for depression and trying to
decide which one(s) demonstrated the greatest efficacy. Of the following, which
should she endorse?
a. Behavioral therapy and cognitive therapy are equally effective for short-term
benefits.
b. Behavioral therapy is slightly more effective than cognitive therapy for long-term
benefits.
c. Medication is less effective than cognitive therapy for short-term benefits.
d. Cognitive therapy is slightly more effective than medication for long-term
benefits.
9.146
Ans. D
Con
p. 317
E
Which psychotherapy approach is closest to the biological model in its view of the
origin of depression?
a. cognitive
b. behavioral
c. psychodynamic
d. interpersonal
9.147
Ans. B
App
p. 317
E
Jose's therapist is asking him about the various roles he plays in his life, whether
some have undergone change recently, and whedier he experiences difficulty
managing his roles as dad, executive, volunteer, and part-time student. What
orientation is the therapist most clearly employing?
a. behavioral
b. interpersonal
c. cognitive
d. psychodynamic
9.148
Ans. B
Con
p. 317
M
What research strategy is represented in the NIMH's Treatment of Depression
Collaborative Research study?
a. correlational
b. experimental
c. case study
d. naturalistic observation
9.149
Ans. C
App
p. 317
M
Merlin is severely depressed. Based on the NIMH treatment study, which treatment
approach would you recommend?
a. interpersonal therapy
b. cognitive therapy
c. antidepressant medication
d. Any of the above will result in similar levels of improvement for Merlin.
229
9.150
Ans. B
Fac
p. 318
M
Constance Hammen suggests several reasons why women experience depression
more frequently than men do. Drawing from her discussion, which characteristic
does NOT apply to women?
a. a socialized sensitivity to interpersonal stress of self and others
b. a susceptibility to alterations in neurochemistry due to hormonal fluctuations
c. a greater willingness to admit and express emotional distress
d. a tendency to employ emotion-focused coping strategies
9.151
Ans. B
App
p. 318
C
You are a graduate student studying depression in the year 2002. Several of
Constance Hammen's predictions have come to fruition, and thus the title of your
thesis could be
a. "Depression: The Homogeneous Disorder"
b. "The Individual and Social Costs of Sub-Clinical Chronic Depression"
c. "Suicide and Depression: The Myth of Social Support"
d. "Treatment of Depression: Medication Alleviates Need for Psychotherapy
Approaches"
9.152
Ans. C
App
p. 317,19
C
A mood disordered client is talking with an intake interviewer at a local mental
health center. Based on research regarding the effectiveness of various therapies,
what recommendation could the intake interviewer make that is best supported by
the data?
a. If bipolar disorder is present, medication alone is the treatment of choice.
b. If unipolar disorder is present, combining antidepressant medication with either
cognitive or interpersonal psychotherapy will probably be most effective for
short- and long-term benefits.
c. If unipolar disorder is present, psychotherapy will probably show somewhat
greater long-term benefits over medication treatment.
d. If bipolar disorder is present, cognitive therapy will slightly outperform
medication for long-term benefits.
9.153
Ans. A
App
p. 319
M
A clinical study is underway with 100 depressed outpatients. Drawing on
information presented in the text, about what number of clients will exhibit
improvement at the end of treatment?
a. 70 regardless of treatment approach
b. 85 if treated with medication; 60 if treated with cognitive or interpersonal
therapy
c. 55 regardless of treatment approach
d. 50 if treated with cognitive or interpersonal therapy; 75 if treated with
medication
Marta is experiencing her first episode of major depression. Each of the following
characteristics are statistically likely to apply to her EXCEPT
a. She will recover within a few months even without formal treatment,
b. She will probably experience a recurrence of depression in the future.
c. She will probably experience an episode of mania in the future.
d. She will benefit equally from either medication or psychotherapy for short-term
benefits.
9.154
Ans. C
Con
p. 291,319
M
*
230
9.155
Ans. B
Fac
p. 319
E
One of the most serious problems associated with mood disorders is suicide. What
percentage of depressed persons commit suicide?
a. 8%
b. 15%
c. 20%
d. 26%
9.156
Ans. D
App
p. 319
M
The local medical examiner might find it difficult to obtain an accurate estimate of
deaths due to suicide for each of the following reasons EXCEPT
a. religious or social beliefs fostering a reluctance to identify a death as a suicide,
b. difficulty differentiating "accidents" from intentional events.
c. implicit suicidal intentions masked by high-risk behaviors.
d. a tendency to classify single-vehicle car accidents as probably suicides.
9.157
Ans. B
Con
p. 319-20
E
Which of the following statements from a student's report on suicide should be
removed because of its inaccuracy?
a. Females are more likely to attempt suicide than are males, while males are more
likely to complete suicide.
b. Psychological autopsies indicate that the people who commit suicide are
clinically depressed.
c. Risk-rescue ratio described by researchers indicates that most suicidal people
hope to be saved from their actions.
d. Suicide rates vary across cultures and across ethnic groups within the U.S.
9.158
Ans. D
App
p. 320
M
Jamie was severely abused as a child. Recently, her husband has been talking about
divorce, and she is increasingly unhappy at her job. On Friday night, she went out
with some acquaintances to a bar; when she got home she took a mild overdose of
sleeping pills. What description would a psychologist give to these actions?
a. suicide attempt
b. quasi-suicide attempt
c. sub-lethal behavior
d. parasuicidal behavior
9.159
Ans. B
Fac
p. 320
E
In which country would you expect to find the lowest suicide rate?
a. the U.S.
b. Ireland
c. Japan
d. Germany
9.160
Ans. A
App
p. 320
M
Which of the following persons is at the lowest risk for committing suicide?
a. Muriel, a 28-year-old black female
b. Matthew, a 60-year-old white male
c. Benny, an 18-year-old black male
d. Rachel, a 45-year-old white female
9.161
Ans. B
App
p. 320
M
Which of the following persons is at the highest risk for completing suicide?
a. Roy, a 16-year-old black male
b. Hubert, a 20-year-old Native American male
c. Samantha, a 40-year-old white female
d. Terri, a 24-year-old Hispanic female
231
9.162
Ans. A
App
p. 320
M
Which of the following persons is at the highest risk for completing suicide?
a. Matthew, a 60-year-old white male
b. Muriel, a 38-year-old black female
c. Benny, an 18-year-old black male
d. Raya, a 22-year-old Hispanic female
*
9.163
Ans. C
App
p. 321
C
An individual has committed suicide impulsively, using a firearm, following a
conviction for armed robbery. No note was left, and no common risk signs were
exhibited. Which of the following persons is most likely to have committed suicide
in this manner?
a. a 28-year-old black male
b. a 45-year-old white male
c. a 19-year-old white male
d. a 17-year-old black male
9.164
Ans. D
Con
p. 320-1
M
A descriptive report on suicide could contain each of the following statements
EXCEPT
a. Suicide rates have increased substantially over the past three decades for young
people.
b. The most common means of attempting suicide involve self-poisoning or drug
overdoses.
c. Gender differences in attempts vs. completion rates are present for both
adolescents and adults.
d. The overall suicide rate for the United States has increased steadily over the past
30 years.
9.165
Ans. A
Fac
p. 321
E
Each characteristic below distinguishes adolescent from adult suicide EXCEPT
a. longstanding mental health problems.
b. the contagion effect.
c. externalizing behavior disorders.
d. suicide pacts.
9.166
Ans. D
App
p. 321
M
*
John, a white male, committed suicide at age 17. Which of the following factors
is LEAST LIKELY to have contributed to his action?
a. substance abuse
b. a recent publicly humiliating experience
c. the suicide of a friend at school
d. social isolation
9.167
Ans. C
Con
p. 322
M
Currently, which paradigm provides the least compelling empirical evidence
regarding the cause of suicide?
a. sociocultural
b. cognitive
c. biological
d. behavioral
232
9.168
Quentin, 35 years old, committed suicide following the loss of his job and his
Ans. D
marriage. A medical autopsy revealed extremely low levels of 5-HIAA in his CSF.
App What seems to be the BEST interpretation of the connection?
p. 322
a. His low level of serotonin probably caused both his depression as well as his
C
suicidal behavior.
b. This is probably just a coincidence; no biological factors have been established
as a cause of suicide.
c. He probably had a family history of schizophrenia, which accounts for this link.
d. This biochemical abnormality is probably related to impulsive, aggressive
behavior, not suicide per se.
9.169
Ans. D
App
p. 322
E
Mahatma Gandhi was willing to commit suicide through self-imposed starvation to
protest social conditions in India. How would Durkheim describe this?
a. fatalistic suicide
b. egoistic suicide
c. anomic suicide
d. altruistic suicide
9.170
Ans. C
App
p. 322
M
An older woman lived alone in a small apartment in a dilapidated senior citizens'
home. Her children rarely visited, and she spent virtually all of her time alone,
watching television. Her suicide would be characterized as
a. anomic.
b. fatalistic.
c. egoistic.
d. alienated.
9.171
Ans. D
App position.
p. 323
M
Karl was a stockbroker in New York who lost $3 million of his investors' funds
through poor market choices. He committed suicide after being fired from his
Which of the following sociocultural views would describe his act?
a. altruistic
b. fatalistic
c. egoistic
d. anomic
9.172
Ans. A
App
p. 323
E
During WWII, many Jewish persons killed themselves during internment in
concentration camps, believing they would eventually die in the gas chambers.
Durkheim would view their action as a representation of
suicide.
a. fatalistic
b. altruistic
c. anomic
d. egoistic
9.173
Ans. A
App
p. 323
M
Social change and mores are associated with suicide rates. Which person below is
at the LOWEST risk of suicide?
a. Chera, a Hispanic female with a strong commitment to Catholicism
b. Carl, an African-American male living in a poor urban area
c. Richard, a Native American male living in a tribe emphasizing individuality
d. Marguerite, a Mexican-American female from a family with strong ties to the
Anglo culture
*
233
9.174
Ans. B
Con
p. 323
C
Considering the role of social support in suicide, you would endorse each of the
following statements EXCEPT
a. Married persons are at a lower risk than are single, divorced, and widowed
persons.
b. A temporary loss of social support is weakly associated with suicidal behavior.
c. Cultural variations in social connectedness have an influence on suicide rates.
d. Loss of social support is a significant factor in suicides committed by the most
vulnerable group in the U.S.
9.175
Ans. A
Con
p. 324
M
Regarding developmental factors in suicide, which of the following are incorrectly
matched?
a. attachment: negative self-schema
b. interpersonal theory: poor coping skills for negative affect
c. psychoanalytic theory: unresolved internalized anger toward primary caregiver
d. cognitive theory: hopelessness derived from early experience
9.176
Ans. D
App
p. 324
E
Reynelda, like many depressed individuals, has several distorted cognitions. Which
of the following cognitive attributes is the best predictor of a suicide attempt?
a. negative automatic thoughts
b. sociotropy
c. attributional triad
d. hopelessness
9.177
Ans. D
Fac
p. 325
E
*
How might school-based suicide-prevention programs have actually contributed to
the increase in suicide among adolescents?
a. by informing adolescents of means of suicide that they otherwise would not have
known about
b. by creating channels of communication in school by which adolescents can more
easily obtain firearms
c. by over-emphasizing risk factors and creating excessive pressure on "normal"
teens
d. by implicitly characterizing suicide as a normal response to severe stress
9.178
Ans. A
App
p. 325
E
You are a member of your state's legislature and are very concerned about the rising
rates of teen suicide. According to Lester's work and the views of many other
psychologists, you should seriously consider passing laws related to
a. strict gun control.
b. professional, qualified staffing of crisis centers and hot lines.
c. serious and substantial consequences for selling alcohol to minors.
d. funding for extracurricular school groups to reduce adolescents' isolation and
hopelessness.
9.179
Ans. C
App
p. 326
C
You have been asked to recommend a suicide prevention program. Which approach
would you expect to be most effective?
a. supportive individual therapy for at-risk persons (e.g., depressed, low social
support)
b. social-skills focused group counseling for persons who have attempted suicide,
given their likelihood of repeat attempts
c. public awareness campaign and programs for substance abuse
d. anger management and self-control techniques to address the aggressive and
impulsive behaviors that underlie suicide
234
9.180
Ans. D
App
p. 326
E
As a crisis line worker, what would be your FIRST concern when talking with a
suicidal individual?
a. How can I help them resolve their current emotional crisis?
b. Who might I refer them to for help with a possible underlying psychological
disorder?
c. Does this person appear to require hospitalization?
d. What level of imminent danger does the person pose to her- or himself?
9.181
Ans. D
Con
p. 326
E
Antidepressant medications are relatively ineffective in treating an acute suicidal
episode for all of the following reasons EXCEPT
a. Their mechanism of action is too slow for a therapeutic effect.
b. An overdose of these medications could cause serious bodily injury or death.
c. During initial treatment, the risk of suicide could actually be increased.
d. They have little effect on the neurotransmitter related to impulsive, violent
behavior.
9.182
You are developing a cognitive-behavioral intervention for your client who currently
Ans. D
believes that suicide is the best solution to her current emotional distress. There
App are several characteristics of her thinking that you would want to address, but
p. 327
is LEAST likely during this crisis.
E
a. minimizing distortions in problem-solving
b. finding "shades of gray" in making judgments
c. viewing hopelessness as a negative interpretation
d. developing higher standards for self-worth
SHORT ANSWER I ESSAY
9.183
What are the distinguishing features of major depression vs. dysthymia vs. bipolar
disorder vs. cyclothymia?
Major depression: episodic disorder of severe unipolar depression
Dysthymia: chronic disorder of less severe unipolar depression symptoms
Bipolar: episodic disorder with both manic and depressive episodes (I vs. II can be
distinguished by duration of mania); depressive episode similar to that of major depression
Cyclothymia: chronic disorder of less severe bipolar symptoms
9.184
Describe the typical characteristics of a major depressive episode in regard to onset,
duration and treatment, and recurrence.
Onset: typically mid-20's in age, more common in females; onset age decreasing in recent
years
Duration & treatment: eight to ten months, typically not treated
Recurrence: as many as three-quarters experience recurrent episodes, with longitudinal
research revealing an average of five to six episodes in a 20-year period
235
9.185
Describe six central non-symptom-related differences between major depression and
bipolar disorder.
The prevalence of bipolar disorder is substantially lower than that for major depression, with
prevalence rates of roughly 1 and 20 percent, respectively. Bipolar disorder shows no appreciable
gender difference in prevalence, while major depression is twice as common in women than in men.
Bipolar disorder also has a somewhat earlier onset than does major depression and appears to be
less affected, in regard to onset and worsening, by psychosocial stressors. Bipolar disorder seems
to be more frequent in higher socioeconomic classes, whereas depression appears to be equally
common across SES groups. Finally, research suggests that bipolar disorder is more strongly
affected by genetic factors than is major depression, although there is some overlap in the risk
factors associated with these mood disorders.
9.186
Describe three research findings that supported the original catecholamine theory
of mood disorders. Why has that theory been revised?
The first piece of evidence came from the finding, in the 1950s, that the drug reserpine
created symptoms of depression in persons who took this hypertension medication. It is known that
reserpine lowers catecholamine levels. Further, medications that were known to increase
catecholamines, particularly norepinephrine, diminished depressive symptoms. Thirdly, these same
drugs caused symptoms of mania in some depressed individuals, suggesting that excessive levels
of catecholamines caused mania and low levels caused depression.
The theory was revised when it was discovered that not all depressed persons exhibited low
catecholamine levels and that not all depressed persons improved when given drugs that increased
norepinephrine. Many studies have revealed that 5-FflAA, a metabolite of serotonin, is frequently
low in persons with depression, and the newest class of drugs, selective serotonin reuptake inhibitors
(SSRI's) have proved to be more generally effective for depressed individuals. Because of the
diversity of neurotransmitter functioning in depressed persons, some form of interactive theory will
probably be needed to understand the role of these biochemicals in this disorder. Too, recent
studies of bipolar disorder suggest that other neural factors, such as sodium ion instability, may play
a role.
9.187
Carlito is depressed following a final decree of divorce from his wife. Drawing
from Freud's theory, explain the origin of Carlito's depression.
Carlito developed a vulnerability to depression as a result of early disappointment in (or,
early over-indulgence by) his parents. From childhood, he has been dependent on others for
approval and his self-esteem is easily swayed, for better or for worse, by others' reactions to his
needs. Vulnerable now to the loss of his marital relationship, he has introjected his wife and feels
angry that she has abandoned him. Unable to effectively cope with this anger, he turns the anger
inward toward himself, and it is this process that produces Carlito's symptoms of major depression.
His depression may be exacerbated if he also maintains excessively high ego ideals, believing that
his marriage should have endured under any circumstances; his failure to achieve his goal will
increase his cognitive symptoms of worthlessness and guilt.
236
9.188
Why might Sandy, who had an insecure attachment to her mother, be vulnerable
to major depression as an adult?
It is possible that Sandy's mother was either unresponsive to Sandy's emotional distress as
a young child or she may have been belittling and unsupportive when she did respond to her
daughter's distress. As a result, Sandy learned to inhibit her help-seeking behaviors and was unable
to successfully leam how to regulate her emotional experiences. Later, as an adult, this inhibition
and ineffective coping will leave her vulnerable to depression in the face of significant life stress.
9.189
Two of the three factors which contribute to the development of hopelessness,
according to Abramson and colleagues, are quite similar to two of the factors outlined in Rehm's
self control model of depression. Provide support for this statement and indicate a primary
distinction between these two models.
Abramson's second factor - focus on most negative consequences of events = Rehm's second
element - concentration on immediate negative events; Abramson's third factor - tendency to draw
negative inferences about overall self-worth = Rehm's fourth element - explanation of events in
terms consistent with negative self-schema.
Primary distinction - Abramson's model focuses primarily on cognitive attributional biases
for external events without an emphasis on high standards for behavior, and Rehm's theory includes
explicit attention to self-imposed operant behavior consequences.
9.190
List the biological treatments available for maj or depression and bipolar (mania) and
briefly indicate their effect:
Major depression:
MAO inhibitors - block the enzyme monoamine oxidase which would otherwise break down
neurotransmitters such as SE or NE.
Tricyclics - block reuptake of NE and SE
SSRI's - selectively slow the reuptake of SE
Unilateral ECT - for severe depression, specific action unknown
Light therapy - for seasonal depression, appears to affect endocrine system
Mania:
Lithium (carbonate) - not yet known
Carbamazepine & valproate - unspecified
9.191
Describe three ways in which adolescent suicide is different from that committed
by adults. What factors appear to have contributed to the rising suicide rate in this age group?
Adolescents are more likely to commit suicide impulsively following an acute life stressor
(particularly following a public humiliation or getting into trouble), rather than as a response to
social isolation or hopelessness. They are, then, less likely to leave a suicide note or to give away
prized possessions. The contagion effect, including the impact of television depictions of suicide,
is more commonly associated with adolescent suicide, as are suicide pacts.
The increasing stresses in the environment, including cultural changes, are primarily
responsible for the rising suicide rate. Ironically, however, prevention programs conducted in the
schools are also in part responsible for this, given the lesser taboo status conferred on the act.
Finally, some psychologists assert that the greater availability of guns is an important culprit, with
gunshots being the most common form of death in adolescent and young adult suicide.
237
Chapter 10
10.1
Ans. B
App
p. 332
E
10.2
Ans. B
Fac
p. 332
E
SCHIZOPHRENIA
In the case of Lionel Aldridge, Lionel believed his dog was causing all his
problems and that enemies were everywhere and he had to fight or mn from
them. These are specific examples of
a. hallucinations.
b. delusions.
c. schizophrenia.
d. psychosis.
are
A psychosis marked by a fragmentation of the basic psychological functions that
normally integrated to respond to the demands of reality is called
a. epilepsy.
b. schizophrenia.
c. Alzheimer's disease.
d. multiple personality disorder.
10.3
Ans. A
App
p. 332,5
E
*
Stephen, an individual with schizophrenia, could have each of the following
symptoms EXCEPT
a. multiple personalities,
b. hallucinations.
c. alogia.
d. emotional disturbance.
10.4
Ans. D
Fac
p. 333
M
The first unequivocal, formal historic description of what is currently called
schizophrenia occurred
a. in ancient Greek writings.
b. in depictions of sinful behavior during the middle ages.
c. in reports made by physicians during the Renaissance,
d. in descriptions of patients from the early 19th century.
10.5
Ans. B
App
p. 333
M
*
If you were a student of , you probably contributed to the influential
work that identified the subtypes of dementia praecox.
a. Pinel
b. Kraepelin
c. Schneider
d. Bleuler
10.6
Ans. C
App
p. 333
C
As a clinician in the 1890s you would classify your patient's silly, immature,
and disorganized psychosis as
a. schizophrenia, affective type,
b. schizophrenia, autistic type.
c. dementia praecox, hebephrenic type,
d. dementia praecox, catatonic type.
10.7
Ans. A
Fac
p. 333
E
The term schizophrenia was coined by
a. Eugen Bleuler.
b. JohnHaslam.
c. Kurt Schneider.
d. Emil Kraepelin.
238
10.8
Ans. B
App
p. 333-4
M
If you employed Bleuler's nosology to describe your schizophrenic patient who
has completely withdrawn from others into an internal world of imagination, you
would diagnose this as the
a. simplex subtype.
b. autistic subtype.
c. hebephrenic subtype.
d. delusional subtype.
10.9
Ans. C
Fac
p. 333
E
The conceptualization of schizophrenia as an early onset, progressive, and
incurable deterioration into mental weakness is most similar to that of
a. Bleuler.
b. Schneider.
c. Kraepelin.
d. Gottesman.
10.10
Ans. D
Fac
p. 333
E
"Schizophrenia" is best conceptualized as a split
a. personality; Kraepelin
b. mind; Kraepelin
c. personality; Bleuler
d. mind; Bleuler
10.11
Ans. A
App
p. 334
C
You are a medical student in 1911, working with psychotic patients. You could
expect to see any of the following primary symptoms in patients EXCEPT
a. auditory hallucinations.
b. incongruent emotion and action.
c. incoherent ideas.
d. self-centered fantasy thinking.
10.12
Ans. B
App
p. 334
M
*
As a physician in the U.S. early in this century, whose definition of
schizophrenia were you most likely to favor?
a. Crow
b. Bleuler
c. Schneider
d. Kraepelin
10.13
Ans. C
Con
p. 333-4
M
Which of the following historical pairs is mismatched?
a. Schneider : first rank
b. Bleuler : Four A's
c. Kraepelin : primary symptoms
d. Morel : demence precoce
10.14
Ans. A
App
p. 334
C
It is 1936, and Rollo is a new patient in a London hospital. Rollo just returned
home from the U.S. where he was first diagnosed with schizophrenia. What
prediction would you make for the diagnosis made by his new physician?
a. manic depression
b. schizophrenia
c. dementia praecox
d. hebephrenia
239
, according to
.
10.15
Ans. B
App
p. 334
M
"Mr. Allegretti exhibits one of the classic Schneiderian symptom of psychosis."
The clinician making this statement is referring to the patient's
a. avocation.
b. delusion of grandeur.
c. catatonia.
d. ambivalence.
10.16
Ans. D
Fac
p. 334
E
,
Which clinician's conceptualization of schizophrenia is preserved in the DSMIV?
a. Kraepelin
b. Schneider
c. Bleuler
d. all of the above
10.17
Ans. C
Con
p. 65,334
C
Which diagnostic approach describes DSM criteria for schizophrenia?
a. classical
b. homogeneous
c. polythetic
d. inclusionary
10.18
Ans. C
App
p. 334-5
M
Which of the following people has schizophrenia according to the DSM-IV?
a. For six months Letitia has held a pervasive belief that her husband is having
an affair. She has spent thousands of dollars hiring private detectives to
follow him.
b. Bob has experiences in which he feels that he is unstoppable and is likely to
behave in a reckless manner. At other times he is depressed and unable to do
even simple tasks.
c. Isaac has been unable to interact with others for six months due to a lack of
emotional responsiveness. He has heard two voices speaking to each other
for a month.
d. Martinique has been depressed for two years. She regularly uses PCP, has
been seeing dead friends, and believes that everyone is out to get her.
10.19
Ans. A
App
p. 334-5
M
Bill has symptoms of catatonia, grossly disturbed speech, and flat affect that
have caused problems in his life, including a demotion at work and hostile
conflict with his spouse. These symptoms have been present for 4 months,
preceded by relatively normal functioning. Why could Bill not be diagnosed as
"schizophrenic"?
a. duration criterion not met
b. hallucinations not present
c. dysfunction criterion not fully met
d. minimum "characteristic symptoms" criterion not met
10.20
Ans. B
App
p. 334
E
Hector has schizophrenia. His positive symptoms could include
a. social withdrawal, apathy, and emotional ambivalence.
b. hallucinations, delusions, and disorganized speech.
c. excessive dopamine, increased ventricles, and frontal lobe atrophy.
d. alogia, avolition, and catatonia.
240
10.21
Ans. B
App
p. 334
M
Reginald is exhibiting several negative symptoms of schizophrenia. Which of
the following statements is LEAST likely to apply to him?
a. His long-term prognosis is probably quite poor.
b. He demonstrates strange behavioral disorganization.
c. Medication will probably not be an effective treatment,
d. He probably has Type II versus Type I schizophrenia.
10.22
Ans. C
Con
p. 33,334
M
As the number of negative symptoms increases, the likelihood of long-term
impairment increases. This is a(n)
a. spurious correlation,
b. negative correlation.
c. positive correlation,
d. causal correlation.
10.23
Ans. D
App
p. 334
M
Dr. Deluded is conducting a family study of schizophrenia. If she focuses on
the positive symptoms of the disorder, she will investigate the clusters of
a. delusions and hallucinations.
b. pathological excesses and deficits.
c. Type I and Type II symptoms.
d. psychoticism and disorganization.
10.24
Ans. A
App
p. 335
M
Andy believes that part of his brain is turned inside out and that this causes him
to think and speak in a language that no one else understands. This is a
a. somatic delusion,
b. delusion of reference.
c. tactile hallucination,
d. delusion of control.
10.25
Ans. B
App
p. 336
M
*
Terri was convinced that when a staff member dropped and broke a glass at
lunch it was a sign that she should avoid drinking her milk because it was
poisoned. This is a
a. circumstantial delusion.
b. delusion of reference.
c. delusion of control,
d. delusion of grandeur.
10.26
Ans. C
App
p. 335-6
M
When a client was involuntarily committed to a hospital, he believed that his
family and therapist had been abducted and replaced by hostile aliens. This is a
delusion of
a. control.
b. reference.
c. persecution.
d. enmity.
10.27
Ans. A
App
p. 336
E
Tsu-Ming was unwilling to attend her group therapy session because everyone
there could hear all her thoughts. She exhibits the delusion called
a. thought broadcasting,
b. thought insertion.
c. thought reference,
d. thought deletion.
241
10.28
Ans. D
App
p. 336
M
In Leon's opening words to the group assembled at the Ypsilanti State Hospital,
which delusion, besides being Jesus Christ, was clearly evident when Leon
spoke of "electronic imposition"?
a. reference
b. control
c. jealousy
d. persecution
10.29
Ans. A
App
p. 336-7
M
Three psychotic men who believe they are the President of the U.S. are brought
together for several months in one ward of a state hospital. What is the most
likely outcome of their frequent contact and interaction?
a. They will maintain their identity without any alteration.
b. They will eventually alternate their turns in that role, one at a time.
c. One or two will probably adopt a similar but different delusional identity to
reduce conflict.
d. Each will repeatedly challenge the identity of the others, leading to a final
rejection of the original identity.
10.30
Ans. B
App
p. 337
E
Ten newly admitted patients at a state hospital are diagnosed with
schizophrenia. What number probably experience hallucinations of some sort?
a. 5
b. 7
c. 9
d. 10
10.31
Ans. C
App
p. 337
E
Briefly mistaking a shadow for a threatening intruder is a(n)
a. delusion.
b. collusion.
c. illusion.
d. hallucination.
10.32
Ans. A
App
p. 337
E
Jill's schizophrenia includes hallucinations. Statistically, Jill is most likely to
experience
a. auditory hallucinations,
b. tactile hallucinations.
c. visual hallucinations.
d. somatic and gustatory hallucinations.
10.33
Ans. D
App
p. 337
E
*
Which of the following hallucinations would be most common for a person with
schizophrenia?
a. seeing figures of demons and ghosts in a crowd
b. feeling ants crawling on one's legs and arms
c. smelling decaying bodies and acrid smoke
d. hearing a command to run in front of a moving car
10.34
Ans. A
Con
p. 337-8
M
From LESS to MORE common, which of the following correctly depicts the
hallucinations of people with schizophrenia?
a. olfactory; tactile; auditory
b. tactile; somatic; visual
c. tactile; visual; auditory
d. gustatory; auditory; visual
242
10.35
Ans. B
App
p. 337
C
From an actual case: A schizophrenic inmate in a prison for the criminally
insane said that he often saw spiritual devils off in the distance. He said that he
knew this was considered "crazy" but couldn't believe his "brain was good
enough to make that up!" Only medication stopped his strange perception. This
would be considered a hallucination for each reason below EXCEPT
a. his report that the devils are visible no matter what he does.
b. his recognition that his experience is strange.
c. his belief that the devils were real.
d. his inability to stop the perception on his own.
10.36
Ans. C
App
p. 338
E
Vincenzo has a formal thought disorder. Which symptom below provides
clinical evidence of this disruption in thinking?
a. a delusion of reference
b. anhedonia
c. derailment
d. alogia
10.37
Ans. C
Fac
p. 338
E
A neologism is a
a. brain structure dysfunction which is implicated in schizophrenia.
b. class of antipsychotic drugs used to reduce positive symptoms.
c. word created by a person exhibiting a formal thought disorder.
d. specific delusion of grandeur in which someone believes he is Napoleon.
10.38
"The neotility of people confounds me. All the while running to the store, I
Ans. D
leapt swiftingly from rock to rock. The future, it said, redores with futility and
App inner reduplication." Which two symptoms of thought disorder are present?
p. 338
a. word salad and perseveration
M
b. neologisms and echopraxia
c. clanging and word salad
d. derailment and neologisms
10.39
Ans. A
App
p. 339
E
"Gene, the jean jeanie" is a phrase that clearly reflects
a. clang associations.
b. perseveration,
c. word salad.
d. loose associations.
*
10.40
Ans. B
Fac
p. 339
E
The dramatic characteristics of catatonia are an example of
a. disrupted affective processes.
b. disordered behavior.
c. cognitive derailment.
d. perceptual misinterpretation.
10.41
Ans. C
App
p. 339-40
M
A clinician is assessing the presence and severity of a client's negative
schizophrenic symptoms. Which of the following is NOT a specific diagnostic
criterion?
a. avolition
b. flat affect
c. social withdrawal
d. alogia
243
10.42
Ans. A
Con
p. 340
M
Which of the following statements is FALSE in regard to the flat affect found in
schizophrenia?
a. The lack of emotional expression appears to be related to a similar lack of
internal emotional experience.
b. It is roughly as common as are auditory hallucinations, with both symptoms
typical of the majority of individuals with the disorder.
c. It is more commonly evident in the residual than the active phase of the
Type I disorder.
d. It could be caused or exacerbated by the medications used to treat the
positive features of the disorder.
10.43
Ans. D
App
p. 340
M
Brannon is volunteering as a nurse's aide in a psychiatric hospital. He finds it
very difficult to engage schizophrenic individuals in conversation because they
seem to have very little to say or speak extremely slowly. This condition is
known as
a. flat verbalization.
b. aphasia.
c. anhedonia.
d. alogia.
10.44
Ans. B
App
p. 340
M
*
Martina spends most of her time staring blankly out a window and is never
interested in any activities occurring on her ward. Which symptom of
schizophrenia does this reflect?
a. psychomotor retardation
b. avolition
c. antimotivational syndrome
d. anhedonia
10.45
Ans. C
Fac
p. 341
E
Which of the following disorders does NOT belong to the "schizophrenic
spectrum"?
a. paranoid personality disorder
b. schizoaffective disorder
c. substance-induced psychotic disorder
d. delusional disorder
10.46
Ans. C
App
p. 341
M
Ms. Racita has hallucinations, delusions, and bizarre motor behavior caused by
temporal lobe epilepsy. This is probably diagnosed as
a. delusional disorder with psychotic features,
b. schizophreniform disorder due to a physical condition.
c. psychotic disorder due to a general medical condition,
d. schizophrenic spectrum disorder.
10.47
Ans. D
Fac
p. 341
E
When schizophrenia is compared to the spectrum disorders, which of the
following descriptions is NOT applicable?
a. There is less research available on characteristics and causes of spectrum
disorders.
b. Spectrum disorders represent more limited and less severe symptomatology.
c. A substantially better prognosis is associated with spectrum disorders.
d. Symptoms of each spectrum disorder have a duration of 6 months or less.
244
10.48
Ans. D
App
p. 341
E
Gisela experienced visual hallucinations, loose associations, and bizarre
behaviors following a traumatic, violent accident. Within three weeks, these
symptoms ceased. Which diagnosis would be most appropriate for her?
a. schizophreniform disorder
b. posttraumatic stress disorder with psychotic features
c. schizophrenic spectrum disorder
d. brief psychotic disorder
10.49
Ans. B
App
p. 341
M
*
Randall has a diagnosis of disorganized schizophrenia. Marta has a diagnosis of
major depression with psychotic features. Erika has a diagnosis of
schizoaffective disorder. Among them,
has the best prognosis.
a. Randall
b. Marta
c. Erika
d. All have equally poor prognoses.
10.50
Ans. A
App
p. 341
M
Alberto is seeking to begin a new society based on his own principles for
creating social harmony and efficiency. He believes he has been chosen to save
humanity from the evils of the impersonal high-tech society that imprisons it.
Which disorder might apply to Alberto?
a. delusional disorder
b. schizophreniform disorder
c. grandiosity disorder
d. process schizophrenia
10.51
Ans. A
App
p. 341
E
If Vera is an inducer who influenced her son, Thad, to act out psychotic
symptoms, this would be called
a. folie a deux,
b. the contagion effect.
c. schizophrenogenic psychosis,
d. Munchausen's proxy.
10.52
Ans. C
Fac
p. 343
E
Roughly what proportion of persons diagnosed with schizophrenia will continue
to suffer symptoms even when they take medication?
a. one tenth
b. one fifth
c. one quarter
d. one third
10.53
Ans. D
App
p. 343-4
M
Statistically speaking, which of the following persons is MOST likely to be
diagnosed with schizophrenia for the first time?
a. Kendra, a 25-year-old female
b. Tracey, a 15-year-old female
c. Michael, a 30-year-old male
d. Geoff, a 24-year-old male
10.54
Ans. C
Fac
p. 343
E
Schizophrenia usually has an onset
a. in early childhood.
b. at the beginning of puberty,
c. in the early twenties.
d. after age 30.
245
10.55
Ans. A
App
p. 344
M
Rebecca is an eight year-old who is diagnosed with autism. Which of the
following is related to her disorder but not to childhood schizophrenia?
a. absence of speech
b. disturbance in mood
c. disturbance in social behaviors
d. difficulty perceiving the environment adaptively
10.56
Ans. B
App
p. 344
E
Elijah's behavior has become increasingly peculiar in the past few months. He
is hoarding newspapers, is sometimes verbally unresponsive to questions from
others, and often responds with irritation when approached. What phase of
schizophrenia will occur next?
a. residual
b. active
c. autistic
d. prodromal
10.57
Ans. C
App
p. 344
E
A psychiatrist is conducting a study of long-term outcomes in schizophrenia.
Based on the data reviewed by Watt and Saiz (1991), the researcher might
expect
% of his sample to completely recover.
a. 10 ~
b. 15
c. 25
d. 32
10.58
Ans. D
Fac
p. 344-5
E
*
Which of the following outcomes is LEAST likely for hospitalized
schizophrenic patients at the end of a 10-year period, based on available data?
a. completely recovered
b. symptoms improved, relative independence achieved
c. symptoms improved, extensive support still needed
d. symptoms unimproved, hospitalized
10.59
Ans. A
App
p. 344-5
C
A diagnosis of schizophrenia has been given to Terrell for the first time.
Which of the following prognoses is LEAST supported by research?
a. He will be hospitalized more often as he ages.
b. He will show substantial improvement in his symptoms.
c. He will undergo the residual phase of the disorder,
d. He will have recurring symptoms.
10.60
Ans. B
App
p.334,45
E
You are conducting epidemiological studies of psychotic disorders in three
countries. You are likely to find the highest prevalence rates if you employ a
definition.
a. Kraepelinian
b. Bleulerian
c. Schneiderian
d. DSM-IV
246
10.61
Ans. C
Fac
p. 345
E
According to the generally accepted standard, the prevalence of schizophrenia in
the world is about
a. 0.2 percent.
b. 0.5 percent.
c. 1.0 percent.
d. 2.0 percent.
10.62
Ans. A
Fac
p. 345
E
What is a person's "morbidity risk"?
a. the likelihood of developing a mental disorder or physical illness during one's
lifetime
b. the likelihood of death due to suicide by someone with a mental disorder
c. the likelihood of developing a physical illness secondary to a mental disorder
d. the likelihood of developing a disorder if a family member develops a mental
disorder
10.63
Ans. D
App
p. 345
M
As a sociocultural psychologist, you would be MOST likely to find empirical
evidence supporting cultural differences for which aspect of schizophrenia?
a. overall morbidity risk for the disorder
b. gender-related differences in morbidity risk
c. causal factors associated with the disorder
d. prognosis for the disorder
10.64
Ans. B
App
p. 345,7
M
Which of the following persons has the best chance of recovery from
schizophrenia?
a. Juan, from Spain
b. Sesh, from India
c. Ann, from Australia
d. Gregory, from the U.S.
10.65
Ans. C
Fac
p. 347
M
Which factor was NOT included in the text's Controversy section regarding
cultural variations in the prognosis for schizophrenia?
a. greater mortality associated with pre- and perinatal injury and illness
b. broader vs. narrower definitions of the disorder
c. differences in mental health services and prevention programs
d. collectivist vs. individualistic social organization patterns
10.66
Ans. D
Con
p. 347
C
If you proposed a biological explanation for the documented differences in
prognosis for schizophrenia across cultures, which of the following findings
would support your view?
a. The milder forms of schizophrenia found in developing countries have a
prognosis similar to that of schizophrenia proper.
b. Children of schizophrenic parents in developing countries are more likely to
exhibit the disorder than are children of such parents in industrialized
countries.
c. The use of a Kraepelinian-based definition results in the identification of
fewer cases of the disorder in industrialized countries.
d. Random samples of adults in developing countries demonstrate fewer
structural brain abnormalities than do such samples in industrialized
countries.
*
247
10.67
Ans. A
Con
p. 345-7
M
You would place LEAST confidence in which of the following descriptions of
schizophrenia as it occurs cross-culturally?
a. its overrepresentation in lower socioeconomic status classes
b. gender similarity in morbidity risk
c. earlier onset and poorer prognosis for males vs. females
d. family aggregation of the disorder
10.68
Ans. B
App
p. 348
E
Kenji has a persistent feeling that everyone is conspiring against him and
frequently hears voices telling him he should hide himself from outsiders;
however, he shows little disorganized behavior or speech. What type of
schizophrenia is this?
a. residual
b. paranoid
c. catatonic
d. undifferentiated
10.69
Ans. C
Fac
p. 348
M
*
High suicide risk, later life onset, generally better prognosis, and relatively
sudden symptom onset are characteristic of which type of schizophrenia?
a. disorganized
b. catatonic
c. paranoid
d. undifferentiated
10.70
Ans. A
App
p. 348
M
Jody began to develop schizophrenic symptoms at age 15. His symptoms came
on gradually and have progressively worsened. Jody often speaks incoherently,
displays inappropriate emotions, and has difficulty maintaining his personal
hygiene. Jody's diagnosis is
a. disorganized type schizophrenia.
b. catatonic type schizophrenia.
c. paranoid type schizophrenia.
d. undifferentiated type schizophrenia.
10.71
Ans. D
Fac
p. 348
E
The DSM-IV preserves each of the original subtypes of dementia praecox.
Which is now referred to as "disorganized"?
a. simple
b. affective
c. catatonic
d. hebephrenic
10.72
Ans. C
App
p. 348
M
Dr. Janeway has a schizophrenic patient requiring constant supervision due to
episodes of relentless motor activity, overexcitability, and difficulty relating to
others due to elective mutism. Her patient has schizophrenia, ________ type.
a. hebephrenic
b. residual
c. catatonic
d. autistic
248
10.73
Ans. D
Con
p. 348
M
Which term does not belong with the other three?
a. echopraxia
b. mutism
c. catalepsy
d. autism
10.74
Ans. B
App
p. 349
E
Mira, a patient suffering from Type
schizophrenia which has a rapid onset
and many positive symptoms, has a
prognosis than a person who has
a gradual onset of predominantly negative symptoms.
a. I; worse
b. I; better
c. II; worse
d. II; better
Lodovic is an inpatient on a psychiatric ward. His psychiatrist describes his
psychotic condition as a reactive schizophrenia. This means that Lodovic
a. had poor premorbid adjustment.
b. exhibited symptoms that came on suddenly.
c. has a relatively poor prognosis.
d. had an onset of symptoms at a very young age.
10.75
Ans. B
App
p. 349
M
10.76
Ans. C
App
p. 350
E
Rita, a person with paranoid schizophrenia, and her family are taking part in a
family aggregation study. This means that Rita is the
a. concordance case,
b. linkage case.
c. proband.
d. contraband.
10.77
Ans. C
Fac
p. 350-1
M
Family studies of schizophrenia demonstrate that
a. genetic inheritance is the cause of schizophrenia.
b. if a first-degree relative has schizophrenia, most of the other family members
will develop schizophrenia.
c. there is a strong positive correlation between genetic relatedness and risk of
schizophrenia,
d. the family environment is the cause of schizophrenia.
10.78
Ans. D
App
p. 350-1
C
Kelli, a schizophrenic proband, comes from a very large family. Which
prediction below is most clearly supported by family studies research?
a. Her family members are about six times more likely to be at risk for
schizophrenia than are members of a control family.
b. One of her parents is more likely to have the disorder than one of her
siblings.
c. If Kelli has an MZ twin, that twin has roughly an 85% chance of developing
die disorder.
d. While her first degree relatives are much more likely to be at risk compared
to control families, most of her family will not develop schizophrenia.
249
10.79
Ans. A
Con
p. 350-1
M
You could legitimately criticize several early family studies of schizophrenia for
each of the following flaws EXCEPT
a. inconsistent definitions of "genetic relatedness."
b. varying operational definitions of "schizophrenia."
c. lack of blind interviewers.
d. failure to specify sample selection criteria.
10.80
Ans. B
App
p. 352
E
If you hypothesize that schizophrenia is caused solely by genetic transmission,
you would predict a
percent concordance between DZ twins.
a. 25
b. 50
c. 75
d. 100
10.81
Ans. D
Con
p. 334,52
M
Whose definition of schizophrenia would produce the highest concordance rate?
a. DSM-IV
b. Kraepelin
c. Schneider
d. Bleuler
10.82
Ans. C
App
p. 352
M
Rick and Ryan are monozygotic twins who have a schizophrenic parent. Rick
has developed schizophrenia. Ryan will
a. eventually develop schizophrenia.
b. have some type of debilitating psychological problem.
c. be at a substantially elevated risk for a psychological disorder.
d. not become schizophrenic unless he has a traumatic experience or brain
injury.
10.83
Ans. C
App
p. 352
M
Tatiana has schizophrenia. Cherise, her MZ twin sister, does not. Whose
children are at greatest risk for schizophrenia?
a. Tatiana's
b. Cherise's
c. Both twins' children are at equal risk, which is about 17%.
d. Both twins' children are at equal risk, which is about 42%.
10.84
Ans. D
App
p. 352
E
*
Which pair of individuals has the highest chance of concordant schizophrenia?
a. Bill and Jodie, whose maternal grandparents were both schizophrenic
b. Cammie and Ashton, who are dizygotic twins with a schizophrenic mother
c. Beth and Kristen, who are siblings with a schizophrenic mother
d. Seth and Christopher, who are monozygotic twins with a schizophrenic
mother
10.85
Ans. A
App
p. 352
E
If Dr. Concorde wished to conduct adoption studies of psychotic disorders,
where might he most wish to work?
a. Denmark
b. Argentina
c. China
d. U.S.
250
10.86
Ans. B
App
p. 352
M
Charles was adopted by the Hestons when he was 9 months old. Under which
of the following conditions is he most at risk for developing schizophrenia?
a. One adoptive parent has the disorder; his biological parents do not.
b. One biological parent has the disorder; his adoptive parents do not.
c. One adoptive parent and step sibling have the disorder; neither biological
parent does,
d. Charles' biological and adoptive mothers are both schizophrenogenic.
10.87
Lani's biological mother and her DZ twin sister have both had schizophrenia.
Ans. C Which of the following questions would be LEAST useful in assessing Lani's
App
own risk for the disorder?
p. 352-3
a. What kinds of social support and levels of traumatic stress are present in
M
Lani's life?
*
b. What degree of schizotypy is evident in Lani?
c. Does Lani possess the recessive gene identified as the likely mode of
transmission?
d. Does Lani exhibit dysfunction in smooth-pursuit eye tracking?
10.88
Ans. D
Fac
p. 353
M
The diathesis-stress model of schizophrenia predicts that
a. a defective genetic inheritance will eventually lead to development of
schizophrenia.
b. a low socioeconomic class combined with a stressful job can lead to
schizophrenia.
c. a pair of monozygotic twins reared apart will develop schizophrenia
concomitantly, if they develop it at all.
d. a biological predisposition for schizophrenia can develop into
schizophrenia in the presence of precipitating environmental factors.
10.89
Ans. D
App
p. 353
E
A research participant is completing measures such as The Physical Anhedonia
Scale and the Magical Ideation Scale. What characteristic is being assessed?
a. hebephrenia
b. schizogenia
c. catalepsy
d. schizotypy
10.90
Ans. A
Fac
p. 353-4
M
Which of the following is a FALSE description of the results of the University
of Wisconsin schizotypy study?
a. "Psychosis-prone" subjects were about 8 times as likely to develop
schizophrenia compared to control subjects.
b. Very few of the "psychosis-prone" students or their relatives developed a
psychotic disorder.
c. High scores on the perceptual aberration and magical thinking measures were
most strongly related to risk of later psychosis.
d. The diathesis did not appear to be specific to schizophrenia, contrary to the
trend evident in other studies.
251
10.91
Ans. B
App
p. 354
E
Dr. Rozoni is studying smooth-pursuit eye tracking which may turn out to be a
genetic marker for schizophrenia. Each of the following findings would support
her hypothesis EXCEPT
a. Her subjects with schizophrenia in remission show abnormalities in the task.
b. Abnormalities in the task are found in persons with severe depression.
c. Relatives of schizophrenic patients show abnormalities in the task more often
than do relatives of control subjects.
d. Concordance between MZ twins is greater than that for DZ twins.
10.92
Ans. C
Con
p. 354
M
Based on available data from several studies, which early physical trauma would
you most confidently identify as a risk factor for schizophrenia?
a. season-of-birth effect
b. complications during the birthing process
c. prenatal exposure to viral infection
d. developmental delay due to malnutrition
10.93
Ans. B
Fac
p. 355
E
As first suggested in the 1920s, it has been documented that the brains of some
schizophrenic persons have
a. smaller ventricles than those of normal persons,
b. larger ventricles than those of normal persons.
c. an abnormally low level of dopamine.
d. abnormally increased frontal lobe volume and blood flow.
10.94
Ans. B
App
p. 355
C
You are inspecting the CT scan of a schizophrenic patient. Using this neuroimaging technique, you are most likely to see
a. hypofrontality.
b. enlarged ventricles.
c. abnormal temporal lobe activity.
d. excessive activity at dopaminergic synapses.
10.95
Rebecca has schizophrenia. Diagnostic assessments have indicated that she has
Ans. C hypofrontality, which is associated with each of the following EXCEPT
App
a. decreased frontal lobe volume.
p. 355-6
b. diminished blood flow to the frontal lobe during problem solving.
M
c. predominance of positive symptoms.
*
d. lowered performance on neuropsychological tests.
10.96
Ans. A
Con
p. 356
M
Hypofrontality is most likely to be associated with
a. avolition.
b. delusions.
c. bizarre behavioral excesses.
d. Type I schizophrenia.
10.97
Ans. A
Con
p. 356
M
Auditory hallucinations are to deficits in problem solving as the
a. temporal lobe is to the frontal lobe.
b. frontal lobe is to the thalamus.
c. lateral ventricle is to the frontal lobe.
d. temporal lobe is to the thalamus.
252
10.98
Ans. B
App
p. 356
M
Lambros is exhibiting significantly abnormal activity of the neurons in his left
temporal lobe. You would predict that he is
a. expressing neologisms, word salad, or other disruption in speech,
b. experiencing an auditory hallucination.
c. failing to successfully solve a difficult puzzle,
d. experiencing a visual hallucination.
10.99
Ans. C
App
p. 356
M
An investigator wishes to understand how the brain creates auditory
hallucinations. Which of the following structures currently appears LEAST
promising as a focus for her research?
a. hippocampus
b. temporal lobe
c. hypothalamus
d. thalamus
Dr. Brane is an experimental neurosurgeon who has caused a normal adult to
experience visual hallucinations by re-routing the patient's normal auditory
sensations to the occipital lobe. What brain structure is the most likely target
of Dr. Brane's work?
a. thalamus
b. hippocampus
c. Broca's area
d. basal ganglia
10.100
Ans. A
App
p. 356-7
C
*
10.101
Ans. D
App
p. 357
C
Lozona is a patient who suffers from schizophrenia, and Janet is a nondisordered
person. When Janet hears a person's voice, what area in her brain is probably
LESS active compared to the same area in Lozona's brain during her
hallucination of a person's voice?
a. temporal lobe
b. Wernicke's area
c. frontal lobe
d. limbic structures
10.102
Ans. B
Con
p. 375-8
M
Your roommate has told you that she/he learned in intro psychology that
schizophrenia is caused by abnormalities in the brain, proven by sophisticated
neuroimaging. Which of the following questions is NOT relevant to a critical
analysis of this statement?
a. How old were the subjects in the studies and how long had they received
treatment for the disorder?
b. Did psychologists, psychiatrists, or neuroscientists conduct these studies?
c. Are the abnormalities found in persons with other mental disorders?
d. Do the abnormalities appear consistently among homogeneous subgroups of
persons with the disorder?
253
10.103
Ans. C
Con
p. 358
C
Each of the following examples supports the dopamine hypothesis of
schizophrenia EXCEPT
a. Rita, a nonpsychotic person, develops positive symptoms of schizophrenia
when she takes high doses of an amphetamine.
b. Mellaril, a neuroleptic, reduces the visual hallucinations and delusions of
reference in a schizophrenic patient.
c. Richard, a person with paranoid schizophrenia, shows a reduction in severity
of delusions when given L-dopa.
d. Toni, a person with Type I schizophrenia, shows abnormally elevated levels
of a dopamine metabolite in his cerebrospinal fluid.
10.104
Ans. A
App
p. 358
E
*
In which brain stmcture is Romiko, a schizophrenic person, most likely to show
a deficit of dopamine?
a. frontal lobe
b. temporal lobe
c. amygdala
d. basal ganglia
10.105
Ans. B
Fac
p. 358
E
For which of the following reasons has the dopamine hypothesis been revised?
a. Only about one half of people with schizophrenia improve with neuroleptics.
b. Changes in the neurotransmitters serotonin and norepinephrine have been
reliably associated with schizophrenic symptoms.
c. Dopamine antagonists, which block dopamine receptors, have no effect on
the positive symptoms of schizophrenia,
d. Abnormal levels of corticosteroids have been found to be more closely
associated with Type I symptoms.
10.106
Ans. C
App
p. 359
M
A biological psychologist is recruiting participants for her high risk study of
schizophrenia. This means she want to locate
a. schizophrenic individuals who have been in remission for several months,
b. persons scoring high on schizotypy who live in stressful environments.
c. nondisordered children of a schizophrenic parent.
d. persons scoring exceptionally high on the MMPI's schizophrenia scale.
10.107
Ans. D
Fac
p. 359
M
*
Adults with schizophrenia in Mednick and Schulsinger's study probably
exhibited each of the following characteristics in childhood EXCEPT
a. generalized cortical deficits.
b. difficulty interacting with peers.
c. odd or uncoordinated motor behavior.
d. inconsistent, neglectful treatment by parents.
10.108
Ans. B
App
p. 361
M
As William developed schizophrenia he became unable to fulfill his
responsibilities at work and at home. He eventually lost his job and his
family. William now lives on the streets. This is an example of
a. social causation.
b. social drift.
c. social residue.
d. poor premorbid adjustment.
254
10.109
When the local automobile manufacturing plant closed, many people moved to
Ans. A
other cities and were able to find new jobs. Which explanation accounts for
App the subsequent overrepresentation of persons with schizophrenia in the
p. 361
economically depressed town?
E
a. social residue
b. social flight
c. social drift
d. social causation
10.110
Ans. D
App
p. 362
C
10.111
Ans. C
App
p. 362
E
There are two groups of Raddites living in Atlantis. One group, the Raddites
of Asian heritage, is socially advantaged; and the other, the Raddites of
European heritage, are disadvantaged. According to the social drift explanation
of schizophrenia, which group would show the highest rate of the disorder?
a. European-heritage Raddites who are members of upper socioeconomic
classes
b. European-heritage Raddites who are members of lower socioeconomic
classes
c. Asian-heritage Raddites who are members of upper socioeconomic classes
d. Asian-heritage Raddites who are members of lower socioeconomic classes
Several years ago, a psychiatrist treating Ian for schizophrenia described the
patient's mother as "schizophrenogenic". The psychiatrist believed that the
mother's
caused Ian's disorder.
a. own schizophrenia
b. repetitive, conflicting messages about interpersonal expectations
c. domineering, overprotective, and cold personality
d. high level of expressed emotion
10.112
Ans. A
App
p. 362
M
Dr. Tolman thinks that Sophie's schizophrenia may have developed due to
childhood experience of conditions described by the double-bind theory, such as
a. receiving incompatible messages from parents, like asking for affection then
rejecting attempts at intimacy.
b. having a mother who is overprotective but also cold, rigid, and
uncomfortable with intimacy.
c. prenatal viral exposure compounded by later brain trauma.
d. early life schizotypy and later social awkwardness and rejection.
10.113
Ans. B
App
p. 362-3
E
The double-bind and schizophrenogenic-mother explanations for schizophrenia
a. have been supported by research and are sometimes used in family studies.
b. are no longer taken seriously by most researchers and clinicians.
c. have had little impact on the general public's understanding of schizophrenia.
d. have been replaced with the expressed-emotion explanation as a cause of the
disorder.
255
10.114
Ans. A
Fac
p. 363
M
The term "expressed emotion" as applied to schizophrenia refers to
a. a family's overinvolvement, criticism, and hostility toward a schizophrenic
member.
b. a method used to help schizophrenic patients identify the feelings that are
associated with relapse.
c. a disturbance in emotional expression in which both positive and negative
emotions are grossly exaggerated.
d. a group counseling tool used to assist families of individuals with
schizophrenia.
10.115
Ans. D
App
p. 363
E
Peter was recently released from a psychiatric hospital after being treated for
schizophrenia. His family is rated high on expressed emotion (EE), which
predicts
a. a high level of double-bind messages directed toward Peter.
b. a decreased likelihood that Peter will discontinue his medication.
c. an increased likelihood of Peter's developing a comorbid mood disorder.
d. a significantly increased risk of relapse for Peter.
10.116
Ans. C
Fac
p. 363-4
M
All of the following are true about expressed emotion EXCEPT
a. high expressed emotion reliably predicts relapses of schizophrenia.
b. high expressed emotion has been found to predict relapses of mood
disorders.
c. high expressed emotion is related to the original onset of schizophrenia,
d. high expressed emotion may be brought about by the schizophrenic
individual's own behavior.
*
10.117
Ans. B
App
p. 364
M
Stephanie is a graduate student of Dr. Rosenfarb. When she views the
videotapes of families who are high in EE, Stephanie will typically observe
compared to the interactions within low EE families.
a. fewer unusual behaviors by the patient
b. more genuinely supportive comments to the patient
c. greater physical distancing and little eye contact
d. more frequent double-bind messages
10.118
Ans. A
App
p. 364-5
M
It is 1942. Wayne is a patient being treated for a severe psychosis in a state
mental hospital. Which of the following treatments would NOT have been
used?
a. a phenothiazine
b. psychosurgery
c. long-term isolation
d. electroconvulsive shock
10.119
Ans. C
Fac
p. 365
E
When did the revolutionary change in the biological treatment of schizophrenia
occur?
a. 1890s
b. 1930s
c. 1950s
d. 1970s
256
10.120
Ans. B
Fac
p. 366
M
Which of the following is an incorrect pairing of a generic and brand name
neuroleptic?
a. fluphenazine I Mellaril
b. thioridazine / Haldol
c. chlorpromazine / Thorazine
d. thiothixene / Navane
10.121
Ans. C
App
p. 366
E
Sung Hee is taking Prolixin for treatment of his schizophrenia. Unfortunately,
he is experiencing a side effect in which he feels compelled to keep moving and
is constantly agitated. This is known as
a. Parkinsonism.
b. tardive dyskinesia.
c. acute akathesia.
d. acute dystonia.
10.122
Ans. D
App
p. 366
M
Pablo is taking a phenothiazine for schizophrenia. He is experiencing side
effects including fine tremors in his hands, a slow shuffling gait, and slowness
of movement. Pablo is experiencing
a. acute dystonia.
b. tardive dyskinesia.
c. akathesia.
d. Parkinsonism.
10.123
Ans. B
App
p. 366
M
Henri is suffering from tardive dyskinesia as a result of taking chlorpromazine.
His expected symptoms include
a. feeling constantly restless and agitated, feeling he must keep moving his
limbs.
b. lip smacking; uncontrollable jerks, ticks, and twitches of his face and body.
c. extremely high fever, muscle rigidity, irregular heart rate and blood pressure.
d. fine tremors of his hands, a blank stare, and muscular rigidity.
10.124
Ans. A
App
p. 366
M
*
An emergency room physician has a patient who is suffering from a high fever,
irregular heart beat, and extreme muscle rigidity. If this patient recently began
taking an antipsychotic medication, what condition should the physician suspect?
a. NMS
b. acute phenocytosis
c. TD
d. acute dystonia
10.125
Ans. A
Con
p. 367
E
Which of the following is the most common problem associated with neuroleptic
medication?
a. noncompliance
b. neuroleptic malignant syndrome
c. TD
d. seizures
257
10.126
Ans. C
App
p. 367
M
Bella is taking an "atypical" antipsychotic medication. It differs from standard
medications in each of the following ways EXCEPT
a. It will effectively treat her negative as well as positive symptoms,
b. It will produce fewer extrapyramidal side effects.
c. It will effect the activity of serotonin rather than dopamine,
d. It could produce a life threatening loss of white blood cells.
10.127
Ans. D
App
p. 367
M
Because of a potentially fatal side effect associated with her medication, Claudia
must have regular blood tests. She is taking
a. Haldol,
b. Compazine.
c. Navane.
d. Clozaril.
10.128
Ans. B
App
p. 368
E
If you were working on a psychiatric ward with Dr. Harry Stack Sullivan, which
treatment approach would you advocate for psychotic patients?
a. biological
b. psychoanalytic
c. cognitive-behavioral
d. family therapy
10.129
Ans. B
App
p. 368
M
Anneke is a patient in a state hospital in 1968. In addition to the biological
treatment she is likely to receive, there are several changes occurring in the
treatment of her schizophrenia. Which of the following does NOT belong?
a. increased involvement of her family, especially for psychoeducation
b. increased reliance on individual cognitive therapy to prevent relapse
c. participation in a behavioral milieu therapy program
d. shorter-term hospital stay accompanied by community-based outpatient care
10.130
Ans. C
App
p. 368
M
If a psychology intern is working on a psychiatric ward whose treatment
program is deemed most effective by Gordon Paul and colleagues, what is its
structure?
a. psychoanalytic-based milieu therapy
b. individualized treatment planning and short-term inpatient stay
c. token economy
d. milieu therapy
10.131
Ans. D
App
p. 368
E
Schizophrenic inpatients are provided a structured group setting in which staff
model adaptive behaviors, patients engage in role playing, and social
reinforcement is provided for successful practice. What is the program's most
likely focus?
a. self-management
b. psychosocial rehabilitation
c. psychoeducation
d. social skills training
258
10.132
Ans. B
Con
p. 369
E
10.133
Ans. C
App
p. 364,69
C
In the design of an effective program for the prevention of relapse in
schizophrenic individuals, Falloon et al. and Hogarty et al.'s studies indicate
one should focus primarily on
a. increasing the patient's social skills.
b. decreasing EE.
c. education about biological treatment and possible side effects.
d. family-based token economy systems.
Under which of the following conditions is Manuel most likely to suffer a
relapse of schizophrenia?
a. His family is low in expressed emotion.
b. His family receives family treatment and Manuel receives social skills
training.
c. Manuel and his family receive psychoeducation.
d. Manuel participates in psychosocial rehabilitation.
10.134
Ans. A
Con
p. 370
E
Which of the following treatment approaches essentially encompasses the other
three?
a. psychosocial rehabilitation
b. family therapy
c. self-management training
d. behavioral milieu program
10.135
Ans. B
App
p. 370
E
Lionel Aldridge successfully copes with his schizophrenia in large part due to
community support and the support of friends. This most closely reflects the
guiding philosophy of which psychological therapy?
a. self-management training
b. psychosocial rehabilitation
c. family therapy
d. milieu therapy
10.136
Ans. C
Fac
p. 370
E
What sort of mental health worker is central to the success of psychosocial
rehabilitation programs?
a. a psychiatric nurse
b. a clinical psychologist
c. a case manager
d. a vocational guidance counselor
10.137
Ans. D
App
p. 370
M
As a schizophrenic outpatient, Chandra would include which of the following
in her proactive crisis plan contain?
a. her family's plan of action for decreasing expressed emotion during home
visits
b. a specific plan for dealing with residual psychotic symptoms in the
workplace
c. a step-by-step plan for handling interpersonal conflict
d. a list of the signs that tell her she is relapsing and what to do when they
occur
*
259
10.138
Ans. A
Fac
p. 372
M
How does Dr. Irving Gottesman account for the fact that neither of Lionel
Aldridge's parents had schizophrenia even though the disorder is usually
believed to be genetically influenced?
a. The disorder is polygenetic and dependent on some form of activating
stressor.
b. Prenatal and perinatal birth complications and viruses will probably be
shown to be more important causes of the disorder.
c. Due to changing standards for diagnosing the disorder, his parents were
probably misdiagnosed with other disorders.
d. The disorder is probably caused by a recessive gene that is carried in his
parents' genotype but not expressed in either one's phenotype.
SHORT ANSWER I ESSAY
10.139
Beginning with the first formal description, trace the history of the evolving concept
of schizophrenia, including reference to historical figures, through the middle of the 20th century.
John Haslam, in London, and Philippe Pinel, in Paris, first documented patient symptoms
and behaviors in the early 1800s. Fifty years later, Morel, in Belgium, gathered the constellation
of symptoms underthe label demence precoce. By the 1890s, Kraepelin's observations of thousands
of mental patients led him to propose three specific subtypes of dementia praecox (the Latin version
of Morel's term): hebephrenia, catatonia, and paranoia; he later added the simplex subtype.
Kraepelin believed that each type represented an early onset, progressively deteriorating disease.
Bleuler noted that some patients had a later life onset of symptoms and that some did recover; he
therefore proposed that the focus be turned to the loosening of various mental processes, which he
labeled "schizophrenia" (split mind). He identified four primary symptoms he believed responsible
for the dismption in mental functions (e.g., loose associations), which in mm led to the other
common symptoms of the disorder (e.g., delusions).
These two systems resulted in differing diagnostic practices in Europe (where Kraepelin's
was preferred) and the U.S. (where Bleuler's was preferred) in the early 20th century. By the
1950s, the work of German psychiatrist Schneider resulted in greater consensus regarding "first
rank" symptoms of delusions and hallucinations, but differing diagnostic practices continued.
10.140
Indicate which earlier definition(s) of schizophrenia is/are most clearly retained
in the DSM-IV.
Schneider's influence is preserved in the DSM-IV, where the single symptom of a bizarre
delusion or certain form of hallucination is sufficient to meet Criterion A. Bleuler's more flexible
conceptualizations regarding onset and course of the disorder are also preserved. Moreover,
Kraepelin's four subtypes, with minor alteration, are preserved in DSM-IV, as is the criterion that
the disorder result in a deterioration of day-to-day functioning.
260
10.141
List and briefly define each of the positive symptoms of schizophrenia, and then
give two examples of the types of behaviors included for each symptom.
Delusions: beliefs that are recognized by others in a culture as extreme and obviously
false but are held with entrenched conviction by a psychotic individual; e.g., somatic delusions,
delusions of persecution, control, reference, grandeur.
Hallucinations: sensory perceptions occurring in the absence of external sensory
stimulation treated as real, uncontrollable, and unalterable; e.g., auditory, tactile, visual, gustatory,
olfactory, somatic.
Disordered thought processes: disruptions in the organization, control, process, and
expression of thoughts; e.g., loose associations/derailment, neologisms, perseveration, word salad,
clang associations.
Disorders of behavior: peculiar motor behavior, e.g., catatonia, inappropriate sexual
behavior, facial grimaces, stereotyped gestures.
10.142
List and briefly define each of the negative symptoms of schizophrenia.
♦Anhedonia: inability to enjoy almost anything or to experience pleasure
♦Social withdrawal: (self-explanatory)
Flat affect: disturbance in the expression of emotion — emotionless facial expression,
empty or glazed look in eyes, little vocal tone, listless demeanor
Alogia: impoverished speech or extremely slow or delayed verbal responses
Avolition: extended lack of activity; inability to sustain attention or memory for activities
(*note that students may not include these because they are not specific to the diagnosis)
10.143
Summarize the strategies and primary findings of each of the four types of studies
that link schizophrenia to genetic factors. In what way does linkage analysis differ in its focus from
these approaches?
Family aggregation studies: examine degree of genetic relatedness to a schizophrenic
proband and the associated risk of developing schizophrenia compared to control families matched
for age, education, and other relevant variables. Findings indicate that the majority of the proband's
family members do not exhibit schizophrenia but that there is a strong positive correlation between
the two measures.
Twin studies: examine concordance between MZ twins, who share 100% of their genetic
code, and DZ twins, who share only 50%. Findings generally show about a 50% concordance rate
for MZ twins vs. 17% for DZ.
Adoption studies: examine rates of schizophrenia in adopted children who did or did not
have a biological parent with schizophrenia. Findings indicate that children bom to a schizophrenic
parent are substantially more likely to exhibit the disorder than are the other adopted children.
High-risk studies: prospective studies of children of schizophrenic parents compared to
(low-risk) children of nondisordered parents; findings indicate that the high-risk children are much
more likely to develop a schizophrenic spectrum disorder and that early childhood cortical deficits
are associated with increased risk of schizophrenia in adulthood.
Students may also mention a linkage analysis: an attempt to identify the specific gene
responsible for a disorder by establishing connections between known genetic markers (e.g., eye
color) and traits consistently associated with the disorder.
261
10.144
Describe why biological interventions are insufficient for the effective treatment
of schizophrenia.
Drug treatment does not address difficulties in interpersonal behavior, deficits in coping
skills, or impairments in vocational skills. Attention to these psychosocial factors has been
particularly relevant for individuals who have spent several years in mental institutions
prior to the discovery of the phenothiazines. Treatment for these psychosocial deficits requires the
inclusion of behavioral milieu, self-management, and social skills training interventions. In order
to maintain the gains provided by drug treatment outside the hospital, community networks are also
needed to reinforce medication compliance (with medication often discontinued due to unpleasant
side effects) and to provide a structured, supportive environment for the practice of those
interpersonal and occupational skills with the goal of more independent living.
While psychosocial factors are not reliably implicated as causal factors in the disorder,
some are strongly related to risk of relapse, even in cases of medication compliance.
Psychoeducational programs as well as problem-solving and communication skills training are
important components in the reduction of expressed emotion, a constellation of negative interaction
patterns reliably associated with relapse.
10.145
Drawing from Falloon et al. (1985) and Hogarty et al.'s (1986) investigations of
family therapy for schizophrenia, describe the factors that appear to be critical for the success of
this method in the prevention of relapse.
Psychoeducation for family members regarding the causes and symptoms of the disorder,
in large part to reduce feelings of guilt and blame;
Structured training in communication, particularly to decrease expressed emotion
(criticalness, overinvolvement, hostility);
Structured training in problem solving, including social skills training for the schizophrenic
member and family focus on rewards for appropriate behaviors.
In general, attention to the bidirectional, interactive effects of patient behavior and the
family environment is needed, rather than exclusive focus on one or the other.
10.146
List the components that could be a part of a successful psychosocial rehabilitation
program, and give one example of what each might involve.
Family therapy (psychoeducation; problem-solving; decreased EE), social skills training
(dealing with hostility; interpersonal work-related skills), assistance with basic living needs
(housing, transportation, medical services), self-management skills (shopping, cooking), peer support
groups (opportunities for modeling, recreation), development of plans to avoid or cope with crises
(safe houses, proactive crisis plan), and vocational rehabilitation (occupational education and
transitional employment.
262
Chapter 11 COGNITIVE DISORDERS
11.1
Ans. A
App
p. 378
E
Thomas is suffering from a cognitive disorder. Which characteristic does NOT
apply to this situation?
a. He must be at least 60 years of age.
b. The course and severity of his disorder may be affected by cultural factors.
c. He has impairment in memory, language, consciousness, perception, or
intelligence,
d. The disorder is caused by a biological change in Thomas' brain.
11.2
Ans. B
App
p. 378
E
An aneurysm (a broken blood vessel) in Morgan's brain has caused impairment
in his language abilities. What sort of brain injury does this reflect?
a. diffuse
b. focal
c. anterograde
d. retrograde
11.3
Ans. C
App
p. 379
M
If Klaus has suffered a stroke in his temporal lobe, each of the following
cognitive processes may be disrupted EXCEPT
a. language comprehension,
b. perception.
c. sensations of touch and temperature,
d. memory.
11.4
Ans. D
App
p. 379
M
Dagmar has an amnestic disorder. Which of the following brain structures is
LEAST likely to be involved in her disorder?
a. hippocampus
b. temporal lobe
c. amygdala
d. hypothalamus
11.5
Ans. A
Con
p. 379
M
Which of the following statements is NOT ageist?
a. "Older people exhibit short-term memory deficits due to distractibility."
b. "People in their 80's aren't capable of physically enjoying sex anymore."
c. "Residents of nursing homes don't need intellectual stimulation; they need
peace and quiet."
d. "Everybody develops some form of dementia if they live long enough."
11.6
Ans. B
App
p. 379
E
Some of the neighborhood children like to tease Joseph, an older widower who
stays at home and keeps to himself most of the time. They often vandalize his
house and joke about his "dodderly" ways. According to your text, what is the
name for the behavior these children are exhibiting?
a. elder abuse
b. ageism
c. misogyny
d. intergenerational hostility
*
263
11.7
Ans. D
Fac
p. 379
E
Which older age group represents the fastest growing segment of the U.S.
population?
a. 55 - 65
b. 65 - 75
c. 75-85
d. 85+
11.8
Ans. B
App
p. 380
E
Moira is 74 years old. If she is like most other older adults, she will describe
herself as
a. forgetful and easily confused,
b. satisfied with her life.
c. unhappy and lonely.
d. preoccupied with health concerns.
11.9
Ans. C
App
p. 380
E
Terrance is going strong at age 76. Which factor below is LEAST likely to be
related to his successful aging?
a. commitment to his spiritual beliefs and practices
b. engaging in a daily physical routine of walking and aerobic exercise
c. the level of income in his previous career
d. attending occasional college courses for fun and interaction with others
11.10
Ans. C
App
p. 380
M
*
Given the normal declines associated with aging, what is MOST likely to
happen to Picard by the time he reaches 70 years of age?
a. a moderate decrease in satisfaction, happiness, and quality of life
b. decreases in memory, creativity, and daily analytical skills
c. decreases in muscular, sensory, and metabolic functions
d. increased difficulty in problem solving and rational decision making
11.11
Ans. D
App
p. 380
M
Thomas is an elderly man who takes medication for a heart problem. His 75year-old wife, Ruth, is also taking medication for arthritis and hypertension.
Based on Lamy's (1985) work, which statement below is probably NOT true
about Thomas and his wife?
a. They may receive prescriptions for their medications from more than one
physician.
b. They may make serious errors in the way they take their medications.
c. They may take medication prescribed for friends or family.
d. They will be less vulnerable to overdosing due to their slower rate of brain
activity.
11.12
Ans. C
App
p. 381
M
Anna Belle is in her late eighties and has been an artist all of her life. She
used to perform on Broadway and has written several stage plays and short
stories. She retired from public life at age 75 and has taken up painting and
sculpture. What has happened to Anna Belle's creativity in the past 10 years?
a. Her creativity has probably decreased.
b. Her creativity is probably at a level similar to what it was in her
professional career.
c. Her creativity has probably increased.
d. Like most traits in older age, individual differences are so wide that no
consistent prediction could be made for Anna Belle.
264
11.13
Ans. A
App
p. 381
M
Gwenneth is 72 years old. She feels she is losing her memory and often
complains about it to a caseworker who regularly visits her. If the caseworker
asks the psychologist to test Gwenneth's memory, what outcome is most likely?
a. Gwenneth has normal memory function.
b. Gwenneth has impaired long-term memory but average short-term memory.
c. Gwenneth, as she expected, has substantially below average memory
function.
d. Gwenneth refuses to be tested because her complaints are primarily a
means of seeking attention.
11.14
Ans. B
App
p. 381
M
Muriel has been diagnosed with a form of dementia. In editions of the DSM
prior to the current version, under what classification would her disorder fit?
a. cognitive disorders
b. organic mental disorders
c. psychophysiological disorders
d. mental disorders due to a general medical condition
11.15
Ans. A
Fac
p. 381
E
Because scientists no longer accept the artificial distinction between mind and
body, you will not find the category of
in the
.
a. organic mental disorders; DSM-IV
b. mental disorders due to a general medical condition; DSM-IV
c. organic mental disorders; ICD-10
d. Both a and c are correct.
11.16
Ans. D
App
p. 382
E
Due Tho is suffering from long-term memory loss but has no other serious
cognitive symptoms. What type of disorder does he have?
a. dementia
b. derangement
c. delirium
d. amnestic disorder
11.17
Ans. A
App
p. 382
E
*
When Cora refers to her hospitalized grandfather as "senile," she is most
likely referring to which disorder?
a. dementia
b. amnestic disorder
c. late life schizophrenia
d. delirium
11.18
Ans. A
App
p. 382
M
Mr. Sato is suffering from an inability to carry out certain motor activities, yet
he has perfectly normal motor faculties, e.g., intact muscles and bones. What is
the name for this condition?
a. apraxia
b. agnosia
c. aphasia
d. anomia
265
11.19
Ans. B
App
p. 382
M
In his advanced stage of Alzheimer's disease, Tiko can no longer recognize his
closest friends even though his visual abilities are still intact. What is the
name for this deficit?
a. akathesia
b. agnosia
c. aphasia
d. apraxia
11.20
Ans. B
App
p. 383
M
Mr. Sawyer has a long history of alcohol abuse. Today, while he knows who
he is, he believes the year to be 1969 and that he is living in an apartment,
oblivious to the fact it is 1992 and he is a long-term patient in a state hospital,
He otherwise expresses no oddities of behavior or perception. What disorder
might this be?
a. retrograde amnesia
b. anterograde amnesia
c. delirium
d. retrograde dementia
11.21
Ans. D
App
p. 383
M
*
Barika was in an automobile accident and suffered head trauma. She can
remember events that happened a few months ago and in the days before the
accident, but she has no memory of anything that has happened since the
accident. Her memory seems to be "frozen" at a certain point in time. What is
Barika's disorder?
a. aphasia
b. perseveration
c. retrograde amnesia
d. anterograde amnesia
Mokando has amnesia but is unaware of it. When asked what was happening
the previous morning, Mokando says he was at home eating breakfast. He
elaborates,describing what he ate and what he was planning for the day as he
ate. In fact, Mokando has been in the hospital for the past week and was in
surgery the previous morning. What term that best describes his behavior?
a. anterograde amnesia
b. agnosia
c. confabulation
d. factitiousness
11.22
Ans. C
App
p. 383
M
11.23
Ans. A
App
p. 383
E
Dr. Delira suspects that her client may be malingering and may not actually
have a true amnestic disorder despite reports of severe memory impairment.
She might consider each of the following to help her make the distinction
EXCEPT
a. performance on the Mini-Mental Status Exam.
b. inconsistent performance on systematic memory assessment.
c. presence or absence of a supporting medical condition.
d. presence of financial gain to the client as a result of the diagnosis.
266
11.24
Tran! !ruk is from a tiny, previously unknown tribe in Africa. Tran! !ruk has
Ans. C
been in a serious accident involving head trauma, and some Western-trained
App medics are assessing the possibility of brain damage. They ask her a series
p. 383
of test questions, e.g., what day she was bom, and she answers very few
M
correctly. What disorder does Tran! !ruk probably have?
a. amnesia
b. delirium
c. It is uncertain, since cultural factors may account for poor test performance.
d. It is uncertain, since Western medicine deals with cognitive disorders that
occur primarily in individuals from Western societies.
11.25
Ans. B
Fac
p. 383-4
M
11.26
Ans. C
Con
p. 383
M
Why do some cases of delirium and amnestic disorders go undocumented?
a. Many hospitals have no procedures for dealing with these disorders, so they
are
labeled as something else and treated accordingly.
b. The disorder may be of short duration and may go untreated, or may
develop so slowly as to be unnoticed.
c. Many people with these disorders suffer them as a result of illegal activity
and are incarcerated instead of being treated by doctors.
d. The number of cases that go undocumented is actually quite small since
concerned family members usually bring these individuals in for treatment.
Altered consciousness is to pure memory loss as
a. dementia is to amnestic disorder.
b. delirium is to dementia.
c. delirium is to amnestic disorder.
d. amnestic disorder is to delirium.
*
11.27
Ans. C
App
p. 384
M
Juanita has just undergone surgery following a heart attack. When she awoke
and saw her husband sitting next to the bed, she believed he was a demon who
had come to take her soul away, and she panicked, becoming violent. What
might this reaction be called?
a. hyperstartle illusion
b. agnosia
c. Capgras syndrome
d. Lewy delusion
11.28
Ans. D
App
p. 384
C
*
Jacques is uncertain of the day or time, gives the same repetitive answer to
questions, is very restless at night, and swings rapidly from despondence to
euphoria. Which of the following would NOT apply to Jacques'condition?
a. There is an increased risk of death due to interference with treatment for
the underlying cause of his disorder.
b. Restoration of Jacques' normal sleep-wake cycle is a favorable prognostic
indicator.
c. He is likely to experience a complete recovery once the underlying cause is
treated.
d. A biologically based treatment for the symptoms is the preferred method of
intervention.
267
11.29
Ans. A
App
p. 385
M
Mr. Gromiko, a registered nurse, worked on the geriatric unit of a regional
hospital that specialized in open-heart surgeries. Of the 100 patients he cared
for in the last six months, how many probably experienced postoperative
delirium of some kind?
a. 80
b. 65
c. 50
d. 36
11.30
Ans. B
App
p. 385
M
Tamara has been taking several medications for a chronic illness. As a result
of drug interactions, her sodium level is abnormal and her kidney function is
impaired. What cognitive disorder is most likely in these circumstances?
a. vascular dementia
b. delirium
c. amnestic disorder
d. Pick's disease
11.31
Ans. C
Con
p. 384-5
M
Which of the following descriptions does not belong with the other three?
a. rapid onset
b. altered consciousness
c. typically irreversible
d. very young and old most susceptible
11.32
Ans. D
App
p. 385
M
Ms. Gallego is an intake worker who is responsible for initial assessment of
new patients. If she suspects a delirium disorder, she should rely on each of
the following EXCEPT
a. a brief visit to the patient's home to assess its condition.
b. an informant interview.
c. MMSE.
d. EEG recordings showing bursts of fast activity.
11.33
Ans. A
App
p. 385
E
Dr. Gordeeva is asking Treya to count out loud by 7s, repeat a simple phrase,
write a sensible sentence, and copy a fairly simple design. What is taking
place?
a. a Mini-Mental Status Examination
b. a Delirium Diagnostic Schedule Interview
c. a Cognitive Orientation Test
d. an Organic Impairment Examination
11.34
Ans. B
Fac
p. 385
E
What simple "bedside" tool might a clinician use to track a patient's delirium?
a. draw a person test
b. draw a clock test
c. MMSE
d. orientation to person, place, and time
11.35
Ans. C
Con
p. 387
E
In regard to the number of medical conditions that could cause a cognitive
disorder, those conditions are most numerous for
a. dementia.
b. amnestic disorder.
c. delirium.
d. Alzheimer's.
*
268
11.36
Ans. D
App
p. 387
C
*
Mrs. McDougal is a 68-year-old woman suffering from delirium. Which of
the following represents a common cause of her disorder?
a. a nutritional deficiency
b. an adverse reaction to an antidepressant
c. exposure to a toxin combined with a recent stressful life event
d. pneumonia combined with medication-induced side effects
11.37
Ans. A
App
p. 387-8
M
Which of the following would you want to find in the room of a delirium
patient?
a. family members and friends
b. a pattern of "looping" in patient-staff interactions
c. frequent use of physical restraints
d. low level lighting to promote calmness
11.38
Ans. B
App
p. 387-8
C
If you could "prescribe" clinically responsive behaviors on the part of primary
care physicians treating delirium, you would advise all of the following
EXCEPT
a. respect for the patient's possessions and privacy.
b. safe observation in an intensive care unit.
c. the lowest and shortest-term doses of medication possible.
d. inclusion of the patient's family members and friends in treatment.
11.39
Ans. C
App
p. 388
E
Sergei is upset by unpredictable, invasive physical examinations. He is
increasingly agitated with nurses, who in turn are more likely to use physical
restraints
for those examinations. This pattern is called
a. synchronicity.
b. treatment escalation.
c. looping.
d. sundowning.
11.40
Ans. D
Con
p. 388
M
What is the difference between dementia and delirium?
a. They differ only in severity of symptoms.
b. Dementia occurs only in adults older than 65; delirium typically occurs
between ages 55 and 75.
c. Dementia is typically caused by conditions that are reversible, while
delirium is more often associated with conditions that persist and may
worsen,
d. Dementia involves the overall, often chronic loss of many cognitive
functions, while delirium is a relatively transient alteration in consciousness.
11.41
Ans. A
App
p. 388
M
*
Rudy has been diagnosed with a dementia. Like many persons with this type
of disorder, which of the following was NOT one of his early symptoms?
a. memory impairment
b. personality change
c. vague, imprecise speech
d. social withdrawal and impaired judgment
269
11.42
Ans. C
App
p. 388
E
Sheree is suffering from dementia. She will repeat what has just been said by
others, but will say nothing of her own. What is this called?
a. repetitive speech
b. Capgras syndrome
c. echolalia
d. confabulation
11.43
Ans. D
Fac
p. 388
E
About what percentage of the world population is affected by dementia at age
65 or older?
a. 25
b. 16
c. 10
d. 5
11.44
Ans. C
Fac
p. 389
M
Which statement below does NOT describe a way to differentiate between
depression and dementia?
a. Persons with dementia often appear unaware of their symptoms whereas
people with depression often communicate strong distress.
b. Stimulant medications lead to reduced confusion and withdrawal in persons
with depression, but increase those characteristics in persons with dementia.
c. Dementia is more likely to begin suddenly and progress more rapidly than
depression.
d. Symptoms of depression are usually worse in the morning while symptoms
of dementia usually increase as the day goes on.
11.45
Ans. D
App
p. 389
C
*
Ott is exhibiting confusion, poor judgment, and increased apathy. If he is
distressed by these symptoms, is usually more disturbed in the morning, and
responds well to stimulant medication, what diagnosis might you suspect?
a. vascular dementia
b. Alzheimer's disease
c. delirium
d. depression
11.46
Ans. A
Fac
p. 389
M
Which description below does NOT represent an aspect of the relationship
between depression and dementia?
a. Both are marked by steadily worsening performance on psychological tests
as tasks become more challenging.
b. Dementia patients can develop depression in reaction to the early stages of
their disorder.
c. The two disorders can be difficult to distinguish when dementia is in an
early stage.
d. The alterations in the brain in early stages of dementia may directly cause
depression.
11.47
Ans. B
App
p. 389
E
Which of the following persons is at greatest risk of developing dementia?
a. Renny, a European American male
b. Malcolm, an African American male
c. Amelia, a European American female
d. Kwaan, an Asian American female
*
270
11.48
Ans. C
App
p. 389
E
Mohammed, an African American male, is at an increased risk for developing
some form of dementia. Which factor is not hypothesized to contribute to this
risk?
a. poverty
b. completion of fewer years of formal education
c. greater genetic vulnerability to vascular illness
d. inferior health care
11.49
Ans. D
Fac
p. 389
E
The two most common causes of dementia are
a. environmental toxins and Alzheimer's disease.
b. drug abuse and cardiovascular disease.
c. head injury and hereditary diseases.
d. Alzheimer's disease and cardiovascular disease.
11.50
Ans. A
App
p. 390
M
*
Philippe's dementia is marked by a sudden onset, step-wise progression of
impairment, with occasional periods of delirium, but little alteration in his
personality. Which form is most likely in this case?
a. vascular dementia
b. Pick's dementia
c. dementia due to Parkinson's disease
d. Alzheimer's disease
11.51
Ans. B
App
p. 390
M
Alejandro, a 45-year-old male, has a disorder marked by extremely uninhibited
and tactless interactions with others, alteration in personality, and evidence of
frontal lobe atrophy. What is the most likely diagnosis for Alejandro?
a. early-onset Alzheimer's
b. Pick's disease
c. Huntington's disease
d. Lewy body dementia
11.52
Ans. D
App
p. 390
C
Which description of Jacques, a victim of the second most common form of
dementia, is INCORRECT?
a. His life expectancy is substantially shorter than that for someone suffering
the most common form of dementia.
b. Had he engaged in active efforts toward prevention, Jacques might have
reduced his risk for this dementia.
c. His symptoms probably appeared rather suddenly and exhibited a patchy,
unpredictable pattern of impairment.
d. His personality will probably undergo significant alteration due to cortical
brain atrophy.
11.53
Ans. A
Con
p. 390
E
Which form of dementia is currently most preventable?
a. vascular dementia
b. the form due to Parkinson's disease
c. Alzheimer's
d. Pick's disease
271
11.54
Henrietta's disorder is remarkable due to its early-occurring hallucinations,
Ans. B
paranoia, increasing immobility, and her occasional periods of clear thought
App processes. Which form of dementia is most likely?
p. 391
a. Pick's disease
M
b. Lewy body dementia
c. Parkinson's disease
d. vascular dementia
11.55
Ans. D
App
p. 391
M
Antonio has developed a neurological disorder. He first developed a tremor in
his hands, which later expanded into several other motor problems, including
slow and effortful movement and a stiff gait. What is Antonio's disorder?
a. Huntington's chorea
b. Pick's disease
c. Tourette's syndrome
d. Parkinson's disease
11.56
Ans. B
App
p. 391
M
Allison has Parkinson's disease. Which development is LEAST likely to be
observed in her case?
a. Lewy bodies
b. disinhibition and flamboyance
c. memory loss and depression
d. muscular rigidity and slow movements
11.57
Ans. A
App
p. 392
E
A neurologist is treating a dementia that has developed subsequent to severe
motor disturbances. Both impairments have been cause by a specific genetic
disruption on chromosome 4. What is the disorder?
a. Huntington's disease
b. Down's syndrome
c. Parkinson's disease
d. Lewy body dementia
11.58
Ans. C
Con
p. 392
M
If it were possible to "catch" a dementia as one might catch a virus, which
disease would one have?
a. Alzheimer's
b. Pick's disease
c. Creut2feldt-Jakob disease
d. cardiovascular disease
11.59
Ans. C
Con
p. 392
M
Which form of brain pathology and dementia are incorrectly matched?
a. neurofibrillary tangles : Alzheimer's disease
b. ballooned neurons in the frontal lobe : Pick's disease
c. neuritic plaques : Huntington's disease
d. abnormal protein deposits : Lewy body dementia
*
*
11.60
Ans. D
Fac
p. 392
E
What infectious disease has at one time been the most common cause of
dementia?
a. HIV/AIDS
b. pneumonia
c. herpes simplex II
d. syphilis
272
11.61
Ans. B
App
p. 393
E
Gary is 70 years old and Fred is 75. What is the chance that Fred will get
Alzheimer's disease compared to the chance Gary will get it?
a. the same
b. double
c. triple
d. quadruple
11.62
Ans. C
App
p. 393
M
*
It's the year 2010. Older adults comprise one-quarter of the U.S. population.
As a health practitioner, you have witnessed a health crisis of dramatic
proportions bankmpting many health care plans and families with ill members,
What disease is most likely to account for this situation?
a. cardiovascular disease
b. delirium disorders
c. Alzheimer's disease
d. Parkinson's disease
11.63
Ans. D
App
p. 393
E
Some studies suggest that Carla is at greater risk for Alzheimer's than is her
dizyogtic twin, Jose. What would these studies implicate as a cause?
a. Carla's longer life expectancy
b. Carla's decision not to have children, resulting in the loss of protective
factors believed to be linked to pregnancy
c. Carla's lack of a stimulating, professional career to maintain mental
alertness
d. Carla's loss of estrogen following menopause
11.64
Ans. C
App
p. 394
M
Mr. Rogers is in the early stage of Alzheimer's disease. While it is difficult to
predict his life expectancy at this point, if he lives an average length of time
after the onset of symptoms, this will be
a. 2 - 6 years.
b. 5 - 9 years.
c. 8-12 years.
d. 10 - 15 years.
11.65
Ans. A
App evident
p. 394
M
Mr. Reagan's brain is being studied at autopsy, following his death from
complications due to Alzheimer's disease. Neural and synaptic loss will be
in each of the following areas EXCEPT
a. primary motor cortex in the frontal lobe.
b. association cortex of the frontal lobe.
c. hippocampus.
d. limbic cortex.
11.66
Ans. B
App
p. 394
E
When a neurologist inspects the brain of someone who died of Alzheimer's
disease, what is he most likely to find?
a. Pick bodies
b. neurofibrillary tangles and neuritic plaques
c. abnormally high numbers of acetylcholine receptors
d. atrophied parietal and occipital lobes
273
11.67
Ans. C
Fac
p. 394
M
How is a definitive diagnosis of Alzheimer's accomplished?
a. through PET and MRI scans
b. through neuropsychological testing and repeated behavioral observation
c. discovery of characteristic brain pathology at autopsy
d. Any of me above can be used with equal utility.
11.68
Ans. D
App
p. 394
M
Mr. Takamoto is a victim of the most common form of dementia in the U.S.
What substance is believed to be responsible for killing the cells in his brain?
a. apolipoprotein E
b. amyloid precursor protein
c. monoamine oxidase B
d. beta-amyloid-4
11.69
Ans. A
Con
p. 395
M
Which of the following items does not belong with the other three?
a. ApoE
b. Down syndrome
c. amyloid plaques
d. chromosome 21
11.70
Ans. C
App
p. 395
M
Gorgi has a type of early-onset Alzheimer's marked by large numbers of
amyloid plaques. One could suspect that a mutation of chromosome
caused these dead areas to form in the brain.
a. 1
b. 14
c. 21
d. 24
*
11.71
Ans. D
Fac
p. 395
M
A person with which of the following genetic patterns is at highest risk for
Alzheimer's?
a. two copies of the ApoE-2 gene
b. one copy of the ApoE-3 gene
c. one copy of the ApoE-4 gene
d. two copies of the ApoE-4 gene
11.72
Ans. A
App
p. 395
M
Robin has two copies of a gene on chromosome 19 that produces a protein
which transports cholesterol in the blood. If this gene is ApoE-4, how likely is
it that she will develop Alzheimer's?
a. 90% chance
b. 50% chance
c. 20% chance
d. Actually this gene may protect her against the disease.
*
11.73
Ans. B
Fac
p. 395
M
In addition to chromosomes 19 and 21, which other chromosomes, with their
abnormal genetic coding of proteins, are implicated in early-onset Alzheimer's?
a. 2, 3, and 4
b. 1 and 14
c. 2 and 25
d. 8 and 22
274
.74
Ans. C
App
p. 395-6
C
Janet has the ApoE-4 gene. She is middle aged and shows no signs of having
Alzheimer's disease. If she were given the appropriate tests, what would
physicians likely find?
a. nothing unusual, since this gene is the normal one that most people have
b. increased blood flow and glucose metabolism in her temporal lobes when
compared to a relative without the gene
c. decreased blood flow and glucose metabolism in her parietal lobes when
compared to a relative without the gene
d. decreased brain volume and activity in her frontal lobes when compared to
a relative without the gene
11.75
Ans. B
Con
p. 396
M
*
In your argument that dementias are discontinuous with normal aging, which
of the following disorders would offer the least consistent evidence?
a. alcohol-related dementia
b. Alzheimer's
c. Huntington's disease
d. vascular dementia
11.76
Ans. C
Con
p. 396
C
Which piece of evidence in regard to aging does not belong with the other
three?
a. evidence for hippocampal dendritic growth in nondemented elderly
b. decline or stabilization of Alzheimer's disease after 100 years of age
c. brain pathology supportive of an Alzheimer's diagnosis in a cognitively
normal individual
d. decline in the percentage of neurofibrillary tangles after age 100
11.77
Ans. D
App
p. 397
M
If you endorse the reserve capacity/threshold model of aging and dementia,
which of the following persons is probably at greatest risk of dementia?
a. a 77-year-old male with a college degree and a history of minor adult
health problems
b. a 55-year-old female with a doctorate in economics and a past history of
alcohol abuse for three years
c. a 62-year-old male with a high school education and a history of high
blood pressure
d. a 73-year-old female with a high school education and a history of poor
health and malnutrition as a child
11.78
Ans. A
Fac
p. 397
E
Genetic defects, lack of education, and early deprivation of mental stimulation
are all hypothesized to lessen
, which sets a presumed threshold
between normal aging processes and dementia.
a. reserve brain capacity
b. synaptic growth potential
c. resistance to infectious disease
d. life expectancy
What kinds of studies described in the chapter provide the clear evidence of
genetic transmission of Alzheimer's?
a. twin studies
b. adoption studies
c. high-risk studies
d. family studies
*
11.79
Ans. D
Con
p. 396-7
E
275
11.80
Ans. B
App
p. 397
E
Evander is a retired boxer. What condition might he have as a result of his
former line of work?
a. Pick's disease
b. Dementia pugilistica
c. Ali's syndrome
d. Dementia paracista
11.81
Ans. A
App
p. 397-8
M
Which of the following persons is hypothesized to be at greatest risk of
developing Alzheimer's disease?
a. Pele, a professional soccer player
b. Dennis, a professional basketball player
c. Tiger, a professional golf player
d. Joe, a professional football player (quarterback)
11.82
Ans. B
App
p. 398
C
Winifred has been on a dialysis machine for an extended time due to kidney
failure, and now she is developing dementia. Which statement below is the
most defensible, based on available data?
a. Winifred's dementia is transient and will subside away after she is taken off
the machine.
b. Winifred probably has elevated levels of aluminum in her brain.
c. Winifred's dementia is most likely caused by the high level of aluminum in
her brain.
d. Winifred's dementia caused abnormal levels of aluminum to be deposited in
her brain.
11.83
Ans. C
App
p. 398
M
Mr. Jetson has had a very dilute solution of tropicamide placed in his eyes. If
his pupils dilate, this suggests that the neurotransmitter
may be
deficient in his brain.
a. norepinephrine
b. serotonin
c. acetylcholine
d. dopamine
Suppose a person unknowingly consumes substances that severely disrupt her
motor movements, physiological arousal, and memory functioning. What
neurotransmitter has probably been affected?
a. dopamine
b. amyloid
c. serotonin
d. acetylcholine
11.84
Ans. D
App
p. 398
M
*
11.85
Ans. D
Fac
p. 398
M
What is the significance of the drug tropicamide in relation to Alzheimer's
disease?
a. It enhances blood flow and energy metabolism in the brain.
b. It reduces the behavioral dysfunction common in Alzheimer's disease.
c. It inhibits destruction of dopamine and norepinephrine in the brain.
d. It may be used in a noninvasive test for early detection of the disorder.
276
11.86
Ans. A
App
p. 399
M
Kayla completed only the third grade in school. It has been proposed that she
has an elevated risk of developing Alzheimer's disease for each of the
following reasons EXCEPT
a. insufficient development of receptors sensitive to dopamine
b. a possibly poor level of health care
c. probable lower levels of mental activity in her early life
d. increased risk of illnesses and physical trauma related to the disorder
11.87
Ans. B
App
p. 399
M
Barry has Alzheimer's disease and is currently taking a FDA-approved drug
which slows the breakdown of a certain neurotransmitter that is linked to
Alzheimer's disease. Which statement below is false, based on information in
your text?
a. ACh is the neurotransmitter affected by the drag.
b. The drag is probably deprenyl.
c. If the drag is stopped, cognitive gains will probably be lost.
d. The drug will be useful if Barry's disease is of mild or moderate severity
but not if he is in the late stages of the disease.
11.88
Ans. C
App
p. 399
E
Cocheta is taking a medication for dementia which promotes synapse formation
and improves her mood and cognitive functioning. What is she probably
taking?
a. deprenyl
b. vitamin E
c. estrogen
d. nimodipine
11.89
Ans. D
Fac
p. 399,401
M
Which of the following proposed treatments for Alzheimer's and their physical
action in the brain are incorrectly paired?
a. vitamin E : inactivates oxygen free radicals
b. prednisone : reduces inflammatory response
c. propentofylline : increases blood flow & metabolism
d. nimodipine : inhibits monoamine oxidase B
11.90
Ans. B
App
p. 401
E
Konane has a tendency to become agitated and wander aimlessly at night,
causing worry and substantial sleep disruption for his caregivers. This behavior
is known as
a. nightwalking.
b. sundowning.
c. Nocturmts endocarsis.
d. dementia-induced insomnia.
If you were caring for a relative with Alzheimer's, which of the following would
NOT be an effective means for managing day-to-day interactions?
a. providing your relative several choices to bolster mental alertness
b. placing written reminders and lists in strategic places in the home
c. creating and maintaining a familiar daily routine and schedule
d. finding a support group for yourself and taking time for your own needs
11.91
Ans. A
App
p. 401-2
M
277
11.92
Ans. A
Fac
p. 402
E
In the so-called "Nun Study," which variable was most clearly associated with
differences in mortality and independent living skills?
a. education
b. diet and health care
c. exposure to toxins
d. use of tobacco and alcohol
11.93
Ans. C
App
p. 402-3
M
If Lucia were one of the nuns, in the "Nun Study" by Snowdon et al. (1989),
who died of Alzheimer's disease, which of the following characteristics would
apply to her compared to the nuns who died from other causes?
a. higher levels of cardiovascular disease
b. lower educational attainment
c. lower idea density in essays written more than 50 years earlier
d. more frequent illnesses and metabolic dysfunction
SHORT ANSWER / ESSAY
11.94
Suppose it were the year 2057 and you are now considered elderly. What aspects
of the normal process of aging will you probably be experiencing?
Generally satisfied with life
Decreases in the following: body flexibility; muscular strength and speed; acuity of hearing,
vision, taste, and smell; vestibular sense/balance; respiratory, cardiac, liver, and kidney functions
Slower metabolism of drugs, leading to greater chance of toxic response and associated need
for lower dosages; increased likelihood of incorrect medication use that could increase chances of
developing symptoms of a cognitive disorder
Slight decline in IQ although this is difficult to predict with accuracy; creativity could
increase; less accurate performance on tasks requiring motor speed, fine motor coordination, or rapid
information processing
Short-term memory possibly slightly impaired, but offset by minimizing distractions;
probably intact long-term memory
Some normal development of neurofibrillary tangles or senile plaques, with increasing risk
of dementia with increasing age (but not an inevitable outcome); risk of dementia possibly reduced
due partly to enhanced brain reserve capacity as a result of college education
11.95
Describe the ideal environment for the treatment of a patient with delirium.
Minimized use of medications, including antipsychotics and sedatives; discontinued use of
medications as soon as feasible
Inclusion of family and friends, along with psychoeducational intervention for the patient
and significant others about the causes and course of the disorder
Avoidance of physical restraints
Well-lit, low-tech room filled with familiar items from home, including a clock and calendar
to aid in orientation
Avoidance of the pattern of looping (demeaning or insensitive treatment provoking hostile
responses which, in mm, provoke more humiliating treatment) by provision of privacy, respect for
possessions, and attempts to actively engage patient in treatment decisions and procedures
278
11.96
Why is advanced age a risk factor for delirium?
Several factors associated with aging contribute to the risk for dementia. Among them are
abnormal sodium levels, severe and/or chronic illnesses, brain disease, fever or hypothermia,
impaired kidney function, changes in living circumstances, impaired vision or hearing, and
increased use of prescription drugs.
11.97
Describe the typical development of dementia and the characteristics of its early,
middle, and later stages.
Early stages of dementia are often marked by changes in personality such as increasing
social isolation and withdrawal, apathy, confusion, and angry outbursts. Speech may become vague,
and individuals may have trouble finding the right words to use. Memory impairment may even
be absent at this stage. Symptoms of depression may be present, and it can be difficult to
determine whether a mood or cognitive disorder accounts for early symptoms.
Certain types of dementia are characterized by other disorder-specific changes as well: the
tremors of Parkinson's disease, the increasing disinhibition of Pick's disease, the gross motor
disruption of Huntington's disease, or the hallucinations and accompanying paranoia of Lewy body
dementia.
Middle stages of dementia are characterized by increasing language and cognitive
degeneration, with more obvious memory impairment. Problems with comprehension and
perception (including hallucinations) become prominent, and increased disturbances in executive
functioning are evident. Individuals in this period have great difficulty learning new information.
Later stages of dementia are characterized by severely impoverished language (i.e., aphasia),
including the possibility of echolalia, and marked cognitive degeneration and memory loss to the
point of agnosia toward close family members and common objects. This very advanced stage of
Alzheimer's, for instance, is marked by immobility (apraxia), inability to engage in basic self-care
skills, and an eventual state of catatonia and complete unresponsiveness.
11.98
Mr. Washington is a 78-year-old patient on a geropsychiatry ward. He was
admitted to the hospital after the death of his wife when he became disoriented, unresponsive to
visitors, and unable to care for his day-to-day needs. What assessment indicators would you look
for in order to distinguish depression from an early stage dementia, given that the diagnosis has
important implications for Mr. Washington's treatment and prognosis?
Onset of symptoms -- if sudden and rapidly progressing, suspect depression
Presence of personal and family history of depression
Level of Mr. Washington's concern about his symptoms — if not particularly concerned,
suspect dementia; if distressed, suspect depression
Time of day during which symptoms are at their worst -- if early, suspect depression; if
they worsen over the course of the day, suspect dementia
Response to stimulant medication — if symptoms improve, suspect depression; if
disorientation and other cognitive symptoms worsen, suspect dementia
Course of symptoms over time (several weeks, months) - if they worsen, suspect dementia;
if symptoms remain consistent or improve slightly, suspect depression
Psychological test performance — if both recent and remote memory are impaired and/or
performance is widely variable across items of equal difficulty, suspect depression; if primarily
recent memory is impaired and/or performance declines steadily with increasing item difficulty,
suspect dementia
279
11.99
List at least five factors believed to lead to dementia.
A misdiagnosed slowly-developing delirium whose underlying cause (poisoning) leads to
permanent brain damage that would earlier have been treatable
Progressive neural degeneration secondary to other diseases (Parkinson's, Huntington's,
multiple sclerosis; lung, kidney, or liver disease)
Brain damage from physical trauma to the head (e.g., subdural hematoma, repetitive sport
injuries in boxing or soccer)
Brain damage from cardiovascular-related strokes or disease or myocardial infarction
Genetic factors that lead to metabolic abnormalities, e.g., inheriting the gene for a certain
type of ApoE protein, whose presence has been linked with lower levels of brain metabolism
Infectious agents (e.g., syphilis; HIV; Creutzfeldt-Jakob)
Vitamin deficiencies I hypothyroidism
Tumors
Low levels of education and low linguistic ability early in life
Multiple combinations of the above factors
280
Chapter 12 PERSONALITY DISORDERS
12.1
Ans. B
Fac
p. 409
M
Which statement about personality disorders is FALSE?
a. Personality disorders reflect enduring patterns of distorted thinking,
emotions, and behavior.
b. Personality disorders can always be traced to early childhood.
c. Personality disorders include behaviors that deviate from the expectations
of one's culture,
d. Personality disorders embody Malreaux's observation that "character is
fate."
12.2
Ans. C
App
p. 409-10
M
Alex is meticulous about his work as well as everything else he does. His
therapist has diagnosed him with obsessive-compulsive personality disorder.
What is the best prediction that can be made for Alex and his disorder?
a. His symptoms are probably ego-dystonic, and he will respond successfully
to a combination of medication and interpersonal therapy.
b. His Axis II disorder will probably worsen over time and develop into foil
blown, comorbid Axis I obsessive-compulsive disorder.
c. He is likely to remain obsessive-compulsive for the next several years and
will probably refuse to participate in long-term treatment.
d. While he may not recognize the severity of his symptoms, he is probably
more distressed by his actions than are the people around him.
12.3
Ans. A
Fac
p. 409,21
E
What personality disorder do Jessica Lange in Frances and Glenn Close in Fatal
Attraction have in common?
a. borderline
b. antisocial
c. histrionic
d. avoidant
12.4
Ans. D
Fac
p. 409
E
Which of the following is NOT a group of personality disorders used in the
DSM-IV?
a. odd/eccentric
b. dramatic/emotional/erratic
c. anxious/fearful
d. withdrawn/neurotic
12.5
Ans. B
App
p. 409
E
Hannah's disorder is marked by long-standing, inflexible patterns of thinking
about and relating to others, and she is relatively untroubled by these patterns.
On which DSM-IV axis would you expect to find her diagnosis?
a. I
b. II
c. IV
d. none of the above; personal distress must be present for a diagnosis to be
made
281
12.6
Ans. A
App
p. 409-10
M
*
Rigaldo's cluster C personality disorder is very resistant to change. Your text
lists several factors believed to be related to this rigidity. Which statement
below does NOT apply?
a. Because these disorders have a strong genetic component, symptoms are
only minimally altered through treatment.
b. There may be overlap between his personality disorder and another type of
disorder, such as chronic depression.
c. His personality disorder may be hard to treat because he perceives his
dysfunctional traits as ego-syntonic.
d. He may believe his problems are due to others and not to his own actions.
12.7
Ans. D
App
p. 410
E
Hank's personality disorder is ego-syntonic. What does this mean?
a. His disorder has arisen from a disruption in the development of the ego.
b. He is unable to view himself and his actions from the perspective of other
people in his life.
c. His disorder is comorbid with an Axis I disorder.
d. He views the symptoms as a natural part of himself.
12.8
Ans. A
App
p. 410
M
Percy is often suspicious, hostile, and distmsting of others. If these traits meet
criteria for an Axis II disorder, which of the following persons probably
exhibits the LEAST subjective distress as a result of this disorder?
a. Percy
b. Percy's wife, Clarice
c. Percy's son, Ellis
d. All of the above are probably equally distressed.
12.9
Ans. D
App
p. 410
E
Charlene has a personality disorder that is quite rare. Which of the following
disorders does she have?
a. schizotypal
b. borderline
c. dependent
d. schizoid
12.10
Roberto is 37 years old and has been diagnosed with a schizoid personality
Ans. B
disorder by Dr. Rabin. This is the first time Roberto has received this diagnosis.
App Which of the following statements is LEAST likely to apply to this case?
p. 410-1
a. Roberto's dysfunctional traits were probably present when he was in his early
M
20s.
b. Dr. Rabin was mistaken to give this Axis II diagnosis to Roberto since this
disorder must be diagnosed by early adulthood.
c. Roberto may have a comorbid Axis I or other Axis II disorder that could
make accurate diagnosis difficult.
d. It is unlikely that Roberto will actively participate in long-term treatment.
282
12.11
Ans. A
App
p. 410-1
E
If Arthur has one of the most commonly occurring personality disorders, it could
be any of the following EXCEPT
a. avoidant,
b. antisocial.
c. histrionic,
d. schizotypal.
12.12
Ans. C
App
p. 411
M
Although he has never formally been diagnosed, Mali exhibits symptoms that
would meet criteria for a histrionic personality disorder. According to the
DSM-IV, you would expect that the onset of Mali's symptoms occurred no later
than age
a. 12.
b. 19.
c. 22.
d. 30.
12.13
Ans. D
App
p. 411
M
Dr. Feng is an epidemiologist interested in studying personality disorders. Each
of the following poses a potential problem for his work EXCEPT
a. his participants' strong disinclination to acknowledge or report their
difficulties.
b. the extensive time required to document Axis II symptom patterns.
c. the overlap in Axis I and II symptoms that makes reliable diagnosis difficult.
d. the infrequency of Axis II disorders compared to other acute clinical
syndromes.
12.14
Ans. B
Fac
p. 411
E
Roughly one in every
Americans will meet criteria for an Axis II disorder
at some point in their lives.
a. 13
b. 10
c. 6
d. 4
12.15
Ans. C
App
p. 411
M
*
Denise and Garrett are fraternal twins. Prevalence data suggest that Garrett is
more likely than Denise to exhibit any of the following disorders EXCEPT
a. narcissistic PD.
b. paranoid PD.
c. dependent PD.
d. antisocial PD.
12.16
Ans. D
App
p. 411
E
Katrina is receiving treatment for major depression and for a comorbid
personality disorder. If that comorbid disorder is more common for females
than males, you could conclude that she has
personality disorder.
a. avoidant
b. dysthymic
c. dependent
d. borderline
283
12.17
Ans. C
App
p. 411
E
Which of the following persons is MOST likely to be diagnosed with a
personality disorder?
a. Lakisha, a 15-year-old South African female
b. Yuan Ho, a 24-year-old Taiwanese male
c. Richie, a 22-year-old European American male
d. Nanato, a 20-year-old Pacific Island female
12.18
Ans. A
App
p. 412
M
Mame may merit a diagnosis of "personality disorder" if she exhibits enduring,
dysfunctional patterns in at least two areas. These areas could include any of
the following according to the DSM-IV EXCEPT
a. occupational functioning.
b. interpersonal functioning.
c. impulse control.
d. affectivity.
12.19
Ans. D
App
p. 412
C
David is known as a tyrant at work and is seen as highly perfectionistic and
obsessed with control. At home, however, he seems to be a different person
altogether and is warm, cooperative, and "laid back." What diagnosis might you
consider?
a. obsessive-compulsive disorder, Axis I
b. obsessive-compulsive personality disorder, Axis II
c. schizoid disorder, Axis I
d. none of the above
12.20
Ans. C
App
p. 412
M
Jake is very shy and withdrawn. He has trouble making friends and is lonely
much of the time. Eventually, Jake went to see a therapist and was diagnosed
with dysthymia and avoidant personality disorder. These two disorders may be
related to each other in any of the following ways EXCEPT
a. The distress associated with the avoidant disorder may be causing the
dysthymia.
b. The dysthymia may have predisposed Jake to the development of the
avoidant disorder.
c. Both are more common in men than in women, and a common biological
vulnerability could cause both disorders.
d. There may actually be only one syndrome present but overlapping criteria
result in two diagnoses.
284
12.21
Ans. C
App
p. 412-3
M
Lacey has an Axis II disorder. Her diagnosis came only after many other Axis I
diagnoses that her current therapist believes were in error. What is one of the
factors that may have led to these misdiagnoses?
a. Reliable diagnosis relies on the presence of chronic, long-standing symptoms,
which are easier to catalogue than are acute symptoms.
b. The criteria for her disorder are distinct and easily separated from other
disorders, but symptoms must be present for a long period of time in order to
be obvious.
c. Overlapping criteria and arbitrary "cutoff rules for diagnosis can lead to
unreliable diagnostic practices.
d. Axis II disorders are rare and are often overlooked because of this as well as
the absence of distressing clinical symptomatology.
12.22
Ans. B
Con
p. 413
C
Drawing from information provided in the text, on what basis were the
diagnostic decision rules regarding Axis II syndromes determined (e.g., 5 of 9
symptoms required for diagnosis)?
a. empirically, although the actual methods are unclear
b. by rational consensus
c. on the basis of clinical field trials
d. on the basis of factor analysis of structured clinical interview data
12.23
Ans. A
Fac
p. 413
E
What is the Big Five model of personality?
a. a dimensional approach to describing personality disorders
b. a categorical approach to describing personality disorders
c. a model that relates personality disorders to the interpretation of the five
DSM diagnostic axes
d. a five-cluster approach to reorganizing the DSM-IV personality disorders
12.24
Ans. B
Con
p. 413
M
The DSM-IV is to the Big Five model as
a. empirical is to theoretical.
b. categorical is to dimensional,
c. dimensional is to categorical.
d. Axis I is to Axis II.
12.25
Ans. A
App
p. 413
M
*
Hansel is debating with his sister, Gretel, about their cruel stepmother. Hansel
says she is clearly a psychopath in a "class all her own"; Gretel says that while
she is very manipulative and lacks empathy, other people are similar but don't
possess the characteristics to such an extreme. Hansel is using a
approach and Gretel uses a
approach to describing their stepmother.
a. categorical; dimensional
b. dimensional; categorical
c. comparative; qualitative
d. circumplex; comparative
285
12.26
Ans. C
Con
p. 413-4
E
Which of the following dimensions does not belong with the other three?
a. openness
b. conscientiousness
c. affectivity
d. neuroticism
12.27
Ans. D
App
p. 413-4
E
Janet's therapist has rated Janet as high on extroversion and low on neuroticism.
Which approach to describing personality disorders is Janet's therapist using?
a. the interpersonal circumplex
b. the approach set forth in the DSM-IV
c. the Wiggins-Costa approach
d. the Big Five model
12.28
Ans. D
App
p. 414
M
Eleni is described by her friends as a very creative person, curious about the
people and events around her, and uninterested in traditional expectations and
custom. You would expect high scores on which of the following factors?
a. agreeableness
b. stability
c. conscientiousness
d. openness
12.29
Ans. A
Fac
p. 414
E
Timothy Leary developed which of the following items?
a. the interpersonal circumplex
b. the tie-dyed wheel of cosmic reality
c. the big five model of personality
d. the Structured Clinical Interview for Personality Disorders
12.30
Ans. C
Fac
p. 415
M
According to Leary's model, what disorder is characterized by extreme
submission and by interpersonal feelings that are slightly more negative than
positive?
a. dependent
b. schizotypal
c. avoidant
d. paranoid
12.31
Ans. D
App
p. 415
M
Eduard has been described as narcissistic. You would expect him to score
on the dominance/submission dimension and to be more
a. low; loving than hateful
b. low; hateful than loving
c. high; loving than hateful
d. high; hateful than loving
286
.
12.32
Ans. B
App
p. 415
E
Ricki feels the world is out to get her and she has trouble making friends
because she distrusts everybody and is frequently manipulative and rade. Which
DSM grouping below includes Ricki's personality disorder?
a. neuroticism/low agreeableness
b. odd/eccentric
c. dominant/aggressive
d. erratic/hateful
12.33
Ahmik tends to experience frequent negative emotions and distressed thinking, is
Ans. C
quite introverted, and is seen by others as cynical, skeptical, and sometimes
App openly rude. These descriptions BEST fit which of the following personality
p. 413,16
disorders?
C
a. antisocial
*
b. borderline
c. schizotypal
d. avoidant
12.34
Ans. A
Con
p. 416
C
Which of the following is LEAST germane to a Big Five description of the
Odd/Eccentric cluster on Axis II?
a. low conscientiousness
b. low agreeableness
c. high neuroticism
d. low extraversion
12.35
Ans. B
App
p. 416
M
Karen is often wondering who is talking about her at work, trying to get her
fired because they are jealous of the high standards she sets for herself. Her
coworkers sense her hostility and d o ^ invite her out for drinks after work;
Karen takes this as another sign that they are scheming behind her back. What
Axis II disorder is most likely?
a. schizoid
b. paranoid
c. obsessive-compulsive
d. narcissistic
12.36
Ans. C
App
p. 416
M
*
Charles Manson, a charismatic leader who convinced his followers to commit
several murders, would MOST likely attract a follower with which of the
following personality disorders?
a. avoidant
b. histrionic
c. paranoid
d. eccentric
12.37
Ans. D
Fac
p. 416-7
M
Which of the following descriptors does NOT apply to paranoid P.D.?
a. more frequently diagnosed in males
b. 0.5 to 2.5 prevalence
c. effects most likely to be observed in occupational settings
d. chronic feelings of inferiority
287
.38
Ans. A
Con
p. 416
E
Diagnostically, which of the following disorders does not belong with the other
three?
a. avoidant
b. schizoid
c. paranoid
d. schizotypal
12.39
Ans. B
App
p. 417
M
The stereotypical social "hermit" who lives alone and is disinterested in others is
MOST likely to be described as
a. schizotypal,
b. schizoid.
c. odd/erratic,
d. borderline.
12.40
Ans. C
App
p. 417
M
Bill finds that his job as a long-distance truck driver suits his strong desire for
solitude. He has never really cared about settling down somewhere and
developing friendships; he also was mostly indifferent when his "girlfriend" of
six weeks left him for another man. What personality disorder might be
present?
a. avoidant
b. antisocial
c. schizoid
d. delusional
12.41
Ans. D
Con
p. 416-7
M
Which of the following descriptors does not belong with the other three?
a. less than 1 percent prevalence
b. odd/eccentric cluster
c. pervasive emotional indifference
d. high neuroticism
*
12.42
Ans. A
App
p. 418
M
In what way is John who has schizotypal personality disorder MOST dissimilar
to Eric who has schizophrenia?
a. John's symptoms do not reflect a formal thought disorder.
b. John is eccentric but does not exhibit ideas of reference or oddities of
speech.
c. John's symptoms are more responsive to antidepressant medication, while
Eric's symptoms respond better to neuroleptics.
d. John's symptoms are not associated with social anxiety while Eric is more
likely to exhibit such anxiety.
12.43
Ans. B
App
p. 418
M
Esteban has a schizotypal personality disorder, and Domingo has a schizoid
personality disorder. Each of the following characterizes both men EXCEPT
a. social isolation.
b. social anxiety.
c. low agreeableness.
d. low extraversion.
288
12.44
Ans. C
Con
p. 418
M
Which of the following descriptors does not belong with the other three?
a. part of the schizophrenia spectrum
b. circumstantial speech and strange mannerisms
c. relatively rare Axis II disorder
d. self-consciousness and social apprehension
12.45
Ans. D
App
p. 418
M
Wilma relies on astrology charts and tarot card readings to make important
decisions in her life. She is also very superstitious and engages in eccentric
rituals
whenever she leaves her home. While her speech is somewhat odd and
she seems ill at ease in social situations, she exhibits no signs of real
psychosis. What disorder is most likely?
a. histrionic
b. schizophrenia
c. borderline
d. schizotypal
12.46
Ans. C
App
p. 418
M
Henry is often seen sitting motionless in front of downtown stores, chanting a
repetitive
phrase. Henry told the police, when they were called in, that he was
communing with the flow of energy generated by all the business deals
transpiring in me buildings around him. If he does not have a formal thought
disorder, what disorder is MOST likely?
a. schizoid
b. paranoid
c. schizotypal
d. borderline
12.47
Ans. A
App
p. 418
M
Suresh believes that people are closely watching his actions as he walks through
the mall, although the people around him are actually oblivious to his presence.
What would you call Suresh's belief?
a. an idea of reference
b. a loose association
c. a delusion
d. a superstition
12.48
Ans. B
Fac
p. 418
M
Which of the following disorders has the LEAST overlap with schizotypal PD in
regard
to symptomatology?
a. avoidant
b. obsessive-compulsive
c. schizoid
d. borderline
12.49
Ans. A
App
p. 418
M
Dr. Nishimoto is assessing a new client. She minks that the client may have a
schizotypal personality disorder. For what reason might Dr. Nishimoto have
difficulty making a reliable diagnostic decision?
a. overlap of symptoms with other Axis II disorders
b. difficulty distinguishing it from Axis I schizophrenia
c. its very rare occurrence
d. all of the above
289
12.50
Ans. D
Con
p. 418
M
Diagnostically, which of the following disorders does not belong with the other
three?
a. antisocial
b. narcissistic
c. histrionic
d. dependent
12.51
Ans. B
App
p. 418
E
Yojiro has a personality disorder. If his is one of the disorders most intensively
studied by researchers, it would fall under the
cluster.
a. fearful
b. dramatic/emotional
c. eccentric
d. neurotic/erratic
12.52
Ans. C
App
p. 418-9
M
Barbara is often noticed for her flair for clothing, her engaging conversations
(later perceived by the listener as empty of content), and her charming and
extraverted personality. She appears to be self-assured and independent. If
these characteristics represent an enduring, inflexible, and dysfunctional pattern,
what diagnosis would be appropriate?
a. narcissistic personality disorder
b. reactive personality disorder
c. histrionic personality disorder
d. borderline personality disorder
12.53
Ans. A
App
p. 418-9
M
*
Said a supervisor of an employee: "Tanya really made a terrific first impression
on me with her wit and self-confidence. Now, though, I'm tired of telling her
how great her ideas are. She really pouts when she isn't the center of attention
in the office." What disorder is being described?
a. histrionic personality disorder
b. borderline personality disorder
c. schizotypal personality disorder
d. dependent personality disorder
12.54
Ans. B
Con
p. 419
M
Which of the following descriptions does not belong with the other three?
a. actively dependent
b. more prevalent in males
c. high extraversion
d. excessive demands for reassurance and praise
12.55
Ans. A
App
p. 419
M
*
Vladimir has a disorder that falls under the dramatic/emotional/erratic cluster.
He could exhibit any of the following scores on the Big Five dimensions
EXCEPT
a. high scores on agreeableness.
b. high scores on neuroticism.
c. high scores on extroversion.
d. low scores on conscientiousness.
290
12.56
Ans. C
App
p. 418-9
M
If you walked into a room that just happened to be populated with persons
diagnosed with some kind of personality disorder, which of the following would
you be MOST likely to recognize nonverbally as you scan the room?
a. paranoid
b. borderline
c. histrionic
d. dependent
12.57
Ans. D
App
p. 419
p. 419
M
Jenny has an antisocial personality disorder. For what reason might she be
misdiagnosed as histrionic?
a. She is assessed by a female clinician who may be biased to make this
mistake.
b. She is assessed by a male clinician who may be biased to make this mistake.
c. The substantial symptom overlap between these two disorders leads to
unreliable diagnoses,
d. Both a and b are applicable.
12.58
Ans. B
Con
p. 419
M
Which of the following conclusions is MOST clearly supported by research?
a. Clinicians are less likely to diagnose a woman with histrionic personality
disorder when she meets the criteria for antisocial personality disorder.
b. A woman who shows the characteristics of antisocial personality disorder is
more likely to receive the label "histrionic personality disorder."
c. Antisocial women are better actors and manipulators of social settings than
are antisocial men.
d. Dependent personality disorder occurs much more often, almost five times as
frequently, in women than it does in men.
12.59
Ans. C
App
p. 419
M
From a 1970s screen actor's biography: While Steve McQueen publicly
denounced drugs, he was a cocaine addict for several years. McQueen felt that
he was above the law and entitled to special privileges because of his star status;
this extended to frequent extramarital affairs. He was so preoccupied with his
stardom that he threatened his wife with a gun for her one sexual indiscretion.
What disorder may have been present?
a. histrionic
b. dependent
c. narcissistic
d. borderline
12.60
Ans. B
App
p. 419
E
One woman summarily fired her primary care physician for his observation that
she had "large pores" in her facial skin. The woman was enraged that the
physician could be so callously critical and insensitive. What disorder is
possible?
a. borderline
b. narcissistic
c. dependent
d. schizotypal
291
12.61
Ans. A
Con
p. 418-9
M
Which of the following descriptions does not belong with the other three?
a. hyperbolic, empty speech
b. fantasies of success, wealth, and power
c. intense reactivity to criticism
d. possible increase in prevalence in the past decade
12.62
Ans. D
Fac
p. 420
M
Which of the cluster B disorders is LEAST common?
a. antisocial
b. histrionic
c. schizoid
d. narcissistic
*
12.63
Ans. A
App
p. 420
M
Jamie's personality disorder is characterized by its unpredictability. Jamie will
swing rapidly from one emotional extreme to another, and his behavior is often
very impulsive. Which disorder does Jamie appear to exhibit?
a. borderline
b. schizoid
c. histrionic
d. schizotypal
12.64
Ans. B
Fac
p. 420
E
Which two personality disorders are considered the most dangerous and are
currently the most studied?
a. paranoid and histrionic
b. borderline and antisocial
c. antisocial and schizotypal
d. schizotypal and borderline
12.65
Ans. C
App
p. 420-1
C
Nancy acts superior and condescending towards others. Without knowing any
more details about her, which personality disorder listed below is she LEAST
likely to have?
a. narcissistic
b. paranoid
c. borderline
d. antisocial
12.66
Ans. D
App
p. 420-1
M
Julie is having frequent crises in her relationship with her boyfriend. Sometimes
she idolizes him and insists she cannot live without him; other times, she is
harshly critical of him and wants to end the relationship permanently. She
complains of a vague sense of emptiness and sometimes drinks excessively to
quell those feelings. What disorder is MOST likely?
a. histrionic
b. dependent
c. narcissistic
d. borderline
292
12.67
Ans. A
Con
p. 420-1
M
Which of the following descriptions does not belong with the other three?
a. lack of guilt
b. self-mutilating behaviors
c. lack of a stable sense of identity
d. fears of abandonment
12.68
Ans. B
Con
p. 419,21
M
What characteristic is shared among the symptoms for histrionic and borderline
personality disorders?
a. self-mutilation
b. intense reactivity to perceived abandonment or rejection
c. brief psychotic symptoms during periods of intense stress
d. idealization of relationship partners
12.69
Ans. D
App
p. 421
M
Lorraine is a psychiatric patient who was hospitalized following a suicide
attempt. What disorder is MOST likely on Axis II?
a. dependent personality disorder
b. histrionic personality disorder
c. impulsive personality disorder
d. borderline personality disorder
12.70
Ans. A
Con
p. 421
M
A dismption in one's sense of identity is a defining feature of Axis I dissociative
disorders. An individual with
personality disorder may report a
similar experience under conditions of extreme stress,
a. borderline
b. antisocial
c. schizoid
d. dependent
12.71
Ans. B
App
p. 421
M
Which of the following persons will exhibit the MOST severe symptoms of a
borderline personality disorder?
a. Adam, a 25-year-old male
b. Maureen, a 26-year-old female
c. Ricardo, a 35-year-old male
d. Mara, a 40-year-old female
12.72
Ans. D
Fac
p. 421
E
What percentage of individuals with borderline personality disorder threaten to
commit suicide at least once in their lifetimes?
a. 8%
b. 25%
c. 56%
d. 75%
*
293
12.73
Ans. C
App
p. 421
M
You are a psychology intern working on an inpatient ward at a large psychiatric
hospital. When you review the patients' hospital charts, the most common Axis
II disorder you discover will be
a. histrionic personality disorder.
b. schizotypal personality disorder.
c. dependent personality disorder.
d. borderline personality disorder.
12.74
Ans. D
Fac
p. 421
E
Which of the following terms does NOT reflect an earlier description of what
the DSM calls "antisocial personality disorder"?
a. sociopathy
b. moral insanity
c. psychopathy
d. social maladroitness
12.75
Ans. A
Con
p. 422
C
Neil was a graduate student of Dr. Cleckley's in the mid 1970s. What disorder
was the most likely topic of Neil's doctoral dissertation research?
a. psychopathic personality
b. antisocial personality disorder
c. borderline personality disorder
d. the Big Five personality factors
12.76
Ans. B
App
p. 422
M
Gerhard is charming, above average in intelligence, and successful. He is also
uninterested in others' feelings and has no genuine interpersonal relationships,
largely due to his insincerity, manipulation of others, and repetitive lying. What
DSM-IV Axis II disorder is most likely for Gerhard?
a. schizoid
b. antisocial
c. sociopath
d. narcissistic
12.77
Ans. C
Con
p. 422
M
Which personality disorder is MOST likely to be associated with above-average
success in occupational functioning in a person with the disorder?
a. paranoid
b. narcissistic
c. antisocial
d. obsessive-compulsive
12.78
Ans. D
App
p. 422
M
Jase is a postdoctoral student working with Robert Hare. What assessment
instrument is Jase most likely to be using with his personality disordered
research participants?
a. the polygraph
b. the Hare APD Inventory
c. theMMPI
d. the Psychopathy Checklist
294
Sasha has a central feature of psychopathy emphasized by Cleckley and Hare
but less important to the DSM-IV diagnosis. This feature is
a. emotional-cognitive instability.
b. overt criminal behavior.
c. behavioral deviance.
d. impulsivity-manipulation.
What is the difference between psychopathy and antisocial personality disorder
as defined in the DSM-IV?
a. None; they are the same thing and can be used as interchangeable diagnostic
terms.
b. Psychopathic individuals are typically homicidal, whereas those with
antisocial personality disorder violate the rights of others but are less
dangerous overall.
c. The definition of psychopathy includes behavioral deviance as well as
insidious personality traits and interpersonal manipulation; antisocial PD is
primarily defined by the former.
d. None of the above is correct.
For a diagnosis of antisocial personality disorder to be made, the person must
currently be at least
years old, and symptoms of the disorder must have
been present by age
.
a. 21; 14
b. 18; 15
c. 18; 12
d. 15; 18
Jerome was diagnosed with a personality disorder when he turned 18. He was
diagnosed with a similar disorder when he was a child. What disorder was this?
a. posttraumatic stress disorder
b. attention deficit hyperactivity disorder
c. conduct disorder
d. anxious-avoidant disorder
Which of the following persons is MOST likely to be diagnosed with antisocial
personality disorder?
a. Kent, a 35-year-old European American male
b. Althea, a 21-year-old Asian American female
c. Carlos, a 16-year-old Hispanic male
d. Shaneal, a 23-year-old African American male
295
12.84
Adam is doing very poorly in high school and has few friends. He recently
Ans. B
found that he fits in with the school "bad boys" and has begun associating with
App these deviant peers. For which of the following personality disorders is Adam
p. 423
at greatest risk, according to Loeber?
M
a. schizoid
b. antisocial
c. dependent
d. borderline
12.85
Ans. D
App
p. 422-3
C
Koa is described by others as possessing superficial charm and an exaggerated
sense of self worth, impulsive and unable to tolerate boredom, and often lacking
empathy as well as remorse for his own actions. These characteristics began
when Koa was 16, with no significant disturbance prior to that age. What
DSM-IV diagnosis is MOST applicable for Koa, now 25 years old?
a. Type I psychopathy
b. antisocial personality disorder
c. borderline sociopath
d. none of the above
12.86
Ans. D
Con
p. 423
E
Diagnostically, which of the following disorders does not belong with the other
three?
a. obsessive-compulsive
b. dependent
c. avoidant
d. histrionic
12.87
Ans. B
App
p. 417,23
M
Erika has a schizoid P.D., and Suzette has an avoidant P.D. On which of the
following characteristics will these two individuals be MOST different?
a. impairment in social skills
b. interest in social acceptance
c. preference for solitary occupations
d. none of the above
12.88
Ans. A
App
p. 424
C
Timo is socially inhibited, perfectionistic, and preoccupied with maintaining a
sense of control. Based on available data, you would reliably predict the
following Big Five factor scores for Timo EXCEPT
a. high conscientiousness.
b. low extraversion.
c. high neuroticism.
d. low agreeableness.
296
12.89
Ans. D
App
p. 423-4
E
Nancy constantly feels inadequate and inept, especially in social situations. In
social encounters she is very inhibited and afraid of making a mistake that she
fears will bring rejection. She avoids occupations and situations that require
social interaction. What type of personality disorder does she have?
a. paranoid
b. schizoid
c. dependent
d. avoidant
12.90
Ans. C
App
p. 424
M
*
A therapist is working with a male client who has a Cluster C personality
disorder that occurs relatively infrequently. Which disorder would this be?
a. obsessive-compulsive
b. dependent
c. avoidant
d. narcissistic
12.91
Drew seeks constant reassurance and advice on matters large and small. He
Ans. A
seems unable to make decisions on his own and clings to others who make his
App decisions for him. What type of personality disorder does he exhibit?
p. 424
a. dependent
E
b. avoidant
c. histrionic
d. paranoid
12.92
Ans. B
App
p. 424,27
C
Tywanna has a dependent personality disorder. Which of the following
descriptions, drawn from theoretical models, would be LEAST applicable to her?
a. extreme submissiveness, as described by Leary
b. inherited anxiety vulnerability, as described by Nigg & Goldsmith
c. high agreeableness, as described by the Big Five model
d. rigid expectations of others, as described by object relations theorists
12.93
Ans. C
App
p. 425
E
Willina is the head of a large software firm. She is very stingy with her money
and is preoccupied with company rules and procedures that she expects her
employees to follow in exact detail. Willina's employees call her a "beancounter" or as "anal-retentive." What personality disorder does she likely have?
a. paranoid
b. histrionic
c. obsessive-compulsive
d. antisocial
297
12.94
Ans. A
App
p. 425
M
Nathan is extremely committed to his work, checking and re-checking every
detail of every report he is asked to prepare. He takes full responsibility for his
work and will not permit co-workers to offer input, lest they be less
conscientious in their efforts. What kind of productivity would you expect from
Nathan if he has symptoms of a personality disorder?
a. very poor to mediocre
b. average
c. somewhat above average
d. well above average to exceptional
12.95
Ans. B
App
p. 425
M
Linden's home is cluttered with many worthless items that he refuses to throw
away. Linden's wife says little to him about her displeasure because she knows
that this would provoke increased criticism of her own imperfect actions, which
Linden voices frequently. Which Axis II disorder is MOST likely for Linden?
a. paranoid
b. obsessive-compulsive
c. domineering
d. schizotypal
12.96
Ans. C
Fac
p. 425
M
*
What is the primary difference between obsessive-compulsive personality
disorder and obsessive-compulsive disorder?
a. The Axis II disorder is less severe but more chronic than the Axis I disorder;
otherwise the symptoms are essentially identical.
b. The Axis I disorder is less responsive to drug treatment and does not appear
to be affected by genetic factors.
c. Although the Axis II disorder is a chronic lifestyle governed by rigid habits,
this disorder lacks obsessive thoughts and compulsive rituals.
d. None of the above is correct.
12.97
Ans. D
Con
p. 426
E
Dr. Lewis Terman studied gifted children in a longitudinal study that lasted for
several decades. If he had measured the Big Five characteristics in these
children, which two would remain most stable in adulthood?
a. extroversion and agreeableness
b. neuroticism and conscientiousness
c. openness and agreeableness
d. extroversion and neuroticism
12.98
Ans. D
App
p. 426
M
Which of the following twin pairs will demonstrate HIGHEST concordance in
personality traits?
a. Molly and Theodore, fraternal twins reared together
b. Sharmilla and Priti, identical twins reared together
c. Domingo and Geraldo, identical twins reared apart
d. either b or c
298
Taka and Umeko are identical twins. They were separated at birth and raised by
different families. Neither twin has met nor even heard of the other twin. On
average, Taka and Umeko will share
% of their personality traits.
a. 33%
b. 50%
c. 64%
d. 80%
If you wished to account for the differences in personality characteristics among
a group of college students, you should emphasize
factors and spend
the least time studying
factors.
a. genetic; non-shared environment
b. shared environment; genetics
c. genetic; shared environment
d. non-shared environment; shared environment
For which of the following personality disorders does current research
demonstrate the WEAKEST genetic contribution?
a. borderline
b. schizotypal
c. obsessive-compulsive
d. antisocial
Which personality disorder and psychosexual stage are mismatched?
a. antisocial : latency
b. obsessive-compulsive : anal stage
c. dependent: oral stage
d. histrionic : phallic stage
Which of the following terms does not belong with the other three?
a. rigid, extreme interpersonal expectations
b. fixation
c. object relations theory
d. early attachment
The notion that individuals with personality disorders tend to create a selffulfilling pattern of interactions which reinforces their symptomatology is the
central
assumption
of
the
explanation of these disorders.
a. object relations
b. evolutionary
c. psychodynamic
d. interpersonal learning
299
12.105
Ans. D
App Imelda's
p. 428
M
Imelda depends on her spouse to help her make decisions about what to wear
each day, what food to buy for the family, and which friends to have. If
husband is highly dominant, which of the following descriptors does
NOT characterize their relationship?
a. reciprocal
b. complementary
c. reinforcing
d. correspondent
12.106
Ans. A
App
p. 428
C
Liza is chronically suspicious and tense, believing that most of her coworkers
are out to cause her trouble. She keeps to herself most of the time. Which of
the following is LEAST likely on the part of her coworkers, according to Leary?
a. reciprocal hostility
b. complementary hostility
c. correspondent isolation
d. reciprocal dominance
12.107
Ans. D
App
p. 428
E
As a graduate student of Theodore Millon, you would be emphasizing a(n)
approach to understanding personality disorders.
a. psychodynamic
b. interpersonal learning
c. genetic
d. evolutionary
12.108
Ans. B
Con
p. 428
M
Which of the following concepts does not belong with the other three?
a. passive accommodation or active modification
b. assimilation of stimuli and blocking of punishment
c. minimization of pain and maximization of pleasure
d. advancing the self and/or caring for others
12.109
Ans. C
Con
p. 428
M
Which of the following descriptions from Millon's theory would NOT be an
appropriate description of histrionic personality disorder?
a. maximization of pleasure
b. advancing the self
c. passive accommodation
d. minimization of pain
12.110
Ans. A
Con
p. 428
C
Which of the following descriptions from Millon's theory would NOT be an
appropriate description of paranoid personality disorder?
a. maximization of pleasure
b. minimization of pain
c. advancing the self
d. passive accommodation
300
12.111
Ans. B
Con
p. 428
M
*
One of the symptoms of borderline personality disorder is an inability to
develop and maintain an adaptive approach in coping with interpersonal
demands. Which fundamental polarity is deficient?
a. minimization of pain/maximization of pleasure
b. passive accommodation I active modification
c. assimilation of stimuli / blocking of punishment
d. advancing the self/caring for others
12.112
Ans. D
App
p. 429
E
Margaret is being treated for borderline personality disorder. Current research
indicates that
is probably a contributor to her disorder.
a. a genetic vulnerability
b. organic brain dysfunction
c. attention deficit/hyperactivity disorder in childhood
d. none of the above
12.113
Ans. A
App
p. 429
M
If Palani has borderline personality disorder, which of the following Axis I
disorders is most likely to be a comorbid condition?
a. major depression
b. social phobia
c. dissociative identity disorder
d. generalized anxiety disorder
12.114
Ans. B
App
p. 429
M
Judy is two years old. She has an insecure attachment with her parents, and her
increasing independence is sometimes fostered by her parents and sometimes
capriciously punished. Judy has trouble trusting adults and is extremely
sensitive to signs of rejection and abandonment. What adult personality disorder
is MOST likely to develop?
a. dependent
b. borderline
c. antisocial
d. histrionic
12.115
Ans. C
Fac
p. 429
E
*
Which of the theorized causes of borderline personality disorder has received the
greatest empirical support?
a. neurological dysfunction
b. infant-caretaker conflicts over independence and dependence
c. early childhood physical or sexual abuse
d. early childhood neglect and insecure attachment
12.116
Ans. D
App
p. 430
E
Abdul has been diagnosed with antisocial personality disorder. In his early
childhood, Abdul probably exhibited each of the following characteristics
EXCEPT
a. physical clumsiness.
b. hyperactivity.
c. difficulty regulating emotions.
d. chronic CNS overarousal.
301
12.117
Ans. D
Fac
p. 430
E
Evidence for genetic factors in antisocial personality disorder comes from
a. twin studies.
b. adoption studies.
c. linkage analysis studies.
d. both a and b.
12.118
Ans. C
App
p. 430
M
If Enrique has an "immature cortex," he would exhibit each of the following
characteristics EXCEPT
a. low levels of high frequency beta waves,
b. a defect in left hemisphere functioning.
c. abnormally rapid evoked potentials.
d. high levels of low frequency theta waves.
12.119
Ans. B
App
p. 430
M
Jonah has the classic symptoms of psychopathy. His CNS underarousal is
implicated as the cause of each of the following EXCEPT
a. thrill-seeking,
b. hypersensitivity to aversive stimuli.
c. extremely low anxiety level,
d. poor self-control skills.
12.120
Ans. B
App
p. 430
M
If Betina, a psychopathic adult female, exhibits EEG activity that is typical of
that found in children, her EEG reveals abnormal
a. activity in the left hemisphere,
b. theta wave activity.
c. alpha wave activity.
d. activity that is similar to that seen in epilepsy.
12.121
Ans. A
Con
p. 430-1
E
If you were reviewing the work of Hare, Quay, and Loeber, you would be
studying
personality disorder.
a. antisocial
b. borderline
c. schizoid
d. paranoid
12.122
Ans. A
Con
p. 430
M
Which of the following characteristics does not belong with the other three?
a. oversensitivity to social rejection
b. immature cortex
c. CNS underarousal
d. difficult temperament
12.123
Ans. B
Fac
p. 431
E
According to Costa, which of the Big Five dimensions is MOST amenable to
treatment?
a. extroversion
b. neuroticism
c. conscientiousness
d. agreeableness
*
302
12.124
Ans. C
Fac
p. 431
E
Which personality dimension is most likely to be altered by a student's
experiences in school?
a. extraversion
b. openness
c. conscientiousness
d. neuroticism
12.125
Ans. D
App
p. 432
M
If Rocco is antisocial, he would be MOST responsive to which of the following
aversive consequences?
a. his wife's threat to leave him if he doesn't change his ways
b. an angry tirade by his boss
c. electric shock
d. a stiff monetary fine
12.126
Ans. A
App
p. 432
E
A child who cannot inhibit his desire to grab a toy from a store shelf, even
though he knows his father will punish him, is most similar to an adult with a(n)
personality disorder.
a. antisocial
b. histrionic
c. borderline
d. narcissistic
12.127
Ans. C
App
p. 432
M
*
Michael is a charming, pathological liar who uses other people for his own ends.
According to Eysenck, Michael's absence of a "conscience" is due to
a. inconsistent parental discipline and parental criminality.
b. disinhibition of behavioral impulsitivity due to abnormally low CNS activity.
c. a biologically-based deficit in classical conditioning of fear responses.
d. early parental loss and later exposure to deviant peers.
12.128
Ans. A
Fac
p. 430,2
E
Which of the choices below is NOT one of the empirically supported
contributors to antisocial personality disorder?
a. reduced sensitivity to rewards
b. central and autonomic nervous system underarousal
c. childrearing practices
d. slower conditioning of anxiety
12.129
Ans. B
App
p. 432
M
If Richard has antisocial personality disorder, which of the following
characteristics is LEAST likely to be true of Richard's family?
a. erratic discipline and poor supervision of Richard's activities
b. upper-middle class SES
c. marital discord and separation
d. a criminal record for Richard's father
12.130
Ans. C
Con
p. 433
E
Which model appears to best explain the development of antisocial behavior?
a. biological model
b. sociocultural/family model
c. diathesis-stress model
d. learning model
303
12.131
Ans. D
App
p. 435
M
Dr. Soo is treating a client with therapy techniques pioneered by Heinz Kohut.
What disorder does Dr. Soo's client probably have?
a. borderline
b. histrionic
c. antisocial
d. narcissistic
12.132
Ans. A
Con
p. 435
M
Which of the following terms does not belong with the other three?
a. splitting
b. self psychology
c. unmet admiration and protection needs
d. narcissistic personality
12.133
Ans. B
App
p. 435
E
Adrienne has a personality disorder for which she is receiving systematic
desensitization and training in social skills. What disorder is most likely?
a. borderline
b. avoidant
c. histrionic
d. schizotypal
*
12.134
Ans. C
App
p. 435
M
Susan is a graduate student in clinical psychology, hoping to become a full-time
therapist. She is beginning to wonder about the wisdom of her chosen career as
a result of me difficulty she is encountering with a current client. The client
calls the clinic three times a week demanding to be seen and has even shown up
at Susan's home in a suicidal crisis. What disorder is MOST likely?
a. histrionic personality disorder
b. dependent personality disorder
c. borderline personality disorder
d. avoidant personality disorder
12.135
Ans. D
Fac
p. 435
M
Which of the following treatments is not typically employed with individuals
with borderline personality disorder?
a. expressive psychotherapy
b. dialectical behavior therapy
c. drug treatment
d. systematic desensitization
12.136
Ans. A
App
p. 435
M
Lillian is reacting to her therapist in many of the same ways she used to respond
to her mother, a process known as
. Lillian sometimes sees her
therapist as "all good" or "all bad," a process called
, which also
characterized her earlier perceptions of her mother.
a. transference; splitting
b. transference; countertransference
c. projection; dichotomizing
d. splitting; reaction formation
304
12.137
Ans. B
Con
p. 435-6
M
Which of the following terms does not belong with the other three?
a. DBT
b. Kemberg
c. diathesis-stress model
d. invalidating environments
12.138
Ans. C
Fac
p. 436
E
Which of the following approaches is currently LEAST important in the
prevention of antisocial personality disorder?
a. pre- and postnatal health care
b. improving academic achievement in school children
c. genetic screening and counseling
d. programs for treating children's impulse control problems
12.139
Ans. D
Fac
p. 436
E
Which two prevention goals were addressed in the Montreal LongitudinalExperimental Study?
a. increased involvement in school & impulse control training
b. reduction in parental substance abuse & increased involvement in school
c. impulse control training & parental training in effective childrearing
d. social skills training & parental training in effective childrearing
12.140
Ans. A
Fac
p. 436
E
Accordmg to Linehan, what causes the development of the unstable sense of self
that is a central feature of borderline personality disorder?
a. difficulty regulating intense emotions
b. an emotionally unstable temperament
c. splitting
d. dialectical environments
12.141
Ans. B
App
p. 436
M
When Julie told her parents that her uncle had sexually abused her, her parents
essentially ignored her distress and trivialized the importance of her experiences.
This kind of response was relatively common in Julie's life. How would
Linehan describe Julie's family situation?
a. an example of psychological splitting
b. an invalidating environment
c. a dysfunctional family system
d. a dialectic stress situation
12.142
Ans. C
App
p. 438
E
Zahur is an antisocial male. If he is representative of most persons with this
disorder, one could expect that Zahur's overt criminal behavior will begin to
decrease at age
a. 28
b. 35
*
c. 40
d. 50
305
12.143
Ans. D
Con
p. 438
M
According to the cross-sectional and longitudinal research conducted on
antisocial "burnout," which of the following statements is BEST supported?
a. The apparent decrease in criminal activity is found only for older cohorts and
is not found in the longitudinal studies.
b. Although Regier et al.'s cross-sectional work suggested that burnout occurred
at age 40, Hare et al.'s longitudinal studies indicated that bumout occurs
early, around age 32.
c. Studies of clinician's assessment practices indicate that this bumout is
actually a function of diagnostic bias toward older clients.
d. This bumout is found for criminal behavior but not for the psychopathic
personality characteristics emphasized by Cleckley and hare.
12.144
Ans. A
App
p. 439
E
For which client is the prognosis for effective treatment MOST guarded?
a. Kenneth, with antisocial personality disorder
b. Gina, with borderline personality disorder
c. Vince, with avoidant personality disorder
d. Otis, with obsessive-compulsive personality disorder
12.145
Ans. D
App
p. 439
E
Dr. Braverman is reviewing the latest information available regarding the most
effective treatment for his antisocial clients. What treatment approach will he
choose?
a. dialectic behavior therapy
b. expressive psychotherapy or other object-relations therapy
c. antipsychotic medication or electroconvulsive therapy
d. He will not find any treatment that is effective.
SHORT ANSWER I ESSAY
12.146
Jasui is a client who is being treated for depression. His therapist believes that Jasui
also exhibits a schizotypal personality disorder. Why might you predict that Jasui will end
treatment once the acute depressive disorder is successfully treated?
Jasui probably will not see himself as troubled or suffering beyond the distress associated
with depressive symptoms. The traits associated with the personality disorder may be seen by Jasui
as a natural, normal part of his day-to-day functioning. Moreover, he will probably attribute most
of the difficulties created by the personality disorder to the actions and attitudes of others and
therefore be disinterested in further treatment.
12.147
Aimee has an Axis I diagnosis of generalized anxiety disorder and an Axis II
diagnosis of avoidant personality disorder. Describe four ways in which this comorbidity can be
understood.
1) Both disorders coexist separately but the hyperarousal of the Axis I disorder, for
instance, could aggravate the interpersonal discomfort of the Axis II disorder.
2) One of the disorders could have occurred earlier in time (possibly the personality
disorder, given its developmental origins), predisposing Aimee to developing the second disorder.
306
[12.147 cont'd]
3) This could be an artifact of the symptom criteria for each disorder; there could be one
underlying disorder that, in essence, is diagnosed twice under different headings.
4) Perhaps these are two separate disorders that are different not so much in kind
(categorically) but in degree (dimensionally), with one representing a milder version of an
underlying continuum of disturbance.
12.148
List the Big Five factors and indicate one personality disorder that represents the
two extremes of each dimension.
Neuroticism: high = paranoid, schizotypal, histrionic, borderline, avoidant, dependent,
obsessive-compulsive; low = not really applicable, although schizoid might come closest
Extroversion: high = histrionic, possibly antisocial or borderline; low = schizoid,
schizotypal, avoidant, obsessive-compulsive
Openness: high = not really applicable to any disorder; low = (not specified in text)
possibly paranoid, schizoid, obsessive-compulsive (most descriptive)
Agreeableness: high = dependent; low = paranoid, schizoid, schizotypal, narcissistic,
borderline, antisocial, obsessive-compulsive
Conscientiousness: high = obsessive-compulsive (although ambition is not matched with
actual productivity); low = borderline, antisocial
12.149
For which three personality disorders does research most reliably document a
genetic contribution?
Schizotypal, antisocial, obsessive-compulsive
12.150
List Millon's three polarities and describe how you would characterize histrionic
Sabrina according to each polarity.
Minimization of pain / maximization of pleasure: Sabrina is probably high on both of these,
and particularly so on maximization of pleasure. She actively seeks out attention, praise, and
approval and also will avoid being around others who have become tired of her flamboyance and
who no longer are charmed by her. She would minimize pain by avoiding attention to her
underlying feelings of insecurity and dependence on others' approval. On the other hand, she may
go so far as to develop physical complaints (pseudo-painful symptoms) to keep others' attention.
Passive accommodation / active modification: Sabrina will typically use active modification
in her approach to dealing with the environment. Because of the underlying need for approval and
acceptance, however, this could be described as an "active dependency."
Advancing the self/ caring for others: Sabrina would be superficially seen as caring for
others, but her real motivation in regard to this polarity is advancing herself and her own needs.
307
12.151
What evidence suggests that genetic and biological factors are important in
understanding antisocial personality disorder? What symptoms are accounted for by these factors?
Twin and adoption studies confirm the role of genetic factors. Concordance rates are higher
for MZ than DZ twins, and adopted children whose biological parents were criminals are more
likely to exhibit antisocial conduct. Adults with this disorder also tended to be hyperactive,
physically clumsy, and impulsive as children. Adults also exhibit an abnormally low level of CNS
arousal as well as theta wave activity that is commonly seen in children (Hare's "immature cortex").
This lack of sufficient cortical arousal may be the factor that leads to thrill seeking and
aggressiveness, difficulties in responding to aversive environmental contingencies for behavior
(especially social/interpersonal cues), and an unusually low anxiety level. Low autonomic nervous
system activity may also intensify this need for stimulating activities and interfere with the learning
of behavioral inhibition, leading to repeated criminal acts and deceitfulness. Taken together, these
factors may account for the lack of remorse or guilt following exploitative mistreatment of others.
12.152
Describe the specific family variables that are consistently associated with antisocial
behavior in offspring.
Parental criminality - serves as a source of role modeling; also disrupts family functioning
Chronic parental uninvolvement, erratic discipline, physical abuse, and poor supervision each fails to provide clear guidance regarding social mles; abuse also role models violence as a
solution to interpersonal conflict
Early parental loss involved emotional conflict (e.g., related to divorce) - psychological
damage due to trauma
Low SES - lack of educational and health resources can cause feelings of alienation or
hostility toward traditional social expectations
Exposure to deviant peers - another role modeling source; also reinforces criminal behavior
12.153
Describe Linehan's diathesis-stress model of borderline personality disorder and
some of the basic components of her system of therapy.
Diathesis = emotionally unstable temperament (biological contribution)
Stress = invalidating environments in which almost all of the child's emotions are strongly
controlled, ignored, punished, or trivialized
These combine to make it very difficult for the individual to cope with any intense emotion
and to impair the development of a stable sense of self, resulting in the disorder.
Her dialectical behavior therapy involves a reduction in high-risk, impulsive behaviors that
supports an increased tolerance for negative behaviors; then confrontation of traumatic experiences
begins; and clients are consistently helped to see that events can be viewed from multiple
perspectives which decreases splitting and encourages a more stable, integrated self-concept.
12.154
To which personality disorder would you assign the worst treatment prognosis? For
which disorders have specialized treatments been developed with some success?
Worst -- antisocial; some success -- avoidant and borderline and, possibly, narcissistic
308
Chapter 13 SUBSTANCE-RELATED DISORDERS
For drug X to be labeled as a "psychoactive" drug, which condition must be
met?
a. Its use leads to intoxication and abuse.
b. It is an illegal substance or a misused prescription substance.
c. It affects the user's thinking, emotions, and behavior.
d. It causes impairment in work or family life or causes personal distress.
Epidemiological data indicate that about
percent of Americans aged 15
to 54 have used at least one illegal dmg in the past year.
a. 10
b. 15
c. 24
d. 33
Sandy has a mental disorder. Disorders such as hers are associated with the
highest level of social and personal dismption. What disorder does she have?
a. substance abuse
b. bipolar disorder
c. schizophrenia
d. generalized anxiety disorder
As a substance abuse counselor in the mid 1980s, Mr. Kaplan probably saw a
decline in the use of each of the following drugs EXCEPT
a. marijuana.
b. alcohol.
c. cocaine
d. none of the above
Martin has ingested a psychoactive substance. He has impaired judgment,
altered thinking, has significantly changed his mood, and shows impaired
motor coordination. What is the name for his condition?
a. substance intoxication
b. physiological dependence
c. psychoactive delirium
d. inebriation
A counselor is questioning a new client about her psychoactive substance use.
On what basis would the counselor diagnose the presence of abuse?
a. the presence of physiological versus psychological dependence
b. the presence of personal impairment as a result of dmg use
c. the presence of polysubstance use
d. both b and c
309
13.7
Ans. D
App
p. 445
M
Why might a person who smokes marijuana on a daily basis NOT be
considered a drug abuser?
a. The person does not suffer from withdrawal symptoms when abstaining
from the drug.
b. Since the individual smokes marijuana everyday, tolerance develops and
signs of impairment are minimized.
c. The individual uses only marijuana and has not developed a polysubstance
abuse partem.
d. The individual is not experiencing nor causing harmful consequences as a
result of the illegal use.
13.8
Ans. C
App
p. 445-6
C
Which of the following persons would be described as having a psychological
dependence on a substance?
a. Paul smokes a joint most days before going to work. Most people are not
aware of his use of marijuana, and he insists he could "quit anytime I want
to."
b. Joe worried he might be an alcoholic and decided to stop drinking. After
two days of not drinking he was so sick with a headache and nausea that he
swore he had a horrible flu.
c. JoAnn had been off work for two months due to a back injury. The doctor
says she no longer needs the pain pills, but JoAnn is trying to obtain the
prescription from different physicians and has missed several days of work
because of these multiple appointments.
d. Mike is a truck driver. He began taking uppers as a way to drive further
on long days. After a couple of months, he thought his supplier was selling
him bad pills because the effect wasn't the same unless he took two or three
times as many pills as before.
13.9
Ans. A
App
p. 445
M
A drug dealer knows that some drugs will be more profitable than others.
That is, some drugs will force his buyers to spend larger and larger sums of
money for the same "kicks." What characteristic is the dealer counting on?
a. physiological dependence
b. craving
c. psychological dependence
d. intoxication dose-response curve
13.10
Ans. C
App
p. 445
E
Keith has been mainlining for a month. He has begun stealing money from
relatives to pay for his habit that is getting more and more expensive. What
most likely accounts for the increased expense?
a. substance intoxication
b. craving
c. tolerance
d. resistance
13.11
Ans. D
App
p. 445
C
If Adriana, an alcoholic, drinks alcohol in the morning in order to avoid the
unpleasant symptoms of withdrawal, what operant consequence occurs for her
behavior?
a. positive reinforcement
b. punishment
c. discrimination
d. negative reinforcement
*
310
13.12
Ans. A
Con
p. 445
M
Diagnostically, which of the following terms does not belong with the other
three?
a. substance-induced disorder
b. substance use disorder
c. dependence
d. abuse
13.13
Ans. B
App
p. 445
M
A college student is feeing expulsion from school after his third arrest for
public drunkenness and an obvious downward spiral in his grades. What
DSM-IV diagnosis is appropriate?
a. substance-induced disorder
b. substance use disorder
c. intoxication disorder
d. alcohol-related disorder
13.14
Ans. A
App
p. 445
M
A 20-year-old male has been admitted to the hospital for acute opioid
intoxication. His family indicates that he has been fired from his job and is
separated from his spouse as a result of his substance use. What DSM-IV
diagnosis(es) is/are warranted?
a. substance-induced disorder and substance abuse
b. substance dependence
c. opioid intoxication and substance-induced disorder
d. substance abuse and substance dependence
Hector has a crystal meth substance abuse disorder. What adverse consequence
would NOT be present as part of bis disorder?
a. a record of arrests for illegal possession
b. repeatedly using the drug while on his job as a forklift operator
c. increased drug intake to avoid withdrawal symptoms
d. physical assault toward a family member during intoxication
13.15
Ans. C
App
p. 445-6
M
13.16
Ans. D
App
p. 446
M
Hakan uses a psychoactive substance. Which description below would indicate
that Hakan has developed substance dependence?
a. Hakan fails to fulfill major obligations at work, and he repeatedly uses the
substance despite its exacerbation of his hypertension.
b. Hakan spends a great deal of time trying to obtain the substance, giving up
important social and recreational activities.
c. Hakan needs markedly increased amounts of the substance to achieve its
desired effects; and he is unsuccessful in his efforts to cut down on use.
d. Any of the above could signify dependence.
13.17
Ans. C
App
p. 446
M
Martina has received a substance-related diagnosis of early full remission.
This means she has been
a. substance dependent for over a year but received treatment and has been
drug-free for at least 3 months.
b. diagnosed as a substance abuser but has a persistent desire to control her
substance use.
c. free of signs of dependence for at least 1 month but for less than 1 year.
d. abusing psychoactive substance but is currently in a treatment program.
*
311
13.18
Ans. D
App
p. 446
C
Mira abuses PCP. In order for Mira's disorder to be diagnosed with a form of
substance dependence, what characteristic(s) must be present?
a. tolerance
b. withdrawal
c. either a orb
d. neither a nor b
13.19
Ans. B
App
p. 447
E
Earl abuses a substance that contributes to half of the fatal traffic accidents
that occur each year. What substance does he use?
a. marijuana
b. alcohol
c. some kind of stimulant, such as methamphetamine
d. some kind of opioid, such as cocaine
13.20
Ans. C
App
p. 447
E
If the average life expectancy for a male is about 72 years, what life
expectancy would you predict for Leo, an alcoholic male?
a. 70
b. 65
c. 62
d. 57
13.21
Ans. A
App
p. 447
E
If Leonard is an average drinker, approximately what will his yearly intake be?
a. 2.5 gallons
b. 3.2 gallons
c. 4.1 gallons
d. 4.9 gallons
13.22
Ans. B
App
p. 447
M
Based on epidemiological data, which of the following persons is MOST likely
to drink alcohol?
a. Bess, a female from Atlanta, Georgia
b. Rick, a male from Philadelphia, Pennsylvania
c. Francis, a male from Seattle, Washington
d. Bryan, a male from Omaha, Nebraska
13.23
Ans. D
Fac
p. 447
E
Roughly what percentage of the American population is abstinent?
a. 15
b. 1
c. 28
d. 33
13.24
Ans. A
Con
p. 447
E
Which of the following statements does NOT apply to Americans' alcohol
use or attitudes in the early 1990s compared to the 1970s and '80s?
a. Young adults report a small but steady decline in alcohol consumption,
b. Heavy drinking, defined as more than 14 drinks/week, has declined.
c. One third of Americans are moderate to heavy drinkers,
d. Social acceptance of heavy alcohol use is diminishing.
312
Natalie has just had a dnnk. Which organ will carry out ethanol oxidation?
a. the brain
b. the liver
c. the small intestine
d. the kidney
Alphonse has an alcohol dependence disorder. Alphonse's tolerance will result
in
metabolism of ethanol; his level of intoxication will be
if he
is eating food while drinking.
a. slower; increased
b. slower; lessened
c. faster; increased
d. faster; lessened
Danette realizes that individuals with alcohol use disorders often suffer
nutritional deficiencies. Though she won't stop her heavy drinking, she makes
a commitment to take high quality vitamins and to eat well at least once a day.
Why might her strategy fail?
a. Alcohol dehydrogenase will build up in her stomach, interfering with
absorption of nutrients into her bloodstream.
b. Her liver's ability to metabolize ethanol has been reduced and thus the
efficiency with which substances enter the bloodstream is compromised.
c. Ethanol and acetaldehyde build up in body cells and dismpt their functions,
including vitamin metabolism.
d. Being female, she probably lacks the beta-2 isoenzyme that slows the
metabolism of ethanol, allowing better absorption of vitamins.
Two people enter a pub at exactly the same time and both leave two hours
later. Both are stopped by police in different parts of town shortly after
leaving. Each person admits having had a couple of cocktails; however, when
their BAC levels are tested, one is .05 and the other is a .10. What would
account for these different levels?
a. Both had four draft beers, but one of the individuals has built up a
physiological tolerance for alcohol, therefore showing a higher BAC level.
b. Both had two shots of 100-proof tequila, but one has the beta-2 isoenzyme
and thus showed a higher BAC level.
c. Both had two mixed drinks, but the person with the .05 level was a woman,
and the other was a man.
d. Both had three glasses of wine, but one didn't feel like eating and had the
higher .10 level.
All other factors being equal, which of the following persons would have the
highest BAC level after one hour?
a. Michelle, who had one drink of 100-proof vodka
b. Bertrand, who had two draft beers
c. Suzanne, who had one draft beer
d. Chester, who had one drink of 100-proof gin
313
13.30
Ans. B
App
p. 447
M
Using the text's definition of a drink, how many drinks would it take for
Barry, an average-sized male, to reach a BAC of 0.2 to 0.25?
a. four shots (ounces) of whiskey
b. two six-packs of beer
c. six mixed drinks
d. eight 4-oz glasses of wine
13.31
Ans. C
App
p. 448
M
Clarence is at significant risk for cirrhosis of the liver as a result of his
consumption of
ounces of ethanol per day. His wife, Melba, is also at
significant risk but at a level of
ounce per day.
a. 3; 6
b. 4; 2
c. 6; 1.5
d. 6; 3.5
Which of the following persons is at a slightly increased risk of cardiovascular
disease?
a. Ricardo, who never drinks alcohol
b. Yvette, who drinks approximately one ounce of alcohol per day
c. Terrance, who drinks approximately two ounces of alcohol per day
d. Norris, who drinks approximately three ounces of alcohol per day
13.32
Ans. A
App
p. 448
M
13.33
Ans. B
App
p. 448
E
Geraldine is a chronic, heavy drinker. Which physical outcome is LEAST
likely?
a. cirrhosis
b. elevation of HDL cholesterol
c. immunosuppression
d. menstrual irregularities
13.34
Ans. C
App
p. 448
M
Mildred is ingesting the most commonly abused psychoactive substance. This
substance will reduce activity of
while increasing activity of
.
a. dopamine; acetylcholine
b. acetylcholine; dopamine
c. glutamate; GABA
d. GABA; glutamate
Rolando has ingested a depressant. If he experiences sedation and a reduction
of anxiety, which region of his brain was probably most strongly affected?
a. cerebellum
b. nucleus accumbens
c. frontal lobes
d. medial septal nucleus
13.35
Ans. D
App
p. 448
M
13.36
Ans. B
Fac
p. 448
E
*
If glutamate activity is decreased and GABA activity is increased, what sort of
substance is affecting the brain?
a. an opioid
b. a depressant
c. a hallucinogen
d. a stimulant
314
A highway patrol officer is asking a driver to walk a straight line along the
side of the road. The officer may not know it, but she is assessing whether the
driver's
may be under the influence of alcohol.
a. nucleus accumbens
b. cingulate gyrus
c. cerebellum
d. hypothalamus
While the medial septal nucleus may account for the negatively reinforcing
effects of alcohol, the
may be the neurological basis for the
positively reinforcing effects of that drug.
a. cerebellum
b. lateral geniculate nucleus
c. thalamus
d. nucleus accumbens
Olds and Milner found that rats would rather stimulate a region of their
hypothalamus than eat or engage in any other rewarding activity. What
neurotransmitter was probably influential in that brain region?
a. dopamine
b. GABA
c. acetylcholine
d. exogenous opiates
If laboratory rats reduce their consumption of alcohol following the injection
of a drug, it is likely that the drug
the neurotransmitter(s)
.
a. increased; dopamine
b. increased; dopamine or serotonin
c. decreased; GABA
d. decreased; GABA or glutamate
In reference to the effects of ethanol, which of the following substances does
not belong with the other three?
a. endorphins
b. dopamine
c. serotonin
d. glutamate
Don has been drinking. He has an unsteady gait, is drowsy, and is having
difficulty inhibiting his aggressive impulses. What is his probable BAC level?
a. .22
b. .15
c. .10
d. .05
Earlene is very intoxicated. If her BAC is .20, her chance of being involved
in a traffic accident is
times higher than usual.
a. 25
b. 19
c. 12
d. 6
315
13.44
Ans. B
App
p. 449-50
M
If Aiyana is a chronic substance abuser who exhibits an increasing impairment
in problem-solving skills and visual-motor skills and has difficulties
communicating with her family, what substance has she probably abused?
a. heroin
b. alcohol
c. methamphetamine
d. cannabis
13.45
Ans. D
App
p. 450
M
Which of the following persons is MOST likely to drink alcohol?
a. a nineteen year-old Asian male
b. an eighteen year-old white female
c. an eighteen year-old black male
d. a thirty year-old white female
13.46
Ans. A
Fac
p. 450
M
In order from LEAST to MOST likely to abuse alcohol, which groups of
Americans are correctly ordered?
a. Black < European < Hispanic
b. Asian < Hispanic < Black
c. Black < Hispanic < European
d. European < Asian < Hispanic
13.47
Ans. B
App
p. 451
M
Paul is 24 years old and has been out of college for two years. Paul is a
junior executive and entertains clients about three nights a week, which usually
involves cocktails and dinner. Additionally, he and his wife have cocktails and
dinner in town about twice a week. Paul doesn't think he has a drinking
problem - after all,his drinking is social and sometimes "just takes the edge
off." How might Jellinek describe Paul?
a. Paul is in the socialized chronic phase.
b. Paul is in the prealcoholic phase.
c. Paul is in the crucial phase.
d. Paul is in the pseudoalcoholic phase.
Arthur drank so much last night that he became unconscious. This is the third
time this has happened in the last six months, and his friends are increasingly
reluctant to go out with him because of his behavior. Jellinek would describe
Arthur's drinking as a reflection of the
a. crisis phase.
b. chronic phase.
c. crucial phase.
d. prodromal phase.
13.48
Ans. C
App
p. 451
M
*
13.49
Ans. B
Fac
p. 451
E
Which of the following represents a correct progression of Jellinek's stages?
a. prodromal > prealcoholic > chronic
b. prealcoholic > prodromal > crucial
c. prodromal > chronic > crucial
d. prealcoholic > critical > chronic
316
13.50
Ans. D
App
p. 451
M
Jamie is a female who began drinking when she was 32. She is prone to
feelings of anxiety but does not act out impulsively when she drinks, although
she is now a substance abuser. How would Cloninger describe her
alcoholism?
a. Prodromal Type
b. Crisis Type
c. Type I
d. Type II
13.51
Ans. A
Fac
p. 451-2
M
When an alcoholic individual is diagnosed with some form of cognitivesensory impairment (e.g., dementia), which comorbidity explanation is usually
relevant?
a. secondary psychiatric disorder model
b. common factor model
c. secondary alcoholism model
d. bidirectional model
13.52
Ans. B
App
p. 452
E
Akule is in Jellinek's chronic stage of substance abuse. He is experiencing
muscle tremors, profuse sweating, and believes that there are small animals
swarming around him, biting at his arms and legs. What is probably
happening?
a. a hallucinogen-induced psychotic disorder
b. an alcohol withdrawal delirium
c. an opioid intoxication disorder
d. a stimulant intoxication delirium
13.53
Ans. C
App
p. 452
M
Walter has the rare alcohol-related disease caused in part by a thiamine
deficiency. This disorder is a type of
a. alcohol-induced delirium.
b. alcohol withdrawal dementia.
c. alcohol-induced persisting amnestic disorder.
d. alcohol-related primary degenerative dementia.
13.54
Ans. D
App
p. 452
M
Ronald is a 60-year-old male with a history of chronic and severe substance
abuse who has been a patient in a state psychiatric facility for two years.
When asked the date, Ronald without hesitation gave an answer that was off
by 12 years. When asked again later, his answer was off by 15 years, and he
seemed oblivious to the discrepancies. What disorder is likely?
a. Type I alcohol-induced dementia
b. Alzheimer's disease
c. opioid-induced NMDA syndrome
d. Wernicke-Korsakoff syndrome
13.55
Ans. C
App
p. 453
M
Lynn and Pat are MZ twins. If Lynn is an alcoholic, which characteristic
below is LEAST associated with Pat's likelihood of developing the disorder?
a. Lynn and Pat are males rather than females.
b. Lynn has severe alcohol abuse problems.
c. Lynn's disorder began at age 35.
d. Lynn has Type II alcoholism.
317
13.56
Ans. B
Fac
p. 453
E
*
Which of the following is NOT one of the promising biological markers of
vulnerability to alcoholism?
a. P300 wave amplitude
b. frequency of D2 receptors
c. beta wave activity
d. MAO enzyme activity
13.57
Ans. A
Fac
p. 454
E
Why has serotonin NOT been emphasized as a highly promising biological
marker for alcoholism?
a. It is extremely impractical to extract it from an individual's central nervous
system.
b. Family studies linking it to alcoholism have not been consistently
replicated.
c. Animal studies have failed to demonstrate the hypothesized relationship of
low serotonin levels to alcohol craving.
d. None of the above is correct.
13.58
Ans. A
Con
p. 453-4
M
Todd is the son of an alcoholic father. Based on available studies of such
fathers and sons, one could expect to find each of the following characteristics
in Todd EXCEPT
a. abnormally low MAO activity.
b. accelerated heart rate change upon alcohol ingestion.
c. abnormally low P300 amplitude.
d. abnormally high beta wave activity.
13.59
Ans. C
App
p. 454
E
One alcoholic beverage producer decided to use the slogan, "It doesn't get any
better than this." If an individual believes that drinking this beverage will lead
to increased contentment and reduced stress, this individual is exhibiting
a. consumer hysteria.
b. belief adherence.
c. alcohol expectancies.
d. reinforcement contingencies.
13.60
Ans. D
Con
p. 454-5
M
In studies evaluating the tension reduction hypothesis, what mechanism
appears to be crucial in this psychological process?
a. the physiological effects of changes in dopamine and serotonin that lead to
increases in pleasant emotional states, suggesting it be called the "pleasure
enhancing hypothesis"
b. the physiological effects of changes in glutamate and GABA that lead to
decreases in unpleasant emotional states, as suggested by the theory
c. the number and intensity of stressors that people experience on a day-to­
day basis
d. the nature of an individual's beliefs about alcohol's ability to reduce
unpleasant emotional states or increase pleasant emotional states
318
How has the research of Alan Marlatt and colleagues been significant in
challenging the disease model of alcohol dependence?
a. Their longitudinal study showed that junior high school students' positive
expectancies could predict later drinking behaviors.
b. Their experimental study indicated that expectations could lead to increased
drinking even when participants' beverages actually had no alcohol.
c. Their study confirmed Freud's contention that alcoholism is a reflection of
frustrated oral needs and regression to the oral stage.
d. Their study was instrumental in showing that problem drinking was more
closely related to parental role modeling than inherited biological
vulnerabilities.
Which of the following men will drink the MOST?
a. Stephen, who has high alcohol expectancies, believes he IS drinking
alcohol and whose beverage does NOT contain alcohol
b. Rudy, who has high alcohol expectancies, believes he is NOT drinking
alcohol and whose beverage does NOT contain alcohol
c. Marco, who has low alcohol expectancies, believes he IS drinking alcohol
and whose beverage DOES contain alcohol
d. Zahur, who has moderate alcohol expectancies, believes he is NOT
drinking alcohol and whose beverage DOES contain alcohol
According to research conducted with the AEQ, for which of the following
persons would you make the most confident prediction that she or he engages
in problem drinking?
a. Martinique, who believes that drinking will increase her experience of
social pleasure
b. Rose, who believes that drinking will lead to increased power
c. Ryan, who believes that drinking will lead to increased power
d. Emmett, who believes that drinking will reduce tension, anxiety, and anger
Which of the following persons is MOST likely to engage in problem
drinking?
a. an Irish teen who believes alcohol will enhance sexual experiences
b. an American teen who believes alcohol will increase aggression and
dominance
c. an American teen who believes alcohol will increase social competence
d. an Irish teen who believes that alcohol will reduce unpleasant emotions
such as anxiety and depression
What variable has been shown to reliably predict junior high school students'
subsequent drinking behaviors?
a. externalizing
b. alcohol expectancies
c. dependent personality
d. both a and b
319
13.66
Ans. A
App
p. 456
E
13.67
Ans. C
Fac
p. 457
M
*
Dimitri is a 12-year-old male who is often getting into trouble for
aggressiveness toward peers, frequent dangerous behaviors (such as trying to
break into school after hours), and impulsive acting-out at home. What is the
name for his behavior pattern?
a. externalizing
b. antisocial personality
c. undersocialization
d. hyperactive temperament
Which of the following family-related variables is LEAST strongly associated
with offspring's likelihood of alcohol abuse during adolescence?
a. parental discipline style
b. presence of family "rituals"
c. parental abstinence from alcohol
d. level of satisfaction with parent-child relationship
13.68
Ans. B
App
p. 457
M
There is a close match between Thongsay's level of alcohol consumption and
that of his parents. What drinking pattern would you predict for the family
members?
a. abstinence
b. moderate consumption
c. very heavy consumption
d. any of the above
13.69
Ans. D
Fac
p. 458
E
What factor is MOST important as a cause of alcohol use disorders?
a. biological
b. psychological
c. social
d. none of the above
13.70
Ans. B
App
p. 458
C
Jeanne's biological father was an alcoholic and her mother was not. Her
parents both died in a car accident when she was only 4 years old. Over the
next 14 years, she lived in 3 separate foster homes. There were no signs of
alcohol abuse in any of her homes. Which of the following is the best
explanation for why she developed alcohol dependence by age 22?
a. Given the strong genetic contributions to this disorder, biological factors are
probably the cause of her disorder.
b. A combination of biological vulnerability, psychological expectancies, and
strained relationships with foster parents probably caused her disorder.
c. The naturally occurring stress of multiple foster homes, along with a
genetic predisposition, was sufficient to cause her disorder.
d. She probably developed an externalizing personality as a result of the early
trauma and foster care experiences, which, along with peer pressure in
adolescence, leads to alcohol use disorders.
13.71
Ans. C
Con
p. 458
M
Legal sanction is to complete abstinence as
a. learning perspective is to moral perspective.
b. disease model is to learning perspective.
c. moral perspective is to disease model.
d. learning perspective is to disease model.
320
13.72
Ans. A
Fac
p. 458
E
*
13.73
Ans. D
Fac
p. 458-9
E
The disease model of alcoholism is endorsed by most persons in each of the
following groups EXCEPT
a. academic psychologists.
b. National Institute on Alcohol Abuse and Alcoholism.
c. physicians.
d. Alcoholics Anonymous.
Based on scientific data, which approach to understanding alcohol abuse and
alcoholism appears to be most reasonable?
a. disease
b. sin
c. habit
d. none of the above
13.74
Ans. B
Con
p. 458
C
Jacques is a participant in a study by Tarter and Vanyukov. If Jacques
displays a disinhibition temperament, what biological marker might you also
expect to find?
a. abnormally small P300 amplitude
b. abnormally low serotonin levels
c. abnormally low MAO activity
d. abnormally slow beta wave activity
13.75
Ans. D
App
p. 458
M
A graduate student is conducting research to determine whether certain
temperaments in combination with certain environments are likely to dispose
an adolescent to problem drinking. What model is the student following?
a. the Minnesota model
b. Marlatt prevention model
c. Cloninger model
d. Tarter and Vanyukov model
13.76
Ans. A
App
p. 460
M
Awenita has entered a program for alcohol dependence. If this program is
based on the most common treatment model used in the U.S., her alcohol
problem will be viewed as a
a. disease.
b. moral weakness.
c. learned habit.
d. deficit in coping and social skills.
13.77
Ans. B
App
p. 460
E
If Aaron receives the most common form of help for his alcoholism, he will
a. enter a hospital-based detox program followed by individual counseling.
b. attend AA meetings.
c. receive outpatient marital and/or family therapy.
d. participate in relapse prevention.
13.78
Ans. C
App
p. 460
M
Marilyn is "first stepping." In other words, she is
a. experiencing the effects of her first ingestion of a hallucinogenic drug.
b. beginning to experience withdrawal from an opioid drug.
c. accepting the fact that she is an alcoholic.
d. participating in the first stage of aversion therapy for alcohol dependence.
321
13.79
Ans. D
Fac
p. 460
M
Which of the following best describes AA's treatment approach?
a. behavioral
b. sociocultural
c. interpersonal
d. spiritual
13.80
Ans. A
Con
p. 460-1
M
If someone were to ask you about the effectiveness of the AA approach, what
empirically-based answer would you give?
a. Insufficient research has been conducted, so its overall effectiveness is not
yet known.
b. More than half of its members drop out during the first year because the
method is not helpful to them.
c. Once a member becomes a sponsor for newcomers, the sponsor's
abstinence rate is nearly 100%.
d. It is effective, although members demonstrate higher relapse rates than do
alcoholics who are treated under the Minnesota model.
13.81
Ans. B
App
p. 461
M
Betty spends a great deal of her life dealing with Ralph's alcohol problem.
She tries to hide his problem from family and friends by making excuses for
him or attempting to act like it doesn't bother her. Ralph can always count on
Betty to explain why he has to miss work because of a bad case of the "flu"
when his hangover keeps him in bed. How might you describe Betty's
behavior?
a. classically conditioned
b. codependent
c. symbiotic
d. agonistic
Which of the following persons is MOST likely to drink less and report greater
marital satisfaction as a result of treatment for alcohol abuse?
a. Eric, who undergoes individual behavioral therapy.
b. Sylvester, whose spouse attends his behavioral therapy sessions.
c. Norris, who receives marital therapy with his spouse.
d. Sylvester and Norris will report similar positive outcomes.
13.82
Ans. C
App
p. 461
M
13.83
Ans. A
App
p. 461
M
Each time Coretta touches a bottle of alcohol, her therapist administers a mild
but aversive shock to her arm. In classical conditioning terms, when Coretta
feels apprehensive upon seeing a bottle in the cabinet at home, the bottle has
become a(n)
a. conditioned stimulus.
b. conditioned response.
c. unconditioned stimulus.
d. unconditioned response.
13.84
Ans. B
Con
p. 461
E
Classical conditioning is to operant conditioning as
a. AA is to behavioral therapy.
b. aversion therapy is to community reinforcement,
c. medication is to aversion therapy.
d. community reinforcement is to AA.
322
13.85
Ans. C
App
p. 462
E
Shelly is experiencing severe DTs. What sort of medication is she most likely
to receive for these symptoms?
a. Antabuse
b. naltrexone
c. Valium
d. dextroamphetamine
13.86
Ans. D
App
p. 462
M
What kind of treatment is Kenesha going through if she is taking disulfiram?
a. This is a kind of antagonist drug that blocks production of endogenous
opiates to decrease her opioid cravings.
b. She is undergoing detox and is receiving treatment for the withdrawal
symptoms of alcohol abuse.
c. She is undergoing detox and is receiving treatment for the withdrawal
symptoms of barbiturate abuse.
d. She is undergoing a kind of aversion therapy in which she will experience
very unpleasant effects if she uses alcohol.
13.87
Ans. A
App
p. 462
M
Marion has a substance abuse disorder. Part of her treatment includes
medication which interferes with the production of endogenous opiates. What
medication would this be, and what is its therapeutic effect?
a. naltrexone; reduction in craving
b. disulfiram; discouragement of drinking
c. benzodiazepine; reduction of withdrawal symptoms
d. carbamazepine; discouragement of drinking
For which of the following persons might controlled drinking be an effective
treatment approach?
a. Don, diagnosed with alcohol dependence
b. Raoul, diagnosed with alcohol abuse
c. Melinda, diagnosed with alcohol dependence
d. None of the above; controlled drinking has not received empirical support
for its efficacy
*
13.88
Ans. B
App
p. 462
E
13.89
Ans. C
Con
p. 463
C
AA's approach to treating alcoholism includes the prediction that if a member
relapses, renewed abuse or dependence will take place. Which of the
following statements is CORRECT in regard to that prediction?
a. RAND corporation research and the Sobells' studies largely support this
prediction.
b. Mariatt and colleagues conclude that this prediction holds true for about 80
percent of those members.
c. The prediction can function as a type of a positive alcohol expectancy and
can itself increase the likelihood of the continued drinking.
d. Relapse prevention studies indicate that this prediction is confirmed
primarily for older, alcohol dependent individuals but not for younger,
alcohol abusing individuals.
13.90
Ans. A
Con
p. 463
E
Which of the following concepts does NOT belong with the other three?
a. relapse aversion process
b. self-defeating cognitions
c. self-fulfilling prophecy
d. abstinence violation effect
323
13.91
Ans. D
App
p. 463
M
Henri agreed to attend a cocktail party in honor of a friend who was receiving
an important award. Henri, a recovering alcoholic, was confident that he
would have one glass of wine "just to fit in" but would drink nothing more,
According to Marlatt and Gordon, what initial factor would precipitate a
relapse for Henri?
a. an abstinence violation effect
b. a negative alcohol expectancy violation
c. community reinforcement
d. an apparently irrelevant decision
13.92
Ans. A
App
p. 464
M
Allen is a participant in an ASTP on his campus. He would experience each
of the following EXCEPT
a. persuasive communication by experts in the field of substance abuse.
b. encouragement to engage in controlled drinking by avoiding the abstinence
violation effect.
c. nonconfrontational discussions with other group members about how his
drinking affects his behavior.
d. an educational emphasis on the short-term negative consequences of
drinking.
13.93
Ans. B
Fac
p. 464
E
What do affective education, resistance training, and normative education have
in common?
a. They are components of AA's treatment approach.
b. They are components of prevention programs aimed at adolescents.
c. They are components of Marlatt and Gordon's ASTP.
d. They are components of brief intervention programs for opioid abusers.
13.94
Ans. C
App
p. 464
M
*
Thu is an adolescent who is participating in a school-based prevention program
targeting substance abuse. What prevention approach is likely to be MOST
effective in changing Thu's behavior and attitudes?
a. skill training in interpersonal communication and assertiveness
b. enhancement of self-esteem and values clarification
c. promotion of peer norms and public commitment to abstinence
d. provision of information about long-term negative consequences of
substance abuse and dependence
13.95
Ans. D
Fac
p. 464-5
M
Data reveal that prevention programs have only a modest impact on
adolescents who complete them. What factor is identified as crucial in
accounting for these outcomes?
a. an overreliance on simplistic "just say no" school-based programs
b. a failure to offer programs to students prior to ninth grade, when alcohol
use has already begun
c. a lack of sufficient programs that incorporate needed multicomponent
approaches
d. the cultural support for alcohol use
324
13.96
Ans. B
App
p. 466
M
If Adrienne is aware of her drinking problem but is not yet willing to make
changes and has not sought professional treatment, which stage of change is
she in, according to Prochaska et al.?
a. preparation
b. contemplation
c. precontemplation
d. prereadiness
13.97
Ans. D
App
p. 466
M
Wilhelm has begun to make small changes in his problem drinking behavior,
such as slightly reducing his alcohol intake and taking better care of his health.
He hopes to cut ties with his "drinking buddies" and form new friendships that
do not involve drinking. Wilhelm is at what stage of readiness-for-change?
a. action
b. maintenance
c. contemplation
d. preparation
13.98
Ans. C
Fac
p. 466-7
E
According to the readiness-for-change model, for whom might an aversionbased therapy approach be LEAST useful for treating problem drinking?
a. someone in the preparation stage
b. someone in the prodromal stage
c. someone in the contemplation stage
d. someone in the maintenance stage
13.99
Ans. B
Fac
p. 468
E
Which of the following drugs is a type of depressant?
a. crystal meth
b. Seconal
c. Dexedrine
d. morphine
13.100
Ans. C
App
p. 469
M
Jim has been suffering from major depression and alcohol dependence for
several years. Recently, he attempted to commit suicide by drinking alcohol
and taking another psychoactive substance. The other drug was most likely
a. a narcotic.
b. an amphetamine.
c. a barbiturate.
d. an hallucinogen.
13.101
Ans. A
Con
p. 469
E
Which of the following descriptions does NOT apply to drugs such as Xanax?
a. less likely than barbiturates to be the lethal agent in completed suicides
b. safer, less toxic than barbiturates
c. affect the CNS through general suppression of brain cell activity
d. can cause dependence and withdrawal even when prescribed therapeutically
13.102
Ans. B
Fac
p. 469
E
For which of the following conditions would a benzodiazepine NOT be
prescribed?
a. anxiety disorders
b. attention deficit hyperactivity disorder
c. withdrawal symptoms of alcohol dependence
d. painful muscle spasms
325
13.103
Ans. C
App
p. 470
M
You are a new intern on a psychiatric unit for geriatric patients. When
conducting a cognitive assessment of your patients, you would want to be
especially alert to potential impairment caused by a commonly prescribed class
of drugs, namely
a. anxiolytics.
b. stimulants.
c. hypnotics.
d. anticholinergics.
13.104
Ans. D
App
p. 470
M
Lewis was arrested for illegal drug possession with intent to sell. After a week
confined in jail, he began to experience withdrawal symptoms such as
sweating, elevated body temperature and coronary activity, as well as nausea
and vomiting. What dmg was he probably addicted to?
a. morphine
b. dextroamphetamine
c. crack cocaine
d. Valium
Margo has undergone several weeks of hospitalization for detox following
depressant abuse. If she experiences the abstinence syndrome, Margo will
a. have symptoms of body aches and mood disruption that may last for a few
months and leave her vulnerable to relapse.
b. begin to engage in apparently irrelevant decisions that foster self-defeating
cognitions, which can lead to the abstinence violation effect.
c. experience mild symptoms of anxiety and physical discomfort that will last
a few days due to an incomplete detoxification process.
d. have short-term impairment in fine motor skills, short-term memory, and
attentional capacities as her body adjusts to its detoxified state.
13.105
Ans. A
App
p. 470
M
13.106
Ans. B
Con
p. 470
E
Which drag does not belong with the other three?
a. nicotine
b. methadone
c. cocaine
d. caffeine
13.107
Ans. C
App
p. 470
M
*
Edmund has just ingested a dmg that is causing feelings of exhilaration and
vigor, as well as talkativeness. He has probably taken some kind of
that is increasing his brain's availability of
.
a. opioid; dopamine
b. opioid; endorphins
c. stimulant; dopamine
d. stimulant; serotonin
Leta's friends are worried about her weight loss over the past few months and
are alarmed that she has begun to accuse her husband of trying to poison her.
If Leta is a substance user, what is she probably abusing?
a. crack cocaine
b. cannabis
c. MDMA
d. methamphetamine
/
13.108
Ans. D
App
p. 471
M
326
13.109
Ans. A
Con
p. 471
E
Which of the following persons is MOST likely to be at risk for HIV infection
as a result of the means by which she or he ingests a psychoactive substance?
a. Anica, a recreational user of amphetamines
b. Marcus, a regular cocaine free-baser
c. Marianna, a daily cannabis smoker
d. Vance, a recreational user of mescaline
13.110
Ans. B
Fac
p. 471
E
What do South American Incas and Sigmund Freud have in common?
a. a belief in the dangers of the leaf of the nicotiniana tabacum
b. an interest in the use of the leaf of the erythroxylon coca
c. the use of peyote as a treatment for some forms of emotional disturbance
d. the use of morphine as a powerful analgesic
13.111
Ans. D
Con
p. 471
E
Which of the following substances and categories are INCORRECTLY paired?
a. barbiturate : depressant
b. nicotine : stimulant
c. mescaline : hallucinogen
d. cocaine : opioid
13.112
Ans. C
App
p. 471
E
Harold is drinking a carbonated soft drink in the year 1895. What substance
is in that legal beverage that will later be an illegal recreational drug?
a. caffeine
b. amphetamine
c. cocaine
d. MDMA
13.113
Ans. D
Fac
p. 471
E
Which psychoactive substance, a focus of the Harrison Act, became a popular
drug of choice for middle- and upper-income groups during the late 1970s?
a. LSD
b. PCP
c. heroin
d. cocaine
13.114
Ans. A
App
p. 472
M
Comedian Richard Pryor suffered severe bums to much of his upper body as a
result of an accident mat occurred while he was ingesting a particular drug.
What drug was this?
a. cocaine
b. LSD
c. methamphetamine
d. heroin
13.115
Ans. B
App
p. 472
E
Marry is smoking a drug that occurs in the form of brownish crystals or
"rocks." This drug is a type of
a. hallucinogen,
b. opioid.
c. stimulant,
d. depressant.
*
327
13.116
Ans. C
Fac
p. 472
E
Cocaine is different from the amphetamines in each of the following ways
EXCEPT
a. cocaine produces faster effects.
b. cocaine's effects last for a shorter length of time.
c. cocaine "crashes" are less likely.
d. cocaine produces a more euphoric experience.
13.117
Ans. A
Fac
p. 472
E
Which drug is sometimes used to treat migraine headaches, asthma, and the
congestion caused by head colds?
a. caffeine
b. nicotine
c. dexedrine
d. cannabis
13.118
Ans. B
App
p. 472
M
Barbara, a law student, has been studying for the bar exam. She has had very
little sleep and is having trouble staying awake. Today, she has had so much
fresh
drip coffee that she has muscle tremors, is agitated and very talkative,
and can no longer study effectively due to disorganized thinking. How many
6 oz. cups of coffee would be needed to produce these effects?
a. 5
b. 7
c. 10
d. 12
13.119
Ans. D
App
p. 472-3
M
Lance drinks two 6 oz. cups of fresh drip coffee every morning. What would
Landolt and colleagues say about the possible risks associated with this use?
a. Lance will probably experience an increased risk of cardiovascular disease,
b. Lance will be at slightly greater risk of developing a mild anxiety disorder
than are people who do not use caffeine.
c. Lance will develop a dependence on the caffeine that will be associated
with mild withdrawal symptoms if he stops drinking coffee.
d. Lance will probably experience REM sleep disruption and decreased total
sleep time.
13.120
Ans. C
Con
p. 473
C
Which of the following terms does NOT belong with the other three?
a. indigenous South American plant
b. French ambassador to Portugal
c. intoxication
d. deadly poison
13.121
Ans. D
App
p. 473
M
Bianca is quite worried about her husband's drug habit. Bianca's husband is
smoking a substance which, in a few direct drops on the tongue, can cause
respiratory failure and death. What substance is being ingested?
a. crack cocaine
b. "ice"
c. mescaline
d. nicotine
328
Which of the following dmgs is LEAST likely to produce intoxication?
a. nicotine
b. caffeine
c. cannabis
d. methadone
Stimulation of dopamine activity in the nucleus accumbens is one of the
central effects of each of the following substances EXCEPT
a. nicotine.
b. heroine
c. alcohol
d. none of the above
Daniel has a substance dependence disorder that is related to what many
experts consider to be the number one public health problem in the U.S.
Daniel's dependence developed quickly due to the substance's effects on which
neurotransmitter(s)?
a. serotonin.
b. endorphins and enkephalins.
c. dopamine and acetylcholine.
d. endorphins and serotonin.
Nicole has stopped ingesting a drug for which she has developed a
dependence. As a result, she exhibits an irritable and depressed mood, has a
slower-than-normal heart rate, and is gaining weight. What substance is the
most likely culprit?
a. barbiturate
b. cannabis
c. alcohol
d. nicotine
Which of the following has NOT been utilized for treatment of cocaine abuse?
a. Antabuse
b. community reinforcement
c. Cocaine Anonymous
d. node-link mapping
Which of the following treatment interventions for cocaine abuse is
conceptually most similar to relapse prevention for alcoholism?
a. bromocriptine therapy
b. node-link mapping
c. community reinforcement
d. Cocaine Anonymous
In the 1970s, about one of every
this number is about one of every
a. 4; 8
b. 3; 6
c. 2; 4
d. 2; 8
329
Americans smoked cigarettes; today,
.
13.129
Ans. D
App
p. 475
M
v
Marko has smoked for several years. He recently tried to quit and is very
disappointed that he was unable to do so. If he is typical of such would-be
quitters, how many times will he try to quit before achieving lasting success?
a. 9 to 10
b. about 8
c. 5 or 6
d. 3 or 4
13.130
Ans. A
App
p. 475
M
Jin-Uk wants to find a treatment for his smoking addiction. What
recommendation would you realistically make to him?
a. Find a program in which you will have frequent contact with a counselor
who helps you quit smoking gradually, including nicotine replacement
therapy.
b. Find a program in which they encourage abmpt "cold turkey" cessation and
they do not rely on nicotine gum or patches.
c. Find a program in which you quit "cold turkey" while also receiving a
prescription for mecamylamine.
d. You could recommend any of the above, given that this substance
dependence disorder is rarely effectively treated.
13.131
Ans. B
App
p. 475
M
A psychology intern is one of a team of counselors offering an intensive
behavioral treatment program for smoking cessation. If she works with 15
clients in a group, roughly what number of those clients will she expect to see
in treatment again within one year if the program shows average results?
a. 12
b. 10
c. 7
d. 4
13.132
Ans. C
Con
p. 462,75
M
Naltrexone is to mecamylamine as
a. anticraving is to anti-withdrawal.
b. endorphins is to serotonin.
c. alcohol is to nicotine.
d. barbiturate is to depressant.
13.133
Ans. D
Con
p. 476
E
Which of the following does not belong with the other three?
a. narcotic
b. poppy plant
c. endorphins
d. cannabis
13.134
Ans. A
Fac
p. 476
M
A recognition of posttraumatic stress disorder came about in part because of
the experiences of Vietnam War veterans. In a similar fashion, Civil War
veterans helped make the addictive potential of
widely known.
a. opioids
b. stimulants
c. cannabis
d. cocaine
330
13.135
Ans. B
Fac
p. 476
E
Opium and heroin are types of
a. endorphins.
b. exogenous opioids.
c. cannabinoids.
d. endogenous opioids.
13.136
Ans. C
App
p. 476
M
Guillermo is in severe pain due to injuries sustained in an automobile accident.
Each of the following substances would reduce his pain EXCEPT
a. endogenous endorphins,
b. exogenous opiates.
c. a narcotic antagonist,
d. an opiate agonist.
13.137
Ans. D
App
p. 476
M
Tchong is addicted to a drug that was developed by German physicians in the
late 19th century as a powerful analgesic. What substance is this?
a. LSD
b. MDMA
c. cocaine
d. heroin
13.138
Ans. A
App
p. 476
E
Theodore is a 25 year-old, relatively affluent male who thinks it is "trendy" to
use a certain illegal drug. This same drug is associated with extremely high
rates of HIV in some inner cities. What drug is Theodore using?
a. heroin
b. crack cocaine
c. methamphetamine
d. PCP
13.139
Ans. B
Con
p. 472,76
E
Mainlining is to free-basing as
a. amphetamine is to heroin.
b. heroin is to cocaine.
c. cocaine is to MDMA.
d. morphine is to heroin.
13.140
Ans. C
App
p. 477
M
Estrella is in a drug-induced state of euphoria. She seems disconnected to the
events going on around her, and her speech is slurred. What sort of drug has
she ingested?
a. LSD
b. cocaine
c. heroin
d. methamphetamine
13.141
Ans. D
App
p. 477
M
Jerome is a heroin addict who mainlines in his home. One night, he went to a
bar and bought a dose of heroin and decided to inject it before going home.
This time, he died of an overdose. What accounts for this outcome?
a. operant conditioning
b. classical conditioning
c. environmental-dependent opioid tolerance
d. both b and c
*
331
13.142
Ans. B
App
p. 477
M
As you read the text and prepared for the exam, which neurotransmitter
probably mediated your learning and memory processes among neurons?
a. MDMA
b. NMDA
c. dopamine
d. endorphins
13.143
Ans. A
App
p. 477
M
Carmen seems unhappy, hyperalert, anxious, and oversensitive to pain. Her
friend is also wondering if Carmen has had the flu for the past few days. If
Carmen has a substance dependence disorder, what is most likely to cause this
syndrome?
a. withdrawal from an opioid
b. withdrawal from a stimulant
c. intoxication from a narcotic
d. withdrawal from a depressant
13.144
Ans. C
Con
p. 477
M
While some clinicians question the need for medication in the treatment of
withdrawal symptoms of alcohol dependence, they would agree that naltrexone
is a central component in detoxification related to
a. cocaine and crack.
b. hallucinogens.
c. narcotics.
d. sedatives and hypnotics.
13.145
Ans. D
Fac
p. 477-8
E
Which of the following statements is FALSE in regard to methadone?
a. It is a synthetic opioid prescribed as a substitute for heroin.
b. It is less addictive than heroin and causes less problematic withdrawal
symptoms.
c. Methadone maintenance therapy leads to reductions in HIV risk and
significantly reduced illicit opioid use.
d. The addition of a psychological therapy component to methadone
maintenance does not appear to affect treatment outcomes.
13.146
Ans. A
App
p. 477-8
M
Eddie is a participant in a methadone maintenance program. Which of the
following outcomes is LEAST likely for him?
a. Eddie will be dependent on this treatment for 10 years or more,
b. Eddie will reduce his risk of contracting HIV.
c. Eddie will increase his use of cocaine.
d. Eddie will require less methadone if he is involved in supportive-expressive
short-term psychoanalysis.
13.147
Ans. D
Fac
p. 479
E
What neurotransmitter is most directly involved in the CNS effects of THC?
a. acetylcholine
b. GABA
c. serotonin
d. THC's neurochemical action has not been determined.
332
13.148
Ans. D
Con
p. 479
M
Which of the following issues BEST describes why it is difficult to compare
studies conducted in the 1970s with studies conducted in the 1990s regarding
the observed effects of frequent marijuana use?
a. Increased concern about legal penalties may cause research participants to
be less candid in their self-reports in the 1990s.
b. Researchers in the 1970s were unlikely to obtain measurements that would
have demonstrated the drug's impairment of psychological characteristics.
c. The demographic characteristics of persons using this drug changed
dramatically over the two decades.
d. The concentration of THC in marijuana grown and distributed in the 1990s
is almost 5 times higher than it was in plants cultivated earlier.
13.149
Ans. C
App
p. 479
M
For which of the following persons would marijuana NOT be considered as a
possible treatment?
a. Jack, who is experiencing anticipatory nausea as a result of his
chemotherapy
b. Marleen, who has been diagnosed with anorexia nervosa
c. Stacey, who has advanced-stage multiple sclerosis
d. Raphael, who has severe glaucoma
Dorian has bloodshot eyes, a faster-tlian-normal heartbeat, and is heading out
the door to the all-night diner to satisfy his munchies urge. What psychoactive
substance has he probably ingested?
a. cocaine
b. marijuana
c. psilocybin
d. crystal meth or "ice"
13.150
Ans. B
App
p. 479
E
13.151
Ans. A
App
p. 479
M
Salome is on a date and has taken a drug that is enhancing her present mood,
seems to make the night pass more slowly, and enhances her enjoyment of the
movie she and her date are viewing -- the dialogue seems witty and the figures
on the screen seem almost real enough to touch. What drug is she probably
using?
a. THC
b. MDMA
c. LSD
d. PCP
13.152
Ans. D
Fac
p. 479
E
THC intoxication is related to impairments in each of the following EXCEPT
a. short-term memory.
b. ability to sustain attention,
c. fine motor coordination.
d. none of the above
333
13.153
Ans. A
App
p. 479
M
There is a group known as Mothers Against Drunk Driving (MADD).
Evidence from automobile and motorcycle accidents suggests that a similar
group might also be concerned about persons who drive under the influence of
a. cannabis.
b. MDMA.
c. benzodiazepines.
d. glutamate.
13.154
Ans. B
App
p. 479
M
If Brandon abuses marijuana, which form(s) of dependence are of greatest
concern?
a. physiological
b. psychological
c. both physiological and psychological
d. Marijuana is not associated with any significant form of dependence.
13.155
Ans. C
Con
p. 479-80
M
John was explaining to his girlfriend why she shouldn't worry about his
occasional use of marijuana. He could defensibly make each of the following
statements EXCEPT
a. "I won't get hooked [physically dependent] on this drug."
b. "Psychological research has not yet documented any significant, lasting
harmful effects of this drag."
c. "A joint contains fewer toxic carcinogens than do the cigarettes that you
smoke."
d. "It used to be legal in the U.S., and some people are strongly in favor of
making it legal again."
13.156
Ans. D
Fac
p. 480
M
Current empirical evidence on the long-term psychological effects of cannabis
provides reliable evidence for which of the following statements?
a. Regular use of the drag causes an amotivational syndrome,
b. Preexisting mild depression leads to the use of marijuana as selfmedication, and the depression also accounts for the amotivational
syndrome.
c. Both regular drug use and the amotivational syndrome are related to a
common underlying genetic predisposition toward abnormally low CNS
activity levels.
d. None of the above has been reliably substantiated.
13.157
Ans. B
Fac
p. 480
E
Which type of hallucination is most common in relation to psychedelic drags?
a. auditory
b. visual
c. olfactory
d. tactile
13.158
Ans. A
App
p. 480
M
Cassie is under the influence of a drag which is making her feel as though she
can "see" the voice of her instructor as she listens to the instructor's lecture.
What is the term for her "seeing" her instructor's voice?
a. synesthesia
b. visual dyskinesia
c. psychedelic perception
d. flashback
334
13.159
Ans. C
Fac
p. 480
M
If an individual is experiencing psychotic-like symptoms as a result of
ingesting a psychoactive substance, what neurotransmitter is most likely
being altered?
a. dopamine
b. endorphins
c. serotonin
d. norepinephrine
13.160
Ans. D
Con
p. 481
M
Which of the following terms are INCORRECTLY paired?
a. rush : heroin
b. trip : LSD
c. munchies : cannabis
d. extreme euphoria : methamphetamine
13.161
Ans. A
App
p. 481
M
Bryce uses LSD. You would be concerned about each of the following
possible consequences EXCEPT
a. physical health risks, such as withdrawal symptoms,
b. a possible hallucinogen persisting perception disorder.
c. panic attacks during intoxication,
d. extremely variable moods.
13.162
Ans. A
App
p. 481
M
*
Tracey is under the influence of a dmg which is making her feel as though her
body has been stretched eight feet. Tracey also "sees" her boyfriend's voice
as he talks to her on the phone. What dmg has she ingested?
a. psilocybin
b. heroin
c. cocaine
d. dexedrine
13.163
Ans. B
App
p. 481
M
*
Eleanor accepted an unknown dmg at a party. Tragedy struck when Eleanor
suddenly collapsed and died on the dance floor. A physician called to the
scene diagnosed the cause of death as hyperthermia. What dmg did she take?
a. LSD
b. Ecstasy
c. NMDA
d. phencyclidine
13.164
Ans. C
Fac
p. 482
E
Like heroin,
a. LSD
b. cannabis
c. PCP
d. barbiturates
13.165
Ans. D
App
p. 482
M
If Clark Kent weren't really Superman but only thought he was because he was
under the influence of a psychedelic, he would MOST likely be taking
a. LSD.
b. Ecstasy
c. mescaline,
d. PCP.
was originally developed to serve as a medical anesthetic.
335
13.166
Ans. A
Fac
p. 482
E
A middle-class European American college student is LEAST likely to use
a. PCP.
b. mescaline,
c. LSD.
d. Ecstasy.
SHORT ANSWER / ESSAY
13.167
List six of the many health risks associated with chronic alcohol abuse.
Vitamin deficiencies; cirrhosis of the liver; hypertension; weakening of heart muscles;
arrhythmia; stroke; anemia; pancreatitis; immunosuppression (including a shorter interval between
HIV infection and development of AIDS); cancers of the mouth, pharynx, larynx, esophagus, breast,
and liver; testosterone suppression in males; menstrual irregularities in females; spontaneous
abortion or damage to a developing fetus; Wernicke-Korsakoff syndrome and several other alcoholrelated cognitive disorders.
13.168
problems?
In what way do women with alcohol problems differ from men with such
Women typically start drinking later in life, do so after some type of crisis, and are less
likely to go on drinking binges. However, their less efficient metabolism of alcohol results in
greater vulnerability to health impairment given equal intake levels of alcohol. Women also tend
to believe that alcohol will increase their sense of power, whereas men tend to believe alcohol to
be more important for enhancing sexual and social pleasure.
13.169
Monty has an alcohol-induced anxiety disorder. What are the four models that
could account for this comorbidity, and what explanation would each offer for his disorder?
Secondary alcoholism model: the anxiety disorder caused the alcohol problem; perhaps
the drinking was a way to self-medicate.
Secondary psychiatric disorder model: the alcohol problem caused the anxiety disorder;
perhaps a chronic, heavy level of drinking has caused physiological agitation experienced as
anxiety.
Common factor model: perhaps one underlying factor causes both disorders; perhaps a
significant dysregulation of GABA is the culprit, with there sometimes being too little and other
times too much GABA production.
Bidirectional model: regardless of which disorder occurred first, the symptoms of each
exacerbate the other's.
336
13.170
What is the P300 change in an evoked potential? Why has it been identified as
a possible biological marker for alcoholism? What limitations are there for this hypothesis?
An evoked potential is a small, very brief change in EEG voltage (the recording of the
brain's electrical activity) in response to a specific sensory stimulus. One sort of change occurs 300
milliseconds after the stimulus presentation, called the P300 (wave), that is hypothesized to indicate
the individual's process of attention. Some studies have found that sons of alcoholic fathers show
smaller P300 amplitude than do sons of nonalcoholic fathers. This has been taken to suggest that
the former offspring are at greater risk for the disorder due to impaired awareness of the effects of
alcohol.
However, studies attempting to replicate these findings have sometimes failed to find the
predicted results, and these lower P300 amplitudes are not specific to alcohol disorders.
13.171
Rafael's father is a chronic alcoholic. What biological markers might you expect
to discover in Rafael that suggest he is at heightened risk for the disorder?
EEG findings: higher-than-normal beta wave activity; less change in overall EEG activity
following alcohol ingestion; lower P300 wave amplitude
Biochemical findings: less monoamine oxidase (MAO) activity; abnormally low serotonin
levels
Heart rate change findings: larger increase in heart rate following ingestion, along with
regular alcohol use
13.172
Groups of 7th and 8th graders are being asked to complete the AEQ. What
predictions could you make about these students' subsequent drinking behavior?
The students who initially believed that drinking alcohol would reduce tension and
increase positive emotions (i.e., had positive alcohol expectancies) were more likely to begin
drinking and to drink more heavily than did students without these expectancies. Moreover, as
students drank more, their subsequent expectancies grew even stronger, resulting in a reciprocal
influence on problem drinking.
13.173
Describe the "ideal" family characteristics that would predict offsprings' low
vulnerability to problem drinking.
Firm but nurturant discipline by parents (but not excessive punishment) including adequate
monitoring of child's whereabouts, emphasis on family rituals, adolescents' satisfaction with parentchild relationship or a sense of feeling close to their parents, low alcohol expectancies on the part
of the parents, lack of parents' antisocial/sensation-seeking behaviors, low alcohol consumption by
parents, lack of the biological markers associated with problem drinking (e.g., abnormal EEG
activity, biochemical abnormalities).
337
13.174
Erin is a 20-year-old college student who averages about three drinks per day but
is experiencing only minor adverse social consequences at this time. What would ASTP offer Erin,
and would she be eligible for this program?
Erin would receive 6 sessions of cognitive-behavioral interventions, in a group format,
aimed at relapse prevention. This Alcohol Skills Training Program would de-emphasize abstinence,
long-term negative consequences (e.g., cirrhosis), and authoritative/expert communications; it instead
would emphasize controlled drinking, avoidance of immediate negative consequences (e.g.,
hangover), and nonconfrontational discussions between Erin and other group members. Yes, she
would be eligible, given that she does not appear to have developed a dependence on alcohol.
13.175
List the factors that complicate treatment for individuals who have a stimulant
abuse disorder. What ethnic differences have been reported?
Frequent prevalence of polydrug use (possibly more than half of persons with this
disorder), which is also associated with the following: comorbid mental disorders, poor health,
difficulty in choosing therapeutic focus (which drug or drugs to focus on in treatment);
Premature termination of therapy, leading to increased likelihood of relapse;
For European Americans, a lack of strong social support is related to relapse, whereas
economic adversity and neighborhood disorganization are more closely tied to relapse for Black
Americans.
13.176
What is the most commonly used illicit drug in the U.S.? How many Americans
report using it weekly? Briefly describe its history of availability and use from the turn of this
century through the 1960s.
Marijuana. At least 5.5 million Americans report weekly use. It was legally available at
the turn of this century and was used primarily by jazz and blues musicians as well as artists.
Social concern became evident in the 1930s and it was soon outlawed; in the 1950s, this took the
form of a belief in "reefer madness." By the 1960s, it was essentially an accepted middle-class
recreational drug, leading some states to relax criminal penalties and raise the proposal that it be
again legalized.
338
Chapter 14
SEXUAL AND GENDER IDENTITY DISORDERS
14.1
Ans. A
Fac
p. 488
E
Which of the following is NOT a general category describing sexual or gender
identity problems?
a. homosexuality
b. transsexualism
c. paraphilia
d. sexual dysfunction
14.2
Ans. C
App
p. 488
E
Thomas is preoccupied with a desire to be a member of the other sex. What
type of gender identity has Thomas developed?
a. female
b. male
c. cross-gender
d. transgendered
14.3
Ans. B
App
p. 488
E
Johnny is three years old. At this age, Johnny has probably already developed
his
a. cultural gender orientation,
b. gender identity.
c. sexual orientation,
d. gender preference.
14.4
Ans. D
App
p. 488
E
Brent, a 19-year-old male, is extremely aggressive in sports and business, and he
generally desires to win at all cost. At home he generally does all of the car
maintenance and yard care. In Western cultures Brent would be displaying a
a. male gender identity.
b. normal male orientation.
c. male sex role polarization.
d. male sex role.
14.5
Ans. A
Con
p. 489
M
Which of the following statements about human sexuality is correct?
a. An individual's gender role, sexual orientation, and gender identity are
independent aspects of a person's sexuality.
b. A female who exhibits behaviors typical of a traditional male gender role
probably also exhibits cross-gender identification and orientation.
c. Gender identity and gender role largely determine an individual's later sexual
orientation.
d. Definition of normal sexual behavior is based on traditional gender role
expectations.
14.6
Ans. D
Fac
p. 489
E
The DSM-IV includes each of the following categories under the heading of
sexual dysfunctions EXCEPT
a. orgasmic disorders,
b. sexual desire disorders.
c. sexual pain disorders.
d. sexual sadism/masochism disorders.
339
14.7
Ans. C
Fac
p. 489
E
Which of the following definitions of normal sexual behavior was NOT offered
in your text?
a. behavior which is commonly practiced
b. behavior defined by prevailing moral or religious codes
c. behavior defined through legislation
d. acts that guarantee the reproduction of the species
14.8
Ans. B
App
p. 489
E
It is 1942, and you are working for Alfred Kinsey. What is the focus of your
work?
a. asking adult men and women about their sexual fantasies
b. compiling results of thousands of surveys on sexual behavior
c. studying the relationship between gender identity and sexual dysfunction
d. developing treatments for sexual desire disorders
14.9
A researcher interested in attitudes toward homosexuality is working with a
Ans. A
randomly sampled group of 100 males. According to the latest large-scale sex
App survey, approximately how many of these males would consider themselves
p. 491,5
homosexual?
M
a. 2 or 3
*
b. 6 or 7
c. 9 or 10
d. 12 to 14
14.10
Ans. B
App
p. 491
M
Dr. Helenos is a couples therapist who specializes in the treatment of sexual
dysfunctions and believes that masturbation is a healthy behavior for all women.
If her 10 new female clients are typical, about how many will probably report
that they have masturbated in the last year, according to Michael et al. (1994)?
a. 2
b. 4
c. 6
d. 9
14.11
Ans. D
App
p. 491
E
Janis is a 22-year-old female. According to the National Health and Social Life
Survey, there is a
% chance that Janis has engaged in sexual intercourse.
a. 52
b. 60
c. 78
d. 90
14.12
Ans. A
App
p. 491
M
According to Michael et al.'s (1994) findings, which of the following persons is
LEAST likely to report more than one sexual partner in the past year?
a. Michi, an Asian American female with a two-year college degree
b. Roberta, a white female with a high school diploma
c. Cassandra, a black female with a high school diploma
d. Adelita, a Hispanic female with a four-year college degree
340
14.13
Ans. C
Fac
p. 491
E
A national survey cited in your text (Michael et al., 1994) found that
percent of Americans had more than one sexual partner in the previous year.
a. 8
b. 12
c. 17
d. 28
14.14
Ans. B
App
p. 492
E
Dr. Moses is a therapist specializing in the treatment of sexual dysfunctions.
Which of his clients' organs is most important in the course of therapy?
a. the genitals
b. the brain
c. the heart
d. the viscera
14.15
Ans. D
App
p. 492
M
Randy is engaged in a sexual fantasy. Research indicates that he will probably
be fantasizing about
a. having sex with multiple partners.
b. having sex in a public place while being observed by strangers.
c. having sex with a famous model.
d. having conventional intercourse with a prior partner.
14.16
Ans. A
Con
p. 493
E
In a normal fetus, what biological factor determines its sex?
a. the father's sperm
b. the mother's egg
c. the mother's level of circulating androgens and estrogens
d. all of the above
14.17
Ans. B
Con
p. 493
M
*
Whereas the
is common to both XX and XY fetuses, the
is the basis for internal female sex organs.
a. Wolffian duct; labioscrotal swelling
b. genital tubercle; Mullerian duct
c. Mullerian duct; Wolffian duct
d. genital tubercle; Wolffian duct
14.18
Ans. D
App
p. 493
E
Which of the following persons produce both androgens and estrogens?
a. Ayita, an XX female
b. Chad, an XY male
c. Lisa, an XXY female
d. all of the above
14.19
Ans. A
App
p. 494
M
Emalia is undergoing puberty. Her ovaries will increase their production of
which will result in maturation of the clitoris, breasts, and nipples.
a. testosterone
b. glucocorticoids
c. estradiol
d. progesterone
341
14.20
Ans. B
App
p. 494
E
Dr. Jekyll has experimentally produced female mice that exhibit "mounting," a
behavior which is normally seen in males. What did Dr. Jekyll probably do to
these mice?
a. removed their internal sex organs
b. exposed them to high levels of androgens during fetal development
c. prevented the production of androgens during fetal development
d. gave them injections of extremely high levels of estrogens
14.21
Ans. C
App
p. 494
M
At birth Samantha had a disorder called congenital adrenal hyperplasia. Which
statement about Samantha, now 6 years old, is TRUE?
a. She exhibited internal but not external abnormalities in sexual anatomy,
b. She will probably be homosexual or bisexual as an adult.
c. She is probably very masculine and tomboyish.
d. She has developed a clear masculine gender identity.
14.22
Ans. A
App
p. 494
M
Cara has androgen insensitivity. Which of the statements below about her
would be TRUE?
a. She will be unable to conceive a child.
b. She has masculine sex characteristics.
c. She is normal aside from tomboyish tendencies.
d. She has an XX chromosome complement with an excessively high level of
circulating androgens.
14.23
Ans. C
Con
p. 494
M
Fetus A has two X chromosomes. Fetus B has an X and a Y chromosome.
Each fetus has begun to develop genitalia. If fetus A and B are both at 8 weeks
of development, what would you expect to see in regard to their genitalia?
a. Fems A would clearly have female genitalia, and Fetus B, male genitalia.
b. Both A and B would share some genital characteristics, but there would be
obvious differences between the two.
c. Their genitalia would appear the same.
d. none of the above
14.24
Ans. B
Con
p. 494
M
If a respondent were asked on a Kinsey-like survey to describe her or his sexual
orientation, what possible answers would be provided?
a. 4 categories: gay, lesbian, straight, bisexual
b. a 10 point scale from "exclusively heterosexual" to "exclusively homosexual"
c. 2 categories: homosexual, heterosexual
d. any of the above
14.25
Ans. C
Con
p. 494
M
Which of the following DSM editions and diagnostic label are mismatched?
a. DSM-III-R : (no label)
b. DSM-III : ego-dystonic homosexuality
c. DSM-II : deviant sexual orientation
d. DSM-I : homosexuality
*
342
14.26
Arts. D
App
p. 494
M
As a physician you are working with a patient who has an XY chromosome
complement. The patient has been diagnosed with androgen insensitivity. The
patient's gender identity would probably be that of
a. male.
b. male but with behaviors characteristic of a female.
c. female but with male secondary sex characteristics.
d. female.
14.27
Ans. B
Fac
p. 494
E
In what year did the American Psychiatric Association declare that
homosexuality was not to be classified as a mental disorder?
a. 1967
b. 1973
c. 1980
d. 1987
14.28
Ans. A
App
p. 494
M
Dr. Rashid has been a therapist for more than 30 years. Each time a new DSM
is published, he reviews it carefully for significant changes in diagnostic
practices. Which edition was he reviewing if he found no reference to
homosexuality as a mental disorder?
a. DSM-III-R
b. DSM-III
c. DSM-II
d. none of the above
The year is 1971. At the request of a family member, Kyle, a homosexual male,
has gone to see a therapist. According to the DSM-II, Kyle would be diagnosed
as suffering from
a. a mental disorder.
b. sexual orientation disturbance.
c. ego-dystonic homosexuality.
d. a paraphilia.
14.29
Ans. A
App
p. 494
M
14.30
Ans. C
App
p. 495
M
Dr. Lancet is conducting a study using a random sample and structured
psychological tests to assess differences in the overall psychological adjustment
of heterosexuals and homosexuals. According to past research, one would
expect Dr. Lancet's findings to indicate
a. a higher prevalence of mental disorders among homosexuals.
b. a higher prevalence of mental disorders among heterosexuals.
c. no differences in the psychological functioning of heterosexual and
homosexual males.
d. some differences between homosexuals and heterosexuals, particularly in
regard to personality disorders.
14.31
Ans. D
Fac
p. 495
M
What percentage of non-Western cultures include homosexual activity as an
acceptable form of sexual behavior?
a. 8%
b. 17%
c. 48%
d. 64%
343
14.32
Ans. A
Fac
p. 495
E
In
% of societies, including Western and non-Western, homosexuality is
absent.
a. 0
b. 3
c. 5
d. 10
14.33
Ans. B
App
p. 495
E
If students at your local high school are similar to those included in Remafedi et
al.'s (1993) study, about
% of them will report predominantly homosexual
attractions.
a. 2
b. 5
c. 10
d. 25
Which of the following biological findings has been consistently replicated in
studies of homosexuality?
a. MZ vs. DZ twin concordance differences
b. a specific gene on the long arm of the X chromosome
c. hypothalamic structural differences
d. none of the above
14.34
Ans. D
Con
p. 495-6
E
14.35
Ans. D
Fac
p. 496
M
Available research indicates that homosexuality
a. is not amenable to change through psychological intervention.
b. can be changed through intensive behavioral therapies,
c. is caused primarily by biological factors.
d. none of the above.
14.36
Ans. C
Con
p. 496-7
M
Which of the following terms does not belong with the other three?
a. fetal underandrogenization
b. atypically large suprachiasmatic nucleus
c. atypically small hippocampal interstitial nuclei
d. birth order
14.37
Ans. A
App
p. 497
M
Dr. Daniels is an opponent of reorientation therapy for homosexuals. She cites
each of the following arguments in defense of her position EXCEPT
a. No homosexual individuals are seriously interested in changing their
orientation.
b. Reorientation therapy increases a client's shame and anxiety about
homosexual feelings instead of decreasing psychological distress.
c. The therapy itself perpetuates the idea that homosexuality is a disorder.
d. There are several well-designed studies indicating that sexual orientation is
not amenable to change.
The Burtons are trying to understand their gay son who came out a few months
ago. Which of the following organizations would probably be most helpful to
them as they try to accept his orientation?
a. NARTH
b. PFLAG
c. Love in Action
d. Exodus International
14.38
Ans. B
App
p. 497
M
344
14.39
Ans. D
App
p. 497
M
Dr. Rubio is a member of NARTH. He could cite each of the following facts in
support of his approach to the treatment of homosexuality EXCEPT
a. the high rate of suicide by gay and lesbian adolescents.
b. the presence of profoundly distressing homosexuality in some individuals.
c. the need for therapists to honor the requests of their clients.
d. the high rate of dysfunction in this group compared to that for heterosexuals.
14.40
Ans. A
App
p. 498
M
Benito is a homosexual. He is the sixth oldest sibling in his family, with five
older brothers. Which of the following theoretical perspectives was presented in
the text as an explanation for Benito's orientation?
a. His mother may have developed antibodies to testosterone, leading to
Benito's underandrogenization.
b. Benito may have been beaten up by his older brothers so frequently that he
overutilized the ego defense mechanism of "identifying with the enemy."
c. A lack of familial attention led Benito to develop extreme strategies for
achieving attention, including professing a gay lifestyle.
d. Benito suffered brain trauma in early childhood, altering his anterior
hypothalamus and anterior commissure.
14.41
Ans. C
App
p. 498
M
Margaret and Sarah are 15-year-old females. Margaret was raised by lesbian
mothers, and Sarah was raised by a single, heterosexual mother. Studies have
shown that
is statistically more likely to be become lesbian.
a. Sarah
b. Margaret
c. neither
d. No research has been conducted to evaluate this factor.
14.42
Ans. B
App
p. 498
M
Chantal is lesbian. Based on currently available research, which of the
following factors is MOST likely to have had some influence on her orientation?
a. growing up with homosexual parents
b. neuroanatomical factors
c. a history of sexual abuse in childhood
d. underdeveloped gender identity
14.43
Ans. C
App
p. 499
E
Kit has both male and female sexual organs. In other words, Kit is a
a. dimorphidite.
b. transsexual,
c. hermaphrodite.
d. bisexual.
14.44
Ans. A
App
p. 499
E
Which of the following individuals is MOST likely to be diagnosed with gender
identity disorder?
a. Martin, 8 years old, who exhibits a traditional feminine gender role and has a
cross-gender identification
b. Sharon, 9 years old, who exhibits a traditional masculine gender role and has
a cross-gender identification
c. Olga, 20 years old, who exhibits a traditional masculine gender role and has
a feminine gender identity
d. Antonio, 22 years old, who exhibits a traditional feminine gender role and is
gay
*
345
14.45
Ans. D
App
p. 499
E
*
14.46
Ans. A
App
p. 499
M
Dr. Farley is assessing a 14-year-old male named Pat. Pat has expressed his
desire to become a female and feels considerable discomfort with his male sex
organs. Pat MOST likely suffers from which of the following?
a. transgenderism
b. cross-gender identification disorder
c. hermaphrodite disorder
d. gender identity disorder
Martinique, living in Aries, France, is seeking to undergo treatment for
transsexualism. She is part of
% of European women seeking such
treatment.
a. .0001
b. .01
c. .5
d. 1.0
14.47
Ans. C
App
p. 500
E
14.48
Ans. D
App
p. 500
E
Dr. Hardy is conducting research on a nationwide sample of transsexual adults.
Available evidence suggests that
of her participants will have a history of
gender identity disorder in childhood.
a. four fifths
b. two thirds
c. one half
d. one quarter
Aaron is a 5-year-old male diagnosed with gender identity disorder. You could
expect to observe each of the following characteristics in him EXCEPT
a. physically pretty features as a baby,
b. ostracism by his male peers in kindergarten.
c. lower than average interest in rough-and-tumble play and typical boys' toys
d. an increase in feminine behaviors in adolescence if Aaron is homosexual.
14.49
Ans. A
Fac
p. 500
M
*
Which of the following outcomes is MOST likely for a child with gender
identity disorder as he/she gets older?
a. The child significantly decreases his/her cross-gender behaviors,
b. The child develops a social phobia or other anxiety disorder by early
adolescence.
c. The child seeks sex reassignment surgery as an adult,
d. The child develops transsexualism.
14.50
Ans. B
App
p. 501
M
Which of the following persons will probably have the best postoperative
adjustment?
a. Lana, a heterosexual male-to-female transsexual
b. Lorenzo, a female-to-male transsexual
c. Dannette, a homosexual male-to-female transsexual
d. either a or c
346
14.51
Ans. C
App
p. 501
M
Mrs. and Mr. Appleton are the parents of a child with gender identity disorder.
According to Green's research, what would you expect to observe about their
parenting practices?
a. Mr. Appleton's submissiveness and Mrs. Appleton's dominance and control
b. both parents' emotional aloofness and disinterest in their child
c. both parents' indifference to their child's cross-gender characteristics
d. Mr. Appleton's authoritarian style and Mrs. Appleton's overpermissive style
14.52
Ans. D
App
p. 502
M
Before Heinz can undergo sex reassignment surgery, it is likely that he will have
to complete each of the following EXCEPT
a. extensive psychological testing.
b. successful living as a member of the other gender for at least one year.
c. chronic gender dysphoria,
d. a heterosexual orientation.
14.53
Ans. C
App
p. 502
M
As a clinician you are working with Cody, a 17-year-old male transsexual, and
his parents. Cody and his parents have decided to alter his gender identity. If
you are like most clinicians, what treatment would you recommend?
a. psychosurgery to remove a portion of Cody's hypothalamus
b. medical treatment involving the use of testosterone supplements and
antidepressants
c. behavioral therapy combined with parental training
d. none; Cody should not be forced to live within restricted social definitions of
gender.
14.54
Ans. B
App
p. 503
E
Darrell is being treated for premature ejaculation. This disorder reflects a
disruption of the phase of sexual response.
a. excitement
b. orgasmic
c. resolution
d. climax
14.55
Ans. A
App
p. 503
E
Bernice is a woman who is experiencing resolution following sex. If she did
not experience the orgasmic phase, she may stay in her current phase for up to
a. 6 hours.
b. 2 hours.
c. 90 minutes,
d. 30 minutes.
14.56
Ans. D
App
p. 503
E
Dominic is undergoing a sexual response stage that his wife does not
experience. Which of the following is he experiencing?
a. orgasmic
b. excitement
c. resolution
d. refractory
347
14.57
Ans. A
App
p. 503
E
Lucy is experiencing an increased heart rate, vasocongestion of the clitoris, and
erection of the nipples. She is in which phase of the sexual response cycle?
a. excitement
b. resolution
c. desire
d. physiological
14.58
Ans. D
Con
p. 504
M
As a clinician in the late 19th century, you most likely regarded a client's sexual
dysfunction as a sign of
a. possession by evil spirits,
b. neurological and vascular abnormalities.
c. negative social conditioning or current relationship distress,
d. unresolved conflicts from early childhood.
14.59
Ans. B
Con
p. 504
E
How would you characterize Masters and Johnson's research procedure?
a. experimental
b. observational
c. correlational
d. survey-based
14.60
Ans. C
Con
p. 504
E
Which of the following clinicians would encourage an adult female to focus on
the pleasure to be had from a vaginal orgasm?
a. Johnson
b. Kaplan
c. Freud
d. Kinsey
14.61
Ans. B
App
p. 504
E
The year is 1957, and you are a research assistant working with two prominent
sex researchers at Washington University in St. Louis. What are the names of
your research directors?
a. Michael and Kaplan
b. Masters and Johnson
c. Heiman and Smith
d. Kinsey and Kinsey
14.62
Ans. A
Con
p. 504
E
Which of the following categories of disorders has the highest lifetime
prevalence?
a. sexual dysfunction
b. mood
c. anxiety
d. personality
14.63
Ans. C
App
p. 504
M
Dr. Sunfish is a marriage counselor working with a couple suffering from a
sexual dysfunction. The couple has expressed concern that they are unique in
their situation. To reassure them, Dr. Sunfish responds by explaining that
enduring sexual dysfunction may affect as many as
% of all intimate
relationships.
a. 30
b. 75
c. 50
d. 20
*
348
14.64
Ans. D
App
p. 504-5
E
*
14.65
Ans. B
App
p. 505
M
Carlotta is talking with her therapist about her HSDD. Her therapist is
explaining that many factors could influence her disorder, including each of the
following, EXCEPT
a. cultural beliefs about sex.
b. impairments in vascular functioning.
c. her sexual history.
d. her level of estrogen.
When Mildred's therapist is assessing the factors that may be contributing to her
HSDD, the therapist will probably be MOST concerned about
a. Mildred's cultural identity.
b. what Mildred learned in her family.
c. Mildred's religious beliefs.
d. whether Mildred is in good physical health.
14.66
Ans. A
App
p. 505
M
Which of the following persons is MOST likely to report the highest degree of
satisfaction and pleasure from their sexual relations?
a. Mia, a 26-year-old who has been married for two years
b. Marty, an 18-year-old single high school senior
c. Alice, a 22-year-old, single college junior
d. Aaron, a recently divorced 35-year-old
14.67
Ans. A
Fac
p. 505
E
Michael et al.'s (1994) recent survey revealed that roughly
of every 10
married persons say that they receive great physical pleasure from sex.
a. 9
b. 7
c. 5
d. 4
14.68
Ans. C
Fac
p. 505
E
The DSM-IV includes several specifiers for sexual dysfunctions, but
NOT one of them.
a. acquired type
b. generalized type
c. aversive type
d. situational type
is
14.69
Marsha, a 23-year-old college student, is fearful of sexual encounters. She is so
Ans. B
disgusted with the thought of any kind of sexual behavior that she refuses to
App date. The few times she has dated she has become panicky if her partner
p. 505
attempted to hold her hand or put his arm around her. Marsha most likely
E
suffers from
a. intimacy avoidance disorder.
b. sexual aversion disorder.
c. FSAD.
d. hypoactive sexual desire disorder.
349
14.70
Ans. B
App
p. 505-6
M
14.71
Ans. D
App
p. 506
M
*
14.72
Ans. A
App
p. 506
E
14.73
Ans. C
App
p. 506
M
Miranda has become disinterested in sex, engages in much less frequent
fantasizing than she has in the past, and is distressed about these changes. She
tells her therapist that her sexual relationship with her husband used to be
"great." What dysfunction is most likely?
a. sexual aversion disorder, acute onset
b. HSDD, acquired type
c. sexual arousal disorder, generalized type
d. HSDD, delayed onset
Kesi is in a depressed episode of her bipolar disorder. She has been
uninterested in sex for several weeks, ignoring her husband's advances and
finding
herself bored by sexual fantasies that had been very exciting. Which
DSM-IV diagnosis is appropriate?
a. impaired arousal disorder
b. hypoactive sexual desire disorder
c. female orgasmic disorder
d. none of the above
A marriage and family counselor is working with a couple who are experiencing
sexual problems. The husband has expressed dissatisfaction with his wife's lack
of sexual interest to the point of suggesting divorce. The partner is also
distressed with her lack of sexual interest, and several physical exams have
failed to uncover any medical problems which may contribute to her disinterest.
After concluding that the woman does not have another mental disorder, the
counselor probably diagnoses her with
a. hypoactive sexual desire disorder.
b. hypoactive sexual activity.
c. sexual inducement disorder.
d. sexual aversion disorder.
Mike is taking testosterone supplements as part of his hormone replacement
therapy, which is aimed at alleviating his flattened sexual desire. The
testosterone supplements are affecting receptors in which part of Mike's brain?
a. reticular activating system
b. frontal lobe
c. hypothalamus
d. pituitary gland
A counseling graduate student is seeing a sexually dysfunctional female client.
The student is being supervised by Dr. Helen Kaplan, and thus treatment will
focus on
a. treating the client's emotional claustrophobia by helping her develop a greater
sense of personal independence.
b. reducing the classically conditioned anxiety the client experiences during sex
by helping her learn relaxation strategies.
c. teaching the client and her partner the techniques of sensate focus.
d. employing cognitive-behavioral techniques to work out more adaptive,
satisfying sexual scripts.
350
14.75
Ms. Sather is helping Tori overcome her HSDD. Ms. Sather and Tori have
Ans. B
explored several possible contributing factors to her disorder, and these probably
App included each of the following EXCEPT
p. 507
a. a history of sexual abuse.
E
b. Tori's usual script negotiation with her partner.
c. Tori's unexpressed anger toward her partner.
d. a history of major depression.
14.76
Katrina is experiencing significant difficulties achieving her normal level of
Ans. D
lubrication during sexual excitement. Her physician assures her mat this is a
App temporary side effect of her new heart medication. The DSM-IV would
p. 507
describe Katrina's condition as
E
a. FSAD.
b. HSDD.
c. sexual dysfunction not otherwise specified.
d. none of the above.
14.77
Ans. D
Fac
p. 507
E
*
Which female sexual dysfunction is LEAST likely to motivate a woman to seek
treatment?
a. HSDD
b. sexual aversion
c. orgasmic disorder
d. FSAD
14.78
Ans. C
App
p. 508
M
Married for a few years, Marvella still finds herself wondering if her sexual
desires are "normal," and she often feels guilty for fantasizing about sex. She
sometimes resents her husband's obvious physical and emotional pleasure during
sex. For which dysfunction is Marvella MOST likely to be at risk?
a. hypoactive sexual desire disorder
b. orgasmic disorder
c. sexual arousal disorder
d. dyspareunia
14.79
Ans. A
Con
p. 508
E
Which of the following descriptions does not belong with the other three?
a. lifelong type
b. male erectile disorder
c. excitement phase-related disorder
d. roughly 50% lifetime prevalence
*
14.80
Ans. D
App
p. 508
E
Adam is a healthy 32-year-old male. Which bodily system is responsible for
Adam's ability to achieve a normal erection?
a. vascular
b. endocrine
c. neurological
d. all of the above
351
14.81
Ans. B
App
p. 508
M
Leif has an erectile disorder that is related to a medical condition. Which
condition is the most likely cause of his disorder?
a. arteriosclerosis
b. diabetes mellitus
c. spinal cord damage
d. a side effect of his antihypertensive medication
14.82
Ans. C
App
p. 508
M
Emmett has had several drinks of straight vodka and has smoked about a pack
of cigarettes. How will these substances affect his erectile functioning?
a. Unless he has underlying cardiovascular disease, these substances will not
substantially affect his ability to achieve and maintain an erection.
b. The drinking will heighten his sexual desire and increase his ability to
achieve an erection, but smoking will slightly decrease that ability.
c. Both substances will make it more likely that he will have difficulty
achieving and maintaining an erection.
d. These substances will impair his erectile functioning only if he develops
performance anxiety.
14.83
Dr. Rosenheim currently has a case load of 10 male patients, all suffering from
Ans. B male erectile disorder. According to the text, approximately how many of these
App
men have erectile disorder caused primarily by psychological problems?
p. 509
a. 1-2
M
b. 6
c. 7-8
d. 9
14.84
Ans. A
App
p. 509
M
*
Occasionally across the past few weeks, Conrad has been unable to maintain an
erection long enough for himself and his partner to have intercourse. Which of
the following psychological factors is MOST likely to be contributing to his
disorder?
a. cognitive distractions
b. performance anxiety
c. unexpressed hostility toward his partner
d. a history of sexual abuse in childhood
14.85
Ans. A
App
p. 509
M
Rick, Luis, and Trevor are participating in a study of sexual performance
anxiety. All received a painful shock at the start of the experiment and then
watched an erotic film. Rick was told he would not be shocked again; Luis was
told he might be shocked; and Trevor was told he would be shocked //he did
not have an adequate erection. Who will have the weakest erection?
a. Rick
b. Luis
c. Trevor
d. either b or c
352
14.86
Ans. C
App
p. 510
E
Alexa is a happily married 26-year-old woman. Alexa has had a life-long
history of not experiencing orgasm, though she feels erotic pleasure during
sexual activity. She may suffer from
a. anorgasmia.
b. an androgen deficiency.
c. female orgasmic disorder.
d. performance anxiety disorder.
14.87
Ans. C
App
p. 510
E
As a therapist specializing in the treatment of sexual dysfunction, which of the
following complaints is MOST likely to be expressed by your female clients?
a. FSAD
b. HSDD
c. orgasmic disorder
d. dyspareunia
14.88
Ans. B
Fac
p. 510
E
In Rosen et al.'s study of predominantly middle-class Caucasian women, about
how many reported that they always experience difficulty achieving orgasm?
a. 15%
b. 9%
c. 6%
d. 3%
14.89
Ans. D
Con
p. 510
M
*
If female orgasmic disorder were restricted only to those women who have
never had an orgasm, Heiman's research suggests that
% of women would
be diagnosable.
a. 1%
b. 4%
c. 7.5%
d. 10%
Dr. Luv recommended "Kegel" strengthening exercises for his female orgasmic
disorder client, telling her that these will strengthen the muscle that enhances
orgasm. These Kegel exercises will target the
muscle.
a. pubococcygeus
b. vaginal
c. labia majora
d. yohimbine
14.90
Ans. A
App
p. 510
E
14.91
Ans. D
App
p. 510
E
A counselor is talking with Mandi about her orgasmic disorder. Which of the
following suggestions from the counselor would be MOST helpful for Mandi?
a. "You should spend several minutes each day strengthening your
pubococcygeus muscle to enhance your orgasmic potential."
b. "Avoid all use of alcohol and drags prior to having sex."
c. "The best thing to do is be patient; the longer you're married, the less likely
you will be to have this problem."
d. none of the above
353
14.92
Ans. B
App
p. 510
M
Carolyn was a victim of sexual abuse as a child. Research evidence suggests
that she is relatively unlikely to experience which sexual dysfunction?
a. HSDD
b. orgasmic disorder
c. sexual arousal disorder
d. vaginismus
14.93
Ans. C
Con
p. 510-11
M
Pilar has an orgasmic disorder. Current research suggests that
be most important in understanding the origin of her disorder.
a. a history of sexual abuse or current relationship distress
b. psychological distraction and anxiety
c. sociocultural attitudes about female sexuality
d. excessive alcohol use
14.94
Ans. B
Con
p. 511
E
Which of the following male sexual dysfunctions is MOST likely to be caused
by medical problems?
a. male orgasmic disorder
b. retrograde ejaculation
c. male erectile disorder
d. HSDD
14.95
Ans. D
App
p. 511
M
Dale suffers from diabetes. During sexual activity Dale reaches orgasm but fails
to ejaculate externally. Dale suffers from
a. premature ejaculation.
b. sexual aversion.
c. male ejaculatory disorder,
d. retrograde ejaculation.
14.96
Ans. A
Con
p. 506,11
C
Two separate clients are seeking help for a type of sexual dysfunction. Client A
has a disorder that is seen more frequently in clinics than is found in the general
population. Client B has a disorder that is seen less frequently in clinics than is
found in the general population. What disorders are most likely?
a. A has HSDD; B has male orgasmic disorder
b. A has female orgasmic disorder; B has HSDD
c. A has premature ejaculation; B has FSAD
d. A has male orgasmic disorder; B has female orgasmic disorder
14.97
Ans. D
Fac
p. 511
E
Research indicates that up to
1% of men of all ages have had some
problems with premature ejaculation.
a. 50
b. 25
c. 64
d. 33
354
may
14.98
Crosby, a 15-year-old male, comes from a strictly religious family. His parents
Ans. C have warned him of the evils associated with masturbation. As a result Crosby
App
tends to masturbate to orgasm quickly to avoid being caught in the act. Crosby
p. 511
may be a likely candidate for
.
M
a. male orgasmic disorder
*
b. sexual aversion
c. premature ejaculation
d. male erectile disorder
14.99
Ans. B
App
p. 512
E
Liam is seeking sex therapy to help him overcome the very uncomfortable pain
he sometimes experiences during orgasm and ejaculation. His therapist would
describe this condition as
a. penilismus.
b. dyspareunia.
c. male orgasmic disorder.
d. somatoform pain disorder.
14.100
Ans. D
App
p. 512
E
Becky and Brent have been married for six months. Despite regular sexual
activity, they have not been able to experience penile penetration. Their
therapist believes that Becky may suffer from
a. hypoactive sexual desire.
b. sexual aversion.
c. dyspareunia.
d. vaginismus.
14.101
Ans. C
App
p. 512
M
Which of the following women is MOST likely to experience vaginismus?
a. Earline, living in the U.S.
b. Monique, living in France
c. Patty, living in Ireland
d. Rosalind, living in Canada
14.102
Ans. A
App
p. 512
M
It is 1952, and Marlene is being treated for frigidity. What treatment is she
probably receiving?
a. individual psychodynamic therapy
b. behavioral couples therapy
c. individual cognitive or client-centered therapy
d. medication
14.103
Ans. D
App
p. 512
E
Suppose you were a sex therapist who approached the treatment of clients on the
theoretical basis emphasized by Masters and Johnson. What therapeutic focus
would you have?
a. provision of education about sexual functioning
b. attention to performance anxiety and partner communication
c. resolution of conflicts associated with early family-based learning
d. both a and b
355
14.104
A couple seeing a marriage counselor is told to avoid intercourse and genital
Ans. A
stimulation, and instead to focus on kissing, massage, and touch. The couple is
App being instructed in which of the following therapeutic techniques?
p. 512
a. sensate focus
E
b. "ludicrous suggestion from the counselor" technique
c. arousal inhibitory technique
d. opponent-process
14.105
Ans. B
App
p. 512-3
M
The O'Flahertys are participating in a form of sex therapy that represents a
streamlined version of Masters and Johnson's original approach. Which of the
following will the couple NOT experience?
a. a once-a-week therapy session
b. interaction with two cotherapists
c. sensate focus techniques
d. education about sexuality and effective communication
14.106
Ans. C
App
p. 513
M
For which of the following clients would you have the most guarded prognosis
for treatment?
a. Tricia, with FSAD
b. Ernesto, with erectile disorder
c. Lara, with HSDD
d. Martina, with female orgasmic disorder
14.107
Ans. D
App
p. 513
M
Vera is participating in treatment for HSDD, and her therapist is employing the
4 phase approach outlined by LoPiccolo and Friedman. Which of the following
will NOT be included in Vera's therapy?
a. encouragement and training in fantasizing
b. cognitive restructuring of irrational beliefs and fears
c. exploration of family history and current attitudes
d. training in conflict resolution with her sexual partner
14.108
Ans. A
App
p. 513
E
Candide believes that his partner should tell him directly that she is interested in
having sex. His partner believes that if she cooks a special meal and dresses
provocatively that Candide should know that he can approach her for sex. This
couple is experiencing a mismatch in their
a. sexual scripts.
b. innuendo cues.
c. sexual role expectations.
d. sensual focus.
14.109
Ans. B
App
p. 513
E
Some Japanese individuals believe that birds' nests found in the caves of
Thailand act as an aphrodisiac. Others believe certain plant extracts are the key
to increased sexuality. Science has shown that the desire-enhancing effects of
these traditional aphrodisiacs are generally
a. completely unfounded.
b. supported by psychophysiological research.
c. placebo effects.
d. harmful to one's sexual relationships.
*
356
14.110
Ans. C
Fac
p. 513
E
The aphrodisiac that gave rise to the term "honeymoon" was a kind of
a. bee pollen.
b. oyster.
c. wine.
d. mandrake root.
14.111
Ans. D
Con
p. 513
M
Which of the following statements about biological treatment for sexual desire
disorders is CORRECT?
a. Regardless of specific drags, medication effects appear to be restricted only
to alleviation of underlying depressive symptoms.
b. Recent research has identified several neurotransmitters, such as serotonin,
that are affected by most traditional aphrodisiacs.
c. Gonadal hormone therapy appears to be most effective for persons with
average or below-average testosterone/estrogen levels.
d. Some antidepressant drugs and yohimbine appear to be able to enhance
sexual desire.
14.112
Ans. B
App
p. 514
M
Anthony is receiving treatment for a sexual dysfunction that involves sensate
focus, anxiety reduction techniques, and information to dispel myths about
sexual functioning. Anthony most likely suffers from
a. sexual aversion.
b. male erectile disorder.
c. premature ejaculation.
d. male orgasmic disorder.
14.113
Ans. A
Fac
p. 514
M
Which of the following is NOT one of the core components of cognitiveinterpersonal treatment for erectile disorder?
a. direct training in masturbation
b. sexual script work
c. relapse prevention
d. conflict resolution
14.114
Ans. C
Fac
p. 514
M
Which of the following has NOT been used with some success in the medical
treatment of male erectile disorder?
a. topical nitroglycerin ointment
b. yohimbine
c. SSRI's
d. short-acting, injectable vasoactive agents
14.115
Ans. D
App
p. 514
M
For what reason might Henry, suffering from an erectile disorder, stop using his
short-acting vasoactive agent?
a. It is prohibitively expensive.
b. With a typical improvement rate of 50%, Henry is unfortunate to be in the
half of men for whom the agent is unsuccessful.
c. Henry dislikes the fact that he cannot conceal the agent while having sex.
d. It is painful and inconvenient.
357
14.116
Ans. C
App
p. 515
M
Megan is receiving treatment for a sexual dysfunction in which she is
encouraged to masturbate, engage in sexual fantasy, and inform her sexual
partner about effective sexual techniques. Megan is most likely receiving
treatment for which of the following?
a. HSDD
b. FSAD
c. female orgasmic disorder
d. sexual aversion
14.117
Ans. B
App
p. 515
M
A therapist has told her new client that they will only need to meet for a few
sessions and that the client can make a great deal of progress related to her/his
sexual dysfunction by reading several books that the therapist recommends.
What disorder does mis client MOST likely have?
a. premature ejaculation
b. female orgasmic disorder
c. male HSDD
d. FSAD
14.118
Ans. A
Fac
p. 514-5,24
E
Medical treatment for sexual disorders has been shown to be effective for each
of the following EXCEPT
a. female orgasmic disorder,
b. premature ejaculation.
c. HSDD.
d. paraphilias.
14.119
Ans. D
Fac
p. 515
E
Asked to recommend the most effective treatment for premature ejaculation, you
would identify
a. the squeeze technique.
b. the stop-and-start technique.
c. SSRI medication.
d. cognitive-behavioral therapy and the stop-and-start technique.
14.120
Ans. C
Con
p. 516
M
Which of the following descriptors applies to all paraphilias?
a. harmful to self or others
b. involvement of an unwilling victim
c. atypical or socially inappropriate sexual stimuli
d. both a and c
14.121
Ans. B
App
p. 516
E
Francine can only achieve sexual arousal and orgasm if her partner wears a
black leather jacket during sexual activity. Francine may have a(n)
a. orgasmic reorientation,
b. pedophilia.
c. paraphilia.
d. sexual dysfunction.
358
14.122
Ans. D
App
p. 516
M
Client "S" has been diagnosed as having a paraphilia. Client S is most likely to
be
a. female,
b. psychotic.
c. an adolescent,
d. male.
14.123
Paulo cannot achieve an erection unless his sexual partner wears high-heeled
Ans. C
shoes and insists that she wear them when they engage in sexual activity. Paulo
App could be described as exhibiting which of the following?
p. 516
a. voyeurism.
E
b. exhibitionism.
c. fetishism.
d. sexual fixation.
14.124
Ans. B
App
p. 516
M
*
Karl often dresses in women's clothing in the privacy of his home to achieve
sexual arousal. He shows a particular preference for this activity during stressful
times at the office. Karl is probably
and is exhibiting
.
a. homosexual / transgenderism
b. heterosexual / transvestic fetishism
c. heterosexual / transsexualism
d. homosexual / transvestic fetishism
14.125
Ans. D
App
p. 516
E
Arthur engages in cross-dressing. What psychological reinforcement does he
obtain from this behavior?
a. disinhibition of homosexual impulses
b. sexual arousal
c. relaxation
d. either b or c
14.126
Ans. A
App
p. 517
E
A lawyer is talking with his recently arrested client about the client's sex-related
charge. What is the client's most likely paraphilia?
a. exhibitionism
b. transvestic fetishism
c. fetishism
d. frotteurism
14.127
Ans. C
App
p. 517
E
Will is known as the "trench-coat bandit" in his home town. He acquired this
nickname by wearing only a trench coat and exposing his genitals to several
elderly women in his neighborhood. Recently arrested and convicted, Will
would be described as a
a. voyeur.
b. frotteurer.
c. exhibitionist.
d. fetishist.
359
14.128
Ans. B
App
p. 517
M
*
14.129
Ans. C
App
p. 517
E
If Irving is an exhibitionist, what prediction would you NOT make about his
future behavior?
a. He will continue to expose himself in similar settings and to similar kinds of
people.
b. He will attempt to physically or sexually assault a future victim.
c. He is more likely to be arrested than is someone with a different paraphilia.
d. He will probably not seek treatment voluntarily.
Walt enjoys the hustle and bustle of crowded downtown subway stations and the
packed elevators he rides each day to his office. In these situations, he can
press his body into an attractive woman's body and enjoy a sexual thrill. Walt's
behavior is called
a. fetishism.
b. active voyeurism.
c. frotteurism.
d. deviant gratification.
14.130
Ans. D
App
p. 517
E
Slater prefers his sexual partners to be bound with chains so that he may inflict
pain on them against their will. Slater finds a great deal of sexual satisfaction
from these activities. Slater is a likely candidate for the diagnosis of
a. sexual masochist.
b. pedophile.
c. frotteurer.
d. sexual sadist.
14.131
Ans. D
App
p. 517
M
Sergei wants his sexual partner to tie him to the bed or blindfold him during
sex. If Sergei's sexual pleasure is enhanced by these activities, he could be
described as
a. a sexual sadist.
b. a sexual masochist.
c. a fetishist.
d. none of the above.
14.132
Ans. C
Fac
p. 518
E
Which of the following is not a type of paraphilia?
a. sexual sadism
b. voyeurism
c. rape
d. frotteurism
14.133
Ans. B
App
p. 518
M
Joe is a convicted rapist. Which of the following characteristics is LEAST
likely to apply to him?
a. He may have been a victim of sexual aggression in childhood.
b. He is primarily motivated by sexual impulses in the commission of his
crime.
c. He is likely to know his victim and to blame her for the rape.
d. He may have experienced depression or substance abuse that contributed to
his crime.
360
14.134
Ans. A
App
p. 518
M
*
Perry shows a high degree of sexual arousal when exposed to audio or video
stimuli depicting rape scenarios. In an interview with his therapist, Perry has
admitted that he believes women enjoy being raped and that he enjoys being
very aggressive with his partners, even when he doesn't have time to have an
orgasm. Which of the following descriptions is probably MOST likely to
describe Perry?
a. rapist
b. sexual sadist
c. psychopath
d. either a or b
14.135
Ans. B
App
p. 518
E
Harry has been a scout master for years. Recently he was arrested for sexually
molesting one of the young boys in his troop. Harry confessed to his courtappointed therapist that he has always been sexually attracted to young boys and
that temptation had finally got the upper hand. What disorder is present?
a. pedophilia
b. juvenile fetishism
c. sexual predatory disorder
d. frotteurism
14.136
Ans. C
Con
p. 519
M
Which of the following explanations is a pedophile MOST likely to give for his
actions against Tina, a 7-year-old child?
a. "I couldn't resist temptation, even though I knew what I was doing was
morally wrong."
b. "The only way I could keep Tina in line is to threaten her with a show of
force, and things just developed from there."
c. "Tina really enjoys my attention, and I'm helping her leam how to relate
effectively to adults."
d. "Her mother should have known better than to leave Tina alone with me.
It's not my fault I have a mental illness."
14.137
Ans. A
App
p. 519
M
Ms. Ching is conducting interviews under the auspices of the Federal Certificate
of Confidentiality program. On average, her sex offender interviewees will
report about
paraphilic acts.
a. 500
b. 350
c. 125
d. 33
14.138
Ans. B
Fac
p. 520
E
Which of the following paraphilias are most likely to be comorbid?
a. pedophilia and sexual sadism
b. exhibitionism and voyeurism
c. frotteurism and sexual masochism
d. fetishism and transvestic fetishism
14.139
Ans. C
App
p. 521
E
Which of the following persons is probably LEAST distressed by her/his
disorder?
a. Mame, with FSAD
b. Carlos, with gender identity disorder
c. Michael, with a paraphilia
d. Veronica, with sexual aversion
361
14.140
Ans. D
Fac
p. 521
M
According to Dr. Judith Becker, which of the following paraphilias is most
likely to be effectively treated?
a. frotteurism
b. fetishism
c. non-incestuous pedophilia
d. incestuous pedophilia
14.141
Ans. C
App
p. 521
M
Stanton's father had a paraphilia. Stanton's parents divorced when he was
young, and Stan grew up with his mother, visiting his father only about once a
month. According to available genetic research, Stanton will probably
a. have a reduced risk of developing a paraphilia since the genes for this
disorder generally skips a generation.
b. be at a much increased risk for the development of a pedophilia.
c. be at no greater risk than children with non-paraphiliac parents for
developing a paraphilia.
d. only be at risk for a paraphilia if his mother also had some form of heritable
mental illness, such as bipolar disorder.
14.142
Ans. B
Con
p. 522
E
A clinician is presenting a theory of the origin of frotteurism and voyeurism. If
this theory draws on the most widely accepted model in this area, the clinician
will focus on
a. sexual stressors encountered during childhood.
b. classical conditioning and social modeling .
c. genetic and biological abnormalities.
d. object relations.
14.143
Ans. C
Fac
p. 523
E
Covert sensitization for a paraphilia has been developed on the basis of each of
the following aversive stimuli EXCEPT
a. olfactory,
b. visual imagery.
c. incarceration,
d. shame.
14.144
Ans. A
App
p. 523
M
Dr. Matisse provides multimodal treatment for his clients who have been courtordered for treatment of a sex offense. Which of the following will NOT be
a central component of this therapy?
a. use of aversive electric shock
b. masturbatory reconditioning
c. discussion of sexual myths and victim suffering
d. relapse prevention
14.145
Ans. D
App
p. 523
M
Dr. Hubble is treating Calvin for his fetishism. Dr. Hubble asks Calvin to
imagine his fetish-inducing object, and just as Calvin becomes aroused by these
images, Dr. Hubble begins suggesting images of Calvin developing lesions on
his face, of maggots crawling over him, and other disgusting stimuli. Dr.
Hubble is using what therapeutic technique to treat Calvin?
a. systematic desensitization
b. shame aversion therapy
c. multimodal aversion treatment
d. covert sensitization
*
362
14.146
Ans. A
App
p. 524
C
*
Knoton has been convicted under his state's sexual predator law. The judge and
prosecuting attorney believe him to be an extremely likely candidate for
recidivism. When Knoton's prison term ends, he will
a. be committed to a mental hospital until the legal authorities judge him as no
longer a threat.
b. be committed to a mental hospital for a time period not to exceed his
original sentence.
c. be released into a probation program in his home town.
d. be released on the condition he seeks outpatient therapy.
14.147
If Omar is a convicted sex offender, research suggests that he is more likely to
Ans. B repeat his offense if he
App
a. has been married.
p. 525
b. victimized boys more often than girls.
M
c. victimized his own daughter.
d. has a relatively small number of previous sex offenses.
SHORT ANSWER/ESSAY
14.148
Trace the changing diagnostic practices in the DSM in regard to homosexuality.
The first two editions of the DSM considered homosexuality to be a mental disorder. In
1973, the American Psychiatric Association officially changed its stance, and the mental disorder
was revised to be used only with individuals who were distressed by their orientation and wanted
change. This label was "sexual orientation disturbance." DSM-III had a similar category, now
called "ego-dystonic homosexuality." However, in the 1987 DSM-III-R, all reference to
homosexuality was omitted, as is also the case with the current fourth edition.
14.149
What two conditions must be present for a diagnosis of gender identity disorder to
be made? What term is often given to adults with this disorder?
Persistent cross-gender identification and a profound discomfort or even disgust with
biological sex and genitalia. Adults - transsexuals.
14.150
List the 4-stage sexual response cycle and indicate the sexual dysfunctions
associated with each. What forms of sexual dysfunction were described prior to the identification
of the 4-stage cycle?
1. Desire - hypoactive sexual desire; sexual aversion.
2. Excitement - female sexual arousal disorder; male erectile disorder.
3. Orgasmic - female & male orgasmic disorder; premature ejaculation.
4. Resolution - (none).
Previous dysfunctions - impotence, premature ejaculation, and frigidity.
363
14.151
If you were a counselor treating a female client for a sexual dysfunction, what areas
of your client's present and past experience would you want to assess before choosing a treatment
plan?
Neurological/vascular medical conditions, her attitudes and beliefs about sex - including
cultural, religious, and (most importantly) family influences, her sexual history mcluding possible
sexual abuse as a child or as an adult, her possible history of depression, and her feelings about and
attitudes toward her current romantic relationship.
14.152
For what reason is rape not classified as a paraphilia?
While some sexual sadists commit acts of rape, most rapists are motivated by aggression
and hostility rather than a desire for sexual excitement and gratification.
14.153
List the paraphilias.
Fetishism, transvestic fetishism, exhibitionism, voyeurism, frotteurism, sexual sadism, sexual
masochism, and pedophilia.
364
Chapter 15
BIOLOGICAL TREATMENT OF MENTAL DISORDERS
15.1
Ans. A
App
p. 530
M
Danette is depressed and has psychotic symptoms. If it is the year 1947, what
treatment would she have been LEAST likely to receive?
a. pharmacotherapy
b. metrazol therapy
c. electroconvulsive therapy
d. psychosurgery
15.2
Ans. B
App
p. 530
E
Katunga has been behaving violently, and his village elders have decided he is
possessed. Based on your text's description of prehistoric treatments for mental
disorders, what are the elders likely to prescribe for Katunga?
a. execution by burning at the stake
b. trephining
c. treatment with an herbal remedy
d. acupuncture-like treatment
15.3
Ans. D
Con
p. 530
E
Which statement below is TRUE?
a. Galen introduced an early form of the transorbital lobotomy procedure.
b. In the early 1960s, non-medicinal treatments such as convulsive therapy
became the most commonly prescribed treatment for mental disorders.
c. It has been proven that past cultures had no effective treatments for mental
disorders,
d. Biologically based treatments for mental disorders have been used for
centuries.
15.4
Ans. C
Fac
p. 531
E
What prevented Gottlieb Burckhardt from perfecting the psychosurgical
procedure he developed?
a. The applications of his procedure were limited, and it was halted due to a lack
of subjects.
b. He was burned at the stake for heresy during the Spanish Inquisition before
his research could be completed.
c. His colleagues stopped him after one patient died and another developed
epilepsy.
d. Nothing; he continued developing it for years and set a precedent for the work
of Moniz.
15.5
Ans. D
Con
p. 531
M
Which of the following terms does not belong with the other three?
a. prefrontal leucotomy
b. severe mood disorders
c. Nobel Prize for medicine
d. Freeman
365
15.6
Ans. A
Fac
p. 531
E
A leucotome is a
a. pick-like instrument used to destroy brain tissue.
b. book that describes precisely where known brain structures are located.
c. psychosurgical procedure developed by Gottlieb Burckhardt.
d. psychosurgical procedure developed by Almeida Lima.
15.7
Ans. B
App
p. 531
M
Max is undergoing surgery. Small holes have been drilled in his skull just over the
frontal lobes, and the doctor is injecting alcohol through the holes. What is the
name for this procedure?
a. a transorbital lobotomy
b. a prefrontal leucotomy
c. a frontal lesioning
d. a subcaudate tractotomy
15.8
Ans. A
Con
p. 531,3
E
Which of the following names does not belong with the other three?
a. Sakel
b. Burckhardt
c. Freeman
d. Moniz
15.9
Ans. B
Fac
p. 531
M
According to Moniz and Lima,
% of their first group of 20 patients were
"failure" cases (i.e., died). In the years that followed,
% of patients died of
cerebral hemorrhage from lobotomies.
a. 1; 3
b. 0; 5
c. 0; 1
d. 1; 5
15.10
Ans. B
App
p. 531
E
Dr. Luke was a psychiatrist who treated several severely psychotic patients in the
late 1940s. For what reason might he have become interested in Freeman and
Watts' transorbital lobotomy procedure?
a. the accuracy and effectiveness of the procedure
b. the ability to quickly conduct this procedure in his office
c. the superiority of this procedure over SST surgery
d. the influence of drug manufacturers and insurance companies
15.11
Ans. D
App
p. 531
M
Psychiatrists at a state mental hospital in the 1940s and '50s may have
considered the use of lobotomies for each of the following patients EXCEPT
a. a patient with severe alcoholism.
b. an obese patient.
c. a mentally retarded patient,
d. none of the above.
366
15.12
Ans. D
App
p. 531
M
Linden has undergone a transorbital lobotomy. Which characteristic below is
probably NOT present in Linden now?
a. lack of motivation
b. poor judgment
c. epileptic seizures
d. blindness
15.13
Ans. A
App
p. 532
M
Jake is undergoing surgery. The surgeon has bilaterally inserted electrodes into
portions of Jake's Papez circuit. In a few minutes, radio frequency waves will
heat the tips of the electrodes and destroy some of the circuit's fibers. What is
the name for this procedure?
a. a cingulatomy
b. a stereotaxic subcaudate tractotomy
c. a prefrontal leucotomy
d. a lobotomy
15.14
Ans. C
App
p. 532
M
Martha has undergone a cingulatomy. Which statement below is probably NOT
true about Martha?
a. There is a roughly one in eight chance that Martha will commit suicide,
b. There is a roughly one in ten chance that Martha will develop postsurgical
seizures.
c. Martha probably suffers from schizophrenia.
d. The procedure lesioned a small portion of tissue in her limbic system.
15.15
Ans. B
Con
p. 531-2
E
Which of the following surgical procedures and brain areas are mismatched?
a. cingulatomy : Papez circuit
b. SST : temporal lobes
c. transorbital lobotomy : frontal lobes
d. standard lobotomy : frontal lobes
15.16
Ans. D
App
p. 532-3
M
For which of the following patients would you NOT recommend psychosurgery?
a. Nanette, a female with severe depression that is unresponsive to medication
b. Kim, a male with intractable, severe bipolar disorder
c. Rosetta, a female with obsessive-compulsive disorder
d. Benton, a male with schizophrenia
15.17
Ans. C
App
p. 532-3
M
Nancy is a schizophrenic. She shows extreme flatness of emotion and is usually
catatonic. Eddie is also a schizophrenic and has paranoid delusions and often
hears voices telling him he is an emissary of the devil. Chinato has obsessivecompulsive disorder. He exhibits self-mutilating patterns, such as excessive
handwashing to a degree that causes his hands to bleed. Alexandria suffers from
bouts of depression which usually last for a few months and then subside, though
they often recur. Which person is the MOST likely candidate for psychosurgery?
a. Nancy
b. Eddie
c. Chinato
d. Alexandria
*
367
15.18
Ans. B
Con
p. 533,6
M
Which statement below is FALSE in regard to psychosurgery today?
a. Psychosurgery is used primarily as a last resort in severe cases, and dramatic
improvements for patients are unlikely.
b. Because more precise modem methods are still ineffective for schizophrenia,
ECT is now the standard non-drug intervention for this chronic disorder.
c. Differing diagnostic practices and varying criteria for success make it difficult
to compare the results of studies on psychosurgery.
d. The absence of data comparisons of psychosurgery to placebo group
outcomes makes the results of psychosurgery hard to determine.
15.19
Ans. A
Con
p. 533
E
If you were to write a comprehensive report on the history of convulsive therapies,
what span of time would your report need to cover?
a. several centuries
b. about one hundred-fifty years
c. about ninety years
d. three decades
15.20
Ans. A
App
p. 533,4
M
If you were afflicted with schizophrenia and were under the care of Dr. Manfred
Sakel during the earlier part of this century, what treatment would you probably
have been prescribed?
a. prefrontal leucotomy
b. insulin-induced coma therapy
c. bilateral electroconvulsive therapy
d. metrazol therapy
*
15.21
Ans. B
App
p. 534
M
If European and U.S. physicians had gathered together in the 1940s to honor
Ladislas von Meduna, the ceremony would have celebrated his proposal that
a. electric current applied bilaterally to the head could safely and effectively treat
schizophrenia.
b. epilepsy and schizophrenia were neurologically incompatible disorders and
thus seizures could treat schizophrenic patients.
c. transorbital lobotomies could be efficiently conducted on patients with varying
kinds of chronic mental disorders.
d. drugs initially intended to treat tuberculosis could successfully reduce the core
symptoms of mood disorders.
15.22
Ans. D
Fac
p. 534
M
What theory did von Meduna propose to explain the results of convulsive
therapy?
a. Seizures rebalance inconsistencies within the libidinal patterns of the patient,
b. The flood of neurotransmitters released during a seizure alters the stores of
neurotransmitters within the patient's neurons, resulting in reduced psychotic
behavior.
c. The patient suppresses any reports of psychotic behavior in order to avoid the
aversive punishment of convulsive therapy, but there is no real improvement.
d. Seizures and psychosis appear to be neurologically incompatible and thus
induced seizures must correct psychotic brain activity.
368
15.23
Ans. D
Con
p. 534
M
Which of the following terms does not belong with the other three?
a. metrazol
b. electricity
c. insulin
d. reserpine
15.24
Ans. B
App
p. 534
E
It is 1948, and a woman named Betina is suffering from schizophrenia. If she were
treated by Cerletti and Bini, what type of therapy would Betina undergo?
a. insulin-induced coma therapy
b. electroconvulsive therapy
c. metrazol therapy
d. a cingulatomy
15.25
Ans. C
Fac
p. 534
E
What observation(s) led to the development of electroconvulsive therapy?
a. Japanese studies of combat hysteria during WWII
b. an accident in Cerletti's laboratory in which a psychotic patient grabbed a live
electrical wire
c. the shocking of hogs prior to slaughter
d. behavioral changes in a mountain shepherd who was stuck by lightning
15.26
Ans. A
App
p. 534-5
M
Jeremiah is a modern ECT patient. Compared to procedures used in the past,
Jeremiah will NOT be given
a. an electrical impulse through his dominant hemisphere.
b. muscle relaxants.
c. supplementary oxygen.
d. increased levels of electricity as treatments are repeated.
15.27
Ans. A
App
p. 535
M
You are a psychology intern observing an ECT session for a psychotically
depressed female. Which of the following will you NOT observe?
a. physical contortions as the convulsion occurs in her brain
b. use of a lower level of current than is used for male patients
c. recording of brain wave activity via EEG
d. a treatment session that takes about 4 minutes to complete
15.28
Ans. C
App
p. 535
M
Nancy will have her very first ECT session tomorrow. How often will she
probably undergo ECT after this first session?
a. 2 more sessions, over next 4 months, as symptoms recur
b. 4 to 6 more sessions, twice a week for the next 3 to 4 weeks
c. 10 more sessions, 2 to 3 times a week for the next 3 to 4 weeks
d. 11 to 12 more sessions, 5 to 6 times a week for the next 2 weeks
15.29
Ans. B
App
p. 535
M
If Ruben has completed a series of modem ECT treatments, which of the
following adverse side effects is Ruben MOST likely to experience?
a. broken bones, elevated blood pressure, procedural memory loss
b. headaches and five-month long episodic memory impairment
c. hyperphagia and loss of semantic memory
d. joint aches, metabolic changes, cognitive impairment
*
369
15.30
Ans. D
App
p. 535
M
Sheree is a data entry operator for a large business firm. Which of the following
memories is she MOST likely to forget following ECT treatment for depression?
a. the procedures for entering data into her computer
b. the meaning of the shorthand her boss uses when he sends assignments to her
c. her home address and phone number and those of her family
d. the conversations she had with her family about the treatment in the days
before it occurred
15.31
Ans. A
App
p. 535
E
If Tyler has a disorder that is among the three disorders that comprise the
majority of ECT cases, he could have any of the following EXCEPT
a. obsessive-compulsive disorder.
b. bipolar disorder.
c. severe depression,
d. schizophrenia.
15.32
Ans. B
App
p. 535
M
Samuel was given ECT followed by an antidpressant for his severe depression;
Jorge received only antidepressant medication. You would anticipate that Samuel's
symptoms would improve
quickly than Jorge's and that Samuel's treatment
outcome would be
Jorge's.
a. more; less optimal than
b. more; equal or superior to
c. less; equal to
d. less; less optimal than
15.33
Ans. C
App
p. 535
M
Dr. Ellis has treated 50 severely depressed patients in the last six months with
ECT. If he prescribes follow-up medication treatment, how many of his patients
will probably experience a relapse?
a. 25
b. 18
c. 10
d. 4
15.34
Ans. D
App
p. 536
E
Dr. McCoy has a new patient who has been diagnosed with chronic schizophrenia,
characterized by delusions and several oddities of behavior and speech. The
patient's symptoms have been relatively stable over time. Which statement below
is a CORRECT prognosis for this patient?
a. Psychopharmacology will be of little help to this patient.
b. This patient may be a candidate for psychosurgery.
c. This patient should be given modem metrazol therapy.
d. This patient is an unlikely candidate for ECT.
15.35
Ans. A
Fac
p. 536
M
By
B what mechanism does ECT affect disordered mood?
a No definitive answer is available.
b It stimulates an increased production and release of catecholamines and
beta-endorphins.
c. It stimulates increased production and release of antidepressin.
d It disrupts the cognitive rumination and other dysfunctional cognitive
processes that maintain depressed mood.
*
370
15.36
Ans. B
App
p. 536
M
At an international conference where mental health experts meet to discuss
advances in treatment of psychopathology, which delegate would be most
reluctant to exhibit enthusiasm for modem ECT?
a. the delegate from India
b. the delegate from the U.S.
c. the delegate from Britain
d. the delegate from Italy
15.37
Ans. C
App
p. 536
E
Dr. McVaugh has decided that his patient, Tamara, is an excellent candidate for
ECT. Which of the following persons will determine whether Tamara actually
undergoes this treatment?
a. an NIMH reviewer of Dr. McVaugh's treatment plan
b. Dr. McVaugh
c. Tamara
d. either b or c
15.38
Ans. C
Fac
p. 537
E
During what decade was today's most common form of biological treatment
introduced?
a. 1930s
b. 1940s
c. 1950s
d. 1970s
15.39
Ans. D
App
p. 537
M
If Dr. Gundy conducts research in the area of psychopharmacology, which of the
following research topics would be of interest to him?
a. improvements in the application of stereotaxic subcaudate tractotomies
b. successful application of ECT to cases of catatonic schizophrenia
c. the presence of placebo effects in psychosurgery outcomes
d. the frequency of comorbid substance abuse in psychiatric patients
15.40
Ans. A
App
p. 537
M
If practices at the local community mental health center are comparable to those
found across the U.S.,
% of outpatients are receiving medication. In the
mid 1970s, that proportion would have been roughly
.
a. 55; one quarter
b. 45; one third
c. 33; one quarter
d. 55; one half
15.41
Ans. B
App
p. 537
M
Dr. Parrilla is a psychiatrist. If she is like most of her colleagues, about %
of her patients will be receiving the most common form of biological treatment
for their disorders.
a. 97
b. 90
c. 76
d. 55
371
15.42
Ans. D
Fac
p. 537,40
E
*
Of the $3 billion spent on antidepressant medications, the largest portion goes to
purchase which drug?
a. imipramine
b. amoxapine
c. clomipramine
d. fluoxetine
15.43
Ans. A
App
p. 539
M
Heroine affects brain functioning by mimicking the action of endogenous opiates.
In other words, heroine is a(n)
a. agonist.
b. reuptake inhibitor.
c. antagonist.
d. neuro-reagent.
15.44
Ans. B
App
p. 539
M
*
If the drug naltrexone causes an increase in perceptions of pain by occupying
receptors that are normally stimulated by endorphins, naltrexone is a type of
a. deactivator.
b. antagonist.
c. inhibitor.
d. agonist.
15.45
Ans. D
App
p. 539
M
A new type of dmg, Dmg X, blocks the effects of the neurotransmitter serotonin
by attaching to serotonin receptors. What type of dmg is Dmg X?
a. an agonist
b. selective serotonin reuptake blocker
c. 5-HT inhibitor
d. an antagonist
15.46
Ans. A
App
p. 540,7
E
Gwynneth is taking a psychoactive substance for her depression disorder. This
substance could come from any of the following categories EXCEPT
a. butyrophenones.
b. monoamine oxidase inhibitors.
c. heterocyclics,
d. SSRI's.
15.47
Ans. B
App
p. 540-1
C
Nikita is taking an antidepressant that is severely reducing her REM sleep and
sometimes causes a precipitous rise in her blood pressure. Which of the
following drugs is she probably taking?
a. Tofranil
b. Nardil
c. Zoloft
d. Wellbutin
15.48
Ans. D
App
p. 540
M
Mariah is taking an MAO inhibitor. What statement about her case is FALSE?
a. Mariah will have no REM sleep while she is taking this dmg.
b. Mariah should not eat aged cheese or drink beer while taking this dmg.
c. Mariah is suffering from depression.
d. Mariah's medication is acting as an agonist for serotonin and norepinephrine.
372
15.49
Ans. D
App
p. 540,3,7
M
*
Anita recently went through a very vicious divorce, and she is now taking an
antidepressant. Which of the following might have been prescribed for her?
a. diazepam
b. chlorpromazine
c. alprazolam
d. sertraline
15.50
Ans. C
App
p. 541
M
Javier is taking a TCA medication to help him with his depression. Which
statement below applies to Javier's case?
a. The known cause of his depression will be relieved.
b. He will need to avoid foods that contain tyramine.
c. He may experience a dry mouth, insomnia, and constipation.
d. He is taking the type of antidepressant that is most widely prescribed.
15.51
Ans. A
Fac
p. 541
E
How are drugs such as fluoxetine different from first generation antidepressants
such as phenelzine or imipramine?
a. These drugs affect primarily serotonin but not norepinephrine.
b. These drugs block the release of both norepinephrine and serotonin.
c. These drugs block the reuptake of dopamine but not norepinephrine.
d. These drugs slow the breakdown of serotonin rather than norepinephrine.
15.52
Ans. B
App
p. 541
M
Of the 100 patients for whom Dr. Moody has prescribed Prozac, how many of
them will probably experience uncomfortable side effects?
a. 22
b. 30
c. 40
d. fewer than 5, which is part of this drug's popularity
15.53
Ans. C
Con
p. 542
M
A therapeutic daily dose of Paxil (paroxetine) is 20 to 50 mg. For which of the
following persons might a dose of 20 mg/day conceivably cause psychotic-like
symptoms of overdose?
a. Missy, a 14-year-old female
b. Philippe, a 42-year-old male
c. Alicia, a 67-year-old female
d. either a or c
15.54
Ans. D
App
p. 542
M
Vincenzo began taking an SSRI yesterday for treatment of his major depression.
About how long will it be before the maximum level of effectiveness is reached?
a. 7 days
b. 15 days
c. three weeks
d. five weeks
*
373
15.55
Ans. D
App
p. 542
M
Bernice has a major depression with severe psychotic symptoms. She believes
she is the antichrist and that she can kill people by simply wishing them dead.
Which antidepressant is likely to be an effective treatment for her?
a. an MAO-I
b. anSSRI
c. a heterocyclic
d. none of the above
15.56
Ans. C
Con
p. 542
M
Which of the following terms does not belong with the other three?
a. naturally occurring salt
b. John Cade
c. neuroleptic
d. secondary messenger alteration
15.57
Ans. B
App
p. 542
M
*
Nadia has been diagnosed with bipolar disorder. She has shown no improvement
with traditional antidepressants such as MAOs or SSRIs. Nadia's psychiatrist has
now prescribed a medication that is believed to work by altering secondary
messengers. What is this medication?
a. buproprion
b. lithium
c. diazepam
d. trazedone
15.58
Ans. A
App
p. 542
M
Koa suffers from an untreated bipolar disorder, and Mapela is receiving lithium
for her bipolar disorder. If they are similar to most persons with this disorder,
Koa's manic episodes occur about every
months, and Mapela's will occur
.
a. 14; much less often
b. 8; much less often
c. 14; slightly less often
d. 9; about as frequently but with much milder symptoms
15.59
Ans. A
App
p. 542
C
Which of the following persons is LEAST likely to take a prophylactic drug?
a. Marsha, with a specific phobia
b. Tiko, with schizophrenia
c. Ronnie, with bipolar disorder
d. Conchita, with recurrent, severe major depression
15.60
Ans. D
App
p. 542
M
Miyoko has been admitted to the hospital in an acute manic state. Which of the
following medications is she MOST likely to receive?
a. lithium
b. a neuroleptic
c. an SSRI
d. both a and b
374
15.61
Ans. B
App
p. 542
M
Errol is slurred in his speech, is having difficulty maintaining his balance, and is
feeling very nauseous. He probably has a toxic level of
in his body.
a. MAO-I
b. lithium
c. Haldol
d. buspirone
15.62
Ans. C
App
p. 543
E
If Pai is receiving the kind of treatment for bipolar disorder that is quickly
becoming the standard of care for this disorder, Pai will receive
a. lithium,
b. psychotherapy.
c. a combination of lithium and psychotherapy,
d. valproic acid.
15.63
Ans. A
Con
p. 543
M
Which of the following medications does not belong with the other three?
a. amoxapine
b. valproic acid
c. lithium
d. carbamazepine
15.64
Ans. B
Con
p. 543
M
Valproic acid is to buspirone as
a. mania is to depression.
b. bipolar disorder is to anxiety disorder,
c. agonist is to antagonist.
d. dopamine is to GABA.
*
15.65
Ans. C
App
p. 543
M
Carleton is taking a medication which belongs to a category more frequently
prescribed than any other type of dmg. Which of the following dmgs is he taking?
a. Prozac
b. Prolixin
c. Xanax
d. lithium
15.66
Ans. D
App
p. 543
E
Pierre suffers from posttraumatic stress disorder, coupled with anxiety attacks and
agoraphobia. To help him cope with his symptoms, a physician will most likely
prescribe an antianxiety drug that belongs to which family of medications?
a. dybenzoxapines
b. butyrophenones
c. phenothiazines
d. benzodiazepines
15.67
Ans. D
Fac
p. 544
E
Which neurotransmitter's postsynaptic binding is facilitated by benzodiazepines?
a. norepinephrine
b. dopamine
c. glutamate
d. GABA
375
15.68
Ans. A
App
p. 544
M
*
Lieux is taking a psychoactive substance that is causing significant drowsiness.
Which of the following substances is the MOST likely culprit?
a. a benzodiazepine
b. anSSRI
c. buspirone
d. anMAO-I
15.69
Ans. B
App
p. 544
M
Arielle has been taking alprazolam for 8 weeks to help relieve symptoms of
agoraphobia. When she stops taking the drug, what will probably happen?
a. If the drug was coupled with the psychotherapy, she should be fully treated,
b. Her anxiety and panic attacks will recur with increased intensity.
c. She will become confused, disoriented, and suffer detoxification effects.
d. Her anxiety and panic attacks will recur, but at a much lower intensity than
before.
15.70
Ans. C
App
p. 544-5
C
Kirsten's physician is reluctant to give anxiety-disordered clients long-term
prescriptions for benzodiazepines. Should he be more willing to prescribe
buspirone?
a. No, because busiprone is an antidepressant.
b. Yes, but busiprone requires extensive blood testing if it is taken.
c. Yes, busiprone acts on different neurotransmitters than benzodiazepines do.
d. No, busiprone is more addictive.
*
15.71
Ans. D
App
p. 545
M
Dr. Dumont is treating 10 patients who have panic disorder. If she has
prescribed Xanax to each of them, how many patients will probably experience
withdrawal symptoms after several months of treatment?
a. 2
b. 5
c. 8
d. 10
15.72
Ans. A
App
p. 546
C
Francoise's therapist is encouraging him to continue taking his prescribed
medication even though Francoise believes that all it has done for the past three
weeks is make him dizzy and give him mild headaches. What medication is
Francoise probably taking?
a. buspirone
b. fluoxetine
c. lithium
d. alprazolam
15.73
Ans. D
App
p. 544,6
C
A physician is reviewing me literature on the treatment of panic attacks. If he
wanted to successfully treat at least half of his patients within an 8-week period,
which of the following medications should he prescribe?
a. Prozac
b. Xanax
c. Tofranil
d. any of the above
376
15.74
Ans. A
App
p. 546
M
If a biological treatment were chosen for Solveig who suffers from OCD, which
of the following is MOST likely?
a. aTCA
b. psychosurgery
c. a benzodiazepine
d. carbamazepine
15.75
Ans. B
App
p. 546
M
Which of the following descriptions is MOST likely to be true for Kamala, a
person who is taking Anafranil for the treatment of OCD?
a. Her obsessions will noticeably decrease within two to three weeks of the start
of treatment.
b. She will discontinue the dmg due to bothersome side effects.
c. She will experience fewer benefits from this dmg than she would from BuSpar.
d. Her compulsions will fully remit within 10 weeks.
15.76
Ans. C
Con
p. 546
E
Which of the following terms does not belong with the other three?
a. major tranquilizers
b. antipsychotics
c. phenobarbitals
d. neuroleptics
15.77
Ans. D
App
p. 546
E
Maude is hearing voices and having paranoid delusions. What general class of
drugs is her physician likely to prescribe to her?
a. monoamine oxidase inhibitors
b. benzodiazepines
c. selective serotonin reuptake inhibitors
d. phenothiazines
15.78
Ans. A
App
p. 546
E
Which of Josef s schizophrenic symptoms will be LEAST affected by the use of an
antipsychotic medication?
a. social withdrawal
b. auditory hallucinations
c. delusions of grandeur
d. incoherent, tangential speech
15.79
Ans. C
Fac
p. 547
E
Neuroleptic drugs have drastically changed the nature of institutionalization for
psychotic individuals. With these drugs, about
% of schizophrenic patients
respond well enough to live completely independently.
a. 54
b. 40
c. 30
d. 19
15.80
Ans. B
Con
p. 547
M
Which of the following medications and their initial uses are mismatched?
a. metrazol therapy : treatment of schizophrenia
b. phenothiazines : treatment of epilepsy
c. MAO-I : treatment of tuberculosis
d. tricyclics : treatment of schizophrenia
*
377
15.81
Ans. C
Fac
p. 547
E
In what country, and when, was chlorpromazine first used to treat mental patients?
a. in the U.S., in the mid 1950s
b. in Italy, in the early 1950s
c. in France, in the early 1950s
d. in the U.S., in the early 1960s
15.82
Ans. D
App
p. 547
E
*
Nigel is taking a typical neuroleptic. Which of the following is occurring in his
brain?
a. The drug is functioning as a dopamine agonist, thereby reducing psychotic
symptoms.
b. The drug is affecting dopamine functioning in the limbic system and frontal
lobes but does not significantly affect other structures.
c. The drug is reestablishing a balance between dopamine and acetylcholine.
d. The drug is functioning as a dopamine antagonist by targeting D2 receptors.
15.83
Ans. A
App
p. 548
M
If Fiona is taking a drug which is acting as a dopamine antagonist in her basal
ganglia, which of the following symptoms will occur?
a. extrapyramidal symptoms
b. dry mouth, blurred vision, and constipation
c. symptoms of anxiety and panic
d. high fever and muscular rigidity
15.84
Ans. B
App
p. 548
M
A group of patients is being treated with neuroleptics. When their dopamine
levels drop out of balance with their levels of acetylcholine, what will result?
a. acute dystonia
b. Parkinsonism
c. acute akathesia
d. TO
15.85
Ans. C
App
p. 548
M
*
Denise has an extrapyramidal syndrome marked by rapid, spasmodic contortions
in her head, neck, and back. Sometimes she looks as though she is having an
epileptic seizure. What side effect does this represent?
a. acute akathesia
b. TO
c. acute dystonia
d. Parkinsonism
15.86
Ans. D
App
p. 548
M
Assaf is displaying uncontrollable restlessness and feels a constant need to keep
moving his arms and legs. What side effect does this represent?
a. neuroleptic malignant syndrome
b. extrapyramidal restiveness
c. acute dystonia
d. acute akathesia
378
Sadie, a long-term psychiatric patient, exhibits uncontrollable twitches in her face
and lateral movements of her jaw, makes smacking sounds with her lips, and has
spasmodic jerks and tics in her trunk and arms. What disorder is present?
a. tardive dyskinesia
b. Parkinsonism
c. neuroleptic malignant disorder
d. acute dystonia
Trisha has been taking chlorpromazine for most of her adult life. She is now
starting to develop some dangerous side effects from this medication. Which
condition below is the LEAST likely to be among these?
a. Parkinsonism
b. neuroleptic malignant syndrome
c. TD
d. none of the above
Which of the following persons is MOST likely to develop TD?
a. Heinz, a 63-year-old schizophrenic male who has taken neuroleptics for 20
years
b. Gertie, a 47-year-old schizophrenic female who has taken neuroleptics for 25
years
c. Raoul, a 36-year-old bipolar male who has taken mood stabilizers for 20 years
d. Melanie, a 55-year-old psychotically depressed female who has taken
neuroleptics for 12 years
The neuroleptic side effect most likely to cause death in persons who develop it is
. The long-term side effect that is unresponsive to antiParkinsonism medication is
.
a. acute akathesia; tardive dyskinesia
b. acute dystonia; neuroleptic malignant syndrome
c. neuroleptic malignant syndrome; tardive dyskinesia
d. toxic phenothiazine poisoning; acute akathesia
Terry has just been mshed to a hospital emergency room with an extremely high
fever, muscle rigidity, and irregular heart rate and blood pressure. If Terry began
taking a neuroleptic a few days ago, what should the physician suspect?
a. acute dystonia
b. Parkinsonism
c. tardive dyskinesia
d. neuroleptic malignant syndrome
379
.92
Ans. D
App
p. 549
M
Janet is taking a medication for schizophrenia, but she is seriously considering
changing it because of the high cost of treatment. With the weekly blood cell count
she must have, the costs of her treatment run her several thousand dollars per year,
What medication she is taking?
a. Sertraline
b. Serzone
c. Prolixin
d. Clozaril
15.93
Ans. B
App
p. 549
M
For psychotic patients who exhibit predominantly negative symptomatology, which
medication would you recommend?
a. Stelazine
b. Clozaril
c. an SSRI
d. Haldol
15.94
Ans. C
Con
p. 549
M
*
Which of the following statements should be OMITTED from a description of the
recent antipsychotic medication that has its primary effect on D4 receptors?
a. It is not associated with the extrapyramidal side effects common to other
antipsychotic medications.
b. It has antagonistic effects on several neurotransmitters besides dopamine.
c. It is free of virtually all annoying side effects.
d. It is effective for the treatment of both positive and negative psychotic
symptoms.
15.95
Ans. D
App
p. 549
E
Vittorio's family would like him to take clozapine for his psychotic disorder
marked predominantly by negative symptoms. For what reason might this be
problematic?
a. Antipsychotics such as this one are not very effective in treating negative
symptoms.
b. Extrapyramidal side effects from the medication may motivate Vittorio to refuse
to keep taking the drug.
c. This drug is effective only for schizoaffective disorder, in which some negative
symptoms are caused by an underlying mood disturbance.
d. The drag may be prohibitively expensive for Vittorio and his family.
15.96
Ans. A
Fac
p. 549
M
Which of the following is NOT an atypical neuroleptic medication?
a. thiothixene
b. risperidone
c. olanzapine
d. clozapine
15.97
Ans. B
Con
p. 551
E
Which of the following medications does not belong with the other three?
a. dextroamphetamine
b. methamphetamine
c. methylphenidate
d. pemoline
380
15.98
Ans. B
App
p. 551
E
Nine-year-old Toshio is taking the commonly prescribed stimulant medication for
his hyperactivity. The medication
the availability of
in his brain.
a. increases; GABA
b. increases; norepinephrine and dopamine
c. decreases; serotonin
d. decreases; dopamine
15.99
Ans. A
App
p. 551
M
*
Forrest, a ten-year-old male, took his ADHD medication at breakfast around
7:30 A.M. Forrest was in a hurry and forgot to take his midday dosage to school.
According to the text, Forrest will most likely experience
a. a rebound effect in the early afternoon after his last dosage, and his ADHD
symptoms will return stronger than ever.
b. a decrease of arousal as the day progresses due to the fact that the stimulant
will wear off.
c. abdominal pains, headaches, and a loss of appetite four to five hours after his
last dosage.
d. normal levels of arousal throughout the day.
15.100
Ans. B
Con
p. 551
M
Which of the following outcomes is LEAST likely for children taking stimulant
medication?
a. improved social relationships
b. long-term academic gains
c. side effects of decreased appetite and physical discomfort
d. improved attention to relevant environmental stimuli
15.101
Ans. D
App
p. 551
M
As a parent of an ADHD child, you are concerned that the medication your child
is taking to treat the disorder may stunt his/her growth. According to the text,
what would your child's clinician recommend to avoid this possibility?
a. a vegetarian diet
b. vigorous exercise to stimulate muscle development
c. reductions in dosage levels
d. periodic drug holidays
15.102
Ans. A
Con
p. 552
E
When physicians read information from studies of pharmacodynamics and
pharmacokinetics today, what sort of sample is most commonly represented in
those studies?
a. a group of white males
b. a group of white males and white females
c. a group of white and Hispanic males
d. a group of white and Asian males
15.103
Ans. D
App
p. 552
M
Dr. Sekka is studying the antagonist effects of clozapine on D4 receptors. This
work is a specific example of
research.
a. psychopathological
b. pharmacokinetic
c. psychodynamic
d. pharmacodynamic
381
15.104
Ans. C
App
p. 552
C
Which of the following pharmacokinetic outcomes is likely to apply to Medgar, a
black male?
a. Medgar will show a higher blood concentration of neuroleptics than will an
Asian male for similar doses.
b. Medgar's metabolism of benzodiazepines will be faster than that of a white male.
c. Medgar will experience a faster therapeutic response to tricyclic drags than will
a white male.
d. None of the above is correct; ethnic differences have not been established in this
area.
15.105
Ans. B
App
p. 552
M
Given equivalent doses, which of the following persons will achieve the highest
blood concentration level of a phenothiazine?
a. Vito, a Hispanic male
b. Hiroski, a Japanese male
c. Robert, a Caucasian male
d. Trevor, an African American male
15.106
Ans. A
App
p. 553
E
Michael was given a sugar pill that he believed was actually an antidepressant
medication. If his symptoms improve significantly, this would be called a(n)
a. placebo effect.
b. pseudochemical effect.
c. experimenter expectancy effect.
d. psychoactive effect.
*
15.107
Ans. A
App
p. 553
M
Vivian has undergone successful therapy for depression. According to the
findings
from the NIMH Treatment of Depression Collaborative Research
Program, which factors was probably MOST important in her treatment?
a. the quality of the relationship with her therapist
b. the placebo effect
c. antidepressant medication
d. interpersonal therapy
SHORT ANSWER I ESSAY
15.108
Describe the "blind" lobotomy techniques used in the past. What were two
important consequences for the Portuguese neurosurgeon who introduced one of these techniques?
The first procedure in this century was the prefrontal leucotomy/lobotomy. Small holes
were drilled in the skull just over frontal lobes, and alcohol was then injected into the tissue to
destroy it. Later, this involved the use of a leucotome that was inserted through the skull, and a
wire loop was rotated to destroy the tissue. In the U.S., the standard/frontal lobotomy involved
holes drilled into each side of the skull into which a cutting instrument was inserted and the frontal
lobe was severed from the rest of the brain. This was replaced by the simpler office procedure in
which a small ice pick-like instrument was inserted into the socket above the eye, undercutting the
frontal lobes.
Moniz, the neurosurgeon who introduced the lobotomy, won the Nobel Prize for Medicine
(in 1949) but was also shot and paralyzed by a disgruntled patient.
382
15.109
List in chronological order the development of convulsive therapies, beginning with
Sakel's procedure. For what disorders) is this therapy used today?
Insulin coma, metrazol therapy, bilateral ECT, unilateral ECT
Used for severe mood disorders (manic episodes of bipolar disorder, major depression with
melancholia, psychotic depression, severely suicidal depression), less severe depression that has
been unresponsive to all other treatment interventions, and, possibly, catatonic stupor and acute
schizophrenic agitation.
15.110
For what reasons has ECT grown in popularity in the past few years?
The promise of antidepressant medications has not been completely fulfilled. The drugs
have several adverse side effects, and they are not effective for all patients. Also, ECT procedures
have become much safer, with fewer adverse side effects, and are highly effective for severely
depressed patients (particularly when combined with medication follow-up). Patients with acute
manic episodes also benefit from this treatment.
15.111
What influence has ancient herbal medicine had on the field of psychology?
Herbal remedies were the predecessors of psychotropic drugs, used in essentially all cultures
with the belief that they could relieve mental distress. This provides precedent and historical
support for an attitude that has fostered the acceptance of drugs in modem society as a common and
appropriate intervention in mental disorders.
15.112
activity.
Describe the various mechanisms by which psychoactive drugs can affect brain
Agonist action — directly mimics the action of neurotransmitters by occupying specific
receptors
Antagonist action — blocks the action of neurotransmitters by inertly occupying receptors
Prolonging of neurotransmitter action — blocking reuptake or slowing enzyme action that
breaks down the neurotransmitters
15.113
Why are benzodiazepines widely prescribed? What are the potentially dangerous
consequences of their use?
They are widely prescribed because anxiety disorders are the most commonly occurring
disorders; the drug acts quickly to relieve symptoms; initial side effects are negligible; they are
relatively inexpensive.
The drags are dangerous because diey can cause dependence and severe withdrawal
symptoms that can even cause greater discomfort than the original symptoms; they can also
combine with alcohol to produce potentially dangerous motor impairment.
383
15.114
Regarding dmg treatment for anxiety disorders: What four types of medication are
effective for the treatment of panic attacks? Besides the benzodiazepines, what dmg is effective
for the treatment of generalized anxiety? for the treatment of OCD?
Panic treatment: MAO-I, TCA, SSRI, and benzodiazepine (Xanax).
BuSpar effectively treats generalized anxiety disorder; Anafranil/clomipramine (a TCA) as
well as the SSRI's are useful for OCD.
15.115
Suppose a relative of yours were to be diagnosed with a severe episode of major
depression. Would you advocate the use of some kind of biological treatment? Using evidence
from your text, defend your answer.
[No modal response predictable.]
384
Chapter 16 PSYCHOTHERAPY
16.1
Ans. D
App
p. 558
E
Which of the following persons can be called a psychotherapist?
a. Dr. Madsen, a psychiatrist
b. Dr. Fuhr, a psychologist
c. Ms. Cosby, a clinical social worker
d. all of the above
16.2
Ans. C
App
p. 558
E
Statistically, which of the following persons is LEAST likely to receive
psychotherapy?
a. Curtis, a 62-year-old male
b. Marta, a 27-year-old female
c. Karen, a 15-year-old female
d. Keifer, a 33-year-old male
16.3
Ans. B
App
p. 558-9
E
Lorena feels tired and irritable and is considering making an appointment to see a
therapist. Lorena's therapy will probably be more successful if she is
a. a minority,
b. more educated.
c. an older adult,
d. a younger adult.
16.4
Ans. B
App
p. 558-9
E
Alicia and Michael are both experiencing an episode of major depression.
is more likely to seek therapy, but if both were to receive therapy,
_______ would exhibit greater improvement.
a. Alicia; Michael
b. Alicia; neither
c. Michael; Alicia
d. Alicia; Alicia
Dominique is a woman living in near-poverty conditions. Compared to someone
from a higher SES class, Dominique will be
likely to seek therapy and
probably
to
terminate it.
a. less; sooner
b. more; sooner
c. less; later
d. equally; sooner
Vicki says that she always encourages her clients to fully express their emotions
and become independent thinkers. Vicki's strategy will most likely need to be
adjusted for clients of different
a. cultural backgrounds.
b. levels of self-esteem.
c. socioeconomic classes.
d. professions.
16.5
Ans. A
App
p. 559
E
16.6
Ans. A
App
p. 559
E
16.7
Ans. C
App
p. 559
M
Marguerite has just begun a training rotation on an inpatient psychiatric unit. In
her first interview, she talked with an individual who is a member of a group
overrepresented in such settings. Who of the following is this likely to be?
a. Suzette, a European American female
b. Stephen, a European American male
c. Carter, an African American male
d. Carlos, a Hispanic male
16.8
Ans. D
Con
p. 559
E
A service organization wishes to encourage people to use the community mental
health center but needs more information about groups that are currently unlikely
to seek help. According to your text, they should be advised to target
a. women.
b. middle-aged adults.
c. people of upper socioeconomic status.
d. Hispanic Americans.
16.9
Ans. A
Con
p. 559
E
Drawing on prevalence rates to predict what problem your next psychotherapy
client is MOST likely to have, you should guess
a. depression,
b. marital difficulties.
c. a psychotic condition,
d. substance abuse.
16.10
Ans. B
App
p. 559
E
Dr. Ruiz is a psychotherapist. If he is typical of most therapists, he will see
about
clients each day.
a. 4
b. 7
c. 11
d. 13
16.11
Ans. C
Con
p. 559-60
C
In a student's summary of the characteristics of effective psychotherapists, which
of the following statements would be TRUE?
a. Therapy outcomes tend to be somewhat more positive when the therapist is a
psychologist rather than a social worker.
b. Evidence conclusively demonstrates that untrained helpers are as effective as
professional therapists.
c. Seasoned, experienced therapists tend to keep clients in therapy somewhat
longer than do novice therapists.
d. Novice therapists appear to produce outcomes that are comparable to those of
more experienced therapists.
16.12
Ans. C
Fac
p. 560
E
*
Research on therapy outcomes shows that
a. novice therapists do better than seasoned therapists.
b. seasoned therapists do better than novice therapists,
c. the quality of die client-therapist relationship is more important than the
therapist's type of training.
d. the therapist's type of training is as important as the quality of the
client-therapist relationship.
386
16.13
Ans. D
Fac
p. 560
M
Psychotherapists agree that
is a necessary ingredient for successful
therapy.
a. professional graduate-level training
b. at least average intelligence in clients
c. clients' exploration of the causes of their problems
d. a positive relationship with clients
16.14
Ans. D
Con
p. 560
C
Which of the following theoretical approaches and rationales for the working
alliance are mismatched?
a. cognitive-behavioral therapy : a means of fostering compliance with treatment
techniques
b. Freudian psychoanalysis : a vehicle for exploring connections between early
experience and current problems
c. interpersonal therapy : a safe context for practicing new patterns of
communication
d. Rogerian client-centered therapy : a new opportunity for soothing past fears and
insecurities
16.15
Ans. B
App
p. 560
M
Several therapists were interviewed about the importance of a positive working
alliance with clients. Which of the following is most likely to be a quote from an
interpersonal therapist? "The therapeutic relationship
a. allows clients to work through and understand how early conflicts still affect
them."
b. is a secure place to practice new ways of communicating with others."
c. is a means of gaining a client's confidence in the treatment method."
d. may help clients to overcome past anxieties."
16.16
Ans. A
App
p. 560
E
For Amelia and her therapist to establish a strong working relationship, several
factors must be present. Which of the following is LEAST crucial to that
relationship?
a. the therapist's expertise in an eclectic method of therapy
b. a strong commitment to therapy on the part of Amelia as well as her therapist
c. the therapist's genuine concern for Amelia's well-being
d. a clearly established therapeutic contract
16.17
Ans. B
App
p. 560
E
In her first session with new clients, Dr. Hardy talks with her clients about their
expectations of therapy, the nature of confidentiality, and other conditions that
will facilitate their work. This is known as a(n)
a. working alliance agreement.
b. therapeutic contract.
c. professional therapy agreement.
d. informed consent contract.
387
16.18
Ans. C
App
p. 560
M
After Dan's especially emotional therapy session, his therapist, Mark, phoned Dan's
family to discuss his worries about some disturbing memories Dan described. Mark
did not tell Dan, an adult client, that he would be contacting his family. Mark
a. was right to involve Dan's family if it was beneficial in Dan's treatment.
b. should have verified the memories before involving the family in treatment.
c. was wrong to involve Dan's family without permission.
d. should have invited family members to the next session instead of calling them
by phone.
16.19
Ans. D
App
p. 561
E
In her work with clients, Dr. Breinholdt adheres to a perspective that is endorsed
by the largest number of psychotherapists. What is this perspective?
a. psychodynamic
b. cognitive-behavioral
c. interpersonal
d. eclectic
16.20
Ans. D
App
p. 561
M
Jonelle tells her clients in their first session of therapy that she is an integrationist,
which means that she
a. believes disorders are caused by poor early parent-child interactions,
b. combines medications with behavioral therapy methods.
c. emphasizes emotional understanding, not just intellectual understanding,
d. uses more than one theoretical approach to therapy.
16.21
Ans. C
App
p. 561
M
*
Dr. Gleason is an eclectic therapist. If she employs the most popular principles
reported in a national survey of therapists, she will use
a. behavioral techniques.
b. phenomenological/experiential methods.
c. cognitive methods.
d. psychodynamic methods.
16.22
Ans. C
App
p. 561
M
Todd is a new patient of a psychoanalytic therapist. In order for Todd to
proceed successfully in therapy, he must
first
and then be willing to
.
a. work through unconscious conflicts; achieve conscious insight
b. analyze his resistance; free associate
c. achieve insight; work through those insights
d. free associate; analyze his countertransference
16.23
Ans. A
App
p. 561-2
E
A therapist said to a client with social phobia, "It is important that we understand
the underlying ambivalence you may have toward your parents, attempting to gain
insight about how these early experiences are being replayed in your current
relationships." What perspective is the therapist employing?
a. psychoanalytic
b. cognitive
c. client-centered
d. phenomenological
388
16.24
Ans. A
Con
p. 561-2
M
Which of the following terms does not belong with the other three?
a. analysis of lifestyle
b. free association
c. dream interpretation
d. analysis of resistance
16.25
Ans. D
App
p. 562
M
When Miranda achieves insight into the sources of her depression, she will
^
understand those unconscious dynamics.
a. intellectually
b. emotionally
c. either a or b
d. both a and b
16.26
Ans. B
App
p. 562
M
Barry's therapist notices that while he is describing his day, he switches from
talking about falling behind on school work to talking about his brother. The
therapist believes this may be significant, especially after several more instances
where Barry describes a failure and then mentions his brother. Barry's therapist is
interpreting Barry's
a. covert sensitization.
b. free association.
c. response prevention.
d. resistance.
16.27
Ans. A
App
p. 562
M
Vittorio is traveling, metaphorically, on the royal road to his client's unconscious
mind. In other words, Vittorio is
a. interpreting his client's dreams.
b. encouraging his client to free associate.
c. analyzing his client's resistance.
d. working through his client's transference.
16.28
Ans. C
App
p. 562
M
Rita woke up feeling anxious and realized that she had dreamed for the third time
this week that she had forgotten to feed her friend's dog, and it had almost died.
Rita's therapist asks her to say whatever she thinks of after hearing the word
"feed" and then later, the word "dog." Rita's therapist wants to find the
content of Rita's dream.
a. manifest
b. neurotic
c. latent
d. intellectual
Boris is telling his therapist about his dream from last night. As Boris recounts
what happened in the dream, he is describing its
content.
a. resistant
b. neurotic
c. latent
d. manifest
*
16.29
Ans. D
App
p. 562
M
389
16.30
Ans. C
App
p. 562
M
Mayron believes all her clients' behaviors are equally important, whether it
involves choice of career, forgetting to make a phone call, or recurring marital
arguments. Mayron looks for the underlying conflicts or defenses which might
explain these behaviors, a process known as
a. behavioral transference.
b. empathic understanding.
c. interpreting everyday behavior.
d. analysis of resistance.
16.31
Ans. B
App
p. 562
M
Said a client to his therapist, "I'm just too tired to talk about anything today. You
wouldn't believe the kind of week I've had at work! Maybe we could cut our
session a little short, if that's okay with you." How would a psychoanalytic
therapist describe this interaction?
a. as a sign of countertransference
b. as a sign of resistance
c. as a sign of latent content
d. as a sign of a maladaptive style of life
16.32
Ans. C
App
p. 562-3
M
Dr. Frost is a Freudian psychoanalyst, and Dr. Wharton is a psychoanalyst
trained in Alexander's methods. Where Dr. Frost will carefully avoid
, Dr. Wharton will actively pursue
.
a. mirror transference; idealizing transference
b. analysis of resistance; ego analysis
c. countertransference; corrective emotional experiences
d. lifestyle analysis; ego analysis
16.33
Ans. D
App
p. 563
M
Edena feels that her parents never really cared about her but cared only about
impressing their friends with Edena's accomplishments. Edena does not trust that
people like her for herself. During a therapy session, she accuses her therapist of
disliking her and of using her to better his career. Edena's psychoanalytic
therapist will conclude that the client is
a. experiencing unconditional positive regard.
b. having a corrective emotional experience.
c. free associating.
d. exhibiting transference.
16.34
Ans. A
App
p. 563
E
Sam's main psychological problem involves his anger toward women. Sam feels
that women are cold and rejecting, so he acts in a cold and noncommittal manner
toward them. If a transference neurosis occurs,
a. Sam will act coldly toward his female therapist for an extended time period.
b. Sam will temporarily develop a profound love for his therapist.
c. his female therapist will be cold and rejecting toward him.
d. Sam will be unable to engage in a corrective emotional experience.
390
16.35
Ans. B
Con
p. 563, 66
M
While Freud would recommend that therapists avoid the expression of unconscious
countertransference, Rogers would strongly recommend that a therapist disclose
tmthfully and tactfully her/his own conscious reactions to a client, known as
a. unconditional positive regard.
p. genuineness.
c. self-analysis.
d. therapeutic challenging.
16.36
Ans. C
App
p. 563
M
Martinique is engaging in corrective emotional experiences with her therapist.
Which of the following descriptions does NOT apply to this therapeutic process?
a. It occurs in the context of a relatively brief psychoanalytic-type therapy.
b. It revolves around client-therapist conversations about present problems.
c. The therapist maintains a relatively neutral, detached stance.
d. Martinique sits face-to-face with her therapist instead of reclining on a couch.
*
16.37
Dr. Sato tries to create close, understanding relationships with his clients so that
Ans. B together they can relive and work through old problems. Because Dr. Sato believes
App
clients need an emotional resolution to conflicts from the past, he is most like a(n)
p. 563
psychotherapist.
M
a. experiential
b. individual psychology
c. psychoanalytically oriented
d. traditional psychoanalytic
16.38
Ans. D
Fac
p. 563
M
What do Hartman, Erikson, and Anna Freud have in common?
a. an emphasis on helping clients attain insight about unconscious libidinal
conflicts
b. reliance on dream interpretation rather than analysis of resistance for the
uncovering of unconscious content
c. an emphasis on object relations theory as a basis for therapy
d. an emphasis on the importance of adaptive ego functioning for clients' success
in therapy
16.39
Ans. A
App
p. 563
E
"Traditional psychoanalysts worry too much about sex and aggression and unknown
urges. I think we should worry about how people work toward goals and how
defense mechanisms play a role in their coping." Such a quote MOST likely comes
from a therapist who agrees with
a. the ego analysts.
b. Adler.
c. Perls.
d. interpersonal therapists.
16.40
Ans. A
App
p. 564
M
*
Jeneca describes herself as a psychodynamic therapist. She is interested in the way
her clients deal with their feelings of inferiority and imperfections. Rather than
uncover repressed sexual or aggressive urges, she helps clients to change their
mistaken thinking. Jeneca's therapy is MOST similar to
therapy.
a. Adlerian
b. Ellis'RET therapy
c. ego analytical
d. cognitive
391
16.41
Ans. B
Con
p. 562-4
E
Unconscious conflict is to maladaptive style of life as
a. Perls is to Kohut.
b. Freud is to Adler.
c. Alexander is to Sullivan.
d. Adler is to Rogers.
16.42
Ans. C
App
p. 546
M
Lozona is an Adlerian psychotherapist. In contrast to a traditional psychoanalyst,
in her work with clients Lozona will NOT
a. utilize a form of dream interpretation,
b. attach any meaning to transference.
c. encourage free association.
d. explore the client's early experiences.
16.43
Ans. D
Fac
p. 564
E
Adlerian individual psychotherapy is MOST similar to which modem approach to
therapy?
a. behavioral
b. Gestalt
c. phenomenological
d. cognitive
16.44
Ans. A
App
p. 564
M
Dr. Shapiro often employs a therapeutic method promoted by theorists such as
Winnicott, Klein, and Kohut. Unlike other psychodynamic therapists, she will
a. see the bonding between infants and caregivers as most important for later
personality and relationships.
b. analyze countertransference.
c. use dream interpretation as a means of discovering conscious conflicts.
d. use free association to discover the defenses used by the ego.
16.45
Ans. B
App
p. 564
M
Hosea views transference as a healthy way to reenact clients' early parent-child
relationships and meet their needs for respect, safety, and closeness. Hosea is
probably a(n)
therapist.
a. Adlerian
b. object relations
c. interpersonal
d. Gestalt
16.46
Ans. C
App therapy,
p. 564
C
In his earliest years of life, Joshua was often ignored by his parents. In his adult
relationships, Joshua never feels sufficiently loved by his significant other. In
what sort of transference should the therapist attempt to encourage?
a. mirror
b. twinship
c. idealizing
d. nurturance
392
Phenomenological therapists assert that therapists must regard their clients as
equals. Conceptually speaking, what sort of transference is MOST likely to foster
this perception on the part of the client?
a. twinship
b. mirror
c. congruence
d. idealizing
Which of the following therapists is MOST likely to view themselves as a sort of
surrogate parent for their clients who were emotionally deprived during infancy?
a. Tywanna, an interpersonal therapist
b. Marcus, a Freudian psychoanalyst
c. Deidre, a Gestalt therapist
d. Beverly, an object relations therapist
LeeAnn believes clients need to understand how they perpetuate conflicts through
their communication with and attitudes toward others. During therapy, LeeAnn tries
not to react as most people would to a client's arrogance and disdain, so that the
client comes to understand that this usual strategy for gaining control over an
interaction will not work. What sort of therapy does this represent?
a. Beck's cognitive therapy
b. Ellis'RET
c. interpersonal
d. object relations
Ingeborg is receiving a form of interpersonal therapy for her depression that was
developed specifically for that disorder. Which of the following would NOT be a
focus of her treatment?
a. the development of better interpersonal skills
b. exploration of her insecure attachment pattern in childhood
c. conflicts between her roles as a parent, a full-time professional, and a wife
d. protracted grief over the loss of her mother two years ago
"Nate, the temper tantrums and acting out you used to get attention from your
parents when you were a child are not going to help you resolve your current
conflicts with your wife. Yelling at her and leaving the house in a rage are
perpemating those conflicts. I'd like to work with you to develop some new,
flexible means of getting the support you really want from her." What
perspective does this therapist MOST likely employ?
a. behavioral
b. phenomenological/experiential
c. client-centered
d. interpersonal
Which of the following descriptors does not belong with the other three?
a. conditions of worth
b. Harry Stack Sullivan
c. exaggerated, self-defeating style of interactions learned in childhood
d. effective treatment for depression
393
16.53
Ans. B
Con
p. 565
E
The notion of empathy, if defined as the ability to view the world from the
unique perspective of one's client, could be said to be MOST crucial to
a. psychodynamic therapies.
b. phenomenological therapies.
c. cognitive therapies.
d. interpersonal therapies.
16.54
Ans. C
Con
p. 565
E
Vlado employs a therapy system whose fundamental concepts are derived from
the writings of persons such as Kierkegaard, Sartre, and Wertheimer. How
would you characterize Vlado's perspective?
a. self psychology
b. interpersonal
c. phenomenological
d. cognitive
16.55
Ans. D
Con
p. 565
E
Who of the following is MOST likely to believe that a client is naturally good?
a. Heinz Kohut
b. Harry Stack Sullivan
c. B. F. Skinner
d. Carl Rogers
16.56
Ans. A
App
p. 565
E
Nadine believes it is her responsibility to help her clients reach their full, innate
potential, at which point they will be able to adaptively solve their own problems.
What is the name for the goal Nadine holds for her clients?
a. self-actualization
b. innate potentiation
c. congruence
d. genuineness
16.57
Ans. B
App
p. 565
M
By creating a relationship in which he is honest and caring, Ted hopes clients will
get to know themselves better. He believes that once clients' perceptions are
more accurate, they will grow to their potential. Ted is MOST likely a(n)
therapist.
a. interpersonal
b. experiential
c. cognitive
d. psychodynamic
16.58
Ans. C
Con
p. 563,5
E
Psychodynamic therapies typically focus on
, while
experiential therapies focus on
.
a. conscious ego coping processes; rigid, maladaptive interpersonal behaviors
b. subjective interpretations of reality; objective interpretations of reality
c. resolution of past childhood experiences; immediate experiences in the
therapy relationship
d. maladaptive vicarious learning experiences; facilitation of individuals'
unrealized potential
394
16.59
Ans. D
App
p. 566
M
Veronica's therapist is asking her to focus on the empty chair across from her and
to imagine someone sitting there whom she most needs to confront at this time.
As Veronica talks to the imagined person, the therapist encourages her to fully
vent the strong, angry feelings she harbors about the individual. What
perspective is represented in this technique?
a. cognitive-behavioral
b. self psychology
c. interpersonal
d. P/E
16.60
Ans. A
App
p. 566
M
*
Seth is 16 years old. He wants to join the drama club at his high school, but his
father expects Seth to maintain the family tradition of joining the basketball team.
Seth agrees join the sports team in order to win his father's approval. His father's
expectation is a (n)
a. condition of worth.
b. incongruence.
c. mirror transference.
d. transference neurosis.
16.61
Ans. B
Con
p. 566-7
E
Which of the following terms does not belong with the other three?
a. empathy
b. unfinished business
c. congruence
d. self-actualization
16.62
Ans. C
App
p. 566
E
To be a client-centered therapist, you should work to create a relationship with the
client by
a. challenging clients' irrational thoughts while being supportive of their efforts to
change.
b. remaining neutral to encourage clients to react to you as they would to important
people from their lives.
c. accepting clients as they are, showing that you understand their feelings, and
being honest about your feelings.
d. working with the client to create an agreement about the behaviors the client
should change.
16.63
Ans. C
App
p. 566
E
Nadia's client cried as he told him that he just found out about his son's drug use.
Because Nadia is a client-centered therapist, she would MOST likely respond by
saying,
a. "Lie down and tell me everything that you think of when I say the word 'drugs'."
b. "Now, now, calm down. It's not the end of the world to have a child do a
dangerous thing."
c. "You must be very upset and worried about your son's behavior."
d. "What do you believe might be contributing to your son's behavior?"
395
16.64
Ans. A
App
p. 566
M
In order to adequately convey his
, Dr. Warren refuses to assign
DSM-IV diagnoses because they pigeonhole and label his clients.
a. unconditional positive regard
b. congruence
c. self-actualization
d. conditions of worth
16.65
Ans. B
App
p. 566
E
Gertrude is engaged in the best-known form of phenomenological therapy. She
feels very comfortable with her therapist because he really seems to understand
her feelings and her views about her life, her goals, and her deepest fears. The
therapist has effectively communicated his
a. conditions of worth.
b. empathy.
c. congruence.
d. permissiveness.
16.66
Ans. C
App
p. 566-7
M
Gladys walked silently into her appointment with her therapist, Nancy, and
moved her chair away from Nancy, sitting down with her legs crossed and arms
folded. Nancy, a client-centered therapist, asked, "Feel like letting me in on
what's going on? I'm here for you." If Gladys does not respond, what is Nancy
MOST likely to do?
a. suggest that they reschedule the appointment for another time when Gladys
feels like talking
b. ask her to focus on an empty chair and talk about the feelings that the image
brings up
c. wait patiently, for as long as it takes, for Gladys to respond
d. encourage her to participate in a relaxation procedure, such as deep breathing
16.67
Ans. D
App
p. 566
M
*
Lani is asking her new therapist for advice to help her resolve the heated
arguments
she has had with her boyfriend recently. For what reason would her
client-centered therapist be unlikely to give such advice?
a. It would prevent Lani's exploration of the rigid, self-defeating interaction
pattern she is perpetuating in her relationship.
b. The therapist might recommend an intervention that is inappropriate for Lani,
given that the two have not established a solid working alliance yet.
c. The client would fail to understand the responsibility she has for her own
behavior.
d. It would interfere with Lani's discovery of her own innate abilities to resolve
her problems.
16.68
Ans. A
App
p. 568
M
Dr. Diamond works with a client who appears to be denying feelings of anger
toward his father and who feels helpless to stand his ground when his father
criticizes his career choice or his discipline of his children. Dr. Diamond believes
the client must reexperience earlier feelings of anger and rage in order to work
through them and recognize his responsibility for changing his current situation.
What form of therapy does this MOST likely represent?
a. Gestalt
b. object relations
c. self psychology
d. client-centered
396
16.69
Ans. B
Con
p. 568
M
16.70
Ans. C
App
p. 568
M
16.71
Ans. D
Con
p. 568
M
In what way is Gestalt therapy different from client-centered therapy?
a. Gestalt therapy is a cognitive-behavioral approach, and client-centered is a
phenomenological approach.
b. A Gestalt therapist is more active and confrontive than is a client-centered
therapist.
c. A Gestalt therapist is less likely to focus on client's emotional experiences.
d. A Gestalt therapist is less likely to display genuineness.
As Nara clasps and unclasps her hands, she tells Judd that she feels completely
relaxed
about her decision to move away from home. Judd suggests that she clasp
her hands more tightly together. "Become your hands! What are they telling you
about your decision?" Judd says. Judd is probably a
therapist.
a. client-centered
b. cognitive
c. Gestalt
d. psychodynamic
Which of the following therapies and their primary theorist are mismatched?
a. self psychology : Kohut
b. client-centered : Rogers
c. systematic desensitization : Wolpe
d. Gestalt: Maslow
*
16.72
Ans. A
App
p. 568
E
Tom is a Gestalt therapist. Which aspect of his client's experience is he MOST
likely to emphasize in treatment sessions?
a. feelings
b. behaviors
c. cognitions
d. healthy transference with the therapist
16.73
Ans. B
App
p. 569
M
Eartha just spent 20 minutes expressing her feelings about a conflict with her
mother to an empty chair in which she imagined her mother sitting. Marlene
spent 20 minutes expressing her feelings about a conflict with her mother to a
research experimenter. Compared to their initial levels, which of them is more
likely to exhibit lower blood pressure following that experience?
a. Marlene
b. Eartha
c. neither person
d. There is no empirical basis on which to make a prediction.
16.74
Ans. C
Con
p. 569
C
Which of the following systems of therapy was developed later than the others?
a. client-centered therapy
b. psychoanalysis
c. behavior therapy
d. psychoanalytically oriented psychotherapy
397
16.75
Ans. D
Con
p. 569
E
Which of the therapy models has been most clearly based on empirical research?
a. Adlerian
b. object relations
c. Gestalt
d. behavioral
16.76
Ans. A
App
p. 569
E
Wilhelm is involved in a type of therapy originally described by persons such as
Lazarus, Wolpe, and Eysenck. His therapist, then, would be most likely to focus
on Wilhelm's
a. behaviors.
b. cognitions.
c. emotions.
d. early life relationships.
16.77
Ans. D
Fac
p. 569
E
Current behavioral therapies include techniques that address clients'
a. behaviors.
b. cognitions.
c. emotions.
d. all of the above
16.78
Ans. B
Con
p. 569
M
While a(n) _ _ _ _ _ therapist is likely to focus on issues related to clients' early
childhood, a(n)
therapist is more likely to focus on the here-and-now.
a. Gestalt; Adlerian
b. object relations; behavioral
c. cognitive; psychodynamic
d. RET; Gestalt
16.79
Ans. C
App
p. 569
M
According to the principle of reciprocal inhibition, you
a. cannot leam a new behavior if you are still exhibiting the old one.
b. will tend to exhibit submissive behaviors when interacting with a person who
exhibits extremely dominant behaviors.
c. will not be able to be anxious about an upcoming exam if you are relaxed.
d. will not be able to leam positive thinking if you do not recognize and inhibit
automatic negative thoughts.
16.80
Ans. A
App
p. 569
M
*
For which of the following clients would you recommend treatment via
systematic desensitization?
a. Heinz, who has a phobia of elevators
b. Amee, who has panic attacks
c. Boris, who has generalized anxiety
d. Hazel, who has a social phobia
*
398
16.81
Ans. B
App
p. 569
M
16.82
Ans. C
Con
p. 569
M
Because Tameka is very frightened of cats, her therapist seats her in a chair, places
a cat in her lap and keeps her in that position until Tameka is calmly petting the
cat. The procedure, which is a type of
, worked because Tameka is not
allowed to give in to her fear.
a. contingency management
b. exposure treatment
c. participant modeling
d. systematic desensitization
Which of the following terms does not belong with the other three?
a. flooding
b. in vivo exposure
c. relaxation techniques
d. extinction
16.83
Ans. D
App
p. 570
E
After a poor haircut, Ernesto's assignment from his therapist is to return to the
salon, explain why he is dissatisfied, and ask that someone correct the problem.
Ernesto is MOST likely involved in
a. aversion therapy.
b. contingency modeling.
c. in vivo desensitization.
d. assertiveness training.
16.84
Ans. B
App
p. 570
E
If a student clinician is being supervised by Albert Bandura, which of the
following treatment techniques is the student MOST likely to be learning?
a. a token economy
b. modeling
c. systematic desensitization
d. rational emotive therapy
16.85
Ans. A
Con
p. 571
E
Which sort of modeling is MOST similar to imaginal desensitization?
a. covert
b. participant
c. contingency
d. coping
16.86
Ans. C
App
p. 571
M
*
In order to strengthen his client's ability to benefit from an intervention for a
social phobia, Dr. Jones displays some signs of anxiety as he eats in public with
his client observing him. Dr. Jones believes this will be more effective than
fearless modeling of such behavior. This is BEST known as modeling.
a. participant
b. contingency
c. coping
d. emotive
399
16.87
Rulon is helping a client address some marital problems. Rulon and his client
Ans. D
have agreed, in writing, that the client will decrease aversive interactions by giving
App
his spouse one genuine compliment each day and will refrain from provoking her
p. 571
into anger by commenting on her weight, which he knows is an irritant to her.
M What form of treatment does this represent?
a. aversion therapy
b. participant contracting
c. in vivo exposure
d. contingency management
16.88
Ans. D
App
p. 571
M
Most of Jeffs students have not been able to work quietly, share the class
supplies, nor turn in their homework on time. Jeff wants to create a token
economy, so he sets up specific rules about tasks or behaviors that will be
rewarded. Which of the following is MOST important for Jeff to do before
implementing his plan?
a. identify behaviors for which tokens will be taken away
b. get parental permission to punish the children for misbehavior
c. demonstrate how the plan works by engaging in participant modeling
d. construct an exchange system that includes desirable rewards
16.89
Ans. B
App
p. 571
M
*
Manny has decided to implement a token economy for adolescent inpatients who
are in treatment for eating disorders. Once he has targeted the eating behaviors
he wants to reinforce, he should then
a. establish an exchange system of items the adolescents would find rewarding.
b. establish the specific contingency rules that determine which behaviors will
receive
tokens.
c. set the exchange rates by which tokens can be earned for the specified target
behaviors.
d. develop a contingency contract that each participant will sign before
participating.
16.90
Ans. C
App
p. 571-2
M
16.91
Ans. D
Fac
p. 571
E
Jean-Claude tries to decrease his clients' aggressiveness by rewarding them for
cooperative behavior with gold stars redeemable for their favorite treats and
activities. Arnold gives his aggressive clients mild shocks while they watch the
most violent sections of action movies. Jean-Claude uses and Arnold
uses
'
a. behavior therapy; covert modeling
b. contingency management; flooding
c. a token economy; aversion therapy
d. classical conditioning; response prevention
Token economies were first successfully used in the treatment of
a. mental retardation.
b. severe depression.
c. hyperactivity and antisocial behaviors.
d. schizophrenia.
400
16.92
Ans. A
App
p. 572
E
Which of the following techniques could clients practice LEAST easily on their
own at home?
a. biofeedback
b. Beck's cognitive therapy
c. empty chair technique
d. self-control contingency management
16.93
Ans. B
App
p. 572
E
Each time Serge lowers his resting pulse rate, a green light flashes on the panel on
front of him and a pleasant tone is played. Serge is learning to control his
hypertension through the procedure known as
a. contingency management.
b. biofeedback.
c. sensory monitoring.
d. somatization therapy.
16.94
Ans. C
Con
p. 572-3
M
What do token economy, biofeedback, and aversion treatments have in common?
a. They typically have only small clinical effects on targeted symptoms.
b. Their basic principles derive from theories in cognitive psychology,
c. Their improvements do not appear to be durable over time.
d. The effects they produce are usually matched by the effects obtained through
relaxation training.
*
16.95
Ans. B
App
p. 572
E
Veronica has given her client a pack of cigarettes that will give him a mild electric
shock each time he tries to take one out to smoke. Veronica is using
therapy to treat her client.
a. biofeedback
b. aversion
c. response prevention
d. object relations
16.96
Edouard is treating an alcoholic who has been charged with manslaughter as a
Ans. D result of his drunk driving. If Edouard wants his client to pair the image of a
App
mangled female body, killed when the client struck her while driving drunk, with
p. 573
the image of a drink in the client's hand, what sort of behavioral therapy can
M
ethically be used?
a. in vivo aversive conditioning
b. aversive contingency contracting
c. imaginal desensitization
d. covert sensitization
16.97
Ans. A
Fac
p. 573
E
Each of the following has contributed to the resurgent interest in behavioral
treatment methods EXCEPT
a. the failure of medications to alter disordered mood,
b. the repeated, documented success of these methods.
c. nonprofessionals' ability to implement many of those methods,
d. their greater efficiency compared to other methods of treatment.
401
16.98
Ans. C
App
p. 573
M
*
"People hate me," says Edwin. "They tolerate me while I am around and then laugh
at me when I leave." Edwin's therapist asks him how he knows this, and Edwin
is not able to give a confident answer. Edwin's homework before his next therapy
session is to speak to his acquaintances and think, "they like me" or "I'd like to
get to know them and they want to know me," rather than thinking that people
dislike him. Edwin's therapist is MOST likely conducting
a. Alexander's psychoanalytically oriented psychotherapy.
b. Ellis' rational emotive therapy.
c. Beck's cognitive therapy.
d. Hartman's ego analysis.
16.99
Ans. D
App
p. 573
M
"I'll never find another person to love. No one will ever want me again." Beck
would characterize this depressed client's thought process as
a. negativistic.
b. pessimistic.
c. irrational.
d. catastrophizing.
16.100
Ans. D
App
p. 574
M
Each time Sapna's client uses the explanation that she is "supposed" to be a dutiful
daughter, Sapna asks her how she knows what she "should" be doing. Sapna's
challenges to her clients' belief system indicate that she is MOST likely using
therapy.
a. client-centered
b. interpersonal
c. psychodynamic
d. rational emotive
16.101
Ans. B
App
p. 574
M
According to Albert Ellis' rational emotive therapy principles, if you are overly
upset about receiving a poor grade on an assignment, your emotional reaction is
caused by
a. the grade.
b. your beliefs about what the grade means.
c. your unconscious conflicts.
d. the behaviors which preceded the poor grade.
16.102
Ans. C
App
p. 574
E
If you agree with Ellis' RET, when your depressed clients describe their feelings,
their beliefs, and current and past events related to their depression, you will
MOST likely
a. ask them to relive the most upsetting of the events.
b. ask them to try to challenge their own catastrophizing through homework.
c. help them to see that it is their beliefs about the events that are most
problematic.
d. help them to vent their feelings, perhaps with the empty chair technique.
16.103
Ans. A
App
p. 575
M
To determine if his hug therapy relieves depression, Emil randomly assigns clients
to a hug therapy or no-therapy control group. The therapy is the
variable.
a. independent
b. confounding
c. factorial
d. dependent
402
16.104
Ans. B
App
p. 575
M
Mary measures her clients' anxiety with a written test and then randomly assigns
them to receive one of three treatments. Afterward, she gives them the anxiety
test again to see which treatment was most effective. The dependent variable is the
a. outcome of the anxiety test prior to therapy.
b. outcome of the anxiety test after therapy.
c. random assignment.
d. type of treatment.
16.105
Ans. D
App
p. 575
M
Dr. Warren believes that RET therapy is more effective for anxious patients than
for depressed patients. To test his hypothesis, he provided RET therapy to a
group of anxious and a separate group of depressed patients. Measurement of
irrational beliefs at the end of the study appeared to support his hypothesis.
Which of the following might pose an alternate explanation of his results?
a. He has a confounded research design that precludes any firm conclusion.
b. Client variables may account for the results.
c. The lack of a factorial design prevents any cause-and-effect conclusion.
d. both a and b
16.106
Ans. A
App
p. 575
M
Dr. Whiteley is planning a study of therapy outcomes for depressed clients,
including attention to the role of the therapist's gender. To create the various
conditions, he is using either RET or Beck's cognitive therapy and is assigning
either a male or female therapist. This is an example of a(n) design.
a. factorial
b. independent
c. randomized
d. confounded
16.107
Ans. B
Fac
p. 576
E
A researcher planning to use a placebo control group should be aware that
a. it will decrease statistical validity.
b. placebo treatments may contain components of actual therapies.
c. people in a placebo group rarely improve.
d. placebo treatments are only used for rare disorders.
16.108
Ans. A
Fac
p. 576
M
If a researcher wants to determine whether therapy is significantly more effective
than no treatment at all, she or he would today MOST likely use a
a. temporary no-treatment group,
b. placebo control group.
c. no-treatment and a placebo control group,
d. either a or b
16.109
Ans. B
App
p. 576
M
An instructor wanted students to participate more actively and decided to
implement a classroom study. The number of questions asked by students during
a discussion period was recorded; then the instructor praised students for each
question and recorded the number of questions. The instructor did not praise at
all during the next session and saw questioning drop to the baseline level. The
number of questions rose again the next time praise was instituted. This is a(n)
a. meta-analysis.
b. ABAB design.
c. placebo groups design.
d. multiple baseline design.
*
403
16.110
The administrators of a group home want to encourage residents to take their
Ans. C
tableware to the sink after meals, leave for work on time, and place dirty clothes
App in their hampers. The first week the residents receive tokens for taking care of their
p. 576
tableware, the second week for promptness, and the third, for taking care of their
C
dirty clothes. During each week the selected behavior increased, but not the others.
The administrators have utilized a(n)
treatment design.
a. ABAB design
b. participant modeling
c. multiple baseline design
d. multiple contingency management
16.111
Ans. D
App
p. 576
E
Dr. Klemknecht is presenting a report on his successful treatment of a client with
dissociative identity disorder. What sort of research design does this represent?
a. experimental
b. randomized
c. statistical
d. N=l
16.112
Ans. A
App
p. 576
C
For which of the following research questions would N=l research be LEAST
appropriate?
a. Is medication intervention superior to cognitive-behavioral therapy for the
treatment of generalized anxiety?
b. What cognitive treatment strategy is most effective for children diagnosed with
conversion disorder?
c. How can I evaluate my own therapeutic effectiveness?
d. Given that my grant money has been cut 70%, how might I conduct valid
therapy outcome research?
16.113
Ans. B
Fac
p. 577
E
A therapy outcome study can be evaluated on each of the following dimensions
of validity EXCEPT
a. statistical
b. reliable
c. internal
d. external
16.114
Ans. B
App
p. 577
M
Dr. Mastrianni has submitted a research proposal for a study of the effectiveness
of Gestalt therapy for adolescent conduct disorder. A professional reviewer
believes that the study will be unable to detect the effect of therapy because too
few clients will be involved. In other words, the study may have low
a. internal validity.
b. statistical validity.
c. design validity.
d. external validity.
16.115
Ans. C
Con
p. 577-8
M
Random assignment to experimental groups increases
use of N=l research decreases validity.
a. internal; statistical
b. statistical; external
c. internal; external
d. external; internal
404
validity, while the
16.116
Ans. C
App
p. 578
C
Which of the following studies would probably have the highest external validity?
a. an experiment comparing treatments for anxious versus substance-abusing
college students
b. a study comparing treatments for anxious volunteers from the community
versus anxious patients in a psychiatric facility
c. a survey asking a representative sample to rate the effectiveness of treatments
they received
d. a clinician's multiple baseline evaluation of one client's response to therapy
16.117
Ans. A
App
p. 578
E
In her university laboratory, Martica plans to have therapists treat a randomly
selected sample of individuals seeking therapy. She will attempt to recreate what
would happen in an actual clinical setting. Martica is planning
a. analogue research.
b. behavior research.
c. beta-analysis.
d. meta-analysis.
16.118
Ans. C
Fac
p. 578
E
Which of the following persons ushered in the modem era of psychotherapy
outcome research?
a. Carl Rogers
b. Joseph Wolpe
c. Hans Eysenck
d. Aaron Beck
16.119
If you wanted to find someone to help you with an emotional problem and you read
Ans. A
Hans J. Eysenck's conclusions about the effects of therapy, you would MOST likely
App a. wait to see if you felt better without treatment.
p. 578
b. ask your physician for advice.
M
c. seek psychoanalysis,
d. seek eclectic therapy.
16.120
Ans. D
App
p. 579
M
*
16.121
Ans. B
App
p. 579
M
After reading 10 research articles each, six graduate students studying the effects
of therapy met to discuss their findings. They each came to a different
conclusion, depending upon which studies they chose, how they evaluated the
quality of the studies, and how they interpreted the outcome. To help them
summarize all of their conclusions, they should use a
a. collaborative analogue study.
b. measure of clinical significance.
c. multiple baseline design.
d. meta-analysis.
According to Smith, Glass, and Miller (1980), if you receive therapy you are
to be better off compared to your friend who did not receive therapy.
a. four times more likely
b. twice as likely
c. no more likely
d. none of the above
405
16.122
Ans. C
Fac
p. 579
E
How likely is it that therapy clients will exhibit deterioration following their
participation in therapy?
a. about as likely as it is for them to exhibit improvement
b. about half as likely as it is for them to exhibit improvement
c. possible, but not very likely
d. extremely unlikely
16.123
Ans. A
App
p. 579
M
Isabella is a psychotherapy client. You would predict a more successful outcome
for her if
a. her therapist is a psychologist rather than a marriage counselor,
b. her therapist has a Ph.D. rather than a four-year college degree.
c. she is in cognitive therapy rather than Rogerian therapy,
d. she receives medication in addition to the psychotherapy.
16.124
Ans. C
Fac
p. 580
C
According to client self-reports in the Consumer Reports study, roughly what
percentage of clients treated for less than 6 months experienced a "major
improvement" as a result of therapy?
a. 90
b. 40
c. 30
d. 20
16.125
Ans. B
Con
p. 579-80
C
In contrast to the Smith et al. and other meta-analytic reviews of psychotherapy
outcomes, the Consumer Reports evaluation found that
a. clients reported greater improvement with either cognitive or Rogerian
therapy than with psychodynamic therapy.
b. clients' report of "major improvements" were related to the length of
treatment.
c. clients who worked with professional therapists reported greater improvement
than did clients of nonprofessionals.
d. none of the above
16.126
Ans. C
Fac
p. 581
M
According to information reviewed in the text, at which point are clinicians
probably LEAST effective?
a. before they begin graduate level training
b. after they have been working in the field for several years
c. when they are involved in intensive training in specific therapy techniques
d. when they rely on psychodynamic treatment techniques
16.127
Ans. D
Fac
p. 581-2
M
Which of the following treatments is NOT among those described as
"well-established"?
a. behavioral marital therapy
b. Beck's therapy for depression
c. systematic desensitization for specific phobias
d. dialectical behavior therapy for borderline personality disorder
406
16.128
Ans. B
App
p. 581
M
If Selma were to ask her clients at what point they began to feel better, she would
most likely find that they see a change after
a. about 2 sessions,
b. about 8 sessions.
c. behavioral techniques are used in addition to other modalities,
d. transference is established.
16.129
Ans. A
App
p. 583
M
To find out if a treatment for anxiety has clinical significance, a researcher might
a. compare clients' anxiety test scores to the test scores of people who are not
anxious.
b. interview clinicians to see if the majority believes the treatment relieves
anxiety.
c. interview clients to see if the majority believe the treatment helped them.
d. measure whether clients' anxiety level is lower than before treatment.
16.130
Ans. B
Con
p. 577,83
C
Is it possible for a study to have statistical validity without also having clinical
significance?
a. No.
b. Yes.
c. It depends on the level of internal validity in the study.
d. No, but a study can have clinical significance without having statistical
validity.
16.131
Ans. C
App
p. 583-4
M
*
According to the specific processes explanation of the factors that influence
success in therapy, Sheila needs to develop a good working relationship with her
clients and also
a. utilize specific therapy techniques to reduce emotional distress.
b. foster clients' increased sense of self-relatedness and openness.
c. help them understand their behavior, accept their emotions, and/or control
their behavior.
■'-,
d. utilize an eclectic treatment approach and a motivating interpersonal style.
16.132
Ans. D
Fac
p. 584
E
The common factors explanation of successful therapy suggests that
a. me characteristics of the client and therapist are unimportant.
b. clients and therapists must have similar personalities.
c. therapists should try to be open and self-related.
d. the connection between client and therapist is the most important factor.
16.133
Ans. A
Con
p. 584
M
Which of the Big Five personality factors is most clearly related to clients' success
in therapy?
a. openness
b. extraversion
c. agreeableness
d. conscientiousness
16.134
Ans. B
App
p. 584
E
If you have the characteristic of self-relatedness, you will most likely
a. be assertive as well as high in private self-consciousness.
b. understand your own emotions and thought processes,
c. think that random events are connected to you.
d. understand your relationships with others.
*
407
16.135
Ans. A
Fac
p. 585
M
According to David Orlinsky, nonprofessional therapists may appear to do as well
as professionals for several reasons. Which of the following was NOT among
the problems he identified in such studies?
a. Clients often lie about feeling better in order to please researchers.
b. Some therapists, regardless of training, are just better at relating to people.
c. Professionals may oversee nonprofessionals, which may improve outcomes.
d. Sometimes "experienced" therapists may have only one year of experience
more than "inexperienced" therapists.
SHORT ANSWER / ESSAY
16.136
Describe the demographic characteristics related to a person's likelihood of receiving
psychotherapy. Do these factors appear to be related to the success of therapy?
Age - children and adolescents less likely to receive therapy; gender - women more likely
to seek therapy; SES - persons from lower SES groups less likely to seek therapy; SES & ethnicity
- poor persons of color least likely to participate in therapy; ethnicity - African Americans more
likely than European Americans, who in turn are more likely to receive therapy than Hispanic
Americans and Asian Americans.
These do not appear to be related to successful therapy outcomes. This is a tentative
conclusion, however, for persons of color, where the research results have been mixed.
16.137
Describe the characteristics of a therapist that foster the working alliance.
Strong personal commitment to and enthusiasm for the therapy, clear communication skills,
strong empathy, genuine concern for and interest in the client's well-being (probably the central
factor), early establishment of a therapeutic contract, maintenance of professional demeanor,
avoidance of reactions that could diminish self-esteem, and no romantic or sexual interactions.
16.138
therapy.
List and briefly describe the five basic techniques employed in psychoanalytic
Free association: The client is required to say everything that comes to mind without any
censorship, with the therapist out of sight, and the therapist listens for patterns that may reflect
unconscious conflicts.
Dream interpretation: The therapist helps the client take the manifest (literal, obvious)
content of dreams and look beyond it to the dream's latent (more trathful, unconsciously-motivated)
content.
Interpretation of everyday behavior: The therapist attempts to pay attention to all facets of
a client's behavior, however apparently innocuous they may appear, to detect slips-of-the-tongue,
patterns of forgetfulness, and "accidents."
Analysis of resistance: The therapist looks for patterns of defense mechanisms such as
intellectualization, somatization, acting out, etc., that signal an attempt to keep unconscious material
out of consciousness.
Analysis of the transference: Given that the client will begin to interact with the therapist
in ways that reflect earlier experiences with important figures, the therapist helps the client
recognize and work through these interactions to resolve the underlying issues.
408
16.139
According to Rogers, what ingredients are crucial for successful therapy?
The therapist's unconditional positive regard for the client, empathetic understanding of the
client's feelings and views, genuineness, and congruence.
16.140
research.
Describe the issues surrounding the use of placebo control groups in psychotherapy
It is essentially impossible to create a wholly inert placebo group omitting all interactions
considered important in all theoretical approaches. Too, the notion that "placebo" connotes a short­
lived and/or trivial outcome is misleading; the nonspecific factors that probably still take place in
such groups can create changes compared to no-treatment control groups. Finally, some researchers
ethically object to such use, given that participants in these groups will be denied potentially more
effective treatment interventions.
16.141
Describe the general tradeoffs between internal, external, and statistical validity in
the conduct of therapy outcome research.
To increase internal validity, maximizing the likelihood that the independent variable and
nothing else caused the results, strong experimental control must be exercised. This control (e.g.,
random assignment of clients and training of therapists) tends to decrease the "real-world" quality
of the study. This then decreases external validity, i.e., the extent to which the study's results
generalize to situations other than those in the study. Ethical concerns must also be addressed in
the use of a no-treatment and/or placebo control group. Finally, it is often difficult to locate a
sufficient number of clients with a particular kind of problem, resulting in low statistical validity
for many studies.
16.142
According to the wealth of research discussed in the chapter, what factors)
appeals) to be crucial for the success of therapy?
a therapist's ability to establish a working relationship in which clients consider and, in
some way attempt, new ways of tliinking, feeling, or behaving
409
Chapter 17 ALTERNATIVES TO INDIVIDUAL PSYCHOTHERAPY
17.1
Ans. D
App
p. 590
E
Lydia's husband was diagnosed with schizophrenia after several months of
bizarre behavior. Which of the following would be most helpful?
a. couples therapy
b. individual psychotherapy
c. primary prevention
d. psychosocial rehabilitation
17.2
Ans. C
App
p. 590
E
Louis has suggested that his client begin an alternative to individual
psychotherapy. Louis MOST likely recommends the alternative because it is
generally more
a. successful.
b. reliable.
c. social.
d. structured.
A town council member claims that homelessness is becoming a problem because
people do not seek help for their mental disorders. She suggests a resolution
that therapists be required to treat some people for free. A psychologist,
however, proposes that the town may need to concern itself more with employment
opportunities and inexpensive housing to decrease individuals' stress that can
cause those disorders. The psychologist is recommending
a. primary prevention.
b. psychosocial rehabilitation.
c. the paradoxical directive.
d. therapeutic contracting.
"I don't understand why people who are having problems don't just talk to a good
therapist," says Mitzy. This view of psychotherapy may be problematic for each
of the following reasons EXCEPT
a. People may hesitate to discuss their problems.
b. Therapists are not widely available in rural and poorer areas.
c. People may not have the funds to pay for therapy.
d. It tends to overemphasize clients' competencies.
17.3
Ans. A
App
p. 590
M
17.4
Ans. D
App
p. 591
E
17.5
Ans. B
App
p. 591
M
*
Which of the following would be LEAST likely to describe a client if he were a
member of a Western culture?
a. defines himself in ways that emphasize independence and autonomy
b. explains others' behaviors on the basis of social roles
c. interprets facial expressions as indicators of emotional states
d. views individual therapy as useful and effective
410
17.6
Ans. B
App increase
p. 591
M
Alton, a school superintendent, is implementing a classroom-based program to
enhance elementary school children's academic performance. Alton hopes to
each student's sense of independence and self-initiative, resulting in
greater self-esteem and better grades. Alton's plan
a. ignores scientific research that fails to document the effectiveness of such
group-based interventions for children.
b. ignores differing cultural views of psychological processes.
c. is essentially a form of psychosocial rehabilitation.
d. is based on the developmental group model of treatment.
17.7
Ans. D
App
p. 591-2
E
A community action group wants to ensure that help for people with
psychological problems is inexpensive, easily accessible, and culturally
acceptable. You should recommend that they focus on
a. encouraging more students to study psychology at the graduate level.
b. giving incentives to cognitive-behavioral clinicians who locate their practices
in your community.
c. secondary prevention programs such as Head Start, halfway houses, etc.
d. group interventions such as family therapy and self-help groups.
17.8
Ans. B
App
p. 592
M
*
If a group of psychologists tell you that they have a psychological wellness
orientation, you would expect that they would
a. attempt to step in and make people well once problems are identified,
b. create programs that encourage psychological health.
c. diagnose psychological disorders early and properly treat them.
d. treat clients within the humanistic/phenomenological framework.
17.9
Ans. A
Con
p. 592
E
The word that is LEAST descriptive of the psychological wellness orientation is
a. pathology.
b. prevention,
c. proactive.
d. social.
17.10
Ans. A
Fac
p. 592
E
Group therapy became popular several decades ago because it was
a. able to provide treatment to people returning from World War II.
b. based on a diathesis-stress model.
c. based on a cognitive-behavioral approach.
d. more cost-effective for insurance companies who covered mental health
problems.
17.11
Ans. B
App
p. 593
E
Vinny disagrees with the group therapist when the therapist suggests that he
appears to have some unresolved feelings of betrayal toward his father. However,
when the other group members share a similar observation, Vinny begins to
reconsider his position. This group process is known as
a. cohesiveness.
b. consensuality.
c. universality.
d. recapitulation.
411
17.12
Ans. C
App
p. 593
E
Mateo has an anxiety disorder and is trying to decide on a type of therapy. His
therapist recommends group therapy because she believes Mateo may open up to
people who have the same problem as he does. Another reason group therapy
may be more helpful for Mateo than individual therapy is that in group therapy
a. anxiety disorders are more successfully treated.
b. the therapist probably will not challenge Mateo.
c. Mateo may be able to advise others and see that he has good ideas.
d. the therapist's interpretations will be more accurate.
17.13
Ans. D
Fac
p. 593
M
In what way is group therapy similar to psychoanalysis?
a. Group members often model appropriate behavior.
b. Group members often free associate.
c. Sharing experiences shows clients that they are not alone.
d. Early family conflicts may be symbolically recreated and explored.
*
17.14
Ans. A
App
p. 593
E
17.15
Ans. B
Fac
p. 593
E
Miranda has kept her eating disorder secret for over two years. She was
surprised and relieved to discover during group therapy that she is not alone and
that several other people understand her distress and fears. This is a function of
the group process known as
a. universality.
b. empathy.
c. cohesiveness.
d. consensuality.
Which of the following processes is NOT considered essential to the success of
group therapy?
a. interpersonal learning
b. empathy
c. altruism
d. cohesiveness
17.16
Ans. C
Con
p. 593
C
What do the group processes of altruism, interpersonal learning, and instilling
hope have in common?
a. A process similar to each of these is found in individual psychoanalysis,
b. Each encourages group members to support and praise each other as well as
to challenge and criticize each other.
c. Each provides an opportunity for members to provide role models to one
another.
d. They are less strongly related to group outcomes than are consensuality,
universality, and recapitulation.
17.17
Ans. D
Fac
p. 594
E
According to many therapists, which group process probably underlies all others?
a. instilling hope
b. universality
c. interpersonal learning
d. cohesiveness
412
17.18
Ans. D
App
p. 594
M
An example of a group fulfilling prophecy is
a. Darrin thinks the group therapy will not be helpful and it is not.
b. Brett won't go to a group if he doesn't believe it will be fulfilling.
c. Chris reacts to another group member much in the same way he reacts to a
member of his family of origin.
d. Del's group expects him to be more assertive, and he is.
17.19
Ans. B
App
p. 594
E
Marvin joins a group in which everyone is trying to quit smoking. Marvin's
group is
a. heterogeneous,
b. homogeneous.
c. hypnotic,
d. variegated.
17.20
Ans. C
App
p. 594
M
*
After Ms. Ito lost her teaching job, she became extremely depressed. Ms. Ito
found a group for people experiencing depression but is unsure what to expect.
You could tell Ms. Ito that her group will MOST likely
a. be heterogeneous.
b. have sessions lasting about 30 minutes.
c. have 6 to 12 members.
d. use the psychological wellness approach.
17.21
Ans. A
App
p. 594-5
M
Your friend is considering entering group therapy for her substance abuse
problem. You might advise your friend that
a. group therapy is more successful when clients know beforehand how the
group will be run.
b. group therapy is generally less effective than individual therapy.
c. a cognitively-based group is more effective than a client-centered group.
d. the sessions will be about two hours long, and the leader will be responsible for
offering therapeutic interpretations and suggestions.
17.22
Ans. B
App
p. 595
M
Marcia has just joined a cognitive-behavioral therapy group. Marcia's group will
be more successful if
a. group members do not have any preconceived expectations about what will
happen or what they should do.
b. group members are honest in their reactions.
c. the group minimizes members' tendencies to recapitulate their early family
experiences.
d. the group directs most of their interactions toward the therapist father than
toward each other.
17.23
Ans. C
App
p. 595
E
If Kristen and Jose, a couple, are in conjoint therapy, this means that they
a. are getting divorced and want it to be amicable.
b. each have a mental disorder requiring treatment.
c. go to see a therapist together.
d. meet with therapists separately but each is addressing marital problems.
413
17.24
Ans. D
App
p. 595
E
For which of the following clients and her/his partner would a clinician be likely
to recommend the use of couples therapy?
a. Moira, who is considering a divorce from her husband
b. Orrin, who is an alcoholic
c. Erika, who is diagnosed with major depression
d. all of the above
17.25
Ans. D
Fac
p. 595
E
*
Which of the following is MOST likely to be considered the primary client in
marital therapy?
a. the spouse who has a DSM-IV diagnosis
b. the wife
c. both disturbed spouses
d. the relationship itself
17.26
Maureen and Sam have an agreement that if Maureen leaves Sam alone to read the
Ans. C
paper when he gets home, he will later listen attentively when she tells him about
App her day later. The two of them
p. 596
a. are in emotionally focused couples therapy.
M
b. are in insight-oriented couples therapy.
c. have a behavioral exchange contract.
d. have a therapeutic contract.
17.27
Ans. B
App
p. 596
M
*
Elise and Ernesto's therapist is training them to change their automatic
assumptions about the other's actions. The therapist has suggested to Elise that
when Ernesto grows quiet and won't respond to her that he may not be trying to
aggravate her but may be too upset to speak. This example suggests that Elise
and Ernesto are in
therapy.
a. emotionally focused
b. cognitive-behavioral
c. insight-oriented
d. structural family
17.28
Ans. A
App
p. 596
E
A therapist is suggesting to a couple that the husband's aggressive behavior may
be an unconscious defense against fears of abandonment that are rooted in early
family conflicts. Jerry and his spouse's therapy is most likely
a. insight-oriented.
b. strategic.
c. cognitive-behavioral.
d. emotionally focused.
17.29
Ans. A
App
p. 596
M
Iola is a Gestalt psychotherapist. In her work with couples, you would expect her
to emphasize
therapy.
a. emotionally focused
b. cognitive-behavioral
c. insight-oriented
d. structural
414
17.30
Ans. B
App
p. 596
M
A group of marriage therapists is discussing the techniques and theoretical
perspectives that they have found most useful. Which of the following issues will
probably be endorsed by the greatest number of participants?
a. behavioral exchange contracts
b. communication training
c. insight into unresolved unconscious conflicts
d. a focus on emotional expression and intimacy
17.31
Ans. C
App
p. 597
M
Ms. Firouzbasch is a behavioral therapist who specializes in the treatment of
couples. If her clients are typical of those studied thus far, one would predict
that
of every 10 couples she has treated will relapse or will be divorced.
a. 7
b. 5
c. 4
d. 2
17.32
Ans. D
App
p. 597
M
Anton and Isabelle are considering conjoint therapy. If they want to maximize the
likelihood of significant immediate benefits, they should choose
a. behavioral therapy,
b. strategic therapy.
c. insight-oriented therapy,
d. any of the above
17.33
Ans. A
App
p. 597
M
A couple tells their therapist that they want the type of therapy that will give them
the greatest chance of long-term success. Their main concern is that they will spend
time and money on therapy and end up divorcing after a few years anyway.
Their therapist should recommend
a. insight-oriented therapy.
b. behavioral therapy.
c. individual psychotherapy.
d. a self-help enrichment group.
17.34
Ans. D
App
p. 597
M
*
Lance is an insight-oriented therapist. While it is sometimes very exhausting to
work with troubled couples, he reminds himself that Snyder et al.'s
comprehensive outcome review suggests that
of every 10 couples will
divorce in the four years following treatment.
a. 5 to 6
b. 3 to 4
c. 2
d. Oto 1
According to available empirical data, which of the following processes appears to
be MOST important for the long-term success of conjoint therapies?
a. cathartic emotional expression
b. understanding and resolving persistent emotional conflicts
c. negotiated solutions to specific problems
d. exploration of the subjectivity and ecology of partners' actions
17.35
Ans. B
Fac
p. 598
M
415
17.36
Ans. B
App
p. 598
E
Allison's anxiety disorder improved enough for her to return home from the
hospital, but once there Allison's symptoms returned. After this happened twice,
her therapist probably suggested
a. therapeutic contracting.
b. family therapy.
c. group therapy.
d. case management.
17.37
Ans. C
Con
p. 598
E
Which of the following terms does not belong with the other three?
a. ecology
b. systems
c. recapitulation
d. circular causality
17.38
Ans. A
App
p. 598
E
Lillian and Joe's 13-year-old child, Amy, is hyperactive and sometimes oppositional.
Their therapist tells them that, contrary to popular opinion, parents are not
automatically blamed for a child's problems. Amy, for example, might have been
temperamentally difficult as an infant and young child, which caused Lillian to
discipline her frequently. This situation might have caused stress for Joe, who in
turn was not as patient with Amy as he otherwise could have been. The therapist
is explaining the principle known as
a. circular causality.
b. behaviorism.
c. economy.
d. subjectivity.
A systems theorist was overheard explaining that a family "is not simply a
collection of individual members but a coherent system of integrated
participants." What principle is this theorist addressing?
a. consensuality
b. subjectivity
c. dynamism
d. ecology
17.39
Ans. D
App
p. 598
E
17.40
Ans. B
App
p. 598
M
A family therapist explaining systems theory to clients tells them that each person
has their own view of what happens in a situation. The child who is told to work
more on homework may see that suggestion as a criticism of his intelligence while
the mother may believe that she is only showing concern and love. The therapist
is giving an example of
a. ecology.
b. subjectivity.
c. a paradoxical directive.
d. circular causality.
17.41
Ans. D
App
p. 598
M
Sixteen-year-old Gerald is a family therapist's identified client. This means that
Gerald
a. is the primary cause of his family's dysfunction.
b. is the only family member who merits a DSM-IV mental disorder diagnosis.
c. is the family member that the therapist will target for intensive treatment,
d. is the means by which the family enters systems treatment.
416
17.42
Ans. D
App
p. 598
M
The Grady's family therapist operates from a behavioral perspective. Therefore,
this therapist will MOST likely
a. ask the children to act out more than usual,
b. encourage the expression of unresolved emotions.
c. emphasize the exploration of subjectivity in family interactions,
d. teach the Grady parents to be consistent in their discipline.
17.43
Ans. A
App
p. 598
M
Stephanie has been diagnosed with conduct disorder. She is also failing 10th grade
and has alienated both of her younger siblings. Stephanie's mother has been
diagnosed with major depression and has been hospitalized twice in the past three
years. What would a strategic family therapist identify as the family's central
problem?
a. a disturbed family process
b. Stephanie's conduct disorder
c. the mother's severe depression
d. both b and c
17.44
Ans. B
App
p. 598
M
Esteban, who has been diagnosed with dependent personality disorder, is being
blamed for causing his family's problems when it is actually the family process,
and its circular causality, that is disordered. A therapist who endorses
therapy is MOST likely to have made this statement.
a. family ecology
b. structural family
c. behavioral family
d. heterogeneous systems
17.45
Ans. C
App
p. 598
E
A therapist hypothesizes that Andrea's eating disorder is a reflection of disturbed
communication and dominance patterns in her family. As a result, the therapist is
MOST likely to recommend
a. group therapy for Andrea.
b. individual therapy with a cognitive-behavioral therapist.
c. structural family therapy.
d. behavioral family therapy.
17.46
Ans. C
App
p. 599
M
*
Celine throws a temper tantrum whenever she is asked to do household chores, and
her parents are having difficulty dealing with her defiant behavior. The therapist
tells Celine to throw more tantrums and follow even fewer of her parents'
directions. The therapist is probably a
family therapist.
a. behavioral
b. psychodynamic
c. structural
d. paradoxic
17.47
Ans. B
Fac
p. 599
E
An example of the paradoxical directive is when a therapist
a. behaves in a manner that is contradictory to clients' expectations.
b. tells a client to increase a problematic behavior.
c. asks a client to act out the role of another family member.
d. tells a client the opposite of what the therapist believes to be true.
417
17.48
Ans. A
App
p. 599-60
C
Ms. Ramirez has issued a paradoxical directive to one of her clients, encouraging
the client to exaggerate his depressed symptoms for one week. Which of the
following outcomes is NOT expected by this family therapist?
a. She expects that the intervention will reduce the circular causality present in
the family.
b. She thinks that the client will recognize the control he has over some of his
symptoms.
c. She expects that the focus of treatment will shift from the identified client to
the family system.
d. She believes she will be in a "win-win" situation regardless of outcome.
17.49
Ans. B
Fac
p. 600
E
According to Szapocznik's study, Enrique's family will be more likely to go into
treatment if
a. the therapist is of their ethnic group,
b. strategic family techniques are used.
c. psychodynamic techniques are used,
d. a self-help program is used.
17.50
Ans. B
App
p. 600
M
Hector and his family have received a standard invitation to participate in family
therapy for Hector's dmg abuse. Rodrigo and his family have received an invitation
participate in an experimental, strategic program for Rodrigo's dmg abuse.
Rodrigo's family is
likely to enter treatment than is Hector's family.
a. about four times more
b. about two times more
c. no more
d. slightly less
to
17.51
Ans. D
App
p. 600
M
*
Your friend's family is going into therapy together. Which type of therapy
approach would you recommend?
a. self-help and bibliotherapy
b. humanistic
c. psychodynamic
d. behavioral
17.52
Ans. A
App
p. 600
E
Viola has joined an organization in which people dealing with cancer share ideas
and support each other without help from a therapist. Viola is participating in
a. a self-help group.
b. a structural support group.
c. homogeneous group therapy,
d. psychosocial rehabilitation.
17.53
Ans. D
App
p. 600-1
E
Twyla has little money and feels completely alone since the break up of her
marriage. "If I thought a therapist would help me without charge, I might think
about it," she tells you, "but really I mink I need to talk to someone who has gone
through the same thing." You should suggest that Twyla try
a. client-centered individual psychotherapy.
b. group therapy.
c. community therapy.
d. a self-help group.
418
17.54
Ans. C
App
p. 601
M
Brent, whose sister is schizophrenic, is joining a self-help group for the first time.
Which of the following is LEAST likely to occur?
a. His group will exhibit the basic processes of cohesiveness and altruism,
b. He will give and receive information about schizophrenia.
c. His group will be focused on relatively heterogeneous problems,
d. He will pay no fee for participating in the group.
17.55
Ans. B
App
p. 601
M
Pete joined a self-help group for individuals who are overweight due to
compulsive eating. This is a type of
a. specific-purpose organization,
b. habit disturbance group.
c. primary prevention,
d. lifestyle organization.
17.56
Ans. A
App
p. 601
M
Virgil is a gay male who is participating in a self-help group to deal with the
economic and social discrimination he faces as a result of his sexual orientation.
This is a type of
a. lifestyle organization.
b. single-purpose group.
c. social disturbance group.
d. significant-other organization.
17.57
Ans. D
Con
p. 601
M
According to outcome research, what basic group process(es) is(are) responsible
for the success of self-help groups?
a. interpersonal learning and consensuality
b. cohesiveness
c. altruism and instilling hope
d. none of the above
*
17.58
Wunnand is a schizophrenic patient. Compared to patients receiving treatment
Ans. C
prior to the 1960s, Wunnand will be less likely to remain in long-term inpatient
App care for each of the following reasons EXCEPT
p. 602
a. the availability of effective antipsychotic medication.
M
b. the growing interest in psychosocial rehabilitation.
*
c. the wide availability of outpatient community treatment.
d. hospitals' unwillingness to provide long-term care.
17.59
Ans. B
App
p. 602
E
As you are reading a book, you come across the following quote: "Mental
hospitals are big, impersonal warehouses. We need to treat people where they
live, rather than shut them away from the community." You recognize this as a
plea for
a. conjoint therapy.
b. deinstitutionalization.
c. empowerment.
d. psychosocial rehabilitation.
17.60
Ans. A
Fac
p. 602
E
The community mental health center movement has
a. decreased the number of inpatients.
b. increased the number of inpatients,
c. reduced homelessness.
d. reduced unemployment.
419
17.61
You are visiting a country with an extensive public mental hospital system and have
Ans. C been asked what would happen if they created community mental health centers and
App
closed the hospitals. Based on results in the U.S., you would predict that it is a
p. 602
idea because
.
M
a. good; people's lives will be improved although costs will not be lessened
b. good; the community health centers will be cheaper and more effective
c. poor; people's lives will not be improved
d. poor; the hospitals provided better individual therapies
17.62
Ans. B
App
p. 602
M
Rhonda is a case manager at a community mental health center. For every 10
schizophrenic clients she sees, about
of them will probably be unemployed.
a. 10
b. 7
c. 5
d. 4
17.63
Ans. D
App
p. 602
E
Gary is 42 years old and has been schizophrenic for twenty years. He is at
greater risk than a non-disordered peer to experience
a. physical illness,
b. premature death.
c. criminal victimization,
d. all of the above
17.64
Ans. C
Fac
p. 602
E
According to evidence presented in the text, how do the overall costs of
schizophrenia compare to those for cancer?
a. Costs for schizophrenia are about half those for cancer.
b. Costs for schizophrenia are about the same as those for cancer.
c. Costs for schizophrenia exceed those for cancer.
d. Costs for schizophrenia are roughly double those for cancer.
17.65
Ans. A
Fac
p. 603
E
What do the National Alliance for the Mentally 111, community-oriented clinicians,
and self-help groups have in common?
a. a commitment to psychosocial rehabilitation
b. a commitment to strategic family communication therapy
c. an interest in supporting greater deinstitutionalization
d. an interest in supporting primary intervention in the community
17.66
Ans. B
App
p. 603
M
The National Alliance for the Mentally 111 and a local self-help group would like
to empower local people with severe mental disorders. To make official mental
health plans for their state, they should include
a. behaviorally-oriented health professionals.
b. community-oriented health professionals.
c. medical doctors.
d. family therapists.
420
17.67
Ans. C
App
p. 603
M
Zelda, who is 26, has been receiving medication, individual psychotherapy, and
group therapy in a mental hospital since she was 16 and is now due to be
released. Zelda has been completely dependent on the institution for her daily care
and has never felt in control of her life. What Zelda needs most is
a. communication training.
b. family therapy.
c. empowerment.
d. secondary prevention.
17.68
Ans. A
App
p. 603-4
M
*
JoAnne has learned how to recognize when her obsessive-compulsive disorder is
returning. Her case manager has helped her to get an apartment, a job, financial
aid, and coordinates efforts of other mental health professionals and her family,
JoAnne is MOST likely receiving
a. psychosocial rehabilitation.
b. secondary prevention interventions.
c. strategic community reintegration.
d. community diversion therapy.
17.69
Ans. D
App
p. 603
E
Keisha has chronic, severe depression. If she is a participant in a psychosocial
rehabilitation program, for whom will education about her disorder be provided?
a. Keisha
b. Keisha's family
c. the local community Keisha lives in
d. all of the above
17.70
Ans. B
App
p. 604
M
Billy Ray knows the symptoms of his schizophrenia and is able to use public
transportation, live on his own, and communicate with others. For his
psychosocial rehabilitation to be complete, Billy Ray should
a. be involved in a selective prevention community program.
b. be given a case manager to help him get the services he needs.
c. receive regular home visits from a medical doctor.
d. receive regular home visits from a psychologist.
17.71
Ans. C
App
p. 604
M
Katja, struggling with chronic substance abuse, agreed to work at thinking
positively and getting to work early, and will have to report on her efforts to her
support group. Katja and her group are using
a. diversion tactics.
b. psychosocial rehabilitation.
c. therapeutic contracting.
d. behavioral contingencies.
17.72
Ans. C
App
p. 604
M
*
Matt tells you that his dad is participating in psychosocial rehabilitation to help
him return home after his hospitalization for posttraumatic stress disorder. Matt's
not sure that it will really do any good, so he asks you what you know about the
program's effectiveness. You can tell Matt that his dad will probably
a. be as likely to relapse but his hospitalizations will be briefer.
b. not generalize any of his training to the home environment, as Matt fears.
c. benefit from the program and will need to stay in it for 2 years.
d. regularly use the skills he has learned if the training continues for at least 6
months.
421
17.73
Monty is in an ACT psychosocial rehab program, and Emil is participating in a
Ans. D
drop-in center program. Compared to Emil, Monty will probably be described by
App each of the following outcomes EXCEPT
p. 604
a. more likely to maintain stable community housing.
M
b. less likely to have a relapse requiring hospitalization.
c. much more likely to be active in his treatment program.
d. none of the above
17.74
Ans. C
App
p. 604
M
When Ahulani begins her psychosocial rehab program and is given information
about her disorder and her treatment, she will probably be told that she should
remain as an active participant in the program for at least
to avoid
rehospitalization and psychological deterioration.
a. 6 months
b. 1 year
c. 2 years
d. permanently
17.75
Ans. D
Con
p. 605
E
In a student's report on the factors that led to the rise of community psychology
in the 1960s, which of the following should be omitted?
a. distrust of traditional psychotherapy
b. the Community Mental Health Centers Act
c. civil rights movement
d. the introduction of effective antipsychotic drugs
17.76
Ans. A
Fac
p. 605
E
Which social approach to the prevention of psychopathology was established in
1965?
a. community psychology
b. family systems psychology
c. psychological wellness programs
d. deinstitutionalization
17.77
Ans. B
App
p. 605
E
A psychologist describes himself as "an agent of social change, helping to
understand the interacting factors that can cause or prevent mental disorders."
What type of psychologist would he be?
a. structural
b. community
c. interpersonal
d. tertiary
17.78
Ans. A
App
p. 605
M
*
Dr. Jacobsen describes himself as an analyst of social systems. Ifhewereto
analyze eating disorders as an interaction of an individual need for control, cultural
glamorization of extreme thinness, and an increasingly competitive job market for
young adults trying to establish independence from their family, what approach
is he endorsing?
a. ecological
b. structural
c. interactive
d. communal
422
17.79
Ans. C
Con
p. 605-6
M
If you were a community psychologist and you were trying to understand
violence in families, you might make each of the following statements EXCEPT
a. We should change the economic systems that make it difficult for people to
make a living wage and that lead them to frustration and aggression.
b. We should provide education to senior high school students to help them learn
effective coping skills in the place of violent acting out.
c. We should more carefully identify persons with tendencies toward aggressive
acting-out and offer group treatment for them and their spouses.
d. We should encourage movie producers to avoid the excessive use of violence
in movies and to portray domestic violence in an unfavorable light.
17.80
Ans. D
Con
p. 605-6
M
Which of the following terms does not belong with the other three?
a. secondary prevention
b. ecological perspective
c. action research
d. psychosocial rehabilitation
17.81
Ans. B
App
p. 606
M
Dr. Haslam is helping a local municipality evaluate the effectiveness of its recent,
large-scale change in the hiring, training, and review of police officers. The city
is hoping to reduce the incidence of race-related complaints lodged against its
officers. Dr. Haslam's work is a type of research.
a. community
b. action
c. primary prevention
d. systems
17.82
Ans. C
App
p. 606
M
A program that tries to lessen the number of problems Ellen experiences due to
her depression is
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. quaternary prevention.
17.83
Ans. D
App
p. 606
M
Ichabod can see that students in his 3rd grade class who live in the housing project
are having more school difficulties and are more likely to drop out later than other
students. He proposes a school program to help them with homework and allow
them to socialize with positive role models. Ichabod's program is an example of
a. universal prevention.
b. quaternary prevention.
c. indicated prevention.
d. selective prevention.
*
17.84
Ans. A
Con
p. 606
M
Indicated prevention is to selective prevention as
a. tertiary is to secondary.
b. secondary is to primary.
c. primary is to tertiary.
d. tertiary is to primary.
423
17.85
Ans. B
App
p. 606
M
If a community psychologist were to emphasize the prevention of heart disease
through mass-media campaigns and school-based programs beginning in junior
high school, this would reflect a kind of
prevention program.
a. tertiary
b. primary
c. secondary
d. responsive
17.86
Ans. C
Fac
p. 606-10
E
A psychologist who focuses her work on the fostering of secure attachments,
enhancing stress-coping skills, and promoting empowerment is primarily interested
in
prevention.
a. social
b. secondary
c. primary
d. selective
17.87
Ans. D
Con
p. 606
M
*
Which of the following interventions is LEAST representative of a primary
prevention approach to the encouragement of secure attachments for infants?
a. school-based parenting classes for all high school students
b. television ad campaigns to discourage young adults' illegal substance use
c. effective social policies for the elimination of poverty
d. community support groups for parents who have a history of abuse in their
own childhoods
17.88
Ans. B
Fac
p. 607
E
The Teen Outreach Program is an example of prevention gained primarily by
a. changing environments.
b. teaching effective problem solving,
c. enhancing stress-coping skills.
d. promoting empowerment.
17.89
Ans. A
App
p. 607
M
If Ryan were a participant in the treatment group of the Montreal Longitudinal
Study, which of the following characteristics would probably NOT apply to him?
a. He is more likely to graduate from high school than is a boy from the control
groups.
b. He will report that his parents' discipline strategies did not really change
after the study.
c, He is more likely to be in an age-appropriate classroom at age 12 than is a boy
from a control group.
d. He is less likely to exhibit delinquent behaviors by age 15 than is a boy from
a control group.
17.90
Ans. D
App
p. 608
M
Gary is a preschooler participating in Head Start. Research indicates that this
prevention program will be successful in
a. increasing Gary's academic success,
b. decreasing Gary's antisocial behaviors.
c. decreasing Gary's hyperactive behaviors,
d. both a and b
424
17.91
Ans. B
Con
p. 606,8
M
Diversion programs are an example of
a. universal
b. selective
c. indicated
d. responsive
17.92
Ans. C
App
p. 608
E
Brett, 15 years old, is attending a class on anger management, spends 8 hours each
week performing community service, and has had to work to repay the costs of
repairing the house he vandalized. Brett is in a(n) _ _ _ _ ^ _ program.
a. indicated prevention
b. empowerment
c. diversion
d. judicial reassignment
17.93
Ans. A
App
p. 608
C
*
Pauline is a community psychologist who believes that putting learning disabled
children in "special" classrooms leads to a self-fulfilling prophecy in which these
students come to see themselves as different and inferior. Pauline would probably
advocate
as a means of preventing this outcome.
a. changing school environments
b. enhancing students' stress-coping skills
c. teaching students effective interpersonal skills
d. promoting students' sense of community
17.94
Ans. B
App
p. 609
M
According to Widom's prospective study, which of the following abused children
is MOST likely to be involved in delinquency in adolescence?
a. Brandon, a white male who has been severely neglected
b. Terrell, a black male who has been physically abused
c. Shara, a white female who has been sexually abused
d. Nate, a white male who has been physically abused
17.95
Ans. B
Con
p. 609
M
Widom's study of the relationship between childhood abuse and adult criminal
behavior is noteworthy for each of the following reasons EXCEPT
a. its longterm prospective design,
b. its experimental methodology.
c. its use of controls for group differences in SES.
d. its sample size.
17.96
Ans. D
App
p. 609
M
Dr. Fabio is interested in developing a prevention program to address the central
problem identified in Widom's study of adolescent and adult violence. Dr. Fabio
is MOST likely to
a. design educational programs for elementary school children that enhance their
ability to cope with academic and social stressors.
b. encourage the implementation of television and magazine ad campaigns that
promote empowerment of disenfranchised youth.
c. encourage increased opportunities for, and use of, jail diversion programs for
first-time offenders.
d. create community-based support groups for parents and children to reduce the
likelihood of family violence.
*
425
prevention.
17.97
Ans. A
App
p. 610
E
Margo is an active participant in her neighborhood watch program. As a result,
community psychologists believe that her sense of
will be promoted.
a. empowerment
b. autonomy
c. safety
d. resilience
17.98
Ans. B
Fac
p. 611
E
Which of the following general domains is NOT included among the risk factors
that have widespread effects on development?
a. ecological context
b. educational context
c. emotional difficulties
d. constitutional handicaps
17.99
Ans. C
Fac
p. 612
E
According to Dr. Melvin Wilson, how might psychologists better serve the socalled urban underclass?
a. by making more frequent referrals to social workers
b. by tailoring individual psychotherapy to the psychological needs of specific
minority groups
c. by actively helping them develop the ability to obtain tangible resources
d. by emphasizing secondary prevention through services targeted toward violent
families or families in which a parent has a severe mental illness
17.100
Ans. D
Fac
p. 612
M
How would Dr. Melvin Wilson respond to the question of whether prevention
programs can actually have negative consequences?
a. No, they can simply foil to demonstrate positive outcomes,
b. Yes, if only a single factor is addressed in a program.
c. Yes, if constitutional handicaps are not addressed in a program,
d. Yes, if the risk factors in the study create their own ecologies.
17.101
Suppose you were a community psychologist interested in the prevention of social
Ans. A
phobia and avoidant personality disorder that are caused, in part, by social
Con
rejection
and social skills deficits. As you design a prevention program, you
p. 611,3
would want to consider each of the following factors EXCEPT
M
a. factorial synergy.
b. the "domino theory."
c. the continuity principle.
d. the shifting of risk factors across developmental stages.
Demographic
estimates suggest that people of color will comprise almost
17.102
D
<;moj
Ans. C
% of the U.S. population by the year 2050.
Fac
a. 20
p. 613
b. 33
E
c. 50
*
d. 60
426
17.103
Ans. B
App
p. 613
M
Dr. Waters is part of a multidisciplinary effort to help devastated flood victims
reestablish their communities and their lives. In order to do so, program planners
intend to capitalize on existing strengths and traditions. In other words, they will
follow the
a. principle of augmentation.
b. continuity principle.
c. universal prevention principle.
d. principle of empowerment.
17.104
Ans. B
App
p. 613
C
If Thuc is conducting research in a Prevention Intervention Research Center, which
of the following questions is he MOST likely to be addressing first?
a. What factors are associated with relapse for individuals with substance abuse
disorders, and how can these be minimized?
b. What academic and interpersonal problems cause the development of substance
abuse problems in adolescents?
c. How is parental substance abuse related to adolescents' likelihood of substance
abuse and school drop-out?
d. How can community-based halfway houses and other residential treatment
programs utilize the continuity principle for the treatment of substance abuse?
17.105
Ans. D
Con
p. 613
M
Which type of prevention strategy is MOST likely to be developed as a result of
a PIRC research study?
a. primary
b. tertiary
c. responsive
d. secondary
17.106
Ans. A
App
p. 614
M
Wangari is developing a multifaceted primary prevention program to reduce the
prevalence of eating disorders in teenage females. Which of the following
cautions is LEAST likely to be applicable to this effort?
a. The choice for primary intervention is probably less appropriate than a choice
for a selective prevention program.
b. The education involved could inadvertantly foster a self-fulfilling prophecy.
c. The females who participate could represent a group that is already at lower
risk than the general population.
d. Her well-funded research may be difficult to replicate in other community
settings.
427
SHORT ANSWER I ESSAY
17.107
therapy.
Describe five of the factors that therapists identify as essential elements in group
Sharing new information: groups benefit not only from the expertise of the leader but also
from the experiences and knowledge of other group members.
Consensuality: while an individual client might discount a therapist's perceptions and
feedback, it is much more difficult to do so when several group members give similar feedback.
Instilling hope: clients can observe the changes and successes of other group members,
raising the client's own expectations for positive outcomes.
Universality: finding out that they are not alone in their experiences or feelings, clients
become less concerned about being "crazy," and are less guarded and secretive.
Altruism: group members can help each other, increasing their own feelings of efficacy and
self-esteem.
Interpersonal learning: in the safe group atmosphere, clients can learn and practice new
social skills, and clients with already established skills can serve as role models for others.
Recapitulation of the primary family: clients interact in ways that symbolically recreate
aspects of interactions with their family of origin, allowing an opportunity to explore lingering
effects of early experience.
Group cohesiveness: often seen as a necessary precondition to the other processes,
cohesiveness is the result of group members' willingness to be committed to the group, to participate
actively, and to express negative as well as positive interpersonal feelings and challenges as well
as support.
17.108
According to outcome research, what type of therapy and therapeutic focus are most
likely to result in long-term success for couples in marital therapy?
Insight-oriented therapy; understanding and resolution of persistent emotional conflicts, not
simply negotiation of solutions to specific contemporary problems.
17.109
How do structural family systems therapists define a "client"?
While there may be an "identified client," or family member who is labeled as the
disordered individual, these therapists view Has family process as the client. The family is not seen
as a collection of components but as an integrated system. Regardless of which member's behavior
prompted the family's entry into therapy, each member contributes, in circular causal fashion, to
maintaining and/or exacerbating other members' behaviors.
428
17.110
Of the eight basic processes hypothesized to be important for the success of therapy
groups, which ones are probably NOT important in the functioning of self-help groups? Which two
would you consider MOST important in self-help groups, and why?
family.
Probably not important: consensuality, interpersonal learning, recapitulation of the primary
Most important (these are arguable, although listed in conceptual priority; coherence of
student rationale should be taken into consideration):
a) sharing of information, because much of the group's purpose is to help educate its
members about the specific problem that brings them together;
b) altruism, because the group exists so that members can help others;
c) instilling hope, because members can observe the successful coping/understanding that
other members exhibit;
d) universality, because members discover their experiences are not bizarre nor are they
alone in struggling with their issues;
e) cohesiveness, because members should feel safe, committed, and able to participate
actively in the group process.
17.111
What are the four common components of psychosocial rehabilitation?
1. Patients' understanding of their own disorder (psychoeducation)
2. Identification and learning of day-to-day living skills and of the potential impact of their
disorder on others with whom they interact
3. Case management
4. A coalition among clinicians, family members, and patients
17.112
What four primary principles guide the thinking and research of community
psychologists?
1. A person's behavior is the result of interacting economic, social, and physical aspects
of the environment. This reflects an ecological perspective (similar to family systems theories).
2. Interventions should take place in the actual settings in which individuals conduct their
lives (e.g., school, work, home).
3. Efforts at change should be directed to social systems, not individuals, at both local and
broader levels.
4. Rather than treating already-existing disorders (equivalent to tertiary prevention), the
emphasis for these psychologists is on proactive prevention. Primary prevention is the central goal,
in which environments and/or individuals are changed in order to counteract risk factors or to
reinforce protective factors so that development of disorders is avoided altogether.
429
17.113
Suppose you wanted to design a primary prevention program aimed at reducing the
prevalence of adolescent substance abuse. Drawing on three of the five general strategies used in
such programs, describe how you might accomplish your goal.
No modal response predictable. Answer should include 3 of the following 5 issues,
with supporting arguments:
1. Encourage secure attachments and reduce family violence.
2. Teach children effective problem solving related to cognitive/academic and
interpersonal functioning.
3. Change environments (e.g., school system, peer groups, availability of housing).
4. Teach more effective coping skills for dealing with stressors.
5. Enhance empowerment.
430
Chapter 18
LEGAL AND ETHICAL ISSUES IN MENTAL DISORDERS
18.1
Ans. A
App
p. 618
E
A friend believes that mental disorders are uncommon and that less money should
be spent on psychological research. To counter your friend's idea, you could point
out that Americans spend about 1 of every days in hospitals for mental health
reasons.
a. 4
b. 7
c. 10
d. 14
18.2
A high school class is recreating the U. S. economy on a small scale. They are
Ans. B
deciding how much of me $100,000 allocated for health care should be assigned
App
to mental health care. Of $100,000 they should plan to spend
on mental
p. 618
health care.
M
a. 5,000
b. 10,000
c. 20,000
d. 50,000
18.3
Rolf says, "I can't see why I should be concerned with mental illness when no
Ans. C
one I know has that sort of problem." You could reply, "Perhaps a friend or
App relative is affected without your knowing it, but more importantly mental disorders
p. 618
affect everyone in society because in the U.S.
M
a. most criminals have mental illnesses."
*
b. about $15 billion is spent for mental health care every year."
c. about $100 billion is spent for mental health care every year."
d. use of the insanity defense accounts for 10% of all legal costs every year."
18.4
Ans. D
Con
p. 618-9
E
A psychologist is addressing the central issues associated with ethical, legal aspects
of mental disorders. This professional would be LEAST likely to ask
a. Which is more important, the independence of people with mental illnesses or
the safety and comfort of the general population?
b. What should mental health professionals do when asked to give expert opinions
in legal forums?
c. What should be the role of laws and law makers in regulating mental health
care?
d. How should psychologists and psychiatrists decide what to charge for their
services?
18.5
Ans. D
App
p. 619-20
M
Which of the following persons can be involuntarily committed to a hospital?
a. Heinz, who has schizotypal personality disorder and spends most of his days
wandering downtown streets shouting warnings of the apocalypse.
b. Dolly, who has agoraphobia that is causing severe dysfunction in her family
and could be successfully treated with a few months of therapy.
c. Merrill, who is not menially disordered but has committed multiple gruesome
murders.
d. none of the above
431
18.6
Ans. C
App
p. 619
C
*
Two friends are debating the rights of individuals versus society. Edna says that
the rights of an individual should always be upheld because everyone has a
constitutional right to maximum freedom. Troy says that states should protect
citizens from dangerous individuals. On which other central issue of rights
expressed by Edna would Troy disagree?
a. Laws allowing civil commitment should be repealed.
b. Deinstitutionalization should be achieved at all costs.
c. We should allow people with mental illness to mm down treatment.
d. We should legally require confidentiality.
18.7
Ans. B
App
p. 620
E
Dr. Megargee is testifying before a state committee on mental health laws. Dr.
Megargee suggests that the committee's job is not only to weigh rights but also to
determine if a potential law will be helpful or harmful to individual clients. Dr.
Megargee's view is most similar to that of
a. an assertive outreach orientation.
b. therapeutic jurisprudence.
c. informed consent.
d. the Durham rule.
18.8
Ans. A
App
p. 620
M
Melody says, "A law may be the fairest way to balance the rights of society with
the rights of the individual, but how will a client feel when he or she realizes the
potential limits on confidentiality associated with the Tarasoff decision? I'd hate
to think that the law would make clients uneasy about talking to their therapists."
Melody's comments show that she has a
perspective.
a. therapeutic jurisprudence
b. parens patriae
c. teleological
d. right to treatment
18.9
Ans. B
App
p. 620
E
Mira's family and her former therapist believe she is so depressed that she is a
danger to herself. Mira's family plans to get a legal order for her to receive
inpatient treatment if she will not resume therapy willingly. That legal order is
a. certification.
b. civil commitment.
c. legal internment.
d. therapeutic jurisprudence.
18.10
Ans. C
App
p. 620
M
A person who agrees with the parens patriae tradition would be most likely to
suggest that
a. effective parenting requires training.
b. people who have a mental disorder should be allowed to make most of their
own decisions.
c. public schools are responsible for maintaining safety by prohibiting students'
possession of potentially dangerous objects.
d. treatment for mental disorders should focus on family therapy approaches.
432
18.11
Ans. A
App
p. 620
M
It is 1953, and Samuel has been committed to a state psychiatric hospital. At
what point will Samuel be released?
a. when his physician decides that treatment is no longer needed
b. when the judge who confined him no longer considers Samuel a danger to
himself or others
c. when a less restrictive treatment setting is available
d. after Samuel complies with prescribed treatment and feels ready to return home
18.12
Ans. A
Con
p. 620
M
Which of the following descriptors does not belong with the other three?
a. competence to stand trial
b. strong bias against psychiatry
c. 1960s social reforms
d. least restrictive alternative
18.13
Ans. B
App
p. 620
M
*
Jamila, diagnosed with schizophrenia, has taken her medication infrequently since
her release from the hospital. Because her hallucinations have led her to harm
others, and Jamila refuses to go to treatment regularly, legal proceedings have
been started to return her to the hospital. To force her to go to the hospital, the
state must also prove that Jamila
a. is a danger to herself.
b. could not be treated with a less restrictive alternative.
c. is criminally insane.
d. has the funds to pay for her treatment.
Dion was involuntarily sent to a state mental hospital because the state showed
that he had a mental disorder, was a danger to himself, and the hospital could
treat him. Later, Dion's lawyer legally claimed that the order should be
overturned because
a. Dion was not improving.
b. Dion was not a danger to others.
c. less restrictive treatment was available.
d. the hospital was overcrowded.
18.14
Ans. C
App
p. 620
C
18.15
Ans. D
App
p. 620
E
Walter, who was diagnosed with multiple personality disorder, attacked a police
officer. The state showed that Walter needed to be restricted to a nearby facility
for the safety of the public. In order to succeed in
, the state also
needed to prove that
.
a. legal confinement; psychodynamic treatment was available at the proposed
facility
b. legal confinement; an assertive outreach orientation would be used at the
facility
c. civil commitment; integrated case management would be used at the facility
d. civil commitment; appropriate treatment was available at the proposed facility
18.16
Ans. C
App
p. 620
E
Javier believes that deinstitutionalization is a good idea. Therefore, he is MOST
likely to be in favor of
a. civil commitment,
b. inpatient treatment.
c. outpatient treatment.
d. managed care systems.
433
18.17
Ans. B
App
p. 620
E
Avila is a patient in a state mental hospital. Her ward is overcrowded because the
number of patients is higher than it is has ever been. What year is it?
a. 1948
b. 1955
c. 1970
d. 1979
18.18
Ans. A
Fac
p. 620
M
Between the late 1960s and the late 1980s, the average daily number of patients in
state mental hospitals
, and the number of patients admitted to all types
of hospitals for mental health care .
a. decreased; increased
b. decreased; decreased
c. increased; decreased
d. increased; remained the same
Sanura was first hospitalized in 1967 for bipolar disorder. By the late 1980s,
Sanura is likely to be hospitalized for a(n)
period of time and to be
frequently admitted for hospital treatment.
a. equal; more
b. longer; less
c. shorter; less
d. shorter; more
Dr. Szulc is responsible for keeping track of all types of hospitalizations for
mental health care. Compared to Dr. Szulc's report to his state health
commission in 1969, his report in 1988 would reflect a
in those admissions.
a. 30% decrease
b. 30% increase
c. 13% decrease
d. 7% increase
18.19
Ans. D
App
p. 620
M
18.20
Ans. B
App
p. 620
M
*
18.21
Ans. C
App
p. 620-1
M
During a class debate, Bob says that deinstitutionalization has been a success
because the number of inpatients in state hospitals has so dramatically decreased.
You may best counter his argument by correctly stating that
a. fewer people may be coming in, but they are staying for longer periods of time.
b. inpatients currently in state hospitals are more seriously mentally ill than were
earlier patients.
c. private psychiatric facilities, specialized treatment units, and general hospitals
are treating many of those patients.
d. all of the above
18.22
Ans. B
Fac
p. 620-3
E
Deinstitutionalization has failed to fulfill its early promise for the mentally ill. In
particular, it has resulted in which of the following unintended consequences?
a. a significant decrease in all forms of inpatient treatment
b. a large number of "criminalized" patients
c. a substantial increase in the number of civil commitment procedures
d. a large number of criminal defendants using the insanity defense
434
18.23
Ans. D
Fac
p. 621
E
In which of the following settings has deinstitutionalization taken place in the past
few decades?
a. public psychiatric hospitals
b. private psychiatric hospitals
c. VA hospitals
d. both a and c
18.24
Ans. C
Fac
p. 621
E
What percentage of homeless individuals are estimated to suffer from severe mental
illness?
a. two thirds
b. one half
c. one third
d. one fifth
18.25
Ans. A
App
p. 621
M
A city task force is meeting to discuss means by which to help their homeless
citizens. Ramona suggests the homeless just need jobs, but Vondria says they are
all crazy so no one would want to hire them. You could reply by saying that
a. about one third may not be able to work unless their severe mental disorders are
under control.
b. about two thirds may not be able to work because they are alcohol or drug
abusers.
c. Ramona is essentially right.
d. Vondria is essentially right.
18.26
Ans. D
App
p. 622
M
Ms. Franklin is a mental health professional who has implemented the system of
care for homeless persons recommended by the NIMH task force. What is her
first
activity?
a. integrated rehabilitation
b. creation of safe havens
c. outpatient commitment for dangerous individuals
d. assertive outreach
18.27
Ans. B
Con
p. 622
E
Which of the following terms does not belong with the other three?
a. safe havens
b. health maintenance organization
c. integrated case management
d. homelessness
18.28
Ans. B
App
p. 621
E
If state legislators have decreed that mental health workers seek out homeless
clients and help them make arrangements for benefits and services, they have
proposed
a. the ALI and McNaughton rules.
b. assertive outreach and integrated case management.
c. a managed care system.
d. therapeutic jurisprudence.
435
18.29
Ans. C
Con
p. 622
C
*
18.30
Ans. D
App
p. 623
E
A person who emphasizes a.parens patriae approach to reducing the problem of
homelessness would probably
a. see institutionalization as less preferable to continued homelessness.
b. discourage the use of civil commitment for mentally ill homeless persons in
favor of half-way houses.
c. not object to the bundling of services in the integrated system of care.
d. emphasize housing options over the use of safe havens.
Scott is a police officer who is trying to decide how to deal with a homeless
person who is schizophrenic and also creating a public disturbance. Scott has the
right
to
a. arrest the person.
b. force him or her into a psychiatric hospital.
c. refer him or her to a mental health agency.
d. all of the above
18.31
Ans. B
App
p. 623
E
Hettie has been living under a railroad trestle and is known in the community for
her abnormal behavior. She has been diagnosed with paranoid schizophrenia, but
she hasn't received treatment in years. According to Teplin's research, Hettie is
a. less likely to be arrested than someone who apparently has no mental illness.
b. more likely to be arrested than someone who apparently has no mental illness.
c. equally likely to be arrested as someone who is apparently not mentally ill.
d. likely to be forced into psychiatric treatment.
18.32
Ans. C
App
p. 623
M
John was walking on an interstate highway and was very nearly hit by cars several
times before the police arrived. Because John appears mentally disturbed he will
MOST likely be
a. committed to a hospital without a court order.
b. committed to a hospital with a court order.
c. arrested and put in jail.
d. returned to his family.
18.33
Ans. D
App
p. 623
M
Officer Zayas is unlikely to hospitalize a disruptive, mentally ill person for each of
the following reasons EXCEPT
a. the hospital often refuses to accept such persons because they are not
sufficiently dangerous.
b. the arrest process involves less paperwork and red tape than does
hospitalization.
c. the hospital does not provide the kind of treatment needed for the person's
disorder.
d. he cannot commit the person without judicial or family consent.
18.34
Ans. A
Con
p. 620,3
M
*
Based on information provided in the text, where are you MOST likely today to
a person with a severe mental illness or substance abuse disorder?
a. in local jails
b. a state or county psychiatric facility
c. in a VA hospital
d. in community-based outpatient services
find
436
18.35
Ans. B
App
p. 624
M
Mr. Nakagawa's therapist believes that he is in need of inpatient treatment for a
severe mental disorder. If their state laws have been changed recently to make
involuntary commitment somewhat easier, on what grounds might the therapist
succeed in hospitalizing her client?
a. The client is an excessive burden to his family.
b. The client is unable to care for his basic daily needs such as grooming and
eating.
c. The client refuses to take his prescribed medication.
d. none of the above
18.36
Ans. C
App
p. 624
M
Dr. Tavianni has hospitalized his schizophrenic client under the criteria of mental
illness and grave disability. This approach is sometimes called the "thank-you
theory," a type of
logic.
a. forensic
b. noblesse oblige
c. parens patriae
d. patient privilege
18.37
Ans. D
App
p. 624
M
Saivatore has been involuntarily committed without a court order. Which of the
following descriptions is INCORRECT?
a. He can be held for only a few days before a hearing must be held,
b. He is mentally ill and in imminent danger of causing himself harm.
c. A law enforcement official made the decision for Saivatore to be hospitalized,
d. This is an illegal situation; it is not possible for Saivatore to be detained
without a formal court order.
18.38
Ans. A
App
p. 624
M
*
Jasper is appearing before a judge who will decide whether or not he requires
involuntary hospitalization. Which of the following is unlikely to occur?
a. The judge will rely primarily on the criterion of dangerousness in making her
or his decision.
b. Jasper will have a lawyer representing him who is able to call and
cross-examine witnesses.
c. Jasper will have already been formally assessed by a mental health
professional.
d. none of the above
18.39
Ans. C
Fac
p. 624
E
Which of the following criteria is MOST frequently used as a basis of
court-ordered civil commitment?
a. danger to self
b. danger to others
c. gravely disabled
d. guilty but mentally ill
18.40
Ans. B
App
p. 624
M
Judge Storey is weighing the pros and cons of ordering outpatient commitment for
a mentally ill, deteriorating patient. Which issue is probably MOST difficult for
the judge to resolve?
a. Will the therapist be liable if this patient acts out aggressively?
b. Should the patient be forced to take his psychotropic medication?
c. Does the community provide treatment that will be effective for this patient?
d. Is the "dangerousness" criterion more important than the "disability" criterion?
437
18.41
Ans. C
Fac
p. 625
M
Which of the following rights does every state in the U.S. recognize?
a. informed consent for treatment
b. right to refuse treatment
c. minimal standards of care
d. both b and c
18.42
Ans. D
Fac
p. 625
M
What do Youngberg v. Romeo and Washington v. Harper have in common?
a. They helped establish the requirement that therapists break confidentiality to
protect potential victims of violent clients.
b. They helped set minimum standards of care for all states in the U.S.
c. They helped establish criteria for the determination of competence to stand trial,
d. They helped identify the legal limits recognized in regard to patients' right to
refuse treatment.
18.43
Ans. A
App
p. 625
M
Tamisha is refusing to take the medication prescribed for her by her psychiatrist
while she is a patient in a state mental hospital. Under which of the following
conditions can she be forced to take the medication?
a. if it is an emergency situation in which Tamisha is an imminent danger to
herself or others
b. if the psychiatrist included the medication in his treatment plan presented to
the court at the time she was committed
c. if she refuses to cooperate with the rules and regulations of the treatment unit
d. none of the above
18.44
Ans. B
App
p. 625
M
Anselmo is refusing to take his prescribed lithium while he is a patient on a
psychiatric ward. Which of the following is a CORRECT statement?
a. He is part of a noncompliant group that comprises about 20% of patients,
b. He will probably eventually be court-ordered to comply with treatment.
c. All states recognize this patient right.
d. The psychiatrist can insist on Anselmo's compliance as long as he is
involuntarily committed.
18.45
Ans. C
App
p. 625
M
Dr. TSouvas was wary of the 1980s1 push for patients' right to refuse psychiatric
treatment. Which of his concerns has been shown to be MOST valid?
a. Hospital wards have become chaotic and dangerous because of such patients,
b. A substantial number of patients have chosen to invoke this right.
c. The process of ensuring mis right is expensive and time-consuming,
d. The need for psychiatrists in inpatient settings has declined.
18.46
Ans. D
App
p. 627
E
Ishi, an involuntarily committed patient, is insisting on her right to treatment. This
means that she has a right to
a. accept or refuse treatment as she sees fit.
b. be treated under conditions of informed consent.
c. be involved in any treatment decisions made for her disorder,
d. receive effective treatment rather than simply be confined.
*
438
.47
Ans. A
App
p. 627
E
18.48
Ans. B
Fac
p. 627
E
Mr. Delaney was hospitalized following his assault on a police officer while Mr.
Delaney was in a delusional state. His prison sentence would have been shorter
than was his involuntary commitment, which involved nothing more than
confinement. His right to
has been violated. .
a. treatment
b. a least restrictive setting
c. due process
d. competent commitment
The experiences of Nicholas Romeo at Pennhurst State Hospital set the precedent
for
a. rights of nondangerous patients,
b. standards of treatment.
c. the right to treatment.
d. rights of mentally retarded criminal defendants.
18.49
Ans. C
App
p. 627
M
Marisa is a committed patient. Which of the following standards of her treatment
is NOT recognized by each state in the U.S.?
a. a safe environment
b. freedom from unnecessary restraint
c. the right to receive visitors
d. adequate medical care
18.50
Ans. D
Fac
p. 627
M
Which landmark case marks the Supreme Court's willingness to hear arguments
about the constitutional rights of a civilly committed mental patient?
a. Youngberg v. Romeo
b. Tarasojfv. Regents of the University of California
c. Cleburne Living Center, Inc. v. City of Cleburne, Texas
d. O'Connor v. Donaldson
18.51
Ans. B
Con
p. 627
C
Which of the following cases and legal rights are mismatched?
a. O'Connor v. Donaldson : rights of nondangerous patients
b. Rouse v. Cameron : right to refuse treatment
c. Youngberg v. Romeo : standards of treatment
d. Ake v. Oklahoma : rights of mentally ill criminal defendants
*
18.52
Ans. A
Con
p. 620,8
M
Which of the four conditions of civil commitment is MOST specifically addressed
in the Supreme Court case won by Kenneth Donaldson?
a. least restrictive treatment
b. presence of mental illness
c. treatment availability
d. informed consent
439
18.53
Ans. D
App
p. 628
M
Felicia heard that a group home for people with mental retardation would be placed
in her neighborhood. Felicia tells you she is worried that her home price will drop,
and she wishes the city would do something. According to the text, you should
suggest that Felicia
a. ask the city to require group homes to locate only in certain zones.
b. ask the city to impose a special permit process for establishing such homes.
c. file a petition signed by the neighbors with the state.
d. do nothing to prevent this event.
18.54
Ans. D
App
p. 628
M
Thomas is a young man living in poverty who has been accused of murder. His
family insists that he is severely mentally ill. Which of the following rights is
extended to Thomas?
a. He will be provided a state-funded psychiatrist to serve as an expert witness.
b. If found guilty, he cannot be executed if he is considered incompetent at the
time of execution.
c. He will be committed for treatment for one year before his case is heard in
court.
d. both a and b
18.55
Ans. C
App
p. 629
M
Harry was convicted of murder and sentenced to death. Ten years later, Harry
has become delusional and no longer understands why he is being held nor what
is going to happen. The state most likely
execute Harry, because
.
a. will; he was not delusional when he committed the crime
b. will; he was not delusional when originally sentenced
c. will not; he doesn't understand what the death penalty is for
d. will not; he has a right to treatment
18.56
Ans. A
App
p. 629
M
For which of the following prison inmates would a sentence of execution not be
carried out?
a. Werner, who because of his mental disorder does not understand why he is to
be executed
b. Sarah, who was mentally ill at the time of her offense and has been
successfully treated
c. Benny, who is suffering from borderline personality disorder and is a danger to
himself
d. both a and c
18.57
Ans. A
App
p. 630
E
After getting a bachelor's degree in psychology, Lois began advertising her
services as a psychologist. Soon she received a notice stating that she did not
have the education and training required to use that title. Lois violated
a. certification laws.
b. privilege laws.
c. the McNaughton rule.
d. ethics laws.
440
18.58
Ans. A
App
p. 630
E
Dr. Horowitz has just completed graduate school and is ready to start a private
therapy practice. Before Dr. Horowitz can start his practice, what types of laws
does he have to know and comply with?
a. licensure and certification laws
b. practice regulation laws
c. ethics and confidentiality laws
d. malpractice and training laws
18.59
Ans. C
App
p. 630
M
Dr. Horvat agrees that certification and licensure laws may protect individuals
from charlatans and unskilled professionals. However, like some other practitioners,
he questions whether
a. states that do not have such laws are putting their citizens in danger.
b. these laws should include confidentiality issues.
c. nontraditional professionals are being economically disadvantaged.
d. such laws should specify the parameters of "effective" therapy.
18.60
Ans. D
App
p. 630
M
Sonya is on trial for the murder of her husband. It is alleged that Sonya
confessed her guilt to Pastor Upton. The court MOST likely will
a. force Pastor Upton to reveal the contents of their conversations,
b. force Sonya to reveal the contents of their conversations.
c. recognize the conversations as confidential,
d. recognize the conversations as privileged.
18.61
Ans. A
Fac
p. 630
M
In
a.
b.
c.
d.
18.62
Ans. C
App
p. 630
E
Dr. Galtberg is legally protected from disclosing information about his clients
except in certain prescribed cases. What is the term for this protection?
a. client-therapist contract
b. confidentiality
c. privilege
d. censure
18.63
Ans. B
App
p. 630
M
During couple counseling, Haile told her therapist that her boyfriend knew she
had a sexually transmitted disease from a previous relationship. Haile was
shocked later in the week when her parents knew about it, but they said the
therapist was right to call them. According to your text, the therapist
a. should not have told them, because of the Tarasoff ruling.
b. should not have told them, because it is a breach of confidentiality.
c. should have told them only if they are paying for the therapy.
d. should have told them only if Haile lives with them.
18.64
Ans. A
Con
p. 630
M
Which of the following terms does not belong with the other three?
a. privilege
b. ethical obligation
c. federal protection only
d. confidentiality
each state of the U.S., privilege exists between
a minister and parishioner.
a parent and child,
a therapist and client.
both a and c
441
18.65
In 1996, a Supreme Court decision was made that was very important to the area
Ans. D
of legislation and mental health. This case ensured the protection of confidential
Fac
communications between a therapist and a client in federal cases. What was the
p. 630 name of the case?
E
a. Tarasojfv. Regents of the University of California
b. O'Conner. v. Donaldson
c. Carter v. Altress
d. Jaffe v. Redmond
18.66
Ans. C
App
p. 630
M
Dr. Redcloud is a psychotherapist treating a client who is involved in a court case.
Under which of the following conditions will their confidentiality be legally
protected?
a. if the legal charge involved in the case is a misdemeanor rather than a felony
b. in any case heard in a U.S. state court
c. in any case heard in federal court
d. when the case does not involve abuse of a minor or other violent offense
18.67
Ans. B
App
p. 631
M .
In her first session with each client, Dr. Fuhr describes the nature of
confidentiality and her commitment to maintaining this aspect of the therapy
relationship. However, there are some limitations to confidentiality, and these
include each of the following EXCEPT
a. the client is imminently suicidal and will not agree to hospitalization that Dr.
Fuhr deems necessary.
b. the client reports that she/he is currently buying and using illegal substances.
c. the client is abusing a child or a disabled adult.
d. the client includes her/his mental condition as part of a court case, and Dr.
Fuhr is called as a witness.
Dr. Natchez has a new adult client diagnosed with borderline personality disorder.
Under which condition below might Dr. Natchez be required to breach
client-therapist confidentiality?
a. if his client claims that his abusive parent has broken the law in the past
b. if his client claims that he knows that a friend or acquaintance has committed
murder
c. if his client indicates that he is abusing other people
d. if his client threatens to terminate treatment prematurely
Dr. Serano is treating an admitted pedophile. When treatment ends, Dr. Serano
plans to testify in court about the client's mental state. Why is this permissible on
legal and ethical grounds?
a. Dr. Serano is conducting a court-ordered psychological evaluation.
b. Pedophiles are a menace to society and have forfeited their legal rights.
c. It was first permitted in past cases such as the Ake v. Oklahoma that set this
precedent.
d. It is not permissible; it is a serious breach of confidentiality.
18.68
Ans. C
App
p. 631
M
*
18.69
Ans. A
App
p. 631
E
442
18.70
Ans. B
Fac
p. 631
M
According to your text, in cases such as Tarasoff \. Regents of the University of
California what issues are the court systems weighing against each other?
a. the importance of a client's safety against the right of society to see justice
done
b. the importance of a client's right to confidentiality against society's interest in
protecting itself from danger
c. the importance of a victim's right for safety against the client's right to fair
treatment
d. the importance of a victim's right to see justice done against the client's right
to confidentiality
18.71
Ans. D
Con
p. 631
M
Which of the following descriptions does not belong with the other three?
a. "The protective privilege ends where the public peril begins."
b. Confidentiality must be broken when a client intends to harm another person,
c. The Tarasoff decision set the precedent for the breaking of confidentiality
when a client is potentially dangerous to another person.
d. Therapists are ethically required to directly warn intended victims of their
client's intentions.
18.72
Ans. A
App
p. 631
M
Dr. Berler's client has indicated that she intends to shoot the woman with whom
her husband is having an affair. What must Dr. Berler do at this point?
a. take whatever action is necessary to protect the intended victim
b. call the intended victim and warn her of the client's intentions
c. seek voluntary or involuntary commitment for her client
d. inform the police of the client's intentions
18.73
Ans. B
Fac
p. 632
M
Why was John Hinckley, Jr.'s psychiatrist not held liable for damages when his
client attempted to assassinate President Reagan?
a. He had been able to get his client to undergo voluntary hospitaliaation, but
Hinckley later carried out his plan.
b. The laws of his state did not require that he take steps to protect the client's
victim.
c. He took the step of informing the President's Secret Service, but the attempt
was not be prevented.
d. He had excellent legal representation and successfully defended himself against
the Tarasoff requirement.
18.74
Ans. B
App
p. 632
E
Dr. Payne is facing a problem with a certain client of his. This client has been
convicted in the past of spouse abuse, and has recently expressed a high level
anger directed toward his wife and children. What is Dr. Payne's dilemma?
a. deciding whether he should refer his client for appropriate medication
b. predicting whether this client will be dangerous in the future
c. deciding how to protect himself from a future malpractice suit should his client
file one in anger
d. deciding how to circumvent legislation requiring him to report his client to the
police so that he can deliver more effective treatment
*
443
18.75
Ans. C
App
p. 632
M
*
18.76
Ans. A
App
p. 632
E
Ramone is trying to predict the dangerousness of one of his clients. Which of
the following factors will enhance his accuracy?
a. Ramone is a licensed, doctoral level psychologist rather than a bachelor's level
social worker.
b. Ramone attempts to predict the client's dangerousness in the next 2 weeks
rather than in the next year.
c. Ramone receives information about his client's history of violence.
d. all of the above
Dr. Aram, a trained psychotherapist, is dealing with a client who may be
potentially dangerous. Based on empirical findings, what are his chances of
predicting this client's future level of dangerousness compared to a layperson's
chances?
a. about the same
b. much better
c. only slightly better
d. worse
18.77
Ans. D
App
p. 632-3
C
Dr. Lutece believes his schizophrenic client with paranoid delusions may become
violent toward his family at some point. Each of the following factors
complicates Dr. Lutece's ability to accurately predict this behavior EXCEPT
a. the relative rareness of dangerous behavior in the general population.
b. Dr. Lutece's desire to avoid a false negative outcome.
c. limited knowledge about the client's day-to-day environments.
d. research evidence that suggests Dr. Lutece's predictions are not better than
those based on chance.
18.78
Ans. A
App
p. 633
M
Dr. Jacobs' San Diego mental health practice has not been affected much by the
Tarasojfv. Regents of the University of California case. According to your text,
why may this be so?
a. Dr. Jacobs was breaking confidentiality to warn victims or the police before
Tarasoffv. Regents of the University of California happened.
b. Dr. Jacobs' practice deals with common mental health problems, and because
Tarasoff dealt with marginal cases, his practice is not included in its
requirements.
c. Potentially dangerous clients have become much less likely to seek treatment
knowing that their confidentiality may be jeopardized.
d. Dr. Jacobs works only with adolescent clients and is therefore exempt from
breaking confidentiality when clients threaten others.
18.79
Ans. B
App
p. 634
M
In order for a family to successfully sue Ms. Richards for failing to prevent the
suicide of their mother, each of the following elements must be present EXCEPT
a. Ms. Richards must be shown to have violated a standard of care in treating
their mother.
b. Ms. Richards' was not a member of the APA and thus was not bound by its
ethical principles.
c. Ms. Richards' negligence must be shown to be the cause of the mother's
suicide.
d. Ms. Richards and the mother had to have been in a special professional
relationship.
*
444
18.80
Ans. D
App
p. 634
E
Dr. Vasquez is facing a malpractice suit. Which of the cases below is LEAST
likely to be the one he is facing?
a. failing to prevent a client from committing suicide
b. failing to inform individuals of potential harm posed toward them by a client
c. engaging in sexual intimacy with a client as part of her treatment for sexual
dysfunction
d. failing to correctly diagnose a comorbid substance abuse disorder in a severely
depressed or anxious client
18.81
Ans. B
Fac
p. 620,31,34
M
Which of the following events did NOT occur during the 1960s?
a. an increase in the number of malpractice claims against psychologists
b. the Tarasoff decision
c. reforms in state civil commitment laws
d. increasing numbers of public mental hospital patients being discharged
18.82
Ans. A
Con
p. 634
M
Which of the following does NOT necessarily belong with the other three?
a. client suicide
b. violation of standard of care
c. sexual contact with client
d. malpractice
18.83
Ans. C
Fac
p. 634
E
What percentage of mental health professionals report having engaged in sexually
intimate behavior with a client?
a. less than one percent
b. over twenty percent
c. two to ten percent
d. eight to fifteen percent
18.84
Ans. A
App
p. 634
E
Which of the following therapists is MOST likely to commit the offense of having
sexual contact with a client?
a. Mitch, who has done so previously
b. Laura, who has done so previously
c. Ricardo, who has not done so previously
d. Melba, who has not done so previously
18.85
Dr. Calderon saw a client for a few sessions while she was dealing with grief over
Ans. C the loss of her mother. Sometime later, Dr. Calderon and the former client ran
App
into each other at an art museum, and they began dating shortly thereafter.
p. 635
According to current APA guidelines, at least
must have passed between
M
the termination of therapy and their romantic relationship.
*
a. 6 months
b. 1 year
c. 2 years
d. It is not ethically permissible to have an intimate relationship with former
clients.
445
18.86
Ans. B
App
p. 635
E
Nancy has engaged in sex with her psychotherapist. Which statement below is
the most likely to be FALSE?
a. The therapist is putting his own needs before Nancy's,
b. The increased level of intimacy has increased the effectiveness of the therapy.
c. The therapist will find it difficult to be objective while making judgments about
Nancy.
d. Nancy's therapist is being exploitive.
18.87
Ans. D
App
p. 635
M
Which of the following cases is NOT likely to be a target of a malpractice suit
regarding repressed memory therapy?
a. A therapist helps a client remember abuse that occurred when the client was 9
months old.
b. A client recalls her childhood sexual abuse after two years of intensive
hypnotherapy.
c. A therapist uses sodium amytal to help a client recall her history of sexual and
physical abuse that occurred at age 8.
d. none of the above
18.88
Ans. A
App
p. 636
E
*
If you were a therapist, what factor below would have the greatest regulatory
impact on your practice?
a. third party payers
b. ethical standards
c. regulatory legislation, such as Tarasoff and other state cases
d. malpractice suits
18.89
Ans. B
Con
p. 636
M
What factor is MOST likely to determine the standards of care that therapists are
expected to follow today?
a. court decisions
b. third-party payers
c. malpractice suits
d. ethical standards
18.90
Ans. C
App
p. 636
E
Carolyn is a member of a managed care system. Her insurance company pays a
set fee each month for each of its members for mental health care. In other
words, Carolyn's insurance company is participating in a
system.
a. fixed-cost
b. flat fee
c. capitation
d. utilization
18.91
Ans. D
Fac
p. 637
E
Who conducts a managed care system's utilization review of therapy?
a. a client's therapist
b. a therapist's clinical supervisor
c. an independent mental health professional hired by the company
d. a case manager who is typically not a mental health professional
446
18.92
Ans. B
App
p. 637
E
Your health care service utilizes a capitation plan. What type of treatments will
this plan MOST favor?
a. thorough assessments that inform careful therapy planning
b. medications and short-term therapy
c. insight-oriented psychotherapy
d. 20-session cognitive-behavioral therapy
18.93
Ans. A
App
p. 637
M
You are a therapist, and you have committed an ethical violation. What type of
violation is it LEAST likely to be?
a. practicing in an area in which you are not competent
b. a breach of confidentiality
c. sexual intimacy with a client
d. a dispute over financial matters
18.94
Ans. B
App
p. 637-8
M
Dr. Smith has been found guilty of the ethical violation of having a sexual
relationship with a client. Which of the following consequences is NOT
associated with this violation?
a. public reprimand
b. an arrest
c. forfeiture of his state licensure
d. expulsion from the APA
18.95
Ans. B
Fac
p. 638
E
Although the practice is controversial, it is estimated that psychologists and
psychiatrists provide expert witness testimony in
% of all federal civil trials.
a. 5
b. 8
c. 15
d. 22
18.96
Ans. D
App
p. 638
E
Dr. Jackson is testifying in a trial in which an individual is being evaluated for
involuntary hospitalization. Dr. Jackson is a
psychologist.
a. civil
b. community
c. litigation
d. forensic
18.97
Ans. C
Fac
p. 640
E
Which of the following psychologists is MOST likely to charge rates of $300 to
$400 per hour of service?
a. a psychodynamic therapist providing individual therapy
b. a clinical psychologist conducting a complete psychological evaluation
c. a forensic psychologist providing expert testimony
d. a forensic psychologist providing inpatient treatment to a defendant deemed
criminally incompetent
447
18.98
Ans. C
App
p. 640
E
Shara's attorney is wondering if Shara adequately understands the nature of the
judicial proceedings she is about to undergo. The attorney is concerned that
Shara is not really able to participate in her own defense. In other words, the
attorney questions her
a. criminal culpability.
b. legal state of mind.
c. competence to stand trial.
d. sufficiency for judicial review.
18.99
Ans. B
Fac
p. 640
M
If a defendant's mental state is an issue in a court case, it is necessary to first
determine
before raising the question of
.
a. intelligence; competence
b. competence; insanity
c. the adequacy of the McNaughton mle; the Durham rule
d. wrongfulness; mental defect
18.100
Ans. D
App
p. 640
E
Mr. Lawrence is evaluating whether his mentally disordered client is competent to
stand trial. Mr. Lawrence could consider each of the following issues EXCEPT
a. Can my client consult meaningfully with me as I prepare this case?
b. Does my client understand what will happen during the trial?
c. Will my client be able to participate meaningfully in his own defense?
d. Does the client understand the wrongfulness of the crime?
18.101
Ans. D
Fac
p. 640
E
Which court representative is responsible for raising the question of criminal
competence?
a. the defense attorney
b. the judge
c. the prosecution
d. any of the above
18.102
Ans. B
App
p. 640
E
Mr. Padgett has been found incompetent to stand trial. What will happen next?
a. Mr. Padgett's court case will be dismissed, and he will be committed for
indefinite treatment.
b. Mr. Padgett will be involuntarily committed to a forensic hospital unit until
such time as he can stand trial.
c. Mr. Padgett will be assigned a special advocate who will work with the
defendent and his lawyer throughout the trial.
d. Mr. Padgett will be evaluated according to the ALI mle, and the prosecution
will determine whether the case actually proceeds to trial.
18.103
Ans. A
App
p. 640
E
Dr. Elsley is a forensic psychologist specializing in the treatment of defendants
found incompetent for trial. If her results are similar to those found in the
research literature, she can expect that at least
of every 10 patients will
ultimately be found competent.
a. 7
b. 5
c. 4
d. 2
*
448
18.104
Ans. A
Con
p. 640
E
Who is ultimately responsible for deciding a defendant's sanity or insanity?
a. the court
b. a clinical psychologist
c. a forensic psychologist
d. any of the above
18.105
Ans. B
Con
p. 640
E
Which of the following persons does not belong with the other three?
a. Archie Brawner
b. Prosenjit Poddar
c. Daniel McNaughton
d. Monte Durham
18.106
Ans. C
App
p. 640-1
M
first
James is accused of attempted murder. If his sanity is being judged against the
legal rule established in the mid 1800s, the court will focus on James'
a. inability to participate effectively in his own defense.
b. cognitive and volitional appreciation of the criminality of his action.
c. failure to understand the wrongfulness of his crime as he committed it.
d. diagnosable psychopathology leading to an inability to inhibit criminal actions.
18.107
Ans. D
App
p. 641
M
*
"Due to bipolar disorder symptoms of psychotic severity, my client was unable to
distinguish right from wrong when she stole large sums of money and purchased
several firearms and explosives, believing she needed to protect herself from her
enemies." Which rule(s) for assessing insanity is(are) reflected in this statement?
a. ALI
b. McNaughton
c. Durham
d. both b and c
18.108
Ans. B
Con
p. 641
M
A psychiatrist is testifying in relation to a criminal defendant's insanity plea. This
expert witness asserts that the defendant has a severe mental illness that caused
the criminal action. This evidence is MOST critical to the
rule.
a. mens rea
b. Durham
c. McNaughton
d. ALI
18.109
Ans. C
App
p. 641
E
Nena is a second-year law student. As she learns about the insanity defense, she
will find that the
rule is virtually never used today.
a. McNaughton
b. GBMI
c. Durham
d. ALI
18.110
Ans. D
Con
p. 641
M
Which of the following represents a CORRECT chronological ordering of the
primary standards used to define insanity?
a. Durham : McNaughton : ALI
b. McNaughton : ALI : Brawner
c. the product test : ALI : Durham
d. McNaughton : Durham : ALI
449
18.111
Ans. A
App
p. 641
M
18.112
Ans. B
App
p. 641
M
Carter was a defendant whose attorney entered a plea of insanity in Carter's 1980
manslaughter case. If Carter's case was heard in a federal court, the
rule
was used.
a. ALI
b. McNaughton
c. Durham
d. IDRA
"While my client had a dim awareness that her assault on her sister was wrong,
she was unable to control her actions due to her psychotic mental condition."
This defense attomey is addressing the
test of insanity.
a. Durham
b. ALI
c. mens rea
d. McNaughton
18.113
Ans. C
Fac
p. 641
M
Although a study in Wyoming found the public believed that the insanity defense
was used in about
of all criminal cases, its actual prevalence is .
a. one third; 1.0 percent
b. one quarter; .01 percent
c. one half; .005 percent
d. one half; 3.5 percent
18.114
Ans. D
App
p. 641
M
*
Ms. Strickland is an attorney considering the use of the insanity defense for her
client. How would you advise her?
a. She will probably be most likely to win such a case if the defendant
committed a violent crime after discontinuing psychotropic medications.
b. She should only recommend this if her client has the funds to pay for a very
expensive defense process.
c. She should pursue this only in a federal court where experts can forcefully
persuade the jury by giving a clear opinion about the defendant's insanity.
d. She is extremely unlikely to win such a case and should carefully consider
other options.
18.115
Ans. A
App
p. 642
C
Erik has just been judged NGRI. Which of the following is LEAST likely?
a. Erik is much more likely to be rearrested or rehospitalized after his release
than is the average criminal.
b. Erik will be hospitalized for a longer period of time than will an NGRI
defendant who committed a less serious offense.
c. His presiding judge will use more stringent criteria in deciding his release than
the release of a civilly committed patient.
d. Erik was held to the standard of the McNaughton rule rather than the ALI
rule.
18.116
Ans. B
Fac
p. 642
E
Which of the following characteristics is MOST clearly related to potential for
violence?
a. serious mental illness
b. active psychotic symptoms
c. lowSES
d. borderline intellectual functioning
450
18.117
Ans. D
App
p. 642
M
Which of the following persons is able to use and can afford to pay for an insanity
defense?
a. Letisha, a middle-class black female
b. Mason, an upper-middle-class white male
c. Benito, a lower-class Italian American male
d. all of the above
18.118
Ans. C
Con
p. 643
M
In a student's report on the presence of mental health experts in trials involving
questions of the defendant's sanity, which statement should be omitted?
a. The media coverage of such trials may contribute to the field's credibility,
given the frequent disagreement amongst those experts.
b. These experts, despite the IDRA, may exert too much influence on the judicial
process.
c. Such experts typically cannot contribute valid assessment and diagnostic
evidence for the use of juries or judges.
d. Experts offer opinions of a defendant's past state of mind and present
dangerousness that may be no better than those of a layperson.
18.119
Ans. D
Con
p. 643
M
Suppose you were serving on a jury that has been asked to consider the GBMI
verdict. Which of the following issues is LEAST likely to complicate your
deliberations?
a. You will have to distinguish between mental illness that leads to insanity and
mental illness that does not.
b. You realize that the defendant may not receive adequate treatment due to
hospital overcrowding.
c. You are skeptical of the conflicting expert testimony presented by psychiatrists
and psychologists.
d. You must follow the ALI rule, in its IDRA revision, which limits this verdict
to schizophrenic defendants only.
18.120
Ans. A
App
p. 643
M
Miyoko has been found GBMI in her criminal trial. This means mat
a. her lawyer employed the insanity defense.
b. she will receive treatment before being placed in the general prison population,
c. her trial could have taken place in any state in the U.S.
d. the Durham rule guided the jury's deliberations.
18.121
In the wake of the John Hinckley, Jr. trial, several changes occurred in the use of
Ans. B the insanity defense. Which of the following is NOT among them?
Fac
a. The burden of proof moved from the prosecution to the defense.
p. 643
b. The use of the GBMI verdict was expanded for use in cases where the
M
insanity plea was not raised.
*
c. The ALI rule was changed to be essentially equivalent to the earlier
McNaughton rule,
d. Experts were prohibited from giving any conclusions about a defendant's
sanity.
451
18.122
Ans. D
App
p. 644-5
M
Which of the following jurors is LEAST likely to be influenced by an expert's
opinion on a defendant's insanity?
a. Marta, who hears only diagnostic testimony
b. Duretha, who hears diagnostic testimony and a penultimate opinion
c. Ayita, who hears diagnostic testimony and both a penultimate and ultimate
opinion
d. none of the above
18.123
Ans. D
Fac
p. 645
M
Which of the following types of instruction is MOST likely to influence jurors'
verdicts in an insanity case?
a. ALI
b. IDRA
c. no instructions at all
d. none of the above
18.124
Ans. A
Con
p. 645
E
Which of the following legal principles is fundamental to the other three?
a. mens rea
b. the McNaughton rule
c. IDRA reforms
d. the ALI rule
18.125
Ans. B
App
p. 645
M
Jerome is being tried for a crime that he committed without forethought or
intention, as a result of a mental disorder. Regardless of the state in which his
case is heard, what principle(s) must be considered by jurors?
a. IDRA rules
b. mens rea
c. ALI rule
d. McNaughton rale
SHORT ANSWER / ESSAY
18.126
In order to balance the tradition of parens patriae with greater attention to
individual patient rights, today's laws require what conditions to be met before a person is
hospitalized against her or his will?
The person is mentally ill; the person is an imminent danger to self or others as a result of
mat mental illness; appropriate treatment for the disorder is available at the proposed site of
commitment; and hospitalization must represent the least restrictive alternative available for that
treatment.
452
18.127
Why is deinstitutionalization, the so-called shift from inpatient to outpatient
treatment, a misleading phenomenon?
The measurement of "average inpatients" is usually taken from average daily census counts
but does not reflect the fact that hospital stays are shorter but also more frequent today. The total
number of admissions to all types of hospitals for mental health care has actually increased more
than 30% from the late 1960s to the late '80s. The census decline, moreover, has occurred primarily
in state and county mental hospitals while treatment in private hospitals has increased in the past
10 years, as has treatment in general hospitals, specialized substance abuse units, residential units,
and other inpatient programs.
18.128
What two criteria are most commonly used to make decisions about civil
commitment?
Mental illness and grave disability
18.129
What is the difference between privilege and confidentiality? To what situations
do these apply?
Privilege is a legal protection given to the communication between certain parries
(minister/parishioner, lawyer/client, husband/wife, physician/patient), based on the assumption that
these relationships could not survive without guaranteed nondisclosure. Confidentiality is not a
legal requirement but an ethical obligation in which a therapist pledges not to disclose a client's
reports during therapy. Confidentiality can be broken if the following conditions occur: the client
needs involuntary hospitalization; the client raises her/his mental condition as part of a legal
proceeding; the client is undergoing court-ordered evaluation; the client is abusing others; or the
client intends to harm a specific person.
18.130
What is the most common basis for malpractice claims against psychotherapists?
For what reasons is this therapist behavior unethical and problematic?
Sexual contact/intimacy. Clients themselves report the experience to be harmful; the
therapist is necessarily putting his/her own needs before those of the client; the therapist is unlikely
to maintain objectivity in her/his treatment decisions and interventions; the therapist is taking
advantage of the fact that the client may be in a state of crisis that impairs their ability to make
sound judgments; and the relationship is exploitative because of me therapist's greater power and
control.
18.131
List the factors that help regulate the practice of psychotherapy.
Legislation, including certification and licensure laws, precedents set by court cases (e.g.,
Tarasoff), and privilege; malpractice lawsuits; third party reimbursement plans and utilization
reviews; ethical standards
453
18.132
What are the four approaches for defining insanity that have been used in state and
federal courts in the U.S.? Describe the central feature(s) of each mle, and indicate how it is used
in the U.S. today.
McNaughton mle: emphasizes the understanding of right from wrong; is used in about 20
states in the U.S.
Durham: emphasizes the presence of mental defect/mental disorder; no longer used.
ALI (aka Brawner): emphasizes defendant's substantial, not absolute, lack of appreciation
for the wrongfulness of an act in terms of cognitive, emotional, and volitional components; used
in about half of the states.
Insanity Defense Reform Act (IDRA): moves burden of proof to defense, omits volitional
component of the ALI, prohibits experts from giving ultimate opinions; used in all federal courts
since 1984.
454