Abnormal Psychology - Test Bank - Fuhr

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 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Chapter 8 Chapter 9 Chapter 10 Chapter 11 Chapter 12 Chapter 13 Chapter 14 Chapter 15 Chapter 16 Chapter 17 Chapter 18 ABNORMAL BEHAVIOR: PAST AND PRESENT PERSPECTIVES ASSESSMENT AND DIAGNOSIS DISORDERS OF INFANCY, CHILDHOOD, and ADOLESCENCE DEVELOPMENTAL DISORDERS AND LEARNING DISABILITIES STRESS, SLEEP, AND ADJUSTMENT DISORDERS PSYCHOLOGICAL FACTORS AND HEALTH ANXIETY DISORDERS DISSOCIATIVE AND SOMATOFORM DISORDERS MOOD DISORDERS AND SUICIDE SCHIZOPHRENIA COGNITIVE DISORDERS PERSONALITY DISORDERS SUBSTANCE-RELATED DISORDERS SEXUAL AND GENDER IDENTITY DISORDERS BIOLOGICAL TREATMENT OF MENTAL DISORDERS PSYCHOTHERAPY ALTERNATIVES TO INDIVIDUAL PSYCHOTHERAPY LEGAL AND ETHICAL ISSUES IN MENTAL DISORDERS 1 33 58 85 110 134 155 181 205 238 263 281 309 339 365 385 410 431 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: Ans. C App p. 217 E * 7. 6 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 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 1. 2 Ans. C App p. 5 E 1. 3 Ans. D Fac p. 5 E 1. 4 Ans. C App p. 5 M 1. 5 Ans. B Fac p. 5 M 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. 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 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 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 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 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. 6 Ans. A App p. 5 E 1 1. 7 Ans. D App p. 5 E 1. 8 Ans. C Con p. 5 M * 1. 9 Ans. C Con p. 5 M 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 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 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 Which humorous Greek is considered the father of medicine? a. Galen b. Hippocrates c. Epictetus d. Aristotle 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 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. 10 Ans. B Fac p. 5 E 1. 11 Ans. A App p. 5 E 1. 12 Ans. C Con p. 5 E 1. 13 Ans. D App p. 6 M 1. 14 Ans. A Fac p. 6 E 1. 15 Ans. B Con p. 6 M 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 "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 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. 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 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 1. 16 Ans. D App p. 6 M 1. 17 Ans. C App p. 6 C 1. 18 Ans. C App p. 6 M 1. 19 Ans. A Con p. 6 M 3 1. 20 Ans. D Fac p. 6 E 1. 21 Ans. B Con p. 6 C 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 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. 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 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 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 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 1. 22 Ans. B Fac p. 6 E 1. 23 Ans. A App p. 7 E 1. 24 Ans. B App p. 7 E 1. 25 Ans. D Fac p. 7 E 4 B Fac p. the strange "magical" treatments carried out in early monastery asylums. therefore I am. 5-7 M 1. Tuke c. 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. and humankind is becoming a topic of study worthy in its own right. D App p. psychological > rational > theological c. A Con p. In what field are you studying? a. 28 Ans. heretics are saying that the sun is the center of the universe. 32 Ans. 7 C 1. philosophy d. 27 Ans. to whom would you mm for humane help? a. advent of humanism c.1. Chiarugi 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. Copernicus d. 7 M Which item does not belong with the other three? a. A App p. supernatural > theological > psychological "I think. clinical psychology b. Plato and Hippocrates b. Copernicus' cosmology You live in a time in which books are becoming more readily available. Weyer b. physical terms. " The author of this phrase asserted that human mental activity could be thought of in mechanical. the name of the city in which the first mental hospital was founded. moral treatment b. family medicine c. b. advent of the printing press d. 29 Ans. Who was he? a. Avicenna and Galen c. d. C Con p. 7 M * 1. Pinel The word "bedlam" derives its meaning from a. the early bedrest treatment used for acutely disturbed patients in asylums. 7 M 1. 26 Ans. psychiatry If you were a mentally disordered person in the 16th century. theological > psychological > rational b. A Con p. Descartes b. Tuke and Pinel d. D App p. Sprenger d. rational > theological > psychological d. 7 M 1. Epictetus c. With whom are you living? a. 7 E 5 . the deplorable conditions found in prison-like Renaissance hospitals for the insane c. 31 Ans. 30 Ans. 1. assisting with the development of a classification system for disorders b. c.. c. d. while less than optimal. the discovery of drags effective for treating mental disorders. contributing to the discovery of the biological cause of general paresis c. an expectation that he would find employment d. What is likely to be the focus of Gregory's efforts? a. In your critique of the mental hygiene movement in the U. the ineffectiveness of moral treatment for severely disturbed patients. and kindness A synopsis of the U. Pinel: France d. b.1. Candide is one of Pinel's early patients. state hospitals resulted in understaffing and eventual custodial care conditions. Emil Kraepelin in the late 1800's. as a result of Dorothea Dix's efforts. A App p. b. the increasing reliance on biological vs social approaches to understanding abnormality. Which treatment would he be most UNLIKELY to receive? a. Chiarugi: Spain b. S. exposure to fresh air. Rush: U. 8 M * Which member of the moral treatment era and his country are mismatched? a.. 35 Ans. The transformation of asylums into U. S. 9 M 1. 8 E 1. A Con p. The treatment approaches taken by the reformers shared the naturalistic assumptions endorsed in the Enlightenment era. the movement was led by a former mental patient who helped form the National Committee for Mental Hygiene. 38 Ans. c. 9 M 1. S. C Con p. 8 E 1. lasting until the 1950's and the discovery of drags. d. sunshine. conducting studies of hypnosis for the cure of hysteria d. B Con p. a release from his chains c. mental hygiene movement should include each of the following statements EXCEPT a. A App p. 9 M 6 . B Con p. 33 Ans. S. bloodletting or purgatives b. 34 Ans. S. Gregory is working for Dr. Tuke: England In your report on the background and outcomes of the moral treatment era. it began an era of humane treatment in the U. its underlying assumptions regarding abnormality were essentially those held by Pinel. which statement should you omit? a. were notably better than the conditions of such institutions in the Middle Ages. treating patients with bloodletting and tranquilizing chairs 1. and Rush. the shortage of staffing and resultant custodial care. you would cite each of the following factors for its decline EXCEPT a. Conditions in asylums of the early 1700's. c. b. Bicetre Hospital in France was the site of the first unchaining of inmates in 1793. 36 Ans. 37 Ans. several large state hospitals were constructed. d. Tuke. mentalistic 1. D App p. psychoanalytic b. D Con p. What is his professional title? a. some physicians were seeking the biological treatments for other mental disorders while Freud was developing the first modern psychological approach. and she also provides psychotherapy. clinical psychologist c. clinical physician b. medical d. and a sense of apprehension. B Fac p. psychiatry. psychiatrist b. hypnotherapy. 41 Ans. Dr. psychological c. personality. hyperalertness. psychological. psychiatric social worker d. psychiatric nurse Dr. 9 M 1. Breuer & the talking cure c. Mesmer & hypnotic anesthesia d. Dmg is a physician who has spent several years in a residency in which he worked with individuals with mental disorders. conducting assessment of intelligence. b. and other characteristics. 10 M 1. 9 M 1. biological d. Esdaile & magnetism b. clinical psychologist d. Which of the following reflects a correctly matched portion of that history? a. 9 E Hypnosis has a history stretching back to the Enlightenment. C App p. d. 44 Ans. psychiatrist 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. C App p. Ramirez works in a local community mental health center. supernatural b. naturalistic. psychoanalysis. What type of professional is she? a. 42 Ans. clinical social worker c.1. cognitive c. biological. supernatural. 11 E 7 . biological is to . 10 E 1. known as a. B Con p. 40 Ans. 39 Ans. c. After the successful discovery of the cause of general paresis. What is this health professional's model of abnormality? a. 43 Ans. psychical conflict therapy. Charcot & treatments for anxiety Hysteria is to general paresis as a. 48 Ans. c. somatic NS. sympathetic d. b. 11 E 1. flashbacks. 47 Ans. 45 Ans. autonomic b. B App p.1. autonomic b. and chemistry of the nervous system. and your adrenaline is pumping. biochemistry d. and other characteristics go together under the label "post traumatic stress disorder". thalamus b. 11 E 1. What is the term for this area of study? a. D App p. Patterns of characteristics such as this are also referred to as a(n) a. like this exam? a. autonomic NS. parasympathetic What portion of your brain automatically regulates breathing. prognosis d. 50 Ans. D App p. Which specific portion of your nervous system is controlling the movements of your hand as you write your answers to mis exam? a. You let out an embarrassing shriek. heart rate. syndrome. neuroscience c. b. sympathetic d. midbrain 1. biocognitive psychology b. c. symptom constellation. B App p. central NS. etiology. C App p. d. C App p. 11 E Hypervigilance. 46 Ans. 49 Ans. sympathetic NS. Viktor is in a graduate program which involves several different disciplines devoted to studying the structure. 11 E 1. somatic c. function. What specific portion of your nervous system is active at this point? a. your heart is racing. and blood pressure so that the rest of your brain can concentrate on other things. neuroanatomy Your peripheral nervous system (NS) contains each of the following branches EXCEPT the a. peripheral You are studying quietly in the library when your best friend sneaks up and surprises you from behind. 12 E 8 . somatic c. medulla d. reticular formation c. emotional numbing. 12 E 1. thalamus c. A App p. central lobe. thyroid. pituitary. Which brain structure might be involved in such a disorder? a. occipital lobe Kitar suffered damage to his cerebellum as a result of an automobile accident. his playing of the violin d. The Four F's of motivation (fighting. 13 E . cerebellum. 13 E * 1. adrenal cortex b. 56 Ans. What structure would this be? a. c. parietal lobe. 12 M * 1. 12 E 1. sometimes during emotionally arousing situations. 51 Ans. D App p.1. To which part of the brain does this refer? a. occipital lobe. 9 1. temporal lobe b. B App p. 13 M 1. Which portion of her endocrine system is most directly involved in the control of such substances? a. reticular formation b. B App p. ability to form and retrieve memories b. 54 Ans. pancreas c. d. 55 Ans. thyroid d! adrenal medulla Atypically short or tall people can probably attribute the distinctiveness of their height to their a. thalamus c. hindbrain. adrenal medulla. d. B App p. maintenance of arousal and attention It is true that you have "eyes in the back of your head". 13 M Narcolepsy is a sleep disorder in which an individual falls asleep without warning. and mating) are primarily controlled by the a. 52 Ans. medulla b. 12 M 1. b. hypothalamus If information that was intended to be relayed to the visual cortex was accidentally misrouted to the auditory cortex by this brain stmcture. A App p. you might "see" noise. c. c. cerebellum. responsiveness to rewarding environmental stimuli c. b. midbrain d. cerebrum d. 57 Ans. C App p. d. hypothalamus Your best friend insists that she has a "sweet tooth" and often craves sugary snacks. 53 Ans. fleeing. feeding. parietal lobe. Which of Kitar's abilities is likely to be impaired? a. C App p. cerebellum b. 63 Ans. Which should it be? Con a. d. dopamine c. 59 For you to read this question. where bundles of their axons form information pathways.1. 14 a. 14 M * 10 . B App p. acetylcholine b. Little is known about the specific behavioral or cognitive effects of identified neurotransmitters. M b. dendrite > synapse > axon > receptor's electrical change Some pesticides are extremely toxic to the human nervous system. axons d. What is the correct order of structures and events you would encounter during the firing of your neuron? a. norepinephrine b. GABA c. causing uncontrollable muscular tremors and convulsions. their chemical messages are carried via App from one neuron to another. Which neurotransmitter is involved in this reaction? a. A following statements about neuron structure and function. 14 either more or less likely to fire. axon > synapse > receptor > dendrite's electrical change b. B patterns. 62 Ans. norepinephrine 1. The binding of a neurotransmitter on a receptor makes the receiving neuron p. 61 Ans. To create this. Neurotransmitters are stored in dendrites and are released into the synaptic cleft when the neuron fires. axon > receptor > synapse > dendrite's electrical change d. 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". 58 Ans. tens of thousands of neurons must fire in several Ans. Neurons are located only in the central nervous system. 14 M Imagine you were a neurotransmitter molecule. synapses E b. D App p. p. 1. synapse > receptor > dendrite > axon's electrical change c. what distinctive part of your brain makes this conversation possible? a. limbic system d. 60 Your study notes from your text reading should include only ONE of the Ans. GABA d. dopamine Yvette was given an experimental drug that made it difficult for her to concentrate and disrupted her sleep and arousal patterns. c. dendrites 1. cerebrum c. acetylcholine d. 14 C 1. A App p. neurotransmitters c. What neurotransmitter was affected? a. midbrain 1. It is a disorder that occurs in approximately one percent of the population. concordant. monozygotic twins b. "If an allele is dominant. formed? a. DNA nucleotides direct the process in which amino acids are assembled into proteins. 16 C 1. 66 Ans. Which of the following is NOT true of this disorder? a. 16 E 1. Blue eye color is a recessive genetic trait. a parent and child c. " Diet sodas have a warning that states. It results in the failure to break down an amino acid found in many foods. A App p. 16 E 11 . 15 M How are proteins. Amino acids direct the production of nitrogen bases which determine which proteins are assembled. C App p. d. genetically predetermined. "Attention phenylketonurics: Contains phenylalanine". both independently contributing to the phenotype. D Fac p. b. D Con p. This means that a blue-eyed person's relevant alleles are a. 67 Ans. "Genes have an indirect effect on behavior through the production of proteins that give rise to various cells' development. D Fac p. and some genes may never be expressed. " c. different. 69 Ans. It is caused by a single dysfunctional gene. Nucleotides direct the production of DNA which assembles nitrogen bases and proteins. polygenic. c. c. c. d. D App p. 65 Ans. Suppose that Dr. b. it must also be a homozygous gene from the mother and the father in order to be expressed. b. alike. monogenic. non-fraternal siblings 1. "Both internal and external events affect the expression of genes. Most human psychological characteristics are a. " b. A classmate has asked you to review her report on genetic influences on behavior. " d. 68 Ans. Which statement would you recommend that she omit from that paper? a. which form and direct the structure of cells. recessive. d. Which family members would be most similar in this characteristic? a. It causes progressive mental deterioration. 16 E 1.164 Ans. Heterozygous chromosomes produce amino acids which assemble the proteins. c. polygenic. b. "Genetic and environmental factors determine physical and behavioral characteristics. Palmer discovered that the impulse to bungee jump was related to a single dominant gene (even though this is an unlikely scenario!). 16 M 1. d. dizygotic twins d. kum b. a study of individuals with the disorder who had been adopted. 18 C Suppose researchers discovered the specific "comedy" gene that influences the ability to tell jokes successfully. Ellis d. 18 E 12 . D Fac p. d. You cannot be certain whether his talent is due to genes or to the environment. A App p. A Con p. chromosome > nucleotide > DNA > gene Which of the following does not belong with the other three? a. Rogers 1. both of whom have the * disorder. a study of the prevalence of schizophrenia in the immediate vs. 18 them to both their biological and adoptive parents. comparing p. Wehr is investigating the role of genetic factors in schizophrenia. 75 Ans. PKU c. 71 Ans. a study of monozygotic twins reared together. A research approach would provide the most compelling evidence for that role? Con a. 70 Ans. 1. children's temperament 1. DNA > gene > chromosome > nucleotide c. b. Any of the above approaches would be equally compelling. 17 E 1. psychoanalysis. d. distant biological relatives of schizophrenic persons. ego analysts. d. behavioral theories. cognitive theories. b. Who would see the misstatement "I loathe you" in place of "I love you" as an indication of unconscious conflict? a. 74 Ans. 18 E 1. If the comedy gene is a dominant allele. Because behavior is affected by both nature and nurture. what can you conclude about his genetic make-up? a. 17 M Which of the following correctly reflects the progression from larger to smaller elements of our genetics? a. Unconscious determinants of both normal and abnormal behaviors are the central concern of a. c. Which Ans. If Javier is an extremely successful stand-up comedian. 72 Dr. c. you can reasonably conclude his ability is genetically determined. Freud c. you cannot determine whether genes and/or environment determined his ability. M b. c. A Con p. If the comedy gene is a recessive allele. 73 Ans. Watson b. B App p. Huntington's d. his ability is necessarily determined by both factors equally. nucleotide > gene > chromosome > DNA d. chromosome > DNA > gene > nucleotide b.1. Her instills guilt for thinking about anything other than her official duties. 19 E 1.. id b. In the end. superego as morality is to . ego d. 81 Ans. B App p. superego. primary defense mechanisms are developed c. 19 E 1. where you are surrounded by a bevy of attractive servants who obey your every whim. What fuels your daydream? a. id. ego d. pleasure principle Captain Janeway's would love to spend hours frolicking with her new bridge officer. A App p. id c. ego b. ego introjection b. 19 M 1. Janeway's decides to review critical systems' maintenance plans with Lt. 80 Ans. 77 Ans. superego c. ego. 76 Ans. You found a nickel near your desk in class. ego. id. 78 Ans. ego Any decent human being would attempt to find the owner of lost money. the ego begins to develop You are debating whether to study for your upcoming psychology exam or go out and gorge on pizza and beer with your friends. id. 19 E 13 . superego. Yalta. D Fac p. your thoughts are far away on a fabulous yacht. superego c. Yalta. repression d. A App p. the fantasy principle Parents begin to shape appropriate personal and social behavior in the first three years of a child's life. Which portion of your personality insists you return it to its rightful owner? a. 79 Ans. id. id b. 19 E Instinct is to a. What portion of your personality made this decision? a. You decide to study for an hour and then get a pizza delivered for you & your roommate. What is the fundamental effect of this influence on her/his personality? a. a. id. aggressive instincts develop d. 19 M * 1. While sitting through a dry lecture in class. Lt. followed by dinner in 10 Forward. superego b. D App p. superego d. superego. libido c. the superego's moral principle develops b. ego. ego c. id d. D Con p. ego ideal 1. ego. 84 Ans. Nothing . unresolved Oedipal complex On the television show Saturday Night Live. anal-retentive b. "Gim'me. c. anal 1. Males and females have similar challenges in the first two stages of development but then diverge in the third stage. orderliness. 20 M 1. 82 Ans. 83 Ans. which statement is incorrect! a. b. regression In regard to Freud's conceptualization of disruptions in psychosexual development. seen as the core of all neuroses. unsuccessful in introjecting parental discipline Danton drinks excessively when he is under pressure from his boss. while her superego says " ". two-year-old Andrea's id says. " The childish mannerisms and simplistic language exhibited by some psychotic adults represents according to Freud. 20 M 1. D App p.it has not formed y e t : "Sugar's not good for your teeth. phallic b. absence of defense mechanisms c. a. 20 E 14 .1. A Con p. oral c. an id defense mechanism d. B App p. " ". "Do I get some. genital d. C App p. and perfectionism in the kitchen. and when you get them back the tops look like they've substituted for chewing gum! According to the psychoanalytic theory. oral fixation b. how would you 'diagnose' your friend? a. 20 E 1. 86 Ans. d. 87 Ans.It has not formed yet. He abandoned the sexual "fantasy" theory to propose that adult disorders were connected to experiences of molestation as a child. 19 M Watching her dad take cookies out of the oven. D App p. d. a chef character is known for his obsessive cleanliness. Which of the following descriptors does NOT apply to him? a. ": "I'm a good girl & don't need cookies. orally fixated d. an inferiority complex c. In what stage did this character become fixated? a. Daddy. "All m i n e ! " : nothing . C App p. Your best friend borrows your pens & pencils. a. " c. He proposed that symptoms of mental disorders in adults are indirect expressions of longterm sexual fantasies and conflicts. unsuccessful in resolving the Oedipal conflict c. Daddy? I'll share with you. The particular stage at which conflicts with parents and the larger social world occur shapes the kinds of symptoms an adult displays. lots. repression b. now!!": "Could I please have a cookie?" b. 85 Ans. 19 E 1. regression d. D Fac p. 1. dominant male What is the correct order of psychosexual development? a. anal: plumber d. b. style of life b. 94 Ans. E b. 20 M 1. "No. the importance of childhood experiences in shaping adult behaviors. oral: gossip columnist c. oral > anal > phallic > latency > genital Contemporary psychoanalytic theorists have substantially disagreed with Freud on each of the following issues EXCEPT a. introjection. will young Tamara most fully resolve her Electa complex? a. Marco also wants to be "just like my Dad" when he grows up. How. 20 C 1. the centrality of unconscious processes. 93 Ans. d. * c. 88 Ans. anal > oral > genital > latency > sexual c. genital: construction worker b. 20 a. superiority strivings b. B App p. 89 Ans. 21 E According to Freud. by identifying with her father b. He is in which psychosexual stage? a. A Con p. known as p. 91 Ans. the Electa complex. you can't touch it. 20 M 1. C App p. " This App Freudian-inspired joke implicitly refers to the young male's fear. anal b. you already broke yours off. phallic c. anal > phallic > latency > puberty > genital d. oral d.1. adaptive social interest 15 . d. B to the young female. by marrying a virile. latency Given that psychosexual stages affect adult behavior. c. by having a child d. penis fixation. oral > anal > phallic > genital > latency b. 20 E 1. A Con p. psychosocial crisis c. 92 Ans. young females feel inferior to and envious of males. an emphasis on internal vs social influences on behavior Which of the following concepts does not belong with the other three? a. B Con p. then. 20 M Marco is four years old and enjoys mimicking his Dad around the house when he's working. 90 Two young children are changing into their swimsuits and the young male says Ans. phallic: surrogate mother 1. which stage and "fixated" adult occupation or activity are incorrectly matched? a. by identifying with her mother c. castration anxiety. instincts as the primary motivation for behavior. 98 Ans. What is the term for your client's reaction? a. D Fac p. Adler's d. fixated association The therapeutic goal of "re-parenting" in order to help a client form healthy. object relations b. A Fac p. "At what stage of psychosexual development did a possible fixation occur?" c. behavioral d. As an adult. 100 Ans. ego analytic c. cognitive Dr. Which theory would most clearly explain the origins of this lifestyle? a. a psychoanalyst. but is not one of them. C App p. a. C App p. which question might you ask? a. exploring transference Last week you had to cancel an appointment with your client. introjection b. 96 Ans. B App p. 97 Ans. Today. challenging irrational beliefs c. 21 E 16 . object relations 1. 21 E 1. planning and instigating the downfall of his competitors. "What sense of inferiority does she harbor from her childhood?" b. social modeling c. 95 Ans. learning d. adult psychopathology can be traced to early disruptions in attachment to caregivers or a failure to achieve secure independence. interpreting dreams b. a. cognitive b. 21 M 1. the client accuses you of not caring about her and abandoning her. 21 M 1. projective identification c. Mahler's If you were to try to understand a client's difficulties by comparing her experiences to the theory proposed by Erikson. he has devoted a great deal of time to 'cutthroat' business tactics. 21 M * Than was bullied by several schoolmates when he was in elementary school. encouraging free association d. Erikson's c. secure adult relationships is the primary focus of therapy. Jung's b. "Does she have a healthy balance of connection and autonomy in her relationships?" d. 99 Ans. a. would employ several techniques in her work. transference d.1. D App p. 21 E 1. Eve. You are aware that these same feelings were often experienced in her interactions with her parents. "Did she develop a sense of trust in her earliest stage of social crisis?" According to theorists. social modeling d. negative reinforcement 1. B App p. consequence) of learning are most clearly outlined in the work of a. c. helplessness) by associating your actions with their environmental consequences (e. operant c. not wanting to be around him when he was intoxicated. 101 The law of effect is most similar to which Freudian concept? Ans. what operant process is occurring for your behavior? a. Pavlov. D App p. fixation * 1. negative reinforcement b.. A App p. punishment c. A a. 22. 22 E If you learn an abnormal behavior (e. 19 c. classical d. When he drank alcohol. he found he didn't think about these problems and his wife and family left him alone. what process accounts for this learning? a. and negative reinforcement makes a behavior likely to reoccur. g. C Con p. 106 Ans. 104 Ans. libido p. 102 Ans. Skinner. extinction Martine was laid off from his job. respondent b. pleasure principle Con b. 22 M 1.1. 103 Ans. Positive reinforcement makes a behavior likely to reoccur. less d. Watson. less. a. modeling The ABC's (antecedent. less. 105 Ans. What learning process accounts for Martine's developing alcohol abuse? a. was having a great deal of conflict in his marriage. 22 M 1. 22 M * 17 . g. more. and his family was frequently trying to give him advice. D Fac p. others take care of your needs for you). more. Thorndike. punishment c. more c. behavior. more When you take out the kitchen trash in order to stop your spouse's angry glare. positive reinforcement d.. 22 M 1. b. less b. reality principle C d. d. classical conditioning b. she just went hungry.. 110 Ans. her irrational. This means a. law of consequence b. When she gets 10 stars. her therapist and family will positively reinforce optimistic statements and punish the negative ones. negative statements will be challenged by her therapist and family. C App p. c. positive reinforcement c. "Nothing will ever get better") are subjected to extinction by her therapist and family. negative reinforcement A snack machine in the psychology building occasionally kept a professor's money without dispensing any snack. tone d. B App p. In Pavlov's original studies of classical conditioning. "I'm a hopeless case". negative reinforcement b. the association between the unconditioned stimulus and the conditioned stimulus d. 107 Ans. d. B Fac p. 22 E 1. b. her classically conditioned responses will be modified by observing the behaviors of her therapist and family. A App p. 22 C 1. extinction c. After a while. 22 M 1. the association of the unconditioned stimulus and unconditioned response b. What consequence occurred for her snack-buying behavior? a. salivation b. food c. g. the association between the conditioned stimulus and the conditioned response 1. law of negative effect A depressed client's negative statements (e. 22 C 18 . her negative statements will be ignored and will tend to become less frequent. what is the crucial association upon which learning is based? a. punishment d. 109 Ans. negative punishment d. 111 Ans. 22 E Miranda's parents put gold stars on a chart on the refrigerator every time she puts her toys neatly away. the association between the neutral stimulus and the conditioned stimulus c. what was the unconditioned stimulus? a. 108 Ans. What operant process is taking place? a.1. alerting responses In classical conditioning. C Con p. she gets to go to a movie. 22 E 1. classical conditioning Mary Cover Jones provided an early example of the effective use of a. S b. 23 E 1. A Con p. how would you label that discomfort? a. 112 Ans.1. behavioral > psychoanalytic > cognitive c. If you find yourself with an unpleasant reaction to this imagined scene. d. b. psychoanalytic > cognitive > behavioral d. and R=response. conditioned response c. a strong puff of air to the eye b. 22 M Close your eyes and imagine that you are sitting in a dentist's chair. B App p. b. shivering in cold weather c. R d. cognitive c. the work of Watson and Rayner indicated that children's fears can be caused not by unconscious conflict but by a. 19-24 E 1. object relations therapy. the Stimulus. a. and the cavity she's drilling is in an area that isn't completely numb. 24 M 1. cognitive > psychoanalytic > behavioral An emphasis on the active information processing of internal and environmental information is the primary concern of the theories. irrational cognitions. 0=organism. c. B Fac p. All three elements apply to both kinds of theories. B Con p. social modeling. O c. 24 E . 118 Ans. 115 Ans. 116 Ans. 22 M * 1. family therapy. However. 114 Ans. unconditioned stimulus d. C Fac p. behavioral d. operant conditioning. In S-O-R terminology. 117 Ans. A Con p. Which element distinguishes cognitive theories from learning theories? a. unconditioned response Which of the following is an unconditioned stimulus? a. Freud might interpret this as an unconscious fear of the child's father. sociocultural b. 113 Ans. d. psychoanalytic > behavioral > cognitive b. conditioned stimulus b. c. behavior therapy. a telephone ring Suppose a five-year-old child has a phobia of horses. biological 19 1. Historically speaking. salivation to the thought of biting into a sour lemon d. what is the chronological order of the following psychological theories? a. cognitive therapy. D App p. a common reaction during this Oedipal stage. external. direct conditioning. vicarious conditioning. internal attribution c. attribution. c. 120 Ans. R d. global If the S-O-R model is defined as S=stimulus(environment). global d. 24 M 1. which element is most important to Albert Ellis? a. d. trial-and-error learning. 124 Ans. O c. 123 Ans. 0=organism(cognition). c. if Cesar does not approach an attractive person and ask for a date because he believes he will make a poor first impression. A App p. catastrophic "You look very nice today!" A person who hears this and thinks to her/himself. Which pattern of attribution is evident in the statement. C App p. observational learning According to Bandura. All are equally relevant in his theory. internal. stable. cognitive-behavioral learning d. classical conditioning c. specific c. 24 E Observational learning could also be thought of as a. external. b. stable. Shandra has watched her sister express a great deal of fear whenever large. appraisal. B Con p. 24 M 1. 122 Ans. expectancy conditioning. which of Cesar's expectancies is impaired? a. "I can't leam chemistry because the instructor covers too much material too fast"? a. b. self-efficacy b. I do look pretty awful most other days" and then feels very despondent is exhibiting a dysfunctional a. conditioned response. noisy dogs come close to their yard. B App p.1. D App p. 121 Ans. What process accounts for Shandra's developing fear of such dogs? a. 25 M 20 . global expectancy. temporary. "Yeah. d. self-appraisal d. S b. and R=response(behavior). internal. C Con p. 25 M 1. operant conditioning b. 25 M 1. global b. 119 Ans. 1. temporary. Which theorist's model is guiding your therapist? a. While the daughter was more talented and more interested in dance. Maslow c. attention to environmental consequences for behavior c. condition of worth. Aaron Beck c. Sullivan.1. conditioned response. at the regional competition. ego: congruence Conditions of worth is to unmet needs as is to a. an emphasis on the self b. 1. 26 E 1. defense mechanism: incongmence d. c. 129 Ans. id: self-actualization c. Maslow. she acquiesced in order to gain his approval. D App p. C App p. Julian Rotter b. 130 Ans. humanistic d. b. d. Albert Ellis What clear similarity is found between cognitive and phenomenological theories? a. In other words. D App p. What theory guides your thinking? a. her father encouraged her to sing instead of dance. reflected appraisal. B Fac p. 26 M 1. the father's suggestion was a a. Carl Rogers d. Ellis d. 25-6 M 1. 128 Ans. Perls . attention to styles of interpersonal interaction You are a psychologist who conceptualizes depression as the result of frustrated attempts to achieve one's potential for growth and congruence. 26 M 1. sociocultural A junior high female won an award for an improvisational dance in her 4-H club at school. 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. interpersonal c. 126 Ans. Rogers. Beck. 127 Ans. However. a belief in self-actualization d. Rogers b. 26 E 21 . B Con p. Which of the following concepts is INCORRECTLY paired? a. negative reinforcer. 125 Ans. superego: conditions of worth b. A Con p. cognitive b. In explaining the origin of anxiety disorders. social relativism d. self-actualization. to permit your clients the freedom to explore their full range of possibilities. dependent personality disorder. interpersonal equity d. 134 Ans. 26 E 1. d. 27 M 1. b.1. generalized anxiety disorder. 26 M * 1. sociocultural c. which theory does NOT belong with the other three? a. c. 133 Ans. b. behavioral drift b. Adrian wants to take care of someone and be her sole source of emotional support. 27 M You are a therapist who believes that it is your role to provide unconditional acceptance. interpersonal Duretha is a sociocultural psychologist. B Fac p. and his girlfriend wants someone who will look out for her and save her from her abusive family. Epidemiological researchers have discovered that acting-out behaviors and poor impulse control are more common in cultures that tolerate and reward aggression. 136 Ans. 27 E 1. reciprocity b. paranoid schizophrenia. she might emphasize a. interpersonal styles. C App p. they are unwilling to end the relationship. D Fac p. social causation 1. D App p. counter-transference In regard to the origins of disturbed behavior. This finding most clearly supports the explanation of disordered behavior. A App p. psychoanalytic b. clinical depression. C App p. rapid technological change. Harry Stack Sullivan would provide a theoretical framework most useful in working with people who exhibit a. congruence c. 135 Ans. you intend to help your clients achieve a. b. a. distorted perception and memory processes. 131 Ans. behavioral d. social selection c. c. 27 E 22 . operant contingencies. In other words. While both have become miserable in this relationship and are mostly unaware of the needs of the other person. conditions of self-worth. positive self-appraisal. c. d. d. phenomenology. What term applies to this situation? a. 132 Ans. social drift b. Sullivan d. 140 Ans. windigo b. problems in living b. 139 Ans. 1. Helzer c. c.1. According to Szasz. B Con p. social relativism c. incongruence d. 28 E 1. its irrelevance for an understanding of the impact of psychiatric diagnosis. what is the most appropriate description for this person's difficulties? a. 28 E 1. C Con p. 28-9 C 23 . selectivity. 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. Which outspoken advocate of the sociocultural perspective asserts mat these labels turn "problems in living" into illnesses needing professional treatment? a. 28 M 1. 28 M * 1. Szasz A person who lives in a country marked by political upheaval. causation. Rosenhan b. 137 Ans. 141 Ans. and inadequate health care may become depressed or anxious. b. 142 Ans. relativism. anorexia nervosa c. 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. d. d. social causation The criterion by which "abnormality" is defined as "not culturally expected" would be most sharply criticized by sociocultural psychologists who emphasize social a. 138 Ans. ongoing and sometimes worsening difficulties experienced by people who have never been labeled. social inequity d. mental disorder but not mental illness c. A App p. c. its essential rejection of the biological model. schizophrenia d. B Con p. environmental pathology You could criticize the social labeling perspective for each of the following reasons EXCEPT a. A App p. alcohol abuse There is a stigma associated with many of the diagnostic labels used by psychiatrists and psychologists. differentiation. a lack of explanation for the origin of problematic behaviors. a shortage of jobs. b. D Fac p. what explanation is this person endorsing? a. C App p. 145 Ans. Given this diathesis. the combination of that tendency and the stressors could cause depression. D App this lack p. Either Rene's response to events or the events themselves will be sufficient to cause depression. the testing of specific hypotheses with operational definitions Bryce. vulnerability-event model b. social c. the organization of his findings into a theory c. victim of a violent attack). 143 Ans. Jerrod insists that his explanation for the psychological cause of depression is based on the scientific method. C App p. 29 E 1. 30 M 1. Rene probably inherited depression from his parents. 146 Ans. it is likely that Rene will experience depression regardless of life circumstances. operational definitions c. What model is represented in this hypothesis? a. his collection of empirical data b. b. diathesis-stress model Due to both biological and family influences. which of the following criteria is NOT relevant to evaluating his explanation? a. 147 Ans. exposure-response model d. additive-factor model c. and explanations that will result from this work? a. 31 M 1. the correlational evidence demonstrating the relationship between cause and effect d. A App p. c. C App p. If relevant stressors occur in Rene's life. a hypothesis b. What is the appropriate term for the set of ideas. is developing her ideas about how parenting styles influence children's development of oppositional defiant disorder.. community d. What kind of psychologists are these? a. If so. d. g. What would you predict about Rene's vulnerability to depression? a. a theory d. a clinical researcher. interventionist 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. 144 Ans. an experimental design 1. 31 E 24 . epidemiological b. predictions.1. 29 M A group of psychologists is discussing ways in which juvenile delinquency can be prevented before it starts. Rene has a tendency to respond to unpleasant events with passivity and pessimism. secondary The Head Start program for disadvantaged preschoolers is what form of prevention? a. tertiary: treatment impact b. In his work. " b. The progress in scientific understanding of abnormality is slow. secondary d. tertiary 1. 150 Ans. cautionary d. What kind of prevention does this represent? a. intermediary b. c. tertiary c. a. D Con p. secondary: selective impact d. " c. The collection of empirical data is common to both the correlational and experimental methods. tertiary: developmental impact Dr. b. "Effectiveness of group therapy was evaluated for patients with severe psychopathology. secondary c. tertiary b. Which description below reflects an operational definition? a. 32 M 1. " Passing federal laws mandating what states must include in their public school curriculum in response to the AIDS crisis represents prevention. C App p. B App p. 32 M 1. 152 Ans.1. primary: universal impact c. evolving from the interplay of theory and hypothesis-testing. B App p. "Participants in the study were observed for signs of anxiety and fear. primary c. Moulding is a developmental psychopathologist. A Con p. 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. 31-4 M * Which of the following statements does NOT characterize the scientific method? a. 151 Ans. " d. 32 M * 1. harmful acts. The abstract concepts of a theory must be operationally defined before being evaluated in a specific research study. 148 Ans. 149 Ans. C App p. 153 Ans. d. "Aggression was measured as a frequency of violent. 32 M 25 . anticipatory b. "Depression was assessed by scores on the Minnesota Multiphasic Personality Inventory. primary d. 31 C 1. primary Which of the following pairs is INCORRECTLY matched in regard to prevention? a. A single well-designed and appropriately conducted study provides conclusive evidence for a given theory. 33 E 1. Knowing that a child has ADHD allows you to predict something about her difficulties in learning. learning disabilities tend to decrease. manipulation b. a. c. As household income increases. What can you conclude about these two variables? a. b. dependent variable. 33 M In an experiment measuring the effects of positive reinforcement on the frequency of prosocial behaviors in conduct disordered adolescents. conduct disordered behavior Shandra is conducting an experiment on the effects of caffeine on anxiety symptoms. Learning disabilities lead to ADHD. 157 Ans. 158 Ans. 33 M 1. correlation . 160 Ans. b. B Con p. c. negative correlation d. measurement. A App p. hypothetical c. g. By what process should she assign her participants to groups? a. anxiety increases. rapid breathing. 159 Ans. independent variable. dependent variable c. 156 Ans. positive correlation b. As household income increases. prosocial behaviors d. Reductions in household income cause increases in anxiety. 34 E . C App p. the IV is and the DV is . random assignment b. A App p. independent-dependent correlation c. As ADHD symptoms increase. A App p. As the neurotransmitter GABA increases. how would you characterize this relationship? a.1. prosocial behaviors. Cause is to as effect is to a. the group of adolescents. C App p. positive reinforcement. correlational b. 1. quasi-experimental If household income and anxiety were negatively correlated. d. What kind of relationship is this? a. experiment. positive reinforcement. 154 Ans. what approach would he use? a. positive reinforcement b. the control group c. non-manipulated assignment 26 1.. control procedure c. symptoms of anxiety (e. 33 M * If Emilio wanted to measure the relationship between marital income and marital dysfunction. difficulties in concentration) decrease. ADHD causes learning disabilities. d. An increase in household income causes reductions in anxiety. sweating. quasi-correlation There is a strong positive relationship between attention deficit hyperactivity disorder (ADHD) symptoms and learning disabilities. 33 E 1. manipulation d. random sampling d. 33 M 1. 155 Ans. anxiety decreases. C App p. experimental d. lack of a control group 1. biased assignment to groups b. 163 Ans. a lack of a manipulated IV c. c. double-blind condition d.1. 33-6 M 1. some randomly-assigned participants receive a "mocktail". 35 M 27 . quasi-experimental. experimental b. For what central reason should you NOT attribute these group differences to genetic influences? a. a new drug. experimental. operational d. b. D Fac p. What problem is present? a. implications for discriminatory or racist practices. and you would use a(n) approach to evaluate whether certain styles cause more severe depression. D App p. On average. However. Behavior genetics research estimates within-group nature/nurture influences and cannot explain differences between groups. correlational c. a. quasi-experimental Controversies surrounding genetic explanations of behavior are related to each of the following factors EXCEPT a. d. 164 Ans. In a study of the effect of alcohol on coordination and problem-solving. the "mocktail" group showed more errors on the dependent variable compared to a group that received no beverage. b. Woodward is conducting an experiment to evaluate the effect of clozapine. C Con p. Adoption studies have shown that environmental factors are more important than genetic factors in determining group differences. measurement of the effect of the dependent variable b. African Americans' IQ is lower than that of European Americans. c. 162 Ans. who in turn have a lower IQ than do Asian Americans. a history of disturbing abuses of research used to eliminate "inferior" individuals. the anticipated neglect of environmental and social factors. You would use a(n) _ approach to evaluate which styles are most closely related to depression. 34-5 M * 1. correlational. correlational. A App p. 34-5 C 1. d. a beverage without alcohol. C App p. random assignment to groups You are a researcher investigating coping styles and depressive disorders. and others receive a beverage with the alcohol taste disguised. as a treatment for schizophrenic symptoms. the assertion on the part of behavioral geneticists that biological interventions are sufficient. 161 Ans. placebo effect d. 34 E Dr. 165 Ans. Which of the following aspects will NOT be useful for this study? a. a placebo control group c. The polygenic factors associated with intelligence have not yet been identified and thus not yet compared across groups. Such an explanation would rule out social and environmental factors and thus fuel fires of racism and discrimination. 1. placebo effects. 35-6 M 1. This is true for each of the following reasons EXCEPT the a. A Fac p. c. 36 C You might choose a quasi-experimental approach under each of the following conditions EXCEPT a. S. The discipline of psychology itself works within the assumptions of science developed over the last 400 years. given the preponderance of excessively thin. 169 Ans. 36 E SHORT ANSWER / ESSAY 1. b. representative c. The growing understanding of genetic factors will require thoughtful consideration of this factor. Most 28 . when the IV cannot physically be manipulated It is not actually possible to conduct direct experimental studies of the causes of psychological disorders in clinical research subjects. 167 Ans. when manipulation of the IV presents a serious ethical violation d. inability to rule out all possible confounds in a single study. Caucasian models in the popular media. 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. inability to employ random assignment. Rohi is planning to conduct a study on eating disorders in the U. manipulated variables d. replication b. confabulations. the use of increase(s) the confidence one can have about the hypothesized effects of such studies. B App p. when participants cannot be assigned randomly to groups b. Cultures that value science tend to produce more compelling explanations for disorders and more effective interventions. B App p. He hypothesizes that European American females will be more likely to exhibit this disorder than will African American females. diversified d. 170 Explanations for the behavior of persons like Nelson. a. What kind of sample will he need? a. described in the chapter. B Con p. Because quasi-experimental designs cannot rule out as powerfully as true experiments can. Describe these and give an example of how a contemporary student of psychology might employ them to understand abnormality. inability to ethically manipulate the hypothesized causes. will depend importantly on several factors that stem from one's culture. representative samples c. reiteration Dr. 166 Ans. confabulations. d. 36 M 1. inability to operationally define the relevant variables. confounds. normative b. The importance one's society places on science and on religion affects views toward abnormality. responsive 1. when you have an insufficient number of participants for a study c. 168 Ans. behavioral) is most accepted. making eventual science of psychology possible Weyer: strong advocate of compassionate treatment for bodily illnesses.generally. S. it became clear that such treatment was not sufficient to address the needs of severe mental illnesses. Freudian. drawing attention away from psychosocial characteristics. 171 Describe the historical contributions of four persons. supernatural causes of abnormality.. the discovery of the biological cause of general paresis sparked a strong movement toward the identification of the biological/genetic causes of other disorders. emphasizing that final answers to questions of abnormality will not be found. 29 . demonological. the state hospitals became overcrowded and understaffed. including abnormal behavior. prior to 1900. moral (or humane) treatment was. ushering in the moral treatment era Rush. in essence. Chiarugi. ? For what reasons did this era end? Philippe Pinel instigated moral treatment in France by unchaining his first "inmate" in 1793. Too. leading to a renewed tendency to offer only custodial care for the mentally ill. Aristotle: emphasis on empirical method. fatally flawed. Who instigated this approach and when? Which person was instrumental in its introduction to the U. The deplorable conditions in asylum at that time were significantly improved by Pinel's encouragement of compassion. 1. Dorothea Dix was instrumental in convincing states to construct mental hospitals for the specialized care of disordered individuals. provided basis for Galen's synthesis of biology and psychological temperament Avicenna: helped preserve the Greek scholarship during Europe's Dark Ages. 172 Despite its early promise in France. the time and place in which one lives out one's life will importantly influence which model of abnormality (e. collecting of environmentally-available information to understand abnormality Hippocrates: developed biological vs. predictable processes Pinel: unchained inmates at La Bicetre in France. and greater personal freedom. supernatural approach to abnormality. Tuke. implemented moral treatment Kraepelin: establishing first formal diagnostic system for classifying mental disorders 1. Dix: in their respective countries. Plato & Epictetus: stressed rationality & perception vs. strongly criticized the persecution of witches Descartes: Renaissance philosopher providing basis from which to study behavior and mental processes and mechanical. g. Perhaps most importantly. who were significant figures in shaping attitudes toward and/or treatment of mental disorders. attention to work and productivity. however. helped bridge Greek philosophy with Renaissance science. Over time. Human psychological characteristics are also polygenic. 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. with the result that one's phenotype is never identical with one's genotype. I cross the synapse toward a dendrite of the next neuron. briefly indicate what each area contributes. Genetic inheritance and life experience combine interactively to ultimately determine individual characteristics. gene controls their expression. language comprehension & production. In regard to any given disorder individual. If this chemical message makes it to the somatic NS through a network of tens of thousands of neurons. 1. In twin studies. 176 Suppose that thrill-seeking behavior (e. 30 . The action of genes is influenced by both internal and external (environmental) triggers. g. and indicate what kind of chemical message you would be communicating if subsequent neurons sent the message to the somatic nervous system. I will make it more likely to produce its own action potential. even if their disorder has been shown to be influenced by genetics. control human characteristics directly but indirectly through the 'programming' of amino acids are assembled into proteins that form the basis of cell development. we cannot specify the extent to which that factor was instrumental in this person's disorder. For each. bungee jumping of the World Trade Tower) is genetically influenced. meaning that no one.. a voluntary muscle movement will occur. which is the tiny gap between two neurons. I begin in the end of an axon. Genes do not. planning. moreover. 175 Explain why it is misleading to ask whether "nature" or "nurture" is the cause of a particular disorder. 173 List four areas of your brain that are involved in the reading of this question and the writing of your response. in fact. If I bind to a receptor on that neuron's dendrite. 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. It is a commonly-held misconception that genes and environment are separate influences on human behavior and mental processes. What kind of supportive evidence would you expect from adoption studies? from twin studies? In an adoption study. Cerebrum: thinking.1. monozygotic twins would show greater concordance for this characteristic than would dizygotic twins or other siblings. where I am pushed into the synapse. 174 Imagine that you are a molecule of acetylcholine. Describe what happens to you during neural communication. 1. [no modal response predictable] 1. In about the fifth year of life. do it. and I tried Exceeding brand tablets. he has failed to consider the possibility of alternative explanations for the outcome of his action. 178 Describe two behaviors that you have learned through the process of operant conditioning. 1. 179 Heard on a television commercial: "Did I review the clinical research? No. More importantly. It is the task of the ego to balance the competing demands of the id and superego with the requirements of the external world.1. I had a headache. and is often excessively rigid in its demands for "proper" behavior. He has not attempted to collect competing evidence in order to evaluate its validity in comparison to his initial findings. the superego develops. 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. but don't get in trouble. as a child encounters limitations and consequences by interacting with the external world. My headache was cured. Failure to use defense mechanisms or their excessive use results in disorder. When unable to cope effectively. the ego makes use of defense mechanisms that prevent distressing unconscious impulses from reaching consciousness. 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. In the first few years of life. which fuels behavior in accord with the pleasure principle — if it feels good. 31 . 177 How does each component of the personality develop. according to Freud. however. in the phallic stage of psychosexual development. inhibitions. In one example. do it (no matter what the consequence). describe an example of punishment. and mores. That's proof enough for me. It is the psychological residue of parental and cultural norms. " Explain how this approach violates the components of critical thinking. libido. the ego develops as an organized portion of the id which operates on the reality principle — if it feels good. explain the process by which you learned a specific behavior through the process of negative reinforcement. This is a clear example of how NOT to gather information. and in the other. and indicate the general characteristics of the associated research design. ] 32 . experiment should explicitly include random assignment to groups. & a measured DV. 180 Dr. [No definitive response predictable: Correlation should specify direction of the proposed relationship between two variables WITHOUT describing a causal relationship. Be sure to give specific operational definitions for the variables in your hypothesis.1. 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. a manipulated IV. either approach should describe variables in concrete. Develop a correlational or an experimental hypothesis to test to evaluate this theory. measurable terms. A App p. deviance 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. It is unclear what level of personal distress Dolf is experiencing. c. There is no evidence that Dolf has sought treatment from a clinician. B App p. dysfunction d. disorder as statistical rarity d. phobia d. which "disorder" would be omitted? a. panic disorder Some introductory psychology students decided to try a social psychology experiment. a person said with exasperation. you would offer just the definition. staring at the other riders. d. presidents as "mentally disordered"? a. disruptive What definition of abnormality would you most likely be using if you defined all U. subjectively distressing c. she might have been labeled as "disordered". "How can you have so many definitions of mental disorder?". 5 Ans. schizophrenia b. What definition applies in this case? a. A App p. By what definition would they be considered "disordered"? a. dysfunction d. "Why don't you just make it simple?" To accommodate them. what clinicians treat d. disorder as what clinicians treat c. B App p. labeling b. 4 Ans. dysfunctional b. 6 Ans. statistical c. 45 M 2. had a young woman worn a bikini to a public beach. disorder as dysfunction b. disorder as a label 33 2. subjective distress c. S. 44 M 2. 3 Ans. 44 M 2. b. deviation b. The deviance definition of abnormality would define Dolf as "disordered". 45 E . 1 Ans. D App p. autism c. What problem is reflected in this definition? a. They stood in a nearly empty elevator with their backs to the door. a. 44 M ASSESSMENT AND DIAGNOSIS In the 1920's. Failure to conform to social norms does not necessarily reflect a mental disorder. C App p. 44 E * 2.Chapter 2 2. 2 Ans. political If a psychologist employed only the "statistical" definition of mental disorder. This definition would fit only if Dolf is experiencing difficulty in everyday functioning. disorder as deviance Which of the following would in fact be considered a disorder by the labeling definition? a.2. occasional anger. distress c. a. subjective distress b. 45 a. or feelings of fear. Which definition does NOT apply? a. 9 Ans. The official diagnostic system used in North America relies most heavily on which disorder definition? a. 7 A clinician defines "mental disorder" according to the nature of the problems Ans. He does. has an antisocial personality disorder. d. 45 M 2. 45 E It is unlikely that any person has lived a life free from sadness. dysfunction d. disorder as dysfunction b. healthy exuberance and rambunctiousness of childhood. She will fail to define differences in the severity of dysfunction and distress in her clients. What definition of disorder are such persons employing? a. dependent personality disorder c. 11 Ans. B App p. become temporarily depressed when he is caught and put in jail. 45 M 2. C App p. He has victimized many people and feels no remorse for any of his actions. A App p. EVERY person could be considered mentally disordered at some point. She will encounter several problems with App this definition. with this rejection causing harm. 8 Ans. c. subjective distress Ted B. dysfunction c. however. 45 C 2. 12 Ans. disorder as what clinicians treat d. Some clients seek help in order to attain goals unrelated to symptoms of a mental disorder. C b. disorder as label c. deviance d. 10 Ans. harm Some people have argued that children diagnosed with attention deficit hyperactivity disorder are exhibiting the common. according to the definition. It is further argued that these children will ultimately be rejected by nondisordered peers. social phobia b. Which of the following is NOT relevant? p. She will underestimate the presence of disorders among people of lower SES. dysfunction 34 2. Thus. C experienced by clients in treatment. 46 E . deviance b. labeling c. She will ignore some problems by tending to focus on characteristics that are rare. what clinicians treat d. 2. deviance b. D Fac p. Alzheimer's d. D App p. posttraumatic stress disorder. and compare this information to your future goals in order to make a thoughtful decision. b. In order to understand and treat clients. d. all three steps of assessment. you are engaging in the process of a. 46 M 2. 2. the first step of assessment only. A App p. and providing therapy. organizing and interpreting it. were both developed by psychiatrists in the U. 46 E 2. 17 What do the DSM-IV and the ICD-10 have in common? They Ans. What individual costs are associated with the adolescents' demeanor and behavior? You are trying to decide what major you should choose in college. What is the actual level of personal distress experienced by the adolescents? b. and diagnosing.2. Con b. C Fac p. and diagnosing. you go to several departments. or are they annoying? c. b. and planning interventions. Thus. Which of the following is NOT an issue applicable to your chosen definition? a. M d. a clinician must engage in a three-step process of a. c. the American Psychiatric Association c. 46 M Which group publishes the official nosological guide used in North America? a. c. c. diagnosis. gathering test data. classifying a nosology. both primarily employ the deviance definition of disorders. are both guides to the assessment of mental disorders. B Fac p. A App p. the second step of assessment only. C a. Might their characteristics be considered acceptable or common in another social setting? d. B App p. 13 Ans. content validity. 14 Ans. b. gather information about requirements. d. 46 c. conducting preliminary intake interviews and administering and scoring tests. gathering information. interviewing and testing. the American Psychological Association b. the World Health Organization d. 16 Ans. In other words. 2. S. 46 M * 2. Are the adolescents' behaviors harmful to society. obtaining personality and behavior tests. diagnosing. the National Institute of Mental Health You have labeled punk rock adolescents walking down the street as "dysfunctional" and therefore disordered. d. and Canada. nosology. This activity comprises a. 35 . the first and second steps of assessment only. 46 M A bachelor's-level "psych technician" works in a community mental health center. assessment. 18 Ans. diagnosing. 15 Ans. are both systems of nosology. p. When you are evaluating assessment data for a consistent picture about a client. validity and reliability c. d. B Fac p. you are concerned with . its association to scores on established tests of interpersonal suspiciousness and distrust c. c. 47 M . standardization. 47 M * 2. reliability. What form of reliability is most important in this case? a. content c.2. interrater b. 47 C 2. reliability. 46 E 2. content validity. 25 Ans. content reliability b. 20 Ans. accuracy. C App p. What is your next assessment task? a. construct validity d. you are concerned with . when you evaluate that data for its meaningfulness. test-retest d. concurrent validity. internal Which of the following pieces of information would permit you to evaluate the reliability of a pencil & paper test of paranoia? a. comprehensiveness and validity d. internal structure and content Moira took an IQ test last year and took it again last week. develop an organized understanding of the client On which two dimensions are psychological assessments evaluated? a. Wan met with Nena and diagnosed her with an anxiety disorder. 22 Ans. concurrent Dr. a. internal c. b. 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. Dr. 21 Ans. evaluate the reliability and validity of the assessment instruments c. 46-7 M 2. 23 Ans. objectivity. A App p. D App p. Tu met Nena and diagnosed her with a mood disorder. reliability and utility b. A App p. what sort of reliability would be most important to you? a. 24 Ans. reliability c. test-retest d. arrive at a diagnosis d. a comparison of answers on one half of the test to answers on the other half b. whether it can predict interpersonal conflict in the future In a study in which observers measure a child's prosocial behaviors in the classroom. D Con p. 19 Ans. compare test results to DSM nosology b. The clinicians have a problem with a. whether the results from two persons who score the test are in agreement d. 46 E 2. interrater b. validity 36 2. A App p. internal reliability. content d. concurrent validity. If Amee's friends also report that she is often edgy. predictive validity. construct M b. Developers of The Inventory to Diagnose Depression. 29 Ans. 28 Ans. 47 M * A test of chronic anxiety can identify who is most likely to later develop cardiovascular disease. and apprehensive.2. 30 Ans. then this MMPI scale demonstrates a. 47 M 2. construct reliability. internal reliability. This demonstrates the validity of the observational ratings. predictive c. internal d. 26 Ans. 27 If you believe that the test you are currently taking does not adequately Ans. concurrent b. b. predictive b. internal Results on the MMPI's Psychasthenia scale indicate that Amee is very anxious. internal d. fidgety. assert that their instrument covers DSM criteria more fully than does the BDI. construct d. the Hopelessness Scale is one of the most useful tests currently available for this assessment. content d. concurrent b. 47 M 231 Ans. content 2. C represent the material that has been covered in class. 47 a. B App p. construct 2. a. Observational ratings of schizophrenic behaviors are positively correlated with the MMPI's Sc scale. c. concurrent b. content c. construct c. What sort of validity is at issue here? a. D App p. A App p. d. predictive While it is difficult to assess future suicide potential. 47 M 37 . concurrent 2. What type of validity does this test demonstrate? a. test-retest c. what element of validity App are you addressing? p. D App p. however. predictive c. 47 C The Beck Depression Inventory (BDI) is commonly used in studies of depression. A App p. Which of the following validities is important here? a. predictive c. validity 38 . B App p. internal validity d. validity without having . 47 M Dr. D Con p. reliability c. consistency. validity. In other words. what validity coefficient would you find? -. forecastive Which of the following coefficients reflect the highest internal consistency? a. a. reliability. he will need assessment instruments that measure attitudes and behaviors that are related to later violence. c = . predictive validity b. 70 One cannot predict intelligence from a person's shoe size because these variables have little relationship. +. A App a. c = +. 47 M 2. 47 C * 2. 62 b. 75 c. 34 Ans. +. meaningfulness. What type of validity must this assessment demonstrate? a. 47. consistency c. r = +. Which expression below MOST accurately describes this relationship? a. internal b. +. -1. B App p. Now. 37 Ans.2. 00 d. D App p. 03 c. 47 M 2. -. 36 Ans. reliability b. conducting initial studies to determine the validity of this instrument. validity d. r = -. 00 d. 37 c. 20 b. validity. 9 M 2. a. 32 Ans. C Fac p. 2. +. construct c. 88 If higher scores on a depression inventory are strongly associated with lower scores on a measure of optimism. 14 An assessment instrument can have a. content validity. descriptive A psychologist is developing an assessment instrument for "optimism". 38 Ans. concurrent d. p. 35 Ans. 47 E 2. 62 b. consistency. +. She is. which she believes will predict effective coping under conditions of extreme life stress. 47. To do so. 05 d. Whiteley wants to develop a program to prevent domestic violence. concurrent d. 9 M * You checked your watch an hour ago and it said 8: 15. it still says 8: 15. your watch has but not . 33 Ans. therefore. reliability. B App p. content b. 43 Ans. true positive b. false positive c. 49 M As a graduate student. 42 Ans. A App p. false positive: incorrect decision that no diagnosis should be made Which diagnostic decision outcome would support the arguments made by the "disorder as a label" critics? a. false positive d. Which of the following is the best candidate? a. it will correctly diagnose Eleni. a. specificity. the test for Alzheimer's disease produced a result. C Con p. 49 E * 2. naturalistic observation 2. A App p. 49 M 2. was diagnosed with Alzheimer's disease when in fact he was experiencing major depression with melancholic features. content validity. false negative d. true negative: correct decision that no diagnosis should be made b. predictive validity c. true positive b. life record b. C App p. sensitivity Richard. B App p. true negative c. unstructured interview c. In other words. 49 E 39 . family ratings of children's temperament c. What assessment will be most useful to you? a. specificity b. 49 M 2. 41 Ans. nonspecific Which of the following terms and outcomes are incorrectly matched? a. if it has good . Dorcha will not be diagnosed as schizophrenic.2. false negative 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. peer ratings of children's aggressiveness d. measurement of family socioeconomic status Eleni. a schizophrenic patient. and Dorcha. objective test d. D Con p. sensitivity. 44 Ans. level of family conflict b. If the test has good . a. false negative: incorrect decision that no treatment is needed c. 48 E 2. diagnostic sensitivity: correct decision to assign a diagnosis d. 39 Ans. sensitivity d. a 70-year-old male. validity. you are working with elementary school children who are at risk for juvenile delinquency. both took a new test for schizophrenia. her nondisordered sister. 40 Ans. b. 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. Several structured interviews are available for various populations. 50-3 E 2. 51 M . mental status examination: structured interview In a student's review of the strengths of the interview method of assessment. The Diagnostic Interview Schedule . 47 Ans. Psychopathology Checklist Revised b. d. 49 M Dr. conduct an interview c. norm referenced. and diagnostic categories. 40 2. d. 51 Ans. Halstead-Reitan Battery: neuropsychological test b. The Schedule for Affective Disorders and Schizophrenia As a prison psychologist. B Con p. 50 E 2. Interrater and test-retest reliability tend to be. b. 50 Ans. personality inventory. standardized. which of the following instruments would you choose to conduct an initial screening of mental illness in inmates? a. 50 M 2. Rogers Psychopathology Screening Scale d. c. C App p. carry out controlled and participant observations d. c. B App p. Clinicians usually prefer the greater reliability and breadth of information provided by unstructured interviews. The Referral Decision Scale The mental status examination is a type of a. ages. 45 Ans. reliable. 50 C 2.2. intelligence test. Bernstein plans to employ several different assessment methods to understand his new client. Structured Diagnostic Inventory c. Which of the following assessments and classification are incorrectly matched? a. 49 Ans. c. 70 or greater. Interviews are a relatively inexpensive and flexible means by which to gather information. 46 Ans. WAIS-R: intelligence test d. b. which statement should be omitted? a. A Fac p. MMPI: projective personality test c. an acceptable level of consistency. structured interview. what will he do? a. C Con p. 48 Ans. valid. The Diagnostic Interview Schedule d. 51 M * 2. conduct an intelligence test Which structured interview would you use if you wanted to conduct a multi-site epidemiological study and your research assistants were nonprofessionals? a.Prison version c. ask the client to complete a structured personality test like the MMPI b. If he begins with the most commonly used tool. Structured Clinical Interview for DSM b. neuropsychological battery. D App p. D App p. d. Tactual performance test -. A Con p. 52-3 M 2. Millon Clinical Multiaxial Inventory-II and the MSE d. 53 M 41 . 52-3 M 2. providing his counselor with a measure of Reggie's a. MMPI-A d. A App p. b. such as schizophrenia b. Rorschach Inkblot c. brain dysfunction associated with some form of dementia. Categories test ~ ability to form abstract concepts b. 51-2 C 2. and the tactile perception test. 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. Incomplete Sentences b. WRAT and WAIS-R c. d. D App p. little or no appetite. C Fac p. a psychotic disorder. d. A App p. 51 E 2. Clara is a patient in a geropsychiatry unit of a state hospital. b. c. Doria-Kansas Battery. intelligence. c. The Diagnostic Interview Schedule 2. dysphoric mood. 57 Ans. a disorder of childhood. trail making test. attitude and interests. which of the following assessments would demonstrate the lowest reliability? a. Which potential disorder might the examiner suspect? a.accuracy of reproduction of forms and simple spelling c. 51-2 E Reggie took the Stanford Binet test. In order to evaluate the possibility of depression vs. such as mental retardation d. 52 Ans. an anxiety disorder. WAIS-R. such as attention deficit disorder Which Halstead-Reitan Battery test and its focus of assessment are incorrectly matched? a. Wide Range Achievement Test. Aphasia screening test -. 53 Ans. what two tests would be most useful? a. 54 Ans. personality. MMPI and Halstead-Reitan b. a cognitive disorder. She could consider using any of the following tests EXCEPT the a. achievement and aptitudes. 56 Ans. Finger tapping test — kinesthetic perception and auditory attention d. and deficits in language production and comprehension. sensory-perceptual exam.2. B App p. Halstead-Reitan Battery. such as dementia c.motor speed and incidental memory Drawing from information presented in the text. 55 Ans. Lately. she has had memory difficulties. Luria-Nebraska and the Rorschach Inkblot test An individual was referred for tests such as the categories test. If you could choose only one personality test. clinical symptoms d. lacking clear guidelines for profile interpretation. 54 M 2. b. scale 9. scale 4. c. c. 54 E Kevin's scores on the L. 63 Ans. Thematic Apperception Test. Minnesota Multiphasic Personality Inventory. b. 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. Hy c. d. a structured clinical interview. c. what scale would be elevated? a. Rorschach inkblot test. d. a clinician could choose a. What information do these scales provide? a. To conduct an adequate assessment of a client. 58 Ans. 54 E 2. 54 M 2. d. b. an attempt to exaggerate her distress. 60 Ans. You have been asked to provide expert testimony in court regarding the psychological functioning of a serial killer. Ma 2. a sign of carelessness in her responding. C App p. 61 Ans. Hs b. 55 M 42 . 62 Ans. c. your concern for validity would lead you to choose the a. Pd d. A Con p. C App p. & K scales of the MMPI-2 were the first items his therapist considered in her profile analysis. You could fairly criticize the MMPI-2 for a. D App p. demonstrating poor reliability and standardization. B App p. 54 M 2. a sign of defensiveness. F. evidence of a severe psychological disorder. the MMPI-2. D App p. California Personality Inventory. observational assessments. d. b. lacking a guiding theory of psychopathology. inter-item reliability b. scale 3. severity of psychological distress 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. test-taking attitude c. 59 Ans.2. You could interpret Reya's responses in several ways EXCEPT as a. None of the above is adequate. demonstrating poor validity for the clinical scales. scale 1. 55 E * 2. a. What type of observation is this? a. Akt would tend to prefer what assessment approach? a. contextual Which client below is most likely to be assessed through naturalistic observation? a. a 50-year-old depressed female observed at work d. hypomania c. what two scales will he frequently see elevated? a. tension. 2. Given that most of the clients are experiencing moderate levels of anxiety. Art. written notation of the frequency and duration of her/his activities with friends. 68 Ans. 1 (Hs) and 8 (Sc) b. a 10-year-old hyperactive female observed at school b. B App p. controlled b. and is easily emotionally excited. 66 Ans. a 19-year-old phobic male observed in a college class c. 57 M 2. b. a 60-year-old alcoholic male observed at home "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. A App p. 3 (Hy) and 9 (Ma) d. 55 M * 2. naturalistic d. tends to jump from one topic to another in her conversations. c. 4 (Pd) and 7 (Pt) c. 69 Ans. careful daily tracking of medication compliance and side effects. 65 Ans. attempts to cognitively monitor and replace negative self-statements with positive ones. observational assessments d. participant c. Seshachari. a marriage and family therapist. 67 Ans. social extroversion As a behavioral psychologist. Dr. 56 E 2. conversion hysteria d. success in resisting compulsive coping behaviors such as smoking. Glenda. unstructured interviews b. Tiffany. One of his tasks is to administer and score the MMPI-2. and depression. B App p. Marcello. conducted a family assessment while having dinner with the family in their home. D App p. 57 C 43 . objective personality tests c. C App p. She would probably exhibit elevated scores on the MMPI-2 scale.264 Ans. psychasthenia b. 2(D)and 7 (Pt) Marta is often overactive. B App p. PET scan or MRI Ms. d. 55 M A graduate student has just begun his first psychological training practicum. 57-8 M Monitoring endocrinological changes in schizophrenia and depression as well as measuring changes in the immune system's response to stressors are examples of a. neuroimaging.2. C Fac p. 57 a. d. 75 Ans. objective personality tests focusing on aggression and impulsivity b. EEG d. D App p. 71 Ans. 57 E 2. B from the office in which she works. depressive 2. A Fac p. 58 E 2. collection of a sample of behaviors that is not reactive to the process of being observed. 58 M * Renaldo has been diagnosed with the a sleep disorder. schizophrenic c. c. available for use at home. dissociative d. b. M b. computer-synthesized EEG d. Clinicians are aware that accurate assessment of sexually deviant individuals is complicated by these persons' tendency to deny and distort their behaviors. evoked potential c. 72 Ans. B adolescents in public settings. was involved in this assessment? a. d. following the theft of money Ans. neuropsychological assessment. electromyogram M b. a procedure for conducting controlled observations. In order to achieve meaningful observations. measurement of physiological arousal during exposure to selected stimuli Physiological measures of blood pressure. What "marker" approach might be useful? a. 74 Shelly has been asked to take a lie detector test. structured clinical interview focusing on sexual beliefs and practices c. biological markers. and skin conductance would be central to the assessment of disorders. neuropsychological tests for brain dysfunction and disinhibition of impulses d. Which neurodiagnostic procedure. the App psychologist should address each of the following components EXCEPT p. c. a. PET c. 2. MRI 44 . the use of computerized tomography. 73 Ans. 70 A social psychologist is conducting a study of interpersonal aggression between Ans. anxiety b. What new neurodiagnostic procedure might App become a better candidate than the current polygraph? p. CT scans b. 58 a. careful training of observers. a method for summarizing ratings that reliably represents the observed behaviors. C App p. SPECTscan 2. muscle tension. 81 Ans. C App p. 60 M 45 . Pictures of the activity of her brain from several different angles were then obtained. MRS scan d. the tracking of utilization of radioactive glucose. the probability that other psychosocial factors are more important in causing this disorder d. 59 E 2. PET scan b. If she suspected a tumor. computer-enhanced three-dimensional x-rays. possibly reflecting disruptions in higher order thought processes. c. SPECT c. insufficient resolution of computer images at this level of measurement c. MRI c. d. A App p. computer-enhanced mapping of varying electrical activity patterns. PET scan b. PET d. 79 Ans. the early 20th century 2. Subbiah received her patient's Halstead-Reitan results that indicated significant brain dysfunction. 59 M * 2. What technique is being used? a. the possibility that longterm medication use may have altered brain structure and function If you are working as a physician during the time that Griesinger and Kraepelin are making their contributions to psychopathology. the poor reliability of brain imaging techniques b. what era are you living in? a. This means that participants will be studied via a. b. Investigators have found connections between cerebral atrophy (the shrinking of brain mass) and symptoms of schizophrenia in adults. D App p. D App p. 59 E 2. For what reason should they be cautious about concluding that atrophy represents a biological contributor to the disorder? a. CT scan c. MRI b. the 19th century d. what imaging technique would she order? a. 59 M 2. 59 E Dr. 77 Ans. MRS A neuroscientist is using MRI technology to evaluate the role of abnormal limbic system functioning in generalized anxiety disorder. MRI d. 80 Ans. B App p. the late European Renaissance c. EEG A radioactive chemical was injected into Cara's blood stream. the tracking of activity of atoms exposed to powerful magnets. What imaging technique provided this information? a. 78 Ans.2. C Con p. ancient Greece b. 76 Ans. CT scan Persons with schizophrenia show abnormal patterns of glucose activity in their frontal lobes. a. low reliability and a virtual lack of validity for several categories It's 1980 and you just received your copy of the DSM-III. ICD-8 and DSM-II c. d. without description of symptoms c. Which aspect should he omit from that review? a. B Fac p. What we now refer to as schizophrenia was termed by Kraepelin. failure to predict the treatment and course of disorders b. All of the above are correctly paired. listings of causal factors only. manic-depressive psychosis c. B Con p. 60-1 C 2. and gender 2. ICD-10 and DSM-III-R d. 60 M * Who proposed the first scientific classification system for mental disorders? a. combinations of clearly specified symptoms required for diagnosis d. B Con p. manic-depressive psychosis. 84 Ans. Griesinger c. an exclusive focus of attention to a single clinical label d. c. 82 Ans. improvement in classification reliability across clinicians c. Which of the following. ICD-6 and DSM-I b. Griesinger and Kraepelin's work in the late 19th century Which of the following classification manuals are INCORRECTLY paired? a. 61 M 46 . D App p. Hippocrates d. Warren is writing a history of the factors that influenced the modem DSM-IV. D App p. Which of the following problems was NOT associated with the first two versions of the DSM? a. 85 Ans. emphasis on differences in disorders according to age. 60 E 2. melancholia. the American Psychiatric Association If you agreed with the most influential classification system of the late 19th century. 60-1 M 2. dementia praecox b. does not belong? a. you would place all disordered individuals into one of three categories. A Fac p. you notice several improvements over the previous editions. however. organic brain disorders. multiple personality disorder Dr. a multiaxial diagnostic system b. Kraepelin b. military classifications for veterans' disorders b. 88 Ans. b. 83 Ans. These did NOT include a. ethnicity. involutional organic dementia d. the publication of reliable and valid structured interview schedules c. 86 Ans. In it. dementia praecox. 87 Ans. the WHO's ICD-6 and subsequent revisions d. 60 E 2. C Con p. 60 C 2.2. B App p. p. to the DSM-IV Sourcebook d. If she wants to find information about App field trials and other activities related to this disorder's inclusion in the DSM-IV. If experts in this area believed that the disorder should be called "attention deficit disorder. DSM-III-R Clinicians following which model of psychopathology demonstrated greater interrater reliability when they utilized DSM-III diagnostic criteria? a. interrater "It introduced multiaxial classification. description of signs and symptoms of disorders b. 89 Ans. the lack of empirical validity support for some diagnostic categories c. " To which DSM does this apply? a. DSM-I b. Attention deficit hyperactivity disorder has gone through several name changes across the various editions of the DSM. D Con p. description of the causal factors related to clinical syndromes d. C first introduced in the DSM-III in 1980. the pending publication of the ICD-10 2. choose the label that is closest to the ICD-10 to adhere to treaty obligations You are serving on the panel to develop the DSM-IV. what would the DSM-IV planning group do? a. inadequate attention to age. to the Proceedings of the DSM-IV Work Groups 47 . and gender issues d. A App p. A Fac p. test-retest b. 61 where should she turn? M a. biological d. cognitive c. 92 Ans. 61 M 2. psychodynamic b. with or without hyperactivity". internal c. to articles in relevant scholarly journals in the late 1980s and early 1990s c. 61 E 2. Which of the following is NOT among the justifications you cite for revising the DSM-III-R? a. psychological and biological treatment recommendations c. C Fac p. 61 C What form of reliability is most important for DSM diagnoses? a. All of the above are addressed. content d. cultural. 61 E 2. include both diagnostic descriptions and permit clinicians to choose the one more relevant to their client population d. DSM-III d. Appendix A b. its lack of multiaxial classification b. 61 E 2. to the DSM-IV manual. 93 Ans. 91 Ans. 90 Ans. 94 Ans.2. Reliability improved regardless of model. 95 Martina is preparing a report on the history of the "posttraumatic stress disorder" Ans. conduct a field trial and have the final decision reviewed by outside advisors c. DSM-II c. leave the decision to a vote of experts who have conducted research in this area b. What is the primary focus of the DSM-III and DSM-IV? a. 61 M * 2. D Con p. 61-2 M 2. a. bipolar disorder On which axis might the following notation be found? — "GAF = 82" a. 61 E 2. where would Mara's diagnosis of "dissociative identity disorder" be noted? a. B Con p. A App p. 100 Ans. 97 Ans. HIV/AIDS c. 62 M * 2. Mara. Axis I only b. A App p. I b. C App p. 101 Ans. mental retardation b. Roediger's assessment report of her client. 102 Ans. II c. Axis III d. I. 99 Ans. and schizotypal personality disorder coded on Axis . It would not necessarily be included but could be noted with an Axis I disorder. D App p. Axis II c. Ill b. It would be listed on Axis IV. C Fac p. II d. Axis I b. homelessness d. Axis IV On which axis or axes of the DSM does a clinician list abnormal behaviors relevant to her client? a. Evans. B Fac p. 98 Ans. How would this situation be reflected in her DSM diagnosis? a.2. Axes I and II d. If Axis III were not included in the DSM. II b. a patient at a VA hospital. II. V Mr. I Gail was divorced six months ago and is in a custody battle for her two children. I. 62 E 2. 96 Ans. Axis II only c. has been diagnosed with major depression coded on Axis . and III Which DSM axis is retained in the DSM-IV largely due to tradition and custom? a. 62 M In Dr. which of the following diagnoses could you NOT list? a. c. Ill d. 61-2 E * 2. HI. IV c. d. II. none of the above 2. b. It would be taken into account when the clinician determines her Axis V GAF. I c. Axes I. 63 E 48 . V d. It would be listed on Axis II. 64 E 2. 103 Ans. sociocultural Manny exhibits symptoms reflecting distorted perception and severe disturbances in his thinking processes. It refers to disorders caused by c. heterogeneous d. polythetic c. 65 M 2. cognitive b. 109 Ans. classical c. b. polythetic Ron did not display all DSM-IV criteria for posttraumatic stress disorder. but his symptoms did meet the minimum criteria for the disorder. C App p. Factitious Disorders c. According to the DSM-IV. A App p. What approach to classification does this represent? a. 64 E 2. multiaxial b. homogeneous d. multiconditional 49 2. D Con p. What is the name for the category in which this disorder is found? a. either psychological or physical factors. biological c. Mood Disorders b. c. 108 Ans. 65 M . 64 M 2. Amnestic and Other Cognitive Disorders c. Dementia. in harmful dysfunction in the individual. D Con p. relatively unchanging behavior style. It refers to disorders that result d. Schizophrenic and Other Psychotic Disorders b Delirium. 107 Ans. and he is unaware of this underlying connection. 64 E A a. how is "mental disorder"? a. Dissociative Disorders d. a. B App p. C App p. Somatoform Disorders d. He most likely has a diagnosis that falls in the __ category. behavioral d. client's diagnosis on Axis I reflects her/his long-standing. 64 M 2. D Fac p. d. It refers to disorders caused by Based on the DSM's definition of "mental disorder.2. 106 Ans. major clinical syndrome(s) associated with clinically significant dysfunction. physical factors. 105 Ans. 104 Ans. It refers to disorders caused by b. Schizophrenia and Other Psychotic Disorders The DSM-IV essentially provides a "menu" of symptoms from which certain ones must be met for diagnosis. classical b. general medical condition(s) relevant to mental health treatment. Anxiety Disorders Ira has a disorder in which physical symptoms are caused by psychological factors. What classification approach is being applied? a. " which model of psychopathology is most clearly omitted? a. general level of psychosocial functioning at the time of diagnosis. the term "mental" defined in reference to psychological factors. B Fac p.2. c. If Erik's disturbance worsens as a result of this diagnosis. d. 115 Ans. A counseling psychologist is working with a client who has both a somatoform disorder and a depression disorder. A App p. 113 Ans. gender. the classical approach was applied to the diagnoses. schizoaffective disorder Erik is experiencing minor behavioral disturbances following his family's move to a new state. c. c. he would encounter each of the following sections EXCEPT a. this would be an example of a. As critics point out in regard to Rosenhan's labeling study. This means that the research sample is a. When a clinician reads through the description of each disorder in the DSM-IV. false positive c. schizophrenia c. polythetic. bipolar disorder with psychotic features b. A counselor diagnosed him with separation anxiety disorder. b. a fatal medical diagnosis on Axis III. D App p. This means that she has a. a stereotype. age. b. 66 C 2. two or more DSM-IV clinical disorders. d. schizoid personality disorder d. C App p. operationally defined diagnostic criteria. an Axis I and an Axis III disorder co-occurring. false negative b. it should be recognized that the hospital staff was understandably motivated to avoid what sort of diagnostic error? a. 66 E 2. 116 Ans. 66 M . treatment recommendations. This comorbidity could have occurred in any of the following ways EXCEPT a. 110 Ans. d. lack of reliability Which of the following labels 'stuck' to Rosenhan and his seven accomplices? a. homogeneous. b. c. which was a false positive diagnosis. overpathologizing. d. a polythetic error. general medical or physical exam findings that could be associated. 65 M 2. 65 E Trisha has a comorbid condition. Not all participants in a study of dissociative identity disorder will exhibit the exact same pattern of symptoms. and cultural features. b. B Con p. b. the self-fulfilling prophecy. overlapping criteria exist in the two sets of disorders. invalid. d. A Con p. the somatoform disorder could have led to the depression disorder. heterogeneous. 50 2. 65 E 2. the same disorder as one of her close family members. 114 Ans. 111 Ans. c. lack of specificity d. both disorders could have been caused by a common life experience. 112 Ans. D App p. 66 E 2. 67 M 2. ease of use by clinicians 51 . This reflects classification. multiaxial The MMPI-2 produces a profile whose interpretation depends on the pattern of scores on all of the clinical scales. dualistic b. heterogeneous. dimensional c. d. Ans. Based on text information. in which symptoms are evaluated on a continuum. D App p. diagnose HPD more frequently than they would if the client were described as a female. categorical. A Con p. b and c A description of a client with histrionic personality disorder is being read by a group of clinicians. b. B App p. 121 Ans. One favors the approach. If the client is described as a male. gender-related bias in the symptoms comprising the anorexia nervosa syndrome b. categorical b. diagnose HPD as frequently as they would if the client were described as a female. " a. C Fac p. 120 Ans. categorical b. dimensional c. polythetic 2. continuous d. Two clinicians are debating the most useful approach to defining anxiety. homogeneous. C App p. a. an eating disorder. dimensional d. the other argues for the approach in which a client either does or does not meet criteria for an anxiety disorder. 68 E 2. 68 M * 2. diagnose HPD less frequently than they would if the client were described as a female. the inherent conceptual weakness of the dimensional approach d. 67 M * Anorexia nervosa. gender-related diagnostic bias on the part of clinicians d. 119 Ans. is much more frequently diagnosed in females than in males.2. show different patterns of diagnosis depending on the clinician's gender. 122 The categorical approach for the DSM has been preserved for several reasons. 118 Ans. c. 68 M 2. the clinicians using DSM-IV criteria will probably a. C Which of the following is NOT one of these? Fac a. which explanation below might best account for this difference? a. 68 b. homogeneous c. categorical d. 117 Ans. an actual gender-related psychosocial or biological difference c. dimensional. compatibility with the approach taken by the medical profession M c. a. homogeneous A critic of the approach to classification of disorders might argue that there is no identifiable dividing line between "normal" and "abnormal. theoretical disagreement about the most relevant diagnostic dimensions p. The physician will probably treat him for some form of physical illness. Donny was experiencing a panic attack but thought he was having a heart attack. b. The physician will construe ambiguous diagnostic signs in a manner compatible with her own treatment specialty. an efficient and reliable method for shorthand communication between clinicians. 128 Ans. c. the type of treatment in which the clinician specializes b. you could cite each of the following benefits EXCEPT a. b. C App p. adjustment disorder. 70 E 52 . The physician will probably refer him for psychological assessment. 68 M 2. whether treatment for Rheanna's disorder is covered by health insurance. premarital counseling. d. a black male d. D App p. 125 Ans. Wardley is developing a new test for anorexia nervosa. The physician will probably refer him for psychiatric treatment with an antianxiety drug. Wendy. social factors or factors related to individual pathology in determining the cause of the disorder? d. Rheanna is undergoing a psychological assessment prior to starting therapy. 123 Ans. c. Should the test focus more on external. 69 M 2. If you wanted to be paid for your therapy services by your client's insurance company. the ability to search for common causal factors among persons with similar disorders. a white female 2. Will scores on the test be consistent for clients who take the test at two different points in time? c. d. A Con p. if different from that of the clinician c. Tomiko. important information on which to base treatment decisions for disordered individuals. 127 Ans. 66-8 M In your argument for the usefulness of diagnostic classification. Does the test measure anorexia or does it measure some other form of psychopathology? b. Rheanna's ethnic group. B App p. 69 M * 2. 69 M 2.2. What is the most likely outcome of his emergency room visit? a. Dr. d. you could only use one of the following diagnoses. bereavement subsequent to the loss of a spouse. Ernie. A App p. Earl. Which of the following factors is LEAST likely to influence the clinician's diagnostic decision? a. Does the test identify anorexia in blacks as well as it does in whites? Which person is least likely to use formal mental health services? a. 126 Ans. 124 Ans. c. b. namely a. an Asian female c. major depression. A App p. Which issue below reflects a concern that the test might be biased? a. the flexibility of the dimensional approach underlying diagnostic syndromes. a Hispanic male b. arbitrary DSM diagnostic decision rules d. D Con p. 70 C 2. lifetime prevalence. 71 E 2. 32 percent d. the clinician should be careful that this is not the result of a. a. C App p. 134 Ans. 19 percent b. However. Froid interpreted Sung Li's avoidance of eye contact as a sign of shyness. what is the lifetime prevalence of the 30 major disorders assessed in that study? a. 71 2. quasi-negative The Kessler et al. 129 Ans. prevalence b. B App p. 71 M 2. incidence. 25 percent c. low self-esteem. reaches a diagnosis that undeipathologizes her client. 131 Ans. alcohol dependency disorder. what kind of diagnostic decision has she made? a. equal to d. somewhat higher c. 70 E Dr. c. 130 Ans. A clinician.2. 2. d. 132 Ans. C Fac p. a. incidence c. The first result is an estimate of . annual epidemiology d. B App p. D Fac p. 133 Ans. overgeneralizing. diagnostic prejudice. quasi-positive c. b. observational unreliability. lower than According to the ECA Project (Robins & Regier. In other words. b. and the second. much higher than b. 48 percent A new client at the Lakeshore Mental Health Clinic has a disorder that appears with greatest frequency in epidemiological studies. 71 E * 53 . and possible depression. It is a a. 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. phobia. (1994) National Comorbidity Survey reported that 48% of their sample had at least one disorder during their life. false negative d. 1991). and 29% had experienced a disorder in the prior year. trying to prove her cultural sensitivity. schizoaffective disorder. overpathologizing. false positive b. morbidity. epidemiology. c. incidence Adjusting for differences in cognitive symptoms that are strongly related to social class. d. major depressive episode. an estimate of . epidemiology c. d. B Con p. psychiatrist. incidence of disorders in any given 12-month period in the U. structured interviewing According to Widiger. general family physician. 136 Ans. C Fac p. lifetime prevalence of anxiety disorders If your goal were to be the kind of practitioner that most people turn to when they experience a mental disorder. a 32-year-old white male with a 10th grade education b. 141 Ans. schizophrenia d.2. an increasing reliance on sociocultural models of mental disorders 2. 137 Ans. 73 E 2. A Con p. a 48-year-old Hispanic male with a high school education c. D App p. 72 M 2. 72 M Considering the demographic differences in epidemiological rates. Deidre is exhibiting the first symptoms of an anxiety disorder. 139 Ans. 12 b. Based on the EC A findings. generalized anxiety disorder c. which of the following persons is most likely to be diagnosed with a mental disorder? a. 22 You are entering a clinical psychology program this fell. intelligence testing d. 16 c. personality testing b. a. panic disorder b. counseling psychologist. comorbidity of lifetime diagnoses d. 19 d. epidemiological findings suggest you should study to become a a. S. which of the following disorders is out of place? a. increasing utilization of projective techniques for psychological assessment b. a 70-year-old white female with a 10th grade education In terms of lifetime prevalence. 72 M 2. 72 M 2. b. According to Thomas Widiger. 73 E 54 . a 67-year-old black female with one year of college d. 138 Ans. 72 E 2. B App p. 135 Ans. increasing acceptance of dimensional diagnostic approaches for Axis I d. clinical social worker. obsessive-compulsive disorder Which of the following occurs with LOWEST frequency? a. c. what age would you predict Deidre to be? a. C App p. A App p. you should receive more training in man has typically been offered in the past. the Research Coordinator for the DSM-IV. c. which of the following trends might one expect in the future? a. 140 Ans. treatment by a mental health practitioner b. a sixth DSM axis for assessment of family/genetic background factors c. Describe the 4 possible diagnostic decisions the psychologist could make and what they would mean. 55 . 2. 143 Describe the relationship between reliability and validity in assessment. if diagnosed "schizophrenic. his distressing symptoms are unlikely to go away without treatment. or the meaningfulness of the outcomes. others would find his behavior disturbing. even if no one has given a label to Doug's experiences. Using each of the definitions from the text. etc. However. False positive: Lyndall is diagnosed with OCD when. this definition could not apply. to others. potentially. " mis could lead to rejection and discrimination by others who interact with Doug. True positive: Lyndall is diagnosed with OCD and actually has the disorder. or across raters. 2. she does not have the disorder. Doug's hallucinations are causing him a great deal of distress. in fact. determine whether this is a description of a "mental disorder. This also reflects a mental disorder because it is rare that people have perceptual experiences like the ones Doug has had. ). Subjective distress: Yes. Label: Probably not. thus demonstrating little or no validity. Both are assessed with correlation coefficients. because Doug refuses to seek help from any sort of health practitioner. Dysfunction that causes harm: Yes. Moreover. Reliability is the extent to which an assessment procedure provides consistent outcomes across items. across time. he may engage in behaviors that cause harm to himself and. in fact. False negative: Lyndall is not diagnosed with OCD when. clearly Doug is incapable of adaptive perception and thinking on a day-to-day basis and cannot plan effectively for the future.SHORT ANSWER I ESSAY 2. What clinicians treat: No. He is quite fearful and upset but refuses to go with his sister to see a doctor. " Deviation from social expectation: Yes. Because of his fears. compounded by his unwillingness to see someone who might be able to help him with his disorder. 144 Lyndall has been assessed by a clinical psychologist who is attempting to decide whether Lyndall has an obsessive-compulsive disorder (OCD). However. Validity is the extent to which an assessment procedure measures what it is intended to measure. given that his behavior is unpredictable and unsettling to observers. a test or other assessment device can be very consistent over time (or raters. thus demonstrating high reliability. the reliability of a procedure sets the upper limit for validity. True negative: Lyndall is not diagnosed with OCD and actually does not have the disorder. she does have the disorder. resulting in potentially worsened symptoms. 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. but may be essentially meaningless. Finally. probably most valid single assessment method Objective personality test . These manuals are essentially descriptive of disorders and thus are not reflective of any one model of psychopathology. the DSM-IV employs a multiaxial approach to diagnosis. including self-monitoring but not naturalistic observation) 2. 147 Who proposed the first systematic classification system in the late 19th century. S. manic-depressive psychosis. gender. 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. medical conditions. it is more congruent with the ICD-10. clearly documented reliability and good validity. and economy of time. it explicitly acknowledges how the factors of age. and culture are associated with various syndromes. an important characteristic in light of the U. However. is based on substantially more empirical field work in addition to expert advisory input. If you could only employ two specific assessment techniques to diagnose this person. 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. based on the medical model cf disorders. which two would you choose and why? Structured Clinical Interview for DSM: most reliable interview method. standardized scoring & computer-based normative interpretation. The DSM-IV. does not appear to be ethnically biased (Could make an argument for an observational method. and general level of psychosocial functioning. 146 You have an appointment with a new adult client. including the syndromes of dementia praecox. The various diagnoses in each of the versions are determined by following operationally defined lists of signs and symptoms collected through careful assessment. Current evidence also suggests that structured interviews may be the most valid assessment tool available to clinicians. 2. treaty obligation to maintain a system consistent with WHO classification. 2. incorporating clinical syndromes.MMPI-2: superior to projective tests. in contrast to the earlier manuals. psychosocial stressors. covers comprehensive information. Like the DSM-III and III-R. 148 Compare and contrast the current classification system represented in the DSM-IV to the DSM-III and III-R.2. and organic brain disorders. Moreover. these interviews are typically much less reliable and less comprehensive in coverage than the published structured interviews. 56 . Emil Kraepelin developed the most influential nosology. increased flexibility. she has lost her full-time job and is experiencing increasing marital discord. For someone to be described with a certain label. will not all have the exact same symptoms and behaviors. marital difficulties Axis V: GAF = 59 2. but they do not have to have all of them. like depression. they have to show a certain number of those characteristics. 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. " For each of the categories included in the DSM. a group of people who have the same general diagnosis. Axis I: Major depression Axis II: Dependent personality disorder Axis III: Hypertension Axis IV: Loss of job. 150 In simpler terms. ones that your high school neighbor would understand. there are several characteristics listed. In the past year. the manual that mental health workers use to determine the best description for their clients' problems.2. thoughts) and some are descriptions of their behaviors or actions. what does the following statement mean? "The DSM employs a polythetic classification approach that results in heterogeneous categories of individuals. Provide the multiaxial DSM diagnosis for Huerta. 149 Huerta has been diagnosed with major depression and a comorbid dependent personality disorder. 2.and overpathologizing as well as varying definitions of "abnormality" 57 . 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. or diagnosis. 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. Some are symptoms that the person tells you about (their feelings. leading to under. Her counselor estimated Huerta's overall level of functioning as a 59. As a result. d. A App p. 3 Ans. c. Kistner is studying mental disorders in children and adolescents. 78 E d. Oldman's work? a. b. 78 M * 3. a. Oldman probably relied on prospective research designs. retrospective c. B App p. developmental psychopathology. research in developmental psychopathology c. Oldman probably viewed children as having disorders that were less intense versions of adult disorders. 4 Ans. 5 Ans. 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. Dr. If you served on a panel responsible for developing childhood disorder categories for the DSM-II (1968). A Con p. D Fac p. Oldman was conducting research on children's psychopathology in the late 1960s. What sort of design does this represent? a. one might expect nearly % of a sample of disordered adults will have disorders that began in childhood or adolescence. Oldman probably used a diagnostic system based on a categorical approach. attachment theory Dr. C App p. If she adopts the perspective outlined by Sroufe and Rutter. d. 25 b. 78 E Dr. deviations or delays in developmental tasks d.Chapter 3 DISORDERS OF INFANCY. CHILDHOOD. c. adult disorders b. 78 E 3. 90 58 . childhood pathology. prospective b. which of the following would be your primary conceptual guide? a. Which of the following descriptions is LEAST applicable to Dr. 78 M 3. developmental Dr. 70 3. cross-sectional d. she will be working within the discipline called a. Dr. 2 Ans. According to Newman et al. developmental psychology. abnormal psychology. Dr. 55 c. and ADOLESCENCE 3. Oldman probably had not yet heard of the discipline of developmental psychopathology. b. Dr. 1 Ans. (1996). Bonnie will fail to achieve emancipation and will develop some form of pathology as an adult. and establishment of effective peer contacts. 7 years old d. C Con p. 79 M 3. psychomaturational task Emma is a child facing the tasks of self-reliance. she will achieve emancipation without difficulty. the genetic factors affecting the nature and timing of developmental tasks are also influential in childhood disorders. There is no evidence linking developmental tasks in childhood with psychopathology. psychological milestone c. b. a. 10 years old Which of the following sequences of developmental tasks is CORRECTLY ordered? a. 7 Ans. d.3. A Fac p. 8 Ans. Bonnie will need additional support from her environment in order to achieve emancipation on par with her peers. D App p. attachment > self-reliance > academic competence d. a child's failure to successfully handle an early developmental task can adversely affect later coping capacities. academic competence > emancipation > autonomy Tommy is learning how to develop autonomy while also responding to parental control of impulses. Bonnie will be delayed in achieving emancipation but will successfully do so by her mid 20's without special assistance. c. Provided that Bonnie's earlier crucial tasks of attachment and autonomy were achieved. Tommy's age c. Bonnie is 14 years old and has had a great deal of difficulty achieving a sense of competence and industry in school. attachment > academic competence > self-reliance b. and he is beginning to use language. 79 M * . C App p. 79 E 3. what prediction is MOST defensible? a. 4 years old c. none of the above Developmental tasks are linked to psychopathology in that a. 79 M 3. d. cultural practices b. Which of the following is NOT related to the timing and nature of these achievements? a. psychosocial requirement d. how old would you expect her to be? a. b. empathy. B App p. B Fac p. 79 M 3. 6 Ans. If Emma is average for these tasks. earlier developmental tasks d. 9 Ans. 11 Ans. 2 years old b. c. developmental tasks cause psychopathology. As she approaches the task of emancipation from her family in the future. developmental task b. 10 Ans. 79 E John Bowlby has theorized that forming an effective attachment relationship with parents is an important of the first year of life. 59 3. empathy > emancipation > self-reliance c. In her study. resistant. insecure/avoidant b. Strange Situation. a Japanese infant c.312 Ans. A App p. 16 Ans. adult monkeys b. 81 M 3. b. D App p. Ali would thus be expected to a. insecure. b. leaving the infant with the stranger. 81 E 3. 17 Ans. excessive Which of the following infants is MOST likely to have a resistant/insecure attachment? a. insecure c. Mark is moderately distressed when his mother leaves and wants to be held by her when she returns. parents bring their infants into a room with a stranger. c. nondistressed Ali is an infant who showed a secure attachment pattern according to Ainsworth's assessment. C App p. c. function better in adult life than will children who show an insecure attachment pattern. have a reduced risk of developing childhood behavior problems compared to infants with other patterns. a Mexican infant d. secure. insecure/distressed c. B App p. Separation Distress Appraisal. Attachment Assessment. Tani. 13 Ans. function about the same in adult life as will infants who show an insecure attachment pattern. secure d. separation distress 3. 15 Ans. Two infants are being observed in Ainsworth's laboratory. d. After a few moments the parents depart. Leon. a. and Mark. a(n) attachment. secure b. 81 M 60 . insecure. secure d. d. Sara is not visibly upset when her mother leaves the room and is disinterested in her mother when she returns. Sara has a(n) attachment. The method Jane is using to assess attachment is the a. 81 M 3. A Con p. Susana. Leah. 81 M 3. a Caucasian American infant 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. elevated stress-related chemicals d. a Black American infant b. D App p. Situational Attachment Protocol. both a and c Which of the following terms does not belong with the other three? a. 80 M Jane is a developmental psychologist conducting research on parent-infant attachment. 14 Ans. Suomi c. categorical b.3. use of structured interviews c. Tim would have high scores on the internalizing dimension of the CBCL. 82 M * 3. Tim would have high scores on the externalizing dimension of the CBCL. a stress-related chemical c. " What approach does this speaker appear to take to classifying childhood disorders? a. c. mild mental retardation "All children at one time or another display some symptoms of abnormal behavior. For some children. Tim would have somatic problems such as nausea and headaches. Trish also complains about several somatic symptoms. statistical b. 22 Ans. Strangeglove would probably conclude that a. C App p. 82 E 61 . diagnostic c. 23 Ans. internalizing d. elevated levels of epinephrine. experiential c. undercontrolled 3. which of the following characteristics would most closely apply to Ricky who has an insecure attachment to his mother? a. theoretical d. As a result. Trish is failing to interact with peers. introverted c. a seven-year-old male. 18 Ans. Strangeglove is using the CBCL to asses Tim. C App p. Dr. statistical criteria Dr. due in part to her depressed mood. 82 E 3. these symptoms are more severe and chronic and thus warrant intervention. a negative temperament b. administration of formal psychological tests d. B App p. 21 Ans. repeated separation from his mother d. 20 Ans. Her symptoms are characteristic of which dimension of the CBCL? a. however. 81 M 3. and often aggressive. categorical approach b. DSM-IV symptom clusters Dr. B App p. 19 Ans. d. 81 M If Suomi's research were found to be replicable with humans. a history of early. on what sort of criteria will she probably rely in order to group together her clients' various symptoms? a. Lawr employs a dimensional approach in the assessment of her child clients. Tim would have high scores on the oppositional/defiant dimension of the CBCL. A App p. Tim is hyperactive. dimensional d. b. inattentive. 81 M 3. passive/overcontrolled b. D Con p. classical Which of the following terms does not belong with the other three? a. she is MORE likely to exhibit which of the following disorders? a. on App which of the following scales would he concentrate? p. impulsivity b. A counselor is most concerned with the student's overcontrolled behaviors. internalizing c. D App p. If the Ans. D App p. 29 Ans. respectively.3. d. 25 Mr. depression and anxiety. ODD b. 84 E * . 84 M 3. thought problems 3. externalizing b. 83 E 3. somatic complaints 3. delinquency and learning disorders. aggressiveness c. c. 24 Ans. ODD c. 84 E 3. delinquent. anxious/depressed E b. 30 Ans. b. b. S. nuisance behaviors d. CD d. Chad has been referred to a child guidance clinic for a disorder that occurs in approximately 5 percent of the general U. 82 M Doris is described by her counselor as exhibiting several "externalizing" problem behaviors. 27 Ans. Marty's two highest scores are found on the delinquent and aggressive behavior scales. social problems c. none of the above 62 3. c. Evanoff. d. ADHD b. His scale scores are 64 and 60. childhood anxiety d. population. 82 a. conduct disordered d. What disorder is this? a. A App p. externalizing behaviors d. learning disability Bobby is an eight-year-old male and Sally is a seven-year-old female. neglect and abuse by parents. one could conclude that a. What description would you give Marty? a. disruptive behaviors and attention deficits. Bobby is 2 to 3 times more likely than Sally to develop these disorders. D App p. normal The two most common reasons children are referred to mental health clinics are a. Sally is 5 to 6 times more likely than Bobby to develop these disorders. Dalila is a fourth-grade student. 26 Ans. B App p. C Fac p. is reviewing a student's CBCL. ADHD c. Bobby is 5 to 6 times more likely than Sally to develop these disorders. Which of the following would NOT be included in this description? a. a school counselor. Sally and Bobby have about the same chance of developing these disorders. Compared to the males in her school classes. 28 Ans. In regard to the disorders most commonly seen in clinics. 83 C On the CBCL profile. 3. Dr. d. * c. they describe how difficult it is to get Eddie to come to dinner. What disorder is most likely for Eddie? a. at home. inattentive defiant disorder. b. a. 31 Ans. the fact that ODD symptoms occur at a very high base rate in the general population c. 84 M * 3. Licht is conducting a treatment program for children with ODD. If he were to follow his preschool children through third grade (about age 9). d. E b. one eighth 3. Aaron. The child exhibits behaviors that are harmful to others or to property. c. C about one of her students. oppositional defiant disorder. the lack of clear DSM-IV criteria for ODD diagnosis b. The child is hyperactive. 63 . In their first clinic session. 36 Dr. 85 M 3. B App p. and Mr. Baez are at their wits' end with their 7-year-old son. c. 84 M Keith has a DSM-IV disorder that is among those most commonly seen in mental health clinics. Which of the following would MOST App likely lead Dr. Aaron engages in covert behaviors such as lying and stealing. 33 Ans.3. Jones is a child psychologist attempting to make a DSM-IV diagnosis of a Ans. the failure of clinicians to verify that behaviors are actually potentially harmful d. attention-deficit hyperactivity disorder c. Yahoo's concern is probably based on which of the following? a. a pervasive developmental disorder Mrs. 85 a. one could predict that will still have significant disruptions in adaptive functioning. 85 continuing problems for Aaron? E a. What disorder is this? a. an anxiety disorder b. b. or do the simplest tasks around the house without a full-blown temper tantrum. 35 As a clinician. The child is verbally abusive to parents and teachers. inattentive. Dr. Aaron shows some aggression and hyperactivity. and in public. one third c. Moderate levels of stress are present in Aaron's family. one quarter d. Problems with ODD are seen in school and at home. Jones to make a diagnosis of conduct disorder? p. one half b. C App p. oppositional defiant disorder d. an excessive reliance on the CBCL that has been shown to "overpatiiologize" children's behaviors Dr. 85 M 3. His disorder is also most likely to occur without comorbidity. Eddie. who has been diagnosed with ODD. Which App of the following observations by the teacher is LEAST likely to predict p. 32 Ans. The child acts inappropriately at school. you are speaking with a third-grade teacher who is concerned Ans. d. do his homework. B App p. and impulsive. Yahoo is concerned that psychologists in his area may be over diagnosing ODD. D 9-year-old male's disruptive behavior. preadolescent hyperactivity disorder. 34 Ans. B App p. conduct disorder. 86 E 3. b. Marsha. 41 Ans. undercontrolled behavior is being assessed by a school counselor. 55 d. 66 3. fearing that he may start a fire if left to his own devices. 86 E 3. 25 b. Jacques is a 10-year-old male whose disruptive. 6 months. destructive. 39 Ans. adolescent-onset disruptive disorder Which of the following CD children is MOST likely to "grow out" of his disorder by the end of his teenage years? a. with a childhood onset at age 10 c. whom of the following would experience the greatest academic difficulty and be most likely to develop adult antisocial problems? a. c. C App p. which of the following DSM-IV symptom categories is NOT relevant? a. 42 Ans. Alvin. 3 months if ADHD has previously been diagnosed. A App p. Gary. you would know that he has been exhibiting his aggressive. with a childhood onset at age 8 b. If CD is likely. 86-7 M 64 . 12 months. serious violation of rules Max's parents have refused to get a new pet after 11-year-old Max drowned the family cat. ODD c. CD d. 38 Ans. A App p. Mark. Ogata has seen 100 clients in his specialized practice for the treatment of conduct disorder. aggression d. D App p. 86 M 3. a 7-year-old female who is prone to physically aggressive behavior d. B App p. His parents also insist that someone always be at home with Max. 40 c. juvenile onset b. an 18-year-old college student prone to burning text books after each term c. 2 years. with an adolescent onset at age 12 d. 86 M If Masako has been diagnosed with CD. d. What DSM-IV disorder is MOST likely? a. a 15-year-old male diagnosed with CD b. If all of them had met DSM criteria by age 13. 40 Ans. this disorder virtually always leads to adult disorders According to several longitudinal studies on CD. 37 Ans. C App p. antisocial personality disorder. none of the above. how many are likely to exhibit antisocial personality disorder as adults? a. an 8-year-old male diagnosed with CD Dr. and deceitful symptoms for at least a. 86 M 3.3. Mike. Reggie. Brandt. destruction of property c. manipulation of others b. The direction of the causal relationship has not been determined through prospective research. What neurotransmitter is associated with these behaviors? a. The comorbidity of substance abuse in disordered adolescents makes accurate hormonal measurement difficult. who has a high level of serotonin in his brain c.3. 44 Ans. Both animal and human studies have produced very inconsistent results. 47 Ans. comorbid depressive and anxious symptoms. who has a high resting heart rate and quick startle response b. 88 M 65 . c. Antisocial behaviors occur with almost equal frequency in females. skin conductance levels and heart rate. the age of the diagnosed individual c. 43 Ans. d. the severity of parental criminal behavior d. who has a very low skin conductance rate d. D App p. 45 Ans. Joshua. B App p. c. Ramon. a seven-year-old female whose parents have recently divorced and who is prone to frequent temper tantrums 3. 87 M * 3. the severity of aggressive and destructive behaviors b. B Fac p. a three-year-old female in foster care with a lower SES family b. 87-8 E 3. a family adversity index. testosterone d. 87 E 3. a nine-year-old male with below average grades and few friends d. who has a low level of GABA in his brain If you wished to predict which adolescents might be at greatest risk of CD and later adult criminal behavior. Amee. the presence of substance abuse For what reason has it been difficult to establish a causal relationship between elevated testosterone levels and long-term antisocial behavior in males? a. d. D Con any p. Daniel is a 14-year-old male with a disruptive behavior disorder that includes aggressiveness and acts of property destruction. Janet. serotonin Which of the following adolescents is MOST likely to display symptoms of a disruptive externalizing disorder? a. Which of the following children has the greatest chance of being diagnosed with conduct disorder? a. you might conduct prospective research involving of the following EXCEPT a. b. Terrance. the neurotransmitter dopamine. 46 Ans. Jackson. 87 C What is the central difference between a diagnosis of CD versus antisocial personality disorder? a. a ten-year-old male with deficits in executive functioning c. dopamine c. C Con p. Jim. Akoni. norepinephrine b. 87 E 3. 48 Ans. C App p. b. with CD. etc. 80 d. Each is a contributing factor to many internalizing disorders. b. 94 What do coercive cycles. the parent/child exchange theory. 88 M * 3. 51 Ans. issuance of commands to Cecil to stop talking back to her. 52 b.3. Each is a contributing factor to CD. and insecure attachment have in common? a. 88 M Which of the following terms does not belong with the other three? a. A App p. If Cecil is diagnosed with a dismptive behavior disorder. adolescent-onset CD b. you might expect to see each of the following behaviors from his mother EXCEPT a. Brian immediately stops his aversive behavior. circular causality. a high family adversity index. Bond is working with preschoolers who have been referred to her clinic for ODD. a. Roy. 88 M 3. 88 M 66 . 52 Ans. 49 Ans. d. c. Deedee will a. They describe the home environment of children with ADHD. Derrick. c. 3. coercive cycles. dyadic-aversive behavior patterns. language processing Brian wants the new Han Solo action figure set. deficits in neuropsychological abilities c. be as "bossy" toward Derrick as she is with Roy. Dr. b. Cecil and his mother are engaged in a dispute. A Con p. His mother eventually gives in and buys him the action figure set. frequent criticism of Cecil's actions. They each describe the primary causal factor in dismptive disorders. close physical proximity. executive functioning d. stop yelling. 54 Ans. d. A App p. eventual reinforcement of his aversive behaviors in a coercive cycle. c. She would expect that approximately % of them demonstrate insecure attachments. b. who is NOT disordered. readily establish a coercive cycle with Derrick as she has with Roy. 88 E 3. he complains loudly and becomes verbally abusive. b. C App p. be as reactive to Derrick's negative behaviors as she is toward Roy's. When his mother refuses to buy it for him. 66 c. be less critical of Derrick than she is of Roy. Brian and his mother's behaviors are an example of a. When Deedee interacts with her best friend's teenage son. 88 M 3. Deedee is the mother of a teenager. B App p. 53 Ans. d. 50 Ans. c. d. D Con p. B App p. 90 M 3. the FAST Track System b. 55 Ans. Melanie fell against Todd's desk and caused him to ruin a picture he was painting. d. Which of the following children is at GREATEST risk for severe aggressive behaviors? a. a male with low neuropsychological test scores. cognitive-behavioral individual therapy for Payat. 57 Ans. A graduate student is working with Dr. Mali. d. as an accident Zuri is a female with CD. social skills training for Payat in a group therapy format. 90 M 3. training in specific parenting skills for Payat's parents. 90 M 67 . c. Which therapy approach is the graduate student employing? a. as a possible act of aggression that should be ignored d. 89 M 3. Insufficient attention was given to Kurt's participation in the coercive cycles. you are using a. The original training generalizes poorly to new settings.3. Kurt's family had too low a family adversity score at the beginning of treatment. D App p. Why might the long-term benefits of this therapy be limited. Self-Instructional Therapy d. 3. A App p. b. b. 58 Ans. deficits in attributional processing during conflicts. d. low levels of serotonin. Eyberg's parent training program for Kurt's CD. Kito. Parent-Child Interaction Therapy Kurt and his family have successfully completed Dr. a male with low neuropsychological test scores and high family adversity scores. In other words. 89 M When she was accidentally pushed by another student. C App p. according to available research? a. Behavioral Management Skill Training c. If Todd has CD. c. b. A App p. a male with high family adversity scores. Each of the children is at equal and high risk. as an attempt to get his attention but not necessarily a sign of aggression c. Any of the above is possible. d. b. 56 Ans. C App p. 60 Ans. c. 59 Ans. c. as a deliberate act of aggression b. 89 M 3. inadequate executive functioning. As Payat's clinician. Her tendency toward aggressive behaviors may be due to each of the following factors EXCEPT a. low levels of estrogen. how will he interpret Melanie's action? a. Charlie. treating disruptive behavior disorders. you are employing the most effective and best studied treatment intervention for Payat's CD. Kurt has adolescent-onset CD. Eyberg. demonstrates more inattention and impulsiveness. B App p. at risk for developing later internalizing disorders. combined type. 92 M 3. home-based parenting training and stress management training If Collette is in the FAST Track program. problem-solving training and anger management for children What do PMHP and FAST Track have in common? a. In order to make a DSM-IV diagnosis of ADHD the clinician must find which of the following? a. 91 C 3. d. nothing. clinically significant impairment in two or more settings b. Emma. B Con p. D Fac p. Tammy. 61 Ans. Nonetheless. Chuck. oppositional behavior toward adults d. an 11-year-old from a lower-class family d. an 8-year-old from a lower-class family b. They are school-based programs aimed at preventing CD in high-risk elementary school children. and his teacher has trouble keeping him under control. ADHD. Which of the following descriptions does not belong with the other three? a. school-based social skills and reading skills training d. 67 Ans. c. a 9-year-old from an upper-middle-class family c. in need of early intervention for symptoms of an eating disorder. b. documented improvements in social and academic functioning at age 14 b. both a and b Eric is extremely active when compared to his classmates. 92 M . b. A clinician is interviewing a child whom he suspects may have ADHD. 92 E 3. 91 E * Which of the following treatments is NOT commonly used to treat disruptive behavior disorders? a. in need of intensive treatment for ADHD and comorbid ODD. D App p. ADHD/inattentive subtype. Which of the following children is MOST likely to be diagnosed with ADHD? a. longterm intervention programs for children diagnosed with disruptive behavior disorders. cognitive restmcturing for children d. she is believed to be a. They are multifaceted. d. They are types of parent-training programs for children with externalizing disorders. at risk for developing later conduct disorder. d. 90 M 3. C App p. 62 Ans. his behavior does not merit a diagnosis of ADHD. he usually completes his assignments on time and gets along well with most of his peers. 64 Ans. medication c. a 10-year-old from a middle-class family 68 3. excessive inattention or excessive hyperactivity/impulsivity c. A Con p. 66 Ans. c. Eric would be diagnosed with a. 63 Ans. c. D App p.3. 6-year nationwide prevention program c. ADHD/hyperactive subtype. 91 M 3. Brian. 65 Ans. skills training for parents b. They are school-based programs used to treat the academic and social deficiencies of children with ADHD. b. anxiety The local high school guidance counselor is reviewing the files of this year's new students. a. inattentive d. compared to ADHD children without hyperactivity? a. 10 to 12 b. 92 E 3. b. b. 92 M 69 . hyperactive subtype. you could expect _____ percent of your students to meet DSM-IV criteria. 50 3. B App p. A Fac p. combined John has ADHD. Each of the following are cited by the text as possible explanations for such children's slightly higher ADHD prevalence EXCEPT a. academic underachievement d. you have many challenges ahead of you. 92 E 3. 75. 68 Ans. 50 c. parental criminal behavior. 92 M * 3. Of the students who were diagnosed with ADHD as children. He is MORE likely to demonstrate which of the following. hyperactive c. 30 d. B App p. 50. oppositional b. 71 Ans. 70 Ans. 1 to 3 Monica and Rick are children with ADHD who come from lower SES families. A App p. she can expect that roughly percent will still meet diagnostic criteria in mid-adolescence. Which of the following is NOT one of the ADHD subtypes? a. 69 Ans. a. higher rates of pregnancy complications. c. Based on national prevalence data. general family instability. B App p. 33 b. and about _ _ percent of those will also exhibit CD. 70. low popularity among peers b. comorbid sensory-motor problems and learning disorders c. Among them will be classroom discipline which will be made more difficult by the presence of children with ADHD. 72 Ans. 92 E As a new public school teacher. inadequate health care. 3 to 9 c. 66.3. 2 to 5 d. Children diagnosed with ADHD in early elementary school rarely show persisting symptomatology in adolescence. a 7-year-old female d. If he is typical of adults with this history. b. 78 Ans. Matt will have residual difficulties but will no longer meet diagnostic criteria. she could exhibit any of the following symptoms in that category EXCEPT a. C App p. often fidgets with hand or feet c. Ted. failure to give close attention to detail. 93 M 3. often does not follow through on instructions b. A Con p. though the impact can be lessened with medication. 74 Ans. ADHD. 77 Ans. 75 Ans. b. ODD. D App p. difficulty organizing tasks and activities. c. c. If Katie has ADHD with the subtype suspected to be more common for females. b. autism.3. The parents are concerned that the ADHD behavior will persist as the child enters adolescence. which of the following outcomes is MOST likely? a. d. Katrina. The child's primary symptoms are likely to persist but will probably dissipate in early adulthood. 76 Ans. 73 Ans. What should you tell these parents? a. "Minimal brain dysfunction" is an earlier term for the disorder now called a. d. Roscoe. 92 M * As a clinician. D Fac p. Matt will develop a comorbid depression or anxiety disorder. 93 M 3. b. 93 M 3. loss of items necessary for activities. None of the above is correct. C App p. a 14-year-old female b. Which of the following subtype symptoms does not belong with the other three? a. B App p. Matt will develop a substance abuse disorder. difficulty playing quietly. There is little chance the ADHD symptoms will persist beyond childhood because the child's ADHD is not comorbid with a disruptive behavior disorder. 93 E 3. d. Cassie. 94 E . He was diagnosed with ADHD when he was 6 years old. often has difficulty awaiting turn For which of the following persons would you be MOST skeptical of a DSMIV ADHD diagnosis? a. c. Children with the inattentive subtype usually develop hyperactive symptoms during adolescence. an 8-year-old male Matt is 35 years old. you are talking with the parents of a young child you diagnosed with ADHD/inattentive type. c. d. often talks excessively d. a 25-year-old male c. 70 3. learning disability. endorphins Which of the following terms does not belong with the other three? a. overstimulating d. If Jacobvitz and Sroufe observe this interaction and make the prediction that Stanley is at risk for later hyperactivity. increase. C Con p. B Fac p. A Fac p. 94 M Palani is a 6 year-old child with a disorder that was formerly called "minimal brain dysfunction. the presence of cerebral asymmetry c. a. thyroid disease b. C App p. 83 Ans. " Which of the following early life problems is probably NOT associated with possible underlying brain dysfunction? a. is interacting with his mother. 94-5 E 3. prolonged oxygen deprivation at birth d. GABA b.3. 95 E 3. 94 E * 3. how might his mother be described? a. an ineffective thyroid b. RAS Preliminary MRI studies suggest that may play a role in the impaired planning and executing of goal-directed behavior in ADHD. overprotective c. the frontal lobes b. decrease. 95 M . impaired frontal lobe activity Stanley. cingulate gyrus d. temporal lobes c. anxious and insecure 71 in 3. 84 Ans. conduct disorder d. aloof and critical b. low birth weight d. maternal intrusiveness Brain abnormalities have been linked to ADHD. D Con p. metabolism acceleration If it were possible to regulate the hyperactivity and impulsivity of ADHD children by implanting a neural impulse generator in a child's brain. 94 M 3. a. norepinephrine d. 85 Ans. B App p. 80 Ans. LGN of the thalamus b. the RAS c. 94 E 3. lead poisoning b. 82 Ans. gene mutation c. his mother's alcohol consumption during pregnancy c. decrease. This medication will the availability of his brain. A App p. catecholamines c. undeiarousal of the RAS d. what brain structure would you target? a. a 42-month-old child. increase. prolonged oxygen deprivation at birth Nine-year-old Toshio is taking a prescribed stimulant medication for his childhood disorder. Which of the following is NOT a focus of such studies? a. 79 Ans. 81 Ans. 17 b. Both Dax and Connelly would respond equally well to medication. C App p. Cylert d. and Connelly. which of the following is it likely to be? a. Of his 20 patients. a four-year-old boy. A App p. Which of the following would she NOT prescribe to a child with ADHD? a. Benzedrine b. B App p. a vegetarian diet b. 96 M 3. 14 c. and his mother often wakes him from his naps prematurely and tries to play games with him long after his interest has waned. D App p. 10 d. you are concerned that the medication your child is taking to treat the disorder may stunt his/her growth. It would be expected that a. vigorous exercise to stimulate muscle development c. 96 E 3. attention-deficit/hyperactivity disorder Dr. D App p. 8 Dax. Neither Dax nor Connelly would be expected to show a positive response. b. separation anxiety disorder c. Connelly would show a more consistent response to the medication than would Dax. 88 Ans. 96 C 3. oppositional defiant disorder b. 90 Ans. Teramoto is a pediatrician who specializes in treating children with ADHD. c.. a fifth grade student. how many are likely to show a positive response to medication? a. have both been diagnosed with ADHD. 87 Ans. As a parent of an ADHD child. 89 Ans. periodic drug holidays 3. reductions in dosage levels d. Dax would show a more consistent response to the medication than would Connelly. Dax and Conelly's respective physicians have prescribed Dexedrine to treat their symptoms. 86 Ans. According to the text what would your child's clinician recommend to avoid this possibility? a. Dexedrine c. d. If he were to develop a childhood disorder. Yates is a psychiatrist specializing in pediatric psychiatry. an eating disorder d. 96 M 72 . Ritalin Dr. 95 M Two-year-old Sven has an underaroused RAS. either a or b 3. C App p. 96 M * 3. 96 M Forrest. improved social relationships b. normal levels of arousal throughout the day. all of the children in the class get an additional 15 minutes to spend at recess. a child with ADHD. to her own efforts d. 91 Ans. A Fac p. took his ADHD medication at breakfast around 7: 30 A. Which of the following outcomes is LEAST likely for children taking stimulant medication? a. M. c. All of the above are likely to be effective. long-term academic gains c. According to the text. medication b. yoked control b. 97 M 73 . conformity reinforcement Which of the following treatment methods is MOST likely to effectively treat the core symptoms of ADHD? a. C App p. and a loss of appetite four to five hours after his last dosage. Forrest will most likely experience a. a decrease of arousal as the day progresses due to the fact that the stimulant will wear off. a ten-year-old male. d. to the drug's effects b. 95 Ans. to the program's training c. 94 Ans. classroom management c. to what factor will Clara probably attribute her growing self-confidence and sustained attention? a. abdominal pains. improved attention to relevant environmental stimuli When Brandon.3. cognitive-behavioral interventions d. finishes his assigned school task and stays in his seat during the reading period. a rebound effect in the early afternoon with his ADHD symptoms returning stronger than ever. 96 E 3. home-school behavior management procedures c. 96 M 3. A App p. group contingency d. What is the name for this intervention approach? a. side effects of decreased appetite and physical discomfort d. If Clara participates in an intensive educational program for ADHD and also takes medication for her disorder. 93 Ans. b. Forrest was in a hurry and forgot to take his midday dosage to school. headaches. 92 Ans. B Fac p. D Con p. 8 b. 98 C * 3. Anthony may suffer from a. 100 Ans. c. d. 98 Ans. C App p. Anthony began to develop anxiety symptoms around age 11. residual anxiety disorder. you could include each of the following statements EXCEPT a. 97 Ans. 4 3. 98 E d. 3. b. c. rapid heart rate. Doctors may give prescriptions based on parents' reports only and may fail to communicate with teachers about proper drug use. perhaps without sufficient cause. nervousness and foreboding about common present and future events b. The use of the drug has increased sharply in the past several years and may still be increasing. anxiety is a more normal facet of daily experience and potentially more adaptive than disruptive behavior. and sweating c. interfering significantly with age-expected activities Until recently. The history of impassioned controversy regarding the drug may create misleading impressions of its usefulness. b. Of the 10 children she is currently treating for anxiety disorders. His symptoms have gradually worsened to the point where Anthony becomes inappropriately apprehensive about numerous everyday occurrences.3. B App p. In order to diagnosis some type of disorder. d. childhood anxiety disorders received less attention from clinicians and researchers than disruptive disorders for each of the following reasons EXCEPT a. persistent anxiety across several weeks or months. c. 6 c. A Con p. b. d. what symptom(s) must be present? a. Children who are given the drag typically develop later adult substance abuse disorders. agoraphobic anxiety disorder. insomnia combined with physical symptoms such as nausea. undifferentiated anxiety disorder. Okamoto specializes in the treatment of childhood internalizing disorders. D App p. 99 Ans. 98 M A child psychologist is assessing the presence and severity of anxiety in a child who has been referred to him. 99 M 74 . such as his father taking a different route when he drives Anthony to school or a new teacher in his class room. generalized anxiety disorder. 1 3. 96 Ans. assessment of internalizing disorders is more difficult than that for externalizing disorders. disruptive disorders are more common than are anxiety disorders. anxiety disorders have less impact on adults than do disruptive disorders. Dr. 97 M In your report on the issues which should be carefully considered in regard to the use of Ritalin. disruptive behavior and academic impairment lasting at least two weeks d. how many probably also exhibit diagnosable depression? a. b. Muriel. Alexi appears to need his parents' help to complete even the simplest of tasks. the development of comorbid specific phobias or social phobia d. anxiety d. 99 E Which of the following is FALSE in regard to separation anxiety disorder? a. 103 Ans. dependent personality disorder of childhood d. Separation anxiety reflects a developmentally inappropriate fear of separation from those to whom the child is most closely attached. B App p. This anxiety disorder is associated with prominent behavioral and cognitive symptoms but somatic symptoms are uncommon. Which of the following is probably of greatest concern in Billy's case? a. such as headaches and stomach cramps c. Julie. 100 E 3. and Mrs. Benne. c. including tying his shoes and deciding what lunch box to take to school. D Con p. Symptoms of separation anxiety may be a sign of good adjustment in infants and young children. she may later develop symptoms of a(n) disorder. the development of aggressive behaviors toward siblings and parents If Russell's separation anxiety symptoms increase because his parents let him stay home from school. Alexi most likely suffers from which of the following? a. parental attachment disorder Mr. 105 Ans. a. 102 Ans. specific phobia b. Cliett are concerned about Billy's separation anxiety disorder and its longterm consequences. depression b. He is very worried about his parents' well being and reports frequent nightmares in which his parents are the victims of horrible accidents. chronic physical ailments.3. eating For which of the following anxiety-disordered children is a comorbid depression disorder MOST likely? a. 104 Ans. 100 E * 3. Children are typically not diagnosed with this disorder until 8 or 9 years of age. D Con p. extinction If Erika has a high level of inhibition in infancy. a kindergartner c. negative reinforcement c. thereby reducing Russell's worrying and distress temporarily. 99 M 3. A App p. 106 Ans. school refusal b. B Con p. Ulani. 101 Ans. externalizing c. a second grader d. C App p. d. 100 C 75 . punishment d. positive reinforcement b. separation anxiety disorder c. what operant process is at work? a. a preschooler b. a fifth grader 3. 100 M 3. childhood depression. exaggerated perceptions of threat c. 101 M 3. D App p. This means that you are offering therapy to your participants. He received a combination of several cognitive-behavioral treatments. Kendall's participants in the first controlled study of the treatment of childhood anxiety disorders. such as having to introduce a speaker in front of a large crowd. 108 Ans. He became indistinguishable from normal peers in regard to symptom severity at the end of treatment. 107 Ans. self-reinforcement c. cerebral asymmetry b. interpersonal therapy You are a graduate student conducting research with Dr. ADHD b. which of the following is LEAST likely? a. D App p. CD. medication and interpersonal Carlos was one of Dr. 102 E 3. 111 Ans. C App p. b. ADHD. 101 M Which of the following diatheses does not belong with the other three? a. 109 Ans. 102 M * 76 . d. 112 Ans. eating disorders but has not 3. 102 E 3. inhibition d. Kendall. peer modeling b.3. B Con p. and you are involved in his study of treatment for childhood anxiety disorders. in vivo exposure b. A App p. systematic desensitization Ivan suffers from astraphobia (fear of storms. and lightning). He exhibited short-term symptom improvement that dissipated six months after treatment ended. If Carlos exhibited characteristics that are typical for children in the study. cognitive-behavioral d. childhood anxiety disorders c. systematic desensitization c coping skills training d. childhood depression d. He maintained his gains on the CBCL internalizing scales one year after treatment ended. Medication is particularly useful for the treatment of been established as an effective treatment for _ _ _ _ _ _ a. 110 Ans. 102 M 3. Majan is taught anxiety-inhibiting techniques such as deep breathing and muscle relaxation. excess physiological arousal Majan is receiving treatment for his anxiety disorder which stems from fear of social scrutiny. a. behavioral management c. Which of the following is LEAST likely to be used in the treatment of this disorder? a. Over the course of his two-hour therapy session Majan is asked to envision increasingly intense scenes. coping skills training d. c. childhood anxiety disorders. In therapy. thunder. A Con p. group contingency reward b. What treatment method is this? a. 118 Ans. conduct disorder d. 116 Ans. Leon appears irritable and lethargic and makes several self-deprecating remarks. D Fac p. likely to develop a comorbid conduct disorder as an adolescent. Susan Campbell's discussion of the high rates of comorbidity among childhood disorders. What disorder is likely? a. c. somewhat more. During examination. more c. A Con p. They are core symptoms of ADHD. negative affectivity c. CBCL scale elevations c. c. C App p. 103 M If William experiences a persistent depressed mood in childhood. 119 Ans. and other high-risk behaviors have in common? a. 115 Ans. suicidal thoughts c. They could be signs of an underlying eating disorder. 117 Ans. somewhat less b. Given Dr. somewhat less. on which diagnostic approach is she MOST likely to rely? a. Keenan is likely than Dora to show significant depression. 114 Ans. They are behavioral signs of long-term insecure attachment patterns. 103 E 3. less d. more. 103 E 3. is/are present in nearly half of all depressed children and adolescents. 113 Ans. DSM-IV criteria b. b. either a or b At age 8. twice as likely to experience depression as an adult. impulsive type. four times as likely to experience depression as an adult. 105 M 77 . low self-esteem c. D App p. hopelessness b. reckless play. posttraumatic stress disorder of childhood b. D Fac p. none of the above What do children and adolescents' substance abuse. 103 E 3. 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. a high level of serotonin b. he is a. a. a. Keenan will be likely than Dora to show such symptoms. much less.3. 105 M 3. separation anxiety disorder 3. B Con p. unlikely to experience clinical depression as an adult. 104 M 3. b. d. separation anxiety disorder d. C App p. suicidal thoughts d. depression Which of the following adult symptoms of depression is NOT exhibited by children with depression? a. They could be signs of suicidal feelings. somewhat more According to the text. ICD-10 criteria d. By age 15. d. 105 E * 3. A Con p. why haven't I thought of that? Which of the following medications and disorders is mismatched? a. 105 C 3. depression: RAS underarousal b. b. Layton's parents exhibit marital conflict and may be hostile toward Layton. c. Tofranil: childhood anxiety Which of the following treatment approaches would you consider for a child with a mild to moderate depression disorder? a. D App p. imipramine: enuresis d. d. anxiety: heightened physiological arousal d. Layton's family expresses high levels of both negative and positive affect. Layton's depressed parent is overcontrolling and insensitive to Layton's emotional needs. a tricyclic antidepressant c. either a or c Which of the following does not belong with the other three? a. recurrent inappropriate compensatory behaviors d. c. disturbed perception of body shape or size c. 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. not depression. 105 M 3. Tricyclics should be given only to severely depressed children who fail to respond to other treatments. The clinician would probably respond in which of the following ways? a. d. ADHD: frontal lobe deficits c. 124 Ans. That's a good idea. C Con p. 125 Ans. enuresis: disruptions in arginine vasopression release If Layton is depressed and he has a depressed parent. B App p. cognitive-behavioral group therapy d. unreasonable fear of gaining weight b. 121 Ans. Layton's family is less cohesive and supportive than are other families. 123 Ans. C App p. 105 E 3. 120 Ans. 122 Ans. 105 M Which of the following childhood disorders and biological findings are mismatched? a.3. b. Prozac: bulimia b. Tricyclics are only used to treat adult depression. D Con p. which of the following characteristics is LEAST likely? a. Tricyclics are used to treat anxiety disorders. cognitive restructuring and coping skills training b. restricting type 3. Dexedrine: ADHD c. 106-7 M 78 . 127 Ans. Jennifer suffers from which of the following? E a. 128 Ans. 106 months. anorexia nervosa. 15 to 1 in favor of Angelica b. or Mike. bulimia nervosa. restricting type c. but this does not meet the DSM-IV criterion for anorexia. A App p. bingeing and vomiting If you were a betting person and had to bet on whether Angelica. B overweight at 96 pounds and a height of 5'5". outright refusal to eat b. despite popular belief to the contrary Based on current data. a fifteenyear-old female. less than 200 calories per day and has had amenorrhea for three p. 130 Ans. what would you expect your odds to be? a. c. obsessive-compulsive type b. B App p. 126 Jennifer exercises more than a world class athlete.3. bulimia nervosa. She will have a body weight of about 82% of average. but this does not meet DSM-IV criterion for anorexia. She will have a body weight that is close to the female ideal reported by both females and males. What attitude does she probably hold about food? a. at which point she detests the thought of food. b. which strategy is she MOST likely to employ? a. c. d. She is obsessed with food and spends a great deal of time cooking elaborate meals for her family. compensatory type d. and restaurants. She goes out of her way to avoid food-related stimuli. Jennifer consumes. anorexia nervosa. television commercials for food. 108 E 3. If 16-year-old Angie has anorexia. She will have a body weight of about 90% of average. had anorexia. 106 E 3. 4 to 1 in favor of Angelica d. misuse of laxatives or diuretics d. 108 E 79 . and this meets the DSM-IV criterion for anorexia. A App p. d. C App p. She will have a body weight of about 82% of average. She often spontaneously thinks about food and is extremely distressed by her inability to control her thoughts. She believes she is Ans. 2 to 1 in favor of Mike. what prediction would you make about next year's Miss America winner? a. on the App average. 129 Ans. restricting type 3. such as grocery stores. 106 M * Alaqua has an eating disorder in which she avoids gaining weight through extreme dieting and excessive exercise. 3. b. excessive exercise c. 10 to 1 in favor of Angelica c. She rarely thinks about food except when she gains even the smallest amount of weight. a fifteen-year-old male. What males rated as their "ideal" shape was substantially thinner than their "current" shape. d. amenorrhea c. 108 C 3. Skinner given such clients? a. her body shape is THINNER than what females themselves described as a. 132 Ans. female's ideal: male's attractive: female's attractive c. emotional distress c. adolescent onset Which of the following concepts does not belong with the other three? a. male's attractive: female's ideal: female's attractive b. arginine hormone Libby is an 18-year-old female who has experienced amenorrhea for the past two months. the most attractive body shape to males. 131 Ans. C App p. What diagnosis has Dr. social phobia c. 108 M 3. separation anxiety disorder b. 134 Ans. Skinner believes that his adolescent clients are struggling with the development of adult sexuality by avoiding forbidden sexual objects and activities. What males rated as their "current" shape was substantially thinner than their "attractive to females" shape. D Fac p. female's ideal: female's attractive: male's attractive Ana's body shape is equivalent to that chosen by college males as "most attractive. 135 Ans. hypothalamic dysfunction b. anorexia d. What might be causing this? a. What males rated as their "current" and "attractive" shapes were essentially the same. B Fac p. 109 E 3. What males rated as "attractive to females" was the same body shape described as attractive by the females. c. 108 M According to Fallon and Rozin's (1985) study of college students' perceptions of actual and ideal body shapes for females. male's attractive: female's attractive: female's current d. which of the following represents a CORRECT ordering from thinnest to heaviest? a. A App p. control of feeding behavior b. their ideal body shape. D App p. both a and b Which of the following statements is CORRECT in regard to college males' ratings of their body shapes? a. b. 133 Ans. 109 M 80 . d. a deficiency of corticosteroids d. 136 Ans. Dr. their current body shape. D Con p. hypothalamus d. c. depression. either a or b 3. 108 M 3. b. " Given this.3. disruptions in serotonin production Emily has just begun treatment for anorexia. 140 Ans. lose weight b. she tends to go through this cycle five times a week. operant conditioning d. 109 E * Micah eats enormous amounts of food then induces vomiting to rid herself of the excess calories. be less healthy and more concerned with thinness. A App p. 143 Ans. 139 Ans. Andrea is anorexic. Her primary goal is to primary goal is to . enuresis c. A App p. 109 E 3. self-administered punishment conditioning 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 will her therapist's first goal be? a.3. confrontation of distorted body images Adelina's parents are seeking a treatment program for their daughter who has bulimia. b. C Fac p. 109 E 3. lose weight. be extremely thin . c. anticonvulsant medication d. an increase in body weight c. Stella is bulimic. 138 Ans. 111 M . 141 Ans. anorexia nervosa d. 110 E 3. What diagnosis is appropriate? a. lose weight. what would you recommend to them? a. pathogenic family interactions c. B App p. lose weight d. 142 Ans. avoid being fat. 109 M 3. group psychotherapy b. a. imipramine c. D App p. individuals with bulimia tend to a. exercise more in order to become extremely thin. bulimia/purging subtype b. an increase in self-esteem d. none 81 3. suffer from more severe emotional problems. Micah suffers from which of the following? a. d. D Fac p. 137 Ans. B App p. exploration of dysfunctional family communication patterns b. be of normal weight or even somewhat overweight. uncontrolled eating disorder Unlike anorexics. encopresis b. Her 3. be extremely thin. avoid being fat c. bulimia/anorexic subtype c. Micah is especially prone to this pattern when she is under emotional distress. 110 M Which of the following causal factors has NOT been implicated in bulimia? a. media portrayal of ideal female body types b. On average. If they are primarily concerned with reducing Adelina's bingeing and purging. developmental delay syndrome d. deficits in desired behaviors that usually cause subjective distress in the child. but are important in assessing children's problems. 111 E 3. The child will probably outgrow the disorder in about a year. encopresis d. Which of the following components is NOT involved? a. parental reinforcement for avoiding accidents d. 146 Ans. somatic complaints. practicing getting out of bed and using the toilet Which of the following disorders is more common in females than in males? a. 82 . preadolescent depression c. 144 Ans. 2. Internalizing . The disorder is probably being caused by marital discord and other family stress and will subside once these issues are addressed. enuresis b. If a child has an irregular release of arginine vasopressin. an eating disorder b. None of the above is correct. bell-and-pad warning system b. excesses of undesirable or nuisance behaviors. 112 E 3. Three scales: withdrawn. A App p. anxious/depressed. What sort of classification system does this assessment procedure represent? 1.3. 145 Ans. 111 M Dr. 148 Describe the three primary components of the CBCL and list their respective scales. 3. What prognosis should Dr. Additional scales that are not sufficiently closely related to the above dimensions. 105. Mills is talking with the parents of a child who has just been diagnosed with enuresis. 111 E SHORT ANSWER I ESSAY 3. C Fac p. what disorder may result? a. d. D Fac p. Externalizing — undercontrolled behaviors.overcontrolled behaviors. B App p. b. encopresis c. Mills make? a. Two scales: aggressive behavior and delinquent behavior. remaking the bed himself and changing clothes after an accident c. bipolar disorder of childhood Ned is participating in dry-bed training for his enuresis. c. none of the above 3. social problems. This approach represents a dimensional approach to classification. thought problems. enuresis d. 147 Ans. The child will probably outgrow the disorder in about three years. according to statistical criteria. Three scales: attention problems. problem solving). The gene mutation causing disruption in thyroid functioning provides primarily conceptual evidence but not empirical evidence at this time. poor parenting skills 3. and more directive and "bossy.. language. prolonged oxygen deprivation is also strongly related to major developmental disabilities. These factors make it difficult for parents to carry out effective child-rearing skills and to foster secure attachment in the child. 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. Males are 2 to 3 times more likely to exhibit and be diagnosed with these disorders. How are these factors linked to the parenting characteristics that contribute to disruptive behavior disorders? Severe marital discord. 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. dopamine & norepinephrine. low SES. underaroused nervous system (e. poor communication skills. father's criminality. " 3. executive functioning deficits. overreactive to negative behavior. and maternal gestational alcohol use is not unique to ADHD and usually involves the larger FAS disorder. such as ODD. to be critical. coercive cycles. low resting heart rate. low skin conductance) Cognitive factors: neuropsychological deficits (in memory. g. making assessment and diagnosis more difficult. 3. Because of the adversity and strain. 83 . mother's mental disorder. impairment in social-cognitive skills associated with interpersonal conflict (jumping to conclusions. 150 List four of the six risk factors that comprise the family adversity index. and it is more difficult to draw the line between normal and/or adaptive emotional reactions and abnormal reactions.3. and ADHD. Internalizing disorders such as anxiety and depression are less likely to demand as much attention from adults to deal with the symptoms. Childhood anxiety is also common (about a 9% prevalence) but less likely to lead to a clinic referral. Too. 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. large family size. parents are probably more likely to resort to coercive cycles. children may have difficulty verbalizing their inner experience. Neurotransmitter deficits of the catecholamines. abnormal levels of testosterone and/or serotonin (related to greater impulsivity and aggression). Biological factors: genetic risks. have not replicated consistently. adverse family conditions (family adversity index). Early life problems: low birth weight has not yet been empirically documented as specific to ADHD. although stimulant medication does affect these transmitters. CD. difficulty handling cognitive demands of conflict) Social/family factors: insecure attachment. foster placement for the child. more likely to be preceeded by pica and battles with parents over eating Similarities = distorted body image and self-evaluation.. 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. interpersonal. 153 List the three anxiety disorders that can contribute to school refusal and indicate the primary motivation for that refusal for each disorder. and family therapy based on Minuchin's model 84 .[3. What are their central similarities? Anorexics: 85% of expected body weight or thinner. difficult to treat successfully 3. 154 Describe the primary differences between anorexia and bulimia. 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. potential threat to health and life. 152 cont'd] Underarousal of RAS is difficult to measure. primarily interested in being extremely thin. 155 disorders? What three psychotherapy methods have shown success in the treatment of eating Cognitive-behavioral — both individual and group. g. dogs) 3. do not binge. often preceeded by picky eating and digestive problems Bulimics: typically of average or slightly heavier weight. amenorrhea present. 3. 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. interventions limited to his school years. 118 E To find the first use of the term "developmental disability. eventually overcoming the disorder through intensive counseling and family involvement. Impairment is evident prior to adulthood and extends through adulthood. " one would need a. lifelong impairment with serious limitations in daily living skills and need for specialized care. 6 Amy is a normal child. 3 months old. He is most likely to need a. C the criteria for defining a "developmental disability. d. ICD-6. A App p. to specify the conditions under which persons with such a disability could be legally committed for institutional treatment 4. 118 a. She is often cooing or babbling and uses her hands to Ans. d. 4 Ans. to provide clearer DSM guidelines to distinguish developmental disorders M from other childhood disorders b. Romero served on the committee charged with the development of Ans. Miguel is a 5-year-old who has a learning disability. p. Long-term specialized care is needed. 5 Ans. b. moderate supervision in his adult occupational activities. Day-to-day functioning and basic skills are significantly impaired. she is App a. 1 year old. " For what primary reason App are he and his committee engaged in this work? p. B App p. The most likely prognosis for her is a. 119 b. Which of the following is NOT a characteristic of such disabilities? a. c. 1 Ans. c. D App p. DSM-II. A Fac p. behavioral interventions to manage destructive or self-injurious behaviors. 118 E 4. 118 M Richard's parents have been told that their son has a developmental disability. to set the stage for research related to behavioral and biological treatments for those disabilities c. 6 months old. Judith has a developmental disability. d. 3 Ans. 4.Chapter 4 DEVELOPMENTAL DISORDERS AND LEARNING DISABILITIES 4. d. c. 85 . Public Law 95-602. intensive interventions to allow him to function relatively normally. 2 Suppose Dr. American Association of Mental Retardation guidelines. 118 E 4. b. If she is average for these milestones. the ability to successfully accomplish basic daily living skills after intensive weekly therapy sessions. b. 18 months old. Symptoms cannot be modified by treatment. b. B maintain balance when she sits. d. E c. to identify which persons would be entitled to specialized treatment services d. 4. ability to live relatively independently with employment in a sheltered workshop. c. C App p. His parents are worried. 12 Ans. A App p. For which infant below would you MOST confidently predict a low IQ in later childhood? a. Ella wants her little sister to play outside with her. C App p. a one-year-old infant with an average habituation time d. how young could Ella's sister be and still play along successfully? a. d. B Con p. but because children are widely different they should continue to monitor his skills and not yet worry. Ella wants to play hopscotch and jump-rope. 7 Ans. 119 M Bly says things like "banky" for 'blanket' and "dada" for 'daddy'. d. Corey shows sign of a delay in normal language ability and should be thoroughly evaluated for a possible developmental disability. so they shouldn't worry. 11 Ans. This means she is capable of a.4. Corey is somewhat delayed in this ability. D App p. 2 years Corey is two years. d. 5 years old Which of the following is applicable to Lita's expressive language development? a. A App p. c. c. 119 M 4. 119 M 4. no developmental disability could possibly be present. b. and they shouldn't worry at all. telling where a body part is without seeing it. 119 E 4. 9 months b. She probably developed this ability faster than did same-age males. Based on average developmental milestones. She developed this ability after her development of receptive language. About how old is Bly? a. 15 months c. c. b. This sort of language milestone is not typically reached until children are two and a half years old. Unless there are disturbances in motor and other cognitive domains. 120 C * 86 . Kylee has well developed gross motor abilities. 4 years old d. displeasing. 10 Ans. a seventeen-month-old infant with a long habituation time 4. She was probably about two years old when she attained this ability. 9 Ans. 119 M * 4. 3 years old c. a six-month-old infant with a short habituation time b. 8 Ans. 2 years old b. good coordination between hand and eye movements. based on your knowledge of development? a. controlling large muscle movements in a coordinated fashion. b. 20 months d. What should you tell them. disruptive body motions. a seven-month-old infant with a long habituation time c. She developed this ability prior to her development of receptive language. three months old and has not yet begun to use three words in combination and very rarely uses functor words. She has a vocabulary of about 40 words like these. a six-month-old child. c. an eight-year-old child. D Fac p. Paco has a. assessing the type of toys the child is most interested in. correctly answered items on the Stanford-Binet test that are answered by an average nine-year-old. c. more intelligent c. How would this be accomplished? a. Which of the following skills is NOT included on a standardized intelligence test? a. She is predicted to be than are infants with a long habituation time. 13 Ans. a deviation IQ of 110. such as puzzle completion b. a. 15 Ans. performance on fine visual-motor skills. d. 120 M * 87 . has a short habituation time. 120 C 4. measuring the time lapsed from when a new object is repeatedly presented until the infant loses interest Dr. gross motor skills b. 120 E Jamie. obtaining information about the abilities of the child's family. 16 Ans. Watson wants to determine the cognitive abilities of a 20-month-old child. 120 M 4. expressive language d. 14 Ans.4. performance on a standardized intelligence test d. 17 Ans. a mental age of 8. administering the Stanford-Binet Intelligence Scale. On what characteristic should she focus? a. observing the infant during normal and REM sleep to compare neural activity level b. D App p. receptive language Paco. b. C App p. habituation speed c. less intelligent b. Carbonell is conducting a study to predict the kindergarten cognitive abilities of children who are 2 years old. less likely to develop dyslexia A psychologist wants to determine the habituation speed of an infant. 119-20 M 4. visual-motor skills c. 4. D App p. measuring the rate at which the infant's neurons fire in the occipital lobe during visual stimulation d. d. a mental age of 9. measuring the time the infant spends trying to learn a new sound in a particular day c. b. 18 Ans. administering the Wechsler Intelligence Scale for Children. a below-average IQ. B App p. A Con p. 120 M 4. She will obtain the most accurate results by a. slower to develop adaptive behavior skills d. family characteristics and abilities Dr. In other words. 120-1 E 4. b. C App p. 50. 121 E Scores on the WISC-III indicate that Yoshi. DSM-IV. developmental milestones. c. b. 120 E 4. at any age. AAMR. A Con p. 20 Ans. differences in definitions established by the AAMR. During an interview with his therapist. 115. and ICD. all of the above Dave's IQ of 73 could be considered "mentally retarded" according to the definition set by the a. d. by the time he completes grade school. c. For Mitch to be classified as mentally retarded. B App p. learning disability. 23 Ans. c. c. c. b. intelligence. adaptive behavior. 24 Ans. b. all of the above 4. high reliability. d. intelligence. 121 E * 88 . ICD-10. Jeffrey was given the Vineland Scales and the test created by the American Association of Mental Retardation. Each of the following issues suggests caution in diagnosing this apparent impairment EXCEPT a. It could be agreed by most psychologists that IQ tests have a. D Fac p. B App p. both a and b. 121 E 4. 25 Ans. 121 C 4. the natural and common tendency for children to exhibit occasional developmental delays. a 12-year-old child. A Con p. as long as mental functioning and adaptive behaviors are impaired. b. in infancy. b. You could guess that his IQ is a. 100. The therapist is assessing Jeffrey's a. c. adaptive behaviors. 120 C 4. neither a nor b. 19 Ans.4. d. b. high validity. Cultural norms and values are important in the definition of a. c. language skills. d. the tendency for this test to overclassify impairment. a lack of normative data on which to base interpretations. Eve achieved a score of 73 on the Vineland. d. has an average IQ. his impairment must begin a. before he turns 18. d. 22 Ans. 12. DSM. 21 Ans. d. C App p. d. both a and b d. nonorganic. trainable b. lives at home and requires minor assistance with dayto-day activities and works part-time in a laundry. a. whose IQ is 76. AAMR b. borderline. whose IQ is 90. mild. severe. Dora. limited. A App p. organic. A clinician using the DSM-IV might not diagnose Clark as mentally retarded because a. Naum. 121-2 M 4. B App p. he does not live in a structured. b. His WAIS-R IQ is 69. his adaptive functioning is not sufficiently impaired. who would meet DSM-IV criteria for mental retardation? a. neither a nor b Jake is mentally retarded. moderate. remedial. is unable to hold a job and barely manages to take care of his daily needs for food and shelter. works full-time. and lives in his own apartment. 4. 121-2 M * 4. C App p. 122 M 89 . 122 E 4. b. b. educable. c. supervised setting. pervasive Of the following persons. 28 Ans. lives in her own apartment. deficits in both IQ and adaptive functioning. Reginald. Ida. 05 b. B App p. He is part of this disability. 7-8 % of the world population with As a clinician responsible for assessing children exhibiting significant impairment in academic and adaptive abilities. whose IQ is 68. mental retardation and a substance dependence disorder. 29 Ans. A App p. DSM-IV c. whose IQ is 64. d. his IQ is not low enough. Nora has a dual diagnosis. 121 C 4. holds a groundskeeping job. and supports herself and her child. cannot hold a job. lives on the streets. . 26 Ans. profound d. This means she has a. 30 Ans. a developmental disability and a separate physical disability. cultural-familial c. c. has never married. 31 Ans. moderate. c. what classification system are you MOST likely to use? a. dropped out of school in ninth grade. mental retardation due to a genetic disorder and environmental deprivation. 3-5 d. d.4. and is unconcerned about his situation. Clark is married. 01-. 27 Ans. the IQ test was not given prior to age 18. 122 E 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. 1-3 c. D App p. and work with supervision. c. 38 Ans. b. marriage. be unable to have a family. d. d. lack of expressive language Marguerite has been given a diagnosis of severe mental retardation. She will be able to learn near-normal speech. A Fac p. live in a group home with the assistance of others on a daily basis. d. 34 Ans. 90 4. He would be diagnosed as a. 122 M 4. 122 M * Mild mental retardation is defined by the DSM-IV by IQ's in the range of about a. b. b. She will have only simple speech. She will be unable to engage in any vocational activity. Beth has been diagnosed as having the level of mental retardation exhibited by 85% of persons with this disability. read on a third-grade level. have neurological damage. 122 E 4. seventh Jim has some adaptive behavioral deficits. b. Which of the following descriptions is MOST likely to apply to her? a. and require constant supervision to survive. and an IQ of 58. c. the cognitive impairments of children with mild mental retardation become evident by grade. 37 Ans. d. be confined to an institution for much of her life. 32 Ans. B App p.50. a. intensive self-care assistance. IQ of 45 d. trainably retarded. 50 . reading and simple math.4. d. moderately retarded. A App p. Beth will probably a. 36 Ans.60. be unlikely to marry and have children. minimally retarded. C App p. He could probably accomplish each of the following EXCEPT a. Although not immediately obvious. 35 Ans. c. performance of unskilled jobs with supervision. and require assistance in taking care of basic living skills. She will have an IQ of 25 or less. 33 Ans. fifth d. 30 . Ryan is diagnosed with moderate mental retardation. mildly retarded. and require daily. third c. 20-40. Which of the following does not belong with the other three? a. 122 M 4. 122 M . c. hold a semiskilled job. b. c. need for supervised group home living b. 122 M 4. 45 . C Fac p. significant cognitive delays evident in early childhood c. D Con p. 122 M 4. expressive language.70. first b. D App p. be unable to read. 5 to 10 b. B Con p. Theo has a. One of 300 known biological causes is responsible for the mental retardation of % of persons with this developmental disorder. Marta is 42 years old and is having her first child. Annette developed cerebral palsy as a result of cerebral injury in infancy. 10% of the mentally retarded population c. Down syndrome. you would predict that caused the client's disability. D App p. non-heritable chromosomal addition known as a. 45 Ans. 123 E 4. C App p. C Fac p. 123 M 4. d. hypoxia. autistic mental retardation. 43 Ans. B App p. 123 M Which of the following does not belong with the other three? a. c. hemiplegic spasticity. namely a. Any of the above are equally plausible causes. a. c. poorly articulated speech d. If Greg has cerebral palsy. a. and requires assistance with even the simplest of needs. d. Williams syndrome. 15 to 25 c. a cultural-familial factor c. He is incapable of advanced speech. b. 123 M 4. 42 Ans. common motor and visual-motor deficits Theo has severe neurological damage. B App p. b. d. A App p. 25 to 50 d. which of the following characteristics necessarily applies? a. 60 to 80 A client in your day treatment program has mild mental retardation. PKU syndrome. Her motor impairment is the type most commonly exhibited.or post-natal problem d. moderate mental retardation. She is concerned about her child's risk of mental retardation due to an abnormal. c. fragile X syndrome. He has muscular impairment due to early cerebral injury. IQ of 30 b. 40 Ans. c.4. Both a and b apply. simplistic. b. 123 M 4. 91 . motoric dystonia. 44 Ans. 41 Ans. a genetic disorder b. b. He has mental retardation. severe mental retardation. d. Knowing nothing else except the findings from research. 122 M 4. 123 M * 4. a peri. profound mental retardation. quadriplegia. is wheelchair bound. 39 Ans. Matthew. have upward slanted eyes. with small hands and fingers. 49 Ans. 51 Ans. Andreas? a. Rollo cannot do either task and is often unwilling to comply with the test-giver's requests. PKU: 12 b. fragile X syndrome. Down syndrome: 21 d. with Williams syndrome b. expressive language skills that exceed overall IQ b. Which observation will probably surprise Dr. and children from local hospitals and group homes were invited to attend. Ricardo. an ability to accurately reproduce complex visual stimuli from memory 92 4. Gina. B App p. Down syndrome. Vonetta. 125-6 M Which of the following disorders and chromosomal location are mismatched? a. oppositional and hyperactive behavior problems d. 46 Ans. Andreas is treating a pediatric patient who has Williams syndrome. with fragile X syndrome c. 52 Ans. A App p. and be able to pass the defect on to her children. daily living skills much better than expected. 125 M 4. and Rollo probably has . have "language in the relative absence of thought". Williams syndrome b. Which of the following characteristics are these parents least likely to observe? a. c. 127 C 4. given the patient's IQ of 55 b. and be moderately retarded. heart defects. d. 127 M . expressive language abilities that greatly exceed the patient's IQ c. fragile X syndrome c. B Fac p. Reya probably has . Williams syndrome: 15 c. FAE d. a high level of sociability and relatively good mental health c. C App p. PKU. b. be short and stocky. Which of the following characteristics probably does NOT apply to her? a. less retardation than her twin brother with the same syndrome c. 48 Ans. 125 E * 4. Mary Ann will a. Which of the following children will be most interested in this activity? a. 126 M 4. with PKU d. an absence of physical stigmata d. PKU Wendy is diagnosed with fragile X syndrome.4. a. Fragile X syndrome: 23 Having been diagnosed with Down syndrome. B App p. A App p. Brian's parents are learning to cope with their child's Down syndrome. an elfin appearance. have quasi-psychotic symptoms. with FAS Dr. 50 Ans. have a long face with a broad flat nose. 124 M 4. 47 Ans. and a smaller-than-normal cerebrum. premature aging and a risk of dementia by age 40 d. a likelihood of passing the defect in chromosome pair 23 to her offspring b. D App p. with mild retardation A storytelling festival took place on a college campus. changing patterns in the speed of acquisition of academic and adaptive skills Reya successfully puts simple pictures in sequential order but has difficulty understanding what higher-order concept the pictures might represent. Williams syndrome. 59 Ans. 127 M 4. C App p. b. 53 Ans. cocaine b. 56 Ans. all of the above areas Which of the following teratogens is most damaging for an infant's development? a. tyrosine. Based on available research. 127 M 93 . PKU Willy's body is poisoning itself with a substance that in normal persons would be the harmless substance. environmental toxins that can produce mental retardation in young children. has a malfunctioning thymus gland that will lead to growth suppression. can lead a normal life and have a near-normal IQ with a special diet. c. PKU d. 127 M * Regarding organic causes of mental retardation. physical development d. A App p. Monique. Down syndrome c. marijuana c. c. d. fragile X b. FAS d. d. B Fac p. trisomy 21 d. 127 E 4. the nurse would anticipate significant difficulties in for these children. has moderate mental retardation. 54 Ans. C Con p.4. 127 E 4. social development c. What condition does Willy have? a. cognitive development b. C App p. exposure to maternal herpes during the birthing process d. autoimmune disorder c. 127 M 4. alcohol 4. has a deletion of a gene on chromosome 7. a. a child with hearing and visual impairments. b. will be retarded and require specialized care for most of her/his life. exposure to alcohol as a result of her mother's binge drinking during pregnancy c. What is the most likely source of her disability? a. 55 Ans. D Con p. 127 M 4. exposure to rubella during the first trimester of her gestation b. which item below does NOT belong with the other three? a. toxic amino acid byproducts found in the CNS of some retarded children. 57 Ans. D App p. She also exhibits microcephaly and cardiac dysfunction. substances which cross the placenta and damage a fetus. FAS b. substances produced as a result of head injury that lead to neural dysfunction. This means that the child a. A nurse in an infant ICU ward cares for several infants born to cocaineaddicted mothers. Tay-Sachs disease A newborn is found to have phenylketonuria. 58 Ans. exposure to environmental deprivation in the first two years of life Teratogens are a. Garrett. seat belt and helmet use and pedestrian safety training d. Beverly. d. developmental alcohol effect disorder. moderate social drinking is safe. D Fac p. Roxanne. It is not proven that any drinking is safe during gestation. How much alcohol is safe for a pregnant woman to ingest? a. flattened jaw line. Occasional binge drinking is safe if it occurs in the third trimester. B App p. minimal teratogenic syndrome. genetic screening. 62 Ibriham's mother drank two glasses of wine several times a week after the first Ans. This disability is called a. counseling. improved birth delivery methods that prevent hypoxia and other complications Which of the following children is at greatest risk for nonorganic mental retardation? a.4. C App p. 61 Ans. relatively inattentive and unresponsive to child's efforts and interests Which of the following is not a method of detecting the possibility of retardation in an unborn child? a. 65 Ans. emotional and social impairments later in childhood 4. c. 63 Ans. a check of the family pedigree b. and family planning c. c. A App p. blood analysis of parents' chromosomes c. a white male d. 129 E 94 . 127 E * 4. 127 b. Which description below is LEAST characteristic of his parents? a. 128 C Which of the following interventions will decrease the common causes of mental retardation? a. 128 M 4. Michael. 66 Ans. shortened eyelids. games. C Fac p. fetal alcohol syndrome. 64 Ans. gestational alcohol effect. or books b. a reduction in IQ of about 7 points p. 60 Ans. b. a black female c. brain cell dysfunction and early-onset dementia M c. likely to converse with Kibur infrequently and with little verbal elaboration d. medical and educational programs to prevent premature birth and low birth weight b. linkage analysis d. One drink per day is safe after the first trimester. Very infrequent. 128 E 4. likely to be authoritarian in their discipline style c. C Fac p. B trimester of her pregnancy. 127 E Rosa exhibits facial deformity and neurological dysfunction as a result of her mother's binge drinking that occurred just prior to pregnancy. and thin upper lip d. a black male b. a white female Kibur is living in a home marked by environmental deprivation. 4. d. unlikely to provide educational toys. What outcome for Ibriham is LEAST likely? App a. b. amniocentesis analysis 4. Satinka is concerned about her developing baby's health. Miranda's parents will be taught how to read effectively to her. c. S. c. Miranda is a child participating in Project Head Start. Children in the program consistently outperform their peers on developmental tasks in early grade school. 129 M Because her cousin has PKU and her husband's niece has Down syndrome. She has a. d. phenylketonuria. 67 Ans. Each of the following services will be offered EXCEPT a. c. Several longitudinal studies have been conducted at several sites across the U. too late to be of help in this decision.4. Long-term follow up shows that most of these children are no more likely to graduate from high school than are comparison group children. B Fac p. If she were faced with a possibility of a first trimester abortion. which statement would you OMIT? a. b. Psychiatric assessment and treatment will be provided for both of Miranda's parents. c. 71 Ans. d. 69 Ans. 130 E 95 . d. D App p. operant conditioning c. In a report on the effectiveness of Project Head Start. respondent conditioning 4. b. 130 M 4. 130 E 4. D Con p. A App p. B App p. social modeling d. 68 Ans. b. Which learning paradigm is most commonly employed for the treatment of moderate to profound mental retardation? a. Research findings have varied according to program quality and choice of outcome measures. why would amniocentesis not be helpful? a. While it could be used to detect these disorders. The procedure cannot be safely performed until the fourth month. FAS. classical conditioning b. Williams syndrome. sacrose intolerance syndrome. This procedure detects only physical defects and does not provide information relevant to genetic disorders. 70 Ans. Support groups and psychoeducational programs on nutrition and behavior management will be provided to Miranda's parents. b. Miranda will attend a preschool which provides an intellectually stimulating environment. d. the results are too unreliable. PKU and Down syndrome are not heritable disabilities and thus the procedure would not be informative. Kenesha's risk of mental retardation can be lessened or even eliminated by early dietary controls. 130 M * 4. 75 Ans. C Fac p. b. C App p. generalization. has learned to appropriately request a toy from her therapist. shaping. Seymour has identified eye contact as the first target step in a behavior modification program for social skills. maintenance c. His mother has an IQ of 65. 130 E 4. direct reinforcement strategies. b. DRO correction. 131 C 96 . targeting. d. a process known as a. children's low IQ scores Trevor is in the intervention group of the Abecedarian Project. 72 Ans. applied behavior sequencing. In order to use an applied behavior analysis. normalization d. As of age 3. family environment b. His IQ is probably around 69 and is similar to that for a comparable child in the control group. what prediction would you make for Trevor's IQ? a. a. C Con p. A App p. 4. Naomi will first have to divide the skill into its component steps known as a. B App p. shaping. differential maintenance. 74 Ans. Which of the following concepts does not belong with the other three? a. His IQ is probably around 90 and is about 7 points higher than that for a comparable child in the control group. It is hoped that this behavior will also occur when Kamuko has a home visit. c.4. 77 Ans. family income. the children's low IQ scores. 130 M Naomi is working with mentally retarded children to teach them basic social skills. operant conditioning Project Head Start targets children on the basis of . 73 Ans. overcorrection. c. d. b. If he initially reinforces quick glances by a child and then reinforces longer glances. an autistic child. His IQ is probably around 82 and is slightly higher than that for a comparable child in the control group. Seymour is engaging in a. Kamuko. b. c. 131 C 4. parental IQ scores d. c. d. d. family income c. target behaviors. but its outcome might be more clearly favorable if it targeted children on the basis of . environmental deprivation. behavior modification program b. 130 E 4. family environment. 130 E 4. analysis units. shaping behaviors. His IQ is probably around 95 and is about 20 points higher than that for a comparable child in the control group. D App p. 76 Ans. 4. escape from task demands b. insufficient numbers of eligible children d. social reinforcement Marissa recently learned to decrease the frequency of temper tantrums as a result of her staff caregivers' DRO strategy for appropriate play behaviors. 132 M 4. Bayard becomes combative and self injurious. 80 Ans. 131 M 4. 83 Ans. A App p. nonaversive punishment b. caregiver attention When he is taken out of the activity room and placed in his chair for lunch. positive reinforcement c. What type of consequence do the staff behaviors represent? a. has an IQ that is about 15 points lower. 82 Ans. 132-3 E 4. 78 Ans. It will probably continue through the process of maintenance. somatomotor release of tension b. frequently engages in moderate head banging when she is by herself. is more likely to have an IQ below 85. shows gains in reading and math skills. nonverbal communication opportunity c. and her behavior is unchanged when her caregivers attempt a DRO modification program. release of endogenous opiates c. 79 Ans. Which of the following is the LEAST likely reinforcer for this behavior? a. b. d. c. calming him down. What probably motivates Mahala's behavior? a. escape from task demands d. availability of public funding c. Compared to a child in the intervention group. aversive punishment 4. 133 C 97 . What prediction would you make about Marissa's play behavior in the future? a. 132 M * Abigail was a member of the control group in the Abecedarian project. B App p. use of unreliable treatment interventions Mahala. 81 Ans. has about an equal chance of having been retained in school. an autistic child. b. lack of documented long-term research success b. Abigail at age 12 a. hitting herself severely on her head and face. What is the primary obstacle to implementing more programs such as the Abecedarian Project? a. D App p. endogenous opiate release d. It will probably become overcorrected. and encouraging him to eat. overcorrection d. It will probably generalize to other social settings. d. c. It will probably require ongoing reinforcement. 131 M * 4. B Fac p. C App p. The staff spend several minutes physically restraining him. A App p. A profoundly mentally retarded adolescent engages in self-injurious behavior. 86 Ans. mood dysfunction. D Fac p. What are they treating? a. a lack of attention to individual educational needs for children in the program c. 133 M 4. She lives in a supervised group home in a residential neighborhood. a. institutional c. 132-3 M Amid a great deal of debate. community. 85 Ans. unprovoked attacks on other patients and staff c.4. What kind of approach to care does this situation reflect? a. A Con p. positive response maintenance and generalization c. 133-4 C 4. 87 Ans. behavioral normalization d. institutionalism c. S. residentialism b. normalization d. D App p. positive psychotic symptoms b. 133 E 4. Ikeda and her staff decide to prescribe the drug naltrexone to a severely mentally retarded patient. What issue is she not likely to address? a. A App p. placement in special education according to IQ and adaptive behavior tests b. and Dimitri is experiencing significant changes in his living situation and educational opportunities as a result of the U. an overemphasis on placement by a single IQ measurement d. 89 Ans. B App p. uncontrollable head-banging If you are ethically opposed to the use of aversive punishment for the control of self-injurious behavior in persons with developmental disabilities. similar to manic-depressive disorder d. self-instructional training Isabella is 20 years old and moderately mentally retarded. community d. determination of his formal individualized education program Coretta has a daughter who has been placed in a self-contained special education classroom. a move from a state institution to a specialized foster home c. 88 Ans. Which of the following does NOT belong? a. 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. community b. C App p. 134 M * 98 . 84 Ans. a disproportionate number of black children in the program b. a possible development of stereotypes and prejudice on the part of nondisabled students and community 4. 133 M 4. on which of the following operant strategies would you rely? a. Dr. DRO program b. both groups'. institutional. guaranteed access to educational services provided by the local school system d. community. assaultive. both groups' It is 1978. IDEA legislation. Coretta has approached the local school board with several concerns about this practice. 94 Ans. 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. E. D Con p. language deficits. 35 . Kraepelin b. b. pervasive developmental disorder. 134 M 4. 25 . H. C Fac p. There are no "special" classrooms. What kind of educational process does this represent? a. atypical autism c. reciprocal social relationships. and seems uninterested in his parents or siblings. 135 E 4. 135-6 M c. b. and profoundly mentally retarded students c. L. integration For which type of disabled student do educators encourage the use of selfcontained special education classrooms? a. B App p. 95 Ans. What diagnostic label would he choose from the DSM-IV? a. 135 M 4. L. mentally retarded students with self-injurious or other behavior disorders Emilio is three years old.55. 135 M 4. 8 0 . What disorder appears to be evident? a. severely impoverished or absent language skills. 4. mentally retarded students who live in institutions rather than community settings d. Suh is treating a 4-year-old child who exhibits stereotypic behavior. moderately. Asperger c. D App p. autism b. 135 E 4. uniformly low scores on standardized IQ tests. 96 Ans. Kanner d. Down Dr. Who first used the term "autism" and identified its core characteristics? a. severely. A App p. stereotypes. If Yoshi has typical autism. normalization c. lack of adaptive. and a relatively average interest in other people. d. C App p. she will exhibit each of the following EXCEPT a. 92 Ans. d. B Con p. inclusion d. mildly mentally retarded students with severe physical stigmata b. Asperger's disorder d. stereotypy disorder c. He has no expressive language skills. 93 Ans. spends hours repetitively rolling marbles along the floor.9 5 . Asperger's disorder d. c. Kanner's disorder The majority of individuals with typical autism will have an IQ in the range of a. autistic spectrum disorder b. 90 Ans. 60-70.4. mainstreaming b. 91 Ans.40.NOS 99 . 4. approximately will have autism. 136 M 4. p. 50 c. and of these disabled children. 9. facilitated communication. 9. a 4-year-old. qualitative impairment in social interaction M b. an African American female If Salim is being assessed for the possibility of an autistic disorder. much as the child would regard crayons as tools for drawing. a Japanese female b. C App p. any 1 of the diagnostic areas d. 4. % will also be mentally retarded. Jiro. 98 Ans. c. a Japanese male c. typical autism b. 75 b. In other words. b. atypical autistic disorder d. A Fac p. what disorder would you suspect? a. 101 Ans. exhibits idiosyncratic and repetitive language use as well as Ans. 100 Alexa. 97 Ans. schizotypal developmental disorder When his parents try to show him interesting objects. expressive interactionism. 136 M If a developmentally disabled child regards other children as "tools" in a game. PKU-related mental retardation c. qualitative impairment in communications 4. and stereotyped patterns of behavior * c. 136 E 4. receptivity. Thelma. 136 E For every 10. a Chinese male d. Erik exhibits a great deal of difficulty coordinating his gestures and eye contact to mesh with his parents'. 4. B App p. perseverative behavior disturbance d. 000 children. d. any 2 of the diagnostic areas 4. 136 a. A App p. restricted.4. 45 Which of the following children is most likely to exhibit autism? a. joint attention. in which of the following areas must he exhibit abnormal functioning prior to age 3? a. Michi. Chang. 99 Ans. language and communication c. 65 d. 102 Ans. repetitive. 137 M 100 . These two symptoms fulfill the DSM criteria of autism. a. social interaction b. Erik has difficulty with a. D developmentally retarded social play and a lack of spontaneous make-believe App play. B App p. 138 M 4. which includes very low scores on each of the following subtests EXCEPT a. 108 Ans. Mrs. b. 103 Ans. B Fac p. Mrs. critical and emotionally aloof. she probably has a vocabulary that is a. 106 Ans. 138 M 101 . b. 107 Ans. 137-8 M 4. D App p. 104 Ans. impairment in social interaction c. 137 C If Mariana has typical autism with some expressive language skills. stereotypic behaviors b. c. substantially larger than would be expected based on her mental age. and Mr. diagnostic practices have changed substantially in the last two editions of the DSM. made up primarily of nonsense words meaningful only to herself and those who know her well. no specific genetic transmission for the disorder has yet been identified. c. C App p. Dr. not substantially different. 4. the disorder is rare among MZ and DZ twins. Ida's repetitive use of idiosyncratic phrases such as "up. b. D App p. d.4. block design. Jaime's complete preoccupation and fascination with door locks of all kinds b. c. A App p. Alani's insistence that every object in her room be left in the exact same place every day c. d. his therapist sees the pattern common for autistic children. anxiety-prone and socially introverted. comparable to that expected for her mental age but limited in day-to-day usefulness. impairments in language d. 138 M 4. c. Stamos are probably a. Rutter has found it difficult to employ twin studies in the search for biological contributions to autistic disorder because a. and Mr. 105 Ans. Stamos have an autistic child. b. Compared to the parents of a nondisordered child. A App p. overly emotionally expressive and smothering. extremely limited in size and utility even when compared to her mental age expectations. the parents of such children are not interested in participating in research. ip. Which of the following descriptions does NOT reflect stereotypic behavior by an autistic child? a. d. pip" and pronoun reversals In which of the three DSM diagnostic areas are mentally retarded children most dissimilar to children with autism? a. comprehension and reasoning. d. Adrian's self-injurious wall-hitting behavior d. 137 M 4. vocabulary. impairments in nonverbal intellectual abilities On Raphael's IQ test. fund of general knowledge. tell a lie. Weinstein works in a neuropsychiatric facility which specializes in treating autism. c.4. dopamine c. an autistic child. which one has the most empirical support at this time? a. twin studies d. 138 M 4. She has probably found evidence of a. None have been conclusively supported. which developmental disorders are correctly portrayed from LEAST to MOST common? a. c. A Con p. biological d. retell a story from the perspective of a person besides herself. d. failure to understand or express emotions in interpersonal situations If Leotie. below-average development in the frontal lobes and cerebellum. 138 M According to information presented in the text. Her specialty involves the use of PET and MRI scans to identify cortical abnormalities in these children. 110 Ans. 137-40 C 102 . she will be unable to do each of the following EXCEPT a. autism: Rett's disorder: moderate mental retardation b. Asperger's disorder: moderate mental retardation: autism 4. 138-9 M 4. 139 C 4. 109 Ans. enkephalin b. 139 E 4. D App p. disruptions in sensory-thalamic-cortical feedback mechanisms. brain imaging studies b. 138 E 4. B Fac p. acetylcholine d. neural degeneration in the temporal lobe and underlying limbic system. form an attachment in the Strange Situation task. family studies Dr. If a sample of Samantha's cerebrospinal fluid were analyzed. D Fac p. C Con p. 113 Ans. has no coherent theory of mind. Samantha has autism. C App p. serotonin Of the psychological factors proposed to account for autism. Based on available theory and data. linkage analysis studies c. deficits in executive functioning b. sociocultural b. correctly answer the "M&M" problem. Rett's disorder: Asperger's disorder: autism d. b. which paradigm is most clearly implicated in understanding the etiology of autism? a. cognitive c. b. which research strategy has NOT yet documented a biological contribution to autism? a. 111 Ans. B App p. 115 Ans. disruptions of attachment c. 112 Ans. d. which neurotransmitter might be expected to be abnormally elevated? a. 114 Ans. inability to engage in social imitation d. hyperfrontality and hemispheric lateralization. childhood disintegrative disorder: Asperger's disorder: Rett's disorder c. In terms of prevalence. increased social indifference. 121 Ans. he could expect to see each of the following symptoms EXCEPT a. If he were to meet a child with a form of atypical autism first described as autistic psychopathy. has childhood disintegrative disorder and Oliana. a tendency for the child to talk incessantly and informatively about her favorite hobby. 103 4. lose her ability to walk. Candice suddenly became extremely clumsy with her hands. 140 M The language characteristics displayed by children with Williams syndrome are most similar to those of which other developmental disorder? a. Asperger's disorder c. Nahele has only minor deficits in expressive and receptive language skills. She will probably return to her previously normal level of functioning once her diet is changed and closely controlled. a 12-year-old male. unable to hold or manipulate objects. Rett's disorder d. 117 Ans. typical autism c. b. b. has typical autism. typical autism c. childhood disintegrative disorder b. trisomy 21 syndrome A graduate student is preparing for a practicum experience in a special education classroom. d. Asperger's disorder b. She will probably be moderately mentally retarded but able to care for her basic daily needs if behavioral treatment begins by age 3. Which disorder does not belong with the other three? a. Nahele's first three years of life were marked by normal developmental patterns. c. c. C Con p. Rett's disorder b. B App p. What prediction would you make for Candice? a. 141 C 4. and other symptoms of typical autism. William's disorder d. d. relatively normal expressive language skills. She will probably develop stereotypic behaviors. an initial onset of symptoms at 28 months of age. Oliana has a higher overall IQ and somewhat better joint attention skills. 120 Ans. 141 M . and show later decreases in her stereotypic behaviors. Rett's disorder Which of the autistic spectrum disorders is known to be more common in females than in males? a. childhood disintegrative disorder At age 15 months. c.4. A Fac p. 141 E 4. a 12-year-old female. 119 Ans. 118 Ans. D App p. 140 M 4. 140 C 4. what is the central difference between them? a. b. 116 Ans. B App p. Asperger's disorder d. A Con p. Oliana has substantially more severe impairments in executive functioning. She will probably become severely mentally retarded. If Nahele. reasonably good nonverbal skills and joint attention. d. she exhibited deficits in expressive language and disinterest in her family members. Thereafter. Whom will you include. as in the Abecedarian project c. his parents. 122 Ans. d. B App p.4. 127 Ans. Lovaas' university lab b. as part of the behavior modification program for Ben. whom you will see in their home c. 123 Ans. 141-2 M 4. d. and in what setting. conduct daily behavioral training sessions for two years. Ben and his parents. Ben. involving parents and peers in multiple settings. whom you will see at home and at school d. show a 20-point gain in IQ. You are one of Dr. If Ramon shows average gains from the program. Ben. c. Doman & Delacato b. early intervention programs should focus on what goal in the treatment of mental retardation? a. be substantially improved but still require medication for disruptive behavior. Crossley d. his parents. helping mothers to be more effective parents b. 141 M If you wanted to replicate the treatment approach of the most extensive and well-documented program for autistic children. no longer display clinical symptoms of a developmental disorder. A App p. 141 M 4. combine a weekly behavior modification program with medication over a twoto three-year period. According to Robert Hodapp. 125 Ans. whom you will see at school Ramon received an intensive treatment program designed by Ivar Lovaas. A Fac p. A Con p. b. b. Long-term use of medication may cause permanent neurological side effects. d. phonological awareness and joint attention skills 104 4. whom you will see in Dr. elimination of self-injurious behavior and other disruptive behaviors that interfere with social skill development d. 142 E . Research has demonstrated the greater efficacy of naltrexone despite slightly increased side effects. you would a. c. To whom would you refer them for a method that shows realistic promise? a. exhibit normal peer interactions. D App p. The medication decreases aggression but worsens remaining autistic symptoms. an autistic child? a. 141 E 4. b. Asperger For what reason might a psychiatrist be hesitant to treat Jacob's highly aggressive autistic behavior with an antipsychotic medication? a. Lovaas' graduate student therapists. fostering gains in IQ. Ruth's parents are understandably desperate to find a treatment program for their autistic daughter. Lovaas c. 126 Ans. 141 M * 4. by age 7 he will a. 124 Ans. combine daily at-home social skills training with educational mainstreaming for preschoolers. 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. and his teachers. C App p. and his peers. Jacob shows no evidence of schizophrenia or any other formal thought disorder. Ben. c. C Fac p. C Fac p. Why is the growing interest in facilitated communication seen as a problem by clinical scientists? a. It diverts attention from effective instructional methods and raises false hope for parents. the Doman-Delacato method is scientifically worthless. and thus expensive. emotionally disturbed children from all SES groups c. exclusionary criteria based on emotional disturbance or cultural disadvantage d. She would probably recommend a treatment program such as Lovaas' in order to enhance verbal communication skills for such children. none of the above 105 4. CNS dysfunction c. emotional disturbance and psychiatric disorders d. D Con p. mildly retarded. families and schools b. b. The method requires the involvement of highly-trained. what factors) do you identify as actually responsible for a learning disability? a. 145 M 4. What might you conclude about this clinician's general perspective? a. b. 144 M * On what group of children did the concept of a learning disability have its most direct effect? a. She does not value and/or is not trained in the scientific method. inherited phonological encoding deficiencies What component is common to the various definitions of learning disability? a. b. they discovered that a. mental health care workers. 144-5 C 4. d. significant discrepancy between IQ and achievement b. lower. Additional empirical research is needed before a conclusion can be reached about the effectiveness of the method. 129 Ans. the Crossley-Biklen method resulted in only minor improvements in the expressive language skills associated with typical autism. D Fac p.and middle-class black and Hispanic children When researchers employed appropriate control groups. 128 Ans. standardized outcome measures. 144-5 E 4. high functioning children b. 146 E . B App p. 143-4 E 4. motor patterning treatment decreased stereotypic behaviors but did not improve intellectual functioning in mentally retarded children. d.4. facilitated communication was effective only for atypical autistic children. 130 Ans. c. d. 131 Ans. c. the presence of an intrinsic CNS dysfunction c. 133 Ans. c. Its success brings into question the validity of the scientific method for evaluating treatment claims. If you take Coles' (1987) stance. She probably relies on standard IQ tests as a valid means of evaluating her clients' abilities. 132 Ans. middle-class white children d. She endorses the behavioral approach to developmental disorders. other equally effective methods are less costly. 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. A App p. and an appropriate statistical approach to evaluate a method for treating a developmental disability. 138 Ans. for many school districts and for the DSM-IV b. 2 to 4 c. no. make abnormal eye tracking movements while watching cartoons or reading picture books. A Fac p. d. 146 C * 4. have difficulty sounding out the phonemes in the word "cat. Of the 100 students in your classes this year. 18 b. 11 c. 136 Ans. 6 to 7 Several more males are diagnosed as learning disabled than are females. a. 106 4. yes. c. Reed wants to identify preschool children who may be at risk for later dyslexia. neither for school districts nor the DSM-IV You are a new school teacher. When females have achievement problems in school. has poor phonetic decoding. 146 M Evian was doing well in all of his school subjects except math. b. not for the DSM-IV c. both a and b Dr. B App p. " b. 146 M 4. including that for arithmetic. 2 As a special education reading instructor. Testing has indicated that Linda has dyslexia. 146-7 C . B App p. yes. yes.4. b. 146 M 4. 134 Ans. Are learning disability criteria met? a. putting males at increased risk for the most common learning disability. for the DSM-IV. have unusual asymmetries in their planum frontalis. d. Why might this be? a. Hemispheric asymmetries in various brain structures are associated with higher levels of androgen hormones. 135 Ans. 3 to 5 d. 146 M 4. Parents are less likely to read to preschool sons and are somewhat more likely to encourage girls to excel in school. 137 Ans. C App p. no. fell between 85 and 110. A App p. about how many will be receiving federally authorized services for a learning disability? a. " c. for every female student in your class. Research indicates that he should select children who a. d. D App p. you will have male students in the class. not for many school districts d. Testing indicated that Evian had an IQ of 115 and his achievement test scores. 139 Ans. no. they typically have lower overall IQ's. perceive the letters "b-u-s" as "s-u-b" or repeats the phrase "dog ran" as "ran dog. Compared to the average student. c. transposes the order of letters and words. she probably a. Referring teachers are more likely to refer males in part because they tend to be less attentive and more disruptive than girls. 1 to 2 b. for many school districts. 5 d. and thus would not meet the IQ discrepancy criterion as frequently. engages in abnormal eye movements. Redding and his son d. influence of insufficient school practice in oral reading and impaired learning readiness. and his father has a learning disability. Given this situation. who are two years apart in age c. the Redding's children. systematic instruction in phonological awareness If you wanted to refer your dyslexic child client for the most effective treatment. Mr. c. d. and they praise not only her successes but also her effort and interest in her work. Redding and his daughter A student's report on proposed causes of learning disabilities could include each of the following research findings EXCEPT a. dietary modification and stress reduction c. larger in his right hemisphere. academic efficacy. Mrs. intensive training in vocabulary and grammatical complexity d. Which family members are most likely to share a similar pattern of reading deficits? a. her parents sit down with her and encourage her to show them what she's doing. Mr. joint attention. evidence of planum temporale symmetry or reversed asymmetry in the brain of poor readers. b.The Redding family is participating in Dr. medication and visual skills d. of equal size in his left and right hemispheres. d. decreased reliance on group-based reading instruction c. d. Kamaria benefits from a. you would recommend a(n) intervention. Stanley is an adult who is an above-average reader. you would expect his planum temporale to be a. Several times when Kamaria does homework. sound-based reading program 107 . group psychotherapy b. which of the following is the LEAST helpful compensatory strategy for Anthony? a. phonological awareness. greater concordance of reading disabilities between MZ rather than DZ twins. larger in his left hemisphere. a. Hoien's dyslexia study. evidence of genetic factors accounting for roughly 65% of the differences in reading achievement in the population. b. learning readiness. c. Anthony's planum temporale is smaller in his left hemisphere than his right. Toni and Rachel. parental reinforcement of Anthony's self-efficacy and academic motivation b. Redding and her daughter b. Based on available research. b. c. less well developed than his medial geniculate nuclei. 4. 149 List the three DSM-IV symptom categories for typical autism. 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). conducted in the least restrictive setting possible. Too. 4. many of these specialized classrooms have been situated in buildings physically segregated from regular classrooms. Some of the common characteristics seen in Down syndrome children are the following: eyes which tend to slant upwards. " Children with this form of MR show the following: moderate MR. usually caused by an extra 21st chromosome when that chromosome fails to split during maturation of the egg. thin face with a broad. in which one tip of the X chromosome has an excess of material. and good mental health. However. premature aging. although the actual implementation of this practice appears to fall short of its goals. Many schools chose self-contained special classrooms for disabled children. The most common heritable form is Fragile X syndrome. shorter-than-average height. activities. nonexistent or poor language skills. or interests 108 . and sociability. making it look thin and "fragile. Severe deficits in reciprocal social relationships. To offset these problems.SHORT ANSWER / ESSAY 4. IQs of about 50. with less severity in females. The school systems were mandated by the 1975 Individuals with Disabilities Education Act (IDEA) to provide special educational services to these children. the reliance on IQ tests for assessment has resulted in a disproportionate number of black children being placed in these classes. and stereotyped or restricted. The goal was to foster greater independence and more "normalized" lifestyles. small hands with short fingers. a long. 146 According to the DSM-IV. 147 What is the most common non-heritable form of biologically-caused mental retardation. most school districts have turned to mainstreaming (portions of the day spent in regular classrooms). 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. and this practice may promote antidisability biases. with worse-than-expected expressive language skills but reasonably good rote learning and visual-motor skills. in comparison to other MR individuals. including dementia by middle age. repetitive patterns of behavior. stocky. fiat nose and large ears. relatively stable emotions. 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. 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. 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. educational. genetic factors (probably polygenetic in nature). 20 points). deficit in theory of mind. 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. lack of an individually tailored curriculum for Yrina Family factors .4. pragmatic use of language absent or extremely limited. describe some of the cognitive deficits she might exhibit.insufficient learning readiness instilled by parents. limited phonological awareness). 150 Troy. failure to attend to salient social stimuli. 149 Mary Ann is an autistic child. impaired executive functioning. His therapist.an educational intervention employing either the whole language or soundbased approach to reading instruction 109 . Drawing on research described in the text. 151 Yrina is at risk for dyslexia.exposure to ineffective group instruction with inadequate opportunity for practice and feedback. and aggression will also be employed. lack of a secure attachment between Yrina and her parents Treatment . 4. taking place at home and in other relevant environments and including Troy's parents and his peers. and familial factors (non-biological) could be associated with this risk? What treatment would you recommend and why? Biological factors . What biological. and he has roughly a 50/50 chance of entering a regular first-grade class. Troy will be involved in intensive training sessions every day for two years. Operant conditioning of stereotypy. Educational factors . or general cognitive abilities in planning and problem solving related to goaldirected behavior (possibly a reflection of frontal lobe deficits) 4. three years old. a psychology graduate student.difficulty with phonetic decoding (or. tantrums. will focus on Troy's language development and on cooperative play with peers. Describe the kinds of interventions Troy receives and what outcomes could be reasonably predicted. or the ability to infer the mental states of other people. is participating in Dr. Lovaas' treatment program for autism. Follow-up five years later should show that Troy will have maintained most of his achievements. Troy should exhibit a substantial increase in IQ scores by age 7 (on average. sexual assault b. the adequacy of her innate immune response c.Chapter 5 STRESS. 3 Ans. b. 154 M 5. 154 M 5. c. 154 E * 5. 6 Ans. c. Stress is a. Which of the following is LEAST likely to be reported? a. Deal immediately with daily hassles in order to avoid entering the resistance phase of stress. 156 E * 110 . primarily a psychological process. one quarter b. Develop more extensive social support. C App p. Maintain an optimistic attitude toward life's challenges. d. dressing conservatively. b. d. C Fac p. d. two thirds d. a. Dr. Dr. 's (1993) phone survey findings. Which of the following would be LEAST useful? a. one half c. Ruiz should gather information in several areas. 4 Ans. Ruiz is conducting an assessment of a new client. It is not possible to avoid stress altogether. c. evaluation of the client's coping strategies Based on Resnick et al. AND ADJUSTMENT DISORDERS 5. 154 M 5. indices of the client's physiological functioning d. B App p. 5 Ans. 1 Ans. 5. the nature of the client's interpretation of the stressors b. A App p. 2 Ans. severe illness or death of loved ones d. caused by traumatic events and major life milestone changes. You would encourage her to take each of the following actions EXCEPT a. paying some of the expenses on the date. subjectively perceived and defined. four fifths A group of adolescents at the local high school is being asked about the experience of traumatic events in their childhood. assault involving a weapon or physical injury Elisa wants to avoid the possibility that she might be a victim of acquaintance rape. refusing to spend the date in an isolated location. you could predict that of adult women in your community have been a victim of a major crime or a noncrime trauma. In order to adequately assess the client's stress. avoiding the use of alcohol or other drugs during the date. B App p. 154 E What response would you give to a friend who wants to know how to avoid stress? a. relatively unaffected by cultural norms. attempted kidnapping c. b. C App p. SLEEP. and Kelly's family visits twice a week on a regular schedule. which patient is under greater stress? a. Marta's family visits twice a week without advance notice. Either a or b is possible. Both are equally stressed by family visits. Cocheta. b. If she has a prior history of rape. An individual with either of these characteristics is more likely to be a victim of bad luck. If an individual has poor social skills or other long-term psychological handicaps. she is less likely to report a sexual victimization than is a student in a control group. Each of these women is at high and equal risk of sexual victimization. Which of the following outcomes is MOST likely? a. how might this influence the person's stress process? a. Margaret. she is just as likely as a control group student to report a sexual victimization. b. Other things being equal. being a victim of violent crime d. who witnessed the murder of her father when she was 10 years old c. Marta and Kelly are both inpatients being treated for clinical depression stemming. Jerod will be overly aggressive as an adult. d. If she has a prior history of rape. The individual may unintentionally bring about some stressful events in her/his life. who was a victim of sexual abuse as a child b. in part. Kelly b. If Ferris & Delville's work with young hamsters were found to be applicable to humans. There is no way to make a prediction in this case. d. dropping out of college due to failing grades c. c. d. from family conflict. Jerod will be chronically ill and susceptible to premature death. she is less likely to report a sexual victimization than is a student in a control group. The individual may experience abnormalities in brain chemistry that could exacerbate the stress responses. 111 . c. Which of the following stressors is MOST damaging to personal adjustment? a. Marta c. The impact of each would depend on an individual's subjective perception. d. Her/his perception and interpretation of stressors may be objectively incorrect. what outcome would you predict for Jerod who has been repeatedly bullied and physically assaulted by older brothers? a. Cyndee. she is just as likely as a control group student to report a sexual victimization.Annette participated in a 9-week acquaintance rape prevention program offered at her university. b. the divorce of one's parents b. Which of the following women is MOST likely to be a victim of sexual assault as an adult? a. who was seriously injured in a car accident at age 12 d. If she has no prior history of rape. Jerod will be overly timid as an adult. Regardless of her personal history. c. Selye's General Adaptation Syndrome Interview d. A App p. whereas Betty is usually oversensitive to changes associated with the alarm phase. and financial difficulties. 158 M . the Schedule of Recent Experience c. caused by the person him/herself b. 158 E * 5. major hassles. C App p. minor. caused by a malicious person c. " What is being assessed? a. HS life change units. 158 M Which combination of stressor characteristics is likely to result in the greatest perceived stress and problems in adjustment? a. 18 Ans. the cumulative effect of small stressors In the last 12 months. Their physiological reactions to stress are different. b. 17 Ans. LES 112 5. 14 Ans. D App p. and uncontrollable How do reactions to stress differ between Marcy. Which of the following is the LEAST likely focus of the group's work? a. 158 M 5. controllable. from Guatemala two years ago. Marcy is more likely to view the stressor as a challenge. 158-9 E 5. the Life Experiences Survey b. cognitive reappraisal of job and marital stressors c. She would exhibit high scores on the a. the positive or negative impact of an event b. d. c. uncontrollable. C App p. " "frequent misplacement of objects. frequent. caused by the person him/herself d. chronic procrastination d. development of optimism and self-esteem b. life change units c. 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. 15 Ans. SRE negative event. c. 158 M 5. " or "unexpected company. B Fac p. 16 Ans. d. the Hassles Scale Mitch is completing a survey where he rates whether he has experienced "too many meetings. enhancement of social support Dr. Williams wants to assess his client's level of stress. a pessimistic person? a. Which scale would probably be MOST sensitive to his client's experience of major events? a. 13 Ans. Marcy often ignores the symptoms of stress. B App p. Marcy tends to feel more threatened by a stressful event compared to Betty. b. with Marcy showing less HYPAC activity.5. who finds such events more expected and controllable. unexpected. an optimistic person. SRE life change units. whereas Betty may see the same event as a threat. and his client is a Hispanic female who came to the U. expected. and Betty. S. unexpected. techniques for the avoidance of the alarm phase of stress d. controllable. Shara has experienced several health. family. unpredictable traumas . predictable stressors that arise from life's milestones.and emotion-focused coping strategies c. weight loss d. body expands its energy supplies. immunosuppression. autonomic reactivity to sustained stressors b. to create adaptation c. What is the most likely topic of her work? a. excitement c. fear b. to defend against environmental threat b. adrenal corticosteroids secreted. weight loss. emotional changes associated with alarm and resistance d. the stage in which physical and psychological coping mechanisms are used to defend against the effects of stress b. catecholamines secreted. getting stuck in traffic jams. immune system weakens. organ damage Which of the following emotional reactions does NOT belong with the other three? a. relatively minor events such as car trouble. behavioral. floods. depression How does Selye describe the alarm stage of the general adaptation syndrome? a. which example below could be considered a significant stressor based upon accumulation? a. having children. to enhance immune system functioning Which of the following physiological reactions correctly reflects an example of the three progressive stages of the GAS? a. physical energy depleted c. cognitive reappraisal and social support interventions in adjustment disorders What is the primary function of physiological reactions to stress? a. immune system weakened. anger d. stressors that are linked to repetitive occupational demands Roberta is a research assistant for Hans Selye. HYPAC activation b. to create conscious awareness of stressors d. the stage marked by emotions such as fear and excitement as well as heightened levels of attention and concentration c. or violent encounters c. the stage in which a person's energy is finally depleted and the ability to cope with stressors is impaired d. like getting married. the stage dominated by sympathetic nervous system activity 113 . sympathetic nervous system aroused.In an examination of different types of stressors. or losing your lecture notes the night before an exam d.earthquakes. or starting college b. find adequate child care. c. C Fac p. B App p. stage of exhaustion. b. 28 Ans.5. His hypothalamus is releasing . He takes several doses of an antacid each day and rarely gets a full night's sleep. blood rushes to muscles c. the release of endogenous opiates b. pituitary: CRH d. a. According to Selye. CRH: HPAC: ACTH c. catecholinergic hormone. 27 Ans. 29 Ans. CRH: ACTH: corticosteroids d. resistance d. alarm d. adrenocorticotrophic hormone. and spend several hours across many days in the hospital. She is entering the stage of stress. 160 C 5. epinephrine and norepinephrine You are alone on a dark street. alarm b. hypothalamus: ACTH c. B App p. A App p. coping Health psychologists who wish to study the coping strategies of individuals experiencing ongoing stressors should seek persons in the stage of stress. stage of resistance. d. the release of adrenal corticosteroids d. D App p. the release of adrenal corticosteroids c. Hector is in the a. 26 Ans. D Fac p. 161 E . Which alarm phase sequence of chemical releases is correctly ordered? a. adrenal cortex: endorphins b. 160 E Leah was informed two days ago that her mother suffered a severe stroke. digestion is stimulated 114 5. C Con p. heart rate increases d. ANS depletion stage. 160 M 5. corticotropin-releasing hormone. adrenal-releasing corticosteroids. Which of the following physiological responses would NOT occur? a. a. ACTH: CRH: epinephrine b. you think someone is following you and getting closer. prodromal b. 25 Ans. resistance c. 31 Ans. 160 E 5. Suddenly. adrenal medulla: catecholamines Levi is learning to ski and has just lost control on a long slope and cannot stop his descent. 160 M * 5. alarm reaction stage. HPAC: corticosteroids: CRH Which of the following structures and substances are correctly paired? a. 160 E 5. regulatory Hector is experiencing "burnout" in his role as a probation officer in an overcrowded. pupils dilate b. a. exhaustion c. 30 Ans. Leah realizes she will need to take an extended leave from work. understaffed judicial system. followed by . Connie notices that no matter what she's eaten recently. 162 M 5. 35 Ans. Physical exercise helps release extra endorphins that help regulate Alexa's cardiovascular activity and facilitate her psychological coping. release of adrenal corticosteroids to shut down the sympathetic system b. 161 M 5. The reactions were caused by the failure of the body to release epinephrine and norepinephrine that would have restored ANS balance. Physical exercise promotes perceptual. and the nausea you feel requires you to sit in the car for 15 minutes. which causes gastrointestinal constriction 5. diversion of blood to internal organs c. d. Alexa finds that her regular exercise routine helps her cope with stressors. By increasing her heart rate and her body's production of glucose she is reducing the production of corticosteroids that prolong stress reactions. 34 Ans. conclusion of alarm phase Suppose Ruza's adrenal medulla is overactive and frequently secretes a substance into her bloodstream. What produces this effect? a. c. A App p. parasympathetic system activity which rapidly activates digestive processes d. her stomach winds up in knots. a child on a bike darts out in front of your car. All reactions are by-products of the sympathetic nervous system activity and mobilization against threat. 32 Ans. d. One day while you are driving to school. When you get back in your car. You prematurely entered the resistance phase of coping. cognitive. anxiety and feelings of panic c. C App p. What causes this reaction? a. the increase in muscle tone throughout the body.5. the release of corticosteroids which interact with stomach acids to create distress c. Physical exercise may result in the release of stress hormones that intensify the alarm phase and prepare her body to cope with stressors. b. when her level of stress increases. The parasympathetic branch of the autonomic nervous system is conserving the body's energy for answering the immediate threat. Which of the following descriptions does NOT apply to her returning state of calm? a. b. 162 M 115 . You would not expect an overt change in behavior. What might best account for this exercise benefit? a. You quickly respond by hitting your brakes and swerving around the child. 161 M Wynona tripped and nearly fell down a long staircase. although her susceptibility to illness would increase. decrease in vigilance and attention d. 33 Ans. and behavioral adjustments which all increase Alexa's immediate ability to cope with a stressor. You discover mat except for a few minor scrapes everything is fine. c. B App p. What consequence would you observe? a. insomnia and feelings of depression d. sympathetic system activity which rapidly deactivates digestive processes b. 36 Ans. your legs are shaking so badly you can't drive. profuse sweating and lethargy b. 161 C 5. B App p. A App p. causing an extended release of catecholamines. exhaustion b. resistance c. 163 E 5. 37 Ans. 162 M In his recollection of falling from the parallel bars and breaking an arm during a gymnastic competition. T cells and B cells d. Ramone is sustaining organ damage. 163 E 116 . c. 39 Ans. antibiotics The human immunodeficiency vims is a type of a. 42 Ans. her immunity functioned effectively. protective clothing b. 163 E 5. the appearance and texture of the parallel bars on which he was performing. 3 M * 5. c. he had to take time off to keep medical and legal appointments for several more days. 41 Ans.5. d. the thoughts that went through his mind as he fell. Rosa is 15 pounds underweight and now feels helpless to avoid bankruptcy. Ramone's ability to continue healing at a normal rate is impaired. Bart is LEAST likely to recall a. specific 5. Ramone may be developing chronic hypertension. b. Ramone is increasingly vulnerable to disease. 38 Ans. A App p. 40 Ans. innate b. d. pathogenic c. If Bobbi is exposed to a cold vims which invades her body but she does not become ill. B Con p. collapse What sort of innate immunity do physicians rely on for defense against pathogens? a. and upon returning to his job. antigen. a. alarm d. b. c. b. 160. interleukin. lymphocyte. 163 E 5. d. creating more tension and anxiety. his fall from the parallel bars as though it happened in slow motion. Which physiological outcome is LEAST likely in this stage of Ramone's stress reaction? a. Ramone was involved in a serious car accident on the way to work. the gasps and cries that went up from the crowd who saw him fall. After four months of working 14 hours a day to try to keep her business afloat. C App p. C App p. He was away from his job for one month. D App p. What GAS stage does she appear to be in? a. microphage. acquired d. skin c. D App p. but a. then their two children were home sick for several days. 163 M 5. antibody d. antigens. Macrophage activity was probably slow to identify this mild pathogen. related to the adaptive cessation of interleukin activity. increased killer T cell production. 44 Ans. 47 Ans. C Fac p. but as of today she feels back to normal. D App p. destroying the pathogen before it can cause symptoms. B App p. B cells d. 46 Ans. d. increased suppressor T cell production. 163 M 5. helper b. Memory T cells are poised to quickly destroy the familiar pathogen. b. Why was her immune system slow to ward off what was probably a minor pathogen? a. Interleukins failed to summon sufficient numbers of helper B cells. macrophages. killer T cells b. This pathogen has been identified by and will be destroyed by . 5. Danoi was well again. 163 M * 5. d. 48 Ans. memory c. There are several T lymphocytes in the body. antigens Yolanda had been under the weather for several days. Why should he not worry about catching the flu again from his children? a. helper T cells. Ronald received a bone marrow transplant from his brother in an effort to treat cancer. decreased antigen production. Danoi had the flu. Helper B cells will release antibodies specific to the pathogen. interleukins c. a. b. B cells had to release several types of antibodies to effectively combat the pathogen. 163 M Mato's body is fighting a foreign pathogen. Autoimmune macrophages will rapidly identify and destroy the familiar pathogen. then his wife caught it. Killer T cells will be more readily recruited by interleukins. a sign of an impending autoimmune disease. increased B cell production. c. macrophages. b. b. c. 163 M 5. David has successfully overcome a respiratory infection. One of the anticipated benefits of this transplant could be a. The match between antigen and sufficient numbers of specific killer T cells was slow. D App p. 163-4 E 117 . A App p. 45 Ans. 43 Ans. d. First Mr. d. A App p.5. likely to inhibit the creation of memory T cells. suppressor is NOT one of them. The fact that his effective killer T cells have now stopped their activity is a. c. c. but Mr. the expected result of suppressor T cell activity. 163-4 M If Wyatt's body were found to be deficient in interleukins. B and T cells could not be recruited to kill a pathogen. D App p. fight-or-flight response c. Lincoln? a. Francine has been ill with the flu and is getting further and further behind in her classwork. he is a. She is engaged primarily in a. D App p. a low number of antigens. managing. Antigens could not be identified. 164 E 118 . 163-4 E * 5. In other words. 4 E 5. 52 Ans. 5. problem-focused coping. coping. enhancement of energy production in muscles and brain d. 53 Ans. For several days. b. C App p. d. b. serotonin c. Antibodies could not be released into the blood. suppressor T cells d. b. 51 Ans. Of me various substances secreted in the body during times of stress. 54 Ans. b. 50 Ans. which one is of specific interest to Dr. 49 Ans. glucocorticoids Which of the following physiological reactions does not belong with the other three? a. cognitive reappraisal. immune defense activation b. c. competent immune system should include each of the following EXCEPT a. such as his neighbor who mows his lawn at 7: 30 on Saturday mornings. Your healthy. d. c. d. the catecholamines b. 160. defensive support.5. 164 E 5. adapting. Lincoln is a health psychologist studying the relationship between stress responses and immune functioning. suppressing. what process in his immune system would be directly affected? a. d. corticosteroid release Bertrand is trying to learn how to tolerate the stressors in his life. Pathogens could not be devoured. Dr. c. a high number of B cells. a high number of killer T cells. C App p. 163-4 E 5. A Con p. emotion-focused coping. D App p. 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. c. a high number of suppressor T cells. because he is using humor to indirectly express his feelings and avoid conflict b. because he is venting his frustration to some friends who understand his concerns c. seek out colleagues at work who will understand and sympathize with her experience. distraction A husband is worried about his wife's excessive weight and her poor health habits. social support c. emotion-focused coping d.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. think about the new worker's lack of experience and the likelihood that this person's abilities will improve in the future. she said to herself. request a meeting with the coworker and their supervisor to discuss the situation. emotion-focused 119 . defense mechanism d. "Well. c. social support b. get away from the pressures of their jobs by going fishing together for several hours twice a month. make a voodoo doll of the person and displace her frustration onto the doll by jabbing it with pins and putting curses on it. problem-focused coping c. problem-focused b. which have led to cardiovascular problems. Victor. defense mechanisms d. emotion-focused coping. inner-focused coping b. I've been wanting to go back to school for my master's degree. cognitive reappraisal c. d. problem-focused coping. b. 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. social support strategy. because he is trying to eliminate the stressor of her shopping by changing his emotional response d. 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. Which coping approach is NOT applicable in this situation? a. problem-focused coping Kristos and his cousin. When Miriam lost her job. I guess this is a sign that it's time to do that!" What coping strategy is she employing? a. a defense mechanism. A App p. 164-5 C . her reliance on social support as a problem-focused rather than emotionfocused coping strategy d. who just lost his job as an advertising executive due to his lack of productivity c. 165 M * Gina has just finalized her divorce. 61 Ans. which coping approach would you be LEAST likely to recommend to employees trying to cope with their fears of another bombing? a. her own perception about her friends and family's level of care for her and her value to them Based on information from Stone and Neale (1984). 165 C * 5. security was noticeably heightened for many federal offices. 62 Ans. D App p. D App p. 165 E 5. who just learned that her mother has lung cancer b. problem-focused coping b. either problem. problem-focused coping. Which characteristic of her social support network is most important in helping her cope with this experience? a. For several years Jillian has had chronic migraine headaches that are usually unresponsive to medication. 63 Ans. A Fac p. who has been arrested on a false charge of cocaine possession d. increasing the number of people she spends time with in order to enhance her social competence d. objective measures of the quantity and quality of the support given by people around her c. Based on evidence presented in the text. Marissa. changing her emotional reaction to her headaches by employing humor After the Oklahoma City federal building bombing. c. C Fac p. c. 60 Ans. emotion-focused coping c. b. B App p. 165 E 5. females are somewhat less likely to use than males are. social support d. defense mechanisms. social support. cognitive reappraisal. social support as a means of coping. d. learning as much as she can about her condition in order to anticipate its course and effects c. the number of friends and family members with whom she interacts regularly b. defense mechanisms 120 5. What coping approach might be MOST helpful? a. Mike. a. d. who was just in an automobile accident and sustained minor injuries The MOST effective coping strategy is a. b.5. 165 C 5. one which fits a given stressor and its context. Which of the following persons might MOST effectively make use of a defense mechanism coping approach? a.or emotion-focused coping. 65 Ans. Emilio. 64 Ans. a denial defense mechanism b. Vondra. emotion-focused coping. stress-induced anxiety disorder A clinician is writing an assessment report. a minimizing effect What variable has been hypothesized to account for the stress/social support connection? a. 69 Ans. D Fac p. when might social support worsen rather than help a person's coping efforts? a. intelligence c. lessening its value c. 67 Ans. when an individual is utilizing problem-focused or defense mechanism coping approaches b. 167 E 5. 167 M 5. A Fac p. 71 Ans. D App p. 167 M * . d. They would be noted on Axis IV. They would be specified on Axis I along with the client's clinical diagnosis. 166 M Jahi has a young child with moderate mental retardation. 166 M 5. How would a client's recent marital separation and arrest for attempted assault be noted in that report? a. B Fac p. when the support occurs indirectly instead of directly. a competence effect c. 68 Ans. how would this condition be described in the DSM-IV? a. 121 5. somatoform disorder b. what kind of effect would this social support have? a. b. They would be described in the "Background" section of the report only. If his friends and family encourage him to seek family counseling to reduce this denial mechanism. C App p. adjustment disorder 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. when it is not associated with increases in the recipient's social competence d. gender d. adjustment disorder d. a buffering effect d. psychological factors affecting medical condition d. They would only be noted if they have exacerbated a previous mental disorder. 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.5. posttraumatic stress disorder c. c. 66 Ans. Type A personality It seems clear that a lack of social support generally puts people at higher risk for both physical and psychological disorders. with associated medical condition c. 166 E 5. social competence b. If his hypertension is more severe as a result of these events. However. when helpers take full responsibility for directing the recipient's coping response Vicente's home was burglarized twice in the past year and he lost several valued family heirlooms. somatoform disorder b. 70 Ans. a direct effect b. psychosomatic disorder. C App p. 167 E 5. b. and other negative emotions c. If his sleep duration is average for his age group. disappointment. 168 M 5. d. he sleeps about 10 hours a night. Recent evidence suggests that she a. a. c. According to Pennebaker. 169 M * 122 . 74 Ans. A Con p. In a therapy group for adults who were sexually abused as children. b. become ill after the stress of school has ended. 's findings? a. "What aspects of interpersonal stressors are most important in adversely affecting individual adaptation?" b. 168 M 5. clients who engaged in cognitive reappraisal in order to reestablish family social support networks If Jen experiences "stressor offset" following finals week of her last semester of college. he sleeps longer than the average 45-year-old. based on Pennebaker et al. clients who expressed very strong feelings of rage. c. D App p. 73 Ans. 76 Ans. For whom might the therapist predict the most improved functioning. clients who expressed mild feelings of anger. which of the following research questions may be most productive for future researchers in the area of stress and coping? a. A therapist wants to enhance her clients' coping resources. d. C App p. "Why is the process of talking about feelings more productive than the process of writing those feelings on paper?" Ariel has insomnia. actually experiences fewer major stressors than do persons without insomnia. c. "What similarities are found across cultures regarding individuals' approach to emotion-focused coping?" c. she will a. will probably develop a mental disorder. reduce the effect of academic stress by pursuing sources of social support. 72 Ans. has a biological disturbance that is also common in many mental disorders. betrayal. use cognitive reappraisal to justify the stress she has just endured. had a preexisting depressive or anxiety disorder that is causing the sleep disturbance. 168 M Kauli is a 73-year-old male. he sleeps about 6 hours a night. 5.5. she asked each of them to talk about their experiences and their feelings. d. A App p. engage in emotion-focused coping and thereby reduce her risk of physical illness. B App p. 75 Ans. "Why are natural disasters more psychologically harmful to their victims than technological disasters are?" d. he sleeps about as long as a typical 9-month-old infant. and other negative emotions d. clients who relied almost exclusively on problem-focused coping b. b. d. Lisa has just begun to dream. b. c. Her PSG activity will be MOST similar to that of a. stage 2 d. D App p. observing several physiological patterns during a client's sleep. stages 3 and 4. b. In order to monitor Angela's transition from stage 2 to stage 3 sleep. he would be very difficult to awaken. c. EMG. structured clinical interview regarding a client's sleep characteristics. Which characteristic below does NOT belong with the other three? a. REM. b. conducting a multifaceted. stage 2. 80 Ans. studying the effects of varying levels of sleep deprivation on cognitive processes such as memory and attention. 169 M 5. immune system replenishment b. he would probably be aware that he is experiencing an erection. forgot to turn on the monitor that tracks eye movements. 78 Ans. 169 E 5. stage 1 If he has a typical night's sleep. Doris. EOG. stage 1. d. d. he would probably report he had been dreaming. Bruno will spend most of his time in a. d. circadian sleep. 79 Ans. Eisenstein is conducting a polysomnographic assessment. graphing a sleep client's responses to various medications for insomnia. stage 1. 82 Ans. What stage of sleep will be difficult to discern? a. learning consolidation d. d. 169 M Dr.5. 77 Ans. B App p. b. REM b. stage 4 c. delta waves c. This means that she is a. he would be in the stage he spends the most time in each night. 169 M 5. 169 E 5. 83 Ans. a research assistant in a sleep lab. b. 5. If interrupted in this stage. C Con p. C App p. a. 81 Ans. c. EEG. A App p. 169 E 5. deep sleep. EKG. c. D App p. you would use an a. 169 E 123 . c. A App p. stage 2. NREM sleep Zachary's EEG shows a preponderance of delta wave activity. The inactivity of the locus coemleus during REM sleep suggests that this stage is important for the regulation of a. 85 Ans. stage 3 and 4 decrease and REM increases. Alex is seeking help from a counselor for impotence. sleepers go through four to six 90-minute sleep stage cycles each night. 169 M 5. melatonin b. 170 M 5. being unable to experience an erection. the circadian rhythm. 169-70 M 5.5. 89 Ans. 88 Ans. 169-70 E * 5. b. b. Subsequently. is an important hormone in the sleep/wake cycle. a. 86 Ans. serotonin. This week. hippocampus b. 87 Ans. Dara has gotten very little sleep while studying for final exams in college. 170 E 124 . your acts as a circadian alarm clock. If the counselor wants to determine whether there is an underlying physical problem. C App p. 84 Ans. corticotrophin c. norepinephrine. what sleep stage will the counselor monitor? a. In the same way that the alarm clock next to your bed lets you know when it's time to get up. REM c. c. 169 C If Loni is in REM sleep. A student's report on characteristics of sleep could include each of the following EXCEPT a. B Con p. rapid eye movements. 170 E 5. brain wave activity similar to stage 1. spend more time in stage 1 & 2 sleep and less time in REM sleep. when she gets a full night's sleep she will a. both NREM and REM sleep stages decline substantially across the lifespan. superior colliculus Although its validity as a treatment for sleep disturbance has been strongly challenged. spend more time in stage 3 & 4 sleep and less time in REM sleep. stage 3 d. d. d. enter REM sleep sooner than usual and spend more time in it. This would not be an effective means of obtaining relevant information. enter deep sleep sooner than usual and spend about half the night in it. c. C Con p. a. deprivation of NREM sleep interferes with consolidation of learning. increased muscle activity. B App p. serotonin d. the endocrine system. b. increased heart rate and respiration. A App p. suprachiasmatin 5. suprachiasmatic nucleus d. stage 1 b. c. A App p. she will exhibit each of the following EXCEPT a. c. b. in the last half of a night's sleep. D Fac p. 90 Ans. d. pineal gland c. d. named for the mental state he exhibits throughout the day. hypothalamus d. It is very likely that you have at some point experienced some of the symptoms of a dyssomnia. 96 Ans. alcohol intoxication or withdrawal. sleep disorders related to another mental disorder d. If it is caused by the substance most frequently associated with this sleep disorder. c. 93 Ans. substance-induced sleep disorders c. d. Which characteristic does NOT apply to Janet? a. substance-induced sleep disorders c. C App p. She suffers significant unhappiness or dysfunction because she has difficulty staying asleep. 171 E 5. 92 Ans. b. medulla Which sleep disorder category will you NOT find in the DSM-IV? a. which category of disorders involve unusual behaviors or abnormal physiological events during sleep? a. C Fac p. its etiology is a. unusual behaviors during sleep. b. D Fac p. 91 Ans. C App p. It is likely that his is functioning abnormally. 95 Ans. and cognitive causes. 171 E 5. 171 M 125 . the quality of your sleep. She is bothered by sleepiness during the day but engages in worry and rumination before bedtime. secondary sleep disorders Roland has a substance-induced sleep disorder. Her disorder probably has biological.5. the timing of your sleeping and waking. d. dyssomnias Janet has just been informed by her physician that she suffers from the most common form of dyssomnia. 171 E 5. sedative withdrawal. This means you could have experienced a disturbance in any of the following EXCEPT a. sleep disorders due to a general medical condition b. locus coemleus b. 170 M * 5. b. She probably has a substantial delay in sleep onset and sleeps fewer than five hours. caffeine intoxication. B App p. A App p. amygdala c. 5. primary sleep disorders b. c. c. d. a. cocaine intoxication or withdrawal. the amount you sleep. 94 Ans. parasomnias d. behavioral. 171 M Sleepy is one of the Seven Dwarfs. According to the DSM-IV. 6 b. whose job requires her to change from day to evening to graveyard shifts every three months Most adults report getting about hours of sleep per night. Shane was suddenly overcome by REM sleep and cataplexy for several minutes. c. What probably accounts for this event? a. REM sleep rebound b. You could give her several suggestions that might help her get a better night's sleep. 171-2 E 5. Avoid drinking caffeine or alcohol for a few hours before bedtime. B Con p. 171 E 5. secondary hypersomnia 126 . Read or watch TV in bed in order to relax. 99 Ans. C Fac p. Dr. This dyssomnia could be App caused by any of the following factors EXCEPT p. Try to develop a reasonably consistent bedtime and try to get up about the same time each morning. which of the following persons is most likely to have a dyssomnia? a. Tabitha's overactive temperament. 7 d. 172 E In the middle of an afternoon meeting. 171 E 5. primary hypersomnia 5. Orcadian sleep disorder d. Which of the following would be LEAST useful? a. whose three-year-old daughter wakes him about once a month when she has a night terror d. cultural pressure for American children to go to bed before the parents do. A App p. Dreme is studying sleep disorders in adults. narcolepsy c. c. Ans. B App p. 5 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. narcolepsy d. the use of Tabitha's crib for activities other than sleep. 5. 100 Ans. 102 Ans. 7. d. who consumes alcohol before bedtime and sleeps about 7 hours b. Develop cognitive reappraisal coping strategies that reduce rumination. on which disorder should he focus? a.5. Cassandra. 7. Marlon. the presence of parental discord or conflict. A and their pediatrician indicates that Tabitha has ISD. D App p. 98 Ans. b. d. M b. self-identified adults with primary insomnia get about hours. primary insomnia c. 5 c. 9. 101 Seven-month-old Tabitha is waking Samantha and Damn several times a night. Delia. who sleepwalks and has occasional nightmares c. 8. 97 Ans. a. 171 M Based on epidemiological data. nightmare disorder b. If he wants to assure himself of an adequate sample size. 172 a. Reggie. sleepwalking disorder. either a or b. childhood sleep disturbance Sammy was found sitting in front of a blank TV screen at 2 o'clock in the morning. primary insomnia: sedative medication c. b. What disorder is present? a. hypersomnia: stimulant medication b. 127 . m. but he recalled nothing about it and seemed unaffected by his ordeal. stage 4 d. primary insomnia. Barbara is a 4-year-old child experiencing a parasomnia that occurs in REM sleep. nocturnal fear disorder d.If high-speed aircraft. d. As had happened several nights before. narcolepsy: antidepressant medication d. environment-induced sleep disorder Children are more likely than adults to suffer several sleep disorders. Bobby woke up at 2 a. nightmare disorder b. d. All of the above are correctly matched. sleep terror disorder. but this is NOT true for a. which disorder might passengers exhibit? a. This means she has a. ultradian sleep stage disorder c. such as the Concorde. sleep terror disorder c. Bobby's parents asked him about his bad dream. c. During what stage of sleep did this behavior probably occur? a. nightmare disorder. stage 2 c. sleep apnea. His parents were unable to wake him as they put him back in bed. In the morning. stage 1 b. come to be routinely used for international travel. delta sleep disorder b. screaming and was agitated and panicked when his parents rushed to see what the problem was. sleep terror disorder. REM Which of the following sleep disorders and medical treatments are mismatched? a. apparently after sleepwalking from his bedroom. b. c. nightmare disorder. circadian rhythm sleep disorder d. the nature of the stressor. 113 Ans.5. c. likely to last a long time. 110 Ans. Southwick is a full-time counselor at a university counseling center and sees many students with an adjustment disorder. The stressor must be severe (such as the death of a loved one) and the person must report adequate coping skills and moderate distress. including assessment in a sleep laboratory to demonstrate that the person really does not differ in sleep onset or duration compared to most adults What factors must be present in order to diagnose as an adjustment disorder according to the DSM-IV? a. 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. In order to specify the type of disorder each student exhibits. Unfortunately. What would you recommend as an effective treatment for an individual with primary insomnia? a. Are the symptoms mild and likely to be of short duration? 5. c. but have lasted for only 2 months. d. 111 Ans. prescription drugs such as Halcion or Dalmane b. b. depressed mood. A graduate student in clinical psychology is working with a client who feels tense. environmental. The symptoms should not exceed what would normally be expected from exposure to an extreme stressor and can last 3 to 12 months. he will need to assess each of the following EXCEPT a. fit Axis I criteria. C Fac p. She may have increased insomnia when she stops taking the drug. cognitive reappraisal therapy. She may experience a side effect of daytime drowsiness. nervous. The person's symptoms are severe. 173 E 5. 173 M 5. b. Which of the following is NOT one of those concerns? a. 112 Ans. Are the stressors interpersonal. A App p. d. individual psychotherapy c. The drug will probably cause both tolerance and dependence effects. sleep hygiene counseling d. b. c. In order to decide whether this reflects an adjustment disorder or if it reflects PTSD. and restless following several stressful experiences. 173-4 M 128 . D App p. the student should consider each of the following EXCEPT a. A App p. The drug may cause hypomanic symptoms during the day. or technological? b. 109 Ans. anxiety symptoms. which is helping her sleep through the night. there are several cautions to bear in mind about this approach. behavioral difficulties. Are specific behavioral and autonomic nervous system symptoms present? d. Are the stressors unusually severe? c. B Fac p. d. Dr. 173 E 5. 173 M Tess is relieved to have "cured" her insomnia by obtaining a prescription for Halcion. 116 Ans. have been inundated by rain which has caused repeated and severe floods. p. Quick-Response Disaster Specialists 5. Why are substantially more females given this diagnosis than are males? * b.5. 114 A health insurance auditor is inspecting the reimbursement claims made by Ans. 5. B App p. 174 E 5. Why are so few clients in outpatient settings given this diagnosis? 5. 174 b. but is probably LEAST important in this initial assessment. Someone with this disorder has symptoms that range widely in form but M are typically mild and of limited duration. 115 Why might adjustment disorder diagnoses be unreliable? Ans. 117 Ans. C a. Immediate Intervention Team d. the depth to which a person was physically submerged during the flood c. a one-time event of moderate severity b. This disorder. 176 E 129 . Crisis intervention teams should assess several characteristics of individuals subjected to this disaster. Many residents of the southeastern U. the degree of control the person felt s/he had during the crisis d. contains negative stereotypes that Fac are often associated with mental illnesses. Parrilla has been recruited by the American Red Cross and the American Psychological Association as a member of the . Any of the above are equally possible. what sort of stressor has he probably endured? a. A App p. c. d. a team that responds to the immediate mental health needs of groups affected by disasters. How many of these clients might actually have an Axis I disorder? c. Disaster Response Network c. Emergency Mobilization Unit b. The diagnosis is often made to avoid using a more serious diagnosis and when symptoms do not fit well into other DSM-IV categories. D App p. used primarily for males. 174-6 M If Ned has an adjustment disorder with mixed anxiety and depressed mood. a minor or moderate stressor of extensive duration d. 173-4 question in mind during this process? C a. App If the auditor has taken this abnormal psychology class. the length of time the person spent in flood waters Dr. a. This diagnosis does not take into account any of the behavioral symptoms which may be present as a direct response to a stressor. Why have therapists provided treatment when this disorder is not associated with significant distress or functional impairment? d. B clients for psychotherapy services they have received for adjustment disorders. a. multiple hassles or repeated failures c. 118 Ans. the number of other flood victims in close proximity to the individual b. she will have which p. S. The physiological effects will far outweigh individuals' psychological ability to cope successfully. C Con p. a medical or interpersonal stressor. a massive release of toxic gases from a chemical manufacturing plant c. She feels depressed. clarifying Jasud's primary goal and the obstacles to that goal. b. has frequent headaches. c. The separation is probably not an isolated relationship stressor but a reflection of longer-term marital discord. 178 several possible solutions for this situation. 123 Jasud's soccer coach is helping him use effective problem-solving to deal with Ans. talking with a mental health professional. A App p. which of the following disasters would cause greatest psychological harm for its victims? a. the coach should next recommend M a. Victims are not likely to blame the government for their exposure. a goal Jasud App had worked toward for three years. D App p. giving victims time to ruminate. 121 Ans. despite evidence to the contrary. Louise has been separated from her husband for 7 months. c. an earthquake that occurred without warning b. loss of property and lives in a lightning-sparked forest fire exacerbated by several months of drought Clients who report one of the three most upsetting life events on Holmes & Rahe's Social Readjustment Rating Questionnaire are experiencing a. 177 E 5. Which of the following is NOT relevant to her situation? a. c. According to the hypothesis set forth in the chapter. an occupational or social stressor. d.5. d. All of the above apply to her situation. It is expected that the tests should have been carefully controlled by government and military leaders. A his failure to win a sports scholarship to the college of his choice. b. Her emotion-focused coping interferes with her ability to employ problemfocused and cognitive reappraisal strategies. 122 Ans. government recently disclosed that military personnel were exposed to high doses of radiation during nuclear tests in the 1940s and 50s. c. S. 176-7 M The U. B App p. some sort of disaster stressor. the type of person most able to enhance Jasud's coping resources. has missed work for several days. 176-7 M * 5. following 22 years of marriage. selecting a general strategy that might remove the obstacles to the goal. d. and spends a great deal of time blaming herself for all the imperfections in me marriage. 5. b. d. 177 E 5. After encouraging Jasud to brainstorm p. 120 Ans. evaluating the short-and long-term consequences of each of those options. b. The nuclear tests occurred with advance notice. Why might the stress of this exposure be particularly damaging to its victims? a. She is less able to make use of her social support network and may begin to alienate remaining support. an interpersonal stressor. 130 . a passenger train derailment with numerous fatalities caused by a tornado d. 119 Ans. social support). a sense of helplessness or lack of control. which could take many forms (e. she will experience weight loss. 125 Given that stressors depend upon individual differences. however. She no longer expends acute physiological energy but begins to engage in more deliberate coping efforts. and may make use of defense mechanisms to deal with additional temporary stressors. an increase in effective problem-focused coping b. She may experience feelings of tension and anxiety. long-term stressors. situational characteristics. an opportunity to reflect on the lower level of stress the students are presently experiencing. her sympathetic nervous system will be activated. Lack of social competence.5. 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. pessimism/introversion. inflexible coping strategy. intentional or careless behavior by others that creates stressors. shortness of breath. creating sensations of a racing heart. 131 . 5. unexpected stressors. 124 Ans. 126 Jenna has just discovered that she failed her first biochemistry exam. Her emotions will probably include panic. She will be faced with the decision to flee the whole situation or to choose a means by which to fight back.. 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. and cultural differences. 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. Jenna will first experience the alarm reaction. fear. Her studies will become ineffective due to impaired attention and concentration. and insomnia. If she enters this stage. If her performance improves in the class. helpless. She will probably feel hopeless. B App p. emotion-focused. impaired coping efforts. technological disaster. Describe how the GAS might apply to Jenna's stress response. also reflects a poor grade. she may move into the stage of resistance. she will at least momentarily reestablish equilibrium. resulting in enhanced optimism SHORT ANSWER / ESSAY 5. In this stage. Based on the information presented in the text. increased vulnerability to illness due to immunosuppression. better immune system functioning and lower levels of psychological distress c. list the characteristics of stressors that tend to create heightened perceptions of harm. and possibly anger or frustration. she may begin to show some signs of the exhaustion stage. g. coping alone rather than with the support of others/lack of social support. and physical fatigue. disorganized thinking. what outcome is anticipated for the students? a. If the next exam. and literal (as well as figurative) knots in her stomach. cumulative stressors. and desperate. increased recognition of and commitment to social support networks d. emotion-focused coping aimed at altering his emotional reaction but not the stressor. muscles begin to relax. 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. Stage 1 — 30-second to 10-minute duration. 5. marked by significant EEG shifts Stage 3 & 4 . e. will summon additional T and B cells. cognitive reappraisal to alter perception and meaning of the stressor.adrenocorticotrophic hormone > ACTH directs release of adrenal cortex secretion of adrenal corticosteroids . Describe in detail the stages you will go through as well as the general pattern of your night's sleep. body temperature begins to drop. 127 List the components of the HYPAC & SAM axes response during the alarm stage of the GAS. 130 Imagine you have just gone to bed for a typical night's sleep. defense mechanism of denial. which. restorative/immune replenishing sleep. c. f. search for or use of social support — can include any of the above components also. easily awakened Stage 2 — 30. 128 Micki has mononucleosis. suppressor T cells stop the activity of killer T cells before they begin to destroy healthy body elements. helper T cells secrete interleukin-2. Answer should include a concrete example of each of the following: problem-focused coping aimed at changing the stressor itself. or humor. deep sleep marked by delta waves. including attention to the various "soldiers" in this battle. b. d.corticotropin-releasing hormone > CRH signals pituitary to secrete ACTH . very difficult to be awakened 132 . projection. a sufficient number of correctly matched killer T cells must be recruited to fully destroy the virus. in turn.students may not think to include the following. Describe the process by which her immune system will fight this illness. macrophages will then summon interleukin-1 which will summon various killer T cells to destroy the remaining pathogen and helper T cells. No modal response reliably predicted. B cells release antibodies.5. Hypothalamus secretes CRH .10 to 20% of night's sleep. 129 Joe's home was destroyed by an earthquake in central Oregon."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 . though it is applicable: HYPAC & SAM also activate endogenous opioids/endorphins] 5. Give an example of how he might utilize each of the coping approaches described in the chapter. macrophages will identify pathogen by locating antigens on its surface and will then devour and produce a digested form of the pathogen. Specific immunity will be involved: a.to 45-minute duration. his parents insisted on counseling. ruminative cognitive process interferes with relaxation and unwinding. 4. 5. The boy reports that he hates school since he broke up with his girlfriend. Use of alcohol disrupts sleep. " the interpersonal stressor had obvious effects. so she drinks several cups of coffee throughout the day and evening. Identify as many alternative solutions to the problem as possible. irregular bedtime disrupts sleep onset. Would you recommend that she ask her doctor for a sedative or tranquilizer to help her sleep? Explain. She's tried such things like going to bed early and reading a book. and the counselor notes that he appears to have low self-esteem. 132 An adolescent male is brought into counseling by his parents because of trouble in school and at home. increasing her intake of wine. She states that before going to bed she has a glass of wine to relax her. increased sympathetic NS activity. has lost weight. then select one general strategy for solving the problem. 133 Describe the seven steps involved in effective problem-solving. return to step 2 or 5 and carry out the process again through step 7. 5. 2. Evaluate the short. doesn't really care about anything. A medication may cause daytime sleepiness. if the problem remains. Assess the effectiveness/usefulness of your actions. 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. When the police brought him home one evening because of curfew violation and disruptive public behavior. 3. concrete alternative approaches/tactics for implementing the general strategy. is likely to cause tolerance and dependence. 133 . and while the teenager typically acts as though the event "was no big deal. Identify the possible contributing factors to this woman's dyssomnia.[5. 7. nonsleep-related activity of reading a book distracts from perception of bed as a place only for sleep (and sex). Take action to implement the chosen tactic. 6. List several specific. virtual body paralysis except for penile erections. possible consolidation of learning Will spend about 90 minutes in NREM stages. Evaluate the pro's and con's of those tactics. and then choose the one that looks most feasible. It is discovered that 3 months have elapsed since the break-up. will sleep 7 hours on average. Clearly define the problem by identifying major goals and relevant obstacles. and going to bed at different times throughout the week. 131 A woman seeks therapy because of insomnia. However. use of caffeine also distruptive. and may create more severe insomnia when it is discontinued. In the morning she is so tired that coffee seems to have no effect. 50% of night in stage 2. What diagnosis best fits the adolescent in this case? Adjustment disorder with mixed disturbance of emotions and conduct 5. likely to be dreaming.and long-term consequences of each of those proposed alternatives. activity of norepinephrine suppressed in locus coeruleus. rapid eye movements. going through about 5 (4-6) stage cycles 5. 1. 130 cont'd] REM — much like stage 1. less than one tenth 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. 184 M 6. 2 Ans. treating. 184 E 6. about one fifth d. 5 Ans. developing and evaluating techniques for promoting behaviors linked with lower exposure to the HIV vims b. If you were a proponent of the biopsychosocial model. 4 Ans. 6. about thirty percent d. 184-5 E 6. and preventing illness. developing psychological interventions that contribute to more effective treatment of hypertension d. evaluating programs to increase compliance with treatment for individuals undergoing chemotherapy c. understanding cognitions associated with high risk behaviors such as unprotected sex Dr.Chapter 6 PSYCHOLOGICAL FACTORS AND HEALTH 6. 3 Ans. b. place greatest emphasis on the biological causes and treatment of illness. C Con p. is an interdisciplinary field incorporating biomedical research. D App p. emphasize the contribution of social factors to the development of illness. 1 Ans. is interested in understanding. establishing relationships between negative affect in childhood and elevated mortality rates in later life b. about five percent b. about ten percent c. c. evaluating the association between breast cancer and socioeconomic class c. B Fac p. about sixty percent Imagine you are a health psychologist. d. about one half b. designing safer treatments for cardiovascular disease and cancer Behavioral medicine is different from health psychology because behavioral medicine a. applying discoveries from biomedical research to develop a cure for AIDS d. 184 E * What portion of patients who visit a physician do so because of physical symptoms caused by psychological distress? a. A App p. Which activity below would probably not interest him in regard to his research endeavors? a. c. Palmer is a health psychologist. d. C Fac p. 185 E 134 . focuses on the role of psychological and social factors in physical health. state that psychological processes play a role in illness and prevention. 184 M 6. 6 Ans. view physical illness as partially dependent on biological vulnerabilities. you would NOT a. C App p. follows a biopsychosocial model. b. Which activity below would be of LEAST interest to you? a. about one third c. ancient Greece c. d. influenza 135 6. cancer c. c. late 19th century Vienna d. b. 185 M * The ancient Greeks held a view of the relationship between mind and body that a. If you emphasized the duality of mind and body. 8 Ans. was essentially the same as that popular during the Renaissance. b. C Fac p. According to your text. 185 M 6. 186 E . c. the heart is the center of the universe. pneumonia b. Aristotle. biological disease. 185 M 6. Franz Alexander. the work of Sir William Osier in the early 1900s. 7 Ans. A App p. If you agreed with Sir William Osier. b. c. when and where might you be living? a. the father of modern behavioral medicine is a. 185 M * 6. B App p. not just a select few. 10 Ans. the symptoms of heart disease can be brought on by negative affect. Sir William Osier. B Con p. and ills of the universe are reflected as illness of the heart. 185 M 6. D Con p. Sigmund Freud. 12 Ans. You were part of the group responsible for revising the category of "psychosomatic disorders" for a new DSM. the symptoms of heart disease are brought on by carelessness. with few links to psychology. the rise of psychiatry in the late 1800s. d. emphasized dualism. d. Why did you decide to change the category? a. you would hypothesize that a. b. Renaissance Europe In a report of the historical influences on the rise of behavioral medicine. the Renaissance dualism preserved in Freud's psychoanalytic theory. a student would include each of the following EXCEPT a. d. which illness below would you be least likely to fall prey to? a. D Con p.6. 13 Ans. tuberculosis d. c. Psychological factors are influential in virtually all diseases. changes in the nature of disease in Western cultures. d. B App p. conflicted with the views later expressed by Freud. 9 Ans. c. is similar to the view taken by modem behavioral medicine scientists. Its title overemphasized the role of psychological factors in some illnesses. "Psychophysiological disorders" was chosen instead because it more correctly identified physiological contributions to these disorders. 185 E 6. heart disease is a natural. If you were alive in the United States in the early twentieth century. b. 11 Ans. It was changed to "somatoform disorders" to recognize the contribution of psychological factors to most diseases. 12th century China b. 186 M 6. "endogenous major depression" on Axis II d. b. even though he has nothing wrong. D Con p. 186-7 E As a health worker in recent years. diseases of the heart and cancer b. somatoform disorder b. He likes the attention he receives. you would correctly diagnose this client. 17 Ans. d. factitious disorder c. factitious disorder c. cerebrovascular diseases and unintentional injuries The DSM-IV tries to differentiate between mental and physical disorders in three ways. involve minor medical conditions associated with severe psychological symptoms. apply to persons who are intentionally exaggerating their physical illnesses. cancer and homicide d. A App p. fraud In order to collect workman's compensation. What description best fits Richard? a. psychosomatic disorder b. What description best fits Jerry? a. d. in part. malingering d.6. are the former diagnoses that are now listed under "mental disorders due to a general medical condition. 15 Ans. 186 M 6. c. A Fac p. "medical illnesses affecting psychological condition" on Axis I c. by including which of the following? a. It provides special rules for classifying mental disorders caused by drugs and medical conditions. A App p. Which item below is not one of them? a. somatoform disorder d. " Jerry likes to go to the hospital and tell the doctors he has something wrong with him. 187 M 6. It explicitly and consistently specifies which disorders are medical and which are mental. D App p. B App p. appear to be caused exclusively by psychological factors with no physical disease. diseases of the heart and homicide c. b. 18 Ans. 187 E 6. 187 E . It directs clinicians to use multiple diagnoses to classify all the conditions that might apply to a given patient. One of your clients has major depression that is caused primarily by long-term insulin-dependent diabetes. It devotes one axis to general medical conditions that are related to a mental disorder. c. 14 Ans. what would you witness as the two leading causes of death in the United States? a. 16 Ans. malingering 136 6. diabetes on Axis III b. 19 Ans. Richard claims he has severely hurt his back in a fall from a ladder although his back is not injured. "diabetes-related depression" on Axis III In what way are somatoform disorders different from the "psychological factors affecting medical condition" category? Somatoform disorders a. Using the DSM-IV. Matthew has a form of App CHD in which blood supply to his heart has been completely stopped. a myocardial infarction. She has experienced a. 189 E Katrina was hospitalized after feeling as though her chest was being squeezed in a vice. underlying biological process. requiring her to gasp for every breath. resulting p. an aneurysm * b. 189 in serious heart damage. an aneurysm. myocardial infarction also d. b. Biological and psychological factors independently influence the course of Bill's COPD. She likes gymnastic sports and is very aggressive. myocardial infarction d. He proposed a link between classical conditioning and certain stomach disorders. an aneurysm. the interactive relationship between Jane's aggressiveness and her environment b. Luca has __. high blood pressure b. 22 Ans. 188 M 6. He proposed a link between emotional states and physical illness. He wrote a critique of the first DSM. decreased social support Marvin was diagnosed with atherosclerosis. d. angina pectoris. C Con p. Sometimes he becomes depressed. a hypertensive induction. myocardial infarction. Bill's COPD itself can account for some changes in his psychological functioning. an aneurysm c. leading to reform in later depictions of the psychophysiological disorders. c. a stroke. 24 Luca has a form of CHD that results from inadequate removal of carbon dioxide Ans. What factor below is not likely to increase Jane's risk of illness? a. 20 Ans. 188 E 6. angina pectoris. Jane is a very competitive individual. 189 E 6. Which of the following is NOT a likely consequence of his condition? a. and Matthew has M a. 188 E What was Franz Alexander's major contribution to health psychology? a. Bill has chronic obstructive pulmonary disease (COPD). D App p. 23 Ans. d. angina pectoris c. 25 Ans. C App p. vasocongestion 6. D from the blood in her heart and creates radiating pain. Which statement below does NOT apply to this case? a. frequent physiological arousal under conditions of stress c. c. Psychological and social influences associated with unhealthy behaviors may indirectly lead to or aggravate Bill's COPD. He helped identify and document the Type A behavior pattern and its connection to CHD. 137 . and he begins to drink excessively. D App p. a tendency to view competitions as challenges rather than threats d. B App p.6. myocardial infarction 6. b. Bill's COPD and his drinking and depression could both be influenced by a common. d. c. b. 21 Ans. 113/74 If Shandra's hypertension is typical. d. c. 80 6. It could lead to diabetes or other pancreatic problems if untreated. 189 E 6. half the risk c. a 64-year-old black female b. 25 b. Ted. his disease is caused by a. excessive sodium intake. 190 E 138 . 31 Ans. 60 d. a 60-year-old black female Sun Cho is a male of Mandarin Chinese heritage. atherosclerosis. A sample of 100 randomly selected black women over the age of 60 are participating in a study of protective factors related to osteoporosis. a 42-year-old white male Hank has been diagnosed with high blood pressure.. d. has average blood pressure. 190 M * 6. 26 Ans. b. What is his risk for developing coronary heart disease compared to that for a male of European descent? a. 29 Ans. D App p. 189 E 6. Mitch. 189 M * Which of the following persons is MOST likely to have CHD? a. Tony. It has an identifiable organic cause. a 52-year-old black male d. 27 Ans. which characteristic applies? a. chronic levels of stress. How many of these women would be expected to exhibit hypertension? a. B App p. If he is like most people with this disorder. Leslie. b. two times the risk d. 121/82 d. 189 E 6. 30 Ans. 141/92 b. 48 c. Which of the following persons is most likely to have hypertension? a. C App p. a 50-year-old white male b. 32 Ans. the same risk Mick. 35 years old. a 37-year-old black male d. Tom. It is affected by levels of sodium in her body. a 70-year-old white female c. 190 E 6. D App p. A App p. 132/87 c. a 45-year-old Chinese American male c. Rodney. Sharon. c. Which reading below probably belongs to him? a. Bella. B App p. one-fifth the risk b. Her diastolic pressure is higher than her systolic pressure. 28 Ans. A App p. no identifiable physical condition. d. Due to the repeated disruptions in his work setting. researchers discovered that a. which group demonstrated the least arterial plaque? a. A plaque-clogged artery has cut off blood flow in her heart. tends to be quite dominant in social settings. Mrs. unstable social hierarchies led to greater plaque buildup in submissive monkeys compared to monkeys in the other groups. a family history of CHD and current levels of social support 139 . what would you predict about his heart function compared to other people? a. stable hierarchies led to lower plaque levels for all the monkeys in that group. A clot or an aneurysm has occurred in her brain. If he has a genetic predisposition to CUD. Ogden has dragged her husband to the office of Drs. submissive monkeys in an unstable social group b. d. In Manuck et al. unstable social hierarchies led to greater plaque buildup in dominant monkeys compared to monkeys in the other groups. he will have a higher risk for developing arterial plaque regardless of social setting. Friedman and Rosenman. a high level supervisor. d. aggressiveness. life at the top was always related to lower levels of cardiovascular plaque buildup. Due to the greater level of responsibility he carries in his environment. dominant monkeys in a stable social group In a study involving manipulations of the social hierarchies of monkeys. What has happened to Samantha? a. b. time urgency. he will have a higher risk for developing arterial plaque. c. 's work with monkeys. b. Blood vessels in her lungs have burst. b. competitiveness c.Samantha has been admitted to the hospital for a stroke. submissive monkeys in a stable social group d. What are these physicians likely to look for in Mr. c. causing unconsciousness. Based on Manuck et al. he will have a higher risk for developing arterial plaque. Insufficient oxygen to her heart has caused severe pain in her chest. chronicity of environmental stressors d. With frequent employee turnover in his division. Due to the greater level of control he exercises in his environment. disrupting blood flow. Andy. chronic essential hypertension b. Ogden? a. he will have a lower risk for developing arterial plaque. c. 's work. dominant monkeys in an unstable social group c. Andy feels pressured to let each new employee know "who's boss" to assert his control and authority. c.6. The majority of Type A individuals were to likely develop some form of CHD when family history. d. based on currently available information? a. there was a tendency in both studies for Type B individuals to have a slightly higher risk for CHD. b. g. Type A individuals were twice as likely as Type B individuals to develop some form of CHD during each study. and smoking were controlled for. 192 M 6. 192 E You are often irritable. B Con p. diet. Type A d. You are a graduate student working toward a Ph. d. 193 C 140 . Varying measurements of Type A personality and cultural differences probably account for some contradictory research findings about that link. Contrary to expectations. Type B b. an unstructured clinical interview d. C App p. 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. 'workaholic' Type A persons?" c. 192-3 M 6. a structured clinical interview What was the central finding from the Western Collaborative Group Study and the Framingham Heart Study? a. impatient. b. Chronic physiological overarousal resulting in rapid hormonal changes could account for the personality-CHD connection. 40 Ans. Jenkins Activity Schedule b. anger. and are rarely satisfied by your achievements. A student's report on the link between Type A personality and CHD could include each of the following statements EXCEPT a. What assessment instrument should you choose? a. What personality type would some health psychologists say you exhibit? a. always seeking competitive activities. "What constellation of negative emotions are most strongly related to physiological overarousal and CHD risk?" 6. 41 Ans. easily annoyed by events that delay the attainment of your goals. Irritable-Competitive Type You have been asked to conduct an assessment of a client's Type A personality. in health psychology. poor nutrition) contribute to the CHD risk associated with the Type A pattern?" d. Hostility. Millon Personality Inventory c. B App p. 38 Ans. 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. and other negative emotions may be more important in CHD than the "hurry sickness" behaviors. cynicism. D. 42 Ans. D App p. 193 M * 6. c. Which of the following topics would be LEAST productive for your dissertation research. Type C c. A Con p. "How do unhealthy behavioral habits (e. "What psychological intervention is most effective for prevention of CHD in hurried. 39 Ans.. "What cognitive and social characteristics are associated with increased cardiovascular reactivity to chronic stressors?" b. 46 Ans. and their families d. What is the App most likely cause of her health problems? p. who should be the targeted population for successful health psychology interventions? a. Andy has little patience with others and typically feels a very strong time urgency. C Fac p. competitiveness and time urgency b. 45 Ans. 48 Ans. changes in scientific funding from Congress d. B App p. 43 Ans. 194-6 a. is overweight. 196 M 6. D App p. substance use d. increased collaboration between psychologists and neurologists c. D suffers from chronic headaches. Ans. appearing edgy and nervous to others. persons age 18 and older who exhibit high levels of negative emotions c. Which component(s) of Andy's behavior may be the MOST harmful to his cardiovascular health. 6. an unhealthy lifestyle * c. psychoneuroimmunology. 196 a. 193 M are Andy is a cynic and is usually hostile and suspicious towards others. Ader and Cohen's rats were instrumental in showing the Con application of those principles to p. and is often cynical in her attitude. 47 Pavlov's dogs were instrumental in demonstrating the principles of classical Ans. stress and negative affect d. negative emotions such as hostility and cynicism c. D Fac p.6. the development of new brain imaging systems b. classical conditioning 141 . according to current research? a. d. the biopsychosocial model. excessive ambition and drive 6. behavioral medicine. lower-SES families living in stressful urban environments What changes in classical scientific thinking encouraged the development of psychoneuroimmunology to become possible? a. M b. Before George goes in for treatment he becomes nauseous. smokes a pack of cigarettes a day. children in middle school and younger. c. He has been receiving chemotherapy for some time now for his illness. whatever he ate the prior night d. Andy is preoccupied with success and accomplishment. the chemotherapy drug c. his cancer b. creative novation therapy. 196 E George has cancer. cyclophosphamide. In his work and personal life. 44 Beth has high blood pressure. His only means of relaxation smoking and occasional excessive alcohol use. young adults identified on the basis of family history and behavioral risk factors b. What is the most likely cause of this nausea? a. the realization that the brain and immune system are connected in important ways 6. a reciprocal interaction between several factors 6. 195 E According to Dr. C conditioning. Karen Matthews. smoking and lack of exercise M b. 51 Ans. S. 1981 d. 1977 c. The side effects of treatment cause such severe anticipatory nausea that she will probably terminate treatment. 49 Ans. what two modes of Ans. Vondra has just been diagnosed with AIDS. conditioned response b. heterosexual contact and mother-child transmission M c. unconditioned response c. No drugs have been developed that have a physiological effect on HIV. D App p. 50 Ans. 20 million b. c. 26 million c. d. Today at home. 1988 Myron contracted HIV-1 during a blood transfusion. 197 M 6. 197 E 6. It destroys T cells in the immune system. 198 b. 30 million d. b. C Fac p. when you are watching television news in the year 2000. 197 E 6. she was putting an antibiotic on a cut when she heard someone squeaking across the wet kitchen floor. what number of people will be reported to have AIDS around the world? a. What effect does this virus have on Myron's body? a. conditioned stimulus d. 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. ? a. 53 Ans. homosexual contact and intravenous drug sharing 142 . unconditioned stimulus When was the first case of AIDS diagnosed in the U. 35 million 6. 198 E 6. C App p. HIV can mutate into strains that are resistant to d r u g treatments. c. B HIV transmission would you be most concerned about? App a. It changes the way in which DNA controls cell growth. homosexual contact and heterosexual contact p. Like most people with HIV. If current predictions are correct. Vondra will probably have no symptoms and thus will not pursue treatment.6. intravenous drug sharing and mother-child transmission * d. What is the term for Mara's resulting nausea? a. It causes autotoxic reactions in the endocrine system. b. A App p. d. 54 As a health care worker in an African or Asian country. A App p. It alters the synthesis and action of several neurotransmitters in the brain. Why will it be very difficult to treat this disease effectively? a. 52 Ans. 1969 b. sexual victimization b. c. Which of the following was probably NOT one of his research questions? a. d. b. you are aware that HIV infection is growing at an alarming rate for women. a gay male in a long-term monogamous relationship b. D App p. What would this problem be? a. a 24-year-old IV heroin user d. Hispanic adolescents. c. What cognitive factors increase the likelihood of adolescent males' use of condoms? d. Which of the following is NOT among the factors that have been linked to that epidemic? a. lack of effective birth control use c. b. young women. 198 M 6. Karen is most likely to die as a result of cancer. intravenous drug use Which of the following persons is at greatest risk for HIV infection? a. As a female between the ages of 18 and 44. Caryn. She discovers that the number of AIDS cases is growing quickly in each of the following groups EXCEPT a. 59 Ans. homicide. Do ruminative coping strategies predict decreased T cell counts in HIV positive females? 6. By the year 2000. poverty d. As a counselor at a local women's health clinic. cancer. 198 E 6. cardiovascular disease. 58 Ans. Have college students changed their "partying" activities (especially alcohol use) in response to the AIDS epidemic? c. d. homosexual contact d. Horst has conducted several psychological studies of HIV and AIDS. Martin. AIDS. D App p. Erica. A App p. low-income blacks. 56 Ans. homosexual contact c. C App p. a 33-year-old heterosexual male A psychologist is making a presentation about the central sexual problem contributing to the AIDS epidemic.6. risky sexual practices Dr. heterosexual contact b. B App p. Jacobo. 60 Ans. A sociologist is studying the growing incidence of AIDS in the U. 198 M 6. a lesbian female from a middle class SES c. 55 Ans. 198 M 143 . 198 M. S. it is predicted that the second most likely of her death will be a. 57 Ans. Asian American males. 198 M 6. A App cause p. By what mechanism does cognitive restructuring prevent the development of AIDS in HIV-positive individuals? b. Andrea's mother has just been diagnosed with breast cancer. 66 Ans. 198-9 M . a Chinese American male d. second. 5 Which of the following persons is somewhat more likely to develop cancer than the other three? a. changing his overly conforming. second. d. c. she has a form of a.. B App p. and her maternal grandparents both died from cancer. Andrea is correct to be concerned about her own risk for several reasons. Several psychosocial factors. although is probably not one of them. increasing his level of social support. b. b. S. HIV. D App p. 199 M Camille has a disease in which disrupted cells are creating a metastasized growth in her body. such as unhealthy habits. first. 199 M 6. You could suggest all of the following as effective measures EXCEPT a. B Fac p. the link between cancer and avoidable environmental hazards c. 144 6. CHD. Corey. 63 Ans. have been implicated in a higher risk for several forms of cancer. a. psychological factors. A App p. b. Neuropsychological factors are now known to be a primary cause of some forms of cancer. In other words. quitting smoking. a Hispanic female c. a Black American male Frederick is concerned about his risk for developing cancer. Cancer is directly caused by a.6. with 1 out of every Americans developing cancer at some point in her/his lifetime. leukemia. genetic tendencies passed on from one's parents. a. 198 E 6. b. c. cancer. a Japanese American female b. her own tendency toward Type C personality traits d. Fumiko. 67 Ans. 61 Ans. 198 E 6. 62 Ans. cell mutations that lead to metastasized growth. The relationship between psychology and cancer exists only in regard to emotional reactions and adjustment after cancer develops. avoiding radiation and other environmental hazards. Type C personality has been shown to be highly correlated with cancer rates. Cancer is the leading cause of death in the U. C App p. c. 186. 198-9 E 6. d. C Fac p. 65 Ans. D Con p. emotionally blunted personality style. 4 d. third. Wang. d. pollutants in the environment. d. 198 E 6. her smoking habit What argument can be made for the relationship between cancer and psychological factors? a. the high prevalence of cancer b. c. 64 Ans. Clara. 2 b. 3 c. How often do patients engage in physical exercise? c. 199 M 6. " d. C App p. geographic location Standardized mortality ratios a. C Con p. stressors and unhealthy behaviors d. c. are a measurement of the average number of deaths due to poor health habits. B c. What signs of physiological reactivity are evident in patients? 6. are highly dependent on a given study's definition of "SES class. nutritional deficiencies and inadequate health care c. c. middle SES patients. 73 Ans. 199 M * 6. fostering maladaptive behaviors such as smoking. have been found to be irrelevant for studies in health psychology. a. are strongly negatively related to socioeconomic status. causing changes in immune system functioning and resilience. 199 M Empirical evidence is LEAST supportive of the link between the Type personality and physical illness. Which component below is not included in the measurement of your SES? a. B Fac p. income d. b. education b. d. occupation c. poor nutrition. 199 E 6. D App p. causing chronic changes in physiological reactivity. Which of the following appears to be most important for understanding the frequency of health problems in her patients? a. Sheng is a health psychologist who wants to investigate factors that contribute to the health problems of lower vs. 70 Ans. C d. b. Fuentes is a registered nurse working in a community health clinic for low SES families. directly causing illnesses such as hypertension and CHD. 69 Ans. dysfunction in biochemical processes such as immune functioning b. 200 C 145 . D Fac p. D Which statement below does not belong? Personality and social factors can increase the risks of physical illness by a.6. A b. and treatment non-compliance. Ms. 71 Ans. 200 M 6. Which of the following questions is LEAST likely to lead to a productive answer? a. What negative life events have taken place in the last several months in the patients' lives? d. B Con p. lack of concern about health issues and greater physical risk-taking Dr. How do patients cope with chronic negative emotion? b. 68 Ans. 72 Ans. avoidance of smoking and drinking c. opportunities for social reinforcement and social connectedness. and biofeedback. emphasis on the worst-case prognosis for his disease as a motivational tool. 74 Ans. and who is widowed d. a. Effective treatment will probably consist of a combination of each of the following techniques EXCEPT a. realistic recovery expectations.6. who exhibits a moderate level of conscientiousness and whose parents were never divorced b. D App p. B App p. Which of the following explanations is probably NOT relevant? a. c. Goldberg provides in the group. Mark. whose parents were never divorced. meditation. She is at a substantially elevated risk of premature death. and dietary management. Residents tend to be undereducated and thus would not adequately comprehend information Ms. Based on available data. b. c. who is high in conscientiousness and is happily married Nara has just undergone triple coronary bypass surgery. Tamara. 75 Ans. 202-3 M 6. 79 Ans. Susan. She has developed mild CHD and is unhappy in her marriage. A Fac p. Goldberg has found it extremely difficult to offer a smoking-cessation group for low-income housing residents. d. counseling focused on Derrick's sense of control over his life. b. 202 E 146 . If you investigate the life experiences of "Termites. what prediction would you make about Alicia compared to other individuals in this study? a. 202 E 6. " you find that predicts a lower risk of premature death. 202 C 6. 78 Ans. Residents may not have sufficient time to attend the group meetings. D App p. meditation. c. 76 Ans. C App p. conscientiousness b. She never married but is at lesser risk of hypertension and strokes. She will respond MOST favorably to an intervention program that includes a. She was described as impulsive at age 11. 200-1 M Ms. b. b. behavioral modification. d. who is high in conscientiousness and whose parents were divorced when he was 14 years old c. 77 Ans. Which of the following "Termite" persons is expected to have the greatest longevity? a. who avoids smoking and drinking. and a support group. and coping skills training. 202-3 M * 6. d. and her parents divorced when she was 17. A App p. relaxation training. cognitive restructuring. d. Residents may be unaware of the health risks associated with smoking. Type B personality d. cognitive restructuring. Their friends and neighbors may not encourage healthy habits such as smoking cessation. highlQ Alicia is one of the "Termites" followed in a longitudinal study between 1921 and the early 1990s. c. Ricardo. Derrick has been diagnosed with CHD. nutritional counseling. She has significant health problems associated with alcohol use and smoking. 6. individual therapy. learning how to resist partners' pressure to engage in risky behaviors d. providing financial bonuses to her physicians for limiting postoperative stays. education and encouragement regarding condom use b. Compared to a teenager in the other educational group. Both are receiving cardiological counseling. B Fac p. and both have exhibited frequent Type A behavior throughout their lives. Recovery will occur more quickly if his physician a. 6. visits to hospitals to talk to people with AIDS caused by risky sexual practices c. c. slightly less likely to maintain sexual abstinence one year later. inflexible nature. Research in behavioral medicine indicates that she should consider a. Elston is almost twice as likely as Stephen to have another heart attack.6. Leon is a. C App p. d. less likely to use intravenous drugs. Dr. b. Arbuckle. assures him that he will have little or no pain and a rapid recovery. 204 M 6. c. Which of the following interventions was not included in the attempts by Kelly et al. C App p. less likely to engage in unprotected intercourse. What outcome is likely? a. Lawrence et al. informs him about the course of the operation and is realistic about how he will feel during recovery. both have more than a 40% recurrence risk. more likely to demonstrate improved immune system responsiveness. c. A App p. 204 M 147 . behavioral rehearsal of self-control techniques to cope with risk-related situations Suppose Leon was in St. providing individual supportive therapy to postoperative patients for several days to reduce risk of postoperative complications. 80 Ans. While Stephen is slightly less likely to have another heart attack than is Elston. 82 Ans. encouraging physicians to communicate to patients only the most optimistic prognoses for postoperative adjustment in order to foster optimism. 83 Ans. wants to save money by reducing a primary source of surgical costs. b. recommending that physicians provide realistic predictions for patients' experience of pain and other surgical aftereffects. Both men exhibit improved cardiovascular functioning. D App p. d. 202 M 6. 202 M * Jorge requires major surgery. c. 204 M 6. but Stephen's Type A behaviors are unaffected due to their ingrained. prepares him for the worst by emphasizing unfavorable surgery outcomes and postoperative complications. 's (1995) 8-week HIV/AIDS risk reduction group. Both men exhibit improved cardiovascular functioning and a reduction in Type A behavior patterns. tells him as little as possible about the postsurgical reactions so he will not experience excessive anxiety and distress. the chief administrator of a regional hospital. 81 Ans. and Stephen also receives Type A-modification counseling. (1989) to reduce gay men's high-risk behaviors associated with HIV/AIDS? a. b. 84 Ans. Stephen and Elston have both had a heart attack. d. d. b. 87 Ans. D App p. the counseling-plus-Type-A modification program for heart attack patients c. -. Kendra. a CBSM program creates reliable changes in participants' a. C App p. According to the University of Miami study of HIV positive individuals. 00 Given the three components identified as crucial for a superior intervention in illness and disease. Naomi has just taken a blood test to determine the presence of HIV in her body. her lack of knowledge about HIV or its transmission. 88 Ans. safe sexual activities. antidepressant medication and social support. a higher-SES. including her sexual choices. c. aerobic exercise. a middle-class lesbian female living in suburban Chicago b. daily relaxation. her fear that a partner will accuse her of infidelity if she asks him to use a condom. c. b. 86 Ans. HIV-specific measures of immune functioning. c. 205 C 6. research described in the chapter suggests that she could increase her immune response most importantly by a. 55 c. 89 Ans. d. She is meeting with a support group to prepare herself for the results. Aaron. +. If she is HIV positive. Rick. . 204-6 M * 148 . Which of the following correlations most closely approximates the relationship between relaxation training and HIV-specific measures of immune competence? a. the year-long intervention for women with metastatic breast cancer b.6. 205 M * 6. 85 Ans. d. a gay male living in Philadelphia Hadiya lives in Africa. D Con p. postnotification depression scores. +. which of the following programs included all three? a. a heterosexual male living in the inner city of Detroit c. She is among a group whose AIDS risk is growing at an alarming rate. b. D Fac p. the CBSM program for HIV positive gay men d. A Con p. cognitive restructuring and assertiveness. Each of the following might explain Hadiya's elevated risk EXCEPT a. the unsanitary living conditions around her. 90 Ans. 08 d . all of the above 6. heterosexual white female living in Seattle d. B App p. Both a and b. 205-6 E 6. 204 C 6. 205 M Which of the following persons is LEAST likely to alter her/his behavior as a result of HIV prevention programs in the community? a. her lack of income which leaves her unable to exert control over her life. Reya. 40 b. d. b. decrease his risk-related behaviors such as overeating. thus increasing longevity and reducing recurrence of cancer. 149 . She will probably survive another three years after beginning the program. Whereas relaxation appears to be effective in improving immune system functioning in HIV positive persons. c. 19 The results from research on creative novation therapy and other related psychological interventions indicate that a. multi-modal psychotherapy techniques can reduce or at least delay the incidence of cancer. self-hypnosis is important for reducing in women with metastatic breast cancer. b. weekly group therapy is required for individual adherence to the full treatment regimen. learn self-hypnosis for control of pain and to support more adaptive problem-solving. the therapist will help him a. 0 b. depression c. d. and freely express emotion. 5 c. competitiveness. lower his blood pressure via reductions in hostility. which of the following outcomes is LEAST likely? a. She will demonstrate greater antipathogen activity after 12 months of treatment. c. and anger. increase his assertiveness. d. b. She will report less emotional distress and a higher level of energy than will women who are not in the program. If she participates in a behavioral intervention program that includes training in self-hypnosis. d. Of the 50 patients in Eysenck and Grossarth-Maticek's creative novation therapy group. smoking. about how many had died from cancer 13 years after the experiment began? a. c. drinking. Type C personality characteristics can be significantly changed. 12 d. maladaptive coping efforts If Samuro is receiving therapy for his Type C personality. antipathogen activity d. a. pain b. reduce feelings of stress. and unsafe sexual practices. b. research replication is needed before any conclusions can be made about their efficacy in treating or delaying cancer. She will report no increase in pain during the 12 months of treatment.Melinda has metastatic breast cancer. D App p. sense of control c. 50 d. c. contingency contract. 99 Ans. token economy. C App p. c. For children whose medical illnesses require lengthy hospitalization and whose compliance with treatment involves painful procedures or side effects. b. antiemetic drug therapy 6. token adherence agreement. formal mutual arrangement. 96 Ans. 209 E * 6. problem-solving strategies Duane does not completely follow the instructions given to him by his physician about the medications he must take to manage AIDS. environmental cue contract. adherence monitoring. C Con p. Duane is part of the noncompliant group that comprises % of medical patients. a. b. 38 c. 100 Ans. Dr. environmental cues c. which strategy would be most effective? a. This compliance strategy is called a a. 207 E A change in a patient's appears to be the most common ingredient in the various interventions discussed in this chapter. a. 204-7 M 6. depressed mood b. B Con p. a token economy d. 98 Ans. Cavaleri gives special coupons to Sally when she follows her prescribed diet and maintains her weight. 62 Rudy uses "post-it" reminders and sets the alarm on his watch to remind him to take his antihypertensive medication. 101 Ans. level of knowledge about a disease d. 207 E 6. 207 M 6. Rudy uses to increase compliance. external incentives Hannah's physician had her sign a written contract about her daily exercise routine and dietary intake restrictions. 97 Ans. contingency contracting b. A App p. a. d. a contingency contract c. Sally can use the coupons to "buy" privileges and toys in the hospital canteen. Her pediatrician is using a(n) a. in return for which she would be able to schedule her appointments at times most convenient for her. B App p. 15 b. a self-administered token economy d. selective reward contract. contingency contract. 209 M 150 . d. environmental cues b.6. A person is diagnosed with a disease. 102 Ans. 000 d. 000 Which description below does NOT represent an example of one of the challenges to health-promotion programs? a. 209-10 E Of the three techniques that comprise effective treatment interventions for medical illnesses. neither of whom developed lung cancer even though they lived past age 70 and smoked for many years. social support d. a. 210 E 6. health belief model. C Fac p. Hans. Jane's high-fat. Michi smokes cigarettes. illegal drug use. 425. Harriet. stress-reduction training b. Adrian. 625. Michael believes he is susceptible to HIV and is feeling pressured by friends and magazine ads describing the plight of AIDS patients. and other controllable behaviors could prevent deaths each year in the U. 210 E 6. high-cholesterol diet will not result in CUD symptoms for several years. A App p. d. which produces few noticeable or distressing symptoms. A person understands the long-term effects of the unhealthy behaviors. a man living in poverty and dealing with CHD. 210 E 6. A Fac p. c. unhealthy eating. B App p. b. whose father died of a heart attack d. 106 Ans. c. Tyree's new job and the birth of his first child have put his daily gym visit low on his list of priorities. which one is most effective for reducing the common side effect of chemotherapy? a. d. 210 M . the necessary treatment will be effective and short term. For whom is the health belief model able to make the most accurate predictions? a. 000 b. A person is often pressured by family and friends to get regular checkups. Alameda. S. A person anticipates that if they become ill. 104 Ans. alcohol. risk behavior model. 107 Ans. a middle-SES woman with a history of cancer in her family 151 6. c. The most influential theory about why people do or do not engage in healthy behaviors is the a. such as smoking or excessive eating. 1. cognitive restructuring c. risk/benefit cost model. a middle-SES man who completed a two-year technical college degree b. 105 Ans. 210 M 6. 103 Ans. 1.6. realistic expectations Experts have estimated that changes in tobacco. d. an upper-SES woman with an above-average understanding of health issues c. Under which condition below is a person MOST likely to alter an unhealthy behavior habit according to the HBM? a. such as hypertension. b. 350. b. as did her parents. B Con p. 000. D Fac p. medical novation theory. 000 c. These could include the following: 1) psychological factors -. lack of exercise. c. outline the worst-case scenario to the patient to create anxiety that will motivate treatment compliance. gender-role related stresses.6. She is more likely to exercise on a regular basis and monitor her diet. She is similar to the average person from either of the other two cities in regard to her level of knowledge and risk. 108 Ans. alcohol & other drug use. 208 E * 6. 152 . lack of education. If she received the dual-focus intervention. reductions in unhealthy eating habits. and social conditions. 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. B App p. Dr. competitiveness) & lack of conscientiousness. 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. inadequate problem-solving skills. C App p. 211 C If Dr. increases in regular physical exercise. be strongly convinced in his own mind that the regimen will have a positive effect on the patient's functioning. It has been three years since Miguela participated in the Stanford Heart Disease Prevention Program. 109 Ans. what would you expect to discover about her? a. lack of social support. urban areas. A Fac p. Subbiah should a. 208 M SHORT ANSWER 6. She has maintained a reduction in her cigarette smoking for the last 3 years. encourage the patient to engage in the regimen even if it has little chance of affecting the patient's long-term prognosis. lack of a sense of control over environment (related to interpretation of stressors). psychological factors. unsafe sexual behavior. d. racism and discrimination. d. c. b. negative emotions (hostility. c. Subbiah wants to persuade his patient to adopt a weekly exercise regimen to address the patient's CHD. 110 Ans. giving several examples of the latter two components of that model. d. mass media and intensive oneon-one counseling were effective in leading to a. inadequate access to health care. give the patient written literature regarding the pro's and con's of this treatment recommendation and encourage an objective decision.risky behaviors such as cigarette smoking. increases in medication compliance. For at-risk residents of Watsonville. b. 2) social conditions -. She has returned to the level of risky behaviors she exhibited prior to the program. 6. reductions in cigarette smoking. 111 Explain how the biopsychosocial model applies to health psychology's understanding of illness. anger.unstable. California. poor diet. b. stress-producing environments such as crowded. sharing of needles 6. Type B individuals. insisted that psychological factors were important in understanding physical illness. its transmission. generate competitiveness. suggested that specific unconscious conflicts caused certain illnesses. Franz Alexander. 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. a mutuallyreinforcing pattern of negative emotions and reactivity may account for some of the CHD risk exhibited by Type A persons. 114 In regard to the AIDS epidemic. or involve criticism. Sir William Osier.6. Given that these situations also tend to generate hostility and anger. sex with multiple partners and/or partners with unknown sexual histories. 115 Given the alarming increase in the incidence of HIV and AIDS in heterosexual women in many developing nations. including greater access to female condoms and vaginal microbicides. support for greater economic independence to reduce subjection to sexual coercion or commercialized sex 153 . reduction in sexual abuse victimization and support for women to take greater control over their sexual lives. 113 When data regarding negative emotion is combined with research on the physiology of Type A vs. this reactivity is most evident. thus. 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. 6. Psychosomatic Medicine. and heterosexual women c) heterosexual contact and mother-child transmission d) excessive use of alcohol/other drags prior to sexual activity. S. 6. Friedman & Rosenman: identified the Type A behavior pattern that has become the most extensively studied psychological risk factor for cardiovascular disease. Hispanic adolescents. a chronic pattern of hostility can engender higher levels of cardiovascular reactivity. what intervention strategies have been proposed to reduce their risk? Education regarding HIV. while his original ideas are not empirically supported. and Friedman & Rosenman important in the history of health psychology? Aristotle: encouraged a monistic approach to understanding the relationship between mind (soul) and body. ? b) which three groups in the U. 112 Why are Aristotle. the role of certain negative emotional states have been connected to various illnesses. Osier: considered the father of behavioral medicine. and related risk behaviors. S. Alexander: in his 1950 text. failure to use a condom. a) which two groups have the highest risk of AIDS in the U. When these stressors are related to interpersonal conflict. 1910 lecture set forth ideas about heart disease that have been supported by modem researchers. supporting what would become the biopsychosocial model for the modem field. stress-reduction: cognitive and/or muscle relaxation training. with at least two applications of the associated techniques: 1. Many people with unhealthy behaviors do not develop a related disease or illness. biofeedback. provide tangible aid if needed. role modeling via interaction with patients who have undergone prescribed treatment. then.6. her/his view toward treatment. An individual's beliefs about their own susceptibility. and thus while outcomes may eventually be extremely aversive. 117 What are the six behavioral risk factors that. if substantially changed. what they think about the treatment for the disease. 6. infrequent use of seatbelts. i. the longer the delays. Offer her some ideas that might help her understand her patients' apparent lack of concern. they are psychologically irrelevant in the present moment.answer should address each of the three components below. failure to obtain or comply with necessary medical treatment. the less the impact. unhealthy eating habits. 119 In your life now or in the future. The delayed consequences for unhealthy behaviors are essentially meaningless to many individuals. whether they are motivated by external cues/pressures 154 . the severity of a potential illness.. provision of realistic information about prognosis and effects and side-effects of treatment. 116 Describe a hypothetical intervention for ovarian cancer that includes each of the components necessary for a successful program. 2. 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]. whether they are bothered by internal cues. S. only slightly affect a given individual's morbidity risk. how severe they think the disease would be for them. cognitive restructuring: training in effective problem-solving. reductions in risky behaviors. development of a greater sense of control over the disease as well as control related to treatment compliance. Changes in lifestyle make long-term adherence difficult due to its inconvenience and to changes in day-to-day priorities. the nature of its cost and effectiveness. might prevent half of the deaths in the U. and risky sexual practices 6. but she is surprised that so many of her patients also seem uninterested in maintaining healthy behaviors. encourage interactions with family and friends. 6. abuse of alcohol & other drugs. 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. She was told in medical school that patients would often be noncompliant with treatment. social support: offer 1 & 2 above in a group setting. hypnosis (including self-hypnosis). Give at least two examples of each of those components. e. 3. Bate is a new family practice physician. 118 Dr. or meditation. 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. each year? use of tobacco. No specific modal response predictable -. S. Dr. interpersonally. A random sample of 100 community residents has been asked to participate in an epidemiological survey. obsessive-compulsive disorder 7. social phobia d. mood disorders. panic disorder c. 5 Ans. anxiety b. There is a frequent occurrence of comorbidity among these disorders. generalized anxiety b. 12 b. A App p. 217 E * 155 . Diagnostic criteria overlap so extensively that reliable diagnosis is difficult. D App p. Stella has been diagnosed with generalized anxiety as well as panic disorder. A commonly committed error is that of assigning two Axis I diagnoses to one person. uncontrollable. but not necessarily a. approximately are experiencing an anxiety disorder or have done so in the past 12 months. would fall under the category of a. population. 216 E Fear is a primitive. Her disorder. 216 M 7. then.Chapter 7 ANXIETY DISORDERS 7. and interferes with his day-to-day activities. somatoform disorders. Which of the following would this be? a. behaviorally. 4 Ans. 3 Ans. 33 Ennis is in a situation causing him to experience both fear and anxiety. cognitively. 25 d. is pervasive. 2 Ans. 216 E 7. In other words. He will express these emotions in several channels. adaptive response to threat. maladaptive fear Duretha has a kind of mental disorder that occurs with greatest frequency in the U. Jason has a(n) disorder. 216 E 7. b. Jason's level of fear. 17 c. c. d. c. however. Many anxiety disorders begin as generalized anxiety and then develop more specific symptomatology. C App p. affective d. This reflects what characteristic of anxiety disorders? a. a. substance abuse and dependence disorders. c. B App p. anxiety disorders. d. Seshachari is treating a client who is diagnosed with one of the most common anxiety disorders. physiologically. 6 Ans. b. B App p. neurotic c. a. 1 Ans. B App p. If they are representative of the larger population. b. d. intense. 216 E 7. either a or b When Natalie is feeling anxious what part of her life will she be most concerned about. posttraumatic stress disorder. 7 Ans. 10 Ans. 217 C Lynette and Keith are fraternal twins. a specific phobia. d. c. d. panic disorder and social phobia. 13 Ans. Edgar spends a great deal of time feeling nervous. Kale is seeking treatment for symptoms that his counselor describes as a type of anxiety disorder. b. having generalized anxiety. d. you would describe Edgar as a. If fear is a signal that there is an external threat. according to Freud. b. Keith is more likely than Lynette to experience a. internal. specific phobia d. interpersonal conflict or threat. c. is a signal of a. C App p. 12 Ans. all three equally Because he never lived up to his parents' expectations. The counselor also told him that roughly 1 out of every 11 adult males experiences this disorder at some point in their lives. the future d. 7. What disorder is this? a. 8 Ans. and unhappy. 217 E 7. comorbid. b. A App p. D App p. 9 Ans. neurotic. 217 E 7. 11 Ans. These differ depending on gender. 217 M 156 . future-oriented foreboding or apprehension. A Con p. If you were Freud. guilty. d. obsessive-compulsive disorder and panic disorder. generalized anxiety c. according to Barlow? a. c. 217 M 7. agoraphobia and generalized anxiety. C Fac p. anxious b. unconscious threat. Based on prevalence data. b. none of the above.7. How might you most accurately describe his emotional state? a. c. the past b. the two least commonly occurring anxiety disorders are a. the present c. neurotic d. 217 E 7. obsessive-compulsive disorder. social phobia b. obsessive-compulsive disorder Of the following. depressed. D App p. fearful c. 217 M 7. repressed unconscious conflict. A vague sense of impending doom or catastrophe has been bothering Aaron for several hours. A App p. anxiety. alarm reaction Which of the following persons is most likely to be diagnosed with a phobia? a. she felt her heart racing and her palms were sweating. Ana. anxiety c. a divorce from his wife of 15 years. 17 Ans. learning and culture War is unquestionably a source of threat. phobia b. a black male d. depressive Evolutionary theory hypothesizes that a 5-month-old infant should possess the capacity for a. a white female Which of the following disorders does not belong with the other three? a. 218 M 7. A Fac p. 14 Ans. D Fac p. B App p. a. anxiety d. fear. specific phobia 157 that 7. According to Freud. somatoform c. What label would you give this reaction? a. and she had vivid pictures in her mind of her plane going up in flames. Lou. biology c. 19 Ans.7. neurotic b. 15 Ans. cognitive processes d. Monica had to fly overseas on business. Sara. 16 Ans. trauma One week after the crash of TWA flight 800. learning and culture b. cognitive processing. The text describes anxiety disorders as a fundamental disturbance in is then shaped into particular patterns by . and rejection by his best friend. It is fitting. d. agoraphobia c. social phobia b. D App p. Don is harboring a great deal of repressed anxiety. a white male b. 217-8 M After several business failures. B App p. anxiety. 20 Ans. 18 Ans. stress d. biology. b. Don will develop a(n) disorder as a result of this repression. material phobia b. 218 E . obsessive disorder d. 217 M 7. neurotic phobia d. then. 218 M 7. a. c. 218 E 7. learning experience. C Con p. conditioning. As she boarded her own flight. behavioral responding. a Hispanic female c. 218 E 7. a son of the god of war. C Con p. that the term comes from the name of a Greek deity. Trevor. somatization. specific phobia c. a. 22 Ans. specific phobias. b. d. Yuan has an irrational fear which has prevented him from seeking employment in any office that is more than one story above ground. Lok is a registered nurse working on a unit with HIV-positive patients. specific fears that fall short of diagnostic criteria? a. heights. tonitrophobia Tani. embarrassment. 158 7. Leanne becomes very agitated and scared. sangephobia. onset prior to age 16. hematophobia b. 27 Ans. belonephobia. B App p. 21 Ans. If she has a fear of exposure to blood. agoraphobic symptoms. C App p. falling. traumatophobia. impairment in health. ephidiophobia c. B App p. 219 E . 26 Ans. 218 E 7. Many individuals with hematophobia. 25 Ans. 219 M 7. b. A Con p. 23 Ans. hematophobia. d. 24 Ans. nyctophobia. b. brontophobia d. 219 C 7. Tamar's irrational fears and avoidance of heights and of elevators are types of a. d. According to the text. one half d. c. belonephobia d. c. Which of the following is most likely? a. enclosed spaces. A Fac p. nyctophobia c. musophobia b.7. d. c. this is probably MOST accurately described as a fear of a. 219 M 7. 9 M 7. c. disruptions in daily functioning. one quarter c. has a phobia that is among the most commonly occurring specific phobias. b. D App p. one fifth Every time her parents take her for a checkup. an adaptive fear. simple anxieties. a tendency to faint when exposed to the stimulus. 218. a 5-year-old male. Her health is in jeopardy due to her unwillingness to take the shots. 218 M * Roughly what proportion of the population has either a true specific phobia or intense. claustrophobia Ms. She screams when the nurse tries to administer routine vaccinations. C App terrified p. and similar phobias have each of the following characteristics EXCEPT a. she has a. What type of fear is this? a. one third b. by the sight of the needle. social phobias. social learning 7. agoraphobia Which of the following statements regarding phobias is CORRECT? a. A App p. a White American male d. a Japanese female c. agoraphobia b. 220 E * 159 . 28 Ans. 31 Ans. 33 Ans. Frank. Which of the following persons is most likely to exhibit TKS? a. 220 E * 7. Minoru lives in Hiroshima. being embarrassed by negative comments after making a public presentation. Inside. revealing his own flaws and insecurities. acute stress reaction d. The symptoms associated with social phobia are culture-general. d. d. D App p. C App p. Japan. c. generalized social phobia b. b. he is probably MOST concerned about a. What is Dr. What disorder does this reflect? a. Dr. b. a Japanese male Dr. Botan. 220 E 7. Nowital is convinced that the client is afraid of her own unrecognized desire to have an incestuous relationship with her father. leaving himself open to others' ridicule about his personal mannerisms. 32 Ans. Nowital's perspective? a. she would humiliate herself. 220 E 7. D App p. 220 E A college senior. specific phobia c. posttraumatic social disorder d.. The biological preparedness associated with specific phobias is culturespecific. psychoanalytic b. 220 M 7. What disorder does she appear to have? a. social phobia Micki's friends don't understand why Micki never goes out to dinner with them. situational specific phobia c. Naum has always avoided classes in which any kind of oral presentation or class participation was required. 29 Ans. and doesn't like to meet new people. 30 Ans. behavioral d. However. won't go to a movie. cognitive c. Agoraphobia is a type of culture-specific disorder. his last class required for graduation requires a 20-minute presentation. If he has symptoms of a social phobia. offending another person by his public behaviors. Nowital is working with a client with a social phobia including intense anxiety when meeting members of the opposite sex. A App p. Dora. c. He is seriously reconsidering whether he wants to complete his degree. Umeko. a Black American female b. Social phobia is a type of culture-general disorder. Micki is sure that if she did any of these things. B Fac p. Which of the following is NOT one of those pieces? a. Freud. by presenting the NS without the CS c. 39 Ans. CR c. oral b. a young infant. 221 C 7. 38 Ans. by presenting the CS without the US b. noisy dogs. the failure to document the generalization of traumatic fear reactions Six year old Ekaterina has a phobia of large. UR b. Wolpe d. unresolved unconscious conflicts b. castration Deidre has an incapacitating snake phobia. how would deconditioning be achieved? a. learned to fear and avoid white rabbits after the sight of a rabbit was repeatedly paired with a loud. According to Freud. latency d. Kendler. Watson. 220-1 E 160 . NS d. Deidre has failed to successfully resolve the stage of psychosexual development. 221 C Deidre has an incapacitating snake phobia. D Fac p. a. 34 Ans. 220 E 7. a. Freud. 37 Ans. 35 Ans. While would wonder about her relationship with her father. 221 M * 7. A App p. modeling c. would wonder how often Ekaterina has seen such dogs on television and in the books her parents read to her.7. B Con p. B Con p. phallic c. 220 C 7. by presenting the UR without the CR d. differences in "prepared" and "unprepared" stimuli as fear elicitors d. Freud c. C App p. A Con p. What causal factor would John Watson emphasize in understanding her fear? a. Bandura b. by removing the CS In the example from the previous question about Little Albert. the difficulty in extinguishing phobias by simple non-threatening exposure b. the influence of vicarious conditioning and modeling c. direct conditioning d. In classical conditioning terms. which element of the classical conditioning process represents Albert's rabbit phobia? a. inherited anxiety sensitivity Little Albert. startling noise made behind him. 36 Ans. CS Several pieces of evidence have indicated that Watson's explanation for phobias is incomplete. Seligman 7. c. MZ twins who have a relatively high level of GABA in their limbic systems. a. Either a or c could apply. 222 M . thalamus b. What process accounts for Carlos' phobia as an adult? a. serotonin d. 40 Ans. A App p. C App p. 42 Ans. 222 E 7. He vividly remembers her hysterical reaction when she found one in her shoe while getting dressed one morning. 44 Ans. 45 Ans. They are more likely to be concordant for than are Evan and Emily. hippocampus c. Martin is a tightrope walker in the circus. b. 161 7. social phobias. direct conditioning c. 41 Ans. DZ twins who have a relatively high level of GABA in their limbic systems. Deidre has an incapacitating snake phobia. b. Norepinephrine activity increases in his brain. D App p. environmental experiences c. leading to excessive limbic system activity? a. GABA b. C App p. MZ twins who have a relatively low level of GABA in their limbic systems. genetic makeup d. agoraphobia. diazepine Johnny just observed a traumatic incident with a schoolmate that will result in Johnny's avoidance of needles for the next 12 years. d. DZ twins who have a relatively low level of GABA in their neocortexes. The amygdala triggers activity in the adrenal gland. stimulus generalization Martin and Melody are MZ twins. If he nearly falls off the wire. 222 M 7. 222 E 7. who are DZ twins. All of the above. amygdala d. Current research does not provide an answer to this question. which neurological response is most likely to help him calm down? a. biological preparedness b. B App p. corpus callosum Which of the following factors appears to be primarily responsible for triggering most phobias in humans? a. 222 M 7. GABA activity increases in the brain. 46 Ans. 221 E As a young child. d. c. b. C App p. B Fac p. What brain structure is MOST clearly implicated in this early phobic response? a. c.7. d. Carlos watched his mother scream any time a spider was found in the house or out in the yard. 43 Ans. modeling d. dopamine c. What neurotransmitter may be unusually low in her brain. 222 E 7. Which of the following twin pairs would probably be most concordant for a phobia? a. specific phobias. operant conditioning b. B App p. D App p. b. elevators b. c. In the past year. 50 Ans. provide unconditional positive regard and empathy. b. 222 E 7. preparedness b. 223-4 E 7. 223 M * 162 . cognitive A demonstrator monkey is displaying a fear reaction to a plastic toy car. an observer monkey will develop a similar fear. A Fac p. After one exposure. a phobic disorder. 48 Ans. an observer monkey will not develop a similar fear. cognitive restructuring c. a. 53 Ans. d. direct conditioning c. Dr. It is not possible to make a prediction because this research has not been replicated. 66 c. 52 Ans. generalized anxiety disorder. anxiety sensitivity d. d. c. construct an anxiety hierarchy. 83 d. C App p. 7. an observer monkey will develop a similar fear. B Con p. 222 E 7. 223 E 7. d. 91 Which of the following does not belong with the other three? a. darkness The behavior of demonstrator and observer monkeys in Mineka and colleagues' studies has provided clearest support for the theory of phobias. D Con p. 45 b. systematic desensitization d. Approximately how many clients responded well to treatment? a. Bandura has treated 100 clients who suffered from a specific phobia. b. in your treatment plan for a client with social phobia you would a. explore the unconscious origins of the client's social fears. After many exposures. participant modeling b. c. Friere wants to maximize her chances of therapeutic success with a client. 222 M Which of the following stimuli would most likely be included in the preparedness theory of phobias? a. posttraumatic stress disorder. As a result. subways c. Despite repeated exposure. injections d. obsessive-compulsive disorder. 49 Ans. 51 Ans. 223 E 7. A App p.7. she should treat someone with a. 47 Ans. combine in vivo exposure with modeling. If Dr. graded exposure Joseph Wolpe is your clinical supervisor. Which finding is MOST likely in regard to an observer monkey? a. His underlying sense of self-efficacy has been enhanced. Train Luella in muscle relaxation. one presentation of an intense CS followed by gradual relaxation Celine's sympathetic nervous system is sending her intense fear messages. she wonders if she's made a horrible mistake. Expose Luella to nonfearful role models. Sergei has a phobia of snakes. Celine begins to feel more calm. C App p. but as she sits in her seat during actual takeoff as part of her third therapy session. Once her sympathetic nervous system becomes fatigued. d.7. 56 Ans. d. b. covert desensitization c. modeling d. Jules has successfully completed the process of systematic desensitization for his phobia of cats. graded exposure scale. Which of the following descriptions is INCORRECT? a. B Fac p. 224 E 7. 54 Ans. anxiety hierarchy. however. What process has she gone through? a. after two hours. presentations of a CS of increasing intensity d. D App p. 55 Ans. 224 M 163 . 57 Ans. His treatment success will not generalize to in vivo situations without additional exposure procedures. her fear has subsided completely. systematic desensitization b. b. Enhance the client's self-efficacy. 58 Ans. systematic distress scale. b. participant modeling d. cognitive restructuring What classical conditioning process underlies graduated exposure therapy? a. repeated presentation of a moderately intense CS c. 223 M 7. "A cartoon drawing of a snake" and "having a snake wrapped around my shoulders" are the two extreme points on his a. presentations of a US of decreasing intensity b. She did need to quickly overcome her fear of flying. C Con p. d. c. sadistic psychotherapy with an unethical charlatan b. His treatment was relatively time consuming. 224 C 7. c. 224 M * Luella's therapist has recommended that they employ systematic desensitization to help Luella overcome her fear of flying. Which psychological treatment technique is MOST likely to benefit from the technological evolution of virtual reality? a. Construct a fear hierarchy. A App p. 59 Ans. fear provocation hierarchy. c. He was able to maintain feelings of relaxation and calmness while imagining the most threatening item on his hierarchy. D App p. What is the first step to take? a. 223 E 7. flooding 7. graduated exposure c. c. What the DSM-II referred to as anxiety neurosis is now divided into several disorders. generalized anxiety c. The client will be exposed to in vivo stimuli such as pictures of bees. imagined vs. C App p. 225 E 7. was dizzy and nauseous. 64 Ans. B App p. c. immediate vs. in vivo modeling. Which of the following would be part of that treatment? a. What disorder is likely? a. 225 M 164 . 60 Ans. etc. 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. These experiences come on rather suddenly and for no apparent reason. sounds of bees. She felt a choking sensation. b. 225 E 7. and thought she was going absolutely crazy. What has she experienced? a. a neurotic fear Marco has an anxiety disorder that sometimes leaves him feeling out of touch with reality and somehow detached from his sense of self. A Con p. a panic attack b. an agoraphobic reaction d. d. graduated exposure. A App p. D Fac p. agoraphobia b. obsessive-compulsive disorder 7. panic d. an anxiety neurosis c. The client will learn relaxation techniques modeled by the therapist and then imagine pictures of bees. 225 E * 7. participant modeling. B App p. desensitized flooding. The client will imagine the therapist watching a bee on a flower. d. 63 Ans. Later. in vivo exposure b. 65 Ans. agoraphobia d. etc. 225 M Which of the following reflects an important difference between systematic desensitization and graduated exposure? a. A therapist has decided to employ participant modeling to treat her client who has apiphobia (fear of bees). 224 E 7. generalized anxiety disorder b. while Antonia observes from a safe distance. helps collect honey with a trained beekeeper. had trouble breathing. d. The client will observe as the therapist watches a bee on a flower. the other does not.7. gradual exposure c. panic disorder c. the sound of bees. This is known as a. etc. collecting honey with a trained beekeeper. Which one does not belong? a. Antonia moves closer and ultimately lets the ants crawl on her shoe. phobia Nashota had a terrifying experience today. One is clearly more effective than the other. b. 62 Ans. 61 Ans. etc. One includes modeling. . 66 Ans. C Con p. 226 C 7. 67 Ans. D App p. 226 M 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 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 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. 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. 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 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 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 7. 68 Ans. A Fac p. 226 E 7. 69 Ans. B App p. 227 M 7. 70 Ans. D Fac p. 227 E 7. 71 Ans. D App p. 227 M 7. 72 Ans. A App p. 227 M . 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 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 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 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 7. 76 Ans. A App p. 228 M 7. 77 Ans. B App p. 228 M * 7. 78 Ans. C Fac p. 229 M 166 7. 79 Ans. B App p. 229 E 7. 80 Ans. D App p. 229 M 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 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. 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. 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 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 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 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. 81 Ans. A App p. 229 M 7. 82 Ans. B App p. 229 M * 7. 83 Ans. C Con p. 230 E 7. 84 Ans. D App p. 231 M 7. 85 Ans. A Fac p. 231 E 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 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 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 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 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 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 7. 87 Ans. D Con p. 231 M * 7. 88 Ans. A Con p. 232 M 7. 89 Ans. D App p. 232 M 7. 90 Ans. B App p. 232 M 7. 91 Ans. B Fac p. 232 E 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 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 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 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. 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. 93 Ans. A App p. 232 M * 7. 94 Ans. C Con p. 232 M 7. 95 Ans. B App p. 232-3 C 7. 96 Ans. D App p. 233 C 7. 97 Ans. A App p. 234 M 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 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. 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 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. 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 For which anxiety disorder are the MZ and DZ twin concordance rates essentially equivalent? a. specific phobias b. panic disorder c. OCD d. agoraphobia 7. 99 Ans. D App p. 234 M 7. 100 Ans. A Fac p. 235 E 7. 101 Ans. B Con p. 235 C 7. 102 Ans. D App p. 235 E 7. 103 Ans. C Fac p. 235 E 170 . 104 Ans. A App p. 235 M 7. 105 Ans. B App p. 235 C 7. 106 Ans. C Fac p. 235 E 7. 107 Ans. D Fac p. 236 M 7. 108 Ans. A Con p. 236 C 7. 109 Ans. C App p. 236 E * 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 Which of the following medications would be most effective for the treatment of OCD? a. Xanax b. Anafranil c. Tofranil d. Lithium 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. 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. Which of the following brain regions does not belong with the other three? a. amygdala b. cingulate gyrus c. orbitofrontal cortex d. caudate nucleus 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 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 7. 110 Ans. B App p. 236 M 171 7. 111 Ans. D Con p. 236 C 7. 112 Ans. A Con p. 236 E 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 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. 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 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 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 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. 7. 113 Ans. B App p. 236 M * 7. 114 Ans. C Con p. 236 M 7. 115 Ans. D Con p. 236 M 7. 116 Ans. B App p. 237 E 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. 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 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 Free-floating anxiety is described in the DSM-IV as a. GAD. b. OCD. c. agoraphobia. d. PTSD 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 7.118 Ans. B Con p. 237 E 7.119 Ans. C App p. 237 M 7.120 Ans. D App p. 237 C * 7.121 Ans. A Fac p. 237 E 7.122 Ans. B App p. 238 M 173 Excessive worrying may reduce physiological arousal when the person is faced with a feared stimulus. Any of the above is equally effective.127 Ans. b.128 Ans.124 Ans.7. OCD c. GAD b. an attempt to avoid mistakes and mishaps. C App p. a 19-year-old white female Which anxiety disorder is MOST likely to be comorbid with another anxiety disorder? a. she will receive a.123 Ans. If she is given the most common form of treatment for this disorder. B Fac p. Kevin. 238-9 M 7. relaxation training c. D Con p. Eva experiences a DSM-IV disorder that some clinicians view as a basic anxiety state rather than a discrete disorder. which treatment method will be most effective for Glenda? a. d. 239 C 7. Glenda experiences a DSM-IV disorder that some clinicians view as a basic anxiety state rather than a discrete disorder. 238 E * Which of the following persons is MOST likely to be diagnosed with GAD? a.125 Ans. Marvin. panic disorder The worrying of an individual with GAD may actually be reinforcing in several different ways. a 29-year-old Hispanic male b. 238 E 7. c. b. an anxiolytic. A Con p. a 35-year-old black female c. cognitive-behavioral control treatment. a combination of A and B d. Worrying can serve as an attempt to maintain tight control over life. The cognitive preoccupation with possible threats may help a person avoid actual emotional distress. generalized anxiety disorder Which anxiety disorder would be most vulnerable to criticism by the sociocultural perspective for reflecting social and economic deprivation rather than individual psychopathology? a. D App p. agoraphobia b. Which description below does NOT apply? a. c. Shambrae. The frequent worrying puts the individual "on alert" and poised to cope more quickly with stressors. a 21-year-old black male d. According to Barlow's findings.126 Ans. d. a combination of relaxation training and cognitive restmcturing. panic disorder d. 238 M 7. agoraphobia d. C App p. cognitive restmcturing b. 7. Denise. specific phobia c. relaxation training. 239 C 174 . counting d.7. B Fac p. hormonal b. D why Patricia is substantially more likely to experience an anxiety disorder than is App Paul. d. hoarding Utilizing a "lie detector. Therapeutic effects may be no stronger than those obtained with a placebo. a. 240 E 7.129 Ans. a. Lasting reductions in chronic worry will not be obtained. spiders. limbic system reactivity While is usually treated with longterm success.132 Ans.131 Ans. specific phobia. gender role socialization d. 239 M Ingeborg is taking a benzodiazepine for GAD. PTSD. checking b. Side effects such as drowsiness and physical dependence will occur. 7. These could include each of the following EXCEPT p. 240 M 175 . 240-1 a. d. of a clearly successful treatment approach. GAD c. Which description is LEAST likely to apply to Ingeborg's reaction? a. social phobia b. washing c.130 Paul and Patricia are fraternal twins.134 Ans. a. Patricia's lower levels of GABA and smaller limbic system structures. c. compulsions of are much more likely among females than among males. agoraphobia b. panic disorder. panic disorder d. B Con p. 240 E Based on differences in behaviors that are expected and encouraged in males versus females. Paul's socialized reluctance to admit or express fear. it would be anticipated that would show significant gender differences but that would be more similar between genders. 240-1 E 7. A App p. GAD c. agoraphobia As expected on the basis of gender role socialization. M b. specific phobia d. C Fac p. OCD. GAD. Patricia's less frequent opportunities to extinguish fears of outdoor creatures such * as snakes. 7. Several reasons have been put forth to explain Ans. c. OCD. GAD symptoms will begin to subside about 6 hours after beginning the drag. social phobia is still in need 7. a. specific phobia.133 Ans. A Fac p. and the like." Pierce and Kirkpatrick (1992) provided support for the hypothesis of gender differences in anxiety disorders. Paul's greater exposure to androgens during puberty. crosscultural c. panic disorder. b. She is experiencing nightmares. chronic PTSD c. watchful for threat. Which of the following is NOT one of the three broad symptom classes of PTSD? a.136 Ans. and feels detached from others. d. persistent avoidance of trauma-related stimuli d. What DSM-IV symptom category does this behavior represent? a. A App p. social isolation 7. MDD Rosalind was a victim of severe domestic violence two weeks ago. He stays away from the scene of the shootout.3 percent. 1. has stopped attending his children's school activities. GAD c.138 Ans. PTSD d. 242 E 7. persistent avoidance b. persistent avoidance and numbing of general responsiveness b. individuals respond to a stressor as though it posed a mortal threat. Persons with have actually been exposed to a life-threatening situation. c. b. PTSD with delayed onset b. 241 E 7. OCD b. GAD Resnick and colleagues reported a lifetime prevalence of PTSD for females of a. 12 percent.139 Ans. and exhibits an exaggerated startle response. What diagnosis is correct? a. feels detached from and avoids friends who know about the attack. a. social isolation and emotional numbing Dave is a police officer who nearly lost his life during the apprehension of a robbery suspect. 19 percent. 240 E 7. 242 M 176 . C App p.135 Ans. persistent reexperiencing d. acute stress disorder d. B App p. frequent reexperiencing and persistent avoidance c. increased physiological arousal b. 5. 241 M * In panic disorder.7. numbing of general responsiveness and interpersonal withdrawal Vietnam veterans with PTSD often refuse to sit with their back to a door. increased arousal c.4 percent. His reactions represent which PTSD symptom category or categories? a.140 Ans. C Con p. 242 M 7. D Con p. frequent reexperiencing of the traumatic event c. preferring to monitor the activities of the people around them. increased physiological arousal and social isolation d.137 Ans. C Fac p. a non-injured victim of crime who believed her life was in danger c. c." and his friends who are against the war refuse to associate with him. d. Minh and Ruth. acute. 242 E 7. His physiological arousal will be heightened.143 Ans. C Con p. Pedro. Chris1 family was relieved that he seemed to cope well with the experience in the weeks that followed. with delayed onset Charles has returned from his tour of duty in Vietnam. Which of the following prewar characteristics is MOST likely to have increased his vulnerability to this disorder? a.146 Ans.142 Ans.144 Ans. Ruth. B Con p. chronic c. 244 E 7. 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. A App p. D App p. His resulting anger will motivate more adaptive problem-focused coping strategies and decrease his risk. One year later. Chris developed symptoms of PTSD that lasted for two months. PTSD. Minh. and his risk will increase. His service in Vietnam will result in PTSD regardless of these posttrauma events. persistent conditioning 7. delayed stress adjustment disorder b. latent onset d. Which of the following persons is most likely to develop PTSD? a. His social support will be decreased. persistent reexperiencing c. He is met by protestors who call him a "baby killer. a crime victim who was injured during the crime and believed his life was in danger b. 244 M 7. however.145 Ans. B App p.7. 30 percent. 45 percent. Marko is a Vietnam veteran with PTSD. c. How would these symptoms be diagnosed? a. PTSD. equally 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. b. social introversion c. persistent symptoms of increased arousal b. d. and thus his general unresponsiveness will be decreased and his risk actually lessened. 10 percent. b. How might these experiences affect his risk for PTSD? a. 18 percent. persistent avoidance d. 244 M 7. 243 M Chris was a passenger in an automobile accident in which a close friend was killed. 244 E * 177 . sensitivity to criticism and interpersonal suspiciousness d. conduct disorder Which PTSD diagnostic category contains symptoms that are best accounted for by Mowrer's two-factor model? a. PTSD. overconcern with bodily functions b. 141 Ans. D Fac p. the meaning assigned to an event. covert desensitization. physiological responses similar to those experienced during the trauma c. as though she was preparing to p. He should probably NOT choose a.147 Norma is a nurse who served in the Vietnam War. cognitive-behavioral therapy. 246 C .153 Ans. 246 E 7. d. working in the oppressive heat of Vietnam. 244 see wounded soldiers. flooding. b. If Donna's memory of her sexual assault is stored as a fear network. three-factor conditioning network. classical conditioning and operant conditioning b. physiological arousal of being keyed up d. Foa and colleagues' approach to the treatment of PTSD is most similar to a. The two-factor M model identifies the as the CS and the as the reinforcer. and escape and avoidance programs comprise a(n) a.148 Ans. b. move to North Dakota 7. trauma of working with wounded soldiers. A Fac p. c. A few years ago. any of the above Ron is seeking treatment for his PTSD. she moved Ans. d. trauma-related environmental stimuli b.150 Ans. cognitive processing therapy. the uncontrollability and physical danger of the event d. A Con p. D App p. 246 E 7. participant modeling. b. C App p. a. heat. A App p.7.152 Ans. physiological arousal of being keyed up. B Fac p. social rejection and generalization of arousal According to Dr.149 Ans. 244 M Paul has PTSD that developed as a result of his being violently assaulted while riding to work on the subway. heat b. fear network. heat. Kaloupek. d. According to behaviorists. direct exposure treatment. intrusive thoughts d. move to North Dakota c. she App often found herself feeling extremely keyed up. chronic depression c. prolonged avoidance of trauma-related stimuli Trauma-related stimuli and responses. which of the following factors is most likely to reduce the severity of PTSD symptoms? a. interoceptive restructuring.151 Ans. c. associative memory node. 245 M 7. operant conditioning and associative fear networks c. persistent exposure to trauma-related stimuli b. exposure to new but less severe stressors d. what two factors are most important in understanding how his symptoms have developed? a. c. 178 7. which element of that network is most likely to activate escape behavior? a. D from Florida to North Dakota because when the weather was hot in Florida. object relations therapy. cognitive trauma schema. 246 M * 7. Possession of a genetically inherited tendency to overreact physiologically and experience anxiety (possibly a deficiency of GAB A). direct or vicarious exposure (modeling. 1 7. 3 d. d. C App p.154 Ans. 247 M 7. the benzodiazepine drugs used to treat anxiety increase the activity of this transmitter. Of the ten women who have participated in the course. 7. 6 c. may be insufficient or may not adequately bind to receptors. D Fac p. exposure. including participant modeling. vivid information exposure) to a fear-producing stimulus or situation. and counselors immediately after the trauma. leading to an increase in physiological arousal and anxiety. and what evidence supports this notion? Amygdala. a primary inhibitory transmitter.155 Ans. avoidance/numbing : SSRI's SHORT ANSWER I ESSAY 7. endorsing perceptions that the world is a dangerous but predictable place. Each of the following factors was probably important in the attempt to prevent posttraumatic stress disorder EXCEPT a. none of the above To reduce the possibility of PTSD subsequent to trauma.159 Which procedures are commonly and successfully used in the treatment of phobias? Systematic desensitization. 7. flashbacks : anxiolytics b.7 M When a town in Pennsylvania lost several of its young adults in a TWA plane crash in 1996.158 What brain structure appears to trigger the intense fear involved in phobias? What neurotransmitter's activity might be disturbed. how many would be predicted to meet DSM criteria five and a half months later? a. friends. including graduated exposure and flooding.156 Ans. 8 b. crisis intervention teams arrived to help residents cope with the trauma.157 Describe the conditions under which humans are most likely to develop a phobia. reexperiencing : antidepressants c. B App p. stimulus or situation has evolutionary importance that "prepares" development of the fear. b. reinforcing individuals' belief in their ability to cope effectively. encouraging interaction with family. 243. 246-7 M Which of the following PTSD symptom categories and medications are mismatched? a. c.7. heightened arousal : antiadrenergics d. a university is offering Foa's 4-session prevention course to students who have been raped. GABA. 179 . and modeling. Kelli generalizes trauma danger signs (e. fear of dying). PTSD: antidepressants (not necessarily SSRI) 7. 4) Racine will then begin to misinterpret minor. -. shaking. 7. her friends avoid her because they don't know how to help or her father blames her for letting herself become a victim). Using Barlow's model. 1) Racine has an inherited predisposition toward autonomic overreactivity. while mere appears to be no specific genetic diathesis for OCD.. Thus. Describe the posttrauma factors that may increase her risk of PTSD.164 Kelli was a victim of a sexual assault while jogging through a public park. 2) She experienced some form of a major life stressor that she interpreted as posing an actual threat to her life. 3) The interoceptive cues associated with the first false alarm become early warning signs for which Racine has become highly vigilant..163 What class of drugs is most effective for GAD? for OCD? for the frequent reexperiencing of PTSD? GAD: benzodiazepines.160 Racine has developed a panic disorder. both studies documented an increased prevalence of various anxiety disorders in both proband families and MZ twins. benign somatic changes (such as an increase in breathing or increase in lactic acid).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. and these misperceptions will in turn hasten the development of full-blown panic symptoms in a sort of self-fulfilling prophecy. strangers approaching her. or the belief that they can approach and manage their reactions to feared objects. Torgersen failed to find a difference in concordance rates between MZ and DZ twins. or that network changes after the assault (e. In other words. there does appear to be some sort of more general vulnerability transmitted genetically. or even their own bodily states. Black and colleagues found that there was no difference in OCD prevalence in families of probands versus families of control subjects. 7. she has developed anxious apprehension. However. -.162 Do the findings of Black and colleagues (1992) and Torgersen (1983) indicate that genetics are unimportant in OCD? Explain. This prompted a "false alarm" of danger to which her sympathetic nervous system responded with panic symptoms (e.g.Kelli believes there is no one she can turn to for help who will listen to her fears. -. describe the etiology of her disorder. racing heart. situations.7. dizziness.Kelli has an insufficient social support network prior to the assault. 7. — Kelli believes that she is incompetent to cope with her experience and feelings.g. 180 .. breathing difficulties. outdoor public areas) to all situations and believes that the world is a dangerous place.g. OCD: SSRI's. wandering uterus d. To what would the healer attribute the symptoms? a. attention b. How would Freud have described Janice's disorder? a. somatization c. somatoform disorder c. memory c. somatoform disorder Janice has been complaining that she cannot feel her feet from her ankles down. B App p.6 Ans. Breuer d. hysterical disorder Which of the following persons does not belong with the other three? a. D Con p. repressive disorders b. neurotic dissociation An ancient Egyptian healer was treating a patient who complained of paralysis in her arms that seemed to have no physical cause. Which classification below is appropriate? a. psychosis Which of the following disorders is MOST similar to the meaning of "hysteria" as used by the Greeks? a. posttraumatic stress reaction d. consciousness d.5 Ans. conversion hysteria b. Freud 8.4 Ans. 252 E 8. 252 E 8. repressive neurosis d. Medical doctors have been able to find no physical cause for her symptoms. b. conversion hysteria b. She has trouble walking because of this and is constantly injuring her feet. B Con p. A Fac p.1 Ans. identity A clinician is consulting the DSM-II for the correct classification of a client whose symptoms include derealization and identity alteration. 252 M Dissociative disorders are marked by disruptions in each of the following areas EXCEPT a. A App p. hysterical neuroses c. Anna 0.Chapter 8 DISSOCIATIVE AND SOMATOFORM DISORDERS 8. Briquet c. dissociative disorder b. dissociative psychoses d. C App p.3 Ans. 252 M * 8. neurotic anxiety c.2 Ans. 252 M 8. 252 E 181 . A App p. B App p. b. exposure to unusually stressful experiences d. After several weeks of poor job performance following the divorce. C App p. 253 M Dr. childhood abuse b.11 Ans. dissociative identity disorder 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. DSM-III-R Danton's therapist believes Danton was exposed to chronic child abuse and has developed a subsequent mental disorder. dissociation George's wife divorced him suddenly.8. splintering c. DSM-I b. 253 E 182 .10 Ans. somatization. conversion disorder d. George was fired. d. DSM-II c. 253 M 8. joint pain. 253 E 8. division of consciousness d. DSM-III d. somatoforming. If he expresses his emotional distress by developing headaches.7 Ans. derealization. What psychological process is occurring? a. Which of the following disorders is the therapist LEAST likely to diagnose? a. splitting b. Asante specializes in the treatment of clients with dissociative or somatoform disorders. he is engaging in the process of a.8 Ans.9 Ans. 8. C Fac p. posttraumatic stress disorder b. 253 E 8. dissociation. multiple visits to medical doctors prior to DSM-IV diagnosis c. histrionic personality disorder c. c. Which of the following commonalties should he expect to find in their personal histories? a. and other physical symptoms. disruptions in memory and consciousness In which version of the DSM would you first see a separation of neuroses into somatoform and dissociative disorders? a. D App p. 254 a. derealization. these would be considered pathological states due to the complexity and infrequency of their experiences. depersonalization. Because Jachim and Spencer experience a loss of identity and derealization. A App p. Spencer is a veteran of WWII who was severely wounded twice in combat. b. Whether Jachim or Spencer is diagnosed as pathological depends on the culture in which they live and the diagnostic practices of mental health professionals. c. amnesia. without an identity. They both involve some form of spirit possession. hypnotizability. 254 M 8. 253 M When Jachim meditates. but they have no subjective meaning to him. he enters a trance-like state in which he is unaware of the world about him. when they do not produce personal distress Marguerite has a dissociative disorder. c. b.12 Ans. B similar to the perceptual hallucinations seen in psychotic disorders. C Con p. B App p. They are considered pathological states in the DSM-FV. She might exhibit any of the following key symptoms EXCEPT a. 254 M 8. 183 . They are forms of dissociation described as normal expressions in some cultures. This is an App example of the key symptom of p. Which of the following statements correctly describes these two men? a. Sometimes he enters a state of mind in which the world has no subjective meaning to him and he feels disconnected from his body. d." When are dissociative states NOT considered pathological? a. Spencer's experience is pathological and may represent PTSD or a dissociative disorder. the possibility of a dissociative disorder is likely for both. d. They each involve characteristics of the mental processes described by Freud as "conversion neuroses. In this state. perceptual de-altering. c. 8. illusory imaging.14 Ans. d. Jachim's experience is not pathological. Regardless of their culture. is exhibiting symptoms Ans. d. M b. a person with dissociative identity disorder. identity confusion.8. His family finds these episodes alarming as does his employer. derealization. What do "speaking in tongues" and Ataque de Nervios have in common? a. b. c. when they do not involve significant identity alteration b. he can hear and feel events in the external world. as if he were no longer himself.13 Ans. when they occur within recognized cultural groups d.16 Lucinda. Sometimes he feels disconnected from his body. when they occur infrequently in an individual c. 254-5 M 8.15 Ans. D Fac p. 255 E 8. A Con p. 2 c.20 Ans. a negative correlation between those measures in both centuries. 255 E Most of the time Marva appears to be a normal adult female. Kraepelin's syndrome. alter d. If you measured interest in spiritualism and the number of cases of multiple personalities in the U. a positive correlation between those measures in both centuries. alter. dissociative fugue. personality fragment.18 Ans. For Lorraine to be diagnosed with dissociative personality disorder. Sara is the most outgoing and Ans. a positive correlation between those measures in the 1800s only. guest personality d. split identity 8. A App p. leading the life of a typical middle-class American. repressed memory complex b.19 Ans. in the 1800s and 1900s. d. Madeline is inhibited and App shy but is in charge most of the time. 255 M 8. you might have heard about the first detailed report of a. M a. dissociative fugue disorder c. 256 and Madeline as a(n) . Sometimes she suddenly changes her behavior. 1 b. an alter 184 . 4 d. a split identity c. Briquet's syndrome. d. B flamboyant identity but is unaware of the other identities. you would find a. c. D App p. a strong relationship between both measures and incidence of child abuse. host personality c. b. dissociative memory disorder d.17 Ans. alter. a poor minority child from the slums. D Fac p. how many alters MUST be present? a. 255 E Which of the following does NOT represent a DSM-IV dissociative disorder? a. Her entire personality changes when this occurs.8. b. 255 C 8. acting like a child and claiming to be Toby. dominant personality.22 Ans. dissociative trance disorder b. multiple identities. depersonalization disorder If you were living in Germany in the late 1700s. c. C Fac p. primary personality * b.S.21 A woman has dissociative identity disorder. Sara would be described as a(n) __ p. What is the term currently used to describe Toby? a. 7 8. 256 M 8. alcoholic adult male d. what difference would probably be observed between his disorder and the same disorder diagnosed in the late 1900s? a. If Erica is typical of clients diagnosed with dissociative identity disorder in 1990. a 5-year-old male b. the host personality d. 8 c. 256 E 8. a 27-year-old male host personality. Joshua.8. Edmund would not have been considered disordered.23 Ans. the powerful. Tori. C Fac P. 256 M * 8. b. C App p. d. The host personality usually does not represent the person's original personality. C App p. 256 M 8. Ohen. which of the following alters is LEAST likely? a. the angry personality fragment b. Edmund would have only two personalities. 32 8. D Con p. the host personality d. B App p. Ahmik. Edmund's personalities would be more clearly differentiated from each other. Juliet. b. an aggressive. Clinicians today are in agreement that this is a bona fide psychological syndrome caused by early trauma. c.24 Ans. she has alters. If Edmund were alive in the late 1800s. the protective alter personality Which of the following identities of a female with dissociative identity disorder is MOST likely to seek help from a therapist? a. Michelle.28 Ans. Meda. Edmund would show more alters of the other gender. Edmund has dissociative identity disorder. Personality fragments are more likely to occur than are complete alters. the original personality b. 2 b. Nodin. c.27 Ans. a suicidal alter c. 256-7 M Which identity of a person with dissociative identity disorder is most likely to seek treatment? a. a. d.25 Ans. her first male alter For Delsin. protective alter c. 15 d.26 Ans. a 42-year-old physically disabled male c. 256 E 185 . A App p. The number of alters present is proportional to the level of abuse suffered in childhood and adolescence. a suicidal adult female Which statement about dissociative identity disorder is TRUE? a. the protector identity. 257 E 8. switching c. a host personality. she engaged in the process of to enter the identity of Rebecca. 256 M 8. b. Yoko. gradual recall of childhood traumas d. B App p. Isabelle. If Estrella is now receiving another diagnosis. altering b. most commonly. from the U. displacing d. the higher number of females diagnosed with dissociative identity disorder c. 256-8 M When Marcia. Eva. 15 b. from Japan c. what is LEAST likely to prompt such changes? a. 256 M 8. flashbacks of memories b. and.29 Ans. Previously she has been diagnosed with major depression with psychotic features. C App p. there will be female clients for each male client the therapist sees. conversion disorder d.31 Ans. B Con p.8.30 Ans. current stressful events c. a. Penelope. dissociative identity disorder Which of the following females is LEAST likely to exhibit dissociative identity disorder? a. multiple personality disorder c. Which finding below is NOT part of that evidence? a. cases where malingering criminals and experimental subjects have been able to effectively simulate dissociative identity disorder Of the dissociative identity disorder clients a therapist treats. hypochondriasis.S. which of the following DSM-IV labels is MOST likely? a. 12 c. from Canada 8. 257 M 8. voluntary switching Certain evidence is commonly used to support the claim that dissociative identity disorder is created by clinicians. the increase in alters exhibited over the past several decades in North America b.32 Ans. schizophrenia. 4 Estrella is 28 years old. a. 9 d. somatization disorder b. A App p. 258 E 186 . the high use of hypnosis to discover alternate personalities d. from Switzerland d.33 Ans.34 Ans. PTSD. D App p. B App p. cohosting When Devorah changes from one identity to another as part of her dissociative identity disorder. was approached by a man who looked a great deal like her abusive father. localized dissociative amnesia b. d. Suppose each of the persons described below were participants in Coons et al. 258. 259 M 187 . A App p. For which DSM-IV disorders should a thorough medical assessment be included? a. and autobiographical memory being dissociated from consciousness. c. b.37 Ans. yes. 258 M 8. generalized dissociative amnesia c. the extensive overlap of symptoms with several disorders that might better account for clients' behaviors. This is an example of amnesia. Adrienne. C App p. what answer would you give. a female who role-plays multiple identities d. but these characteristics are often exaggerated by some overzealous clinicians. either a or b If one of your friends asked you whether dissociative disorder really exists.40 Ans. selective c. all of the above Nathaniel has a dissociative amnesia in which he can remember nothing of his first marriage. 259 E 8. however. based on information presented in the text? a. Henry. somatoform pain disorder d. yes b. c. the implausibility of important ideas. b. none of the above Which of the following statements BEST reflects your text's conclusion about the validity of dissociative identity disorder? a. a. He can. Cases of dissociative identity disorder are fabricated on the basis of leading interviewing techniques and hypnosis by clinicians. There is overwhelming evidence that dissociative identity disorder does not exist.8. systematized b. D Con p. 258-9 M 8. There is overwhelming evidence that dissociative identity disorder exists. documentation of inappropriate use of hypnosis by overzealous therapists. a female with dissociative identity disorder c. A Con p. continuous d. Nanette. C Con p. as a severe manifestation of PTSD d.'s study of EEG activity. a male with dissociative identity disorder b.69 M 8. the failure to document the presence of a single case in Japan.35 Ans. localized 8. 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.38 Ans. Severe trauma probably can create splintering of consciousness. D Fac p. d.36 Ans. remember the friends he had during that time.39 Ans. emotions. no c. Which of them would demonstrate the largest EEG changes across personalities? a. 44 Ans.46 Ans. she might expect these men to have a history of a. p. 259 M 8. localized c. a 25-year-old male If Dr. exposure to severe sexual abuse. 259 M 8. This is a type of a. C App p. 4 to 7 c. B App p. He will generalize his localized amnesia for the crime to a generalized amnesia that will preclude further diagnostic testing. b. 5 to 14 d. Alvin. b. b. 260-1 C .8. selective dissociative amnesia. d. 259 E 8. l t o 3 b. Wechsler is in charge of assessing the psychiatric casualties of American GI's during WWII. the names of soldiers who were with him. An initial assessment raises the possibility of a dissociative amnesia because Hugh has no memory for the event. localized dissociative amnesia.42 Ans. a 13-year-old male c.41 Chris was a passenger in an automobile accident in which his young sister was Ans. abnormal functioning in their hippocampus. c. What percentage of his patients will exhibit dissociative amnesia or other dissociative episodes? a. Hugh was recently involved in a violent crime for which he has been charged with attempted murder. If Hugh is. in fact. B killed. 12 to 19 Which of the following persons is MOST likely to be diagnosed with a dissociative amnesia? a. short-term M b. repressed memory syndrome. discontinuous d. this App is a form of amnesia. If he has dissociated his memories of the day following the accident. C App p. 259 M * Alberto was a member of the first group of soldiers to reach the concentration camp of Auschwitz during WWII. and the railroad cars outside the camp but he cannot recall anything about the camp inhabitants he saw. A App p. he will be unable to simulate brain wave changes when the interviewer begins to question him about the crime itself. Dr. d. systematized 8. 188 8. a 30-year-old female d. Carmen. c. He can remember the weather on the day they arrived. When assessed via EEG.45 Ans. a malingerer.43 Ans. Stephanie. d. which of the following reactions is MOST likely from him? a. exposure to violent stressors such as combat. opioid drug abuse that predisposes them to memory deficits. Marcus. He will exhibit a kind of "la belle indifference" in regard to his memory loss. D App p. c. 259 a. a 23-year-old female b. Arbuckle is treating young adult males who exhibit sudden losses of memory for personally important information. dissociative fugue. He will be eager to participate in an interview under the influence of sodium amytal. which diagnostic conclusion would he probably offer? a. d. 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. 260-1 LEAST likely? M a. You will perform quite differently on several psychological tests depending on which personality is dominant. The investigator Ans. role-playing subjects also demonstrate these changes.8. 261-2 E If Nicholas Spanos had been able to testify in Bianchi's trial. schizophrenia 8. You will probably resist the suggestive manipulation of the hypnotist and give little or no evidence of an alter personality. dissociative identity disorder d. c. Strong support for the existence of distinct alters is established. she was traumatized by the horror she witnessed.48 You have been asked to pretend that you are an accused murderer. Andrea had no memory of her life as Becky before the bombing. dissociative amnesia c. Which of the following outcomes is p. 8. 8.51 Ans. c.47 Ans. D running the study then asks you to role-play responses to a hypnosis session much App like the one Kenneth Bianchi underwent. b. dissociative fugue c. A Con p. depersonalization disorder d. 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. Later. pseudotrance disorder Becky was in a cafe in Paris when a terrorist bomb went off outside. bipolar disorder d. You will describe an alternate personality but claim amnesia for this personality * after the session. dissociative identity disorder Which of the following risk factors might increase Victor's risk of dissociative fugue following a traumatic life event? a. You will describe a childhood marked by abuse and familial discord. 262 M 189 . C App p. B App p. None of the above. B Con p. d. The imaginative involvement and absorption common to persons with this disorder are probably neurologically-based. What was this woman suffering from? a.49 Ans. 260-1 E 8. No clear conclusion is possible. malingering b. dissociative amnesia b. b. a family history of schizoid personality disorder b.50 Ans. somatization disorder c. as she switches from an alter to her host personality b. dissociative identity disorder b. Rosetta feels as though she were in a dream. B App p. dissociative amnesia. Paula has a dissociative disorder.57 Ans. Which of the following is most likely? a. d. 262 E 8. schizotypal symptoms c. Terrell. he is at significantly increased risk of another episode within the next five years. as he experiences an episode of derealization d. c. dissociative psychotic disorder Miguel is a chronic substance abuser who vehemently denies his substance use. a person in a fugue state If Keith is in a dissociative fugue. depersonalization disorder c. D App p. Olga. Which of the following characteristics is LEAST likely to describe her? a.8.54 Ans. 262 C * 8. 262 M Which of the following persons is LEAST likely to display symptoms suggestive of a mental disorder? a. hovering above her own body. fantasy proneness d. Martin. psychogenic flight disorder. b. which prognosis is most accurate? a. as a symptom of several other physical and mental disorders. c. he is at increased risk of developing a different dissociative disorder. and the objects around her seem strangely unreal. B App p. fugue b. Which of the following disorders is/are more commonly diagnosed in females? a.52 Ans.53 Ans. d. a history of childhood abuse 190 8. D Con p. dissociative fugue. b. d. A Fac p. both a and b Depersonalization occurs a. If he has occasional "blackouts" due to drug intoxication. C App p. as a rare and dysfunctional reaction to severe stressors. depersonalization c. b. 262 M 8. c. more commonly in males than in females. 263 E . Frances. While he is unlikely to experience another fugue in the future. high hypnotizability b. dissociative identity disorder. The fugue will end in a few days and he will recover fully. dissociative fugue d. The fugue will end in a few weeks and he will remember most of the events that happened during that time. a naive clinician might mistakenly diagnose Miguel's sudden departures from home and confusion about his identity as a.58 Ans. Once the fugue ends. 262 E 8. trance disorder d. in isolation from the occurrence of derealization.56 Ans.55 Ans. a person with generalized dissociative amnesia c. 262 E 8. B App p. high hypnotizability b. 263 M * A game. what is the primary causal factor in dissociative identity disorder? a. Persons most involved in this game were probably a. 265 E According to Frank Putnam and colleagues. somatization disorder d. 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. c. What have Steve Lynn and his colleagues found in regard to a person's vulnerability to dissociative disorders? a. C Con p. and other magical endeavors. 8. p. D App p. There is a high need for dependency among persons likely to develop dissociative disorders. d. 263-4 Which disorder is Ariel MOST likely to develop? E a. There appears to be a relationship between child abuse and dissociative symptoms. self-hypnotizability. She is likely to malinger a dissociative identity disorder. spell-casting.61 Ans. She is likely to exhibit symptoms of dissociation. c. fantasy proneness. known as "Dungeons and Dragons" required that players create imaginative characters and engage in fantasy-based combat. d. She is likely to exhibit symptoms of clinical depression. d. B novel. high in derealization.60 Ans. creativity. c. low in somatization.62 Ans. b. There appears to be a relationship between fantasy proneness and dissociative symptoms. b. high in absorption. both a and c The process of "dissociation" believed to underlie the dissociative disorders could be reconceptualized to include each of the following EXCEPT a. She is also quite suggestible. multiple identities role enactment 191 . a personality marked by fantasy proneness and absorption d. c. schizophrenia 8. b. low in absorption. 263 M 8. D Fac p. 263 M 8.59 Ans. b. Priscilla has completed a questionnaire that shows she is extremely high on fantasy proneness.64 Ans. B Fac p. popular in the late 1980s. dissociative amnesia b. dissociative identity disorder c. What prediction might you make about her? a. C App p. 263-4 E 8. role-playing.63 Ariel finds it easy to ignore everything around her in order to lose herself in a Ans. There appears to be no relationship between creativity and dissociative symptoms. d.8. severe childhood trauma c. c. b. and distress. Isadora. but the presence of a dissociative disorder is in essence an acceptable way to express her deep frustrations.66 Ans. Terri. who scores low on a measure of absorption d. 266-8 M In your report evaluating the dissociation-trauma model of dissociative identity disorder. Carolyn. 267 M 8. assessment for the dissociative disorder should be postponed until those symptoms are resolved. a clinical therapist b.69 Ans.68 Ans. Loftus' discussion of Hyman's work in the area of memory implantation. sense of failure. you could cite each of the following problems EXCEPT a. Childhood abuse occurs with less frequency than has previously been believed. Marion. Documentation of childhood abuse is usually obtained through the adults' retrospective and potentially inaccurate recall. It is entirely possible that Mildred was abused. b. It is possible to implant false memories of abuse during therapy.67 Ans. you might predict that her might be smaller than that of most adults. d. c. C Con p. A App p. a client her. D Fac p. According to Elizabeth Loftus. who has a history of severe. 268 M * . frontal lobes After several months of therapy for major depression. who scores high on the Dissociative Experiences Scale b. Mildred confides to her therapist that she was repeatedly abused as a child and that her previous therapist suspected a dissociative disorder. a.8. hippocampus c. 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. either a or b d. which of the following persons would be most susceptible to this phenomenon? a. what will Mildred's therapist MOST likely conclude? a. 268 M 8.65 Ans. 268 E 8. Many individuals who have experienced childhood abuse do not develop this disorder. Based on recent MRI studies.or himself c. long-term sexual abuse as a child Cassie is an adult female with a diagnosis of dissociative identity disorder. who scores low on a measure of hypnotizability c. 192 8. particularly with persons who score high on measures of hypnotizability. C App p. Hypnosis-based assessment should be conducted soon in order to evaluate the possibility of that disorder. neither a nor b According to Dr. 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. B App p. hypothalamus b. Because the depressive symptoms can increase the likelihood that Mildred will be susceptible to memory implantation. If her current therapist takes Spanos' approach to understanding dissociative identity disorder. d. cerebellum d. 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. 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 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 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 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 Which of the following disorders is LEAST likely to remit spontaneously? a. dissociative identity disorder b. depersonalization c. dissociative amnesia d. dissociative fugue 8.71 Ans. B App p. 269 M 8.72 Ans. C App p. 269 M * 8.73 Ans. D Con p. 269-70 E 8.74 Ans. D App p. 270 M 8.75 Ans. A Fac p. 270 E 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 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 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 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. 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 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 8.77 Ans. C Con p. 265-71 M 8.78 Ans. D Fac p. 271 E 8.79 Ans. B App p. 271 M * 8.80 Ans. D Fac p. 271 E 8.81 Ans. A App p. 271 E 194 8.82 Ans. A App p. 273 M 8.83 Ans. D App p. 273 E 8.84 Ans. C Con p. 262,73 M 8.85 Ans. B App p. 273 M 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 Which of the following psychological states is nearly always considered a pathological condition? a. somatization b. derealization c. dissociation d. all of the above 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 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. 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 8.86 Ans. C Fac p. 273 E 8.87 Ans. A App p. 274 E 195 8.88 Ans. D App p. 274 C * 8.89 Ans. B Fac p. 274 M 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 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. 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. 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 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 8.91 Ans. C App p. 274 E 8.92 Ans. D Fac p. 274 M 8.93 Ans. A App p. 275 M 196 8.94 Ans. B App p. 275 M * 8.95 Ans. C Con p. 275,9 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 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 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 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 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. Which of the following types of symptoms is LEAST common in conversion disorder? a. cognitive deficits b. sensory deficits c. motor deficits d. seizurelike 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 8.101 Ans. B App p. 276 C 8.102 Ans. C App p. 276 M 8.103 Ans. D App p. 276 C 8.104 Ans. A Fac p. 277 E 8.105 Ans. D App p. 277 E * 8.106 Ans. C App p. 277 M 8.107 Ans. D 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. 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 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 How would Anna O.'s disorder be classified in the DSM-IV? a. neurosis b. somatization disorder c. conversion disorder d. dissociative identity disorder 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 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 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 8.108 Ans. C Con p. 277 E 8.109 Ans. C Con p. 277 M 8.110 Ans. A App p. 278 E 8.111 Ans. B App p. 278 E 8.112 Ans. C Con p. 274,9 M 199 8.113 Ans. A Con p. 279 M 8.114 Ans. A Fac p. 278-9 M * 8.115 Ans. B App p. 279 E Which of the following disorders occurs MOST frequently? a. pain disorder b. hypochondriasis c. body dysmorphic disorder d. somatization disorder 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. 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. obsessive somatoform disorder somatization disorder body dysmorphic disorder somatophobic disorder 8.117 Ans. D App p. 279 E 8.118 Ans. A App p. 279 C , 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 201 283 M A multicomponent treatment program including antidepressant medication. A Con p. and individual and family psychotherapy is MOST likely to be used for a. Natasha. Artie. provide a combination of systematic desensitization and coping skills training. Carter. c.126 Ans. a child alter.129 Dr. diagnosed with somatization disorder c. stressor . Ophelia. David. concentrate on the reduction of comorbid depression or negative affectivity. an alter who acts out impulsive or forbidden behaviors (e. with body dysmorphic disorder 8. dissociative identity disorder. you would a. diathesis. promiscuity or substance abuse).130 Ans. negative reinforcement c. with hypochondriasis c. any of the above For which of your somatoform clients would you MOST likely recommend medication intervention? a.131 List the types of alters commonly found in persons with dissociative identity disorder. conversion. with conversion disorder M b. diagnosed with body dysmorphic disorder d. design a training program for physicians to deal with such patients. c. 282 C 8. with pain disorder d. B App p. d. body dysmorphic disorder. a suicidal or self-injurious alter. Previn is considered a leading expert in the treatment in obsessive-compulsive Ans. positive reinforcement. 283 a. SHORT ANSWER / ESSAY 8. 202 . biofeedback. 15 alters are commonly reported. somatization d. Greg.. dissociation. 282 M * Primary gain is to secondary gain as is to a.8. diagnosed with conversion disorder b. 283 C 8. At the present time. If you wanted to offer the most useful strategy for the treatment of persons with somatoform disorders. Which of the following clients is MOST likely to be referred to him for App successful treatment of her/his somatoform disorder? p. diagnosed with hypochondriasis 8. reinforcement b. A Fac p.127 Ans. D disorder. Vivian. and a powerful and dominant alter protective of the host personality. d. b. b. pain disorder. Keisha. how many are typically associated with the disorder? An alter of the other gender.g.128 Ans. somatization disorder. C App p. becomes associated with the child's developing personality: during the dissociative states in childhood. have limited access to social support and child care. according to Putnam and colleagues. When a child experiences such unrelenting trauma from which there is no physical escape. although childhood abuse is found in virtually all cultures. are poor.134 List five of the characteristics of parents who are abusive toward their children. repeatedly utilized. Data pertaining to physiological differences across alters are not always replicated. choose aggressive means of conflict resolution. frustration. 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.132 Describe how a person might develop dissociative identity disorder based on the dissociation-trauma model. 8. particularly in early to middle childhood. 203 . are young (teenagers) when they have children. gave birth to children with congenital defects. This spontaneous dissociation. Also. become easily annoyed when stressed. memories. Hyman. and behaviors characteristic of that state form the basis for the later identities in adulthood that are kept out of normal consciousness. Bianchi's celebrated case was eventually found to be fraudulent. with exposure to severe childhood trauma. the work of Loftus. Spanos. and some therapists see such cases much more frequently than do other therapists. For example. suggests that the disorder is in essence a socially acceptable means of expressing distress. few clients begin therapy with this complaint. one of which may be imagining themselves as another person—someone stronger or smarter. 8. she/he must rely on extreme psychological coping mechanisms. Children who possess high hypnotizability would be particularly likely to engage in such a process. moreover. are embroiled in marital conflict. and others indicates that memories can be implanted and that such memories are not easily distinguished from memories of actual events. This trauma is most commonly sexual abuse and may also be a combination of sexual and physical abuse. 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. including sensationalized cases.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. Ofshe's involvement in Paul Ingram's case is a compelling example of this phenomenon. moreover.8. Persons asked to role-play alters are able to convincingly do so. They possess little knowledge about normal child development. obscuring the boundaries of this proposed syndrome. There is a great deal of symptom overlap with other disorders. The disorder almost always begins. including unrealistic expectations for children's behaviors and skills. disagree with each other about appropriate childrearing and discipline strategies. and disagreement but does not actually involve mental dissociation. feelings. have a history of abuse themselves. If Maurice chronically engages in this. select symptoms that may reflect any sort of physical dysfunction. attaching more negative interpretations than are warranted. he may become more acutely aware of his bodily changes and minor discomforts. whereas somatization disorder may be marked by more vague complaints. His tendency to be impulsive may contribute to an urge to seek out repeated medical assessment and treatment for his symptoms. in contrast to the multiple complaints of somatization disorder that must occur within 4 specific categories. negative affectivity. includes an explicit fear of having a serious medical illness (or illnesses). How might these factors combine to foster a somatoform disorder? Private self-consciousness is the tendency to concentrate on internal sensations and private thoughts. Hypochondriasis. Because he is also likely to feel worried and pessimistic (and possibly also guilty.136 Maurice is high in private self-consciousness. shy. and impulsivity. and/or depressed). 8.135 What distinguishes hypochondriasis from somatization disorder? Hypochondriasis is marked by a focus on a few. tired.8. 204 . further. he may begin to attach feelings of concern about those physical sensations. 288 M 9. but the causal direction is unclear. Juanita has an affective disorder. B Fac p. bipolar disorder. hypomanic disorder. sustaining an optimistic or positive outlook on life. 288 E 9. double affective disorder. d. 288 E The chapter's opening case study described Margaret's experiences of unipolar depression. physical symptoms such as headaches and stomach aches.Chapter 9 MOOD DISORDERS AND SUICIDE 9. C App p. Prolonged creative efforts intensify artists' moods. c. feelings of hopelessness and guilt. 288 E 9.3 Ans. C App p. c. d. 288 M * 9. This is termed a. as in the case of van Gogh or Ernest Hemingway.1 Ans. D App p. dysthymia. expansive euphoria. anhedonic depression. bipolar disorder. Mood disorders and creativity are related. b. maintaining balanced. b. Individuals with this disorder could experience each of the following symptoms EXCEPT a. double depression. unipolar depression. expressing her emotions effectively to other people. c. anhedonia. leading to innovative insights. This means she has significant difficulty a. cyclothymic disorder. C Fac p. Another term for major depression is a. c. d. b. b.2 Ans. major depression. What conclusion regarding mood disorders and creativity is most appropriate? a. as found in Andreasen's study of creative writers. d. productive emotional functioning. Tito has episodes of both depression and mania that occur over time.6 Ans. c. often leading to a depressive breakdown. b. The most common mood disorder in Western cultures is a. d. c. understanding other persons' feelings and behaviors in important relationships. B Con p. dysthymic disorder. The intensity and depth of emotional experience in mood disorders fuels the artist's imagination. b. d. 9. 288 C 205 . difficulties concentrating. Studies of creative writers and other artists have helped document the role of genetics in mood disorders.5 Ans.4 Ans. Substance abuse and depression are two distinct categories of disorders that overlap only when an individual uses drugs with depressant CNS effects. will experience at least one significant episode of depression sometime in their lives? a. Stan. which statement is accurate? a. are typically caused by genetic or biological factors and should be treated with medication. b. A Fac p. Approximately how many adults in the U. c. include persistent physical and behavioral disturbances that significantly impair relationship and work abilities. 289 E 9. anxiety disorder c. suicide In regard to the comorbidity between substance abuse and depression. Sarah. culture Of the following. 1 in 10 c. a 28-year-old geography graduate student d. 289-90 C 206 . Which of the following is least likely to be a comorbid diagnosis for Cerise? a.9. 1 in 3 A person's likelihood of experiencing a depressive disorder is related to what characteristic? a. C Fac p. must last for at least 2 months and be associated with somatic. if untreated. a 30-year-old successful bank president b. James. perceptual.7 Ans. dissociative disorder b. like alcohol. C App p. 289-90 E 9. d. while some people use drags to relieve depressive symptoms. 289 M To differentiate them from common sad moods. depressive disorders a. socioeconomic class c.S. require longterm psychotherapy in order to reduce emotional disturbance that. Raymond. and memory impairments.10 Ans. a 50-year-old auto worker Cerise has been diagnosed with depression. 289 M 9.11 Ans. Studies of brain functioning reveal that the central neurotransmitters affected by alcohol and other drugs are also the neurotransmitters that control mood functioning.9 Ans. gender d.12 Ans. d.8 Ans. 1 in 18 b. Long-term substance abuse can lead to legal and financial difficulties that cause depression. b. substance abuse d. 1 in 5 d. will lead to suicide. c. D Fac p. Most individuals who abuse alcohol or other drugs do so to relieve the underlying distress of a mood disorder. who is MOST likely to experience depression? a. D Con p. race and ethnicity b. 289 E 9. C App p. 9. a 17-year-old high school drop-out c. dysthymia with melancholic features. symptoms must have continued for at least two weeks. more. She is probably experiencing a. Chandra has been told by her therapist that she suffers from dysthymia. mixed mood disorder b. 291 E 9. c. mood incongruent psychotic symptom. c. unipolar depression and bipolar depression.16 Ans. less. Chandra's dysthymia is severe and in its course.15 Ans. insomnia. c. each of the following criteria must be met EXCEPT a. B App p. double depression disorder The two major categories of depressive disorders are a. b. mood congruent psychotic symptom. C App p. anxious depression d. 207 9. major dysthymia. dysthymia and double depression. b. daily fatigue.14 Ans. double depression. A App p. A severely depressed female believed that she was being encouraged by the spirits of her dead parents to commit suicide. 290 E 9.19 Ans. a negative life event must have preceded the onset of symptoms.13 Ans.9. This would be specified as a a. In contrast to major depression. anhedonia. a. major depression and dysthymia.18 Ans. 290 E * The concept of" " has been advanced to help explain the substantial overlap between symptoms of depression and anxiety. physical or cognitive symptoms must be present. either depressed mood or anhedonia must be present. 290 M 9. A Fac p. a. 290 M 9. episodic d. d. and suicidal ideation. present nearly every day. psychomotor retardation. c. less. b. schizoaffective symptom. endogenous depression and major depression. b. chronic c. 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. 291 C .17 Ans. B Con p. hypersomnia. 290 M 9. d. Complete this analogy: Somatic symptom is to persistent fatigue as cognitive symptom is to a. c. d. negative affect c. impaired immune functioning. b. episodic depression. To diagnose an individual with major depression. d. hopelessness. chronic b. B Fac p. d. D App p. incongruent delusional symptom. D Fac p. A App p. 75 Which of the following items should be removed from a student's report on the course and recurrence of major depression? a. psychiatrists d. lasting about 8 to 10 months. exhibits symptoms of early morning wakening. treated. a. panic attacks c.22 Ans. c. The first episode usually occurs in the mid-20's. Fewer than half of the adults with this disorder will experience a recurrence of major depression during their lifetime. chronic Dimitri. One-quarter of these individuals also have dysthymic disorder and are much more likely to relapse in the future. A App p. untreated.25 Ans. B Fac p. 291-2 C Which of the following symptoms might be exhibited by a severely depressed person in contrast to an individual with less severe depression? a. b. hypomania Where do many depressed people first mm for help for their distress? a. delusions b. 25 b. with seasonal pattern d. schizophrenia d. five d. three In as many as % of cases of major depression. A Con p. What specifier most clearly applies? a. 291 M 9. 291 E 9. 291 M 9. 60 d. C App p. five c. with echopraxic features d. individuals will experience recurrent episodes. primary care physicians b. 291 M 9. Which of the following is NOT one of the pattern specifiers for major depression? a. with atypical features c. and substantial weight loss. untreated. with atypical features b. her depression will be and will last about months. with somatic features 208 9. nine b. Most episodes subside without treatment. d. a. 292 E 9.9. mental health counselors c. 292 M . with anxiety features c.26 Ans. mental health telephone hotlines If Neila's episode of major depression is similar to the majority of people with this disorder.21 Ans.20 Ans. with melancholic features b. 48 c. with the average age of onset decreasing in recent years.24 Ans. significant motor agitation or slowness. a 45-year-old male. treated. A Fac p.23 Ans. postpartum onset. b. D Con p. c. echopraxia b. echopraxia. major depression. The occurrence of depressed symptoms during these several months is referred to as a. echolalia c. with seasonal pattern b. with postpartum onset c. 9.32 Ans. echolalia. c. catatonia. B Con p. 295 E 209 . waxy flexibility. have an onset significantly linked to psychosocial stressors. adjustment disorder with depressed mood. affect women and men in approximately equal proportions.30 Ans. 293 E 9. B Fac p. this is called a. major depression. parataxia d. labor-related mood disorder. b. endogenous c. 292 M 9.28 Ans. bereavement.33 Ans. b. with bereavement symptoms.31 Ans. 292-3 M 9. Which diagnostic specifier for major depressive symptoms is least well supported as a special subdivision according to several research studies? a. with atypical features Which of the following criteria applies correctly to dysthymic disorder? a. not otherwise specified. d.29 Ans. pathological grief reaction. Onset is typically slower and duration much longer than major depression. Hayes' wife died five months ago. catatonia If Cheryl experiences a depressive episode shortly after giving birth. B App p. autistic d. atypical When a depressed person automatically mimics another person's every movement. this is called . A Fac p. Automatic. The individual's daily functioning is usually severely impaired. d. are two relatively distinct disorders. Irritable or depressed mood in children must last at least 2 years. 293 E 9. 292 E Echopraxia and echolalia are examples of symptoms related to which specific depressive features? a. b. a. are both strongly linked to genetic factors.27 Ans. Research evidence indicates that unipolar and bipolar mood disorders a. c. d. catatonic b. Depressed mood in adults must last at least 1 year. 292-3 E 9. A Fac p. c. with catatonic features d. major depression. post-birth dysphoria. d. parrot-like repetition of another's words is called .. D Fac p. and frequent flight of ideas. women. and a family history of the disorder increases this risk. 295-6 M . and bipolar episodes are affected by psychosocial stressors.37 Ans. 295 M 9. inflated self-esteem.36 Ans. later. "The depressive symptoms experienced as part of a bipolar disorder are clinically the same as those of a major depressive disorder.39 Ans. b. later. what is the most appropriate DSM-IV label for David's symptoms? a. d. earlier. bipolar disorder. little need for sleep.40 Ans. equally common between genders c. more common in men bipolar . D Fac p. c. women. impulsivity.25%. expansive.35 Ans. d. C Fac p. Major depression is more common in . b. C Fac p. less Nikolai is experiencing a manic episode. more d.9. b. b. earlier. a. Which sentence should be OMITTED? a. impulsive. A App p. disorder is . too rare to estimate. "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. c. 210 9. anxiety and depression.34 Ans. David is exhibiting a very irritable mood. more common in women b. about 1%. With no history of major depression. men. 295 E 9. d. cyclothymia and dysthymia. men. c. irritable. equally common between genders d. cyclothymic disorder. 295 E 9. atypical depression with manic features. elevated. about . 295 E 9. a. This means he would exhibit one of the following mood states EXCEPT a. A App p. This means that her mood alternates between a." Bipolar disorder has a(n) onset than does major depression. The lifetime risk of bipolar disorder in the population is a. mania and depression. "Women and men are equally at risk for this disorder." b. B Fac p. A App p. "Manic episodes are often triggered by life stress and will usually not occur again in the future once the life stress is managed. manic disorder. hypermania and hypomania. more b. A mental health clinic is preparing a pamphlet for their clients to provide information about bipolar disorder." d. d. c. about 5%. 295 E * 9.38 Ans. 295 C Teresa has been diagnosed with bipolar disorder. less c. A App p. flight of ideas c. severity of depressive episodes. c.41 Ans. 296 M 9. Bipolar II disorder signifies the presence of mild manic episodes that are unlikely to require hospitalization.S. struggling advertising executive. psychosis If Enrique's bipolar disorder is typical. What manic disturbance does this belief reflect? a. 5. 296 M 211 . a young. duration of manic episodes. Kalin is certain he will then move to New York and create similar winning ad campaigns for every small business in the U. C App p. the two disorders are clearly different and have virtually no symptom overlap. 9 c. Both disorders are marked by episodes of major depression. d. with a history of major depression last year. bipolar II with rapid cycling Bipolar I and II are distinguished on the basis of the a. b. presence or absence of psychotic features. 15 Of the following. is spending 20 hours a day at work developing "the $64 million dollar campaign" for a small. c. Functioning can become so impaired as to require psychiatric hospitalization. What diagnostic category would best fit this description? a. a. his episodes of mania will last up to month(s) and occur with a median frequency of episodes in his lifetime. bipolar I b. b. d. 295 M Kalin. A Con p. 296 M 9. 6 b. Such a mistake is unlikely. 30 d.42 Ans. Bipolar II disorder. the majority of bipolar individuals exhibit interepisode recovery. 295-7 C 9.46 Ans.45 Ans. A Fac p. A psychological evaluation requested by her lawyer revealed clear manic symptoms. Tasha was admitted to the hospital after she was arrested for writing thousands of dollars in bad checks over the past two weeks. B App p. A student's report on bipolar disorder could include all of the following pieces of information EXCEPT a. B App p.44 Ans. which best explains why bipolar disorder may be mistaken for schizophrenia? a. more individuals are diagnosed as exhibiting Bipolar I vs. local shoe store. 3. Psychotic delusions of grandeur or other delusions can occur in both disorders. d. bipolar I with psychotic features d. grandiosity b. 9. 3. 1. b. pressured thinking d. bipolar II c. 296 C 9. duration of interepisode recovery periods.43 Ans. women and men are equally likely to exhibit rapid cycling of episodes. c.9. b. atypical mood disorder with somatic features. to evaluate the proportion of genetic influence by comparing MZ vs DZ twins. c. For what purpose do mood disorder researchers conduct a linkage analysis? a.49 Ans. The most accurate prediction regarding his identical twin. c. 212 9. 298 M . a form of mania that alternates rapidly with depression b. c. b. d. 10 Rick has been diagnosed with bipolar disorder. is that Martin will probably a. Martin. bipolar II disorder with full interepisode recovery. a type of mania occurring only in cyclothymia d. depression not otherwise specified. Benjamin is exhibiting a depressive disorder that is caused by severe dysfunction of his thyroid gland. d. a more severe form of mania c. develop some kind of mood disorder. 298 E 9. A Fac p.52 Ans. 298 E 9.9. d. Like the other 3 to 4% of young adults like her. 4 c. b. b. The best diagnosis for this depression would be a.50 Ans. mood disorder due to a general medical condition.53 Ans. a. to determine the effectiveness of drug treatments for disorders linked to biological causes. monozygotic twins. 297 E Which of the following accurately describes hypomania? a. c. no consistent evidence could be found for genetic influences for mood disorders.48 Ans. develop cyclothymia. a less severe form of mania Over the past few years. 298 E 9. D App p. cyclothymic disorder. 7 d. bipolar disorder was linked to genetic markers on the 11th chromosome. dizygotic twins. D App p. c. B Fac p. atypical depression with manic features. d.51 Ans. to identify genetic overlap between unipolar and bipolar mood disorders through family studies. 2 b. bipolar disorders I and II were found substantially more frequently in MZ twins than in DZ twins. are times more likely to both have major depressive disorder than are Sue & Sam. develop a form of unipolar depression. D Fac p. also develop bipolar disorder. 296-7 E 9. medically-induced mood disorder. unipolar disorder was linked to genetic markers on the X chromosome. to identify and trace a genetic marker for a disorder across generations. C App p. Katarina's moods have fluctuated between elevated and depressed. she is probably exhibiting a. B App p. but she has maintained adequate functioning on a day-to-day basis. hypomanic-depressive disorder. d. Tim & Tom. 298 M * 9. b.47 Ans. The mid 1980's studies of an Amish community in Pennsylvania claimed that a. Genetic factors are more influential in unipolar disorder than in bipolar disorder. a. While genetics are influential for some disordered individuals. If you hypothesized that genetic influences are important in mood disorders. bipolar I disorder.55 Ans. C Con p. which of the following studies would best support your idea? a. d. it is not scientifically possible. d. The genetic vulnerability to mood disorders could involve faulty neurotransmitter functioning or endocrine system dysfunction. b. to estimate the separate contribution of those factors in mood disorders.9. the failure to replicate the findings of the Amish study cast doubt on the validity of such research topics. While genetic factors may be influential in mood disorders. B Fac p. 298 M 9. 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. a twin study of bipolar disorder d. b. a family study of cyclothymic disorder Which of the following summary statements is best supported by current research? a. bipolar disorders with psychotic features. A Con p. 298-9 C 213 . adoption studies are conducted to compare the frequency of disorders in biological vs adoptive relatives. major depression with rapid cycling. bipolar and unipolar mood disorders. d. 297-9 M 9. adoptive relatives of individuals with major depression b.57 Ans. environmental factors explain the causes of most mood disorders. 9. a linkage analysis of dysthymia in a close-knit population c. comparison of biological vs.58 Ans. studies of families with common psycho-social characteristics are required in order to hold this factor constant to measure genetic influences.56 Ans. and family studies suggest that genetic influences are equally important in both unipolar and dysthymic depression. Because MZ twins have both genetics and environment in common. adoption. 298-9 C * 9. Twin. c. c. Genetic factors are more influential in bipolar disorder than in unipolar disorder. In regard to genetic influences on mood disorders. b. 299 C First-degree relatives of individuals diagnosed with bipolar disorder tend to show high rates of a. A Con p. d. with current technologies. B Con p. it has been concluded that both factors contribute equally to the high prevalence of mood disorders in these twins. Genetic factors appears to be equally influential in the development of both unipolar and bipolar mood disorders. b. c.54 Ans. c. low. Patients given reserpine for high blood pressure developed symptoms of depression. c.63 Ans. If the original catecholamine theory explains Rhonda's mood disorder. what behaviors would you expect if a person's dopamine level was abnormally high? a. serotonin Each of the following findings contributed to the original catecholamine theory EXCEPT a. lower c.59 Ans. B Fac p.61 Ans. higher According to the hypothesized influence of transmitters. good concentration and introverted 9. a. Rhonda's depressed symptoms are the result of levels of . d. Carlito has been exhibiting inattentiveness and poor concentration. C 9. norepinephrine. low. 300 C 214 . a. Drag treatments for schizophrenia were found to also affect major depressive disorder. acetylcholine b. Twin studies documented the presence of depleted catecholamine levels in the brains of depressed MZ twins. Drugs that lower catecholamine levels increase symptoms of depression. decreased anxiety and little inhibition of his actions. serotonin. The effectiveness of shock therapy for severe depression was discovered.62 Ans. higher d. 299-301 b. C App p. norepinephrine d. 300 C 9. poor impulse control and under-inhibited actions d. D Fac p. B App p. Low levels of the 5-F£LAA metabolite have been found in many depressed individuals. Medications for depression that increase catecholamine levels trigger mania in some individuals. serotonin c. serotonin. norepinephrine. c. lower b. 299 E 9. dopamine d. high. high. A Fac p. B App p.64 Ans. 299 M 9. It is possible that the neurotransmitter is than usual. b. the catecholamines c. aggressiveness and extroversion c.9. low aggression and good impulse control b. 299 M Which neurotransmitter has NOT yet been implicated in mood disorders? a. norepinephrine b. serotonin What occurred during the 1950s that led to the development of theories about biological processes in depression? a. d.60 Ans. Drag treatment for bipolar disorder lowers norepinephrine activity. 9.65 Ans. D Con p. 300 M 9.66 Ans. D Con p. 300 M 9.67 Ans. C Fac p. 300 M * 9.68 Ans. B App p. 300 E 9.69 Ans. B Con p. 299-301 C 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. 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. 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 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 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. 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 9.70 Ans. C Fac p. 301 M 215 9.71 Ans. A App p. 301 E 9.72 Ans. C App p. 301 E * 9.73 Ans. D Con p. 301 M 9.74 Ans. B Con p. 302 M Which portion of Anna's brain is primarily responsible for regulating her endocrine system? a. hypothalamus b. medulla c. cingulate gyms d. thalamus 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 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. 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. As a psychoanalyst, which psychosexual development stage is most important in your explanation of depression? a. genital b. phallic c. anal d. oral 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 9.75 Ans. D App p. 302 M 9.76 Ans. D App p. 302 C 216 9.77 Ans. D Fac p. 302 E 9.78 Ans. A Fac p. 302 E * 9.79 Ans. C App p. 302 M 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 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 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. 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 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. 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. 9.80 Ans. C Fac p. 303 E 9.81 Ans. D Con p. 303 M 9.82 Ans. D Con p. 303 M 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. 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 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 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 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 9.84 Ans. C App p. 304 C 9.85 Ans. B App p. 304 C 9.86 Ans. A App p. 304 M * 9.87 Ans. B Fac p. 304 E 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 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." 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." 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. 9.89 Ans. D App p. 304 M 9.90 Ans. C App p. 305 M 9.91 Ans. C Con p. 306 E 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 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. 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 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 9.94 Ans. D Fac p. 306 E 9.95 Ans. D App p. 306 M 9.96 Ans. A App p. 306 E 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." 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. 9 98 Ans. D Con p. 306 E 221 9.102 Ans. B App p. 308 M 9.103 Ans. A Con 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 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. 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 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 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. 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 9.104 Ans. D App p. 308 C 9.105 Ans. B Con p. 308 E 9.106 Ans. D Con p. 308-9 C 9.107 Ans. C App p. 309 E 222 9.108 Ans. A App p. 309 E 9.109 Ans. A Fac p. 309 M 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. 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 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." 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 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 9.110 Ans. D Con p. 309 E 9.111 Ans. C App p. 309 M 9.112 Ans. A App p. 310 M 9.113 Ans. B App p. 3i E 10 223 C App p. which person below is at greatest risk for depression? a. c. Tamara. A App p. d. who has a sociotropic personality and just lost his job d. A App p. Maria. What kind of drug would she be taking? a.118 Ans. 312 E * . Most models of unipolar depression include both a diathesis and a stress component. She could be taking A or C 224 9. Both biological and psychological predispositions are relevant to the understanding of a depressive diathesis. 55 years old Rosalind has been given a drag that alleviates her depressive symptoms by making neurotransmitters such as norepinephrine and serotonin more available at the synapse. Stephen. Drawing on available research. what percentage would you predict will show improvement in their symptoms? a. You would include all of the following statements EXCEPT a. about 65% To which of the following clients would you NOT recommend antidepressant medication for their major depression? a. 14 years old b.115 Ans. B App p. Sabrina. B Con p. a tricyclic b. 312 E 9. who has a sociotropic personality and just moved away from home for the first time b. who has an autonomy-oriented personality and just broke up with her boyfriend c. both of which must be present for depression to occur. 45 years old d.116 Ans. anSSRI c. especially for later episodes d. about 75% d. about 95% b. Norris. b. Edgar. this is achieved by preventing the transmitters' chemical breakdown. self-control theory's "excessive self-reward" A group of depressed adults is being treated with antidepressant medication.119 Ans. Individuals become depressed for many different reasons and no single cause of this disorder will be isolated.and interpersonally-oriented stressors. 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. D App p. 306-311 C Drawing on socialization and personality style research. Which psychological theory has the most support for explaining Marvin's disorder? a. Timothy.114 Ans. psychodynamic "flight from depression" b. about 80% c.9. an MAO inhibitor d. Marvin has bipolar disorder. Research has effectively eliminated the cognitive perspective in terms of contributions to understanding depression onset. achievement. Nancy. 311 M 9.117 Ans. 312 E 9. life stress disruptive of social or biological rhythms c. 310 M 9. 21 years old c. Fluoxetine c. The specific mechanisms by which antidepressants affect symptoms are not fully understood. 312 E 9. phenelzine c. Which category of antidepressants does this drug fit? a. b. 312 E 9. MAO inhibitor.9. Ron.121 Ans.123 Ans. SSRI d. A App p. c.122 Ans. serotonergic d. dopamine. amitriptyline b.124 Ans. Impact on neurotransmitter levels and amelioration of symptoms occur simultaneously. imipramine b. 313 M 225 . What type of antidepressant medication should not be prescribed for Ron? a. MAO inhibitor.125 Ans. SSRI Martin's SSRI medication for depression will target the neurotransmitter a. bupropion Nardil is to Tofranil as a.120 Ans. d. tricyclic. A student's report on antidepressant medications could include each of the following statements EXCEPT a. sertraline. d. A App p. MAO inhibitor b. MAO inhibitors are least likely to be used due to side-effect concerns. C App p. SSRI. b. tricyclic c. sertraline d. 312 M 9. A Con p. has developed cardiovascular problems. SSRI to Conchita's psychiatrist has recommended that she take Prozac to alleviate her depressive symptoms. MAO inhibitor c. 312-3 M Antonio's depression is being treated with a medication that prevents the reuptake of both norepinephrine and serotonin. D App p. Which drug might he be taking? a. The various categories of medications are about equally effective in treating symptoms. serotonin. C Con p. tricyclic b. sertraline d. 312 E 9. reserpine. a Vietnam veteran with severe depression. c. buproprion 9. Because of concerns about toxicity and mood alterations. 4 to 6 months d. 313 M 9. About how long would you expect her to be treated with the drug? a.127 Ans. longterm prevention of depression. high blood pressure b. trazedone d.131 Ans.126 Ans. calming. d. In other words. what side effect could result? a. anSSRI. d. she intends to prescribe the drug for a. 313 M * 226 . The chemical mechanism by which it works in the brain is not known. Moodi is prescribing an antidepressant for its prophylactic property.. C App p. B App p. A App p. an SSRI b.130 Ans. cyclothymia Each of the following statements applies to the drug lithium EXCEPT a. 313 E 9. sedative effects. cardiac dysfunction Your sister has begun taking an antidepressant medication. epileptic seizures d. B App p.128 Ans. major depression b. trazedone. a tricyclic c. a tricyclic. bipolar disorder d. 9. an MAO inhibitor. 313 E 9. a. c. C App p. an MAO inhibitor If Gerardo takes an MAO inhibitor and does not adhere to dietary restrictions. has a family history of bipolar disorder. It is effective for approximately 80% of individuals with bipolar disorder. Marco. 3 to 4 months c. simultaneous treatment of depression and mania. birth control. It is often intended to be used prophylactically. Lithium has been prescribed for Sammi's mood disorder. also suffering unipolar depression. Given the sideeffects of certain medications.129 Ans. about one year Dr. about 6 weeks b. mental retardation c. A Con p. 313 M 9. 313 M Paulette's depression is marked by psychomotor agitation. blood levels must be monitored regularly. c. b. Paulette might be a candidate for but Marco should probably NOT receive . b. What mood disorder is most likely? a. major depression with psychotic features c. Prozac d. kidney damage b. administration of oxygen. Compared to the treatment she might have received in the 1950s. valproate c. carbamazepine b. which conclusion would you. what anticonvulsant medication might be tried? a. Lithium has not been effective. b. tegretin Tiko has bipolar disorder with prominent depressive features. carbamazepine d. valproate Which antidepressant has stirred intense controversy. While side-effects associated with Prozac are less troublesome than those of other drugs. buproprion c. You would be concerned about the possibility of each of the following side effects EXCEPT a. Paxil If you listened carefully to the controversy around Prozac. d. unilateral vs bilateral administration. Parnate b. fewer treatment sessions without need for prophylactic follow-up. endorse? a. Prozac has demonstrated biochemical effects similar to those linked to violently aggressive behavior. its effectiveness as a treatment for depression is not yet reliably demonstrated. and thus his physician has prescribed a. Martina is scheduled for ECT. d. ECT d. Case studies. as a critical thinker. thorazine b. While not conclusive. high blood pressure d.You are a psychiatric nurse responsible for monitoring prescribed treatment with lithium. tremors If an individual responds poorly to lithium. c. b. c. 227 . an anesthetic or other muscle relaxer. she will benefit from each of the following improvements EXCEPT a. and media investigations provide compelling evidence of the behavioral dangers of Prozac. Elavil c. thyroid damage c. Well-controlled studies indicate that suicidal behavior in persons taking Prozac is no more likely than in persons taking other antidepressants. anecdotes. in part for its adherents' claims that it makes you feel "better than well"? a. C App p.141 You are a junior high school teacher who wants to refer a severely depressed Ans. B App p. 25 to 30 Greta has major depression. more than 15 d. consisting of two hours of increasingly bright light in the morning before waking. B student to a psychotherapy group.9. 315 M What side-effect of ECT is still relatively common today.142 Ans.140 Ans. include her playing a more active role in the therapy session. 315 a. 315 M 9. and how to develop and enjoy positive friendships. What is the best prediction as to how many will experience a relapse of their depression? a. broken bones c. work through unconscious conflicts to alter underlying personality structure. supportive-expressive d. self-monitoring skills d. Due to a lack of resources. d. be substantially shorter in length. for its effect on phase delays in the endocrine system. 9. her approach will NOT a. an SSRI. memory loss b. low-level ECT. fewer than 10 b. death Thirty patients have been treated with ECT at the state hospital and have responded well. 315 E 9. A App p. C App p. 315 M Dr. A Fac p. though less severe than in previous years? a. oxygen deprivation in the brain d. short-term psychodynamic c. Coping with Depression course c. seasonal pattern. you would be App most confident with which of the following interventions? p. focus on issues of self-esteem. during the winter months. Based on available research. 10 to 15 c. Compared to traditional psychodynamic therapy. consisting of several hours of bright light during the morning and early afternoon. c. interpersonal 9.139 Ans. none of them will undergo continuing treatment once they are released as outpatients. b. c. What approach is Olga's therapist endorsing? a. 316 M 228 . Froid is offering short-term dynamic psychotherapy to her depressed clients. d. sleep difficulties.143 Ans. how to communicate her ideas and feelings assertively. Olga's therapist is helping her leam how to relax. cognitive-behavioral restmcturing M b. light therapy. and other specific current symptoms.138 Ans. cognitive 9. despite its name. light therapy. b. The effective treatment for her depression would probably be a. behavioral b. executive. D App p. affective-expressive b. 317 E 9.144 "You say you're depressed because your wife doesn't love you anymore. B Con p.What therapeutic approach is this counselor using? E a.148 Ans.149 Ans. cognitive b. 317 M Tawny was comparing some of the therapy modalities for depression and trying to decide which one(s) demonstrated the greatest efficacy. B actions lead you to make this conclusion?. Behavioral therapy is slightly more effective than cognitive therapy for long-term benefits. c. behavioral d. and part-time student. What orientation is the therapist most clearly employing? a. B App p. 9. interpersonal Jose's therapist is asking him about the various roles he plays in his life. volunteer. cognitive therapy c. Can you think of other reasons why App she might be acting that way? Might you feel differently if you considered a p. 317 M 9. 317 M 229 . whether some have undergone change recently..9. 316 different explanation?" -. which treatment approach would you recommend? a. D Con p. What Ans.. psychodynamic d.147 Ans. Which psychotherapy approach is closest to the biological model in its view of the origin of depression? a. Behavioral therapy and cognitive therapy are equally effective for short-term benefits. naturalistic observation Merlin is severely depressed. 317 E 9. and whedier he experiences difficulty managing his roles as dad. interpersonal c. Medication is less effective than cognitive therapy for short-term benefits. which should she endorse? a. cognitive d. C App p. cognitive c. case study d. experimental c. Cognitive therapy is slightly more effective than medication for long-term benefits. Any of the above will result in similar levels of improvement for Merlin. correlational b. interpersonal therapy b. Based on the NIMH treatment study. Of the following. b. behavioral b. interpersonal 9.146 Ans.145 Ans. psychodynamic What research strategy is represented in the NIMH's Treatment of Depression Collaborative Research study? a. antidepressant medication d. d. behavioral c. 70 regardless of treatment approach b. "Suicide and Depression: The Myth of Social Support" d.151 Ans.and long-term benefits. a susceptibility to alterations in neurochemistry due to hormonal fluctuations c. d. a tendency to employ emotion-focused coping strategies You are a graduate student studying depression in the year 2002. Drawing from her discussion. If unipolar disorder is present. 55 regardless of treatment approach d. what recommendation could the intake interviewer make that is best supported by the data? a. which characteristic does NOT apply to women? a. 317.9. 9. C Con p. d. a socialized sensitivity to interpersonal stress of self and others b.152 Ans. 318 M Constance Hammen suggests several reasons why women experience depression more frequently than men do. 318 C 9. If bipolar disorder is present. 291. She will probably experience an episode of mania in the future.19 C 9.319 M * 230 . combining antidepressant medication with either cognitive or interpersonal psychotherapy will probably be most effective for short. b. a greater willingness to admit and express emotional distress d. 85 if treated with medication. "The Individual and Social Costs of Sub-Clinical Chronic Depression" c. psychotherapy will probably show somewhat greater long-term benefits over medication treatment. She will benefit equally from either medication or psychotherapy for short-term benefits. 60 if treated with cognitive or interpersonal therapy c. She will recover within a few months even without formal treatment. If unipolar disorder is present. She will probably experience a recurrence of depression in the future. 75 if treated with medication Marta is experiencing her first episode of major depression. and thus the title of your thesis could be a. Each of the following characteristics are statistically likely to apply to her EXCEPT a.153 Ans. "Treatment of Depression: Medication Alleviates Need for Psychotherapy Approaches" A mood disordered client is talking with an intake interviewer at a local mental health center. c. B Fac p. Drawing on information presented in the text. B App p.154 Ans. about what number of clients will exhibit improvement at the end of treatment? a. cognitive therapy will slightly outperform medication for long-term benefits. A App p. medication alone is the treatment of choice. Based on research regarding the effectiveness of various therapies. 319 M 9. b. C App p. c. Several of Constance Hammen's predictions have come to fruition. 50 if treated with cognitive or interpersonal therapy. "Depression: The Homogeneous Disorder" b. A clinical study is underway with 100 depressed outpatients.150 Ans. If bipolar disorder is present. 161 Ans. Risk-rescue ratio described by researchers indicates that most suicidal people hope to be saved from their actions. suicide attempt b. b. c. Rachel. a 45-year-old white female Which of the following persons is at the highest risk for completing suicide? a. Matthew. a 24-year-old Hispanic female 231 9. B App p. parasuicidal behavior In which country would you expect to find the lowest suicide rate? a. an 18-year-old black male d.9.157 Ans. Hubert. Psychological autopsies indicate that the people who commit suicide are clinically depressed. a 28-year-old black female b. On Friday night. B Fac p. 20% d. D App p.160 Ans. Japan d. 15% c. the U. her husband has been talking about divorce. difficulty differentiating "accidents" from intentional events.156 Ans.159 Ans. d. Ireland c. 319 M 9. Females are more likely to attempt suicide than are males. 320 M 9.S. b. a 40-year-old white female d. and she is increasingly unhappy at her job. Samantha. she went out with some acquaintances to a bar. 320 M . Germany Which of the following persons is at the lowest risk for committing suicide? a. What description would a psychologist give to these actions? a. Jamie was severely abused as a child. a 20-year-old Native American male c. Suicide rates vary across cultures and across ethnic groups within the U. B Con p. D App p. Terri. 8% b. sub-lethal behavior d. Which of the following statements from a student's report on suicide should be removed because of its inaccuracy? a. Benny. Roy. a 60-year-old white male c. religious or social beliefs fostering a reluctance to identify a death as a suicide.S. A App p.158 Ans. 26% 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. d. Muriel. Recently. while males are more likely to complete suicide. a 16-year-old black male b. b. implicit suicidal intentions masked by high-risk behaviors. 320 M 9. quasi-suicide attempt c.155 Ans. 320 E 9. 319-20 E One of the most serious problems associated with mood disorders is suicide. a tendency to classify single-vehicle car accidents as probably suicides. c. when she got home she took a mild overdose of sleeping pills. What percentage of depressed persons commit suicide? a. 319 E 9. B Fac p. which paradigm provides the least compelling empirical evidence regarding the cause of suicide? a. 320 M * Which of the following persons is at the highest risk for completing suicide? a. externalizing behavior disorders. c. committed suicide at age 17. using a firearm. No note was left. Raya.164 Ans.9.167 Ans. a 17-year-old black male A descriptive report on suicide could contain each of the following statements EXCEPT a. d. 321 C 9. John. substance abuse b. and no common risk signs were exhibited. 322 M 232 . Benny. 321 M * 9. 320-1 M 9. cognitive c.163 Ans. b. C Con p. sociocultural b. social isolation Currently. The most common means of attempting suicide involve self-poisoning or drug overdoses. a 45-year-old white male c. A Fac p. completion rates are present for both adolescents and adults. the suicide of a friend at school d. A App p. the contagion effect. following a conviction for armed robbery. b. a 22-year-old Hispanic female An individual has committed suicide impulsively. d. 321 E 9. Which of the following factors is LEAST LIKELY to have contributed to his action? a. a 60-year-old white male b. Gender differences in attempts vs. C App p. a recent publicly humiliating experience c. D App p. Which of the following persons is most likely to have committed suicide in this manner? a. behavioral 9. an 18-year-old black male d. Muriel. Matthew. D Con p. a 19-year-old white male d. Suicide rates have increased substantially over the past three decades for young people. a 28-year-old black male b. c. a white male.162 Ans.165 Ans. Each characteristic below distinguishes adolescent from adult suicide EXCEPT a. The overall suicide rate for the United States has increased steadily over the past 30 years. suicide pacts. biological d. longstanding mental health problems. a 38-year-old black female c.166 Ans. believing they would eventually die in the gas chambers. D marriage. which accounts for this link.9. Richard. fatalistic c.168 Quentin. no biological factors have been established as a cause of suicide. b. Karl was a stockbroker in New York who lost $3 million of his investors' funds through poor market choices. How would Durkheim describe this? a. fatalistic. c. egoistic. anomic d. A App p. a Hispanic female with a strong commitment to Catholicism b. 322 a. This is probably just a coincidence.172 Ans. This biochemical abnormality is probably related to impulsive.173 Ans.170 Ans. altruistic suicide An older woman lived alone in a small apartment in a dilapidated senior citizens' home. alienated. aggressive behavior. 323 M * 9. committed suicide following the loss of his job and his Ans.169 Ans. d. He committed suicide after being fired from his Which of the following sociocultural views would describe his act? a. A medical autopsy revealed extremely low levels of 5-HIAA in his CSF. anomic suicide d. c. 35 years old. A App p. He probably had a family history of schizophrenia. many Jewish persons killed themselves during internment in concentration camps.171 Ans. Her suicide would be characterized as a. 323 M 233 . and she spent virtually all of her time alone. a Native American male living in a tribe emphasizing individuality d. His low level of serotonin probably caused both his depression as well as his C suicidal behavior. 9. 322 E 9. fatalistic b. an African-American male living in a poor urban area c. 322 M Mahatma Gandhi was willing to commit suicide through self-imposed starvation to protest social conditions in India. egoistic Social change and mores are associated with suicide rates. egoistic suicide c. not suicide per se. b. d. a. Durkheim would view their action as a representation of suicide. a Mexican-American female from a family with strong ties to the Anglo culture 9. p. Which person below is at the LOWEST risk of suicide? a. altruistic b. altruistic c. anomic. Carl. egoistic d. D App p. 323 E 9. App What seems to be the BEST interpretation of the connection? p. Her children rarely visited. C App p. Marguerite. watching television. Chera. fatalistic suicide b. anomic During WWII. D App position. and widowed persons.174 Ans. you should seriously consider passing laws related to a. which of the following are incorrectly matched? a. supportive individual therapy for at-risk persons (e. cognitive theory: hopelessness derived from early experience Reynelda. by over-emphasizing risk factors and creating excessive pressure on "normal" teens d. by informing adolescents of means of suicide that they otherwise would not have known about b. D Fac p. 326 C . c. b. strict gun control. A Con p. attributional triad d. 324 M 9. interpersonal theory: poor coping skills for negative affect c. negative automatic thoughts b. B Con p. A App p. by implicitly characterizing suicide as a normal response to severe stress You are a member of your state's legislature and are very concerned about the rising rates of teen suicide..S. Married persons are at a lower risk than are single.177 Ans. 324 E 9. psychoanalytic theory: unresolved internalized anger toward primary caregiver d. by creating channels of communication in school by which adolescents can more easily obtain firearms c. Loss of social support is a significant factor in suicides committed by the most vulnerable group in the U. hopelessness How might school-based suicide-prevention programs have actually contributed to the increase in suicide among adolescents? a. depressed. like many depressed individuals. 325 E 9. d.179 Ans. Which approach would you expect to be most effective? a. has several distorted cognitions. serious and substantial consequences for selling alcohol to minors.175 Ans. c. A temporary loss of social support is weakly associated with suicidal behavior.178 Ans. Cultural variations in social connectedness have an influence on suicide rates. According to Lester's work and the views of many other psychologists. anger management and self-control techniques to address the aggressive and impulsive behaviors that underlie suicide 234 9. 323 C Considering the role of social support in suicide. given their likelihood of repeat attempts c. Which of the following cognitive attributes is the best predictor of a suicide attempt? a.g. sociotropy c. You have been asked to recommend a suicide prevention program. divorced.176 Ans. C App p. Regarding developmental factors in suicide. b. D App p.9. d. social-skills focused group counseling for persons who have attempted suicide. 325 E * 9. funding for extracurricular school groups to reduce adolescents' isolation and hopelessness. qualified staffing of crisis centers and hot lines. low social support) b. you would endorse each of the following statements EXCEPT a. public awareness campaign and programs for substance abuse d. professional. attachment: negative self-schema b. II can be distinguished by duration of mania). Does this person appear to require hospitalization? d. the risk of suicide could actually be increased. 9. viewing hopelessness as a negative interpretation d. minimizing distortions in problem-solving b. finding "shades of gray" in making judgments c. How can I help them resolve their current emotional crisis? b. c. what would be your FIRST concern when talking with a suicidal individual? a.183 What are the distinguishing features of major depression vs. During initial treatment. dysthymia vs. D Con p. b. D believes that suicide is the best solution to her current emotional distress. violent behavior. There App are several characteristics of her thinking that you would want to address. but p. typically not treated Recurrence: as many as three-quarters experience recurrent episodes. An overdose of these medications could cause serious bodily injury or death. 326 E 9.180 Ans. developing higher standards for self-worth SHORT ANSWER I ESSAY 9. Their mechanism of action is too slow for a therapeutic effect.181 Ans. Who might I refer them to for help with a possible underlying psychological disorder? c. 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. 326 E As a crisis line worker.182 You are developing a cognitive-behavioral intervention for your client who currently Ans. onset age decreasing in recent years Duration & treatment: eight to ten months. and recurrence. They have little effect on the neurotransmitter related to impulsive.9. bipolar disorder vs. E a. duration and treatment. d. depressive episode similar to that of major depression Cyclothymia: chronic disorder of less severe bipolar symptoms 9. 327 is LEAST likely during this crisis. D App p. more common in females.184 Describe the typical characteristics of a major depressive episode in regard to onset. Onset: typically mid-20's in age. What level of imminent danger does the person pose to her. with longitudinal research revealing an average of five to six episodes in a 20-year period 235 .or himself? Antidepressant medications are relatively ineffective in treating an acute suicidal episode for all of the following reasons EXCEPT a. medications that were known to increase catecholamines. Many studies have revealed that 5-FflAA. these same drugs caused symptoms of mania in some depressed individuals. selective serotonin reuptake inhibitors (SSRI's) have proved to be more generally effective for depressed individuals. and it is this process that produces Carlito's symptoms of major 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. Too. he turns the anger inward toward himself. diminished depressive symptoms. with prevalence rates of roughly 1 and 20 percent. Finally. explain the origin of Carlito's depression. a metabolite of serotonin. he has introjected his wife and feels angry that she has abandoned him. by psychosocial stressors. while major depression is twice as common in women than in men. believing that his marriage should have endured under any circumstances. particularly norepinephrine. Bipolar disorder seems to be more frequent in higher socioeconomic classes. such as sodium ion instability. Bipolar disorder shows no appreciable gender difference in prevalence. he has been dependent on others for approval and his self-esteem is easily swayed.9. recent studies of bipolar disorder suggest that other neural factors. 9. may play a role. whereas depression appears to be equally common across SES groups. His depression may be exacerbated if he also maintains excessively high ego ideals. in regard to onset and worsening. his failure to achieve his goal will increase his cognitive symptoms of worthlessness and guilt. From childhood. is frequently low in persons with depression. Unable to effectively cope with this anger. for better or for worse. suggesting that excessive levels of catecholamines caused mania and low levels caused depression. early over-indulgence by) his parents. that the drug reserpine created symptoms of depression in persons who took this hypertension medication. It is known that reserpine lowers catecholamine levels. Why has that theory been revised? The first piece of evidence came from the finding. Thirdly. research suggests that bipolar disorder is more strongly affected by genetic factors than is major depression. and the newest class of drugs.187 Carlito is depressed following a final decree of divorce from his wife. The prevalence of bipolar disorder is substantially lower than that for major depression. Further. Vulnerable now to the loss of his marital relationship. some form of interactive theory will probably be needed to understand the role of these biochemicals in this disorder.186 Describe three research findings that supported the original catecholamine theory of mood disorders.185 Describe six central non-symptom-related differences between major depression and bipolar disorder. Carlito developed a vulnerability to depression as a result of early disappointment in (or. 236 . by others' reactions to his needs. Bipolar disorder also has a somewhat earlier onset than does major depression and appears to be less affected. 9. in the 1950s. respectively. although there is some overlap in the risk factors associated with these mood disorders. Drawing from Freud's theory. Because of the diversity of neurotransmitter functioning in depressed persons. given the lesser taboo status conferred on the act. who had an insecure attachment to her mother. as are suicide pacts.block reuptake of NE and SE SSRI's .selectively slow the reuptake of SE Unilateral ECT . Sandy learned to inhibit her help-seeking behaviors and was unable to successfully leam how to regulate her emotional experiences. Abramson's third factor . Provide support for this statement and indicate a primary distinction between these two models. Later. As a result.block the enzyme monoamine oxidase which would otherwise break down neurotransmitters such as SE or NE. 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. including cultural changes. with gunshots being the most common form of death in adolescent and young adult suicide.unspecified 9.focus on most negative consequences of events = Rehm's second element . rather than as a response to social isolation or hopelessness. 9. Tricyclics . this inhibition and ineffective coping will leave her vulnerable to depression in the face of significant life stress. then. Primary distinction . are primarily responsible for the rising suicide rate. Abramson's second factor .not yet known Carbamazepine & valproate . They are. Ironically. less likely to leave a suicide note or to give away prized possessions. including the impact of television depictions of suicide. as an adult. 237 .tendency to draw negative inferences about overall self-worth = Rehm's fourth element .for seasonal depression.for severe depression. prevention programs conducted in the schools are also in part responsible for this. The contagion effect.191 Describe three ways in which adolescent suicide is different from that committed by adults. however.188 Why might Sandy. are quite similar to two of the factors outlined in Rehm's self control model of depression. some psychologists assert that the greater availability of guns is an important culprit. and Rehm's theory includes explicit attention to self-imposed operant behavior consequences.explanation of events in terms consistent with negative self-schema. specific action unknown Light therapy . 9. The increasing stresses in the environment.189 Two of the three factors which contribute to the development of hopelessness. 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). according to Abramson and colleagues. appears to affect endocrine system Mania: Lithium (carbonate) .9. Finally.concentration on immediate negative events. is more commonly associated with adolescent suicide.Abramson's model focuses primarily on cognitive attributional biases for external events without an emphasis on high standards for behavior.190 List the biological treatments available for maj or depression and bipolar (mania) and briefly indicate their effect: Major depression: MAO inhibitors . in reports made by physicians during the Renaissance. schizophrenia. hallucinations. c.4 Ans. d.3 Ans. autistic type. multiple personalities. b. an individual with schizophrenia. schizophrenia. C App p.5 E * 10.2 Ans. dementia praecox. Lionel believed his dog was causing all his problems and that enemies were everywhere and he had to fight or mn from them. schizophrenia. b. Alzheimer's disease. d. d. could have each of the following symptoms EXCEPT a. c. c. in ancient Greek writings. c. b. Bleuler As a clinician in the 1890s you would classify your patient's silly. emotional disturbance. JohnHaslam. The first unequivocal. B App p. affective type.6 Ans. D Fac p. dementia praecox. If you were a student of .7 Ans.5 Ans.1 Ans. a. A Fac p. d. and disorganized psychosis as a. formal historic description of what is currently called schizophrenia occurred a. Kurt Schneider. 238 10. immature. 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. 333 M 10. Eugen Bleuler. c.Chapter 10 10. Kraepelin c. b. Emil Kraepelin. 332 E SCHIZOPHRENIA In the case of Lionel Aldridge. alogia. catatonic type. Pinel b. in depictions of sinful behavior during the middle ages. 333 M * 10. 332 E 10. 332. d. schizophrenia. you probably contributed to the influential work that identified the subtypes of dementia praecox. b. A App p. b. hallucinations. These are specific examples of a. B App p. epilepsy. The term schizophrenia was coined by a. 333 C 10. B Fac p. Schneider d. multiple personality disorder. Stephen. d. 333 E . delusions. c. in descriptions of patients from the early 19th century. psychosis. hebephrenic type. and Rollo is a new patient in a London hospital. self-centered fantasy thinking. As a physician in the U. Gottesman. Bleuler : Four A's c. A App p. working with psychotic patients. where he was first diagnosed with schizophrenia. incongruent emotion and action. 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. 10.12 Ans. autistic subtype. Rollo just returned home from the U. you would diagnose this as the a.10. Kraepelin b. Bleuler. and incurable deterioration into mental weakness is most similar to that of a.S.11 Ans. Schneider d. c. 333-4 M 10. simplex subtype. Bleuler . Schneider. The conceptualization of schizophrenia as an early onset. "Schizophrenia" is best conceptualized as a split a. incoherent ideas. whose definition of schizophrenia were you most likely to favor? a. 334 C 10. 334 M * You are a medical student in 1911. manic depression b. Kraepelin : primary symptoms d. hebephrenia 10. early in this century. What prediction would you make for the diagnosis made by his new physician? a. C Con p. 334 C 239 . Kraepelin. b. D Fac p. Crow b. progressive. You could expect to see any of the following primary symptoms in patients EXCEPT a. mind. B App p. A App p. personality.10 Ans. b. d.8 Ans. schizophrenia c. dementia praecox d. Bleuler d. d. Morel : demence precoce It is 1936. Kraepelin c. delusional subtype.9 Ans. b.13 Ans. C Fac p. mind. auditory hallucinations. c. according to . Schneider : first rank b. Kraepelin Which of the following historical pairs is mismatched? a. c. d. 333 E 10. personality. hebephrenic subtype.S. B App p. Bleuler c.14 Ans. 333 E 10. social withdrawal. delusions. His positive symptoms could include a. Isaac has been unable to interact with others for six months due to a lack of emotional responsiveness. These symptoms have been present for 4 months. and believes that everyone is out to get her. Martinique has been depressed for two years. and disorganized speech. b. minimum "characteristic symptoms" criterion not met Hector has schizophrenia. 334 E . catatonia. dysfunction criterion not fully met d. 334 E 240 . c. b. classical b. polythetic d. Allegretti exhibits one of the classic Schneiderian symptom of psychosis. avolition.17 Ans. b. and flat affect that have caused problems in his life. c. She has spent thousands of dollars hiring private detectives to follow him. 334-5 M 10. c.18 Ans.20 Ans. 10. He has heard two voices speaking to each other for a month." The clinician making this statement is referring to the patient's a. d. including a demotion at work and hostile conflict with his spouse. duration criterion not met b.15 Ans. 334-5 M "Mr. Kraepelin b. Which clinician's conceptualization of schizophrenia is preserved in the DSMIV? a. grossly disturbed speech.334 C 10. B App p. increased ventricles. D Fac p.10. apathy. homogeneous c. avocation. preceded by relatively normal functioning. Bill has symptoms of catatonia. She regularly uses PCP. excessive dopamine.19 Ans. d. and catatonia. hallucinations not present c. Schneider c. Why could Bill not be diagnosed as "schizophrenic"? a. At other times he is depressed and unable to do even simple tasks. has been seeing dead friends. d. ambivalence. and emotional ambivalence. Bleuler d. Bob has experiences in which he feels that he is unstoppable and is likely to behave in a reckless manner. C App p. For six months Letitia has held a pervasive belief that her husband is having an affair. alogia. C Con p.16 Ans. inclusionary Which of the following people has schizophrenia according to the DSM-IV? a. hallucinations. 10. B App p. and frontal lobe atrophy. 334 M 10. A App p. 65. all of the above Which diagnostic approach describes DSM criteria for schizophrenia? a. delusion of grandeur. spurious correlation. b. persecution. delusion of control. delusion of control. c. 335 M 10. thought deletion. d. c. Tsu-Ming was unwilling to attend her group therapy session because everyone there could hear all her thoughts. delusions and hallucinations. 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. C Con p. This is a a. thought reference. reference.10. His long-term prognosis is probably quite poor.27 Ans.25 Ans. A App p. thought insertion. delusion of grandeur. d. b. she will investigate the clusters of a. psychoticism and disorganization. B App p. control. Dr. somatic delusion. c. This is a a. 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 delusion of a. She exhibits the delusion called a. negative correlation. D App p. enmity.24 Ans. causal correlation. c.21 Ans. the likelihood of long-term impairment increases. 33.22 Ans. b. 336 E . This is a(n) a. b. c. d. Medication will probably not be an effective treatment. d. If she focuses on the positive symptoms of the disorder. He probably has Type II versus Type I schizophrenia.26 Ans. delusion of reference. d. circumstantial delusion. d. positive correlation. b. 241 10.23 Ans. c. thought broadcasting. A App p. d. b. When a client was involuntarily committed to a hospital. He demonstrates strange behavioral disorganization. B App p. Which of the following statements is LEAST likely to apply to him? a. 334 M 10. 334 M 10. b. As the number of negative symptoms increases. tactile hallucination. c. delusion of reference. pathological excesses and deficits. Deluded is conducting a family study of schizophrenia. 335-6 M Reginald is exhibiting several negative symptoms of schizophrenia.334 M 10. C App p. 336 M * 10. he believed that his family and therapist had been abducted and replaced by hostile aliens. Type I and Type II symptoms. 34 Ans. They will maintain their identity without any alteration. hearing a command to run in front of a moving car From LESS to MORE common. was clearly evident when Leon spoke of "electronic imposition"? a. D App p. visual hallucinations. collusion. auditory d. 337 E * 10. d. jealousy d. olfactory. feeling ants crawling on one's legs and arms c.10. besides being Jesus Christ. seeing figures of demons and ghosts in a crowd b. 337-8 M . tactile hallucinations. Jill is most likely to experience a. Which of the following hallucinations would be most common for a person with schizophrenia? a. 337 E 10. A Con p.33 Ans. tactile.31 Ans. visual 242 10. which of the following correctly depicts the hallucinations of people with schizophrenia? a. B App p. d. Jill's schizophrenia includes hallucinations. persecution Three psychotic men who believe they are the President of the U. b. Statistically.28 Ans. illusion. They will eventually alternate their turns in that role. auditory b. Each will repeatedly challenge the identity of the others. 10 Briefly mistaking a shadow for a threatening intruder is a(n) a. A App p. 337 E 10. b. are brought together for several months in one ward of a state hospital. b. auditory hallucinations. somatic and gustatory hallucinations. control c. delusion. D App p. reference b. 336-7 M 10. somatic. hallucination. What is the most likely outcome of their frequent contact and interaction? a. c. c. leading to a final rejection of the original identity. C App p. visual. Ten newly admitted patients at a state hospital are diagnosed with schizophrenia.30 Ans. 337 E 10. gustatory. What number probably experience hallucinations of some sort? a. 5 b. which delusion. A App p. one at a time. smelling decaying bodies and acrid smoke d. 9 d.32 Ans. 7 c. tactile. d. auditory. visual c. 336 M In Leon's opening words to the group assembled at the Ypsilanti State Hospital.S. One or two will probably adopt a similar but different delusional identity to reduce conflict.29 Ans. tactile. c. clang associations. 10. 338 E 10. perceptual misinterpretation. b.36 Ans.41 Ans. The future. his belief that the devils were real. 339-40 M . 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. b. C App p. C Fac p. disrupted affective processes. All the while running to the store. clanging and word salad d. flat affect c. word salad. 339 E 10. B App p. d. alogia 243 10. c. loose associations. The dramatic characteristics of catatonia are an example of a.40 Ans. anhedonia c. word salad and perseveration M b. social withdrawal d.35 Ans. D leapt swiftingly from rock to rock. d. disordered behavior. Vincenzo has a formal thought disorder. specific delusion of grandeur in which someone believes he is Napoleon. derailment and neologisms 10.38 "The neotility of people confounds me. d. alogia A neologism is a a. Which symptom below provides clinical evidence of this disruption in thinking? a. his recognition that his experience is strange. avolition b.10. c. 339 E * "Gene. his inability to stop the perception on his own.39 Ans.37 Ans. 338 E 10. redores with futility and App inner reduplication. A clinician is assessing the presence and severity of a client's negative schizophrenic symptoms. a delusion of reference b. C App p. derailment d. cognitive derailment. I Ans. c. neologisms and echopraxia c. perseveration. brain structure dysfunction which is implicated in schizophrenia. the jean jeanie" is a phrase that clearly reflects a. class of antipsychotic drugs used to reduce positive symptoms. 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. Which of the following is NOT a specific diagnostic criterion? a. This would be considered a hallucination for each reason below EXCEPT a. b. d. c. B Fac p. 338 a. it said. A App p." Which two symptoms of thought disorder are present? p. word created by a person exhibiting a formal thought disorder. his report that the devils are visible no matter what he does. b. which of the following descriptions is NOT applicable? a. d. It could be caused or exacerbated by the medications used to treat the positive features of the disorder. b. b.46 Ans. b. A substantially better prognosis is associated with spectrum disorders. antimotivational syndrome d. B App p. and bizarre motor behavior caused by temporal lobe epilepsy. psychotic disorder due to a general medical condition. c. delusional disorder Ms. A Con p. There is less research available on characteristics and causes of spectrum disorders. c. D App p. Symptoms of each spectrum disorder have a duration of 6 months or less. 341 E 244 . delusions.44 Ans. It is more commonly evident in the residual than the active phase of the Type I disorder. substance-induced psychotic disorder d. aphasia. This condition is known as a. c. c. schizophrenic spectrum disorder. It is roughly as common as are auditory hallucinations. C App p. 340 M Which of the following statements is FALSE in regard to the flat affect found in schizophrenia? a. paranoid personality disorder b. Brannon is volunteering as a nurse's aide in a psychiatric hospital. d. anhedonia Which of the following disorders does NOT belong to the "schizophrenic spectrum"? a. Racita has hallucinations. Martina spends most of her time staring blankly out a window and is never interested in any activities occurring on her ward. avolition c. with both symptoms typical of the majority of individuals with the disorder. flat verbalization. The lack of emotional expression appears to be related to a similar lack of internal emotional experience. b.45 Ans. 10. 341 E 10.43 Ans. When schizophrenia is compared to the spectrum disorders. This is probably diagnosed as a.47 Ans.42 Ans. schizoaffective disorder c. 341 M 10. 340 M 10. D Fac p. schizophreniform disorder due to a physical condition. d. 340 M * 10. Spectrum disorders represent more limited and less severe symptomatology. C Fac p. psychomotor retardation b. alogia. delusional disorder with psychotic features. He finds it very difficult to engage schizophrenic individuals in conversation because they seem to have very little to say or speak extremely slowly. d. Which symptom of schizophrenia does this reflect? a.10. anhedonia. d. Within three weeks. A App p. Kendra. and bizarre behaviors following a traumatic. these symptoms ceased. Geoff. delusional disorder b. 341 M 10. schizophreniform disorder c. Which disorder might apply to Alberto? a. brief psychotic disorder Randall has a diagnosis of disorganized schizophrenia. Among them. d. 341 M * 10. 245 10. Which diagnosis would be most appropriate for her? a. process schizophrenia If Vera is an inducer who influenced her son. c. loose associations. this would be called a. C Fac p. in early childhood. a 30-year-old male d. one fifth c. Alberto is seeking to begin a new society based on his own principles for creating social harmony and efficiency. which of the following persons is MOST likely to be diagnosed with schizophrenia for the first time? a. a 15-year-old female c.50 Ans. A App p. posttraumatic stress disorder with psychotic features c. All have equally poor prognoses. Roughly what proportion of persons diagnosed with schizophrenia will continue to suffer symptoms even when they take medication? a. violent accident. Michael.54 Ans.48 Ans. to act out psychotic symptoms. Thad. b. Marta has a diagnosis of major depression with psychotic features.53 Ans. one quarter d. has the best prognosis. one third Statistically speaking. one tenth b.52 Ans. 343-4 M 10. D App p. Erika has a diagnosis of schizoaffective disorder. a. a 25-year-old female b. folie a deux. Randall b. at the beginning of puberty. 341 E 10. schizophreniform disorder b. schizophrenic spectrum disorder d. b. Munchausen's proxy. Erika d. B App p.10. D App p. the contagion effect. 343 E 10. schizophrenogenic psychosis. 343 E . Marta c.51 Ans. after age 30. He believes he has been chosen to save humanity from the evils of the impersonal high-tech society that imprisons it. 341 E Gisela experienced visual hallucinations. a 24-year-old male Schizophrenia usually has an onset a. grandiosity disorder d. in the early twenties. c.49 Ans. C Fac p. Tracey. A App p. 32 Which of the following outcomes is LEAST likely for hospitalized schizophrenic patients at the end of a 10-year period. 344 E Rebecca is an eight year-old who is diagnosed with autism. 344-5 E * 10. a. Schneiderian d. Kraepelinian b. residual b. What phase of schizophrenia will occur next? a. He is hoarding newspapers. He will be hospitalized more often as he ages.45 E 246 . symptoms unimproved. 344-5 C 10.60 Ans.57 Ans. c. relative independence achieved c. He will have recurring symptoms. You are likely to find the highest prevalence rates if you employ a definition. a. C App p. D Fac p.334. 10 ~ b. Which of the following prognoses is LEAST supported by research? a. extensive support still needed d.55 Ans. symptoms improved. 15 c. symptoms improved. He will undergo the residual phase of the disorder. B App p. You are conducting epidemiological studies of psychotic disorders in three countries. autistic d. 344 M 10. b. active c. A App p. Bleulerian c. based on available data? a. completely recovered b. difficulty perceiving the environment adaptively Elijah's behavior has become increasingly peculiar in the past few months. He will show substantial improvement in his symptoms. B App p. disturbance in social behaviors d. the researcher might expect % of his sample to completely recover. is sometimes verbally unresponsive to questions from others. 25 d. prodromal A psychiatrist is conducting a study of long-term outcomes in schizophrenia. disturbance in mood c. and often responds with irritation when approached.10. Which of the following is related to her disorder but not to childhood schizophrenia? a. hospitalized A diagnosis of schizophrenia has been given to Terrell for the first time.56 Ans. 344 E 10. absence of speech b.58 Ans. d. DSM-IV 10.59 Ans. Based on the data reviewed by Watt and Saiz (1991). 7 M 10. 345 M 10. from Australia d. 347 M * 10. which of the following findings would support your view? a.65 Ans. d. C Fac p.62 Ans. from Spain b. from India c. Children of schizophrenic parents in developing countries are more likely to exhibit the disorder than are children of such parents in industrialized countries. you would be MOST likely to find empirical evidence supporting cultural differences for which aspect of schizophrenia? a.66 Ans. the prevalence of schizophrenia in the world is about a. D App p.2 percent. Which factor was NOT included in the text's Controversy section regarding cultural variations in the prognosis for schizophrenia? a. The milder forms of schizophrenia found in developing countries have a prognosis similar to that of schizophrenia proper. B App p. 2. b. differences in mental health services and prevention programs d.and perinatal injury and illness b. 345 E 10. c. 347 C 247 . overall morbidity risk for the disorder b. Sesh. The use of a Kraepelinian-based definition results in the identification of fewer cases of the disorder in industrialized countries. D Con p.64 Ans. Ann. collectivist vs. Juan.63 Ans. 0.0 percent. the likelihood of developing a mental disorder or physical illness during one's lifetime b. individualistic social organization patterns If you proposed a biological explanation for the documented differences in prognosis for schizophrenia across cultures.61 Ans. the likelihood of developing a disorder if a family member develops a mental disorder As a sociocultural psychologist. C Fac p. the likelihood of developing a physical illness secondary to a mental disorder d. prognosis for the disorder Which of the following persons has the best chance of recovery from schizophrenia? a.0 percent. broader vs. d. 345. b. 345 E According to the generally accepted standard. A Fac p.10. 1. greater mortality associated with pre. Gregory. c. gender-related differences in morbidity risk c.5 percent. from the U. What is a person's "morbidity risk"? a. narrower definitions of the disorder c. the likelihood of death due to suicide by someone with a mental disorder c. 0. 10.S. Random samples of adults in developing countries demonstrate fewer structural brain abnormalities than do such samples in industrialized countries. causal factors associated with the disorder d. affective c. catatonic type schizophrenia. A Con p. 348 E You would place LEAST confidence in which of the following descriptions of schizophrenia as it occurs cross-culturally? a. The DSM-IV preserves each of the original subtypes of dementia praecox. 348 M * 10. 348 M 10. displays inappropriate emotions.71 Ans. Jody often speaks incoherently. simple b. catatonic d. overexcitability. B App p.68 Ans. A App p. undifferentiated High suicide risk. females d. 345-7 M 10. family aggregation of the disorder Kenji has a persistent feeling that everyone is conspiring against him and frequently hears voices telling him he should hide himself from outsiders.72 Ans. Which is now referred to as "disorganized"? a. What type of schizophrenia is this? a. and has difficulty maintaining his personal hygiene. disorganized b. a.10. paranoid d. paranoid type schizophrenia.70 Ans. 348 E 10. His symptoms came on gradually and have progressively worsened. and difficulty relating to others due to elective mutism. paranoid c. d. hebephrenic b.69 Ans. however. disorganized type schizophrenia. c.67 Ans. Janeway has a schizophrenic patient requiring constant supervision due to episodes of relentless motor activity. residual b. generally better prognosis. catatonic c. gender similarity in morbidity risk c. C App p. 348 M 248 . Her patient has schizophrenia. catatonic d. earlier onset and poorer prognosis for males vs. Jody's diagnosis is a. b. D Fac p. undifferentiated type schizophrenia. later life onset. undifferentiated Jody began to develop schizophrenic symptoms at age 15. autistic 10. hebephrenic Dr. C Fac p. catatonic d. and relatively sudden symptom onset are characteristic of which type of schizophrenia? a. ________ type. its overrepresentation in lower socioeconomic status classes b. residual c. he shows little disorganized behavior or speech. contraband.73 Ans. b. II. linkage case. If Kelli has an MZ twin.10. c. mutism c. c. most of the other family members will develop schizophrenia. that twin has roughly an 85% chance of developing die disorder. b. While her first degree relatives are much more likely to be at risk compared to control families. had poor premorbid adjustment. proband. Kelli. Which prediction below is most clearly supported by family studies research? a. better c. autism Mira. 349 E Which term does not belong with the other three? a. 10. concordance case. 349 M 10. B App p. C App p. B App p. D Con p. 350 E 10.78 Ans. and her family are taking part in a family aggregation study. This means that Rita is the a. 350-1 M 10. most of her family will not develop schizophrenia. D App p. Rita. worse d.75 Ans. Family studies of schizophrenia demonstrate that a. comes from a very large family. there is a strong positive correlation between genetic relatedness and risk of schizophrenia. a person with paranoid schizophrenia. I.74 Ans. II. I. His psychiatrist describes his psychotic condition as a reactive schizophrenia. One of her parents is more likely to have the disorder than one of her siblings. had an onset of symptoms at a very young age. exhibited symptoms that came on suddenly. c. C Fac p. b. 348 M 10. catalepsy d. better Lodovic is an inpatient on a psychiatric ward.77 Ans. d. b. a schizophrenic proband.76 Ans. d. 350-1 C 249 . if a first-degree relative has schizophrenia. worse b. a patient suffering from Type schizophrenia which has a rapid onset and many positive symptoms. a. d. genetic inheritance is the cause of schizophrenia. the family environment is the cause of schizophrenia. c. This means that Lodovic a. Her family members are about six times more likely to be at risk for schizophrenia than are members of a control family. has a relatively poor prognosis. echopraxia b. has a prognosis than a person who has a gradual onset of predominantly negative symptoms. d. 25 b." c. 352 E 250 . 352 M You could legitimately criticize several early family studies of schizophrenia for each of the following flaws EXCEPT a. 350-1 M 10. 352 E 10.79 Ans. varying operational definitions of "schizophrenia. Both twins' children are at equal risk. Whose children are at greatest risk for schizophrenia? a. 10. which is about 42%. d. her MZ twin sister. C App p. you would predict a percent concordance between DZ twins. Tatiana's b.80 Ans.82 Ans. Schneider d.81 Ans. not become schizophrenic unless he has a traumatic experience or brain injury. A Con p. U. D Con p. who are dizygotic twins with a schizophrenic mother c. 75 d. d. C App p. does not. have some type of debilitating psychological problem. A App p. where might he most wish to work? a. a. Cherise. 352 E * 10. Argentina c. d. B App p. Both twins' children are at equal risk.52 M 10. Tatiana has schizophrenia. Rick has developed schizophrenia. Seth and Christopher. whose maternal grandparents were both schizophrenic b. which is about 17%. Cherise's c. DSM-IV b. be at a substantially elevated risk for a psychological disorder. Beth and Kristen.10. Which pair of individuals has the highest chance of concordant schizophrenia? a. D App p. Bleuler Rick and Ryan are monozygotic twins who have a schizophrenic parent.83 Ans.84 Ans.85 Ans. who are monozygotic twins with a schizophrenic mother If Dr. Bill and Jodie. c. Denmark b. eventually develop schizophrenia. lack of blind interviewers. Cammie and Ashton. Concorde wished to conduct adoption studies of psychotic disorders. China d. If you hypothesize that schizophrenia is caused solely by genetic transmission. 352 M 10." b. failure to specify sample selection criteria. Kraepelin c. Ryan will a. 50 c. inconsistent definitions of "genetic relatedness. b.S. 100 Whose definition of schizophrenia would produce the highest concordance rate? a. 334. who are siblings with a schizophrenic mother d. 10. d. Does Lani exhibit dysfunction in smooth-pursuit eye tracking? 10. catalepsy d. his adoptive parents do not. schizogenia c.90 Ans. 353 E 10. What characteristic is being assessed? a. What kinds of social support and levels of traumatic stress are present in M Lani's life? * b. One adoptive parent and step sibling have the disorder. b. schizotypy Which of the following is a FALSE description of the results of the University of Wisconsin schizotypy study? a. b. A research participant is completing measures such as The Physical Anhedonia Scale and the Magical Ideation Scale. a biological predisposition for schizophrenia can develop into schizophrenia in the presence of precipitating environmental factors.10. Charles' biological and adoptive mothers are both schizophrenogenic. One adoptive parent has the disorder. 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. D Fac p. B App p. hebephrenia b. c.89 Ans. his biological parents do not.86 Ans. Does Lani possess the recessive gene identified as the likely mode of transmission? d. The diathesis did not appear to be specific to schizophrenia. contrary to the trend evident in other studies. 353-4 M 251 . Ans. b. a low socioeconomic class combined with a stressful job can lead to schizophrenia. c. One biological parent has the disorder. neither biological parent does. D App p. A Fac p. 352-3 a. d.88 Ans. "Psychosis-prone" subjects were about 8 times as likely to develop schizophrenia compared to control subjects.87 Lani's biological mother and her DZ twin sister have both had schizophrenia. C Which of the following questions would be LEAST useful in assessing Lani's App own risk for the disorder? p. High scores on the perceptual aberration and magical thinking measures were most strongly related to risk of later psychosis. Very few of the "psychosis-prone" students or their relatives developed a psychotic disorder. 10. a defective genetic inheritance will eventually lead to development of schizophrenia. What degree of schizotypy is evident in Lani? c. c. 353 M The diathesis-stress model of schizophrenia predicts that a. a pair of monozygotic twins reared apart will develop schizophrenia concomitantly. d. if they develop it at all. d. hypofrontality. larger ventricles than those of normal persons. lateral ventricle is to the frontal lobe. A Con p. A Con p. bizarre behavioral excesses. lowered performance on neuropsychological tests. Auditory hallucinations are to deficits in problem solving as the a.95 Rebecca has schizophrenia. 354 M 10. You are inspecting the CT scan of a schizophrenic patient. b. Using this neuroimaging technique. it has been documented that the brains of some schizophrenic persons have a. b. b. d. C Con p. Each of the following findings would support her hypothesis EXCEPT a. developmental delay due to malnutrition As first suggested in the 1920s. frontal lobe is to the thalamus. avolition. 10. prenatal exposure to viral infection d.10. enlarged ventricles.92 Ans. Concordance between MZ twins is greater than that for DZ twins. Relatives of schizophrenic patients show abnormalities in the task more often than do relatives of control subjects. diminished blood flow to the frontal lobe during problem solving. abnormal temporal lobe activity.97 Ans. B App p.91 Ans. C hypofrontality. 355-6 b. * d. c. 356 M 10. M c. Based on available data from several studies. complications during the birthing process c. excessive activity at dopaminergic synapses. 354 E Dr. abnormally increased frontal lobe volume and blood flow. 356 M Hypofrontality is most likely to be associated with a. d. 10. which early physical trauma would you most confidently identify as a risk factor for schizophrenia? a. Type I schizophrenia. delusions. predominance of positive symptoms. 252 . b. Diagnostic assessments have indicated that she has Ans. Her subjects with schizophrenia in remission show abnormalities in the task. b. season-of-birth effect b. c. d. temporal lobe is to the thalamus. c. smaller ventricles than those of normal persons. temporal lobe is to the frontal lobe. c. 355 C 10.96 Ans. 355 E 10. c.93 Ans. p. Rozoni is studying smooth-pursuit eye tracking which may turn out to be a genetic marker for schizophrenia. B Fac p. you are most likely to see a. B App p.94 Ans. which is associated with each of the following EXCEPT App a. Abnormalities in the task are found in persons with severe depression. decreased frontal lobe volume. d. an abnormally low level of dopamine. 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. psychiatrists. B Con p. Brane's work? a. Are the abnormalities found in persons with other mental disorders? d. C App p. hippocampus b. hippocampus c. A App p. experiencing a visual hallucination.99 Ans. expressing neologisms. or neuroscientists conduct these studies? c. experiencing an auditory hallucination. frontal lobe d. temporal lobe c. 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. Wernicke's area c. hypothalamus d.100 Ans.10. Did psychologists. 356 M 10. and Janet is a nondisordered person. d. An investigator wishes to understand how the brain creates auditory hallucinations. failing to successfully solve a difficult puzzle. c. Do the abnormalities appear consistently among homogeneous subgroups of persons with the disorder? 10. 356-7 C * 10. Which of the following questions is NOT relevant to a critical analysis of this statement? a. proven by sophisticated neuroimaging. What brain structure is the most likely target of Dr. or other disruption in speech. How old were the subjects in the studies and how long had they received treatment for the disorder? b. b.98 Ans. You would predict that he is a. 357 C 10. D App p.101 Ans. thalamus Dr. word salad. thalamus b. 375-8 M 253 . Which of the following structures currently appears LEAST promising as a focus for her research? a. When Janet hears a person's voice. 356 M Lambros is exhibiting significantly abnormal activity of the neurons in his left temporal lobe. Broca's area d. limbic structures Your roommate has told you that she/he learned in intro psychology that schizophrenia is caused by abnormalities in the brain.102 Ans. temporal lobe b. B App p. basal ganglia Lozona is a patient who suffers from schizophrenia. basal ganglia For which of the following reasons has the dopamine hypothesis been revised? a. This is an example of a. d.107 Ans. He eventually lost his job and his family. In which brain stmcture is Romiko. develops positive symptoms of schizophrenia when she takes high doses of an amphetamine.105 Ans. neglectful treatment by parents. most likely to show a deficit of dopamine? a. odd or uncoordinated motor behavior. b. C App p.106 Ans. 361 M 254 . nondisordered children of a schizophrenic parent. Mellaril. This means she want to locate a. difficulty interacting with peers. 359 M * 10. B App p. c. b. 10. schizophrenic individuals who have been in remission for several months.103 Ans. Richard. social causation. 358 E * 10. Only about one half of people with schizophrenia improve with neuroleptics. Changes in the neurotransmitters serotonin and norepinephrine have been reliably associated with schizophrenic symptoms. shows a reduction in severity of delusions when given L-dopa. c. social residue.10. Toni. B Fac p. b. 358 C Each of the following examples supports the dopamine hypothesis of schizophrenia EXCEPT a. d. poor premorbid adjustment.104 Ans. D Fac p. As William developed schizophrenia he became unable to fulfill his responsibilities at work and at home. A biological psychologist is recruiting participants for her high risk study of schizophrenia. Adults with schizophrenia in Mednick and Schulsinger's study probably exhibited each of the following characteristics in childhood EXCEPT a. Abnormal levels of corticosteroids have been found to be more closely associated with Type I symptoms. reduces the visual hallucinations and delusions of reference in a schizophrenic patient. temporal lobe c. social drift. a nonpsychotic person. William now lives on the streets. d. d. a schizophrenic person. 358 E 10. frontal lobe b. generalized cortical deficits. 359 M 10. c. A App p. persons scoring exceptionally high on the MMPI's schizophrenia scale. have no effect on the positive symptoms of schizophrenia. a person with Type I schizophrenia. shows abnormally elevated levels of a dopamine metabolite in his cerebrospinal fluid. d. Rita. a person with paranoid schizophrenia. c. c. b. C Con p. which block dopamine receptors. amygdala d. inconsistent. persons scoring high on schizotypy who live in stressful environments.108 Ans. a neuroleptic. Dopamine antagonists. b. have been replaced with the expressed-emotion explanation as a cause of the disorder. receiving incompatible messages from parents. social residue b. b. A App p. are disadvantaged. having a mother who is overprotective but also cold. European-heritage Raddites who are members of lower socioeconomic classes c. Tolman thinks that Sophie's schizophrenia may have developed due to childhood experience of conditions described by the double-bind theory. social drift d. One group. such as a. social flight c. b. Asian-heritage Raddites who are members of upper socioeconomic classes d. 362-3 E 255 . The psychiatrist believed that the mother's caused Ian's disorder. high level of expressed emotion Dr. a. The double-bind and schizophrenogenic-mother explanations for schizophrenia a. 362 M 10. many people moved to Ans. are no longer taken seriously by most researchers and clinicians. European-heritage Raddites who are members of upper socioeconomic classes b. is socially advantaged.110 Ans. social causation 10. and uncomfortable with intimacy. which group would show the highest rate of the disorder? a. 361 economically depressed town? E a. C App p. d. repetitive. a psychiatrist treating Ian for schizophrenia described the patient's mother as "schizophrenogenic". 362 C There are two groups of Raddites living in Atlantis. own schizophrenia b. overprotective.109 When the local automobile manufacturing plant closed. and cold personality d. have been supported by research and are sometimes used in family studies. According to the social drift explanation of schizophrenia. the Raddites of Asian heritage.10. Which explanation accounts for App the subsequent overrepresentation of persons with schizophrenia in the p. 362 E 10. prenatal viral exposure compounded by later brain trauma. A other cities and were able to find new jobs. 10.113 Ans. c. rigid. like asking for affection then rejecting attempts at intimacy.111 Ans. d. c. Asian-heritage Raddites who are members of lower socioeconomic classes Several years ago. conflicting messages about interpersonal expectations c. and the other. early life schizotypy and later social awkwardness and rejection. the Raddites of European heritage.112 Ans. domineering. B App p. D App p. have had little impact on the general public's understanding of schizophrenia. 1950s d. d.115 Ans. Stephanie will typically observe compared to the interactions within low EE families. high expressed emotion reliably predicts relapses of schizophrenia. a disturbance in emotional expression in which both positive and negative emotions are grossly exaggerated. and hostility toward a schizophrenic member. D App p. c. a high level of double-bind messages directed toward Peter. 1970s 10. a significantly increased risk of relapse for Peter. 1930s c. electroconvulsive shock When did the revolutionary change in the biological treatment of schizophrenia occur? a. a. C Fac p. criticism. an increased likelihood of Peter's developing a comorbid mood disorder. 364 M 10. Which of the following treatments would NOT have been used? a.10. c.116 Ans. a family's overinvolvement. b. 365 E 256 . His family is rated high on expressed emotion (EE).117 Ans. 364-5 M 10. A Fac p. a decreased likelihood that Peter will discontinue his medication. All of the following are true about expressed emotion EXCEPT a. b. Rosenfarb. Wayne is a patient being treated for a severe psychosis in a state mental hospital. A App p.119 Ans. greater physical distancing and little eye contact d. c. fewer unusual behaviors by the patient b. d.114 Ans.118 Ans. a group counseling tool used to assist families of individuals with schizophrenia. b. more frequent double-bind messages It is 1942. Stephanie is a graduate student of Dr. 363 M The term "expressed emotion" as applied to schizophrenia refers to a. high expressed emotion is related to the original onset of schizophrenia. which predicts a. 1890s b. more genuinely supportive comments to the patient c. d. Peter was recently released from a psychiatric hospital after being treated for schizophrenia. 363-4 M * 10. psychosurgery c. a method used to help schizophrenic patients identify the feelings that are associated with relapse. high expressed emotion has been found to predict relapses of mood disorders. high expressed emotion may be brought about by the schizophrenic individual's own behavior. When she views the videotapes of families who are high in EE. 363 E 10. a phenothiazine b. C Fac p. B App p. long-term isolation d. 125 Ans. B App p. extremely high fever.120 Ans. thiothixene / Navane Sung Hee is taking Prolixin for treatment of his schizophrenia.123 Ans. irregular heart rate and blood pressure. a slow shuffling gait. d. feeling constantly restless and agitated. fine tremors of his hands. D App p. ticks. Pablo is taking a phenothiazine for schizophrenia. tardive dyskinesia. irregular heart beat. Parkinsonism. and muscular rigidity. If this patient recently began taking an antipsychotic medication. He is experiencing side effects including fine tremors in his hands. and slowness of movement. 366 M 10. acute akathesia. TD d.122 Ans. Henri is suffering from tardive dyskinesia as a result of taking chlorpromazine. what condition should the physician suspect? a. neuroleptic malignant syndrome c. uncontrollable jerks. NMS b. This is known as a. he is experiencing a side effect in which he feels compelled to keep moving and is constantly agitated. b. A Con p. Pablo is experiencing a. akathesia. chlorpromazine / Thorazine d. Unfortunately. A App p.124 Ans. C App p. His expected symptoms include a. acute phenocytosis c. 366 M * 10. and twitches of his face and body. feeling he must keep moving his limbs. fluphenazine I Mellaril b. seizures 10. B Fac p. 366 E Which of the following is an incorrect pairing of a generic and brand name neuroleptic? a. acute dystonia. c. 366 M 10. 366 M 10. 367 E 257 . noncompliance b. c.121 Ans. tardive dyskinesia. TD d.10. b. c. Parkinsonism. An emergency room physician has a patient who is suffering from a high fever. and extreme muscle rigidity. lip smacking. b. d. acute dystonia Which of the following is the most common problem associated with neuroleptic medication? a. a blank stare. d. thioridazine / Haldol c. muscle rigidity. acute dystonia. participation in a behavioral milieu therapy program d. patients engage in role playing. D App p. What is the program's most likely focus? a. 367 M 10. In addition to the biological treatment she is likely to receive.10. Which of the following does NOT belong? a. c.130 Ans. c. It will produce fewer extrapyramidal side effects. She is taking a. psychosocial rehabilitation c. increased involvement of her family. b. which treatment approach would you advocate for psychotic patients? a.131 Ans.126 Ans. increased reliance on individual cognitive therapy to prevent relapse c. B App p. C App p. Claudia must have regular blood tests. d. self-management b. especially for psychoeducation b. biological b. 368 M Bella is taking an "atypical" antipsychotic medication. Harry Stack Sullivan. cognitive-behavioral d. shorter-term hospital stay accompanied by community-based outpatient care If a psychology intern is working on a psychiatric ward whose treatment program is deemed most effective by Gordon Paul and colleagues.129 Ans. 368 E 10. psychoanalytic-based milieu therapy b. 368 E 258 . psychoeducation d.127 Ans. and social reinforcement is provided for successful practice. individualized treatment planning and short-term inpatient stay c. Clozaril. Navane. B App p. D App p. 368 M 10. what is its structure? a. b. 367 M 10. If you were working on a psychiatric ward with Dr. Compazine. Haldol. It could produce a life threatening loss of white blood cells. psychoanalytic c.128 Ans. It differs from standard medications in each of the following ways EXCEPT a. It will effect the activity of serotonin rather than dopamine. It will effectively treat her negative as well as positive symptoms. token economy d. milieu therapy Schizophrenic inpatients are provided a structured group setting in which staff model adaptive behaviors. family therapy Anneke is a patient in a state hospital in 1968. C App p. there are several changes occurring in the treatment of her schizophrenia. social skills training 10. d. Because of a potentially fatal side effect associated with her medication. His family receives family treatment and Manuel receives social skills training.137 Ans. family therapy c. a list of the signs that tell her she is relapsing and what to do when they occur 10. a clinical psychologist c. 370 M 259 . increasing the patient's social skills.'s studies indicate one should focus primarily on a. 370 E 10. 369 E 10. milieu therapy What sort of mental health worker is central to the success of psychosocial rehabilitation programs? a.69 C In the design of an effective program for the prevention of relapse in schizophrenic individuals. education about biological treatment and possible side effects. psychosocial rehabilitation b. C Fac p. family therapy d. psychosocial rehabilitation c. her family's plan of action for decreasing expressed emotion during home visits b. 370 E 10. b. c. self-management training b. B App p. 370 E * 10. C App p. a step-by-step plan for handling interpersonal conflict d. 364. a psychiatric nurse b.133 Ans. a specific plan for dealing with residual psychotic symptoms in the workplace c.10. His family is low in expressed emotion. Manuel and his family receive psychoeducation. Which of the following treatment approaches essentially encompasses the other three? a. This most closely reflects the guiding philosophy of which psychological therapy? a. b.136 Ans. behavioral milieu program Lionel Aldridge successfully copes with his schizophrenia in large part due to community support and the support of friends.134 Ans. a case manager d. Chandra would include which of the following in her proactive crisis plan contain? a. self-management training d.135 Ans. D App p. decreasing EE. Manuel participates in psychosocial rehabilitation. c. Falloon et al. d. family-based token economy systems. a vocational guidance counselor As a schizophrenic outpatient. B Con p. A Con p. Under which of the following conditions is Manuel most likely to suffer a relapse of schizophrenia? a. d.132 Ans. and Hogarty et al. S. in Paris. loose associations). SHORT ANSWER I ESSAY 10. By the 1950s.. 260 . b. in London. he later added the simplex subtype. By the 1890s. Kraepelin believed that each type represented an early onset. his parents were probably misdiagnosed with other disorders.10. d. are preserved in DSM-IV.140 Indicate which earlier definition(s) of schizophrenia is/are most clearly retained in the DSM-IV. including reference to historical figures. the work of German psychiatrist Schneider resulted in greater consensus regarding "first rank" symptoms of delusions and hallucinations. Moreover. with minor alteration. Schneider's influence is preserved in the DSM-IV. 372 M How does Dr.138 Ans. Due to changing standards for diagnosing the disorder. Morel. The disorder is polygenetic and dependent on some form of activating stressor. Bleuler noted that some patients had a later life onset of symptoms and that some did recover. c. progressively deteriorating disease. gathered the constellation of symptoms underthe label demence precoce. 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. and Philippe Pinel. in Belgium.g. Kraepelin's four subtypes. These two systems resulted in differing diagnostic practices in Europe (where Kraepelin's was preferred) and the U. where the single symptom of a bizarre delusion or certain form of hallucination is sufficient to meet Criterion A. He identified four primary symptoms he believed responsible for the dismption in mental functions (e. which in mm led to the other common symptoms of the disorder (e. catatonia.g. John Haslam. Prenatal and perinatal birth complications and viruses will probably be shown to be more important causes of the disorder. (where Bleuler's was preferred) in the early 20th century. trace the history of the evolving concept of schizophrenia. 10. which he labeled "schizophrenia" (split mind). 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. A Fac p. delusions). Fifty years later.139 Beginning with the first formal description. and paranoia. Bleuler's more flexible conceptualizations regarding onset and course of the disorder are also preserved. but differing diagnostic practices continued. through the middle of the 20th century. first documented patient symptoms and behaviors in the early 1800s. he therefore proposed that the focus be turned to the loosening of various mental processes. as is the criterion that the disorder result in a deterioration of day-to-day functioning. The disorder is probably caused by a recessive gene that is carried in his parents' genotype but not expressed in either one's phenotype.. . and other relevant variables. Findings generally show about a 50% concordance rate for MZ twins vs. e. visual. perseveration. e. e. and expression of thoughts. 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. inappropriate sexual behavior. facial grimaces. catatonia. and then give two examples of the types of behaviors included for each symptom..142 List and briefly define each of the negative symptoms of schizophrenia. 17% for DZ. 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. gustatory.g. loose associations/derailment. ♦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.. control. little vocal tone. and DZ twins. Hallucinations: sensory perceptions occurring in the absence of external sensory stimulation treated as real. tactile. e. uncontrollable. Disorders of behavior: peculiar motor behavior. 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. eye color) and traits consistently associated with the disorder.143 Summarize the strategies and primary findings of each of the four types of studies that link schizophrenia to genetic factors.. who share only 50%.g.10. 10. 261 . process. Findings indicate that children bom to a schizophrenic parent are substantially more likely to exhibit the disorder than are the other adopted children. who share 100% of their genetic code. stereotyped gestures. control. 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. neologisms.g. auditory. word salad.141 List and briefly define each of the positive symptoms of schizophrenia. listless demeanor Alogia: impoverished speech or extremely slow or delayed verbal responses Avolition: extended lack of activity. empty or glazed look in eyes. somatic delusions.g.. olfactory. inability to sustain attention or memory for activities (*note that students may not include these because they are not specific to the diagnosis) 10.g. grandeur. education. reference. Disordered thought processes: disruptions in the organization. delusions of persecution. High-risk studies: prospective studies of children of schizophrenic parents compared to (low-risk) children of nondisordered parents. Adoption studies: examine rates of schizophrenia in adopted children who did or did not have a biological parent with schizophrenia. somatic. and unalterable. Twin studies: examine concordance between MZ twins. 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. clang associations. and social skills training interventions. Psychoeducation for family members regarding the causes and symptoms of the disorder. community networks are also needed to reinforce medication compliance (with medication often discontinued due to unpleasant side effects) and to provide a structured. Psychoeducational programs as well as problem-solving and communication skills training are important components in the reduction of expressed emotion.144 Describe why biological interventions are insufficient for the effective treatment of schizophrenia. Family therapy (psychoeducation. in large part to reduce feelings of guilt and blame. a constellation of negative interaction patterns reliably associated with relapse. (1985) and Hogarty et al. medical services).145 Drawing from Falloon et al. Drug treatment does not address difficulties in interpersonal behavior. some are strongly related to risk of relapse. In order to maintain the gains provided by drug treatment outside the hospital. including social skills training for the schizophrenic member and family focus on rewards for appropriate behaviors. particularly to decrease expressed emotion (criticalness. cooking). Treatment for these psychosocial deficits requires the inclusion of behavioral milieu. describe the factors that appear to be critical for the success of this method in the prevention of relapse. In general. and vocational rehabilitation (occupational education and transitional employment.10. transportation. peer support groups (opportunities for modeling. hostility). social skills training (dealing with hostility. 10. decreased EE). interpersonal work-related skills). overinvolvement. even in cases of medication compliance. development of plans to avoid or cope with crises (safe houses. While psychosocial factors are not reliably implicated as causal factors in the disorder. self-management skills (shopping. attention to the bidirectional.146 List the components that could be a part of a successful psychosocial rehabilitation program. recreation). 10. proactive crisis plan). self-management. Structured training in problem solving. 262 . interactive effects of patient behavior and the family environment is needed. problem-solving. or impairments in vocational skills. deficits in coping skills. assistance with basic living needs (housing.'s (1986) investigations of family therapy for schizophrenia. and give one example of what each might involve. supportive environment for the practice of those interpersonal and occupational skills with the goal of more independent living. rather than exclusive focus on one or the other. Structured training in communication. 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. B App p. diffuse b." Some of the neighborhood children like to tease Joseph. memory. what is the name for the behavior these children are exhibiting? a. consciousness. An aneurysm (a broken blood vessel) in Morgan's brain has caused impairment in his language abilities. The disorder is caused by a biological change in Thomas' brain. Dagmar has an amnestic disorder. or intelligence. 379 E 263 . B App p.3 Ans. perception. each of the following cognitive processes may be disrupted EXCEPT a. "Residents of nursing homes don't need intellectual stimulation.5 Ans. Which characteristic does NOT apply to this situation? a. He has impairment in memory. Which of the following brain structures is LEAST likely to be involved in her disorder? a. sensations of touch and temperature. they need peace and quiet. 378 E 11. b.1 Ans. language comprehension. d. 379 M 11. hypothalamus Which of the following statements is NOT ageist? a. focal c. "Everybody develops some form of dementia if they live long enough. C App p. "Older people exhibit short-term memory deficits due to distractibility. retrograde If Klaus has suffered a stroke in his temporal lobe. misogyny d. perception." b. amygdala d. 379 M 11." d." c. intergenerational hostility 11.Chapter 11 COGNITIVE DISORDERS 11.2 Ans. 378 E * Thomas is suffering from a cognitive disorder. ageism c. A Con p. elder abuse b. language. "People in their 80's aren't capable of physically enjoying sex anymore. d. 379 M 11. According to your text.6 Ans.4 Ans. an older widower who stays at home and keeps to himself most of the time. temporal lobe c. b. The course and severity of his disorder may be affected by cultural factors. He must be at least 60 years of age. D App p. c. What sort of brain injury does this reflect? a. anterograde d. hippocampus b. A App p. c. They often vandalize his house and joke about his "dodderly" ways. C App p. d. Like most traits in older age. C App p. 380 M * 11.9 Ans. C App p. Her creativity has probably decreased. 379 E 11.12 Ans. Based on Lamy's (1985) work. Ruth.65 b. preoccupied with health concerns.10 Ans. c. population? a. They may take medication prescribed for friends or family. b. 380 M Which older age group represents the fastest growing segment of the U. b. sensory. d. individual differences are so wide that no consistent prediction could be made for Anna Belle.S. decreases in memory. engaging in a daily physical routine of walking and aerobic exercise c. c.8 Ans. Which factor below is LEAST likely to be related to his successful aging? a. b. Anna Belle is in her late eighties and has been an artist all of her life. attending occasional college courses for fun and interaction with others Given the normal declines associated with aging. They may receive prescriptions for their medications from more than one physician.11. increased difficulty in problem solving and rational decision making Thomas is an elderly man who takes medication for a heart problem. decreases in muscular. 55 . what is MOST likely to happen to Picard by the time he reaches 70 years of age? a. They may make serious errors in the way they take their medications. satisfied with her life. 380 E 11. His 75year-old wife. D App p. is also taking medication for arthritis and hypertension. B App p. she will describe herself as a. a moderate decrease in satisfaction.7 Ans. which statement below is probably NOT true about Thomas and his wife? a.11 Ans. unhappy and lonely. If she is like most other older adults. 75-85 d. She retired from public life at age 75 and has taken up painting and sculpture. Terrance is going strong at age 76. forgetful and easily confused. and daily analytical skills c. D Fac p. d. and quality of life b. She used to perform on Broadway and has written several stage plays and short stories. 380 E 11. and metabolic functions d. the level of income in his previous career d. 381 M 264 .75 c. What has happened to Anna Belle's creativity in the past 10 years? a. 11. Her creativity has probably increased. 85+ Moira is 74 years old. happiness. 65 . They will be less vulnerable to overdosing due to their slower rate of brain activity. commitment to his spiritual beliefs and practices b. c. creativity. Her creativity is probably at a level similar to what it was in her professional career. DSM-IV b. Gwenneth refuses to be tested because her complaints are primarily a means of seeking attention.14 Ans.11. delirium d. 381 M Gwenneth is 72 years old. what outcome is most likely? a. e. cognitive disorders b. delirium Mr. amnestic disorder c. Both a and c are correct. yet he has perfectly normal motor faculties.13 Ans. A App p." she is most likely referring to which disorder? a. 382 E 11. What is the name for this condition? a. A App p. agnosia c. as she expected. derangement c. Due Tho is suffering from long-term memory loss but has no other serious cognitive symptoms. organic mental disorders. apraxia b.17 Ans. mental disorders due to a general medical condition. 382 M 265 . DSM-IV c. D App p. A Fac p. 381 M 11. has substantially below average memory function.15 Ans. d. anomia 11. organic mental disorders c. late life schizophrenia d.18 Ans. A App p. Sato is suffering from an inability to carry out certain motor activities. Gwenneth has normal memory function. intact muscles and bones. Gwenneth. She feels she is losing her memory and often complains about it to a caseworker who regularly visits her. 381 E 11. B App p. dementia b. If the caseworker asks the psychologist to test Gwenneth's memory. a. mental disorders due to a general medical condition Because scientists no longer accept the artificial distinction between mind and body.. In editions of the DSM prior to the current version. ICD-10 d.g. amnestic disorder When Cora refers to her hospitalized grandfather as "senile.16 Ans. What type of disorder does he have? a. psychophysiological disorders d. under what classification would her disorder fit? a. c. Muriel has been diagnosed with a form of dementia. Gwenneth has impaired long-term memory but average short-term memory. dementia b. 382 E * 11. you will not find the category of in the . organic mental disorders. b. aphasia d. He otherwise expresses no oddities of behavior or perception. When asked what was happening the previous morning. while he knows who he is. factitiousness Dr. Delira suspects that her client may be malingering and may not actually have a true amnestic disorder despite reports of severe memory impairment. What is Barika's disorder? a. 383 E 266 . anterograde amnesia b. She can remember events that happened a few months ago and in the days before the accident. performance on the Mini-Mental Status Exam. What disorder might this be? a. What is the name for this deficit? a. Today.21 Ans. but she has no memory of anything that has happened since the accident.11. b. retrograde amnesia b. 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.19 Ans. akathesia b. 383 M * 11. agnosia c. aphasia b. In fact. aphasia d. B App p. anterograde amnesia Mokando has amnesia but is unaware of it.describing what he ate and what he was planning for the day as he ate. perseveration c. She might consider each of the following to help her make the distinction EXCEPT a. D App p. C App p. What term that best describes his behavior? a. 11. anterograde amnesia c. confabulation d. retrograde dementia Barika was in an automobile accident and suffered head trauma.20 Ans. Sawyer has a long history of alcohol abuse. presence of financial gain to the client as a result of the diagnosis. oblivious to the fact it is 1992 and he is a long-term patient in a state hospital. apraxia Mr. 383 M 11. Mokando has been in the hospital for the past week and was in surgery the previous morning. agnosia c.23 Ans. c. He elaborates.22 Ans. A App p. 383 M 11. Mokando says he was at home eating breakfast. retrograde amnesia d. presence or absence of a supporting medical condition. Her memory seems to be "frozen" at a certain point in time. delirium d. he believes the year to be 1969 and that he is living in an apartment. inconsistent performance on systematic memory assessment. d. gives the same repetitive answer to questions. e. Altered consciousness is to pure memory loss as a. D App p. she believed he was a demon who had come to take her soul away. 11. b. and she answers very few M correctly. The number of cases that go undocumented is actually quite small since concerned family members usually bring these individuals in for treatment. 383 M * 11. C App p. amnesia b. What might this reaction be called? a. c. He is likely to experience a complete recovery once the underlying cause is treated. since Western medicine deals with cognitive disorders that occur primarily in individuals from Western societies. Capgras syndrome d. delirium is to dementia. d. Tran! !ruk has Ans. Which of the following would NOT apply to Jacques'condition? a. hyperstartle illusion b. and she panicked.25 Ans. delirium c. so they are labeled as something else and treated accordingly. C Con p. Many people with these disorders suffer them as a result of illegal activity and are incarcerated instead of being treated by doctors. previously unknown tribe in Africa. The disorder may be of short duration and may go untreated. 11. amnestic disorder is to delirium.27 Ans. dementia is to amnestic disorder. d.g. d.24 Tran! !ruk is from a tiny. 384 C * 267 .. delirium is to amnestic disorder. They ask her a series p.28 Ans. c. is very restless at night. Many hospitals have no procedures for dealing with these disorders. C been in a serious accident involving head trauma. It is uncertain. A biologically based treatment for the symptoms is the preferred method of intervention. When she awoke and saw her husband sitting next to the bed. 383 of test questions. What disorder does Tran! !ruk probably have? a. what day she was bom. Juanita has just undergone surgery following a heart attack. It is uncertain. since cultural factors may account for poor test performance. c. Restoration of Jacques' normal sleep-wake cycle is a favorable prognostic indicator. b. becoming violent. There is an increased risk of death due to interference with treatment for the underlying cause of his disorder. or may develop so slowly as to be unnoticed. b. agnosia c. and swings rapidly from despondence to euphoria. and some Western-trained App medics are assessing the possibility of brain damage.11. d. 384 M 11.26 Ans. Lewy delusion Jacques is uncertain of the day or time. B Fac p. 383-4 M Why do some cases of delirium and amnestic disorders go undocumented? a. MMSE d. Gordeeva is asking Treya to count out loud by 7s. d. altered consciousness c.33 Ans. Dr. an Organic Impairment Examination What simple "bedside" tool might a clinician use to track a patient's delirium? a.34 Ans. A App p. C Con p. What is taking place? a. MMSE. What cognitive disorder is most likely in these circumstances? a. she should rely on each of the following EXCEPT a. a Mini-Mental Status Examination b. draw a clock test c. write a sensible sentence. very young and old most susceptible Ms. a registered nurse.29 Ans. EEG recordings showing bursts of fast activity. Gallego is an intake worker who is responsible for initial assessment of new patients. typically irreversible d. those conditions are most numerous for a. rapid onset b. Gromiko. her sodium level is abnormal and her kidney function is impaired. Of the 100 patients he cared for in the last six months. 385 M 11. a brief visit to the patient's home to assess its condition. If she suspects a delirium disorder. B Fac p. d. 384-5 M 11. delirium c. 385 M 11. vascular dementia b. a Cognitive Orientation Test d.31 Ans. 385 E * 11. delirium. c. orientation to person. C Con p. Alzheimer's. As a result of drug interactions. A App p. draw a person test b. B App p. 50 d. Pick's disease Which of the following descriptions does not belong with the other three? a.35 Ans.11. an informant interview. b. and time In regard to the number of medical conditions that could cause a cognitive disorder. worked on the geriatric unit of a regional hospital that specialized in open-heart surgeries. 80 b.32 Ans. 385 E 11. 387 E . b. D App p. c.30 Ans. 385 M Mr. place. repeat a simple phrase. 65 c. how many probably experienced postoperative delirium of some kind? a. amnestic disorder d. a Delirium Diagnostic Schedule Interview c. dementia. 36 Tamara has been taking several medications for a chronic illness. amnestic disorder. and copy a fairly simple design. 268 11. 388 E 11. Dementia is typically caused by conditions that are reversible. a nutritional deficiency b. you would advise all of the following EXCEPT a. 388 M * 269 . vague.37 Ans. b. synchronicity.39 Ans. safe observation in an intensive care unit. Sergei is upset by unpredictable. McDougal is a 68-year-old woman suffering from delirium. which of the following was NOT one of his early symptoms? a. b. Like many persons with this type of disorder. memory impairment b. A App p. low level lighting to promote calmness If you could "prescribe" clinically responsive behaviors on the part of primary care physicians treating delirium. c. What is the difference between dementia and delirium? a. d. This pattern is called a. D Con p. looping. A App p. d. D App p. personality change c. c.11. Dementia occurs only in adults older than 65. who in turn are more likely to use physical restraints for those examinations. c. treatment escalation. They differ only in severity of symptoms. pneumonia combined with medication-induced side effects Which of the following would you want to find in the room of a delirium patient? a. an adverse reaction to an antidepressant c. a pattern of "looping" in patient-staff interactions c. Which of the following represents a common cause of her disorder? a.36 Ans.41 Ans. the lowest and shortest-term doses of medication possible. 388 M 11. sundowning. often chronic loss of many cognitive functions. He is increasingly agitated with nurses. respect for the patient's possessions and privacy. delirium typically occurs between ages 55 and 75. family members and friends b. while delirium is a relatively transient alteration in consciousness. d. Rudy has been diagnosed with a dementia.40 Ans. C App p. B App p. while delirium is more often associated with conditions that persist and may worsen. exposure to a toxin combined with a recent stressful life event d. inclusion of the patient's family members and friends in treatment. Dementia involves the overall. social withdrawal and impaired judgment 11. 387-8 C Mrs. b. 387 C * 11. imprecise speech d. frequent use of physical restraints d. invasive physical examinations. 387-8 M 11.38 Ans. 43 Ans. What is this called? a. an African American male c. delirium d. a European American male b. Renny. D App p. Ott is exhibiting confusion. d. Persons with dementia often appear unaware of their symptoms whereas people with depression often communicate strong distress. Symptoms of depression are usually worse in the morning while symptoms of dementia usually increase as the day goes on.42 Ans. Which of the following persons is at greatest risk of developing dementia? a. 10 d. b. C Fac p.47 Ans. echolalia d. repetitive speech b. 389 E * 270 . 5 Which statement below does NOT describe a way to differentiate between depression and dementia? a. but will say nothing of her own. A Fac p. D Fac p. and increased apathy. c. Dementia is more likely to begin suddenly and progress more rapidly than depression. 389 M Sheree is suffering from dementia. Amelia. d. vascular dementia b.45 Ans. The alterations in the brain in early stages of dementia may directly cause depression. confabulation About what percentage of the world population is affected by dementia at age 65 or older? a. an Asian American female 11. Stimulant medications lead to reduced confusion and withdrawal in persons with depression. a European American female d. is usually more disturbed in the morning. b. 388 E 11.46 Ans. 389 C * 11. 389 M 11. Both are marked by steadily worsening performance on psychological tests as tasks become more challenging. B App p. Malcolm. poor judgment. 25 b. C App p.44 Ans. 16 c. Dementia patients can develop depression in reaction to the early stages of their disorder. Capgras syndrome c. and responds well to stimulant medication. If he is distressed by these symptoms. but increase those characteristics in persons with dementia. what diagnosis might you suspect? a. Kwaan. 388 E 11. Alzheimer's disease c. The two disorders can be difficult to distinguish when dementia is in an early stage. depression Which description below does NOT represent an aspect of the relationship between depression and dementia? a. She will repeat what has just been said by others. c.11. with occasional periods of delirium. Alzheimer's d. 390 E 271 . His symptoms probably appeared rather suddenly and exhibited a patchy. Alzheimer's disease and cardiovascular disease.49 Ans.50 Ans. D Fac p. poverty b.48 Ans. d. Jacques might have reduced his risk for this dementia.52 Ans. 389 E 11. head injury and hereditary diseases.51 Ans. d. and evidence of frontal lobe atrophy. Which form of dementia is currently most preventable? a. environmental toxins and Alzheimer's disease. greater genetic vulnerability to vascular illness d. dementia due to Parkinson's disease d. A App p. C App p.53 Ans. c. B App p. vascular dementia b. a victim of the second most common form of dementia. is at an increased risk for developing some form of dementia. an African American male. His personality will probably undergo significant alteration due to cortical brain atrophy. is INCORRECT? a. Lewy body dementia Which description of Jacques. vascular dementia b.11. 390 M * 11. step-wise progression of impairment. Pick's disease c. b. Pick's disease 11. 389 E Mohammed. Alzheimer's disease Alejandro. A Con p. the form due to Parkinson's disease c. completion of fewer years of formal education c. Had he engaged in active efforts toward prevention. 390 M 11. unpredictable pattern of impairment. has a disorder marked by extremely uninhibited and tactless interactions with others. a 45-year-old male. b. c. Huntington's disease d. D App p. Which form is most likely in this case? a. early-onset Alzheimer's b. Philippe's dementia is marked by a sudden onset. alteration in personality. drug abuse and cardiovascular disease. What is the most likely diagnosis for Alejandro? a. 390 C 11. inferior health care The two most common causes of dementia are a. Pick's dementia c. Which factor is not hypothesized to contribute to this risk? a. but little alteration in his personality. His life expectancy is substantially shorter than that for someone suffering the most common form of dementia. 392 M * 11. Which form of dementia is most likely? p. Huntington's chorea b. Parkinson's disease d. ballooned neurons in the frontal lobe : Pick's disease c. 391 M * 11.57 Ans. Which development is LEAST likely to be observed in her case? a. Tourette's syndrome d.11. HIV/AIDS b. muscular rigidity and slow movements A neurologist is treating a dementia that has developed subsequent to severe motor disturbances. C Con p. B App p. Creut2feldt-Jakob disease d. Pick's disease c. 391 a. vascular dementia 11. Lewy body dementia c. B paranoia. 392 M 11. 392 E 11. neuritic plaques : Huntington's disease d. Lewy body dementia If it were possible to "catch" a dementia as one might catch a virus. D Fac p. which disease would one have? a. Huntington's disease b. and her occasional periods of clear thought App processes. 391 M Antonio has developed a neurological disorder. Down's syndrome c. Pick's disease c. D App p. What is the disorder? a. Alzheimer's b.55 Ans. What is Antonio's disorder? a. which later expanded into several other motor problems. Both impairments have been cause by a specific genetic disruption on chromosome 4. Pick's disease M b.56 Ans. Parkinson's disease Allison has Parkinson's disease. herpes simplex II d.59 Ans. syphilis 272 11. Parkinson's disease d.54 Henrietta's disorder is remarkable due to its early-occurring hallucinations. Lewy bodies b. including slow and effortful movement and a stiff gait. A App p. C Con p.58 Ans. abnormal protein deposits : Lewy body dementia What infectious disease has at one time been the most common cause of dementia? a. pneumonia c. increasing immobility.60 Ans. cardiovascular disease Which form of brain pathology and dementia are incorrectly matched? a. Ans. neurofibrillary tangles : Alzheimer's disease b. He first developed a tremor in his hands. memory loss and depression d. disinhibition and flamboyance c. 392 E . Carla's longer life expectancy b. hippocampus. Carla's decision not to have children. 10 .62 Ans. atrophied parietal and occipital lobes 11. D App p. association cortex of the frontal lobe. B App p. A App evident p. 5 . 394 M 11. Neural and synaptic loss will be in each of the following areas EXCEPT a. 393 M * Gary is 70 years old and Fred is 75.65 Ans.6 years. this will be a.63 Ans. you have witnessed a health crisis of dramatic proportions bankmpting many health care plans and families with ill members. Reagan's brain is being studied at autopsy. following his death from complications due to Alzheimer's disease. 8-12 years. 2 .66 Ans.S. 393 E 11.64 Ans. What disease is most likely to account for this situation? a. resulting in the loss of protective factors believed to be linked to pregnancy c. 393 E 11. abnormally high numbers of acetylcholine receptors d. C App p. c. population. b. b. if he lives an average length of time after the onset of symptoms. B App p. double c. C App p. cardiovascular disease b. Parkinson's disease Some studies suggest that Carla is at greater risk for Alzheimer's than is her dizyogtic twin. delirium disorders c. While it is difficult to predict his life expectancy at this point. Carla's loss of estrogen following menopause Mr. What would these studies implicate as a cause? a. Older adults comprise one-quarter of the U. primary motor cortex in the frontal lobe. Mr. When a neurologist inspects the brain of someone who died of Alzheimer's disease. Jose. 394 E 273 . As a health practitioner. Alzheimer's disease d. d.9 years. c. what is he most likely to find? a. d. triple d. the same b. professional career to maintain mental alertness d. Rogers is in the early stage of Alzheimer's disease.11. neurofibrillary tangles and neuritic plaques c. limbic cortex. quadruple It's the year 2010. What is the chance that Fred will get Alzheimer's disease compared to the chance Gary will get it? a. Carla's lack of a stimulating. Pick bodies b. 394 M 11.15 years.61 Ans. 2. through neuropsychological testing and repeated behavioral observation c. beta-amyloid-4 Which of the following items does not belong with the other three? a. discovery of characteristic brain pathology at autopsy d.70 Ans. C Fac p. with their abnormal genetic coding of proteins. ApoE b. 90% chance b. Takamoto is a victim of the most common form of dementia in the U.73 Ans.69 Ans.72 Ans. a. are implicated in early-onset Alzheimer's? a.11. 21 d.S. 395 M 11. 24 A person with which of the following genetic patterns is at highest risk for Alzheimer's? a.71 Ans. 14 c. one copy of the ApoE-4 gene d. amyloid precursor protein c. which other chromosomes. 395 M * How is a definitive diagnosis of Alzheimer's accomplished? a. Down syndrome c. and 4 b. 394 M 11. chromosome 21 Gorgi has a type of early-onset Alzheimer's marked by large numbers of amyloid plaques. monoamine oxidase B d. D Fac p. Actually this gene may protect her against the disease. A App p. 395 M * 11. 2 and 25 d. 50% chance c. 8 and 22 11. 395 M 11. apolipoprotein E b. One could suspect that a mutation of chromosome caused these dead areas to form in the brain. If this gene is ApoE-4. What substance is believed to be responsible for killing the cells in his brain? a.67 Ans. 20% chance d. two copies of the ApoE-2 gene b. 1 b. 395 M 274 . B Fac p. 1 and 14 c. A Con p. Any of me above can be used with equal utility. how likely is it that she will develop Alzheimer's? a. Mr.68 Ans. amyloid plaques d. through PET and MRI scans b. 3. 394 M 11. D App p. C App p. one copy of the ApoE-3 gene c. In addition to chromosomes 19 and 21. two copies of the ApoE-4 gene Robin has two copies of a gene on chromosome 19 that produces a protein which transports cholesterol in the blood. lack of education. A Fac p. 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.74 Ans.76 Ans. B Con p. Alzheimer's c. evidence for hippocampal dendritic growth in nondemented elderly b. 396 C 11. decreased blood flow and glucose metabolism in her parietal lobes when compared to a relative without the gene d.77 Ans. life expectancy What kinds of studies described in the chapter provide the clear evidence of genetic transmission of Alzheimer's? a. D App p. and early deprivation of mental stimulation are all hypothesized to lessen . high-risk studies d. increased blood flow and glucose metabolism in her temporal lobes when compared to a relative without the gene c. which of the following disorders would offer the least consistent evidence? a. brain pathology supportive of an Alzheimer's diagnosis in a cognitively normal individual d. what would physicians likely find? a. a 77-year-old male with a college degree and a history of minor adult health problems b.75 Ans. a. synaptic growth potential c.79 Ans. which of the following persons is probably at greatest risk of dementia? a. 397 M 11. decreased brain volume and activity in her frontal lobes when compared to a relative without the gene In your argument that dementias are discontinuous with normal aging. alcohol-related dementia b. decline in the percentage of neurofibrillary tangles after age 100 If you endorse the reserve capacity/threshold model of aging and dementia. 396-7 E . nothing unusual. since this gene is the normal one that most people have b. 397 E * 11.78 Ans.. family studies 275 11. D Con p. decline or stabilization of Alzheimer's disease after 100 years of age c. a 73-year-old female with a high school education and a history of poor health and malnutrition as a child Genetic defects. Huntington's disease d. vascular dementia Which piece of evidence in regard to aging does not belong with the other three? a. 396 M * 11. C Con p. 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. which sets a presumed threshold between normal aging processes and dementia. resistance to infectious disease d. reserve brain capacity b. If she were given the appropriate tests. adoption studies c. twin studies b. Winifred's dementia caused abnormal levels of aluminum to be deposited in her brain. Winifred's dementia is transient and will subside away after she is taken off the machine. It enhances blood flow and energy metabolism in the brain. If his pupils dilate. Dementia pugilistica c. Dementia paracista Which of the following persons is hypothesized to be at greatest risk of developing Alzheimer's disease? a. acetylcholine What is the significance of the drug tropicamide in relation to Alzheimer's disease? a. based on available data? a. 398 M * 11. b.80 Ans. What condition might he have as a result of his former line of work? a. B App p.11. 397-8 M 11. Dennis. Joe. and memory functioning. D Fac p. 398 M 276 .85 Ans. Pele. It inhibits destruction of dopamine and norepinephrine in the brain. d. Which statement below is the most defensible. D App p. this suggests that the neurotransmitter may be deficient in his brain. Tiger. physiological arousal. a professional golf player d. Pick's disease b. Winifred probably has elevated levels of aluminum in her brain. Mr. 398 C Evander is a retired boxer. and now she is developing dementia. acetylcholine d. serotonin d.82 Ans.81 Ans. a. b. It may be used in a noninvasive test for early detection of the disorder. C App p. amyloid c. 397 E 11. Jetson has had a very dilute solution of tropicamide placed in his eyes. norepinephrine b. What neurotransmitter has probably been affected? a. A App p. a professional basketball player c. Ali's syndrome d. dopamine Suppose a person unknowingly consumes substances that severely disrupt her motor movements. a professional soccer player b. a professional football player (quarterback) Winifred has been on a dialysis machine for an extended time due to kidney failure. 398 M 11. c. c. B App p.83 Ans. 11. serotonin c. Winifred's dementia is most likely caused by the high level of aluminum in her brain. It reduces the behavioral dysfunction common in Alzheimer's disease.84 Ans. d. dopamine b. The drag is probably deprenyl. d. dementia-induced insomnia.90 Ans. nightwalking. b. A App p. ACh is the neurotransmitter affected by the drag. Nocturmts endocarsis.401 M 11.88 Ans. This behavior is known as a.11. providing your relative several choices to bolster mental alertness b.89 Ans. D Fac p. finding a support group for yourself and taking time for your own needs 11. 399 M 11. A App p. estrogen 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. which of the following would NOT be an effective means for managing day-to-day interactions? a. b. increased risk of illnesses and physical trauma related to the disorder 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. B App p. 401-2 M 277 . 399. nimodipine : inhibits monoamine oxidase B Konane has a tendency to become agitated and wander aimlessly at night. Which statement below is false. c. C App p. vitamin E c.91 Ans.86 Ans. nimodipine Which of the following proposed treatments for Alzheimer's and their physical action in the brain are incorrectly paired? a. probable lower levels of mental activity in her early life d. placing written reminders and lists in strategic places in the home c. deprenyl b. If you were caring for a relative with Alzheimer's.87 Ans. vitamin E : inactivates oxygen free radicals b. Cocheta is taking a medication for dementia which promotes synapse formation and improves her mood and cognitive functioning. d. If the drag is stopped. based on information in your text? a. propentofylline : increases blood flow & metabolism d. insufficient development of receptors sensitive to dopamine b. It has been proposed that she has an elevated risk of developing Alzheimer's disease for each of the following reasons EXCEPT a. causing worry and substantial sleep disruption for his caregivers. c. 399 E 11. 399 M Kayla completed only the third grade in school. sundowning. a possibly poor level of health care c. B App p. 401 E 11. cognitive gains will probably be lost. What is she probably taking? a. creating and maintaining a familiar daily routine and schedule d. prednisone : reduces inflammatory response c. 11. Minimized use of medications. respect for possessions. and smell. less accurate performance on tasks requiring motor speed. C App p. which of the following characteristics would apply to her compared to the nuns who died from other causes? a. with increasing risk of dementia with increasing age (but not an inevitable outcome). discontinued use of medications as soon as feasible Inclusion of family and friends. leading to greater chance of toxic response and associated need for lower dosages. and attempts to actively engage patient in treatment decisions and procedures 278 . lower educational attainment c. and kidney functions Slower metabolism of drugs. who died of Alzheimer's disease. probably intact long-term memory Some normal development of neurofibrillary tangles or senile plaques. risk of dementia possibly reduced due partly to enhanced brain reserve capacity as a result of college education 11. including a clock and calendar to aid in orientation Avoidance of the pattern of looping (demeaning or insensitive treatment provoking hostile responses which. exposure to toxins d. vision. including antipsychotics and sedatives. acuity of hearing. 402 E 11.95 Describe the ideal environment for the treatment of a patient with delirium. lower idea density in essays written more than 50 years earlier d. muscular strength and speed. along with psychoeducational intervention for the patient and significant others about the causes and course of the disorder Avoidance of physical restraints Well-lit. education b. more frequent illnesses and metabolic dysfunction SHORT ANSWER / ESSAY 11." which variable was most clearly associated with differences in mortality and independent living skills? a. 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. A Fac p. in the "Nun Study" by Snowdon et al. diet and health care c. cardiac. taste. 402-3 M In the so-called "Nun Study. low-tech room filled with familiar items from home. (1989). but offset by minimizing distractions. or rapid information processing Short-term memory possibly slightly impaired. creativity could increase. fine motor coordination. in mm.93 Ans. respiratory. provoke more humiliating treatment) by provision of privacy. What aspects of the normal process of aging will you probably be experiencing? Generally satisfied with life Decreases in the following: body flexibility. higher levels of cardiovascular disease b. vestibular sense/balance.92 Ans. liver. use of tobacco and alcohol If Lucia were one of the nuns.94 Suppose it were the year 2057 and you are now considered elderly. 97 Describe the typical development of dementia and the characteristics of its early. impaired kidney function. and angry outbursts. He was admitted to the hospital after the death of his wife when he became disoriented. the gross motor disruption of Huntington's disease. suspect depression Presence of personal and family history of depression Level of Mr. Washington's concern about his symptoms — if not particularly concerned. What assessment indicators would you look for in order to distinguish depression from an early stage dementia. with more obvious memory impairment. if distressed. severe and/or chronic illnesses.11. for instance. months) .98 Mr. inability to engage in basic self-care skills. Washington is a 78-year-old patient on a geropsychiatry ward. Middle stages of dementia are characterized by increasing language and cognitive degeneration. Certain types of dementia are characterized by other disorder-specific changes as well: the tremors of Parkinson's disease. 11. fever or hypothermia. This very advanced stage of Alzheimer's. middle. suspect depression Psychological test performance — if both recent and remote memory are impaired and/or performance is widely variable across items of equal difficulty. given that the diagnosis has important implications for Mr. and increased disturbances in executive functioning are evident. suspect depression Time of day during which symptoms are at their worst -. suspect dementia Course of symptoms over time (several weeks. Individuals in this period have great difficulty learning new information. and marked cognitive degeneration and memory loss to the point of agnosia toward close family members and common objects. suspect dementia Response to stimulant medication — if symptoms improve. and an eventual state of catatonia and complete unresponsiveness. unresponsive to visitors.if sudden and rapidly progressing. if they worsen over the course of the day. is marked by immobility (apraxia). suspect depression.if early. and unable to care for his day-to-day needs. aphasia). Speech may become vague. suspect dementia 279 . and increased use of prescription drugs.96 Why is advanced age a risk factor for delirium? Several factors associated with aging contribute to the risk for dementia. suspect dementia. Symptoms of depression may be present.e. 11. changes in living circumstances. apathy. Later stages of dementia are characterized by severely impoverished language (i. and it can be difficult to determine whether a mood or cognitive disorder accounts for early symptoms. and later stages. suspect depression. Early stages of dementia are often marked by changes in personality such as increasing social isolation and withdrawal. Among them are abnormal sodium levels. Problems with comprehension and perception (including hallucinations) become prominent.. if disorientation and other cognitive symptoms worsen. including the possibility of echolalia. Memory impairment may even be absent at this stage.if they worsen. Washington's treatment and prognosis? Onset of symptoms -. impaired vision or hearing. and individuals may have trouble finding the right words to use. brain disease. if symptoms remain consistent or improve slightly. if primarily recent memory is impaired and/or performance declines steadily with increasing item difficulty. the increasing disinhibition of Pick's disease. or the hallucinations and accompanying paranoia of Lewy body dementia. suspect depression. suspect dementia. confusion. multiple sclerosis. subdural hematoma.g. lung. syphilis. Huntington's.. or liver disease) Brain damage from physical trauma to the head (e. kidney.11..g. 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. inheriting the gene for a certain type of ApoE protein. whose presence has been linked with lower levels of brain metabolism Infectious agents (e. e. HIV. 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.g. 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 .99 List at least five factors believed to lead to dementia.. He is likely to remain obsessive-compulsive for the next several years and will probably refuse to participate in long-term treatment. B App p.4 Ans.Chapter 12 PERSONALITY DISORDERS 12." Alex is meticulous about his work as well as everything else he does. avoidant Which of the following is NOT a group of personality disorders used in the DSM-IV? a. 409 E 281 . and behavior. emotions. 409 M Which statement about personality disorders is FALSE? a. none of the above. withdrawn/neurotic Hannah's disorder is marked by long-standing. While he may not recognize the severity of his symptoms. anxious/fearful d.1 Ans. B Fac p. Personality disorders embody Malreaux's observation that "character is fate. b. d. personal distress must be present for a diagnosis to be made 12.5 Ans. Personality disorders can always be traced to early childhood. 409 E 12. borderline b. Personality disorders reflect enduring patterns of distorted thinking. 409-10 M 12. A Fac p. comorbid Axis I obsessive-compulsive disorder.3 Ans. odd/eccentric b. C App p. What is the best prediction that can be made for Alex and his disorder? a. c. c. I b. 409. and she is relatively untroubled by these patterns. On which DSM-IV axis would you expect to find her diagnosis? a. histrionic d.21 E 12. His Axis II disorder will probably worsen over time and develop into foil blown. dramatic/emotional/erratic c. inflexible patterns of thinking about and relating to others. d.2 Ans. IV d. and he will respond successfully to a combination of medication and interpersonal therapy. What personality disorder do Jessica Lange in Frances and Glenn Close in Fatal Attraction have in common? a. D Fac p. antisocial c. Personality disorders include behaviors that deviate from the expectations of one's culture. II c. His symptoms are probably ego-dystonic. His therapist has diagnosed him with obsessive-compulsive personality disorder. b. he is probably more distressed by his actions than are the people around him. schizotypal b.12. He is unable to view himself and his actions from the perspective of other people in his life. hostile. A App p.10 Roberto is 37 years old and has been diagnosed with a schizoid personality Ans. d. Roberto may have a comorbid Axis I or other Axis II disorder that could make accurate diagnosis difficult. schizoid 12. c. d. which of the following persons probably exhibits the LEAST subjective distress as a result of this disorder? a.9 Ans. App Which of the following statements is LEAST likely to apply to this case? p. B disorder by Dr. Ellis d. Percy's son. b. Which of the following disorders does she have? a.7 Ans. Percy b. All of the above are probably equally distressed. His disorder is comorbid with an Axis I disorder. 410-1 a. Charlene has a personality disorder that is quite rare. There may be overlap between his personality disorder and another type of disorder. 282 . What does this mean? a. and distmsting of others. It is unlikely that Roberto will actively participate in long-term treatment. Percy is often suspicious.8 Ans. This is the first time Roberto has received this diagnosis. Hank's personality disorder is ego-syntonic. Your text lists several factors believed to be related to this rigidity. d. If these traits meet criteria for an Axis II disorder. A App p. His disorder has arisen from a disruption in the development of the ego. b. Which statement below does NOT apply? a.6 Ans. b. 410 E 12. dependent d. He views the symptoms as a natural part of himself. Rabin. c. Dr. Rabin was mistaken to give this Axis II diagnosis to Roberto since this disorder must be diagnosed by early adulthood. c. D App p. His personality disorder may be hard to treat because he perceives his dysfunctional traits as ego-syntonic. 410 M 12. such as chronic depression. D App p. Because these disorders have a strong genetic component. 409-10 M * Rigaldo's cluster C personality disorder is very resistant to change. borderline c. 410 E 12. Percy's wife. He may believe his problems are due to others and not to his own actions. Clarice c. Roberto's dysfunctional traits were probably present when he was in his early M 20s. symptoms are only minimally altered through treatment. Roughly one in every Americans will meet criteria for an Axis II disorder at some point in their lives.12 Ans. d. narcissistic PD. 411 M If Arthur has one of the most commonly occurring personality disorders. c. D App p. Although he has never formally been diagnosed. B Fac p.14 Ans. If that comorbid disorder is more common for females than males.12. dependent PD. a. 410-1 E 12. antisocial PD. the extensive time required to document Axis II symptom patterns. you could conclude that she has personality disorder. Mali exhibits symptoms that would meet criteria for a histrionic personality disorder. 411 E 12. d. paranoid PD. Feng is an epidemiologist interested in studying personality disorders. 12. d. Dr. the overlap in Axis I and II symptoms that makes reliable diagnosis difficult.16 Ans. dependent d.13 Ans. 10 c. b. schizotypal. the infrequency of Axis II disorders compared to other acute clinical syndromes. Each of the following poses a potential problem for his work EXCEPT a. a. antisocial. According to the DSM-IV. c. histrionic. Katrina is receiving treatment for major depression and for a comorbid personality disorder. avoidant.15 Ans. C App p. you would expect that the onset of Mali's symptoms occurred no later than age a. dysthymic c. D App p. b. b. 6 d. c. C App p. 30. 411 E 283 . A App p. b. d. 411 M * 12. 13 b. 22.11 Ans. it could be any of the following EXCEPT a. 4 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. 411 M 12. 19. borderline 12. c. his participants' strong disinclination to acknowledge or report their difficulties. avoidant b. 19 Ans. Axis I b. 412 M 284 . c. d. C App p.20 Ans. Jake went to see a therapist and was diagnosed with dysthymia and avoidant personality disorder. cooperative. These areas could include any of the following according to the DSM-IV EXCEPT a. and "laid back. 412 M Which of the following persons is MOST likely to be diagnosed with a personality disorder? a. Yuan Ho. David is known as a tyrant at work and is seen as highly perfectionistic and obsessed with control. a 15-year-old South African female b. affectivity. however. dysfunctional patterns in at least two areas. These two disorders may be related to each other in any of the following ways EXCEPT a. a 24-year-old Taiwanese male c. none of the above Jake is very shy and withdrawn. 411 E 12. A App p. Eventually. b. impulse control. The distress associated with the avoidant disorder may be causing the dysthymia. b. At home." What diagnosis might you consider? a. Axis II c. d. Axis I d.17 Ans. The dysthymia may have predisposed Jake to the development of the avoidant disorder. obsessive-compulsive disorder. a 20-year-old Pacific Island female Mame may merit a diagnosis of "personality disorder" if she exhibits enduring. occupational functioning. he seems to be a different person altogether and is warm.18 Ans. D App p. and a common biological vulnerability could cause both disorders. c. 12. 412 C 12. Both are more common in men than in women. He has trouble making friends and is lonely much of the time. Richie. interpersonal functioning. Nanato.12. obsessive-compulsive personality disorder. a 22-year-old European American male d. There may actually be only one syndrome present but overlapping criteria result in two diagnoses. C App p. Lakisha. schizoid disorder. B Con p. b. d. which are easier to catalogue than are acute symptoms. A Fac p. by rational consensus c.24 Ans. d. qualitative d. long-standing symptoms. a dimensional approach to describing personality disorders b. c. c. B Con p. categorical. a model that relates personality disorders to the interpretation of the five DSM diagnostic axes d. Hansel says she is clearly a psychopath in a "class all her own". What is one of the factors that may have led to these misdiagnoses? a. on the basis of clinical field trials d. empirical is to theoretical. a five-cluster approach to reorganizing the DSM-IV personality disorders The DSM-IV is to the Big Five model as a. categorical is to dimensional. Gretel. other people are similar but don't possess the characteristics to such an extreme. b.. about their cruel stepmother. C App p. empirically. on what basis were the diagnostic decision rules regarding Axis II syndromes determined (e. but symptoms must be present for a long period of time in order to be obvious. Reliable diagnosis relies on the presence of chronic. although the actual methods are unclear b. Drawing from information provided in the text. 413 C 12. 413 E 12. a categorical approach to describing personality disorders c. 413 M 12. A App p. comparative 12. The criteria for her disorder are distinct and easily separated from other disorders. 413 M * 285 . 412-3 M Lacey has an Axis II disorder.25 Ans. dimensional. Gretel says that while she is very manipulative and lacks empathy. Overlapping criteria and arbitrary "cutoff rules for diagnosis can lead to unreliable diagnostic practices. Axis I is to Axis II. comparative. categorical c. Hansel is debating with his sister. circumplex.g.22 Ans. dimensional b. 5 of 9 symptoms required for diagnosis)? a.23 Ans.21 Ans.12. Axis II disorders are rare and are often overlooked because of this as well as the absence of distressing clinical symptomatology. a. dimensional is to categorical. Hansel is using a approach and Gretel uses a approach to describing their stepmother. on the basis of factor analysis of structured clinical interview data What is the Big Five model of personality? a. Her diagnosis came only after many other Axis I diagnoses that her current therapist believes were in error. conscientiousness d. and uninterested in traditional expectations and custom.31 Ans. the approach set forth in the DSM-IV c. curious about the people and events around her. loving than hateful d. C Con p. the interpersonal circumplex b.30 Ans.26 Ans. the Structured Clinical Interview for Personality Disorders According to Leary's model. You would expect him to score on the dominance/submission dimension and to be more a. agreeableness b. conscientiousness c. D App p. hateful than loving c. neuroticism Janet's therapist has rated Janet as high on extroversion and low on neuroticism. D App p. 413-4 E 12.28 Ans. hateful than loving . D App p. stability c. 415 M 12. high. loving than hateful b. the big five model of personality d. high. the tie-dyed wheel of cosmic reality c. the interpersonal circumplex b. low. 12. low. what disorder is characterized by extreme submission and by interpersonal feelings that are slightly more negative than positive? a. dependent b. A Fac p.29 Ans. 415 M 286 . openness Timothy Leary developed which of the following items? a. schizotypal c. openness b.27 Ans. the Big Five model Eleni is described by her friends as a very creative person.12. C Fac p. 414 M Which of the following dimensions does not belong with the other three? a. You would expect high scores on which of the following factors? a. Which approach to describing personality disorders is Janet's therapist using? a. affectivity d. the Wiggins-Costa approach d. avoidant d. 413-4 E 12. 414 E 12. paranoid Eduard has been described as narcissistic. obsessive-compulsive d. A Con p. low conscientiousness b. would MOST likely attract a follower with which of the following personality disorders? a.5 to 2. paranoid c. trying to get her fired because they are jealous of the high standards she sets for herself. antisocial * b. more frequently diagnosed in males b. paranoid d. 0. Which DSM grouping below includes Ricki's personality disorder? a. These descriptions BEST fit which of the following personality p. erratic/hateful 12.32 Ans. Her coworkers sense her hostility and d o ^ invite her out for drinks after work.33 Ahmik tends to experience frequent negative emotions and distressed thinking. is Ans. effects most likely to be observed in occupational settings d. 416 C 12. chronic feelings of inferiority 12. high neuroticism d.34 Ans.12. 416 M * 12. a charismatic leader who convinced his followers to commit several murders. avoidant b. borderline c.5 prevalence c. dominant/aggressive d.35 Ans. low agreeableness c.36 Ans. schizoid b. eccentric Which of the following descriptors does NOT apply to paranoid P.D. C quite introverted. 416-7 M 287 . What Axis II disorder is most likely? a. C App p. B App p. and sometimes App openly rude. odd/eccentric c.? a. low extraversion Karen is often wondering who is talking about her at work. skeptical. avoidant 12. histrionic c. D Fac p.16 disorders? C a. 413. schizotypal d. narcissistic Charles Manson.37 Ans. 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. neuroticism/low agreeableness b. Karen takes this as another sign that they are scheming behind her back. 416 M Which of the following is LEAST germane to a Big Five description of the Odd/Eccentric cluster on Axis II? a. and is seen by others as cynical. B App p. 12. 417 M Diagnostically. A App p. b.39 Ans. d..40 Ans. John's symptoms are more responsive to antidepressant medication. odd/erratic. schizotypal The stereotypical social "hermit" who lives alone and is disinterested in others is MOST likely to be described as a. low agreeableness. b.42 Ans. low extraversion. schizoid c. d. D Con p. antisocial c. odd/eccentric cluster c. 416-7 M * 12. social anxiety. He has never really cared about settling down somewhere and developing friendships. 418 M 288 . A Con p. B App p. avoidant b. less than 1 percent prevalence b. b. schizotypal. and Domingo has a schizoid personality disorder. pervasive emotional indifference d. Each of the following characterizes both men EXCEPT a. paranoid d. John is eccentric but does not exhibit ideas of reference or oddities of speech. high neuroticism In what way is John who has schizotypal personality disorder MOST dissimilar to Eric who has schizophrenia? a. delusional Which of the following descriptors does not belong with the other three? a. 417 M 12. which of the following disorders does not belong with the other three? a. d. B App p. he also was mostly indifferent when his "girlfriend" of six weeks left him for another man. schizoid d. John's symptoms are not associated with social anxiety while Eric is more likely to exhibit such anxiety. social isolation. c.41 Ans. C App p. borderline. c. What personality disorder might be present? a. John's symptoms do not reflect a formal thought disorder. c. avoidant b. schizoid. Bill finds that his job as a long-distance truck driver suits his strong desire for solitude.43 Ans. 416 E 12. 418 M 12.38 Ans. Esteban has a schizotypal personality disorder. while Eric's symptoms respond better to neuroleptics. part of the schizophrenia spectrum b. Henry told the police. its very rare occurrence d. schizoid d.12. What would you call Suresh's belief? a. she exhibits no signs of real psychosis. schizophrenia c. a delusion d. If he does not have a formal thought disorder. a superstition Which of the following disorders has the LEAST overlap with schizotypal PD in regard to symptomatology? a. B Fac p. What disorder is most likely? a. obsessive-compulsive c. schizotypal Henry is often seen sitting motionless in front of downtown stores. Nishimoto is assessing a new client. 418 M Which of the following descriptors does not belong with the other three? a. Nishimoto have difficulty making a reliable diagnostic decision? a. that he was communing with the flow of energy generated by all the business deals transpiring in me buildings around him. She minks that the client may have a schizotypal personality disorder. histrionic b. C Con p. borderline Dr. relatively rare Axis II disorder d. self-consciousness and social apprehension Wilma relies on astrology charts and tarot card readings to make important decisions in her life. A App p.45 Ans. A App p. 418 M 12. circumstantial speech and strange mannerisms c. C App p. difficulty distinguishing it from Axis I schizophrenia c.49 Ans. although the people around him are actually oblivious to his presence.47 Ans. schizotypal d. While her speech is somewhat odd and she seems ill at ease in social situations. schizoid b.44 Ans. borderline Suresh believes that people are closely watching his actions as he walks through the mall. avoidant b. 418 M . 418 M 12. She is also very superstitious and engages in eccentric rituals whenever she leaves her home. For what reason might Dr. D App p. what disorder is MOST likely? a. 418 M 12. paranoid c.46 Ans. a loose association c.48 Ans. an idea of reference b. chanting a repetitive phrase. when they were called in. overlap of symptoms with other Axis II disorders b. borderline d. 418 M 12. all of the above 289 12. b. more prevalent in males c. a. neurotic/erratic Barbara is often noticed for her flair for clothing. A App p.12. B Con p. He could exhibit any of the following scores on the Big Five dimensions EXCEPT a. 419 M * 290 . antisocial b. schizotypal personality disorder d.54 Ans. eccentric d. fearful b. what diagnosis would be appropriate? a. dependent personality disorder Which of the following descriptions does not belong with the other three? a. B App p. high extraversion d. dramatic/emotional c. though. borderline personality disorder c. 418 M 12. excessive demands for reassurance and praise Vladimir has a disorder that falls under the dramatic/emotional/erratic cluster.52 Ans. D Con p. She really pouts when she isn't the center of attention in the office. dependent Yojiro has a personality disorder. She appears to be self-assured and independent. c. I'm tired of telling her how great her ideas are." What disorder is being described? a. Now. high scores on neuroticism. 12. reactive personality disorder c. high scores on agreeableness. and her charming and extraverted personality. inflexible. high scores on extroversion. A App p. actively dependent b. narcissistic personality disorder b. d.55 Ans. 418-9 M Diagnostically. If these characteristics represent an enduring. If his is one of the disorders most intensively studied by researchers. her engaging conversations (later perceived by the listener as empty of content). borderline personality disorder Said a supervisor of an employee: "Tanya really made a terrific first impression on me with her wit and self-confidence. histrionic d.51 Ans. 418 E 12. which of the following disorders does not belong with the other three? a. narcissistic c. it would fall under the cluster. 418-9 M * 12. and dysfunctional pattern. histrionic personality disorder d. histrionic personality disorder b. low scores on conscientiousness. 419 M 12. C App p.53 Ans.50 Ans. narcissistic c. 419 M 12.59 Ans. dependent Jenny has an antisocial personality disorder. Which of the following conclusions is MOST clearly supported by research? a. McQueen felt that he was above the law and entitled to special privileges because of his star status. almost five times as frequently. C App p. d.58 Ans. From a 1970s screen actor's biography: While Steve McQueen publicly denounced drugs.60 Ans. b. c. histrionic d. dependent c.56 Ans. She is assessed by a female clinician who may be biased to make this mistake. C App p. 419 E 291 . 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. 419 M 12. histrionic b. What disorder is possible? a." c. narcissistic d. 419 p.57 Ans. Dependent personality disorder occurs much more often. She is assessed by a male clinician who may be biased to make this mistake. paranoid b. B Con p. b. 418-9 M If you walked into a room that just happened to be populated with persons diagnosed with some kind of personality disorder. in women than it does in men. borderline c. The substantial symptom overlap between these two disorders leads to unreliable diagnoses. Both a and b are applicable. dependent d. which of the following would you be MOST likely to recognize nonverbally as you scan the room? a. schizotypal 12. B App p. D App p. he was a cocaine addict for several years. borderline One woman summarily fired her primary care physician for his observation that she had "large pores" in her facial skin. d.12. A woman who shows the characteristics of antisocial personality disorder is more likely to receive the label "histrionic personality disorder. 419 M 12. What disorder may have been present? a. The woman was enraged that the physician could be so callously critical and insensitive. For what reason might she be misdiagnosed as histrionic? a. borderline b. Antisocial women are better actors and manipulators of social settings than are antisocial men. Clinicians are less likely to diagnose a woman with histrionic personality disorder when she meets the criteria for antisocial personality disorder. and his behavior is often very impulsive. schizotypal and borderline Nancy acts superior and condescending towards others. wealth. 420 E 12. which personality disorder listed below is she LEAST likely to have? a. 420 M 12. Without knowing any more details about her. paranoid c. A Con p.63 Ans. borderline d. 420 M * Which of the following descriptions does not belong with the other three? a.66 Ans. Jamie will swing rapidly from one emotional extreme to another. 420-1 C 12. borderline b. D App p. borderline and antisocial c. histrionic c.65 Ans. antisocial and schizotypal d.61 Ans. borderline 12.64 Ans. schizoid c. fantasies of success. other times. intense reactivity to criticism d. What disorder is MOST likely? a. antisocial b. hyperbolic. histrionic b. She complains of a vague sense of emptiness and sometimes drinks excessively to quell those feelings. 420-1 M 292 . narcissistic d. schizotypal Which two personality disorders are considered the most dangerous and are currently the most studied? a. Sometimes she idolizes him and insists she cannot live without him. schizoid d. paranoid and histrionic b. Which disorder does Jamie appear to exhibit? a. empty speech b. histrionic d.62 Ans. possible increase in prevalence in the past decade Which of the cluster B disorders is LEAST common? a. dependent c. she is harshly critical of him and wants to end the relationship permanently. B Fac p.12. D Fac p. A App p. narcissistic b. 418-9 M 12. narcissistic Jamie's personality disorder is characterized by its unpredictability. C App p. antisocial Julie is having frequent crises in her relationship with her boyfriend. and power c. 67 Ans. D Fac p. antisocial c.72 Ans. borderline personality disorder A dismption in one's sense of identity is a defining feature of Axis I dissociative disorders. B App p. 421 E 293 .71 Ans.69 Ans.70 Ans. impulsive personality disorder d. A Con p. lack of a stable sense of identity d. a 26-year-old female c. B Con p.68 Ans. A Con p. a. a 40-year-old female What percentage of individuals with borderline personality disorder threaten to commit suicide at least once in their lifetimes? a. 25% c. 56% d. schizoid d. intense reactivity to perceived abandonment or rejection c. fears of abandonment What characteristic is shared among the symptoms for histrionic and borderline personality disorders? a. What disorder is MOST likely on Axis II? a. 421 M 12. histrionic personality disorder c. 75% 12. Mara. dependent Which of the following persons will exhibit the MOST severe symptoms of a borderline personality disorder? a. a 35-year-old male d. Ricardo.21 M 12.12. borderline b. self-mutilating behaviors c. brief psychotic symptoms during periods of intense stress d. a 25-year-old male b. 420-1 M 12. lack of guilt b. D App p. idealization of relationship partners Lorraine is a psychiatric patient who was hospitalized following a suicide attempt. An individual with personality disorder may report a similar experience under conditions of extreme stress. 421 M * 12. dependent personality disorder b. Adam. 8% b. 419. Maureen. self-mutilation b. 421 M Which of the following descriptions does not belong with the other three? a. b. 422 M 294 . the most common Axis II disorder you discover will be a. obsessive-compulsive Jase is a postdoctoral student working with Robert Hare.73 Ans. What disorder was the most likely topic of Neil's doctoral dissertation research? a.12. and successful. d. 421 M You are a psychology intern working on an inpatient ward at a large psychiatric hospital. largely due to his insincerity.76 Ans. 422 M 12. social maladroitness Neil was a graduate student of Dr. paranoid b. borderline personality disorder. the Big Five personality factors Gerhard is charming. antisocial personality disorder c. psychopathy d. D Fac p. theMMPI d. Which of the following terms does NOT reflect an earlier description of what the DSM calls "antisocial personality disorder"? a. dependent personality disorder. c. A Con p. histrionic personality disorder.74 Ans. psychopathic personality b. above average in intelligence. sociopathy b. moral insanity c. sociopath d. the Hare APD Inventory c. borderline personality disorder d.77 Ans. C Con p. C App p. 422 C 12. What DSM-IV Axis II disorder is most likely for Gerhard? a. narcissistic Which personality disorder is MOST likely to be associated with above-average success in occupational functioning in a person with the disorder? a. Cleckley's in the mid 1970s. and repetitive lying.75 Ans. antisocial d. schizotypal personality disorder. the Psychopathy Checklist 12. B App p. D App p. 421 E 12. the polygraph b. What assessment instrument is Jase most likely to be using with his personality disordered research participants? a. He is also uninterested in others' feelings and has no genuine interpersonal relationships. narcissistic c. antisocial c. 422 M 12. When you review the patients' hospital charts. manipulation of others.78 Ans. schizoid b. Kent. the person must currently be at least years old. 15. 18 Jerome was diagnosed with a personality disorder when he turned 18. This feature is a. impulsivity-manipulation. a 35-year-old European American male b. Althea. a 23-year-old African American male 295 . anxious-avoidant disorder Which of the following persons is MOST likely to be diagnosed with antisocial personality disorder? a. Shaneal. b. a 21-year-old Asian American female c.Sasha has a central feature of psychopathy emphasized by Cleckley and Hare but less important to the DSM-IV diagnosis. emotional-cognitive instability. 18. d. For a diagnosis of antisocial personality disorder to be made. b. posttraumatic stress disorder b. they are the same thing and can be used as interchangeable diagnostic terms. a 16-year-old Hispanic male d. The definition of psychopathy includes behavioral deviance as well as insidious personality traits and interpersonal manipulation. d. 21. He was diagnosed with a similar disorder when he was a child. What disorder was this? a. What is the difference between psychopathy and antisocial personality disorder as defined in the DSM-IV? a. 14 b. antisocial PD is primarily defined by the former. None of the above is correct. Carlos. None. behavioral deviance. and symptoms of the disorder must have been present by age . c. conduct disorder d. a. Psychopathic individuals are typically homicidal. 18. c. attention deficit hyperactivity disorder c. whereas those with antisocial personality disorder violate the rights of others but are less dangerous overall. 15 c. 12 d. overt criminal behavior. now 25 years old? a.86 Ans. dependent d. d. Based on available data. impulsive and unable to tolerate boredom. avoidant d. according to Loeber? M a. which of the following disorders does not belong with the other three? a. On which of the following characteristics will these two individuals be MOST different? a. Type I psychopathy b. c. dependent c. B found that he fits in with the school "bad boys" and has begun associating with App these deviant peers. 423 at greatest risk. low extraversion. with no significant disturbance prior to that age.D. borderline 12.88 Ans. impairment in social skills b. 12. B App p. D Con p.23 M 12. He recently Ans. What DSM-IV diagnosis is MOST applicable for Koa. none of the above Timo is socially inhibited. preference for solitary occupations d. b. histrionic Erika has a schizoid P. These characteristics began when Koa was 16. antisocial personality disorder c. and often lacking empathy as well as remorse for his own actions.87 Ans. 422-3 C Koa is described by others as possessing superficial charm and an exaggerated sense of self worth. D App p.84 Adam is doing very poorly in high school and has few friends. high neuroticism. A App p. antisocial c.D. high conscientiousness. interest in social acceptance c. and preoccupied with maintaining a sense of control. obsessive-compulsive b.12. borderline sociopath d. 423 E 12.. schizoid b. perfectionistic.85 Ans. you would reliably predict the following Big Five factor scores for Timo EXCEPT a. 424 C 296 . For which of the following personality disorders is Adam p. low agreeableness. 417. none of the above Diagnostically. and Suzette has an avoidant P. dependent E b. Which of the following descriptions. 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.90 Ans.92 Ans. B App p. as described by object relations theorists Willina is the head of a large software firm. schizoid c. 424. dependent d. as described by the Big Five model d. C App p." What personality disorder does she likely have? a. paranoid 12. as described by Nigg & Goldsmith c. obsessive-compulsive b. C App p. 423-4 E Nancy constantly feels inadequate and inept. What type of personality disorder does he exhibit? p. A seems unable to make decisions on his own and clings to others who make his App decisions for him. histrionic c. Which disorder would this be? a.12. He Ans. high agreeableness.89 Ans. She avoids occupations and situations that require social interaction. antisocial 297 . dependent c. as described by Leary b. would be LEAST applicable to her? a.93 Ans. avoidant d. What type of personality disorder does she have? a. obsessive-compulsive d. rigid expectations of others. 424 a.27 C 12. inherited anxiety vulnerability. paranoid b. D App p. histrionic d. 425 E Tywanna has a dependent personality disorder. extreme submissiveness. especially in social situations. avoidant A therapist is working with a male client who has a Cluster C personality disorder that occurs relatively infrequently. 424 M * 12.91 Drew seeks constant reassurance and advice on matters large and small. paranoid b. avoidant c. drawn from theoretical models. narcissistic 12. Willina's employees call her a "beancounter" or as "anal-retentive. In social encounters she is very inhibited and afraid of making a mistake that she fears will bring rejection. which Linden voices frequently.94 Ans. somewhat above average d. 426 M 298 . d. Which Axis II disorder is MOST likely for Linden? a. this disorder lacks obsessive thoughts and compulsive rituals. D App p.12. average c. Dr. 425 M * 12. C Fac p.96 Ans. Sharmilla and Priti.97 Ans.95 Ans. B App p. Molly and Theodore. What kind of productivity would you expect from Nathan if he has symptoms of a personality disorder? a. either b or c 12. 425 M 12. openness and agreeableness d. domineering d. 426 E 12. well above average to exceptional Linden's home is cluttered with many worthless items that he refuses to throw away. neuroticism and conscientiousness c. schizotypal What is the primary difference between obsessive-compulsive personality disorder and obsessive-compulsive disorder? a. He takes full responsibility for his work and will not permit co-workers to offer input. extroversion and neuroticism Which of the following twin pairs will demonstrate HIGHEST concordance in personality traits? a. otherwise the symptoms are essentially identical. If he had measured the Big Five characteristics in these children. checking and re-checking every detail of every report he is asked to prepare. D Con p. identical twins reared apart d. obsessive-compulsive c. which two would remain most stable in adulthood? a. b. The Axis I disorder is less responsive to drug treatment and does not appear to be affected by genetic factors. paranoid b. A App p. None of the above is correct.98 Ans. The Axis II disorder is less severe but more chronic than the Axis I disorder. 425 M Nathan is extremely committed to his work. fraternal twins reared together b. identical twins reared together c. very poor to mediocre b. Linden's wife says little to him about her displeasure because she knows that this would provoke increased criticism of her own imperfect actions. extroversion and agreeableness b. Although the Axis II disorder is a chronic lifestyle governed by rigid habits. lest they be less conscientious in their efforts. Domingo and Geraldo. Lewis Terman studied gifted children in a longitudinal study that lasted for several decades. c. 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. rigid. schizotypal c. 50% c. genetic. genetics c. you should emphasize factors and spend the least time studying factors. 33% b. 64% d. evolutionary c. object relations b. shared environment For which of the following personality disorders does current research demonstrate the WEAKEST genetic contribution? a. histrionic : phallic stage Which of the following terms does not belong with the other three? a. shared environment. They were separated at birth and raised by different families. Neither twin has met nor even heard of the other twin. psychodynamic d. borderline b. Taka and Umeko will share % of their personality traits.Taka and Umeko are identical twins. On average. genetic. fixation c. non-shared environment. non-shared environment b. antisocial : latency b. a. antisocial Which personality disorder and psychosexual stage are mismatched? a. shared environment d. object relations theory d. dependent: oral stage d. a. obsessive-compulsive d. a. 80% If you wished to account for the differences in personality characteristics among a group of college students. obsessive-compulsive : anal stage c. extreme interpersonal expectations b. interpersonal learning 299 . minimization of pain and maximization of pleasure d. minimization of pain c.108 Ans. you would be emphasizing a(n) approach to understanding personality disorders. passive accommodation d.109 Ans.107 Ans. evolutionary Which of the following concepts does not belong with the other three? a. D App Imelda's p. She keeps to herself most of the time.110 Ans. minimization of pain Which of the following descriptions from Millon's theory would NOT be an appropriate description of paranoid personality disorder? a. 428 M Imelda depends on her spouse to help her make decisions about what to wear each day. which of the following descriptors does NOT characterize their relationship? a. maximization of pleasure b. passive accommodation 12. believing that most of her coworkers are out to cause her trouble. passive accommodation or active modification b. A Con p. 428 C 12. If husband is highly dominant. C Con p. and which friends to have.12. 428 E 12. correspondent isolation d. 428 M 12. advancing the self and/or caring for others Which of the following descriptions from Millon's theory would NOT be an appropriate description of histrionic personality disorder? a. advancing the self c. maximization of pleasure b. reciprocal b. B Con p. advancing the self d. correspondent Liza is chronically suspicious and tense. interpersonal learning c. complementary hostility c. complementary c. assimilation of stimuli and blocking of punishment c. A App p. what food to buy for the family. psychodynamic b. reciprocal dominance As a graduate student of Theodore Millon. genetic d. 428 C 300 .105 Ans. according to Leary? a. D App p. reinforcing d. 428 M 12. reciprocal hostility b.106 Ans. Which of the following is LEAST likely on the part of her coworkers. a. a.12. b. organic brain dysfunction c. D App p. d. 429 E * 12. early childhood physical or sexual abuse d. Judy has trouble trusting adults and is extremely sensitive to signs of rejection and abandonment. B Con p. She has an insecure attachment with her parents. antisocial d. generalized anxiety disorder Judy is two years old. infant-caretaker conflicts over independence and dependence c. dependent b. minimization of pain/maximization of pleasure b. and her increasing independence is sometimes fostered by her parents and sometimes capriciously punished. hyperactivity.112 Ans. 429 M 12. advancing the self/caring for others Margaret is being treated for borderline personality disorder.116 Ans. major depression b. a genetic vulnerability b.111 Ans. borderline c. A App p. chronic CNS overarousal. 428 M * 12. Which fundamental polarity is deficient? a. physical clumsiness. dissociative identity disorder d. C Fac p. Abdul probably exhibited each of the following characteristics EXCEPT a. assimilation of stimuli / blocking of punishment d. c. 430 E Which of the theorized causes of borderline personality disorder has received the greatest empirical support? a. passive accommodation I active modification c. histrionic 12. 429 E 12. B App p. none of the above If Palani has borderline personality disorder. difficulty regulating emotions. 429 M One of the symptoms of borderline personality disorder is an inability to develop and maintain an adaptive approach in coping with interpersonal demands. early childhood neglect and insecure attachment Abdul has been diagnosed with antisocial personality disorder. attention deficit/hyperactivity disorder in childhood d. 301 . D App p.113 Ans. In his early childhood.114 Ans. neurological dysfunction b.115 Ans. Current research indicates that is probably a contributor to her disorder. social phobia c. What adult personality disorder is MOST likely to develop? a. which of the following Axis I disorders is most likely to be a comorbid condition? a. 120 Ans. A Con p. d. 430 M 12. you would be studying personality disorder. poor self-control skills. activity that is similar to that seen in epilepsy. d. neuroticism c. B App p. 430-1 E 12. linkage analysis studies.12. 430 M 12. a. conscientiousness d. 431 E 302 . b. immature cortex c. b. b. If Enrique has an "immature cortex. agreeableness 12. CNS underarousal d. a defect in left hemisphere functioning. and Loeber. d. schizoid d.121 Ans. a psychopathic adult female. adoption studies. abnormally rapid evoked potentials. If you were reviewing the work of Hare. both a and b. c. 430 M 12. borderline c. difficult temperament According to Costa. antisocial b. c. extremely low anxiety level. oversensitivity to social rejection b. His CNS underarousal is implicated as the cause of each of the following EXCEPT a. exhibits EEG activity that is typical of that found in children. c. low levels of high frequency beta waves.122 Ans. extroversion b. D Fac p.123 Ans. which of the Big Five dimensions is MOST amenable to treatment? a. Quay.118 Ans. twin studies. b.119 Ans.117 Ans. alpha wave activity. paranoid Which of the following characteristics does not belong with the other three? a. high levels of low frequency theta waves. thrill-seeking." he would exhibit each of the following characteristics EXCEPT a. 430 M * Evidence for genetic factors in antisocial personality disorder comes from a. hypersensitivity to aversive stimuli. her EEG reveals abnormal a. d. c. activity in the left hemisphere. 430 E 12. B Fac p. theta wave activity. Jonah has the classic symptoms of psychopathy. If Betina. A Con p. C App p. B App p. even though he knows his father will punish him. central and autonomic nervous system underarousal c. b. biological model b.128 Ans. C Fac p. slower conditioning of anxiety If Richard has antisocial personality disorder. his wife's threat to leave him if he doesn't change his ways b. a criminal record for Richard's father Which model appears to best explain the development of antisocial behavior? a.12. which of the following characteristics is LEAST likely to be true of Richard's family? a. 432 M 12. 432 E Which personality dimension is most likely to be altered by a student's experiences in school? a. D App p. conscientiousness d. histrionic c. electric shock d. reduced sensitivity to rewards b.125 Ans. 430. borderline d. 432 M 12. openness c. 431 E 12. Michael's absence of a "conscience" is due to a. sociocultural/family model c. c.127 Ans. Which of the choices below is NOT one of the empirically supported contributors to antisocial personality disorder? a. d.129 Ans. diathesis-stress model d.126 Ans. erratic discipline and poor supervision of Richard's activities b. a. is most similar to an adult with a(n) personality disorder. 432 M * 12. C Con p. A App p. a biologically-based deficit in classical conditioning of fear responses.130 Ans. marital discord and separation d. extraversion b. A Fac p. he would be MOST responsive to which of the following aversive consequences? a. C App p. childrearing practices d. upper-middle class SES c. narcissistic Michael is a charming.2 E 12. antisocial b. an angry tirade by his boss c. disinhibition of behavioral impulsitivity due to abnormally low CNS activity.124 Ans. 433 E . According to Eysenck. early parental loss and later exposure to deviant peers. neuroticism If Rocco is antisocial. a stiff monetary fine A child who cannot inhibit his desire to grab a toy from a store shelf. B App p. learning model 303 12. pathological liar who uses other people for his own ends. inconsistent parental discipline and parental criminality. dialectical behavior therapy c. unmet admiration and protection needs d. reaction formation 12. 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. D App p. 435 M 12. Soo is treating a client with therapy techniques pioneered by Heinz Kohut. expressive psychotherapy b. A Con p.133 Ans. projection. splitting b. countertransference c. dependent personality disorder c. drug treatment d." a process called . C App p. What disorder is MOST likely? a. transference. narcissistic Which of the following terms does not belong with the other three? a. a. histrionic c. narcissistic personality Adrienne has a personality disorder for which she is receiving systematic desensitization and training in social skills. antisocial d. systematic desensitization Lillian is reacting to her therapist in many of the same ways she used to respond to her mother. borderline personality disorder d. B App p. What disorder does Dr. borderline b. dichotomizing d.131 Ans. 435 M 12. histrionic d. Soo's client probably have? a. 435 M 12. What disorder is most likely? a.12. 435 M 304 . avoidant c. a process known as . D Fac p. splitting. self psychology c. hoping to become a full-time therapist. histrionic personality disorder b. Lillian sometimes sees her therapist as "all good" or "all bad. which also characterized her earlier perceptions of her mother. A App p. schizotypal Susan is a graduate student in clinical psychology. transference. 435 M 12.132 Ans.134 Ans.135 Ans. splitting b. 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. borderline b. 435 E * Dr.136 Ans. avoidant personality disorder Which of the following treatments is not typically employed with individuals with borderline personality disorder? a. 436 E 12.140 Ans. what causes the development of the unstable sense of self that is a central feature of borderline personality disorder? a. 50 305 .137 Ans. Kemberg c. How would Linehan describe Julie's family situation? a. a dysfunctional family system d. increased involvement in school & impulse control training b. improving academic achievement in school children c. reduction in parental substance abuse & increased involvement in school c. genetic screening and counseling d. 436 E 12. 40 12. an invalidating environment c. A Fac p. an emotionally unstable temperament c. social skills training & parental training in effective childrearing Accordmg to Linehan.142 Ans. 435-6 M 12.141 Ans.and postnatal health care b. DBT b.12. splitting d. 28 b.138 Ans. diathesis-stress model d. difficulty regulating intense emotions b. B App p. If he is representative of most persons with this disorder. dialectical environments When Julie told her parents that her uncle had sexually abused her. a dialectic stress situation Zahur is an antisocial male. invalidating environments Which of the following approaches is currently LEAST important in the prevention of antisocial personality disorder? a. C Fac p. impulse control training & parental training in effective childrearing d. an example of psychological splitting b. B Con p. This kind of response was relatively common in Julie's life. programs for treating children's impulse control problems Which two prevention goals were addressed in the Montreal LongitudinalExperimental Study? a. 438 E * d. pre. D Fac p.139 Ans. 35 c. one could expect that Zahur's overt criminal behavior will begin to decrease at age a. 436 E 12. C App p. 436 M Which of the following terms does not belong with the other three? a. her parents essentially ignored her distress and trivialized the importance of her experiences. Kenneth. antipsychotic medication or electroconvulsive therapy d.12. around age 32. This bumout is found for criminal behavior but not for the psychopathic personality characteristics emphasized by Cleckley and hare. He will not find any treatment that is effective. 2) One of the disorders could have occurred earlier in time (possibly the personality disorder. 12. 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. Hare et al. What treatment approach will he choose? a. Moreover. 439 E SHORT ANSWER I ESSAY 12. with borderline personality disorder c. expressive psychotherapy or other object-relations therapy c. Vince. Studies of clinician's assessment practices indicate that this bumout is actually a function of diagnostic bias toward older clients. 1) Both disorders coexist separately but the hyperarousal of the Axis I disorder. c. d. For which client is the prognosis for effective treatment MOST guarded? a. 439 E 12. His therapist believes that Jasui also exhibits a schizotypal personality disorder. Braverman is reviewing the latest information available regarding the most effective treatment for his antisocial clients. 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. A App p. 306 . predisposing Aimee to developing the second disorder. with obsessive-compulsive personality disorder Dr.146 Jasui is a client who is being treated for depression.'s cross-sectional work suggested that burnout occurred at age 40. The apparent decrease in criminal activity is found only for older cohorts and is not found in the longitudinal studies. with avoidant personality disorder d.143 Ans. normal part of his day-to-day functioning. given its developmental origins). D Con p. 438 M According to the cross-sectional and longitudinal research conducted on antisocial "burnout. with antisocial personality disorder b. 12. The traits associated with the personality disorder may be seen by Jasui as a natural.'s longitudinal studies indicated that bumout occurs early. Gina. Describe four ways in which this comorbidity can be understood. dialectic behavior therapy b. for instance. Although Regier et al. Otis.144 Ans. b. could aggravate the interpersonal discomfort of the Axis II disorder.147 Aimee has an Axis I diagnosis of generalized anxiety disorder and an Axis II diagnosis of avoidant personality disorder." which of the following statements is BEST supported? a.145 Ans. D App p. antisocial 12. narcissistic. On the other hand.[12. this could be described as an "active dependency. She would minimize pain by avoiding attention to her underlying feelings of insecurity and dependence on others' approval. Minimization of pain / maximization of pleasure: Sabrina is probably high on both of these. with one representing a milder version of an underlying continuum of disturbance. possibly antisocial or borderline.147 cont'd] 3) This could be an artifact of the symptom criteria for each disorder. avoidant. schizoid. antisocial. borderline. is diagnosed twice under different headings. praise. Passive accommodation / active modification: Sabrina will typically use active modification in her approach to dealing with the environment. Neuroticism: high = paranoid. Because of the underlying need for approval and acceptance. 12. histrionic. in essence. dependent. schizoid. obsessive-compulsive Openness: high = not really applicable to any disorder. She actively seeks out attention. 307 . borderline. obsessive-compulsive. schizotypal. and particularly so on maximization of pleasure." Advancing the self/ caring for others: Sabrina would be superficially seen as caring for others. there could be one underlying disorder that. but her real motivation in regard to this polarity is advancing herself and her own needs. low = (not specified in text) possibly paranoid.149 For which three personality disorders does research most reliably document a genetic contribution? Schizotypal. avoidant. obsessive-compulsive 12. 4) Perhaps these are two separate disorders that are different not so much in kind (categorically) but in degree (dimensionally). schizotypal. although schizoid might come closest Extroversion: high = histrionic.148 List the Big Five factors and indicate one personality disorder that represents the two extremes of each dimension. low = borderline. antisocial. low = not really applicable. and approval and also will avoid being around others who have become tired of her flamboyance and who no longer are charmed by her. obsessive-compulsive (most descriptive) Agreeableness: high = dependent. schizotypal.150 List Millon's three polarities and describe how you would characterize histrionic Sabrina according to each polarity. low = paranoid. obsessive-compulsive Conscientiousness: high = obsessive-compulsive (although ambition is not matched with actual productivity). however. low = schizoid. she may go so far as to develop physical complaints (pseudo-painful symptoms) to keep others' attention. lack of educational and health resources can cause feelings of alienation or hostility toward traditional social expectations Exposure to deviant peers ..154 To which personality disorder would you assign the worst treatment prognosis? For which disorders have specialized treatments been developed with some success? Worst -. 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.12. punished. possibly.serves as a source of role modeling. also reinforces criminal behavior 12. Adults with this disorder also tended to be hyperactive.psychological damage due to trauma Low SES . erratic discipline. physically clumsy. 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").avoidant and borderline and. leading to repeated criminal acts and deceitfulness. related to divorce) .antisocial. integrated self-concept. narcissistic 308 .another role modeling source. This lack of sufficient cortical arousal may be the factor that leads to thrill seeking and aggressiveness. and adopted children whose biological parents were criminals are more likely to exhibit antisocial conduct. impulsive behaviors that supports an increased tolerance for negative behaviors. some success -. difficulties in responding to aversive environmental contingencies for behavior (especially social/interpersonal cues). Concordance rates are higher for MZ than DZ twins. resulting in the disorder. 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. physical abuse. these factors may account for the lack of remorse or guilt following exploitative mistreatment of others.152 Describe the specific family variables that are consistently associated with antisocial behavior in offspring.153 Describe Linehan's diathesis-stress model of borderline personality disorder and some of the basic components of her system of therapy. also disrupts family functioning Chronic parental uninvolvement. Her dialectical behavior therapy involves a reduction in high-risk.g. Parental criminality . and an unusually low anxiety level. and impulsive as children. Diathesis = emotionally unstable temperament (biological contribution) Stress = invalidating environments in which almost all of the child's emotions are strongly controlled. and poor supervision each fails to provide clear guidance regarding social mles. 12. Taken together. ignored. and clients are consistently helped to see that events can be viewed from multiple perspectives which decreases splitting and encourages a more stable. then confrontation of traumatic experiences begins. abuse also role models violence as a solution to interpersonal conflict Early parental loss involved emotional conflict (e. Low autonomic nervous system activity may also intensify this need for stimulating activities and interfere with the learning of behavioral inhibition. b. b. He has impaired judgment. generalized anxiety disorder As a substance abuse counselor in the mid 1980s. substance intoxication b. On what basis would the counselor diagnose the presence of abuse? a. physiological dependence c. 33 Sandy has a mental disorder. c. alcohol. and behavior. bipolar disorder c. Mr. schizophrenia d. It causes impairment in work or family life or causes personal distress. psychoactive delirium d. substance abuse b. the presence of physiological versus psychological dependence b. d. Its use leads to intoxication and abuse. c. a. which condition must be met? a. both b and c 309 .Chapter 13 SUBSTANCE-RELATED DISORDERS For drug X to be labeled as a "psychoactive" drug. What disorder does she have? a. Kaplan probably saw a decline in the use of each of the following drugs EXCEPT a. the presence of personal impairment as a result of dmg use c. altered thinking. and shows impaired motor coordination. 15 c. It is an illegal substance or a misused prescription substance. It affects the user's thinking. Disorders such as hers are associated with the highest level of social and personal dismption. cocaine d. What is the name for his condition? a. has significantly changed his mood. emotions. the presence of polysubstance use d. marijuana. 10 b. inebriation A counselor is questioning a new client about her psychoactive substance use. 24 d. Epidemiological data indicate that about percent of Americans aged 15 to 54 have used at least one illegal dmg in the past year. none of the above Martin has ingested a psychoactive substance. After two days of not drinking he was so sick with a headache and nausea that he swore he had a horrible flu. psychological dependence d. 445 M * 13. d. Most people are not aware of his use of marijuana. Which of the following persons would be described as having a psychological dependence on a substance? a. punishment c. but JoAnn is trying to obtain the prescription from different physicians and has missed several days of work because of these multiple appointments. The doctor says she no longer needs the pain pills. JoAnn had been off work for two months due to a back injury. That is.9 Ans. craving c.10 Ans. 445 M Why might a person who smokes marijuana on a daily basis NOT be considered a drug abuser? a. and he insists he could "quit anytime I want to. positive reinforcement b. 445 C . The individual uses only marijuana and has not developed a polysubstance abuse partem. drinks alcohol in the morning in order to avoid the unpleasant symptoms of withdrawal. d. C App p. c.13. What most likely accounts for the increased expense? a. C App p. substance intoxication b. what operant consequence occurs for her behavior? a. D App p." What characteristic is the dealer counting on? a. c. The person does not suffer from withdrawal symptoms when abstaining from the drug. tolerance d. an alcoholic. D App p. Joe worried he might be an alcoholic and decided to stop drinking. 445 E 13. After a couple of months. physiological dependence b. b. Mike is a truck driver. He began taking uppers as a way to drive further on long days. A drug dealer knows that some drugs will be more profitable than others. intoxication dose-response curve Keith has been mainlining for a month. discrimination d.7 Ans. The individual is not experiencing nor causing harmful consequences as a result of the illegal use. negative reinforcement 310 13.11 Ans. resistance If Adriana. Paul smokes a joint most days before going to work. craving c. He has begun stealing money from relatives to pay for his habit that is getting more and more expensive. some drugs will force his buyers to spend larger and larger sums of money for the same "kicks. Since the individual smokes marijuana everyday. 445-6 C 13.8 Ans. A App p. tolerance develops and signs of impairment are minimized." b. 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. substance-induced disorder and substance abuse b. diagnosed as a substance abuser but has a persistent desire to control her substance use. Any of the above could signify dependence. substance-induced disorder b. which of the following terms does not belong with the other three? a. B App p. abuse A college student is feeing expulsion from school after his third arrest for public drunkenness and an obvious downward spiral in his grades. Hakan needs markedly increased amounts of the substance to achieve its desired effects. A Con p. free of signs of dependence for at least 1 month but for less than 1 year. repeatedly using the drug while on his job as a forklift operator c. C App p. and he repeatedly uses the substance despite its exacerbation of his hypertension. 13.14 Ans. increased drug intake to avoid withdrawal symptoms d. physical assault toward a family member during intoxication Hakan uses a psychoactive substance.17 Ans. substance-induced disorder b. substance use disorder c. What adverse consequence would NOT be present as part of bis disorder? a. dependence d. Martina has received a substance-related diagnosis of early full remission. A App p. b. opioid intoxication and substance-induced disorder d. 445-6 M 13. 445 M 13. 446 M 311 . D App p.16 Ans. abusing psychoactive substance but is currently in a treatment program. c. What DSM-IV diagnosis(es) is/are warranted? a. 445 M Diagnostically. a record of arrests for illegal possession b. substance use disorder c. substance abuse and substance dependence Hector has a crystal meth substance abuse disorder.15 Ans. 446 M * 13. This means she has been a. d. substance dependent for over a year but received treatment and has been drug-free for at least 3 months. intoxication disorder d.13 Ans. Which description below would indicate that Hakan has developed substance dependence? a. and he is unsuccessful in his efforts to cut down on use. c.12 Ans. alcohol-related disorder A 20-year-old male has been admitted to the hospital for acute opioid intoxication. C App p. giving up important social and recreational activities.13. d. b. Hakan spends a great deal of time trying to obtain the substance. Hakan fails to fulfill major obligations at work. substance dependence c. 445 M 13. 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 is appropriate? a. In order for Mira's disorder to be diagnosed with a form of substance dependence.19 Ans.20 Ans. 4. tolerance b. Georgia b. 447 E 13. Heavy drinking. Social acceptance of heavy alcohol use is diminishing. Francis. B App p. either a orb d. has declined. 447 E Mira abuses PCP. C App p. 3. 33 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. 62 d. alcohol c. 65 c. Bess. One third of Americans are moderate to heavy drinkers. 312 . D Fac p. such as methamphetamine d. such as cocaine If the average life expectancy for a male is about 72 years.21 Ans. 2. approximately what will his yearly intake be? a. Young adults report a small but steady decline in alcohol consumption. 447 E 13.24 Ans. Pennsylvania c. 15 b.1 gallons d. 57 If Leonard is an average drinker. B App p. Rick. what life expectancy would you predict for Leo. D App p. Bryan. c.9 gallons Based on epidemiological data. 1 c. defined as more than 14 drinks/week. What substance does he use? a. 447 E 13. some kind of stimulant. d. withdrawal c. Nebraska Roughly what percentage of the American population is abstinent? a. marijuana b. a male from Omaha. 447 M 13. neither a nor b Earl abuses a substance that contributes to half of the fatal traffic accidents that occur each year. A App p. Washington d. a male from Philadelphia.13.5 gallons b.18 Ans. 70 b. 4. a male from Seattle. a female from Atlanta. what characteristic(s) must be present? a. 447 E 13. b.22 Ans. 446 C 13. 28 d.2 gallons c. an alcoholic male? a. some kind of opioid. A Con p. which of the following persons is MOST likely to drink alcohol? a.23 Ans. Both had four draft beers. b. c. increased d.Natalie has just had a dnnk. b. Both had two shots of 100-proof tequila. Bertrand. the liver c. a. increased b. but one has the beta-2 isoenzyme and thus showed a higher BAC level. c. Though she won't stop her heavy drinking. but one of the individuals has built up a physiological tolerance for alcohol. therefore showing a higher BAC level. the small intestine d. including vitamin metabolism. All other factors being equal. Both are stopped by police in different parts of town shortly after leaving.10 level. slower. one is . Both had three glasses of wine. Each person admits having had a couple of cocktails. Which organ will carry out ethanol oxidation? a. Alphonse's tolerance will result in metabolism of ethanol. when their BAC levels are tested. faster. the brain b. she probably lacks the beta-2 isoenzyme that slows the metabolism of ethanol. Two people enter a pub at exactly the same time and both leave two hours later.05 level was a woman. lessened Danette realizes that individuals with alcohol use disorders often suffer nutritional deficiencies. but one didn't feel like eating and had the higher . Alcohol dehydrogenase will build up in her stomach. Suzanne. and the other was a man. who had one draft beer d. she makes a commitment to take high quality vitamins and to eat well at least once a day.05 and the other is a . Michelle. d. who had two draft beers c. faster. Being female. What would account for these different levels? a. Why might her strategy fail? a. d.10. but the person with the . Her liver's ability to metabolize ethanol has been reduced and thus the efficiency with which substances enter the bloodstream is compromised. Ethanol and acetaldehyde build up in body cells and dismpt their functions. allowing better absorption of vitamins. who had one drink of 100-proof gin 313 . lessened c. slower. who had one drink of 100-proof vodka b. Both had two mixed drinks. Chester. interfering with absorption of nutrients into her bloodstream. which of the following persons would have the highest BAC level after one hour? a. however. his level of intoxication will be if he is eating food while drinking. the kidney Alphonse has an alcohol dependence disorder. 5 d. acetylcholine.36 Ans. acetylcholine b.33 Ans. a hallucinogen d. dopamine c. is also at significant risk but at a level of ounce per day. who drinks approximately two ounces of alcohol per day d. to reach a BAC of 0. 448 M 13. 2 c. heavy drinker. elevation of HDL cholesterol c. 448 M Using the text's definition of a drink. a depressant c. eight 4-oz glasses of wine Clarence is at significant risk for cirrhosis of the liver as a result of his consumption of ounces of ethanol per day. cerebellum b. Yvette. If he experiences sedation and a reduction of anxiety. a.25? a.2 to 0. Norris. Terrance. who drinks approximately three ounces of alcohol per day Geraldine is a chronic. C App p. frontal lobes d. Which physical outcome is LEAST likely? a. glutamate Rolando has ingested a depressant. which region of his brain was probably most strongly affected? a.34 Ans. 6. 448 M 13.31 Ans. C App p. 6. His wife. 447 M 13. an average-sized male. what sort of substance is affecting the brain? a. nucleus accumbens c. six mixed drinks d. This substance will reduce activity of while increasing activity of . 1. B Fac p. how many drinks would it take for Barry. B App p. four shots (ounces) of whiskey b. GABA. glutamate. who never drinks alcohol b. A App p. 448 E 13. who drinks approximately one ounce of alcohol per day c.30 Ans. a stimulant 13. Melba. GABA d. dopamine. B App p.32 Ans. menstrual irregularities Mildred is ingesting the most commonly abused psychoactive substance.5 Which of the following persons is at a slightly increased risk of cardiovascular disease? a. 448 E * 314 . Ricardo.13. 3. 448 M 13. 4. immunosuppression d. an opioid b. medial septal nucleus If glutamate activity is decreased and GABA activity is increased. 3. two six-packs of beer c.35 Ans. a. cirrhosis b. D App p. 6 b. her chance of being involved in a traffic accident is times higher than usual. dopamine b. 19 c. serotonin d. . it is likely that the drug the neurotransmitter(s) . nucleus accumbens b. GABA d. He has an unsteady gait.15 c. increased. exogenous opiates If laboratory rats reduce their consumption of alcohol following the injection of a drug. lateral geniculate nucleus c. dopamine b. What neurotransmitter was probably influential in that brain region? a. 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. thalamus d. dopamine c. decreased. is drowsy.A highway patrol officer is asking a driver to walk a straight line along the side of the road. . increased.20. cerebellum b. cingulate gyrus c. which of the following substances does not belong with the other three? a. and is having difficulty inhibiting his aggressive impulses. a. decreased. the may be the neurological basis for the positively reinforcing effects of that drug. glutamate Don has been drinking. 25 b. endorphins b.10 d. dopamine or serotonin c. acetylcholine d. 12 d. . a. GABA c. The officer may not know it. a. hypothalamus While the medial septal nucleus may account for the negatively reinforcing effects of alcohol. What is his probable BAC level? a. If her BAC is . 6 315 . .22 b. but she is assessing whether the driver's may be under the influence of alcohol. a. cerebellum d. GABA or glutamate In reference to the effects of ethanol.05 Earlene is very intoxicated. which usually involves cocktails and dinner. he and his wife have cocktails and dinner in town about twice a week. Paul is in the prealcoholic phase. 450 M 13. Paul is in the socialized chronic phase. cannabis Which of the following persons is MOST likely to drink alcohol? a. 450 M 13.46 Ans. Arthur drank so much last night that he became unconscious.after all.48 Ans. European < Asian < Hispanic Paul is 24 years old and has been out of college for two years. c. b." How might Jellinek describe Paul? a. Black < Hispanic < European d. d. B App p. which groups of Americans are correctly ordered? a. Paul is a junior executive and entertains clients about three nights a week. Paul is in the crucial phase. a nineteen year-old Asian male b. 451 M * 13.47 Ans. crisis phase. D App p.49 Ans. methamphetamine d. This is the third time this has happened in the last six months. b. and his friends are increasingly reluctant to go out with him because of his behavior. Paul is in the pseudoalcoholic phase. crucial phase. 451 E 316 . a thirty year-old white female In order from LEAST to MOST likely to abuse alcohol. 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. d. Black < European < Hispanic b. an eighteen year-old white female c. what substance has she probably abused? a. prodromal > prealcoholic > chronic b. prealcoholic > critical > chronic 13. heroin b. prodromal phase. Additionally. B App p. Asian < Hispanic < Black c. prodromal > chronic > crucial d. A Fac p. Jellinek would describe Arthur's drinking as a reflection of the a. B Fac p.his drinking is social and sometimes "just takes the edge off. c. Which of the following represents a correct progression of Jellinek's stages? a.13. 451 M 13.44 Ans. alcohol c. chronic phase. an eighteen year-old black male d. Paul doesn't think he has a drinking problem . prealcoholic > prodromal > crucial c.45 Ans. C App p. and he seemed oblivious to the discrepancies. an alcohol withdrawal delirium c. b. bidirectional model Akule is in Jellinek's chronic stage of substance abuse. This disorder is a type of a. C App p.55 Ans. Lynn's disorder began at age 35. D App p. c. although she is now a substance abuser. When asked again later. Lynn has Type II alcoholism. She is prone to feelings of anxiety but does not act out impulsively when she drinks. dementia). 453 M 317 . and believes that there are small animals swarming around him. 451 M Jamie is a female who began drinking when she was 32. C App p. an opioid intoxication disorder d. 452 M 13. which comorbidity explanation is usually relevant? a. If Lynn is an alcoholic. Type I d. D App p. Type I alcohol-induced dementia b. alcohol-induced delirium. d. Wernicke-Korsakoff syndrome Lynn and Pat are MZ twins. 452 M 13. a hallucinogen-induced psychotic disorder b.52 Ans. When asked the date. Ronald without hesitation gave an answer that was off by 12 years.13. What disorder is likely? a.50 Ans. B App p. profuse sweating.51 Ans.53 Ans. opioid-induced NMDA syndrome d. Type II When an alcoholic individual is diagnosed with some form of cognitivesensory impairment (e. Alzheimer's disease c. which characteristic below is LEAST associated with Pat's likelihood of developing the disorder? a.g. alcohol withdrawal dementia. biting at his arms and legs. Lynn and Pat are males rather than females. 452 E 13. Lynn has severe alcohol abuse problems. his answer was off by 15 years. alcohol-related primary degenerative dementia. alcohol-induced persisting amnestic disorder. Crisis Type c. 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. c. A Fac p. common factor model c. secondary psychiatric disorder model b. b. secondary alcoholism model d. He is experiencing muscle tremors. What is probably happening? a. Prodromal Type b. a stimulant intoxication delirium Walter has the rare alcohol-related disease caused in part by a thiamine deficiency. How would Cloninger describe her alcoholism? a. 451-2 M 13.. 13.54 Ans. d. It is extremely impractical to extract it from an individual's central nervous system. 453-4 M 13. abnormally high beta wave activity. MAO enzyme activity Why has serotonin NOT been emphasized as a highly promising biological marker for alcoholism? a. suggesting it be called the "pleasure enhancing hypothesis" b. 454-5 M 318 .58 Ans. A Con p. the physiological effects of changes in dopamine and serotonin that lead to increases in pleasant emotional states. d. "It doesn't get any better than this.60 Ans. beta wave activity d. reinforcement contingencies. b. Animal studies have failed to demonstrate the hypothesized relationship of low serotonin levels to alcohol craving. this individual is exhibiting a. the nature of an individual's beliefs about alcohol's ability to reduce unpleasant emotional states or increase pleasant emotional states 13. P300 wave amplitude b. c. D Con p. 454 E 13. accelerated heart rate change upon alcohol ingestion. b.59 Ans. alcohol expectancies. consumer hysteria. abnormally low MAO activity.13. c. as suggested by the theory c. Todd is the son of an alcoholic father. Based on available studies of such fathers and sons. In studies evaluating the tension reduction hypothesis. abnormally low P300 amplitude. the number and intensity of stressors that people experience on a day-to­ day basis d.57 Ans. 454 E Which of the following is NOT one of the promising biological markers of vulnerability to alcoholism? a. the physiological effects of changes in glutamate and GABA that lead to decreases in unpleasant emotional states. d. Family studies linking it to alcoholism have not been consistently replicated. A Fac p. b.56 Ans. c. belief adherence. what mechanism appears to be crucial in this psychological process? a. One alcoholic beverage producer decided to use the slogan. frequency of D2 receptors c. 453 E * 13. None of the above is correct. d. B Fac p. C App p. one could expect to find each of the following characteristics in Todd EXCEPT a." If an individual believes that drinking this beverage will lead to increased contentment and reduced stress. believes he IS drinking alcohol and whose beverage DOES contain alcohol d. for which of the following persons would you make the most confident prediction that she or he engages in problem drinking? a. Their longitudinal study showed that junior high school students' positive expectancies could predict later drinking behaviors. and anger Which of the following persons is MOST likely to engage in problem drinking? a. an American teen who believes alcohol will increase social competence d. who believes that drinking will lead to increased power d. believes he IS drinking alcohol and whose beverage does NOT contain alcohol b. d. Ryan. an Irish teen who believes alcohol will enhance sexual experiences b. Rose. externalizing b. who believes that drinking will reduce tension. Their study was instrumental in showing that problem drinking was more closely related to parental role modeling than inherited biological vulnerabilities. b. alcohol expectancies c. Their experimental study indicated that expectations could lead to increased drinking even when participants' beverages actually had no alcohol. Marco. Stephen. who has high alcohol expectancies. Martinique. who has high alcohol expectancies. Their study confirmed Freud's contention that alcoholism is a reflection of frustrated oral needs and regression to the oral stage. who believes that drinking will increase her experience of social pleasure b. who has low alcohol expectancies. who has moderate alcohol expectancies. dependent personality d. believes he is NOT drinking alcohol and whose beverage does NOT contain alcohol c. Which of the following men will drink the MOST? a. Zahur. 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. who believes that drinking will lead to increased power c. Rudy. anxiety.How has the research of Alan Marlatt and colleagues been significant in challenging the disease model of alcohol dependence? a. Emmett. both a and b 319 . an American teen who believes alcohol will increase aggression and dominance c. c. believes he is NOT drinking alcohol and whose beverage DOES contain alcohol According to research conducted with the AEQ. 13.69 Ans. hyperactive temperament Which of the following family-related variables is LEAST strongly associated with offspring's likelihood of alcohol abuse during adolescence? a.68 Ans. which. 457 M * Dimitri is a 12-year-old male who is often getting into trouble for aggressiveness toward peers. parental abstinence from alcohol d.71 Ans. psychological expectancies. 457 M 13.70 Ans. psychological c. learning perspective is to moral perspective. moral perspective is to disease model. C Fac p. d. moderate consumption c.66 Ans. leads to alcohol use disorders. frequent dangerous behaviors (such as trying to break into school after hours). she lived in 3 separate foster homes. Her parents both died in a car accident when she was only 4 years old. B App p. none of the above Jeanne's biological father was an alcoholic and her mother was not. b. There were no signs of alcohol abuse in any of her homes. abstinence b. d. What drinking pattern would you predict for the family members? a. social d. very heavy consumption d. The naturally occurring stress of multiple foster homes. Over the next 14 years. c. externalizing b. antisocial personality c. Given the strong genetic contributions to this disorder. was sufficient to cause her disorder. along with a genetic predisposition. 456 E 13. and strained relationships with foster parents probably caused her disorder. presence of family "rituals" c. biological factors are probably the cause of her disorder. biological b. Which of the following is the best explanation for why she developed alcohol dependence by age 22? a. She probably developed an externalizing personality as a result of the early trauma and foster care experiences. b. parental discipline style b. any of the above What factor is MOST important as a cause of alcohol use disorders? a. 458 C 13. A combination of biological vulnerability. What is the name for his behavior pattern? a. level of satisfaction with parent-child relationship There is a close match between Thongsay's level of alcohol consumption and that of his parents. undersocialization d. Legal sanction is to complete abstinence as a.67 Ans. D Fac p. c.13. A App p. 458 E 13. 458 M 320 . C Con p. learning perspective is to disease model. along with peer pressure in adolescence. disease model is to learning perspective. and impulsive acting-out at home. B App p. 72 Ans. abnormally low serotonin levels c. c. which approach to understanding alcohol abuse and alcoholism appears to be most reasonable? a. 458 C The disease model of alcoholism is endorsed by most persons in each of the following groups EXCEPT a. c. B App p. moral weakness.13. abnormally small P300 amplitude b.75 Ans." In other words. attend AA meetings.S. 458 M 13. physicians. disease b. deficit in coping and social skills. b. her alcohol problem will be viewed as a a. abnormally slow beta wave activity 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. 460 E 13. receive outpatient marital and/or family therapy.. abnormally low MAO activity d. participate in relapse prevention. 458 E * 13.76 Ans. 460 M 321 . disease. If Jacques displays a disinhibition temperament. B Con p.73 Ans. participating in the first stage of aversion therapy for alcohol dependence. National Institute on Alcohol Abuse and Alcoholism. b. Marilyn is "first stepping. Tarter and Vanyukov model Awenita has entered a program for alcohol dependence. c. A Fac p. What model is the student following? a.78 Ans. If this program is based on the most common treatment model used in the U. academic psychologists. learned habit. b. Based on scientific data. 13. enter a hospital-based detox program followed by individual counseling. Marlatt prevention model c. accepting the fact that she is an alcoholic. 460 M 13. d.74 Ans. A App p. C App p. Cloninger model d. D App p. d.77 Ans. experiencing the effects of her first ingestion of a hallucinogenic drug. none of the above Jacques is a participant in a study by Tarter and Vanyukov. she is a. D Fac p. If Aaron receives the most common form of help for his alcoholism. b. sin c. beginning to experience withdrawal from an opioid drug. the Minnesota model b. habit d. Alcoholics Anonymous. he will a. what biological marker might you also expect to find? a. d. d. 458-9 E 13. c. sociocultural c. c.84 Ans. her therapist administers a mild but aversive shock to her arm. C App p. b. 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.83 Ans. codependent c. D Fac p. d.13. d.79 Ans. 460-1 M Which of the following best describes AA's treatment approach? a. AA is to behavioral therapy. c. b. although members demonstrate higher relapse rates than do alcoholics who are treated under the Minnesota model. 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. Sylvester. symbiotic d. c. Norris. Betty spends a great deal of her life dealing with Ralph's alcohol problem.80 Ans. medication is to aversion therapy. 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. Insufficient research has been conducted. who undergoes individual behavioral therapy. A App p. what empirically-based answer would you give? a. conditioned response. 461 M 13. B App p. Once a member becomes a sponsor for newcomers. Sylvester and Norris will report similar positive outcomes. d. conditioned stimulus. 460 M 13. who receives marital therapy with his spouse. How might you describe Betty's behavior? a. 461 M 13.81 Ans. spiritual If someone were to ask you about the effectiveness of the AA approach. aversion therapy is to community reinforcement. b. B Con p. so its overall effectiveness is not yet known. classically conditioned b. c. unconditioned stimulus. when Coretta feels apprehensive upon seeing a bottle in the cabinet at home. Classical conditioning is to operant conditioning as a. Each time Coretta touches a bottle of alcohol. community reinforcement is to AA. Eric. whose spouse attends his behavioral therapy sessions.82 Ans. More than half of its members drop out during the first year because the method is not helpful to them. 461 M 13. A Con p. In classical conditioning terms. the sponsor's abstinence rate is nearly 100%. interpersonal d. the bottle has become a(n) a. d. 13. behavioral b. It is effective. b. unconditioned response. 461 E 322 . abstinence violation effect 323 13. naltrexone. 462 M * 13. C Con p. 462 M Shelly is experiencing severe DTs. Mariatt and colleagues conclude that this prediction holds true for about 80 percent of those members. controlled drinking has not received empirical support for its efficacy AA's approach to treating alcoholism includes the prediction that if a member relapses. Marion has a substance abuse disorder. Raoul. Antabuse b. dextroamphetamine What kind of treatment is Kenesha going through if she is taking disulfiram? a. discouragement of drinking c. Don. Valium d. Part of her treatment includes medication which interferes with the production of endogenous opiates.86 Ans. Which of the following concepts does NOT belong with the other three? a.89 Ans. C App p. self-defeating cognitions c. self-fulfilling prophecy d. B App p. What sort of medication is she most likely to receive for these symptoms? a. This is a kind of antagonist drug that blocks production of endogenous opiates to decrease her opioid cravings. What medication would this be. naltrexone c. benzodiazepine. disulfiram. She is undergoing a kind of aversion therapy in which she will experience very unpleasant effects if she uses alcohol. Relapse prevention studies indicate that this prediction is confirmed primarily for older. 462 E 13. D App p. RAND corporation research and the Sobells' studies largely support this prediction. diagnosed with alcohol dependence d. c. 463 E . and what is its therapeutic effect? a. reduction in craving b.87 Ans. diagnosed with alcohol abuse c. Which of the following statements is CORRECT in regard to that prediction? a. A Con p.13. alcohol abusing individuals. None of the above. A App p. d. d. alcohol dependent individuals but not for younger. Melinda. diagnosed with alcohol dependence b. discouragement of drinking For which of the following persons might controlled drinking be an effective treatment approach? a. She is undergoing detox and is receiving treatment for the withdrawal symptoms of barbiturate abuse. b. reduction of withdrawal symptoms d. c. 462 E 13.85 Ans. 463 C 13.88 Ans. carbamazepine. relapse aversion process b. renewed abuse or dependence will take place. b. She is undergoing detox and is receiving treatment for the withdrawal symptoms of alcohol abuse. The prediction can function as a type of a positive alcohol expectancy and can itself increase the likelihood of the continued drinking.90 Ans. 95 Ans. resistance training. According to Marlatt and Gordon. B Fac p. They are components of AA's treatment approach. an overreliance on simplistic "just say no" school-based programs b. c. C App p. They are components of brief intervention programs for opioid abusers. community reinforcement d. 464 E 13. b. the cultural support for alcohol use 13. an apparently irrelevant decision Allen is a participant in an ASTP on his campus. 463 M Henri agreed to attend a cocktail party in honor of a friend who was receiving an important award. D App p.92 Ans. What factor is identified as crucial in accounting for these outcomes? a.13. an abstinence violation effect b. enhancement of self-esteem and values clarification c. skill training in interpersonal communication and assertiveness b. encouragement to engage in controlled drinking by avoiding the abstinence violation effect. a recovering alcoholic. when alcohol use has already begun c. a failure to offer programs to students prior to ninth grade. 464-5 M 324 .93 Ans. A App p. What prevention approach is likely to be MOST effective in changing Thu's behavior and attitudes? a. Henri. a lack of sufficient programs that incorporate needed multicomponent approaches d. Thu is an adolescent who is participating in a school-based prevention program targeting substance abuse. an educational emphasis on the short-term negative consequences of drinking. b. 464 M 13. c. a negative alcohol expectancy violation c. d. 464 M * 13. promotion of peer norms and public commitment to abstinence d. nonconfrontational discussions with other group members about how his drinking affects his behavior. d. What do affective education. and normative education have in common? a. They are components of Marlatt and Gordon's ASTP. was confident that he would have one glass of wine "just to fit in" but would drink nothing more. what initial factor would precipitate a relapse for Henri? a.94 Ans. He would experience each of the following EXCEPT a. persuasive communication by experts in the field of substance abuse. D Fac p.91 Ans. They are components of prevention programs aimed at adolescents. provision of information about long-term negative consequences of substance abuse and dependence Data reveal that prevention programs have only a modest impact on adolescents who complete them. d. someone in the prodromal stage c.101 Ans. someone in the maintenance stage Which of the following drugs is a type of depressant? a. affect the CNS through general suppression of brain cell activity d. such as slightly reducing his alcohol intake and taking better care of his health. someone in the contemplation stage d. 469 E 13. attention deficit hyperactivity disorder c. can cause dependence and withdrawal even when prescribed therapeutically For which of the following conditions would a benzodiazepine NOT be prescribed? a.100 Ans. Recently. D App p. for whom might an aversionbased therapy approach be LEAST useful for treating problem drinking? a.96 Ans. contemplation c. less toxic than barbiturates c. c. prereadiness Wilhelm has begun to make small changes in his problem drinking behavior. The other drug was most likely a. preparation According to the readiness-for-change model.99 Ans.97 Ans. 466 M 13. a narcotic.98 Ans. C Fac p. a barbiturate. B Fac p. preparation b. maintenance c. an amphetamine. Wilhelm is at what stage of readiness-for-change? a. according to Prochaska et al. 468 E 13. painful muscle spasms 13. Seconal c. someone in the preparation stage b. less likely than barbiturates to be the lethal agent in completed suicides b. He hopes to cut ties with his "drinking buddies" and form new friendships that do not involve drinking. C App p. 469 M 13. an hallucinogen. morphine Jim has been suffering from major depression and alcohol dependence for several years. 466-7 E 13.13. b. which stage of change is she in. crystal meth b. precontemplation d. 469 E 325 . anxiety disorders b.102 Ans.? a. Which of the following descriptions does NOT apply to drugs such as Xanax? a. withdrawal symptoms of alcohol dependence d. action b. contemplation d. B App p. A Con p. safer. Dexedrine d. he attempted to commit suicide by drinking alcohol and taking another psychoactive substance. 466 M If Adrienne is aware of her drinking problem but is not yet willing to make changes and has not sought professional treatment. B Fac p. he began to experience withdrawal symptoms such as sweating. you would want to be especially alert to potential impairment caused by a commonly prescribed class of drugs. B Con p. 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. anticholinergics. MDMA d. 470 M 13. After a week confined in jail. anxiolytics. Lewis was arrested for illegal drug possession with intent to sell. He has probably taken some kind of that is increasing his brain's availability of . 470 M You are a new intern on a psychiatric unit for geriatric patients. have symptoms of body aches and mood disruption that may last for a few months and leave her vulnerable to relapse. C App p. a. Which drag does not belong with the other three? a.107 Ans. and attentional capacities as her body adjusts to its detoxified state. Margo will a. crack cocaine d. methadone c. as well as talkativeness. 470 E 13.108 Ans. C App p. stimulant. D App p. What dmg was he probably addicted to? a. have short-term impairment in fine motor skills. what is she probably abusing? a. If she experiences the abstinence syndrome. short-term memory. b.13.104 Ans. caffeine Edmund has just ingested a dmg that is causing feelings of exhilaration and vigor. dextroamphetamine c. When conducting a cognitive assessment of your patients. cocaine d. hypnotics. methamphetamine / 13. namely a. d. dopamine b. elevated body temperature and coronary activity. 470 M 13. A App p. D App p. cannabis c. If Leta is a substance user. c. experience mild symptoms of anxiety and physical discomfort that will last a few days due to an incomplete detoxification process. 471 M 326 . dopamine d. begin to engage in apparently irrelevant decisions that foster self-defeating cognitions. crack cocaine b.103 Ans. opioid.106 Ans. nicotine b. as well as nausea and vomiting. which can lead to the abstinence violation effect. Valium Margo has undergone several weeks of hospitalization for detox following depressant abuse. 470 M * 13. morphine b. endorphins c. stimulant. opioid. stimulants.105 Ans. b. c. d. " This drug is a type of a. stimulant. hallucinogen. C App p. opioid. heroin Marry is smoking a drug that occurs in the form of brownish crystals or "rocks. became a popular drug of choice for middle.and upper-income groups during the late 1970s? a. Marianna. a belief in the dangers of the leaf of the nicotiniana tabacum b.109 Ans. Marcus. a recreational user of mescaline What do South American Incas and Sigmund Freud have in common? a.115 Ans. nicotine : stimulant c. c.13. a recreational user of amphetamines b. 472 M * 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. LSD c. What drug was this? a. 471 E 13. cocaine b. Anica. 471 E 13. What substance is in that legal beverage that will later be an illegal recreational drug? a. amphetamine c. d. mescaline : hallucinogen d. 471 E 13. A App p. 472 E 327 . heroin d.110 Ans. caffeine b. 13. A Con p. B Fac p. 471 E 13. cocaine : opioid Harold is drinking a carbonated soft drink in the year 1895. the use of peyote as a treatment for some forms of emotional disturbance d. MDMA Which psychoactive substance. b. 471 E 13. barbiturate : depressant b. D Fac p. methamphetamine d. an interest in the use of the leaf of the erythroxylon coca c. B App p. cocaine 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. PCP c. D Con p. cocaine d.114 Ans. depressant.112 Ans. a daily cannabis smoker d. the use of morphine as a powerful analgesic Which of the following substances and categories are INCORRECTLY paired? a.113 Ans. Vance. a regular cocaine free-baser c. a focus of the Harrison Act. LSD b.111 Ans. Which of the following terms does NOT belong with the other three? a. asthma. 472 E 13. She has had very little sleep and is having trouble staying awake. Which drug is sometimes used to treat migraine headaches.13. 7 c. D App p. cups of fresh drip coffee every morning. indigenous South American plant b. mescaline d. cocaine's effects last for a shorter length of time. cocaine produces faster effects. b. d. 10 d. dexedrine d. c. nicotine 13. a law student. she has had so much fresh drip coffee that she has muscle tremors. and the congestion caused by head colds? a.116 Ans. cups of coffee would be needed to produce these effects? a. Lance will develop a dependence on the caffeine that will be associated with mild withdrawal symptoms if he stops drinking coffee. and can no longer study effectively due to disorganized thinking.120 Ans. cocaine produces a more euphoric experience. cocaine "crashes" are less likely. 12 Lance drinks two 6 oz. is agitated and very talkative. can cause respiratory failure and death. 472-3 M 13.117 Ans. B App p. 473 M 328 .121 Ans. French ambassador to Portugal c. How many 6 oz. caffeine b. in a few direct drops on the tongue. What would Landolt and colleagues say about the possible risks associated with this use? a. Lance will be at slightly greater risk of developing a mild anxiety disorder than are people who do not use caffeine. crack cocaine b. cannabis Barbara. C Con p. c. C Fac p. Today. deadly poison Bianca is quite worried about her husband's drug habit. b. What substance is being ingested? a. A Fac p.118 Ans. d. nicotine c. has been studying for the bar exam. Bianca's husband is smoking a substance which. 473 C 13. intoxication d. 472 E 13. 472 M Cocaine is different from the amphetamines in each of the following ways EXCEPT a.119 Ans. "ice" c. Lance will probably experience REM sleep disruption and decreased total sleep time. D App p. 5 b. Lance will probably experience an increased risk of cardiovascular disease. 4 d. Cocaine Anonymous In the 1970s. As a result. serotonin. 2. methadone Stimulation of dopamine activity in the nucleus accumbens is one of the central effects of each of the following substances EXCEPT a.S. b. Nicole has stopped ingesting a drug for which she has developed a dependence. 8 b. barbiturate b. nicotine Which of the following has NOT been utilized for treatment of cocaine abuse? a. has a slower-than-normal heart rate. alcohol d. she exhibits an irritable and depressed mood. bromocriptine therapy b. c. cannabis c. b. heroine c. community reinforcement d.Which of the following dmgs is LEAST likely to produce intoxication? a. today. Daniel's dependence developed quickly due to the substance's effects on which neurotransmitter(s)? a. 3. node-link mapping c. dopamine and acetylcholine. 8 Americans smoked cigarettes. . caffeine c. What substance is the most likely culprit? a. cannabis d. 329 . endorphins and enkephalins. 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. community reinforcement c. node-link mapping Which of the following treatment interventions for cocaine abuse is conceptually most similar to relapse prevention for alcoholism? a. Cocaine Anonymous d. and is gaining weight. 2. nicotine b. about one of every this number is about one of every a. 6 c. endorphins and serotonin. nicotine. alcohol d. Antabuse b. 4. d. how many times will he try to quit before achieving lasting success? a. barbiturate is to depressant. 476 E 13. narcotic b. C Con p. 5 or 6 d. alcohol is to nicotine. If she works with 15 clients in a group. Find a program in which you quit "cold turkey" while also receiving a prescription for mecamylamine.133 Ans. b. 475 M 13. Civil War veterans helped make the addictive potential of widely known. 475 M 13. 476 M 330 . He recently tried to quit and is very disappointed that he was unable to do so. including nicotine replacement therapy. 4 Naltrexone is to mecamylamine as a. 9 to 10 b. poppy plant c. D App p. A psychology intern is one of a team of counselors offering an intensive behavioral treatment program for smoking cessation. 10 c.13.131 Ans. B App p. endorphins d. c. 462. cannabis A recognition of posttraumatic stress disorder came about in part because of the experiences of Vietnam War veterans. Find a program in which they encourage abmpt "cold turkey" cessation and they do not rely on nicotine gum or patches. In a similar fashion. A App p. given that this substance dependence disorder is rarely effectively treated. opioids b. cocaine 13. roughly what number of those clients will she expect to see in treatment again within one year if the program shows average results? a. endorphins is to serotonin.132 Ans. b. cannabis d. If he is typical of such would-be quitters. stimulants c. 12 b. about 8 c.130 Ans. You could recommend any of the above. Find a program in which you will have frequent contact with a counselor who helps you quit smoking gradually. d. anticraving is to anti-withdrawal. 475 M v Marko has smoked for several years. D Con p. d. Which of the following does not belong with the other three? a. A Fac p.129 Ans.75 M 13. What recommendation would you realistically make to him? a. 7 d.134 Ans. a. c. 3 or 4 Jin-Uk wants to find a treatment for his smoking addiction. methamphetamine d. C App p. What substance is this? a. morphine is to heroin. amphetamine is to heroin. both b and c 13. exogenous opiates. One night.136 Ans. c. What accounts for this outcome? a. d. d. b. c. cocaine d. methamphetamine Jerome is a heroin addict who mainlines in his home.141 Ans. and her speech is slurred.135 Ans. D App p. cocaine is to MDMA. b. a narcotic antagonist. endogenous endorphins. What drug is Theodore using? a. C App p. heroin b. heroin d. heroin Theodore is a 25 year-old. cocaine c. 476 E 13. PCP Mainlining is to free-basing as a. he went to a bar and bought a dose of heroin and decided to inject it before going home. crack cocaine c. What sort of drug has she ingested? a. This time.138 Ans. She seems disconnected to the events going on around her. exogenous opioids.139 Ans. D App p. A App p. environmental-dependent opioid tolerance d.137 Ans. Estrella is in a drug-induced state of euphoria.140 Ans. classical conditioning c. c. operant conditioning b. an opiate agonist. b. endorphins. 476 E * Opium and heroin are types of a. endogenous opioids. he died of an overdose. 477 M 13. 472. cannabinoids. Each of the following substances would reduce his pain EXCEPT a. B Con p. Tchong is addicted to a drug that was developed by German physicians in the late 19th century as a powerful analgesic. 477 M 331 . LSD b. relatively affluent male who thinks it is "trendy" to use a certain illegal drug. Guillermo is in severe pain due to injuries sustained in an automobile accident. LSD b. d. 476 M 13. MDMA c.13. heroin is to cocaine. B Fac p. 476 M 13.76 E 13. This same drug is associated with extremely high rates of HIV in some inner cities. hyperalert. sedatives and hypnotics. d. Eddie will increase his use of cocaine. Methadone maintenance therapy leads to reductions in HIV risk and significantly reduced illicit opioid use. A App p. c. serotonin d. Eddie will be dependent on this treatment for 10 years or more. anxious. THC's neurochemical action has not been determined.144 Ans. which neurotransmitter probably mediated your learning and memory processes among neurons? a. GABA c. Eddie is a participant in a methadone maintenance program. D Fac p. It is less addictive than heroin and causes less problematic withdrawal symptoms. d. 477 M 13. Eddie will require less methadone if he is involved in supportive-expressive short-term psychoanalysis. hallucinogens.145 Ans. D Fac p. b. narcotics. withdrawal from a depressant While some clinicians question the need for medication in the treatment of withdrawal symptoms of alcohol dependence. 479 E 332 . What neurotransmitter is most directly involved in the CNS effects of THC? a. and oversensitive to pain. Her friend is also wondering if Carmen has had the flu for the past few days. they would agree that naltrexone is a central component in detoxification related to a. 13. c. dopamine d. b. d. B App p. Eddie will reduce his risk of contracting HIV. NMDA c. endorphins Carmen seems unhappy. The addition of a psychological therapy component to methadone maintenance does not appear to affect treatment outcomes.13.142 Ans. A App p. Which of the following outcomes is LEAST likely for him? a. 477-8 E 13. If Carmen has a substance dependence disorder. acetylcholine b. 477 M 13. Which of the following statements is FALSE in regard to methadone? a. 477 M As you read the text and prepared for the exam. withdrawal from a stimulant c. MDMA b.146 Ans. It is a synthetic opioid prescribed as a substitute for heroin. intoxication from a narcotic d.143 Ans.147 Ans. b. cocaine and crack. C Con p. what is most likely to cause this syndrome? a. 477-8 M 13. c. withdrawal from an opioid b. D Con p. Jack.149 Ans. 479 E 13. c.13. and enhances her enjoyment of the movie she and her date are viewing -. fine motor coordination. For which of the following persons would marijuana NOT be considered as a possible treatment? a. and is heading out the door to the all-night diner to satisfy his munchies urge. MDMA c. seems to make the night pass more slowly. b. who has been diagnosed with anorexia nervosa c. who has advanced-stage multiple sclerosis d. Stacey.148 Ans.152 Ans. 479 M 13. who is experiencing anticipatory nausea as a result of his chemotherapy b.the dialogue seems witty and the figures on the screen seem almost real enough to touch. What drug is she probably using? a. d.150 Ans. b. What psychoactive substance has he probably ingested? a. PCP THC intoxication is related to impairments in each of the following EXCEPT a. Researchers in the 1970s were unlikely to obtain measurements that would have demonstrated the drug's impairment of psychological characteristics. A App p. THC b. 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. D Fac p. psilocybin d. 479 M 13. short-term memory. The concentration of THC in marijuana grown and distributed in the 1990s is almost 5 times higher than it was in plants cultivated earlier.151 Ans. c. Raphael. ability to sustain attention. marijuana c. cocaine b. who has severe glaucoma Dorian has bloodshot eyes. Marleen. crystal meth or "ice" Salome is on a date and has taken a drug that is enhancing her present mood. d. 479 E 333 . B App p. LSD d. The demographic characteristics of persons using this drug changed dramatically over the two decades. none of the above 13. a faster-tlian-normal heartbeat. Increased concern about legal penalties may cause research participants to be less candid in their self-reports in the 1990s. C App p. b. Regular use of the drag causes an amotivational syndrome. c. benzodiazepines. He could defensibly make each of the following statements EXCEPT a. "Psychological research has not yet documented any significant. d. What is the term for her "seeing" her instructor's voice? a. visual c. cannabis. which form(s) of dependence are of greatest concern? a. b. both physiological and psychological d. auditory b. Both regular drug use and the amotivational syndrome are related to a common underlying genetic predisposition toward abnormally low CNS activity levels.. 480 M 334 . 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. "A joint contains fewer toxic carcinogens than do the cigarettes that you smoke. olfactory d. A App p. and the depression also accounts for the amotivational syndrome. flashback 13. Which type of hallucination is most common in relation to psychedelic drags? a. A App p. tactile 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. 479-80 M 13. physiological b. synesthesia b. B App p. "It used to be legal in the U. psychological c.158 Ans. 480 M 13. MDMA. psychedelic perception d." c. Preexisting mild depression leads to the use of marijuana as selfmedication. Marijuana is not associated with any significant form of dependence. If Brandon abuses marijuana. "I won't get hooked [physically dependent] on this drug. 480 E 13. glutamate. c. 479 M 13. None of the above has been reliably substantiated." b. C Con p.154 Ans. d." Current empirical evidence on the long-term psychological effects of cannabis provides reliable evidence for which of the following statements? a. D Fac p.156 Ans. visual dyskinesia c.157 Ans.155 Ans. John was explaining to his girlfriend why she shouldn't worry about his occasional use of marijuana.S. lasting harmful effects of this drag." d.13. and some people are strongly in favor of making it legal again.153 Ans. B Fac p. Tracey is under the influence of a dmg which is making her feel as though her body has been stretched eight feet. You would be concerned about each of the following possible consequences EXCEPT a. norepinephrine Which of the following terms are INCORRECTLY paired? a. rush : heroin b. such as withdrawal symptoms. A App p. C Fac p. What dmg has she ingested? a. 481 M 13. cocaine d. C Fac p.163 Ans.160 Ans. 482 E 13. mescaline. munchies : cannabis d. LSD. 480 M If an individual is experiencing psychotic-like symptoms as a result of ingesting a psychoactive substance. he would MOST likely be taking a. phencyclidine Like heroin. PCP. extremely variable moods. psilocybin b. D App p.161 Ans.164 Ans. dexedrine Eleanor accepted an unknown dmg at a party. PCP d. 481 M * 13. 335 . physical health risks. Tragedy struck when Eleanor suddenly collapsed and died on the dance floor. Ecstasy c. a. Ecstasy c. b.13. 13. LSD b. heroin c. D Con p. what neurotransmitter is most likely being altered? a. c. LSD b.165 Ans. panic attacks during intoxication. endorphins c. cannabis c. A physician called to the scene diagnosed the cause of death as hyperthermia. b. dopamine b.159 Ans.162 Ans. barbiturates was originally developed to serve as a medical anesthetic. d. Tracey also "sees" her boyfriend's voice as he talks to her on the phone. extreme euphoria : methamphetamine Bryce uses LSD. 481 M 13. A App p. serotonin d. 482 M If Clark Kent weren't really Superman but only thought he was because he was under the influence of a psychedelic. a possible hallucinogen persisting perception disorder. B App p. What dmg did she take? a. 481 M * 13. d. trip : LSD c. NMDA d. 13. spontaneous abortion or damage to a developing fetus. their less efficient metabolism of alcohol results in greater vulnerability to health impairment given equal intake levels of alcohol. do so after some type of crisis. anemia. LSD. perhaps a chronic. immunosuppression (including a shorter interval between HIV infection and development of AIDS). whereas men tend to believe alcohol to be more important for enhancing sexual and social pleasure. Bidirectional model: regardless of which disorder occurred first. menstrual irregularities in females. 13. the symptoms of each exacerbate the other's.167 List six of the many health risks associated with chronic alcohol abuse. heavy level of drinking has caused physiological agitation experienced as anxiety. weakening of heart muscles. arrhythmia. 336 . perhaps a significant dysregulation of GABA is the culprit. Women also tend to believe that alcohol will increase their sense of power. and are less likely to go on drinking binges. d. esophagus. pancreatitis. hypertension. Ecstasy. Vitamin deficiencies. stroke. cirrhosis of the liver. testosterone suppression in males. What are the four models that could account for this comorbidity.169 Monty has an alcohol-induced anxiety disorder. with there sometimes being too little and other times too much GABA production. b.168 problems? In what way do women with alcohol problems differ from men with such Women typically start drinking later in life. perhaps the drinking was a way to self-medicate. Wernicke-Korsakoff syndrome and several other alcoholrelated cognitive disorders. 13. and liver. larynx. Secondary psychiatric disorder model: the alcohol problem caused the anxiety disorder. SHORT ANSWER / ESSAY 13. pharynx. PCP. 482 E A middle-class European American college student is LEAST likely to use a. breast. mescaline. However.166 Ans. cancers of the mouth. c. A Fac p. Common factor model: perhaps one underlying factor causes both disorders. and what explanation would each offer for his disorder? Secondary alcoholism model: the anxiety disorder caused the alcohol problem. Firm but nurturant discipline by parents (but not excessive punishment) including adequate monitoring of child's whereabouts.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. lack of parents' antisocial/sensation-seeking behaviors. lack of the biological markers associated with problem drinking (e. abnormal EEG activity.g.. called the P300 (wave).e. as students drank more. 13. 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. abnormally low serotonin levels Heart rate change findings: larger increase in heart rate following ingestion.173 Describe the "ideal" family characteristics that would predict offsprings' low vulnerability to problem drinking. 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. Some studies have found that sons of alcoholic fathers show smaller P300 amplitude than do sons of nonalcoholic fathers. had positive alcohol expectancies) were more likely to begin drinking and to drink more heavily than did students without these expectancies. less change in overall EEG activity following alcohol ingestion. resulting in a reciprocal influence on problem drinking. adolescents' satisfaction with parentchild relationship or a sense of feeling close to their parents. and these lower P300 amplitudes are not specific to alcohol disorders. studies attempting to replicate these findings have sometimes failed to find the predicted results.171 Rafael's father is a chronic alcoholic. along with regular alcohol use 13. their subsequent expectancies grew even stronger. low alcohol expectancies on the part of the parents. emphasis on family rituals. that is hypothesized to indicate the individual's process of attention. very brief change in EEG voltage (the recording of the brain's electrical activity) in response to a specific sensory stimulus. Moreover. low alcohol consumption by parents. 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. One sort of change occurs 300 milliseconds after the stimulus presentation.172 Groups of 7th and 8th graders are being asked to complete the AEQ..13. lower P300 wave amplitude Biochemical findings: less monoamine oxidase (MAO) activity. 337 . biochemical abnormalities). 13. this took the form of a belief in "reefer madness. avoidance of immediate negative consequences (e. in a group format.176 What is the most commonly used illicit drug in the U. and authoritative/expert communications.S.5 million Americans report weekly use. in the 1950s. Yes. At least 5..g.175 List the factors that complicate treatment for individuals who have a stimulant abuse disorder. 13. 13. a lack of strong social support is related to relapse.? How many Americans report using it weekly? Briefly describe its history of availability and use from the turn of this century through the 1960s. and would she be eligible for this program? Erin would receive 6 sessions of cognitive-behavioral interventions.13.. Premature termination of therapy. poor health. and nonconfrontational discussions between Erin and other group members. difficulty in choosing therapeutic focus (which drug or drugs to focus on in treatment). given that she does not appear to have developed a dependence on alcohol. What ethnic differences have been reported? Frequent prevalence of polydrug use (possibly more than half of persons with this disorder). Social concern became evident in the 1930s and it was soon outlawed. hangover).g. This Alcohol Skills Training Program would de-emphasize abstinence.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. cirrhosis). What would ASTP offer Erin. It was legally available at the turn of this century and was used primarily by jazz and blues musicians as well as artists. whereas economic adversity and neighborhood disorganization are more closely tied to relapse for Black Americans. For European Americans. Marijuana. which is also associated with the following: comorbid mental disorders. leading some states to relax criminal penalties and raise the proposal that it be again legalized. 338 . it was essentially an accepted middle-class recreational drug." By the 1960s. leading to increased likelihood of relapse. long-term negative consequences (e. aimed at relapse prevention. it instead would emphasize controlled drinking. she would be eligible. c. is extremely aggressive in sports and business. d. 488 E 14. Definition of normal sexual behavior is based on traditional gender role expectations. Which of the following statements about human sexuality is correct? a. D App p. paraphilia d. a 19-year-old male. sexual sadism/masochism disorders. and gender identity are independent aspects of a person's sexuality. b. B App p. c. 488 E SEXUAL AND GENDER IDENTITY DISORDERS Which of the following is NOT a general category describing sexual or gender identity problems? a.Chapter 14 14. D Fac p. sexual desire disorders. A Fac p. transsexualism c. sexual orientation. The DSM-IV includes each of the following categories under the heading of sexual dysfunctions EXCEPT a. What type of gender identity has Thomas developed? a. d.3 Ans.2 Ans.6 Ans. and he generally desires to win at all cost.5 Ans. b. male c. sexual dysfunction Thomas is preoccupied with a desire to be a member of the other sex. female b. male sex role polarization. Brent. c. normal male orientation. sexual pain disorders. b.4 Ans. gender identity. 489 E 339 . orgasmic disorders. A female who exhibits behaviors typical of a traditional male gender role probably also exhibits cross-gender identification and orientation. cultural gender orientation. gender preference. A Con p. 14. 488 E 14. sexual orientation. C App p. d. 488 E 14. b.1 Ans. Gender identity and gender role largely determine an individual's later sexual orientation. At this age. male gender identity. male sex role. transgendered Johnny is three years old. In Western cultures Brent would be displaying a a. d. 489 M 14. c. An individual's gender role. homosexuality b. Johnny has probably already developed his a. cross-gender d. At home he generally does all of the car maintenance and yard care. 9 or 10 d. B App p.9 A researcher interested in attitudes toward homosexuality is working with a Ans. B App p. 6 d. developing treatments for sexual desire disorders 14. 489 E Which of the following definitions of normal sexual behavior was NOT offered in your text? a. according to Michael et al. 2 b.14. Michi. 12 to 14 14. behavior which is commonly practiced b. 491. 78 d. about how many will probably report that they have masturbated in the last year. asking adult men and women about their sexual fantasies b. 491 M Dr. studying the relationship between gender identity and sexual dysfunction d.12 Ans. an Asian American female with a two-year college degree b. According to the latest large-scale sex App survey. approximately how many of these males would consider themselves p. (1994)? a. What is the focus of your work? a.5 homosexual? M a. A randomly sampled group of 100 males. 491 E 14.8 Ans. and you are working for Alfred Kinsey. there is a % chance that Janis has engaged in sexual intercourse.'s (1994) findings. 52 b. a.7 Ans. Adelita. acts that guarantee the reproduction of the species It is 1942. behavior defined through legislation d. a white female with a high school diploma c. If her 10 new female clients are typical. Roberta. a Hispanic female with a four-year college degree 14. which of the following persons is LEAST likely to report more than one sexual partner in the past year? a. behavior defined by prevailing moral or religious codes c. 9 Janis is a 22-year-old female. compiling results of thousands of surveys on sexual behavior c. 90 According to Michael et al. a black female with a high school diploma d. 4 c. Helenos is a couples therapist who specializes in the treatment of sexual dysfunctions and believes that masturbation is a healthy behavior for all women. 489 E 14. According to the National Health and Social Life Survey. C Fac p. Cassandra. A App p. 60 c. 491 M 340 .10 Ans.11 Ans. D App p. 6 or 7 c. 2 or 3 * b. 1994) found that percent of Americans had more than one sexual partner in the previous year. the father's sperm b. 17 d. Wolffian duct d. Mullerian duct c. a.18 Ans. Chad. C Fac p. Lisa. the heart d. the mother's egg c. 12 c. In a normal fetus. Mullerian duct. 493 E 14. an XY male c. D App p.15 Ans.19 Ans. B Con p. 493 E 14.13 Ans. the is the basis for internal female sex organs. genital tubercle. what biological factor determines its sex? a. testosterone b. and nipples. having sex with a famous model. the genitals b. the viscera Randy is engaged in a sexual fantasy. 492 M 14.16 Ans. an XX female b. Ayita. breasts. 492 E 14. 494 M 341 .17 Ans. d. B App p. Her ovaries will increase their production of which will result in maturation of the clitoris. an XXY female d. 491 E 14. genital tubercle. labioscrotal swelling b. all of the above Whereas the is common to both XX and XY fetuses. b. 28 Dr. glucocorticoids c. 493 M * A national survey cited in your text (Michael et al. Wolffian duct Which of the following persons produce both androgens and estrogens? a. having conventional intercourse with a prior partner. A Con p. all of the above Emalia is undergoing puberty. 8 b. progesterone 14.14 Ans. the brain c. a. D App p. c. having sex in a public place while being observed by strangers. Which of his clients' organs is most important in the course of therapy? a. a. Wolffian duct.14.. estradiol d. Moses is a therapist specializing in the treatment of sexual dysfunctions. A App p. the mother's level of circulating androgens and estrogens d. Research indicates that he will probably be fantasizing about a. having sex with multiple partners. Each fetus has begun to develop genitalia. 494 M 14.24 Ans. DSM-III : ego-dystonic homosexuality c. Fems A would clearly have female genitalia." a behavior which is normally seen in males. exposed them to high levels of androgens during fetal development c. Cara has androgen insensitivity. d. What did Dr. If fetus A and B are both at 8 weeks of development. what possible answers would be provided? a. She has masculine sex characteristics. and Fetus B. but there would be obvious differences between the two.14. Which statement about Samantha. A App p. is TRUE? a. heterosexual d.23 Ans. 4 categories: gay. DSM-I : homosexuality 14. She is normal aside from tomboyish tendencies.20 Ans. bisexual b. Which of the statements below about her would be TRUE? a. what would you expect to see in regard to their genitalia? a. male genitalia. c. prevented the production of androgens during fetal development d. C App p. d. any of the above Which of the following DSM editions and diagnostic label are mismatched? a. C Con p. C Con p. She will probably be homosexual or bisexual as an adult. gave them injections of extremely high levels of estrogens At birth Samantha had a disorder called congenital adrenal hyperplasia. She has developed a clear masculine gender identity. Fetus A has two X chromosomes. She is probably very masculine and tomboyish. b. 494 M 14. none of the above If a respondent were asked on a Kinsey-like survey to describe her or his sexual orientation. DSM-II : deviant sexual orientation d. now 6 years old. She will be unable to conceive a child. Both A and B would share some genital characteristics.21 Ans. 494 M * 342 . DSM-III-R : (no label) b. lesbian. 494 M 14. Jekyll has experimentally produced female mice that exhibit "mounting. B Con p. Their genitalia would appear the same. a 10 point scale from "exclusively heterosexual" to "exclusively homosexual" c. b. 494 M 14. straight. She has an XX chromosome complement with an excessively high level of circulating androgens. removed their internal sex organs b. d. c. 494 E Dr. b. She exhibited internal but not external abnormalities in sexual anatomy. Jekyll probably do to these mice? a. B App p.22 Ans.25 Ans. 2 categories: homosexual. c. Fetus B has an X and a Y chromosome. Lancet's findings to indicate a. A App p. c. d. particularly in regard to personality disorders. b. According to the DSM-II. no differences in the psychological functioning of heterosexual and homosexual males. d. 494 M As a physician you are working with a patient who has an XY chromosome complement. some differences between homosexuals and heterosexuals. Kyle. 64% 14.29 Ans. 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. male. 48% d.31 Ans. female but with male secondary sex characteristics.28 Ans. c.14. Each time a new DSM is published. b. According to past research. male but with behaviors characteristic of a female. 495 M 343 . c. C App p. The patient has been diagnosed with androgen insensitivity. ego-dystonic homosexuality. a higher prevalence of mental disorders among homosexuals. he reviews it carefully for significant changes in diagnostic practices. Kyle would be diagnosed as suffering from a. a mental disorder. 17% c. one would expect Dr. 494 M 14. 494 E 14. 1967 b. DSM-II d. 8% b. Which edition was he reviewing if he found no reference to homosexuality as a mental disorder? a. 495 M 14. 1980 d. sexual orientation disturbance. At the request of a family member. The patient's gender identity would probably be that of a. B Fac p. 494 M 14. DSM-III-R b. a higher prevalence of mental disorders among heterosexuals. Rashid has been a therapist for more than 30 years. 1987 Dr.26 Arts. d. has gone to see a therapist. Dr. What percentage of non-Western cultures include homosexual activity as an acceptable form of sexual behavior? a. a paraphilia. DSM-III c. none of the above The year is 1971. b. In what year did the American Psychiatric Association declare that homosexuality was not to be classified as a mental disorder? a. A App p. female. 1973 c.27 Ans. D Fac p.30 Ans. D App p. a homosexual male. 2 b. No homosexual individuals are seriously interested in changing their orientation. PFLAG c.14. homosexuality is absent. Daniels is an opponent of reorientation therapy for homosexuals. d. 0 b. 497 M 14.'s (1993) study. Exodus International 344 14. 10 d. 3 c. including Western and non-Western. 5 d. A Fac p. fetal underandrogenization b. C Con p. 10 If students at your local high school are similar to those included in Remafedi et al. atypically small hippocampal interstitial nuclei d. D Fac p. Reorientation therapy increases a client's shame and anxiety about homosexual feelings instead of decreasing psychological distress. B App p. Which of the following terms does not belong with the other three? a.34 Ans. Which of the following organizations would probably be most helpful to them as they try to accept his orientation? a. hypothalamic structural differences d.38 Ans. 496 M 14. 495 E In % of societies. 5 c. c. can be changed through intensive behavioral therapies. is caused primarily by biological factors. 496-7 M 14. is not amenable to change through psychological intervention.35 Ans. a. Love in Action d. about % of them will report predominantly homosexual attractions.32 Ans. 495 E 14. none of the above Available research indicates that homosexuality a. birth order Dr. a specific gene on the long arm of the X chromosome c.33 Ans. D Con p. DZ twin concordance differences b.37 Ans. atypically large suprachiasmatic nucleus c. B App p. 495-6 E 14. b. a. She cites each of the following arguments in defense of her position EXCEPT a. c. b. A App p. The Burtons are trying to understand their gay son who came out a few months ago. NARTH b. 25 Which of the following biological findings has been consistently replicated in studies of homosexuality? a. d.36 Ans. The therapy itself perpetuates the idea that homosexuality is a disorder. none of the above. There are several well-designed studies indicating that sexual orientation is not amenable to change. 497 M . MZ vs. with five older brothers. a. the high rate of dysfunction in this group compared to that for heterosexuals. Chantal is lesbian. neither d. which of the following factors is MOST likely to have had some influence on her orientation? a. bisexual. Martin. 498 M * 14. A lack of familial attention led Benito to develop extreme strategies for achieving attention. Benito may have been beaten up by his older brothers so frequently that he overutilized the ego defense mechanism of "identifying with the enemy. who exhibits a traditional masculine gender role and has a feminine gender identity d. Margaret and Sarah are 15-year-old females. altering his anterior hypothalamus and anterior commissure." c. heterosexual mother. c. Rubio is a member of NARTH. Margaret was raised by lesbian mothers. Based on currently available research. His mother may have developed antibodies to testosterone. 498 M 14. b. d. Kit is a a. In other words. and Sarah was raised by a single. Which of the following theoretical perspectives was presented in the text as an explanation for Benito's orientation? a. d. the high rate of suicide by gay and lesbian adolescents.44 Ans. the presence of profoundly distressing homosexuality in some individuals. C App p. including professing a gay lifestyle.14. dimorphidite. 499 E 14. Studies have shown that is statistically more likely to be become lesbian. neuroanatomical factors c. He is the sixth oldest sibling in his family. No research has been conducted to evaluate this factor.42 Ans. A App p. Which of the following individuals is MOST likely to be diagnosed with gender identity disorder? a. who exhibits a traditional feminine gender role and has a cross-gender identification b. D App p. b. who exhibits a traditional feminine gender role and is gay 345 14. Benito suffered brain trauma in early childhood. 498 M Dr. growing up with homosexual parents b.43 Ans. He could cite each of the following facts in support of his approach to the treatment of homosexuality EXCEPT a.40 Ans. hermaphrodite. 499 E . Olga. c. b. 20 years old. 8 years old. Antonio. a history of sexual abuse in childhood d. underdeveloped gender identity Kit has both male and female sexual organs. B App p. Benito is a homosexual. d. 22 years old. Margaret c.39 Ans. Sharon. 497 M 14. transsexual. Sarah b.41 Ans. C App p. the need for therapists to honor the requests of their clients. A App p. who exhibits a traditional masculine gender role and has a cross-gender identification c. leading to Benito's underandrogenization. 9 years old. B App p. Available evidence suggests that of her participants will have a history of gender identity disorder in childhood. a. A Fac p. b.14. hermaphrodite disorder d. A App p. . D App p.50 Ans. a heterosexual male-to-female transsexual b. gender identity disorder Martinique. The child develops a social phobia or other anxiety disorder by early adolescence. D App p. four fifths b. Hardy is conducting research on a nationwide sample of transsexual adults. Which of the following persons will probably have the best postoperative adjustment? a. d. a female-to-male transsexual c.47 Ans. is seeking to undergo treatment for transsexualism.46 Ans. Pat has expressed his desire to become a female and feels considerable discomfort with his male sex organs. lower than average interest in rough-and-tumble play and typical boys' toys d. 500 M * 14. 499 E * 14. C App p. living in Aries. c. two thirds c. Which of the following outcomes is MOST likely for a child with gender identity disorder as he/she gets older? a. b. 500 E 14. 1. 501 M 346 . a. cross-gender identification disorder c. Pat MOST likely suffers from which of the following? a. . France. a homosexual male-to-female transsexual d. one quarter Aaron is a 5-year-old male diagnosed with gender identity disorder. transgenderism b. an increase in feminine behaviors in adolescence if Aaron is homosexual. The child develops transsexualism. . Farley is assessing a 14-year-old male named Pat.5 d. c.48 Ans.0 14. 499 M Dr. 500 E Dr. Lana.01 c. The child significantly decreases his/her cross-gender behaviors. Lorenzo. physically pretty features as a baby. The child seeks sex reassignment surgery as an adult. either a or c 14.49 Ans.0001 b. Dannette. ostracism by his male peers in kindergarten. one half d. She is part of % of European women seeking such treatment.45 Ans. You could expect to observe each of the following characteristics in him EXCEPT a. B App p. a heterosexual orientation. Darrell is being treated for premature ejaculation. b.14. If you are like most clinicians. 503 E 347 . a. both parents' indifference to their child's cross-gender characteristics d. C App p. behavioral therapy combined with parental training d.56 Ans. c. A App p. it is likely that he will have to complete each of the following EXCEPT a. c. extensive psychological testing.53 Ans. medical treatment involving the use of testosterone supplements and antidepressants c. Appleton's dominance and control b. excitement b. a 17-year-old male transsexual. Appleton's submissiveness and Mrs. Which of the following is he experiencing? a. none. Mr. 2 hours. 30 minutes. Mr. d. she may stay in her current phase for up to a. 503 E 14. climax Bernice is a woman who is experiencing resolution following sex. resolution d. D App p. what would you expect to observe about their parenting practices? a. This disorder reflects a disruption of the phase of sexual response. what treatment would you recommend? a. 502 M 14. orgasmic c. D App p.55 Ans. 6 hours. 502 M 14. both parents' emotional aloofness and disinterest in their child c. As a clinician you are working with Cody. 503 E 14. Appleton's overpermissive style Before Heinz can undergo sex reassignment surgery. and his parents. psychosurgery to remove a portion of Cody's hypothalamus b. According to Green's research. Appleton are the parents of a child with gender identity disorder. Dominic is undergoing a sexual response stage that his wife does not experience. orgasmic b. Appleton's authoritarian style and Mrs. 90 minutes. and Mr. d. excitement c.52 Ans. If she did not experience the orgasmic phase.54 Ans. Cody should not be forced to live within restricted social definitions of gender. resolution d. Cody and his parents have decided to alter his gender identity. b. successful living as a member of the other gender for at least one year.51 Ans. 501 M Mrs. C App p. refractory 14. chronic gender dysphoria. neurological and vascular abnormalities. Sunfish is a marriage counselor working with a couple suffering from a sexual dysfunction. personality Dr. A Con p. Michael and Kaplan b. desire d. D Con p. Louis.63 Ans. What are the names of your research directors? a. negative social conditioning or current relationship distress. unresolved conflicts from early childhood. b.61 Ans. Kinsey The year is 1957. 504 E 14. She is in which phase of the sexual response cycle? a. Kinsey and Kinsey Which of the following categories of disorders has the highest lifetime prevalence? a. 504 E 14. 504 E 14. vasocongestion of the clitoris. survey-based 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. c. The couple has expressed concern that they are unique in their situation. physiological As a clinician in the late 19th century. 30 b.57 Ans. Freud d. 75 c. observational c. anxiety d.58 Ans. 504 M 14. correlational d. mood c. a.14. experimental b. To reassure them. Masters and Johnson c. Sunfish responds by explaining that enduring sexual dysfunction may affect as many as % of all intimate relationships. Heiman and Smith d. Dr. 504 M . 20 348 14. resolution c. Kaplan c. How would you characterize Masters and Johnson's research procedure? a.62 Ans. you most likely regarded a client's sexual dysfunction as a sign of a. B App p. C Con p. C App p. possession by evil spirits. 503 E * Lucy is experiencing an increased heart rate.59 Ans. d.60 Ans. sexual dysfunction b. A App p. 504 E 14. B Con p. and you are a research assistant working with two prominent sex researchers at Washington University in St. excitement b. 50 d. and erection of the nipples. 505 E Carlotta is talking with her therapist about her HSDD. her sexual history. B disgusted with the thought of any kind of sexual behavior that she refuses to App date. 7 c. She is so Ans. sexual aversion disorder. Mildred's religious beliefs. EXCEPT a. an 18-year-old single high school senior c. what Mildred learned in her family. c. single college junior d. 5 d. A Fac p. a. but NOT one of them. 504-5 E * 14.67 Ans.65 Ans. including each of the following. 505 E 14. Her therapist is explaining that many factors could influence her disorder. Mia. c.14. b. the therapist will probably be MOST concerned about a. situational type is 14. B App p. intimacy avoidance disorder. generalized type c. d. aversive type d.68 Ans. 4 The DSM-IV includes several specifiers for sexual dysfunctions. b.66 Ans. hypoactive sexual desire disorder. FSAD. The few times she has dated she has become panicky if her partner p. acquired type b. impairments in vascular functioning. 9 b. b. Marty. c. 505 M 14. 505 attempted to hold her hand or put his arm around her. a 22-year-old. is fearful of sexual encounters.64 Ans. A App p. Marsha most likely E suffers from a. her level of estrogen. d. Aaron.'s (1994) recent survey revealed that roughly of every 10 married persons say that they receive great physical pleasure from sex. Which of the following persons is MOST likely to report the highest degree of satisfaction and pleasure from their sexual relations? a. C Fac p. When Mildred's therapist is assessing the factors that may be contributing to her HSDD. d. cultural beliefs about sex.69 Marsha. 349 . Mildred's cultural identity. D App p. a 26-year-old who has been married for two years b. a recently divorced 35-year-old Michael et al. whether Mildred is in good physical health. 505 M 14. a. a 23-year-old college student. Alice. 14.70 Ans. B App p. 505-6 M 14.71 Ans. D 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. 14.72 Ans. A App p. 506 E 14.73 Ans. C App p. 506 M 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 * 14.78 Ans. C App p. 508 M Which female sexual dysfunction is LEAST likely to motivate a woman to seek treatment? a. HSDD b. sexual aversion c. orgasmic disorder d. FSAD 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 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 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 14.79 Ans. A Con p. 508 E * 14.80 Ans. D App p. 508 E 351 14.81 Ans. B App p. 508 M 14.82 Ans. C 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 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 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 14.85 Ans. A App p. 509 M 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. 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 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% 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 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 14.87 Ans. C App p. 510 E 14.88 Ans. B Fac p. 510 E 14.89 Ans. D Con p. 510 M * 14.90 Ans. A App p. 510 E 14.91 Ans. D App p. 510 E 353 14.92 Ans. B App p. 510 M 14.93 Ans. C Con p. 510-11 M 14.94 Ans. B Con p. 511 E 14.95 Ans. D App p. 511 M 14.96 Ans. A Con p. 506,11 C 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 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 may 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 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. 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 % 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 14.97 Ans. D Fac p. 511 E 354 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. 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. 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 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 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 14.100 Ans. D App p. 512 E 14.101 Ans. C App p. 512 M 14.102 Ans. A App p. 512 M 14.103 Ans. D App p. 512 E 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 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 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 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. 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. 14.106 Ans. C App p. 513 M 14.107 Ans. D App p. 513 M 14.108 Ans. A App p. 513 E 14.109 Ans. B App p. 513 E 356 14.110 Ans. C Fac p. 513 E 14.111 Ans. D Con p. 513 M The aphrodisiac that gave rise to the term "honeymoon" was a kind of a. bee pollen. b. oyster. c. wine. d. mandrake root. 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. 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. 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 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 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. 14.112 Ans. B App p. 514 M 14.113 Ans. A Fac p. 514 M 14.114 Ans. C Fac p. 514 M 14.115 Ans. D App p. 514 M 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 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 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. 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. 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 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. 14.117 Ans. B App p. 515 M 14.118 Ans. A Fac p. 514-5,24 E 14.119 Ans. D Fac p. 515 E 14.120 Ans. C Con p. 516 M 14.121 Ans. B App p. 516 E 358 517 E Karl often dresses in women's clothing in the privacy of his home to achieve sexual arousal. D App p. d.122 Ans. frotteurer. C App p. sexual arousal c. 516 M Client "S" has been diagnosed as having a paraphilia. D App p. Paulo App could be described as exhibiting which of the following? p. d. voyeurism. E b. d.123 Paulo cannot achieve an erection unless his sexual partner wears high-heeled Ans. A App p. a. frotteurism Will is known as the "trench-coat bandit" in his home town.124 Ans.14. What psychological reinforcement does he obtain from this behavior? a. b. 516 a. homosexual / transvestic fetishism Arthur engages in cross-dressing. sexual fixation. Recently arrested and convicted. exhibitionism.126 Ans. male. Will would be described as a a. fetishism d. voyeur. c. 517 E 14. Client S is most likely to be a. relaxation d. exhibitionist. Karl is probably and is exhibiting . fetishism. 516 E 14. b. He shows a particular preference for this activity during stressful times at the office. exhibitionism b. fetishist. homosexual / transgenderism b. 14. transvestic fetishism c. disinhibition of homosexual impulses b.127 Ans. heterosexual / transvestic fetishism c. heterosexual / transsexualism d. either b or c A lawyer is talking with his recently arrested client about the client's sex-related charge. He acquired this nickname by wearing only a trench coat and exposing his genitals to several elderly women in his neighborhood. female. c. 359 . B App p. c. an adolescent. C shoes and insists that she wear them when they engage in sexual activity. psychotic. 516 M * 14. What is the client's most likely paraphilia? a. 14.125 Ans. a fetishist. Slater prefers his sexual partners to be bound with chains so that he may inflict pain on them against their will. He may have been a victim of sexual aggression in childhood. 517 M * 14. voyeurism c. d. frotteurism Joe is a convicted rapist. Slater is a likely candidate for the diagnosis of a. C Fac p. He may have experienced depression or substance abuse that contributed to his crime. Walt enjoys the hustle and bustle of crowded downtown subway stations and the packed elevators he rides each day to his office. deviant gratification. 517 E If Irving is an exhibitionist. b. Sergei wants his sexual partner to tie him to the bed or blindfold him during sex. active voyeurism. He is primarily motivated by sexual impulses in the commission of his crime. sexual sadism b. 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. Which of the following characteristics is LEAST likely to apply to him? a. D App p. he could be described as a.128 Ans. c. In these situations. 518 M 360 . a sexual sadist. b. He will attempt to physically or sexually assault a future victim. fetishism. d. 14. Which of the following is not a type of paraphilia? a. He is more likely to be arrested than is someone with a different paraphilia. d. none of the above. b. 517 M 14. frotteurer. b.130 Ans. d. pedophile. c. sexual sadist. sexual masochist. rape d. B App p. c. b.133 Ans. Slater finds a great deal of sexual satisfaction from these activities. frotteurism. He will probably not seek treatment voluntarily. c. a sexual masochist. 518 E 14. B App p. he can press his body into an attractive woman's body and enjoy a sexual thrill.132 Ans. If Sergei's sexual pleasure is enhanced by these activities. He is likely to know his victim and to blame her for the rape. D App p.14. C App p. 517 E 14. d.131 Ans. c.129 Ans. Walt's behavior is called a. " d. exhibitionism and voyeurism c. frotteurism and sexual masochism d.134 Ans. 521 E . juvenile fetishism c. sexual predatory disorder d. psychopath d. pedophilia b. rapist b. fetishism and transvestic fetishism Which of the following persons is probably LEAST distressed by her/his disorder? a. Which of the following descriptions is probably MOST likely to describe Perry? a. with gender identity disorder c. A App p. 518 E 14." Ms. 518 M * Perry shows a high degree of sexual arousal when exposed to audio or video stimuli depicting rape scenarios. her sex offender interviewees will report about paraphilic acts. frotteurism Which of the following explanations is a pedophile MOST likely to give for his actions against Tina. "The only way I could keep Tina in line is to threaten her with a show of force. with a paraphilia d. 350 c. even though I knew what I was doing was morally wrong. with sexual aversion 361 14. a.137 Ans.14. Recently he was arrested for sexually molesting one of the young boys in his troop. with FSAD b. "Her mother should have known better than to leave Tina alone with me.139 Ans. Michael. 500 b. 519 M 14." b. 520 E 14. "I couldn't resist temptation. C App p. What disorder is present? a. even when he doesn't have time to have an orgasm. 519 M 14. It's not my fault I have a mental illness. either a or b Harry has been a scout master for years. 33 Which of the following paraphilias are most likely to be comorbid? a." c. a 7-year-old child? a. sexual sadist c. In an interview with his therapist. A App p. B Fac p. Perry has admitted that he believes women enjoy being raped and that he enjoys being very aggressive with his partners. Veronica. B App p. and I'm helping her leam how to relate effectively to adults.138 Ans. and things just developed from there. 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.135 Ans. pedophilia and sexual sadism b. Mame.136 Ans. Carlos. On average. "Tina really enjoys my attention. Ching is conducting interviews under the auspices of the Federal Certificate of Confidentiality program. C Con p. 125 d. Hubble is treating Calvin for his fetishism. the clinician will focus on a.141 Ans. fetishism c. shame. If this theory draws on the most widely accepted model in this area. have a reduced risk of developing a paraphilia since the genes for this disorder generally skips a generation. masturbatory reconditioning c. b. b. frotteurism b. and just as Calvin becomes aroused by these images. Dr.143 Ans. A clinician is presenting a theory of the origin of frotteurism and voyeurism. visiting his father only about once a month. use of aversive electric shock b. Dr. d. of maggots crawling over him. be at no greater risk than children with non-paraphiliac parents for developing a paraphilia. d. b. 523 E 14. Dr. 521 M 14. olfactory. 522 E 14. and Stan grew up with his mother. 523 M * 14. covert sensitization 362 14.144 Ans. c. object relations. According to available genetic research. Judith Becker. C App p. be at a much increased risk for the development of a pedophilia. Matisse provides multimodal treatment for his clients who have been courtordered for treatment of a sex offense. Hubble begins suggesting images of Calvin developing lesions on his face. D App p. shame aversion therapy c. sexual stressors encountered during childhood. non-incestuous pedophilia d. Dr. Hubble asks Calvin to imagine his fetish-inducing object. classical conditioning and social modeling . c. B Con p. 523 M .140 Ans. visual imagery. c. systematic desensitization b. A App p. D Fac p. Stanton will probably a. only be at risk for a paraphilia if his mother also had some form of heritable mental illness. discussion of sexual myths and victim suffering d. Stanton's parents divorced when he was young.14. which of the following paraphilias is most likely to be effectively treated? a. incarceration.142 Ans. C Fac p. Hubble is using what therapeutic technique to treat Calvin? a. and other disgusting stimuli.145 Ans. such as bipolar disorder. Which of the following will NOT be a central component of this therapy? a. relapse prevention Dr. Covert sensitization for a paraphilia has been developed on the basis of each of the following aversive stimuli EXCEPT a. genetic and biological abnormalities. incestuous pedophilia Stanton's father had a paraphilia. d. multimodal aversion treatment d. 521 M According to Dr. be committed to a mental hospital until the legal authorities judge him as no longer a threat. be released on the condition he seeks outpatient therapy.Knoton has been convicted under his state's sexual predator law." DSM-III had a similar category. In 1973.transsexuals. 14. be committed to a mental hospital for a time period not to exceed his original sentence. 14. The judge and prosecuting attorney believe him to be an extremely likely candidate for recidivism.148 Trace the changing diagnostic practices in the DSM in regard to homosexuality. now called "ego-dystonic homosexuality. p. male erectile disorder. c.hypoactive sexual desire.female sexual arousal disorder. This label was "sexual orientation disturbance. Previous dysfunctions . premature ejaculation. he will a. What forms of sexual dysfunction were described prior to the identification of the 4-stage cycle? 1. d." However. Orgasmic . Resolution . 363 . When Knoton's prison term ends. 3. 14. sexual aversion. research suggests that he is more likely to Ans.female & male orgasmic disorder. all reference to homosexuality was omitted. and frigidity.147 If Omar is a convicted sex offender. Excitement . in the 1987 DSM-III-R.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. premature ejaculation. A App p.146 Ans. as is also the case with the current fourth edition.150 List the 4-stage sexual response cycle and indicate the sexual dysfunctions associated with each. 525 b. b. d. Desire . and the mental disorder was revised to be used only with individuals who were distressed by their orientation and wanted change. SHORT ANSWER/ESSAY 14. Adults . B repeat his offense if he App a. be released into a probation program in his home town. has been married. 14.(none). 524 C * The first two editions of the DSM considered homosexuality to be a mental disorder. victimized boys more often than girls. victimized his own daughter. the American Psychiatric Association officially changed its stance. has a relatively small number of previous sex offenses.impotence. 4. M c. 2. 14. religious. sexual masochism. her possible history of depression. what areas of your client's present and past experience would you want to assess before choosing a treatment plan? Neurological/vascular medical conditions.153 List the paraphilias. voyeurism. her attitudes and beliefs about sex . her sexual history mcluding possible sexual abuse as a child or as an adult.including cultural. frotteurism. 364 . 14.14. sexual sadism. and (most importantly) family influences. and pedophilia. and her feelings about and attitudes toward her current romantic relationship.152 For what reason is rape not classified as a paraphilia? While some sexual sadists commit acts of rape. exhibitionism. Fetishism. most rapists are motivated by aggression and hostility rather than a desire for sexual excitement and gratification. transvestic fetishism.151 If you were a counselor treating a female client for a sexual dysfunction. execution by burning at the stake b. He was burned at the stake for heresy during the Spanish Inquisition before his research could be completed. trephining c. Which of the following terms does not belong with the other three? a. 530 M 15. what are the elders likely to prescribe for Katunga? a. b. 531 M 365 . treatment with an herbal remedy d. Galen introduced an early form of the transorbital lobotomy procedure. b. and his village elders have decided he is possessed. In the early 1960s.4 Ans. Nobel Prize for medicine d. non-medicinal treatments such as convulsive therapy became the most commonly prescribed treatment for mental disorders. His colleagues stopped him after one patient died and another developed epilepsy.5 Ans. The applications of his procedure were limited. pharmacotherapy b. he continued developing it for years and set a precedent for the work of Moniz. Biologically based treatments for mental disorders have been used for centuries. 530 E 15. and it was halted due to a lack of subjects. severe mood disorders c. It has been proven that past cultures had no effective treatments for mental disorders. psychosurgery Katunga has been behaving violently. What prevented Gottlieb Burckhardt from perfecting the psychosurgical procedure he developed? a. C Fac p. If it is the year 1947.1 Ans. 531 E 15. Nothing. acupuncture-like treatment Which statement below is TRUE? a. d. Based on your text's description of prehistoric treatments for mental disorders.Chapter 15 15. what treatment would she have been LEAST likely to receive? a. d. prefrontal leucotomy b. A App p. electroconvulsive therapy d. D Con p.2 Ans. Freeman 15. c. D Con p.3 Ans. c. B App p. metrazol therapy c. 530 E BIOLOGICAL TREATMENT OF MENTAL DISORDERS Danette is depressed and has psychotic symptoms. 531 M A leucotome is a a. 1 d. the superiority of this procedure over SST surgery d. 0. a transorbital lobotomy b. died). an obese patient. Burckhardt c. a. 5 Dr. % of patients died of cerebral hemorrhage from lobotomies. Max is undergoing surgery. book that describes precisely where known brain structures are located. a subcaudate tractotomy Which of the following names does not belong with the other three? a. B App p. 1. In the years that followed. A Fac p.. 0. d. 3 b. b. For what reason might he have become interested in Freeman and Watts' transorbital lobotomy procedure? a. none of the above. the influence of drug manufacturers and insurance companies 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. b. 531. D App p. Small holes have been drilled in his skull just over the frontal lobes. the accuracy and effectiveness of the procedure b. pick-like instrument used to destroy brain tissue. d. What is the name for this procedure? a. 15. Moniz According to Moniz and Lima. Sakel b. 531 E 15. c. B App p. a mentally retarded patient. 1.8 Ans. psychosurgical procedure developed by Almeida Lima. Luke was a psychiatrist who treated several severely psychotic patients in the late 1940s.7 Ans.e. 531 M 15. 531 E 15. a patient with severe alcoholism. a prefrontal leucotomy c. A Con p. a frontal lesioning d. the ability to quickly conduct this procedure in his office c. B Fac p.10 Ans. % of their first group of 20 patients were "failure" cases (i.6 Ans.9 Ans. c.11 Ans. 531 M 366 . and the doctor is injecting alcohol through the holes. Freeman d. psychosurgical procedure developed by Gottlieb Burckhardt.15. 5 c.3 E 15. 12 Ans. Which characteristic below is probably NOT present in Linden now? a. 531 M 15. poor judgment c. What is the name for this procedure? a. though they often recur. a stereotaxic subcaudate tractotomy c. standard lobotomy : frontal lobes For which of the following patients would you NOT recommend psychosurgery? a. Rosetta. a lobotomy Martha has undergone a cingulatomy. D App p. a male with schizophrenia Nancy is a schizophrenic. 532 M Linden has undergone a transorbital lobotomy. a prefrontal leucotomy d. cingulatomy : Papez circuit b. 532 M * 15.17 Ans. There is a roughly one in ten chance that Martha will develop postsurgical seizures. C App p. D App p. He exhibits self-mutilating patterns. Eddie is also a schizophrenic and has paranoid delusions and often hears voices telling him he is an emissary of the devil. d. A App p. SST : temporal lobes c.16 Ans. a male with intractable. 532-3 M . 531-2 E 15. B Con p. Alexandria 367 15. Chinato d. Martha probably suffers from schizophrenia. severe bipolar disorder c.15 Ans. Nancy b. transorbital lobotomy : frontal lobes d. Chinato has obsessivecompulsive disorder. lack of motivation b. Nanette. The procedure lesioned a small portion of tissue in her limbic system. epileptic seizures d. There is a roughly one in eight chance that Martha will commit suicide. C App p. Which person is the MOST likely candidate for psychosurgery? a.13 Ans. a female with severe depression that is unresponsive to medication b. Which of the following surgical procedures and brain areas are mismatched? a. c. Kim.14 Ans.15. b. 532-3 M 15. She shows extreme flatness of emotion and is usually catatonic. a cingulatomy b. blindness Jake is undergoing surgery. In a few minutes. Alexandria suffers from bouts of depression which usually last for a few months and then subside. Eddie c. Benton. a female with obsessive-compulsive disorder d. such as excessive handwashing to a degree that causes his hands to bleed. The surgeon has bilaterally inserted electrodes into portions of Jake's Papez circuit. Which statement below is probably NOT true about Martha? a. radio frequency waves will heat the tips of the electrodes and destroy some of the circuit's fibers. Seizures rebalance inconsistencies within the libidinal patterns of the patient. about ninety years d. d. d.6 M Which statement below is FALSE in regard to psychosurgery today? a.20 Ans. what span of time would your report need to cover? a. Seizures and psychosis appear to be neurologically incompatible and thus induced seizures must correct psychotic brain activity. If you were to write a comprehensive report on the history of convulsive therapies. insulin-induced coma therapy c. c. b. Because more precise modem methods are still ineffective for schizophrenia. the ceremony would have celebrated his proposal that a. drugs initially intended to treat tuberculosis could successfully reduce the core symptoms of mood disorders. physicians had gathered together in the 1940s to honor Ladislas von Meduna. but there is no real improvement. prefrontal leucotomy b. and dramatic improvements for patients are unlikely. c. 533. resulting in reduced psychotic behavior.4 M * 15. bilateral electroconvulsive therapy d. epilepsy and schizophrenia were neurologically incompatible disorders and thus seizures could treat schizophrenic patients. transorbital lobotomies could be efficiently conducted on patients with varying kinds of chronic mental disorders. B Con p. electric current applied bilaterally to the head could safely and effectively treat schizophrenia. Manfred Sakel during the earlier part of this century.21 Ans. The absence of data comparisons of psychosurgery to placebo group outcomes makes the results of psychosurgery hard to determine. The flood of neurotransmitters released during a seizure alters the stores of neurotransmitters within the patient's neurons. metrazol therapy If European and U. several centuries b.19 Ans. 15. c. Psychosurgery is used primarily as a last resort in severe cases. d.15. 534 M 368 .22 Ans. Differing diagnostic practices and varying criteria for success make it difficult to compare the results of studies on psychosurgery. B App p. What theory did von Meduna propose to explain the results of convulsive therapy? a.18 Ans. D Fac p. 533. b. A App p. The patient suppresses any reports of psychotic behavior in order to avoid the aversive punishment of convulsive therapy. three decades If you were afflicted with schizophrenia and were under the care of Dr. 533 E 15. b.S. ECT is now the standard non-drug intervention for this chronic disorder. A Con p. about one hundred-fifty years c. what treatment would you probably have been prescribed? a. 534 M 15. Japanese studies of combat hysteria during WWII b.25 Ans. what type of therapy would Betina undergo? a. broken bones. an electrical impulse through his dominant hemisphere. a treatment session that takes about 4 minutes to complete Nancy will have her very first ECT session tomorrow. 535 M . D Con p.15. electroconvulsive therapy c. 11 to 12 more sessions. reserpine It is 1948. physical contortions as the convulsion occurs in her brain b. 534-5 M * Which of the following terms does not belong with the other three? a. behavioral changes in a mountain shepherd who was stuck by lightning Jeremiah is a modern ECT patient. the shocking of hogs prior to slaughter d. Which of the following will you NOT observe? a. Compared to procedures used in the past. recording of brain wave activity via EEG d. electricity c. 5 to 6 times a week for the next 2 weeks If Ruben has completed a series of modem ECT treatments. A App p. 535 M 15.24 Ans. 534 E 15.26 Ans. joint aches. 2 to 3 times a week for the next 3 to 4 weeks d. supplementary oxygen. and a woman named Betina is suffering from schizophrenia. an accident in Cerletti's laboratory in which a psychotic patient grabbed a live electrical wire c. metrazol b. metabolic changes. If she were treated by Cerletti and Bini. muscle relaxants. b. c. elevated blood pressure. use of a lower level of current than is used for male patients c.27 Ans. increased levels of electricity as treatments are repeated. d. 2 more sessions. 10 more sessions. C Fac p. 4 to 6 more sessions.29 Ans. as symptoms recur b. a cingulatomy What observation(s) led to the development of electroconvulsive therapy? a. which of the following adverse side effects is Ruben MOST likely to experience? a. headaches and five-month long episodic memory impairment c. hyperphagia and loss of semantic memory d. metrazol therapy d. 535 M 15. over next 4 months. You are a psychology intern observing an ECT session for a psychotically depressed female. B App p. A App p. 534 E 15. insulin d. procedural memory loss b.28 Ans. B App p. insulin-induced coma therapy b. 534 M 15. twice a week for the next 3 to 4 weeks c.23 Ans. cognitive impairment 369 15. C App p. Jeremiah will NOT be given a. How often will she probably undergo ECT after this first session? a. D App p. Jorge received only antidepressant medication. By what mechanism does ECT affect disordered mood? B a No definitive answer is available. 536 E 15. Psychopharmacology will be of little help to this patient. d.34 Ans. schizophrenia. If he prescribes follow-up medication treatment. Samuel was given ECT followed by an antidpressant for his severe depression. a. more. equal to d. c. C App p. more. b. how many of his patients will probably experience a relapse? a. b It stimulates an increased production and release of catecholamines and beta-endorphins. This patient may be a candidate for psychosurgery. This patient should be given modem metrazol therapy. he could have any of the following EXCEPT a. 536 M * . Which of the following memories is she MOST likely to forget following ECT treatment for depression? a. 535 E 15. Ellis has treated 50 severely depressed patients in the last six months with ECT. 4 Dr. her home address and phone number and those of her family d. the procedures for entering data into her computer b. 535 M 15. 535 M 15. less. characterized by delusions and several oddities of behavior and speech. the conversations she had with her family about the treatment in the days before it occurred If Tyler has a disorder that is among the three disorders that comprise the majority of ECT cases. c. B App p.15. bipolar disorder. A App p. c. D App p. less optimal than Dr. A Fac p. McCoy has a new patient who has been diagnosed with chronic schizophrenia.33 Ans. You would anticipate that Samuel's symptoms would improve quickly than Jorge's and that Samuel's treatment outcome would be Jorge's. obsessive-compulsive disorder. It stimulates increased production and release of antidepressin.32 Ans. the meaning of the shorthand her boss uses when he sends assignments to her c. 25 b.31 Ans. 18 c. equal or superior to c. The patient's symptoms have been relatively stable over time. Which statement below is a CORRECT prognosis for this patient? a. severe depression. 10 d. d It disrupts the cognitive rumination and other dysfunctional cognitive processes that maintain depressed mood. 535 M Sheree is a data entry operator for a large business firm.30 Ans. less. This patient is an unlikely candidate for ECT.35 Ans. b. 370 15. d. less optimal than b. 41 Ans. 1950s d. about % of her patients will be receiving the most common form of biological treatment for their disorders. Which of the following persons will determine whether Tamara actually undergoes this treatment? a.S. the presence of placebo effects in psychosurgery outcomes d. that proportion would have been roughly . Gundy conducts research in the area of psychopharmacology.15. a. C App p. 55.39 Ans. 76 d. the delegate from Britain d. one quarter d. A App p. 45. 33. the delegate from India b. 537 M 15.. McVaugh has decided that his patient. an NIMH reviewer of Dr. Tamara. 90 c. 537 M 371 . 1970s If Dr. one half Dr. one third c. c.36 Ans. D App p. 537 E 15. 1930s b. one quarter b. the delegate from the U. % of outpatients are receiving medication. In the mid 1970s. 1940s c. 97 b.37 Ans.40 Ans. 55 15. 536 M At an international conference where mental health experts meet to discuss advances in treatment of psychopathology. successful application of ECT to cases of catatonic schizophrenia c. the delegate from Italy Dr. McVaugh's treatment plan b. Parrilla is a psychiatrist. improvements in the application of stereotaxic subcaudate tractotomies b. McVaugh c. Dr. B App p.S. which delegate would be most reluctant to exhibit enthusiasm for modem ECT? a. C Fac p. is an excellent candidate for ECT. B App p. 537 M 15. 55. a. the frequency of comorbid substance abuse in psychiatric patients If practices at the local community mental health center are comparable to those found across the U. which of the following research topics would be of interest to him? a. either b or c During what decade was today's most common form of biological treatment introduced? a.38 Ans. 536 E 15. Tamara d. If she is like most of her colleagues. agonist. Nikita is taking an antidepressant that is severely reducing her REM sleep and sometimes causes a precipitous rise in her blood pressure. What type of dmg is Dmg X? a. Mariah is suffering from depression. c. d.48 Ans.44 Ans. 540. Nardil c. Tofranil b. c. selective serotonin reuptake blocker c. clomipramine d. D Fac p. 5-HT inhibitor d. d. neuro-reagent. Wellbutin Mariah is taking an MAO inhibitor. What statement about her case is FALSE? a. A App p. fluoxetine Heroine affects brain functioning by mimicking the action of endogenous opiates. c. SSRI's.47 Ans. Mariah should not eat aged cheese or drink beer while taking this dmg. inhibitor. monoamine oxidase inhibitors. heroine is a(n) a. d. c. 537. Mariah's medication is acting as an agonist for serotonin and norepinephrine. an antagonist Gwynneth is taking a psychoactive substance for her depression disorder. deactivator. This substance could come from any of the following categories EXCEPT a. b. agonist. naltrexone is a type of a. 539 M * 15. reuptake inhibitor.7 E 15. d. an agonist b. 539 M 15. Mariah will have no REM sleep while she is taking this dmg. B App p.15. D App p. A new type of dmg. antagonist. blocks the effects of the neurotransmitter serotonin by attaching to serotonin receptors. 540-1 C Of the $3 billion spent on antidepressant medications. 372 15. butyrophenones. In other words. Zoloft d. 540 M . B App p.42 Ans. b. antagonist.43 Ans. Dmg X. b. 539 M 15. If the drug naltrexone causes an increase in perceptions of pain by occupying receptors that are normally stimulated by endorphins. heterocyclics. the largest portion goes to purchase which drug? a. Which of the following drugs is she probably taking? a.46 Ans. imipramine b. amoxapine c.45 Ans. D App p. b. A App p.40 E * 15. 53 Ans. 541 M 15.49 Ans. D App p. 541 M 15. and she is now taking an antidepressant. D App p. sertraline Javier is taking a TCA medication to help him with his depression. 22 b.50 Ans. These drugs block the reuptake of dopamine but not norepinephrine. and constipation. How are drugs such as fluoxetine different from first generation antidepressants such as phenelzine or imipramine? a. a 42-year-old male c. 30 c. He may experience a dry mouth. Which of the following might have been prescribed for her? a. how many of them will probably experience uncomfortable side effects? a. Missy. 542 M 15. 40 d.51 Ans. d.15.7 M * 15. b. either a or c Vincenzo began taking an SSRI yesterday for treatment of his major depression. fewer than 5. These drugs block the release of both norepinephrine and serotonin. About how long will it be before the maximum level of effectiveness is reached? a.3. three weeks d. diazepam b. C App p. Alicia. C Con p. These drugs affect primarily serotonin but not norepinephrine. He will need to avoid foods that contain tyramine. These drugs slow the breakdown of serotonin rather than norepinephrine. Of the 100 patients for whom Dr. 540. Moody has prescribed Prozac. a 67-year-old female d. He is taking the type of antidepressant that is most widely prescribed. b. B App p. 7 days b. insomnia.52 Ans. which is part of this drug's popularity A therapeutic daily dose of Paxil (paroxetine) is 20 to 50 mg. chlorpromazine c. 541 E * Anita recently went through a very vicious divorce. Which statement below applies to Javier's case? a.54 Ans. c. The known cause of his depression will be relieved. 542 M 373 . A Fac p. a 14-year-old female b. alprazolam d. d. For which of the following persons might a dose of 20 mg/day conceivably cause psychotic-like symptoms of overdose? a. Philippe. 15 days c. c. five weeks 15. 56 Ans. buproprion b. and Mapela is receiving lithium for her bipolar disorder.15. B App p. 9. Marsha. John Cade c. 8. none of the above Which of the following terms does not belong with the other three? a. with recurrent. trazedone Koa suffers from an untreated bipolar disorder. Koa's manic episodes occur about every months. A App p. lithium b. Conchita. 542 M * 15. severe major depression Miyoko has been admitted to the hospital in an acute manic state. She believes she is the antichrist and that she can kill people by simply wishing them dead. 542 M 15.58 Ans. a heterocyclic d. Tiko. Which of the following medications is she MOST likely to receive? a. D App p. an SSRI d. diazepam d. 14.55 Ans. anSSRI c. What is this medication? a. C Con p. 542 M 15. A App p. an MAO-I b. If they are similar to most persons with this disorder. Ronnie. Nadia's psychiatrist has now prescribed a medication that is believed to work by altering secondary messengers. Which antidepressant is likely to be an effective treatment for her? a. D App p. with bipolar disorder d. lithium c.60 Ans. both a and b 15. naturally occurring salt b. with a specific phobia b. secondary messenger alteration Nadia has been diagnosed with bipolar disorder. neuroleptic d. 542 M Bernice has a major depression with severe psychotic symptoms. much less often b. and Mapela's will occur . slightly less often d. She has shown no improvement with traditional antidepressants such as MAOs or SSRIs. 542 C 15. with schizophrenia c. 14.57 Ans.59 Ans. much less often c. a. about as frequently but with much milder symptoms Which of the following persons is LEAST likely to take a prophylactic drug? a. 542 M 374 . a neuroleptic c. 61 Ans. dopamine is to GABA.15.64 Ans. D App p. lithium c. c.62 Ans.65 Ans. dybenzoxapines b. To help him cope with his symptoms. 543 M 15. b. a physician will most likely prescribe an antianxiety drug that belongs to which family of medications? a. phenothiazines d. 543 E 15. butyrophenones c. GABA 375 15. Prozac b. carbamazepine Valproic acid is to buspirone as a. B App p. dopamine c. 543 M 15. 542 M 15.67 Ans. benzodiazepines Which neurotransmitter's postsynaptic binding is facilitated by benzodiazepines? a. d. norepinephrine b. agonist is to antagonist. 544 E . valproic acid c. valproic acid. 543 M * Errol is slurred in his speech. D Fac p. Which of the following medications does not belong with the other three? a. lithium. buspirone If Pai is receiving the kind of treatment for bipolar disorder that is quickly becoming the standard of care for this disorder. lithium d. B Con p. Which of the following dmgs is he taking? a. lithium Pierre suffers from posttraumatic stress disorder. mania is to depression. a. C App p. A Con p. amoxapine b.66 Ans. MAO-I b. Xanax d. psychotherapy. c. d. b. Carleton is taking a medication which belongs to a category more frequently prescribed than any other type of dmg. and is feeling very nauseous. He probably has a toxic level of in his body. Haldol d. 543 E 15.63 Ans. glutamate d. a combination of lithium and psychotherapy. is having difficulty maintaining his balance. bipolar disorder is to anxiety disorder. coupled with anxiety attacks and agoraphobia. C App p. Pai will receive a. Prolixin c. anMAO-I Arielle has been taking alprazolam for 8 weeks to help relieve symptoms of agoraphobia. 5 c. c. If the drug was coupled with the psychotherapy. what will probably happen? a. but at a much lower intensity than before.71 Ans. lithium d. What medication is Francoise probably taking? a.68 Ans. Xanax c. When she stops taking the drug. and suffer detoxification effects. busiprone is more addictive. Prozac b. 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. Should he be more willing to prescribe buspirone? a.15. 8 d.70 Ans. Her anxiety and panic attacks will recur with increased intensity. No. she should be fully treated. but busiprone requires extensive blood testing if it is taken. anSSRI c.69 Ans. Kirsten's physician is reluctant to give anxiety-disordered clients long-term prescriptions for benzodiazepines. d. 546 C 15. She will become confused. No. 544 M Lieux is taking a psychoactive substance that is causing significant drowsiness. C App p. c. 545 M 15. A App p. Yes. d. 10 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. Dr. how many patients will probably experience withdrawal symptoms after several months of treatment? a. because busiprone is an antidepressant. 544 M * 15. buspirone b. If she has prescribed Xanax to each of them. fluoxetine c.73 Ans. D App p. a benzodiazepine b. b. alprazolam A physician is reviewing me literature on the treatment of panic attacks. Dumont is treating 10 patients who have panic disorder. disoriented. 2 b. Yes. b. buspirone d. any of the above 15. busiprone acts on different neurotransmitters than benzodiazepines do. 544. A App p. D App p. Which of the following substances is the MOST likely culprit? a. Her anxiety and panic attacks will recur.6 C 376 . B App p. Tofranil d.72 Ans. 544-5 C * 15. A App p. selective serotonin reuptake inhibitors d. A App p. phenothiazines Which of Josef s schizophrenic symptoms will be LEAST affected by the use of an antipsychotic medication? a. monoamine oxidase inhibitors b.15. 546 E 15. 546 E 15.78 Ans. a. benzodiazepines c.74 Ans. 546 M * If a biological treatment were chosen for Solveig who suffers from OCD. tangential speech Neuroleptic drugs have drastically changed the nature of institutionalization for psychotic individuals. 547 E 15. b. Her obsessions will noticeably decrease within two to three weeks of the start of treatment. She will experience fewer benefits from this dmg than she would from BuSpar. a person who is taking Anafranil for the treatment of OCD? a. Which of the following terms does not belong with the other three? a. auditory hallucinations c. aTCA b. 19 Which of the following medications and their initial uses are mismatched? a. C Fac p.76 Ans. 54 b. phenobarbitals d. B Con p. C Con p. B App p. 546 E 15. 547 M .80 Ans. incoherent. c. tricyclics : treatment of schizophrenia 377 15. phenothiazines : treatment of epilepsy c. Her compulsions will fully remit within 10 weeks. MAO-I : treatment of tuberculosis d. 546 M 15. neuroleptics Maude is hearing voices and having paranoid delusions. What general class of drugs is her physician likely to prescribe to her? a. social withdrawal b. a benzodiazepine d. She will discontinue the dmg due to bothersome side effects. d. about % of schizophrenic patients respond well enough to live completely independently. With these drugs. carbamazepine Which of the following descriptions is MOST likely to be true for Kamala. antipsychotics c.79 Ans. D App p.75 Ans.77 Ans. 40 c. psychosurgery c. 30 d. delusions of grandeur d. major tranquilizers b. which of the following is MOST likely? a. metrazol therapy : treatment of schizophrenia b. What side effect does this represent? a. and when. 547 E 15. and back. acute dystonia b. symptoms of anxiety and panic d. dry mouth. C Fac p. 548 M 15. what will result? a. D App p.84 Ans.85 Ans. blurred vision. Which of the following is occurring in his brain? a.83 Ans. The drug is functioning as a dopamine antagonist by targeting D2 receptors. in the early 1950s c. 548 M 15. The drug is functioning as a dopamine agonist. If Fiona is taking a drug which is acting as a dopamine antagonist in her basal ganglia. Parkinsonism Assaf is displaying uncontrollable restlessness and feels a constant need to keep moving his arms and legs. in Italy. high fever and muscular rigidity A group of patients is being treated with neuroleptics. TO Denise has an extrapyramidal syndrome marked by rapid. in the U. What side effect does this represent? a. C App p. thereby reducing psychotic symptoms. acute dystonia d. spasmodic contortions in her head. b.15.86 Ans. was chlorpromazine first used to treat mental patients? a.S. D App p. in the mid 1950s b. neck. A App p. Parkinsonism c. TO c.. neuroleptic malignant syndrome b. 548 M * 15. 548 M 378 . c.. acute akathesia 15. in France. acute akathesia d. acute dystonia d. The drug is affecting dopamine functioning in the limbic system and frontal lobes but does not significantly affect other structures. extrapyramidal restiveness c.S.82 Ans. in the U. and constipation c.81 Ans. The drug is reestablishing a balance between dopamine and acetylcholine. When their dopamine levels drop out of balance with their levels of acetylcholine. extrapyramidal symptoms b. acute akathesia b. Sometimes she looks as though she is having an epileptic seizure. 547 E * In what country. B App p. in the early 1950s d. d. which of the following symptoms will occur? a. in the early 1960s Nigel is taking a typical neuroleptic. neuroleptic malignant syndrome c. neuroleptic malignant syndrome 379 . acute dystonia. none of the above Which of the following persons is MOST likely to develop TD? a. She is now starting to develop some dangerous side effects from this medication. exhibits uncontrollable twitches in her face and lateral movements of her jaw. Parkinsonism b. Parkinsonism c. Heinz. toxic phenothiazine poisoning. The long-term side effect that is unresponsive to antiParkinsonism medication is . and has spasmodic jerks and tics in her trunk and arms. a long-term psychiatric patient. tardive dyskinesia d. Gertie. makes smacking sounds with her lips. acute akathesia Terry has just been mshed to a hospital emergency room with an extremely high fever. acute dystonia Trisha has been taking chlorpromazine for most of her adult life. muscle rigidity. a 47-year-old schizophrenic female who has taken neuroleptics for 25 years c. a. What disorder is present? a. TD d. Which condition below is the LEAST likely to be among these? a. neuroleptic malignant syndrome c. Melanie. neuroleptic malignant syndrome. If Terry began taking a neuroleptic a few days ago. 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 . and irregular heart rate and blood pressure. tardive dyskinesia b. tardive dyskinesia d. Parkinsonism c. a 63-year-old schizophrenic male who has taken neuroleptics for 20 years b.Sadie. acute dystonia b. Raoul. a 36-year-old bipolar male who has taken mood stabilizers for 20 years d. acute akathesia. what should the physician suspect? a. neuroleptic malignant disorder d. tardive dyskinesia b. b. 549 E 15. Sertraline b. It is not associated with the extrapyramidal side effects common to other antipsychotic medications. Clozaril c. Haldol 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. B Con p. 549 M 15. Vittorio's family would like him to take clozapine for his psychotic disorder marked predominantly by negative symptoms. Extrapyramidal side effects from the medication may motivate Vittorio to refuse to keep taking the drug. Clozaril For psychotic patients who exhibit predominantly negative symptomatology.96 Ans. d. It is effective for the treatment of both positive and negative psychotic symptoms. It is free of virtually all annoying side effects. For what reason might this be problematic? a. methamphetamine c. the costs of her treatment run her several thousand dollars per year.93 Ans. The drag may be prohibitively expensive for Vittorio and his family. It has antagonistic effects on several neurotransmitters besides dopamine. thiothixene b. which medication would you recommend? a. 549 M * 15. dextroamphetamine b. but she is seriously considering changing it because of the high cost of treatment. This drug is effective only for schizoaffective disorder. in which some negative symptoms are caused by an underlying mood disturbance. pemoline 380 15. d. B App p. Serzone c. A Fac p. 549 M Janet is taking a medication for schizophrenia. c. clozapine Which of the following medications does not belong with the other three? a. What medication she is taking? a. olanzapine d. D App p. Which of the following is NOT an atypical neuroleptic medication? a. 551 E . methylphenidate d. Prolixin d. an SSRI d. With the weekly blood cell count she must have.92 Ans. Antipsychotics such as this one are not very effective in treating negative symptoms. risperidone c.97 Ans. C Con p.95 Ans.. D App p. c. Stelazine b.94 Ans. b. 549 M 15. c. and a loss of appetite four to five hours after his last dosage. normal levels of arousal throughout the day. Forrest was in a hurry and forgot to take his midday dosage to school.100 Ans. a.101 Ans. 552 M . a ten-year-old male. improved attention to relevant environmental stimuli As a parent of an ADHD child. improved social relationships b. increases. and his ADHD symptoms will return stronger than ever. decreases. B App p. pharmacodynamic 381 15. headaches. 551 M 15. norepinephrine and dopamine c. D App p. a group of white males b.102 Ans. 552 E 15. B Con p. D App p. pharmacokinetic c. long-term academic gains c. 551 E 15. 551 M 15. Forrest will most likely experience a. reductions in dosage levels d.99 Ans. serotonin d.15. 551 M * Nine-year-old Toshio is taking the commonly prescribed stimulant medication for his hyperactivity. A App p. periodic drug holidays When physicians read information from studies of pharmacodynamics and pharmacokinetics today. a rebound effect in the early afternoon after his last dosage. a. a group of white and Asian males Dr. Which of the following outcomes is LEAST likely for children taking stimulant medication? a. GABA b.103 Ans. psychopathological b. side effects of decreased appetite and physical discomfort d. you are concerned that the medication your child is taking to treat the disorder may stunt his/her growth. The medication the availability of in his brain. psychodynamic d. took his ADHD medication at breakfast around 7:30 A. Sekka is studying the antagonist effects of clozapine on D4 receptors. abdominal pains.M. A Con p.98 Ans. According to the text. This work is a specific example of research. According to the text. d. vigorous exercise to stimulate muscle development c. what sort of sample is most commonly represented in those studies? a. a group of white and Hispanic males d. increases. decreases. a vegetarian diet b. a decrease of arousal as the day progresses due to the fact that the stimulant will wear off. b. dopamine Forrest. what would your child's clinician recommend to avoid this possibility? a. a group of white males and white females c. this would be called a(n) a. won the Nobel Prize for Medicine (in 1949) but was also shot and paralyzed by a disgruntled patient.15. an African American male Michael was given a sugar pill that he believed was actually an antidepressant medication. psychoactive effect.106 Ans. Trevor. Vito. Moniz. the neurosurgeon who introduced the lobotomy. 552 M 15. which of the following persons will achieve the highest blood concentration level of a phenothiazine? a. According to the findings from the NIMH Treatment of Depression Collaborative Research Program. b. this involved the use of a leucotome that was inserted through the skull. a Hispanic male b. pseudochemical effect. and alcohol was then injected into the tissue to destroy it. This was replaced by the simpler office procedure in which a small ice pick-like instrument was inserted into the socket above the eye. placebo effect. 552 C Which of the following pharmacokinetic outcomes is likely to apply to Medgar. which factors was probably MOST important in her treatment? a. If his symptoms improve significantly. 553 E * 15. Medgar will experience a faster therapeutic response to tricyclic drags than will a white male. antidepressant medication d.104 Ans. Medgar will show a higher blood concentration of neuroleptics than will an Asian male for similar doses. B App p. Hiroski.107 Ans. interpersonal therapy 15. ethnic differences have not been established in this area. In the U. 382 . 553 M SHORT ANSWER I ESSAY 15. the quality of the relationship with her therapist b. C App p. the placebo effect c. A App p. A App p. 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. experimenter expectancy effect. None of the above is correct. Later.. c. 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. c. undercutting the frontal lobes. Vivian has undergone successful therapy for depression.105 Ans. Small holes were drilled in the skull just over frontal lobes. b. a black male? a. d.108 Describe the "blind" lobotomy techniques used in the past. a Caucasian male d. Given equivalent doses.S. Robert. Medgar's metabolism of benzodiazepines will be faster than that of a white male. and a wire loop was rotated to destroy the tissue. d. a Japanese male c. the drug acts quickly to relieve symptoms. possibly. major depression with melancholia.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. For what disorders) is this therapy used today? Insulin coma. severely suicidal depression).109 List in chronological order the development of convulsive therapies. initial side effects are negligible. metrazol therapy. 15. unilateral ECT Used for severe mood disorders (manic episodes of bipolar disorder. used in essentially all cultures with the belief that they could relieve mental distress. with fewer adverse side effects. 15. 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. they are relatively inexpensive. psychotic depression. The drugs have several adverse side effects. 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. and.111 What influence has ancient herbal medicine had on the field of psychology? Herbal remedies were the predecessors of psychotropic drugs. 383 . 15. less severe depression that has been unresponsive to all other treatment interventions. beginning with Sakel's procedure. and they are not effective for all patients. ECT procedures have become much safer. Patients with acute manic episodes also benefit from this treatment. catatonic stupor and acute schizophrenic agitation.110 For what reasons has ECT grown in popularity in the past few years? The promise of antidepressant medications has not been completely fulfilled. and are highly effective for severely depressed patients (particularly when combined with medication follow-up). they can also combine with alcohol to produce potentially dangerous motor impairment. bilateral ECT. The drags are dangerous because diey can cause dependence and severe withdrawal symptoms that can even cause greater discomfort than the original symptoms.112 activity.15. Also. [No modal response predictable. BuSpar effectively treats generalized anxiety disorder. TCA. what dmg is effective for the treatment of generalized anxiety? for the treatment of OCD? Panic treatment: MAO-I. 15. SSRI. Would you advocate the use of some kind of biological treatment? Using evidence from your text.114 Regarding dmg treatment for anxiety disorders: What four types of medication are effective for the treatment of panic attacks? Besides the benzodiazepines. and benzodiazepine (Xanax). defend your answer.] 384 .115 Suppose a relative of yours were to be diagnosed with a severe episode of major depression.15. Anafranil/clomipramine (a TCA) as well as the SSRI's are useful for OCD. sooner c. cultural backgrounds. c. Dominique will be likely to seek therapy and probably to terminate it. 558-9 E 16.1 Ans. is more likely to seek therapy. Alicia Dominique is a woman living in near-poverty conditions. Marta. neither c. later d. Dr. Compared to someone from a higher SES class. levels of self-esteem. 558 E 16. which of the following persons is LEAST likely to receive psychotherapy? a. B App p. Alicia d. 16. Madsen.4 Ans. Cosby. a 62-year-old male b. less.5 Ans. C App p. d.2 Ans. a psychiatrist b. a psychologist c. an older adult. a clinical social worker d. 559 E . equally. Karen. more. A App p. but if both were to receive therapy. Michael. 558-9 E Which of the following persons can be called a psychotherapist? a. B App p. socioeconomic classes.6 Ans.3 Ans. D App p.Chapter 16 PSYCHOTHERAPY 16. c. less. more educated. 559 E 16. Curtis. a 33-year-old male Lorena feels tired and irritable and is considering making an appointment to see a therapist. all of the above Statistically. Alicia. Michael b. Vicki's strategy will most likely need to be adjusted for clients of different a. a. sooner b. Lorena's therapy will probably be more successful if she is a. Keifer. a 27-year-old female c. Alicia and Michael are both experiencing an episode of major depression. a younger adult. b. Alicia. sooner Vicki says that she always encourages her clients to fully express their emotions and become independent thinkers. Fuhr. a minority. A App p. a 15-year-old female d. Ms. Dr. Alicia. d. professions. b. _______ would exhibit greater improvement. 558 E 16. a. c. d. b. C Fac p. marital difficulties.16. Dr. he will see about clients each day. experienced therapists tend to keep clients in therapy somewhat longer than do novice therapists. the quality of die client-therapist relationship is more important than the therapist's type of training. Suzette. an African American male d. a psychotic condition. people of upper socioeconomic status. 560 E * 386 . C Con p. 4 b. b. middle-aged adults. Drawing on prevalence rates to predict what problem your next psychotherapy client is MOST likely to have. a European American male c. c.11 Ans. In her first interview. d. 559 E 16. 559-60 C 16. c. you should guess a. D Con p. 559 E 16. According to your text.10 Ans. Who of the following is this likely to be? a. C App p. a Hispanic male 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. Stephen. a.8 Ans. 559 E 16. Research on therapy outcomes shows that a.12 Ans. a European American female b. depression. Seasoned. Carter.9 Ans. If he is typical of most therapists. seasoned therapists do better than novice therapists. novice therapists do better than seasoned therapists. d. the therapist's type of training is as important as the quality of the client-therapist relationship. she talked with an individual who is a member of a group overrepresented in such settings. 13 In a student's summary of the characteristics of effective psychotherapists. Evidence conclusively demonstrates that untrained helpers are as effective as professional therapists. 16. B App p. 7 c. Carlos. 559 M Marguerite has just begun a training rotation on an inpatient psychiatric unit. Hispanic Americans. b. they should be advised to target a. d. women. b. Therapy outcomes tend to be somewhat more positive when the therapist is a psychologist rather than a social worker. 11 d. c. which of the following statements would be TRUE? a.7 Ans. substance abuse. Ruiz is a psychotherapist. A Con p. Novice therapists appear to produce outcomes that are comparable to those of more experienced therapists. is a secure place to practice new ways of communicating with others. Which of the following is most likely to be a quote from an interpersonal therapist? "The therapeutic relationship a. B App p. Rogerian client-centered therapy : a new opportunity for soothing past fears and insecurities Several therapists were interviewed about the importance of a positive working alliance with clients. D Con p. a positive relationship with clients Which of the following theoretical approaches and rationales for the working alliance are mismatched? a. D Fac p." For Amelia and her therapist to establish a strong working relationship. d. clients' exploration of the causes of their problems d. Dr.14 Ans. informed consent contract. several factors must be present. This is known as a(n) a.15 Ans.16. 560 M 16." c. may help clients to overcome past anxieties. working alliance agreement. a. therapeutic contract. 560 M 16. the therapist's genuine concern for Amelia's well-being d. cognitive-behavioral therapy : a means of fostering compliance with treatment techniques b. a strong commitment to therapy on the part of Amelia as well as her therapist c. professional graduate-level training b. B App p. Which of the following is LEAST crucial to that relationship? a. and other conditions that will facilitate their work. at least average intelligence in clients c. 560 E 387 . interpersonal therapy : a safe context for practicing new patterns of communication d. allows clients to work through and understand how early conflicts still affect them. is a means of gaining a client's confidence in the treatment method. b. 560 C Psychotherapists agree that is a necessary ingredient for successful therapy." d.16 Ans. a clearly established therapeutic contract In her first session with new clients. professional therapy agreement. c. 560 E 16.17 Ans." b. 16.13 Ans. Freudian psychoanalysis : a vehicle for exploring connections between early experience and current problems c. the nature of confidentiality. A App p. the therapist's expertise in an eclectic method of therapy b. Hardy talks with her clients about their expectations of therapy. cognitive c. uses more than one theoretical approach to therapy. achieve insight. b. If she employs the most popular principles reported in a national survey of therapists. eclectic Jonelle tells her clients in their first session of therapy that she is an integrationist. free associate. In her work with clients. phoned Dan's family to discuss his worries about some disturbing memories Dan described. combines medications with behavioral therapy methods. 561 M 16. not just intellectual understanding. behavioral techniques.19 Ans. In order for Todd to proceed successfully in therapy. psychodynamic methods.21 Ans. 561-2 E 388 . c. d. analyze his countertransference A therapist said to a client with social phobia.20 Ans. phenomenological 16. 561 E 16. What is this perspective? a. "It is important that we understand the underlying ambivalence you may have toward your parents. was right to involve Dan's family if it was beneficial in Dan's treatment.23 Ans. his therapist. D App p. which means that she a. C App p. d.16. psychoanalytic b. Gleason is an eclectic therapist. Dr. that he would be contacting his family. was wrong to involve Dan's family without permission. D App p. 561 M * 16. b. psychodynamic b. a. c. should have invited family members to the next session instead of calling them by phone. client-centered d.18 Ans. Mark did not tell Dan. should have verified the memories before involving the family in treatment. achieve conscious insight b. Mark. free associate c. cognitive-behavioral c. Dr. d. interpersonal d. Todd is a new patient of a psychoanalytic therapist. work through unconscious conflicts. A App p. b. Mark a.22 Ans. believes disorders are caused by poor early parent-child interactions. c. he must first and then be willing to . cognitive methods. work through those insights d. she will use a. 561 M 16. analyze his resistance. C App p. C App p. Breinholdt adheres to a perspective that is endorsed by the largest number of psychotherapists. attempting to gain insight about how these early experiences are being replayed in your current relationships. an adult client. 560 M After Dan's especially emotional therapy session. phenomenological/experiential methods." What perspective is the therapist employing? a. emphasizes emotional understanding. on the royal road to his client's unconscious mind. manifest 16. d.16. she will ^ understand those unconscious dynamics. a. response prevention. D App p. b. 562 M 16.26 Ans. the word "dog. 562 M 389 . In other words. D App p. analyzing his client's resistance. metaphorically.28 Ans. encouraging his client to free associate. A Con p. analysis of resistance When Miranda achieves insight into the sources of her depression. and it had almost died. c. latent d. a. he switches from talking about falling behind on school work to talking about his brother. resistance. he is describing its content. both a and b Barry's therapist notices that while he is describing his day. working through his client's transference. intellectual Boris is telling his therapist about his dream from last night. Barry's therapist is interpreting Barry's a. As Boris recounts what happened in the dream.24 Ans. c. dream interpretation d. b. either a or b d. A App p. manifest b. Vittorio is traveling. free association.29 Ans. latent d. resistant b. Rita's therapist asks her to say whatever she thinks of after hearing the word "feed" and then later. interpreting his client's dreams.27 Ans. 562 M 16. B App p. analysis of lifestyle b. The therapist believes this may be significant. 561-2 M 16.25 Ans. 562 M * 16. C App p. emotionally c. 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. neurotic c. especially after several more instances where Barry describes a failure and then mentions his brother. a." Rita's therapist wants to find the content of Rita's dream. free association c. d. covert sensitization. 562 M Which of the following terms does not belong with the other three? a. intellectually b. Vittorio is a. neurotic c. as a sign of resistance c. 562 M 16. as a sign of a maladaptive style of life Dr. a. and Dr. D App p. Wharton will actively pursue . corrective emotional experiences d. b. lifestyle analysis. a process known as a. empathic understanding. as a sign of latent content d. having a corrective emotional experience. Sam feels that women are cold and rejecting. Where Dr. experiencing unconditional positive regard. B App p. A App p. C App p. so he acts in a cold and noncommittal manner toward them. idealizing transference b. b. interpreting everyday behavior. behavioral transference. C App p. Sam's main psychological problem involves his anger toward women.34 Ans. Dr. You wouldn't believe the kind of week I've had at work! Maybe we could cut our session a little short. Sam will act coldly toward his female therapist for an extended time period. or recurring marital arguments. c. Mayron looks for the underlying conflicts or defenses which might explain these behaviors. forgetting to make a phone call. d. she accuses her therapist of disliking her and of using her to better his career. d. d. mirror transference. as a sign of countertransference b. b.32 Ans. "I'm just too tired to talk about anything today. 16. c. 563 E 390 . Frost will carefully avoid . During a therapy session. Edena's psychoanalytic therapist will conclude that the client is a. ego analysis Edena feels that her parents never really cared about her but cared only about impressing their friends with Edena's accomplishments. 562 M Mayron believes all her clients' behaviors are equally important. Sam will temporarily develop a profound love for his therapist. ego analysis c. analysis of resistance. 562-3 M 16.16. Wharton is a psychoanalyst trained in Alexander's methods. if that's okay with you. countertransference. exhibiting transference. Frost is a Freudian psychoanalyst.31 Ans. If a transference neurosis occurs. his female therapist will be cold and rejecting toward him. analysis of resistance. Sam will be unable to engage in a corrective emotional experience.30 Ans. Said a client to his therapist. free associating. 563 M 16. a. c. Edena does not trust that people like her for herself. whether it involves choice of career." How would a psychoanalytic therapist describe this interaction? a.33 Ans. 563 psychotherapist. Jeneca's therapy is MOST similar to therapy.37 Dr. Because Dr. Perls. c. 563 E 16. A App p. understanding relationships with his clients so that Ans. M a. She is interested in the way her clients deal with their feelings of inferiority and imperfections. 563. reliance on dream interpretation rather than analysis of resistance for the uncovering of unconscious content c. Which of the following descriptions does NOT apply to this therapeutic process? a. experiential b. Adler. individual psychology c." Such a quote MOST likely comes from a therapist who agrees with a. It occurs in the context of a relatively brief psychoanalytic-type therapy. Martinique is engaging in corrective emotional experiences with her therapist. Ellis'RET therapy c. The therapist maintains a relatively neutral. therapeutic challenging. d. detached stance.35 Ans.40 Ans. interpersonal therapists. I think we should worry about how people work toward goals and how defense mechanisms play a role in their coping.39 Ans. 564 M * . unconditional positive regard. an emphasis on helping clients attain insight about unconscious libidinal conflicts b.16. Erikson. d. an emphasis on object relations theory as a basis for therapy d. B together they can relive and work through old problems. Martinique sits face-to-face with her therapist instead of reclining on a couch. p. It revolves around client-therapist conversations about present problems. b. 563 M * 16. B Con p. Jeneca describes herself as a psychodynamic therapist. and Anna Freud have in common? a. self-analysis. a. D Fac p.38 Ans.36 Ans. C App p. he is most like a(n) p. d. she helps clients to change their mistaken thinking. Rogers would strongly recommend that a therapist disclose tmthfully and tactfully her/his own conscious reactions to a client. b. cognitive 391 16. traditional psychoanalytic 16. ego analytical d. Sato believes App clients need an emotional resolution to conflicts from the past. A App p. 16. Rather than uncover repressed sexual or aggressive urges. 66 M While Freud would recommend that therapists avoid the expression of unconscious countertransference. the ego analysts. known as a. psychoanalytically oriented d. c. genuineness. an emphasis on the importance of adaptive ego functioning for clients' success in therapy "Traditional psychoanalysts worry too much about sex and aggression and unknown urges. Adlerian b. c. 563 M What do Hartman. Sato tries to create close. Hosea is probably a(n) therapist. phenomenological d. d. Alexander is to Sullivan. In contrast to a traditional psychoanalyst. twinship c.16. object relations c. 546 M 16. C App p. B Con p. Adlerian b. d. A App p. C App therapy. Perls is to Kohut.43 Ans. encourage free association. 564 E 16. 562-4 E 16. utilize a form of dream interpretation. 564 M Unconscious conflict is to maladaptive style of life as a.42 Ans. Shapiro often employs a therapeutic method promoted by theorists such as Winnicott. Gestalt In his earliest years of life. Joshua was often ignored by his parents.45 Ans. use free association to discover the defenses used by the ego. 564 M 16. D Fac p. Freud is to Adler. cognitive Dr. in her work with clients Lozona will NOT a. c.46 Ans. Adler is to Rogers. b. interpersonal d. use dream interpretation as a means of discovering conscious conflicts. In what sort of transference should the therapist attempt to encourage? a. attach any meaning to transference. and Kohut. nurturance 16. c. a. In his adult relationships.44 Ans. d. explore the client's early experiences.41 Ans. safety. c. b. Gestalt c. Klein. analyze countertransference. Joshua never feels sufficiently loved by his significant other. she will a. b. idealizing d. see the bonding between infants and caregivers as most important for later personality and relationships. Lozona is an Adlerian psychotherapist. Unlike other psychodynamic therapists. B App p. Adlerian individual psychotherapy is MOST similar to which modem approach to therapy? a. mirror b. Hosea views transference as a healthy way to reenact clients' early parent-child relationships and meet their needs for respect. and closeness. p. 564 C 392 . behavioral b. Beck's cognitive therapy b. and a wife d.Phenomenological therapists assert that therapists must regard their clients as equals. a Freudian psychoanalyst c. Deidre. self-defeating style of interactions learned in childhood d. the development of better interpersonal skills b. Tywanna. interpersonal d. During therapy. an interpersonal therapist b. 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. a full-time professional. Beverly. I'd like to work with you to develop some new. object relations Ingeborg is receiving a form of interpersonal therapy for her depression that was developed specifically for that disorder. twinship b. an object relations therapist LeeAnn believes clients need to understand how they perpetuate conflicts through their communication with and attitudes toward others. LeeAnn tries not to react as most people would to a client's arrogance and disdain. Conceptually speaking. exaggerated. conditions of worth b. exploration of her insecure attachment pattern in childhood c. Harry Stack Sullivan c. a Gestalt therapist d." What perspective does this therapist MOST likely employ? a. congruence d. what sort of transference is MOST likely to foster this perception on the part of the client? a. so that the client comes to understand that this usual strategy for gaining control over an interaction will not work. Yelling at her and leaving the house in a rage are perpemating those conflicts. Which of the following would NOT be a focus of her treatment? a. mirror c. client-centered d. interpersonal Which of the following descriptors does not belong with the other three? a. effective treatment for depression 393 . behavioral b. 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. conflicts between her roles as a parent. phenomenological/experiential c. Ellis'RET c. Marcus. flexible means of getting the support you really want from her. protracted grief over the loss of her mother two years ago "Nate. What sort of therapy does this represent? a. if defined as the ability to view the world from the unique perspective of one's client. 563.57 Ans.16. experiential c. D Con p. Ted hopes clients will get to know themselves better. Ted is MOST likely a(n) therapist. interpersonal therapies. d.58 Ans. B App p. B Con p. 565 E The notion of empathy. cognitive therapies. c. 565 M 16. F.5 E 394 . a. Carl Rogers Nadine believes it is her responsibility to help her clients reach their full. Heinz Kohut b. interpersonal b. innate potentiation c. phenomenological d. they will grow to their potential. innate potential. 565 E 16. Sartre. What is the name for the goal Nadine holds for her clients? a. at which point they will be able to adaptively solve their own problems. C Con p. 565 E 16. self psychology b.56 Ans. maladaptive vicarious learning experiences. Skinner d. and Wertheimer. B. A App p. 565 E 16. resolution of past childhood experiences. b. immediate experiences in the therapy relationship d. genuineness By creating a relationship in which he is honest and caring. facilitation of individuals' unrealized potential 16. Vlado employs a therapy system whose fundamental concepts are derived from the writings of persons such as Kierkegaard.53 Ans. subjective interpretations of reality. psychodynamic Psychodynamic therapies typically focus on . Harry Stack Sullivan c. could be said to be MOST crucial to a. cognitive d.55 Ans. while experiential therapies focus on . conscious ego coping processes. rigid. maladaptive interpersonal behaviors b. objective interpretations of reality c. C Con p. a. interpersonal c.54 Ans. phenomenological therapies. congruence d. He believes that once clients' perceptions are more accurate. cognitive Who of the following is MOST likely to believe that a client is naturally good? a. self-actualization b. psychodynamic therapies. How would you characterize Vlado's perspective? a. the therapist encourages her to fully vent the strong. calm down. 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. b. empathy b. A App p. d.60 Ans. 566-7 E 16. accepting clients as they are. What perspective is represented in this technique? a. but his father expects Seth to maintain the family tradition of joining the basketball team. b. angry feelings she harbors about the individual. she would MOST likely respond by saying. cognitive-behavioral b. C App p. D App p.61 Ans.63 Ans. "Lie down and tell me everything that you think of when I say the word 'drugs'. incongruence.16. B Con p. congruence d. c. His father's expectation is a (n) a. d. P/E Seth is 16 years old. 566 M * 16. working with the client to create an agreement about the behaviors the client should change. Which of the following terms does not belong with the other three? a. condition of worth. 566 E 395 . Because Nadia is a client-centered therapist. a. mirror transference. showing that you understand their feelings. "Now. and being honest about your feelings. C App p. As Veronica talks to the imagined person. self psychology c.59 Ans." c. Nadia's client cried as he told him that he just found out about his son's drug use. challenging clients' irrational thoughts while being supportive of their efforts to change." d. c. now. It's not the end of the world to have a child do a dangerous thing. 566 E 16. interpersonal d." b. unfinished business c. you should work to create a relationship with the client by a. "What do you believe might be contributing to your son's behavior?" 16. He wants to join the drama club at his high school.62 Ans. remaining neutral to encourage clients to react to you as they would to important people from their lives. Seth agrees join the sports team in order to win his father's approval. "You must be very upset and worried about your son's behavior. transference neurosis. self-actualization To be a client-centered therapist. The therapist might recommend an intervention that is inappropriate for Lani. The therapist has effectively communicated his a. and moved her chair away from Nancy. b.65 Ans. 566 M * 16. Dr. self psychology d. a. d. Warren refuses to assign DSM-IV diagnoses because they pigeonhole and label his clients. object relations c. She feels very comfortable with her therapist because he really seems to understand her feelings and her views about her life. C App p. self-actualization d. empathy.64 Ans. A App p. For what reason would her client-centered therapist be unlikely to give such advice? a. sitting down with her legs crossed and arms folded. Nancy. and her deepest fears. for Gladys to respond d. 566 E In order to adequately convey his . The client would fail to understand the responsibility she has for her own behavior. 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. 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. wait patiently.67 Ans. It would interfere with Lani's discovery of her own innate abilities to resolve her problems. Nancy. encourage her to participate in a relaxation procedure. a client-centered therapist. A App p. ask her to focus on an empty chair and talk about the feelings that the image brings up c. for as long as it takes. such as deep breathing Lani is asking her new therapist for advice to help her resolve the heated arguments she has had with her boyfriend recently. 566 M 16. b. asked. 568 M . B App p. D App p. suggest that they reschedule the appointment for another time when Gladys feels like talking b. 566-7 M 16. given that the two have not established a solid working alliance yet.68 Ans. What form of therapy does this MOST likely represent? a. c. permissiveness. congruence c. unconditional positive regard b. c. Gestalt b." If Gladys does not respond. self-defeating interaction pattern she is perpetuating in her relationship. conditions of worth Gertrude is engaged in the best-known form of phenomenological therapy. congruence. It would prevent Lani's exploration of the rigid. conditions of worth.16. d. client-centered 396 16. her goals.66 Ans. Gladys walked silently into her appointment with her therapist. what is Nancy MOST likely to do? a. Dr. "Feel like letting me in on what's going on? I'm here for you. client-centered b. Marlene spent 20 minutes expressing her feelings about a conflict with her mother to a research experimenter.73 Ans. b. neither person d. d. D Con p. systematic desensitization : Wolpe d. a. A Gestalt therapist is more active and confrontive than is a client-centered therapist. 568 M * 16. Gestalt d.69 Ans. C App p. A Gestalt therapist is less likely to display genuineness. Judd is probably a therapist. Compared to their initial levels. Eartha c.71 Ans. which of them is more likely to exhibit lower blood pressure following that experience? a. c. self psychology : Kohut b. 568 E 16. 569 C 397 . and client-centered is a phenomenological approach. Which aspect of his client's experience is he MOST likely to emphasize in treatment sessions? a. 568 M 16. client-centered : Rogers c. behaviors c. There is no empirical basis on which to make a prediction. Judd suggests that she clasp her hands more tightly together. Gestalt therapy is a cognitive-behavioral approach. "Become your hands! What are they telling you about your decision?" Judd says. cognitive c. psychodynamic Which of the following therapies and their primary theorist are mismatched? a. behavior therapy d.74 Ans. A Gestalt therapist is less likely to focus on client's emotional experiences. Which of the following systems of therapy was developed later than the others? a. cognitions d. psychoanalysis c. healthy transference with the therapist 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. she tells Judd that she feels completely relaxed about her decision to move away from home. Marlene b. psychoanalytically oriented psychotherapy 16.70 Ans. B App p.72 Ans. As Nara clasps and unclasps her hands. 569 M 16. B Con p. 568 M In what way is Gestalt therapy different from client-centered therapy? a.16. A App p. client-centered therapy b. C Con p. Gestalt: Maslow Tom is a Gestalt therapist. feelings b. d. you a. D Con p. cognitions. Adlerian b. behaviors. who has panic attacks c.16. cognitive.77 Ans. cannot leam a new behavior if you are still exhibiting the old one. behavioral Wilhelm is involved in a type of therapy originally described by persons such as Lazarus. then. B Con p. who has a social phobia 16. 569 E * Which of the therapy models has been most clearly based on empirical research? a. who has generalized anxiety d. and Eysenck. behavioral c. 569 E 16. emotions. A App p. d. Amee. emotions. object relations. would be most likely to focus on Wilhelm's a. Boris.76 Ans. Gestalt According to the principle of reciprocal inhibition. His therapist. Hazel. c. A App p. c. Current behavioral therapies include techniques that address clients' a. Gestalt. 569 E 16. a(n) therapist is more likely to focus on the here-and-now. Adlerian b.78 Ans. D Fac p. a. d. will not be able to be anxious about an upcoming exam if you are relaxed. all of the above While a(n) _ _ _ _ _ therapist is likely to focus on issues related to clients' early childhood. Heinz. behaviors. b. c.80 Ans. object relations c. b. will tend to exhibit submissive behaviors when interacting with a person who exhibits extremely dominant behaviors.75 Ans. psychodynamic d. 569 M 16. 569 M * 398 . will not be able to leam positive thinking if you do not recognize and inhibit automatic negative thoughts. early life relationships. Wolpe. cognitions. who has a phobia of elevators b. b. For which of the following clients would you recommend treatment via systematic desensitization? a. C App p.79 Ans. Gestalt d. 569 M 16. RET. participant b.83 Ans. extinction After a poor haircut. a.81 Ans. and ask that someone correct the problem. in vivo exposure c. coping d. exposure treatment c. places a cat in her lap and keeps her in that position until Tameka is calmly petting the cat.82 Ans. contingency modeling. systematic desensitization d. which of the following treatment techniques is the student MOST likely to be learning? a. Dr. participant c. If a student clinician is being supervised by Albert Bandura. in vivo desensitization. d.16. aversion therapy. The procedure. Ernesto's assignment from his therapist is to return to the salon. Jones believes this will be more effective than fearless modeling of such behavior. a. B App p. relaxation techniques d. b. contingency c. 570 E 16. D App p. C Con p. explain why he is dissatisfied. modeling c. systematic desensitization Which of the following terms does not belong with the other three? a. 569 M 16. contingency d. c. rational emotive therapy Which sort of modeling is MOST similar to imaginal desensitization? a.84 Ans. Ernesto is MOST likely involved in a. covert b. coping In order to strengthen his client's ability to benefit from an intervention for a social phobia. assertiveness training. emotive 16. Jones displays some signs of anxiety as he eats in public with his client observing him. B App p. Dr. flooding b.85 Ans. contingency management b. a token economy b. 571 M * 399 . which is a type of . 570 E Because Tameka is very frightened of cats. worked because Tameka is not allowed to give in to her fear. C App p. This is BEST known as modeling. her therapist seats her in a chair.86 Ans. participant modeling d. 569 M 16. A Con p. 571 E 16. in writing. 571 M * 16. Jean-Claude tries to decrease his clients' aggressiveness by rewarding them for cooperative behavior with gold stars redeemable for their favorite treats and activities. share the class supplies. establish the specific contingency rules that determine which behaviors will receive tokens. D have agreed. aversion therapy d. severe depression.88 Ans. Rulon and his client Ans. b. classical conditioning.90 Ans. Jean-Claude uses and Arnold uses ' a. d. behavior therapy. D App p. that the client will decrease aversive interactions by giving App his spouse one genuine compliment each day and will refrain from provoking her p. Which of the following is MOST important for Jeff to do before implementing his plan? a. 16. establish an exchange system of items the adolescents would find rewarding. demonstrate how the plan works by engaging in participant modeling d. c. b. nor turn in their homework on time. in vivo exposure d. contingency management. schizophrenia. identify behaviors for which tokens will be taken away b. develop a contingency contract that each participant will sign before participating. response prevention Token economies were first successfully used in the treatment of a. Jeff wants to create a token economy.89 Ans. aversion therapy b. flooding c. mental retardation. 571-2 M 16. 571 M Most of Jeffs students have not been able to work quietly. so he sets up specific rules about tasks or behaviors that will be rewarded. c. which he knows is an irritant to her. construct an exchange system that includes desirable rewards Manny has decided to implement a token economy for adolescent inpatients who are in treatment for eating disorders. C App p. 571 E 400 . set the exchange rates by which tokens can be earned for the specified target behaviors. Arnold gives his aggressive clients mild shocks while they watch the most violent sections of action movies. a token economy. hyperactivity and antisocial behaviors.87 Rulon is helping a client address some marital problems. get parental permission to punish the children for misbehavior c. d. covert modeling b. he should then a. participant contracting c. B App p.91 Ans. 571 into anger by commenting on her weight. Once he has targeted the eating behaviors he wants to reinforce. D Fac p. M What form of treatment does this represent? a. contingency management 16.16. a green light flashes on the panel on front of him and a pleasant tone is played. biofeedback b. What do token economy. aversion c. d.93 Ans. with p. Veronica is using therapy to treat her client. 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. covert sensitization 16. d. 573 the image of a drink in the client's hand. B App p. documented success of these methods. b. killed when the client struck her while driving drunk. A App p. in vivo aversive conditioning b. If Edouard wants his client to pair the image of a App mangled female body. object relations 16. the failure of medications to alter disordered mood. 572-3 M * 16.92 Ans. nonprofessionals' ability to implement many of those methods. d. b. Their improvements do not appear to be durable over time. 401 . The effects they produce are usually matched by the effects obtained through relaxation training. Serge is learning to control his hypertension through the procedure known as a. b. biofeedback b. c. c. self-control contingency management Each time Serge lowers his resting pulse rate. Their basic principles derive from theories in cognitive psychology. sensory monitoring.97 Ans. contingency management.16. somatization therapy. C Con p.95 Ans.96 Edouard is treating an alcoholic who has been charged with manslaughter as a Ans. empty chair technique d. A Fac p. 573 E Each of the following has contributed to the resurgent interest in behavioral treatment methods EXCEPT a. response prevention d. the repeated. biofeedback. 572 E 16. c. Beck's cognitive therapy c. and aversion treatments have in common? a. B App p. aversive contingency contracting c. imaginal desensitization d. 16. what sort of behavioral therapy can M ethically be used? a. D result of his drunk driving. a. biofeedback. They typically have only small clinical effects on targeted symptoms. their greater efficiency compared to other methods of treatment.94 Ans. 572 E Which of the following techniques could clients practice LEAST easily on their own at home? a. when your depressed clients describe their feelings. if you are overly upset about receiving a poor grade on an assignment. D App p. Edwin's therapist is MOST likely conducting a. their beliefs.102 Ans. perhaps with the empty chair technique." Edwin's therapist asks him how he knows this. d. b. ask them to relive the most upsetting of the events. a. Alexander's psychoanalytically oriented psychotherapy. help them to see that it is their beliefs about the events that are most problematic. d. the grade. The therapy is the variable. 575 M . rational emotive According to Albert Ellis' rational emotive therapy principles. 574 M 16. irrational. a. b. dependent 402 16. confounding c. the behaviors which preceded the poor grade. c. "they like me" or "I'd like to get to know them and they want to know me.16. A App p. client-centered b. "I'll never find another person to love. psychodynamic d. Ellis' rational emotive therapy. help them to vent their feelings.100 Ans. Edwin's homework before his next therapy session is to speak to his acquaintances and think. d. 574 M 16. factorial d. Each time Sapna's client uses the explanation that she is "supposed" to be a dutiful daughter. D App p. To determine if his hug therapy relieves depression. Sapna's challenges to her clients' belief system indicate that she is MOST likely using therapy. interpersonal c. C App p. and Edwin is not able to give a confident answer. negativistic. B App p. If you agree with Ellis' RET. Sapna asks her how she knows what she "should" be doing. Hartman's ego analysis. "They tolerate me while I am around and then laugh at me when I leave. C App p. your beliefs about what the grade means. c." rather than thinking that people dislike him. c. No one will ever want me again. catastrophizing.99 Ans. and current and past events related to their depression." Beck would characterize this depressed client's thought process as a." says Edwin. b.101 Ans. your emotional reaction is caused by a. c. b. you will MOST likely a. Beck's cognitive therapy. your unconscious conflicts. pessimistic. Emil randomly assigns clients to a hug therapy or no-therapy control group. ask them to try to challenge their own catastrophizing through homework. d. 574 E 16.103 Ans.98 Ans. 573 M 16. independent b. 573 M * "People hate me. Warren believes that RET therapy is more effective for anxious patients than for depressed patients. multiple baseline design. then the instructor praised students for each question and recorded the number of questions. meta-analysis. she gives them the anxiety test again to see which treatment was most effective.105 Ans. Dr. b. he is using either RET or Beck's cognitive therapy and is assigning either a male or female therapist. placebo treatments are only used for rare disorders. The number of questions asked by students during a discussion period was recorded. This is an example of a(n) design. people in a placebo group rarely improve. The lack of a factorial design prevents any cause-and-effect conclusion. 576 M 16. 403 16. placebo groups design. including attention to the role of the therapist's gender. random assignment. d. d. b.109 Ans. confounded A researcher planning to use a placebo control group should be aware that a. Whiteley is planning a study of therapy outcomes for depressed clients. c. c. A App p. This is a(n) a. independent c. 575 M Mary measures her clients' anxiety with a written test and then randomly assigns them to receive one of three treatments. 575 M 16. Which of the following might pose an alternate explanation of his results? a. placebo treatments may contain components of actual therapies. it will decrease statistical validity. To test his hypothesis. The dependent variable is the a. B Fac p. c. He has a confounded research design that precludes any firm conclusion. c. a. b.104 Ans. both a and b Dr. A Fac p. c. Client variables may account for the results. b. B App p. type of treatment. B App p. he provided RET therapy to a group of anxious and a separate group of depressed patients. If a researcher wants to determine whether therapy is significantly more effective than no treatment at all.107 Ans. outcome of the anxiety test after therapy. d. The number of questions rose again the next time praise was instituted. Measurement of irrational beliefs at the end of the study appeared to support his hypothesis. D App p. Afterward.108 Ans. d.106 Ans. ABAB design. d. The instructor did not praise at all during the next session and saw questioning drop to the baseline level. outcome of the anxiety test prior to therapy. either a or b An instructor wanted students to participate more actively and decided to implement a classroom study. b. randomized d. 575 M 16. no-treatment and a placebo control group. temporary no-treatment group. 576 E 16. placebo control group. 576 M * . factorial b.16. she or he would today MOST likely use a a. To create the various conditions. internal. internal d. The administrators have utilized a(n) treatment design. B Fac p. During each week the selected behavior increased. the second week for promptness. 577-8 M validity. while the . B App p. multiple contingency management 16. how might I conduct valid therapy outcome research? A therapy outcome study can be evaluated on each of the following dimensions of validity EXCEPT a. Klemknecht is presenting a report on his successful treatment of a client with dissociative identity disorder. statistical. 577 M 16. leave for work on time. and place dirty clothes App in their hampers. the study may have low a. 576 tableware. Given that my grant money has been cut 70%. A professional reviewer believes that the study will be unable to detect the effect of therapy because too few clients will be involved. What cognitive treatment strategy is most effective for children diagnosed with conversion disorder? c.113 Ans. statistical d. for taking care of their C dirty clothes. design validity. a. D App p. 576 E 16. participant modeling c. statistical b. but not the others. Is medication intervention superior to cognitive-behavioral therapy for the treatment of generalized anxiety? b. randomized c. external Dr.16. reliable c. In other words. 576 C Dr. external d. b. A App p. internal 404 16. The first week the residents receive tokens for taking care of their p. multiple baseline design d. C tableware to the sink after meals. How can I evaluate my own therapeutic effectiveness? d. external. a. internal. c. d. C Con p.111 Ans. external c. Mastrianni has submitted a research proposal for a study of the effectiveness of Gestalt therapy for adolescent conduct disorder. and the third. statistical b.114 Ans. 577 E 16. external validity.110 The administrators of a group home want to encourage residents to take their Ans. What sort of research design does this represent? a.115 Ans. experimental b.112 Ans. N=l For which of the following research questions would N=l research be LEAST appropriate? a. ABAB design b. statistical validity. Random assignment to experimental groups increases use of N=l research decreases validity. internal validity. 119 If you wanted to find someone to help you with an emotional problem and you read Ans. collaborative analogue study.120 Ans. M c. Carl Rogers b. 579 M * After reading 10 research articles each. meta-analysis. behavior research. seek eclectic therapy. b. none of the above 16. six graduate students studying the effects of therapy met to discuss their findings. Eysenck's conclusions about the effects of therapy. and Miller (1980). they should use a a.116 Ans.16. d. how they evaluated the quality of the studies. ask your physician for advice. Joseph Wolpe c. c. wait to see if you felt better without treatment. if you receive therapy you are to be better off compared to your friend who did not receive therapy. Hans Eysenck d. no more likely d.117 Ans. They each came to a different conclusion. 579 M 405 .118 Ans. To help them summarize all of their conclusions. 578 E 16. a clinician's multiple baseline evaluation of one client's response to therapy In her university laboratory. you would MOST likely App a. B App p. C Fac p. D App p. meta-analysis. Martica plans to have therapists treat a randomly selected sample of individuals seeking therapy. twice as likely c. seek psychoanalysis. p. multiple baseline design. d. 578 E 16. analogue research. an experiment comparing treatments for anxious versus substance-abusing college students b. depending upon which studies they chose. 16. c. She will attempt to recreate what would happen in an actual clinical setting. beta-analysis. A App p. Aaron Beck 16. Glass. a.121 Ans. 578 C Which of the following studies would probably have the highest external validity? a. b. Which of the following persons ushered in the modem era of psychotherapy outcome research? a. 578 b. measure of clinical significance. According to Smith. a survey asking a representative sample to rate the effectiveness of treatments they received d. a study comparing treatments for anxious volunteers from the community versus anxious patients in a psychiatric facility c. A Hans J. Martica is planning a. four times more likely b. d. and how they interpreted the outcome. C App p. 20 In contrast to the Smith et al. roughly what percentage of clients treated for less than 6 months experienced a "major improvement" as a result of therapy? a.123 Ans. and other meta-analytic reviews of psychotherapy outcomes. possible. 579 M 16. 581-2 M 406 . d. 40 c. d. C Fac p. before they begin graduate level training b. systematic desensitization for specific phobias d. 30 d. when they rely on psychodynamic treatment techniques Which of the following treatments is NOT among those described as "well-established"? a. C Fac p. c. at which point are clinicians probably LEAST effective? a. clients reported greater improvement with either cognitive or Rogerian therapy than with psychodynamic therapy. 90 b. she is in cognitive therapy rather than Rogerian therapy. but not very likely d. clients who worked with professional therapists reported greater improvement than did clients of nonprofessionals. 579-80 C 16. rather than a four-year college degree. According to client self-reports in the Consumer Reports study. her therapist is a psychologist rather than a marriage counselor.16.D. her therapist has a Ph.125 Ans. A App p. 580 C How likely is it that therapy clients will exhibit deterioration following their participation in therapy? a. after they have been working in the field for several years c. extremely unlikely Isabella is a psychotherapy client. 581 M 16. clients' report of "major improvements" were related to the length of treatment. none of the above According to information reviewed in the text. behavioral marital therapy b. about as likely as it is for them to exhibit improvement b. C Fac p. about half as likely as it is for them to exhibit improvement c. Beck's therapy for depression c.122 Ans. she receives medication in addition to the psychotherapy. b. dialectical behavior therapy for borderline personality disorder 16. You would predict a more successful outcome for her if a. when they are involved in intensive training in specific therapy techniques d.126 Ans. 579 E 16. B Con p.124 Ans.127 Ans. D Fac p. c. b. the Consumer Reports evaluation found that a. 584 M 16. c.83 C * 16. Yes. 577. Which of the Big Five personality factors is most clearly related to clients' success in therapy? a. help them understand their behavior. think that random events are connected to you. It depends on the level of internal validity in the study. b. accept their emotions.16. c. Sheila needs to develop a good working relationship with her clients and also a. conscientiousness If you have the characteristic of self-relatedness. d. b.129 Ans. 581 M 16. 584 E 16. According to the specific processes explanation of the factors that influence success in therapy. 584 E . A Con p. d. compare clients' anxiety test scores to the test scores of people who are not anxious.130 Ans. No.133 Ans. C App p. b. about 8 sessions. be assertive as well as high in private self-consciousness. b. d. therapists should try to be open and self-related. d. and/or control their behavior. B Con p. c. me characteristics of the client and therapist are unimportant. b. c. B App p. extraversion c. agreeableness d. c. behavioral techniques are used in addition to other modalities. Is it possible for a study to have statistical validity without also having clinical significance? a. d. she would most likely find that they see a change after a. 583-4 M * 16.132 Ans. D Fac p. interview clients to see if the majority believe the treatment helped them. measure whether clients' anxiety level is lower than before treatment. utilize an eclectic treatment approach and a motivating interpersonal style. transference is established. you will most likely a. but a study can have clinical significance without having statistical validity.131 Ans. 583 M If Selma were to ask her clients at what point they began to feel better. d. B App p. the connection between client and therapist is the most important factor. a researcher might a. b.128 Ans. interview clinicians to see if the majority believes the treatment relieves anxiety. The common factors explanation of successful therapy suggests that a. understand your own emotions and thought processes. foster clients' increased sense of self-relatedness and openness.134 Ans. To find out if a treatment for anxiety has clinical significance. understand your relationships with others. ■'-. clients and therapists must have similar personalities. utilize specific therapy techniques to reduce emotional distress. about 2 sessions. No. c. 407 16. openness b. A App p. however apparently innocuous they may appear.women more likely to seek therapy. Professionals may oversee nonprofessionals. regardless of training." Analysis of resistance: The therapist looks for patterns of defense mechanisms such as intellectualization. unconsciously-motivated) content. gender .135 Ans. Strong personal commitment to and enthusiasm for the therapy. Interpretation of everyday behavior: The therapist attempts to pay attention to all facets of a client's behavior. early establishment of a therapeutic contract. and no romantic or sexual interactions. clear communication skills. nonprofessional therapists may appear to do as well as professionals for several reasons. genuine concern for and interest in the client's well-being (probably the central factor). SHORT ANSWER / ESSAY 16.137 Describe the characteristics of a therapist that foster the working alliance. where the research results have been mixed.poor persons of color least likely to participate in therapy. and "accidents. are just better at relating to people. 16. however. 408 . Do these factors appear to be related to the success of therapy? Age . to detect slips-of-the-tongue. ethnicity . maintenance of professional demeanor. Sometimes "experienced" therapists may have only one year of experience more than "inexperienced" therapists.136 Describe the demographic characteristics related to a person's likelihood of receiving psychotherapy.persons from lower SES groups less likely to seek therapy. who in turn are more likely to receive therapy than Hispanic Americans and Asian Americans. c.16. patterns of forgetfulness. Which of the following was NOT among the problems he identified in such studies? a. These do not appear to be related to successful therapy outcomes. 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. that signal an attempt to keep unconscious material out of consciousness. 585 M According to David Orlinsky.138 therapy. somatization. Analysis of the transference: Given that the client will begin to interact with the therapist in ways that reflect earlier experiences with important figures.children and adolescents less likely to receive therapy. 16. the therapist helps the client recognize and work through these interactions to resolve the underlying issues. strong empathy. obvious) content of dreams and look beyond it to the dream's latent (more trathful. SES & ethnicity . This is a tentative conclusion. Clients often lie about feeling better in order to please researchers. which may improve outcomes. with the therapist out of sight. SES . Some therapists.African Americans more likely than European Americans. for persons of color. acting out. etc. b. and the therapist listens for patterns that may reflect unconscious conflicts. Dream interpretation: The therapist helps the client take the manifest (literal. A Fac p. avoidance of reactions that could diminish self-esteem.. d. given that participants in these groups will be denied potentially more effective treatment interventions. resulting in low statistical validity for many studies. 16. 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. Too.. it is often difficult to locate a sufficient number of clients with a particular kind of problem.. what ingredients are crucial for successful therapy? The therapist's unconditional positive regard for the client.16. and congruence. To increase internal validity. random assignment of clients and training of therapists) tends to decrease the "real-world" quality of the study. i. empathetic understanding of the client's feelings and views. Finally. genuineness. 16. Ethical concerns must also be addressed in the use of a no-treatment and/or placebo control group. the nonspecific factors that probably still take place in such groups can create changes compared to no-treatment control groups. or behaving 409 .g.139 According to Rogers. This control (e. the notion that "placebo" connotes a short­ lived and/or trivial outcome is misleading. This then decreases external validity. Finally. in some way attempt. external.e. and statistical validity in the conduct of therapy outcome research. strong experimental control must be exercised. the extent to which the study's results generalize to situations other than those in the study. new ways of tliinking.140 research. maximizing the likelihood that the independent variable and nothing else caused the results.142 According to the wealth of research discussed in the chapter. 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. some researchers ethically object to such use. feeling.141 Describe the general tradeoffs between internal. 16. social. primary prevention. c. Therapists are not widely available in rural and poorer areas. "I don't understand why people who are having problems don't just talk to a good therapist. Louis MOST likely recommends the alternative because it is generally more a. structured.2 Ans. interprets facial expressions as indicators of emotional states d. A town council member claims that homelessness is becoming a problem because people do not seek help for their mental disorders. 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. This view of psychotherapy may be problematic for each of the following reasons EXCEPT a. however. Which of the following would be LEAST likely to describe a client if he were a member of a Western culture? a. 590 E Lydia's husband was diagnosed with schizophrenia after several months of bizarre behavior. People may hesitate to discuss their problems. c.5 Ans.4 Ans. She suggests a resolution that therapists be required to treat some people for free. individual psychotherapy c. 590 M 17. B App p.3 Ans. therapeutic contracting.Chapter 17 ALTERNATIVES TO INDIVIDUAL PSYCHOTHERAPY 17. D App p. A App p. defines himself in ways that emphasize independence and autonomy b. primary prevention d. Which of the following would be most helpful? a." says Mitzy. d. 590 E 17. C App p. 591 M * 410 . D App p. People may not have the funds to pay for therapy. successful. It tends to overemphasize clients' competencies. c. b. psychosocial rehabilitation. b. 591 E 17. b. reliable.1 Ans. d. d. A psychologist. couples therapy b. The psychologist is recommending a. views individual therapy as useful and effective 17. psychosocial rehabilitation Louis has suggested that his client begin an alternative to individual psychotherapy. explains others' behaviors on the basis of social roles c. the paradoxical directive. universality. treat clients within the humanistic/phenomenological framework. You should recommend that they focus on a. is implementing a classroom-based program to enhance elementary school children's academic performance. ignores differing cultural views of psychological processes.11 Ans. a school superintendent. This group process is known as a. attempt to step in and make people well once problems are identified. prevention. 592 E 17. Vinny begins to reconsider his position. pathology. c. d.6 Ans. diagnose psychological disorders early and properly treat them. Group therapy became popular several decades ago because it was a. b. social. b.9 Ans. d. able to provide treatment to people returning from World War II. A Con p.7 Ans. more cost-effective for insurance companies who covered mental health problems. secondary prevention programs such as Head Start. is based on the developmental group model of treatment. giving incentives to cognitive-behavioral clinicians who locate their practices in your community. A Fac p. halfway houses. d. based on a diathesis-stress model. based on a cognitive-behavioral approach. d. b. create programs that encourage psychological health. 591-2 E 17. ignores scientific research that fails to document the effectiveness of such group-based interventions for children. c.10 Ans. etc. b. c. 593 E 411 . c. c.8 Ans. B App p. d. 17. when the other group members share a similar observation. B App increase p. d. encouraging more students to study psychology at the graduate level. recapitulation. you would expect that they would a.17. However. Alton hopes to each student's sense of independence and self-initiative. resulting in greater self-esteem and better grades. 592 E 17. cohesiveness. b. Alton's plan a. c. Vinny disagrees with the group therapist when the therapist suggests that he appears to have some unresolved feelings of betrayal toward his father. A community action group wants to ensure that help for people with psychological problems is inexpensive. easily accessible. is essentially a form of psychosocial rehabilitation. B App p. b. consensuality. 592 M * 17. 591 M Alton. D App p. If a group of psychologists tell you that they have a psychological wellness orientation. group interventions such as family therapy and self-help groups. proactive. and culturally acceptable. The word that is LEAST descriptive of the psychological wellness orientation is a. B Fac p.16 Ans. b. 594 E 412 . b. 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. Another reason group therapy may be more helpful for Mateo than individual therapy is that in group therapy a. c. C Con p. interpersonal learning. universality. universality. cohesiveness What do the group processes of altruism. b.14 Ans. 593 E Mateo has an anxiety disorder and is trying to decide on a type of therapy. instilling hope b. empathy. the therapist's interpretations will be more accurate. 593 C 17. They are less strongly related to group outcomes than are consensuality. b. Early family conflicts may be symbolically recreated and explored. cohesiveness 17. 593 M * 17. Group members often model appropriate behavior. interpersonal learning b. This is a function of the group process known as a. Sharing experiences shows clients that they are not alone. empathy c.13 Ans. c.15 Ans. altruism d. His therapist recommends group therapy because she believes Mateo may open up to people who have the same problem as he does. A process similar to each of these is found in individual psychoanalysis. Miranda has kept her eating disorder secret for over two years. d.17 Ans. Which of the following processes is NOT considered essential to the success of group therapy? a. Group members often free associate.12 Ans. C App p. 593 E 17. d. Each encourages group members to support and praise each other as well as to challenge and criticize each other. D Fac p. anxiety disorders are more successfully treated. and instilling hope have in common? a. and recapitulation. cohesiveness. consensuality. interpersonal learning d. d. According to many therapists. In what way is group therapy similar to psychoanalysis? a. 593 E 17. c. the therapist probably will not challenge Mateo. D Fac p. d. Mateo may be able to advise others and see that he has good ideas. universality c. A App p. which group process probably underlies all others? a.17. c. Each provides an opportunity for members to provide role models to one another. variegated. d. 595 E 413 . B App p. a couple. b. Del's group expects him to be more assertive. Ms. C App p.23 Ans. are getting divorced and want it to be amicable. d. d. Marcia has just joined a cognitive-behavioral therapy group. she became extremely depressed. c. c. Brett won't go to a group if he doesn't believe it will be fulfilling. this means that they a. If Kristen and Jose. b. c.22 Ans. Chris reacts to another group member much in the same way he reacts to a member of his family of origin. use the psychological wellness approach. c. group therapy is generally less effective than individual therapy. each have a mental disorder requiring treatment. 17. group therapy is more successful when clients know beforehand how the group will be run. and he is.18 Ans. Marvin's group is a. homogeneous. d. B App p. You might advise your friend that a. d. the group directs most of their interactions toward the therapist father than toward each other.17. a cognitively-based group is more effective than a client-centered group. After Ms. group members are honest in their reactions. D App p. c. the group minimizes members' tendencies to recapitulate their early family experiences. Darrin thinks the group therapy will not be helpful and it is not.21 Ans. b. have sessions lasting about 30 minutes. A App p. b. have 6 to 12 members. b. 594 M * 17. Marvin joins a group in which everyone is trying to quit smoking. heterogeneous. go to see a therapist together. Ito lost her teaching job. Marcia's group will be more successful if a. the sessions will be about two hours long. Ito found a group for people experiencing depression but is unsure what to expect. are in conjoint therapy.19 Ans. Ito that her group will MOST likely a. You could tell Ms. 594 M 17. d. C App p. meet with therapists separately but each is addressing marital problems. b. 594-5 M An example of a group fulfilling prophecy is a. Your friend is considering entering group therapy for her substance abuse problem. 594 E 17. hypnotic. be heterogeneous. c. group members do not have any preconceived expectations about what will happen or what they should do. and the leader will be responsible for offering therapeutic interpretations and suggestions. 595 M 17.20 Ans. are in emotionally focused couples therapy. insight-oriented d.28 Ans. d. you would expect her to emphasize therapy. who is considering a divorce from her husband b. b. he will later listen attentively when she tells him about App her day later. insight-oriented. c. cognitive-behavioral c. 595 E 17. emotionally focused. M b. 596 a. Iola is a Gestalt psychotherapist. Jerry and his spouse's therapy is most likely a. emotionally focused b. 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. have a therapeutic contract. D Fac p. a. In her work with couples. the spouse who has a DSM-IV diagnosis b.29 Ans. c. 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.25 Ans.24 Ans. 596 E 17. structural family 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. The two of them p. both disturbed spouses d. have a behavioral exchange contract. Erika. the wife c. who is diagnosed with major depression d. are in insight-oriented couples therapy. strategic. cognitive-behavioral c. B App p. 17.26 Maureen and Sam have an agreement that if Maureen leaves Sam alone to read the Ans. Moira. the relationship itself 17. a. d. 596 M 414 . emotionally focused b. all of the above Which of the following is MOST likely to be considered the primary client in marital therapy? a. Orrin. A App p. A App p.17.27 Ans. D App p. structural 17. 596 M * Elise and Ernesto's therapist is training them to change their automatic assumptions about the other's actions. who is an alcoholic c. insight-oriented d. C paper when he gets home. cognitive-behavioral. 17. behavioral exchange contracts b. he reminds himself that Snyder et al. 3 to 4 c. cathartic emotional expression b. a self-help enrichment group. insight-oriented therapy. Firouzbasch is a behavioral therapist who specializes in the treatment of couples. Which of the following issues will probably be endorsed by the greatest number of participants? a. D App p.31 Ans. 2 17. c. If they want to maximize the likelihood of significant immediate benefits. exploration of the subjectivity and ecology of partners' actions 17. 597 M Anton and Isabelle are considering conjoint therapy. which of the following processes appears to be MOST important for the long-term success of conjoint therapies? a.35 Ans. 597 M 17. B Fac p. While it is sometimes very exhausting to work with troubled couples. a focus on emotional expression and intimacy Ms. behavioral therapy. Their main concern is that they will spend time and money on therapy and end up divorcing after a few years anyway.30 Ans. 4 17. 7 b. If her clients are typical of those studied thus far. d. C App p. behavioral therapy. Their therapist should recommend a. b. D App p. 5 to 6 b. they should choose a.'s comprehensive outcome review suggests that of every 10 couples will divorce in the four years following treatment. communication training c. insight-oriented therapy. d. negotiated solutions to specific problems d. strategic therapy. 2 d. any of the above A couple tells their therapist that they want the type of therapy that will give them the greatest chance of long-term success. Lance is an insight-oriented therapist.32 Ans. B App p. 597 M d. individual psychotherapy. Oto 1 According to available empirical data. 597 M * 17. 5 c. A App p. one would predict that of every 10 couples she has treated will relapse or will be divorced. c. understanding and resolving persistent emotional conflicts c.33 Ans. a. 598 M 415 .34 Ans. insight into unresolved unconscious conflicts d. 596 M A group of marriage therapists is discussing the techniques and theoretical perspectives that they have found most useful. a. b. 36 Ans. might have been temperamentally difficult as an infant and young child." What principle is this theorist addressing? a. is hyperactive and sometimes oppositional. 598 E Allison's anxiety disorder improved enough for her to return home from the hospital.40 Ans. her therapist probably suggested a. contrary to popular opinion.39 Ans. D App p. is the means by which the family enters systems treatment. for example. case management. is the family member that the therapist will target for intensive treatment. This situation might have caused stress for Joe. circular causality Lillian and Joe's 13-year-old child. c. Sixteen-year-old Gerald is a family therapist's identified client. 416 17. A App p. behaviorism. Which of the following terms does not belong with the other three? a. Their therapist tells them that. 598 E 17. b. group therapy. b. 598 E 17. circular causality. c. circular causality. c. D App p. is the only family member who merits a DSM-IV mental disorder diagnosis.17. systems c. a paradoxical directive. After this happened twice. 598 E 17. B App p. Amy. economy. family therapy. parents are not automatically blamed for a child's problems. d. subjectivity. The therapist is giving an example of a. 598 M 17.38 Ans. Amy. which caused Lillian to discipline her frequently. but once there Allison's symptoms returned. B App p. consensuality b. 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. C Con p. is the primary cause of his family's dysfunction. d. The therapist is explaining the principle known as a. A systems theorist was overheard explaining that a family "is not simply a collection of individual members but a coherent system of integrated participants. dynamism d. ecology b. This means that Gerald a. ecology. who in turn was not as patient with Amy as he otherwise could have been.37 Ans. b. d. d. ecology A family therapist explaining systems theory to clients tells them that each person has their own view of what happens in a situation. 598 M . subjectivity c. c. subjectivity. recapitulation d. therapeutic contracting.41 Ans. b. and its circular causality. 598 M 17. behavioral family d. 599 E 417 . tells a client the opposite of what the therapist believes to be true. and her parents are having difficulty dealing with her defiant behavior. that is disordered. the therapist is MOST likely to recommend a. Stephanie's mother has been diagnosed with major depression and has been hospitalized twice in the past three years. heterogeneous systems A therapist hypothesizes that Andrea's eating disorder is a reflection of disturbed communication and dominance patterns in her family. group therapy for Andrea. 598 M The Grady's family therapist operates from a behavioral perspective. B App p. structural family c. C App p. The therapist is probably a family therapist. D App p. a. Stephanie's conduct disorder c. structural family therapy. A therapist who endorses therapy is MOST likely to have made this statement. individual therapy with a cognitive-behavioral therapist. tells a client to increase a problematic behavior. d. b. psychodynamic c. d. encourage the expression of unresolved emotions. who has been diagnosed with dependent personality disorder. 598 E 17.45 Ans. Celine throws a temper tantrum whenever she is asked to do household chores. A App p. paradoxic An example of the paradoxical directive is when a therapist a.44 Ans. teach the Grady parents to be consistent in their discipline. a disturbed family process b. the mother's severe depression d. c. family ecology b. Therefore. She is also failing 10th grade and has alienated both of her younger siblings. C App p. structural d. c. B Fac p. behaves in a manner that is contradictory to clients' expectations. As a result. d. both b and c Esteban.47 Ans. behavioral family therapy. a. asks a client to act out the role of another family member.42 Ans. emphasize the exploration of subjectivity in family interactions. 598 M 17. The therapist tells Celine to throw more tantrums and follow even fewer of her parents' directions.17. What would a strategic family therapist identify as the family's central problem? a.43 Ans. ask the children to act out more than usual. b.46 Ans. behavioral b. b. 17. Stephanie has been diagnosed with conduct disorder. is being blamed for causing his family's problems when it is actually the family process. this therapist will MOST likely a. 599 M * 17. c. no more d. psychosocial rehabilitation.49 Ans. a self-help group. b. Which of the following outcomes is NOT expected by this family therapist? a. Hector and his family have received a standard invitation to participate in family therapy for Hector's dmg abuse. self-help and bibliotherapy b. encouraging the client to exaggerate his depressed symptoms for one week. Enrique's family will be more likely to go into treatment if a." she tells you.53 Ans. B Fac p. She expects that the focus of treatment will shift from the identified client to the family system. 600 M to 17. She believes she will be in a "win-win" situation regardless of outcome. Viola is participating in a. strategic program for Rodrigo's dmg abuse. c. b. 600-1 E 418 . D App p. b. c. Which type of therapy approach would you recommend? a. b.48 Ans. about four times more b. d. She expects that the intervention will reduce the circular causality present in the family. about two times more c.51 Ans.52 Ans.50 Ans. "If I thought a therapist would help me without charge. 600 E 17. a self-help program is used. c. "but really I mink I need to talk to someone who has gone through the same thing. I might think about it. slightly less Your friend's family is going into therapy together. psychodynamic techniques are used. d. A App p. According to Szapocznik's study. psychodynamic d. She thinks that the client will recognize the control he has over some of his symptoms. 600 M * 17. 600 E 17. A App p. 17. community therapy. Rodrigo's family is likely to enter treatment than is Hector's family. a self-help group. Ramirez has issued a paradoxical directive to one of her clients. D App p." You should suggest that Twyla try a. the therapist is of their ethnic group. group therapy. strategic family techniques are used. 599-60 C Ms. B App p. c. Rodrigo and his family have received an invitation participate in an experimental. homogeneous group therapy. behavioral Viola has joined an organization in which people dealing with cancer share ideas and support each other without help from a therapist. client-centered individual psychotherapy. d. a structural support group. a. humanistic c.17. Twyla has little money and feels completely alone since the break up of her marriage. d. 602 a. b. The community mental health center movement has a. the growing interest in psychosocial rehabilitation.58 Wunnand is a schizophrenic patient. b. rather than shut them away from the community. c. A Fac p. none of the above 17. 601 M 17.57 Ans.55 Ans. c. Compared to patients receiving treatment Ans. is joining a self-help group for the first time. altruism and instilling hope d. habit disturbance group. 602 E As you are reading a book.56 Ans. d.59 Ans. Pete joined a self-help group for individuals who are overweight due to compulsive eating. Wunnand will be less likely to remain in long-term inpatient App care for each of the following reasons EXCEPT p. His group will be focused on relatively heterogeneous problems. c. d. what basic group process(es) is(are) responsible for the success of self-help groups? a. c. * c. empowerment. lifestyle organization. social disturbance group. This is a type of a. whose sister is schizophrenic. 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. b. you come across the following quote: "Mental hospitals are big. He will give and receive information about schizophrenia. the wide availability of outpatient community treatment. b. 601 M 17.17. 17. B App p. 602 E . 601 M 17. decreased the number of inpatients. reduced unemployment. cohesiveness c. 601 M * Brent.54 Ans. D Con p. deinstitutionalization. single-purpose group. b. specific-purpose organization. This is a type of a. C prior to the 1960s. lifestyle organization. interpersonal learning and consensuality b. According to outcome research. the availability of effective antipsychotic medication. d. B App p. We need to treat people where they live. significant-other organization. He will pay no fee for participating in the group. d. conjoint therapy. hospitals' unwillingness to provide long-term care. M b. His group will exhibit the basic processes of cohesiveness and altruism. psychosocial rehabilitation. d. primary prevention.60 Ans. d. reduced homelessness. 419 17. Which of the following is LEAST likely to occur? a. increased the number of inpatients. C App p. A App p. c. impersonal warehouses." You recognize this as a plea for a. 603 E 17. C been asked what would happen if they created community mental health centers and App closed the hospitals. For every 10 schizophrenic clients she sees.S. 603 M Rhonda is a case manager at a community mental health center. 7 c. how do the overall costs of schizophrenia compare to those for cancer? a. 10 b. community-oriented clinicians. premature death. b. B App p. Costs for schizophrenia are about the same as those for cancer.64 Ans. c. family therapists. an interest in supporting primary intervention in the community The National Alliance for the Mentally 111 and a local self-help group would like to empower local people with severe mental disorders.65 Ans. C Fac p. 5 d. people's lives will not be improved d. d.63 Ans.17. a commitment to strategic family communication therapy c. 602 E 17. 602 E 17. c. all of the above According to evidence presented in the text. medical doctors. Costs for schizophrenia are roughly double those for cancer. about of them will probably be unemployed. and self-help groups have in common? a. 420 . To make official mental health plans for their state. physical illness. poor. D App p. you would predict that it is a p. good. M a. 602 idea because . Costs for schizophrenia are about half those for cancer. d. A Fac p. poor. What do the National Alliance for the Mentally 111. good. the hospitals provided better individual therapies 17. b. He is at greater risk than a non-disordered peer to experience a.62 Ans. community-oriented health professionals. criminal victimization. 4 Gary is 42 years old and has been schizophrenic for twenty years. Costs for schizophrenia exceed those for cancer. a. d.61 You are visiting a country with an extensive public mental hospital system and have Ans. the community health centers will be cheaper and more effective c. c. b. a commitment to psychosocial rehabilitation b. behaviorally-oriented health professionals. 602 M 17. an interest in supporting greater deinstitutionalization d.66 Ans. people's lives will be improved although costs will not be lessened b. B App p.. Based on results in the U. they should include a. b.71 Ans. c. financial aid. c. d. and group therapy in a mental hospital since she was 16 and is now due to be released. for whom will education about her disorder be provided? a. Her case manager has helped her to get an apartment. secondary prevention interventions. benefit from the program and will need to stay in it for 2 years. JoAnne has learned how to recognize when her obsessive-compulsive disorder is returning. Zelda has been completely dependent on the institution for her daily care and has never felt in control of her life. empowerment.70 Ans. therapeutic contracting. Keisha has chronic. has been receiving medication. 604 M * . C App p. b. a job. and coordinates efforts of other mental health professionals and her family. 603 M Zelda. be given a case manager to help him get the services he needs. Keisha's family c. family therapy. Billy Ray should a. psychosocial rehabilitation. d. severe depression. d. For his psychosocial rehabilitation to be complete. 603-4 M * 17. diversion tactics. regularly use the skills he has learned if the training continues for at least 6 months. C App p. strategic community reintegration. What Zelda needs most is a.17. and will have to report on her efforts to her support group.69 Ans. not generalize any of his training to the home environment. D App p. C App p. agreed to work at thinking positively and getting to work early. be as likely to relapse but his hospitalizations will be briefer. B App p. 604 M 17. d. and communicate with others. as Matt fears. A App p. so he asks you what you know about the program's effectiveness. 421 17.68 Ans. behavioral contingencies. the local community Keisha lives in d. Katja and her group are using a. who is 26. 604 M 17. Katja. b. Keisha b. b. struggling with chronic substance abuse.72 Ans. psychosocial rehabilitation. d. community diversion therapy. be involved in a selective prevention community program. individual psychotherapy. Matt tells you that his dad is participating in psychosocial rehabilitation to help him return home after his hospitalization for posttraumatic stress disorder. all of the above Billy Ray knows the symptoms of his schizophrenia and is able to use public transportation. 603 E 17. receive regular home visits from a medical doctor. receive regular home visits from a psychologist. secondary prevention. live on his own. You can tell Matt that his dad will probably a. If she is a participant in a psychosocial rehabilitation program.67 Ans. c. Matt's not sure that it will really do any good. c. JoAnne is MOST likely receiving a. communication training. c. b. A Fac p. and an increasingly competitive job market for young adults trying to establish independence from their family.75 Ans." What type of psychologist would he be? a. C App p. tertiary Dr. 605 M * 422 .78 Ans. structural b. community psychology b. 1 year c. deinstitutionalization A psychologist describes himself as "an agent of social change. helping to understand the interacting factors that can cause or prevent mental disorders. 605 E 17. 2 years d. M b. ecological b. 605 E 17. none of the above 17. structural c. a. civil rights movement d. what approach is he endorsing? a. less likely to have a relapse requiring hospitalization. which of the following should be omitted? a. and Emil is participating in a Ans. communal 17. the introduction of effective antipsychotic drugs Which social approach to the prevention of psychopathology was established in 1965? a. interactive d. c.76 Ans. 604 M When Ahulani begins her psychosocial rehab program and is given information about her disorder and her treatment. 605 E 17. psychological wellness programs d. 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. Compared to Emil. distrust of traditional psychotherapy b. family systems psychology c. D drop-in center program. A App p. much more likely to be active in his treatment program. Ifhewereto analyze eating disorders as an interaction of an individual need for control. D Con p. 604 a.17. interpersonal d. 6 months b.73 Monty is in an ACT psychosocial rehab program. Monty will probably be described by App each of the following outcomes EXCEPT p. d.74 Ans. community c.77 Ans. the Community Mental Health Centers Act c. Jacobsen describes himself as an analyst of social systems. permanently In a student's report on the factors that led to the rise of community psychology in the 1960s. more likely to maintain stable community housing. B App p. cultural glamorization of extreme thinness. b. psychosocial rehabilitation Dr.17. tertiary is to secondary. primary prevention d. b. Indicated prevention is to selective prevention as a. We should provide education to senior high school students to help them learn effective coping skills in the place of violent acting out. secondary prevention. D App p. C App p. tertiary prevention. 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. primary prevention. systems A program that tries to lessen the number of problems Ellen experiences due to her depression is a. c. Haslam is helping a local municipality evaluate the effectiveness of its recent. A Con p. We should more carefully identify persons with tendencies toward aggressive acting-out and offer group treatment for them and their spouses. He proposes a school program to help them with homework and allow them to socialize with positive role models. universal prevention. action research d. 606 M 17. secondary is to primary. training. secondary prevention b. The city is hoping to reduce the incidence of race-related complaints lodged against its officers. 605-6 M 17. D Con p. d. c.82 Ans. Dr. 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. ecological perspective c. and review of police officers. 605-6 M If you were a community psychologist and you were trying to understand violence in families. 606 M * 17. you might make each of the following statements EXCEPT a. indicated prevention.84 Ans. 606 M 17. selective prevention. C Con p. Ichabod's program is an example of a. tertiary is to primary. c. Haslam's work is a type of research. d.79 Ans. quaternary prevention. 606 M 423 .83 Ans. community b. d. b.80 Ans. 17. large-scale change in the hiring.81 Ans. action c. quaternary prevention. We should encourage movie producers to avoid the excessive use of violence in movies and to portray domestic violence in an unfavorable light. d. b. c. primary is to tertiary. Which of the following terms does not belong with the other three? a. B App p. A App p. secondary d. tertiary b. changing environments. increasing Gary's academic success. community support groups for parents who have a history of abuse in their own childhoods The Teen Outreach Program is an example of prevention gained primarily by a. which of the following characteristics would probably NOT apply to him? a.90 Ans. d. C Fac p. decreasing Gary's hyperactive behaviors. both a and b 17. D App p. He is more likely to be in an age-appropriate classroom at age 12 than is a boy from a control group. If Ryan were a participant in the treatment group of the Montreal Longitudinal Study. b. selective Which of the following interventions is LEAST representative of a primary prevention approach to the encouragement of secure attachments for infants? a. 606 M * 17. Research indicates that this prevention program will be successful in a. b. enhancing stress-coping skills. 608 M 424 . decreasing Gary's antisocial behaviors. enhancing stress-coping skills. 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. c. 607 E 17.17.85 Ans. He is less likely to exhibit delinquent behaviors by age 15 than is a boy from a control group. 606-10 E 17. responsive A psychologist who focuses her work on the fostering of secure attachments. b. and promoting empowerment is primarily interested in prevention. He is more likely to graduate from high school than is a boy from the control groups. c. d. 607 M 17. He will report that his parents' discipline strategies did not really change after the study. teaching effective problem solving. B App p. effective social policies for the elimination of poverty d. social b.87 Ans.88 Ans.86 Ans. this would reflect a kind of prevention program. primary d. a. c. school-based parenting classes for all high school students b.89 Ans. television ad campaigns to discourage young adults' illegal substance use c. Gary is a preschooler participating in Head Start. promoting empowerment. d. B Fac p. a. primary c. secondary c. D Con p. 17. empowerment c. Brett is in a(n) _ _ _ _ ^ _ program. selective c. 609 M 17.8 M 17. b. Pauline would probably advocate as a means of preventing this outcome. c. a. a. d.96 Ans. Fabio is MOST likely to a. Brett. indicated prevention b. universal b. a black male who has been physically abused c. a white female who has been sexually abused d. changing school environments b. create community-based support groups for parents and children to reduce the likelihood of family violence. its sample size. C App p. spends 8 hours each week performing community service.94 Ans. 609 M * 425 . its use of controls for group differences in SES. B Con p. encourage increased opportunities for. Dr. B App p. its experimental methodology. jail diversion programs for first-time offenders. b. and has had to work to repay the costs of repairing the house he vandalized. and use of.91 Ans. D App p. c. diversion d. indicated d. Dr. a white male who has been physically abused Widom's study of the relationship between childhood abuse and adult criminal behavior is noteworthy for each of the following reasons EXCEPT a. which of the following abused children is MOST likely to be involved in delinquency in adolescence? a. judicial reassignment 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. A App p. Nate. teaching students effective interpersonal skills d.92 Ans. a white male who has been severely neglected b. 609 M 17. responsive prevention. Brandon. d. encourage the implementation of television and magazine ad campaigns that promote empowerment of disenfranchised youth. Fabio is interested in developing a prevention program to address the central problem identified in Widom's study of adolescent and adult violence. 606. is attending a class on anger management. 17. promoting students' sense of community According to Widom's prospective study. 608 C * 17. Shara. enhancing students' stress-coping skills c. 15 years old. design educational programs for elementary school children that enhance their ability to cope with academic and social stressors.95 Ans. B Con p. its longterm prospective design. Terrell. 608 E Diversion programs are an example of a.93 Ans. autonomy c. A App p. 612 E Margo is an active participant in her neighborhood watch program. in part. c. A phobia and avoidant personality disorder that are caused. constitutional handicaps According to Dr. 612 M 17. b. ecological context b. 17. As you design a prevention program. 613 b.99 Ans. d. b. by making more frequent referrals to social workers b. by tailoring individual psychotherapy to the psychological needs of specific minority groups c. 20 p. 60 426 .17. Fac a. B Fac p. Demographic estimates suggest that people of color will comprise almost 17. 610 E 17. emotional difficulties d. safety d. 50 * d. d.3 would want to consider each of the following factors EXCEPT M a.S. 33 E c. if constitutional handicaps are not addressed in a program. factorial synergy. Melvin Wilson. 611 E 17. Yes. if only a single factor is addressed in a program. C % of the U.98 Ans. educational context c. Melvin Wilson respond to the question of whether prevention programs can actually have negative consequences? a.101 Suppose you were a community psychologist interested in the prevention of social Ans. by emphasizing secondary prevention through services targeted toward violent families or families in which a parent has a severe mental illness How would Dr. empowerment b. D Fac p.97 Ans. Yes. population by the year 2050. you p. C Fac p. by social Con rejection and social skills deficits. how might psychologists better serve the socalled urban underclass? a. 611." c. the shifting of risk factors across developmental stages.moj < Ans.100 Ans.102 D . the "domino theory. if the risk factors in the study create their own ecologies. the continuity principle. community psychologists believe that her sense of will be promoted. a. Yes. they can simply foil to demonstrate positive outcomes. by actively helping them develop the ability to obtain tangible resources d. No. As a result. resilience Which of the following general domains is NOT included among the risk factors that have widespread effects on development? a. 17. B App p. In other words. 614 M 427 .104 Ans. In order to do so.105 Ans. 17.103 Ans. c.106 Ans. 613 M 17. B App p. The females who participate could represent a group that is already at lower risk than the general population. Which of the following cautions is LEAST likely to be applicable to this effort? a. d. program planners intend to capitalize on existing strengths and traditions. b. and how can these be minimized? b. principle of augmentation. How is parental substance abuse related to adolescents' likelihood of substance abuse and school drop-out? d. c. universal prevention principle. Waters is part of a multidisciplinary effort to help devastated flood victims reestablish their communities and their lives. d. Her well-funded research may be difficult to replicate in other community settings. they will follow the a. continuity principle. If Thuc is conducting research in a Prevention Intervention Research Center. b. tertiary c. What academic and interpersonal problems cause the development of substance abuse problems in adolescents? c. What factors are associated with relapse for individuals with substance abuse disorders. The choice for primary intervention is probably less appropriate than a choice for a selective prevention program. responsive d. 613 M Dr. secondary Wangari is developing a multifaceted primary prevention program to reduce the prevalence of eating disorders in teenage females. A App p. D Con p. How can community-based halfway houses and other residential treatment programs utilize the continuity principle for the treatment of substance abuse? Which type of prevention strategy is MOST likely to be developed as a result of a PIRC research study? a. 613 C 17. The education involved could inadvertantly foster a self-fulfilling prophecy. which of the following questions is he MOST likely to be addressing first? a. primary b. principle of empowerment. clients become less concerned about being "crazy.SHORT ANSWER I ESSAY 17. in circular causal fashion. Group cohesiveness: often seen as a necessary precondition to the other processes. not simply negotiation of solutions to specific contemporary problems. cohesiveness is the result of group members' willingness to be committed to the group. clients can learn and practice new social skills. what type of therapy and therapeutic focus are most likely to result in long-term success for couples in marital therapy? Insight-oriented therapy. Universality: finding out that they are not alone in their experiences or feelings. 428 .109 How do structural family systems therapists define a "client"? While there may be an "identified client. 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. increasing their own feelings of efficacy and self-esteem. each member contributes. allowing an opportunity to explore lingering effects of early experience. and clients with already established skills can serve as role models for others. understanding and resolution of persistent emotional conflicts.107 therapy." or family member who is labeled as the disordered individual. it is much more difficult to do so when several group members give similar feedback. 17. Altruism: group members can help each other. 17. to maintaining and/or exacerbating other members' behaviors.108 According to outcome research. to participate actively. Recapitulation of the primary family: clients interact in ways that symbolically recreate aspects of interactions with their family of origin." and are less guarded and secretive. raising the client's own expectations for positive outcomes. and to express negative as well as positive interpersonal feelings and challenges as well as support. 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. these therapists view Has family process as the client. Consensuality: while an individual client might discount a therapist's perceptions and feedback. Interpersonal learning: in the safe group atmosphere. Instilling hope: clients can observe the changes and successes of other group members. family members. 2.111 What are the four common components of psychosocial rehabilitation? 1.. This reflects an ecological perspective (similar to family systems theories). recapitulation of the primary Most important (these are arguable. not individuals. c) instilling hope. because members should feel safe. Case management 4. because members discover their experiences are not bizarre nor are they alone in struggling with their issues. committed. Probably not important: consensuality. Patients' understanding of their own disorder (psychoeducation) 2. which ones are probably NOT important in the functioning of self-help groups? Which two would you consider MOST important in self-help groups. at both local and broader levels. d) universality. e) cohesiveness. and able to participate actively in the group process. and physical aspects of the environment.112 What four primary principles guide the thinking and research of community psychologists? 1. because the group exists so that members can help others. the emphasis for these psychologists is on proactive prevention. 4. 17. although listed in conceptual priority. coherence of student rationale should be taken into consideration): a) sharing of information. work.g. 3.110 Of the eight basic processes hypothesized to be important for the success of therapy groups. school. Efforts at change should be directed to social systems. 429 . and why? family. 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. A person's behavior is the result of interacting economic. interpersonal learning. Rather than treating already-existing disorders (equivalent to tertiary prevention). Identification and learning of day-to-day living skills and of the potential impact of their disorder on others with whom they interact 3. A coalition among clinicians.17. social. because members can observe the successful coping/understanding that other members exhibit. home). b) altruism. Interventions should take place in the actual settings in which individuals conduct their lives (e. because much of the group's purpose is to help educate its members about the specific problem that brings them together. and patients 17. Primary prevention is the central goal. 113 Suppose you wanted to design a primary prevention program aimed at reducing the prevalence of adolescent substance abuse. school system. Answer should include 3 of the following 5 issues. 4. No modal response predictable. peer groups. Change environments (e. Enhance empowerment. availability of housing). 5. describe how you might accomplish your goal.17. Teach children effective problem solving related to cognitive/academic and interpersonal functioning. 2.. Encourage secure attachments and reduce family violence.g. with supporting arguments: 1. Teach more effective coping skills for dealing with stressors. 3. 430 . Drawing on three of the five general strategies used in such programs. who has agoraphobia that is causing severe dysfunction in her family and could be successfully treated with a few months of therapy. 10. Which is more important." You could reply.5 Ans. M a. the independence of people with mental illnesses or the safety and comfort of the general population? b. 618 health care.000 b. none of the above 431 18.000 allocated for health care should be assigned App to mental health care.2 A high school class is recreating the U. Dolly." 18. 10 d. who is not menially disordered but has committed multiple gruesome murders. but more importantly mental disorders p. A App p. B deciding how much of me $100. To counter your friend's idea. 50. S. who has schizotypal personality disorder and spends most of his days wandering downtown streets shouting warnings of the apocalypse. How should psychologists and psychiatrists decide what to charge for their services? Which of the following persons can be involuntarily committed to a hospital? a.000 they should plan to spend on mental p. 618 affect everyone in society because in the U. use of the insanity defense accounts for 10% of all legal costs every year." c. a. They are Ans.S. Merrill. D App p.4 Ans.3 Rolf says. economy on a small scale. 4 b. c.1 Ans. What should mental health professionals do when asked to give expert opinions in legal forums? c. C one I know has that sort of problem. What should be the role of laws and law makers in regulating mental health care? d. Of $100." d. This professional would be LEAST likely to ask a. 7 c. 5. b. legal aspects of mental disorders. about $100 billion is spent for mental health care every year.Chapter 18 LEGAL AND ETHICAL ISSUES IN MENTAL DISORDERS A friend believes that mental disorders are uncommon and that less money should be spent on psychological research. M a. 20. 14 18. D Con p.000 18. 618-9 E A psychologist is addressing the central issues associated with ethical. 618 E 18. most criminals have mental illnesses. about $15 billion is spent for mental health care every year." * b. 619-20 M . Heinz. d. you could point out that Americans spend about 1 of every days in hospitals for mental health reasons.000 c. "I can't see why I should be concerned with mental illness when no Ans. "Perhaps a friend or App relative is affected without your knowing it.000 d. That legal order is a. c. A person who agrees with the parens patriae tradition would be most likely to suggest that a. C App p.6 Ans. parens patriae c. b. 620 E 18. b. B App p." Melody's comments show that she has a perspective. informed consent. 619 C * Two friends are debating the rights of individuals versus society. We should legally require confidentiality. a. C App p. teleological d. Megargee's view is most similar to that of a. Dr. Dr. Troy says that states should protect citizens from dangerous individuals. c. civil commitment. legal internment. d. 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. treatment for mental disorders should focus on family therapy approaches. d. 620 M 432 . d.18. therapeutic jurisprudence. Megargee is testifying before a state committee on mental health laws. 620 M 18. people who have a mental disorder should be allowed to make most of their own decisions. public schools are responsible for maintaining safety by prohibiting students' possession of potentially dangerous objects. right to treatment Mira's family and her former therapist believe she is so depressed that she is a danger to herself. therapeutic jurisprudence b. c. B App p.10 Ans. Edna says that the rights of an individual should always be upheld because everyone has a constitutional right to maximum freedom. Mira's family plans to get a legal order for her to receive inpatient treatment if she will not resume therapy willingly. b. "A law may be the fairest way to balance the rights of society with the rights of the individual. b. effective parenting requires training.7 Ans. 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. Melody says. A App p. c. Laws allowing civil commitment should be repealed. an assertive outreach orientation. Deinstitutionalization should be achieved at all costs. 620 E 18. 18.9 Ans. certification. We should allow people with mental illness to mm down treatment. the Durham rule. d. Dr. therapeutic jurisprudence.8 Ans. On which other central issue of rights expressed by Edna would Troy disagree? a. after Samuel complies with prescribed treatment and feels ready to return home Which of the following descriptors does not belong with the other three? a. In order to succeed in . Later. civil commitment. Walter. b. 620 M It is 1953. psychodynamic treatment was available at the proposed facility b. inpatient treatment. Therefore. At what point will Samuel be released? a. the state must also prove that Jamila a.18. attacked a police officer.15 Ans. d. b. B App p. managed care systems. 620 M 18. and Samuel has been committed to a state psychiatric hospital. civil commitment. 433 18. c.13 Ans. A Con p. least restrictive alternative Jamila. when his physician decides that treatment is no longer needed b. 620 C 18.16 Ans. diagnosed with schizophrenia. Because her hallucinations have led her to harm others. who was diagnosed with multiple personality disorder. is criminally insane. 620 E . he is MOST likely to be in favor of a. less restrictive treatment was available. when the judge who confined him no longer considers Samuel a danger to himself or others c. Dion was involuntarily sent to a state mental hospital because the state showed that he had a mental disorder. Dion's lawyer legally claimed that the order should be overturned because a. 620 M * 18. legal confinement. Dion was not improving. strong bias against psychiatry c. when a less restrictive treatment setting is available d. 1960s social reforms d. c. c. has the funds to pay for her treatment. has taken her medication infrequently since her release from the hospital. To force her to go to the hospital. an assertive outreach orientation would be used at the facility c. The state showed that Walter needed to be restricted to a nearby facility for the safety of the public. the hospital was overcrowded. integrated case management would be used at the facility d. 620 E 18. and the hospital could treat him. appropriate treatment was available at the proposed facility Javier believes that deinstitutionalization is a good idea. Dion was not a danger to others. was a danger to himself. legal confinement. legal proceedings have been started to return her to the hospital. d. D App p. C App p.11 Ans. A App p. d. C App p. civil commitment. could not be treated with a less restrictive alternative. competence to stand trial b. is a danger to herself. the state also needed to prove that . a. and Jamila refuses to go to treatment regularly.12 Ans. outpatient treatment. b.14 Ans. 1979 Between the late 1960s and the late 1980s. What year is it? a. shorter. Bob says that deinstitutionalization has been a success because the number of inpatients in state hospitals has so dramatically decreased. it has resulted in which of the following unintended consequences? a. a. all of the above Deinstitutionalization has failed to fulfill its early promise for the mentally ill. decreased c. equal.17 Ans. 620 M 18.20 Ans. longer. 620-1 M 18. but they are staying for longer periods of time. 620 M Avila is a patient in a state mental hospital. a. 1970 d. a large number of "criminalized" patients c. A Fac p. 1955 c. more Dr. B Fac p. Compared to Dr. a large number of criminal defendants using the insanity defense 18.18. c. a. b. d.22 Ans. shorter. decreased. B App p. more b. a significant decrease in all forms of inpatient treatment b. 620 E 18. his report in 1988 would reflect a in those admissions.19 Ans. the average daily number of patients in state mental hospitals . decreased. increased. and general hospitals are treating many of those patients. less d. 620-3 E 434 .18 Ans.21 Ans. specialized treatment units. and the number of patients admitted to all types of hospitals for mental health care . Her ward is overcrowded because the number of patients is higher than it is has ever been. B App p. 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. 620 M * 18. increased b. 7% increase During a class debate. Szulc is responsible for keeping track of all types of hospitalizations for mental health care. 13% decrease d. decreased d. Szulc's report to his state health commission in 1969. inpatients currently in state hospitals are more seriously mentally ill than were earlier patients. 30% decrease b. private psychiatric facilities. a substantial increase in the number of civil commitment procedures d. increased. D App p. fewer people may be coming in. You may best counter his argument by correctly stating that a. In particular. 1948 b. 30% increase c. less c. C App p. the ALI and McNaughton rules. assertive outreach Which of the following terms does not belong with the other three? a. b. 18. assertive outreach and integrated case management. integrated rehabilitation b.26 Ans. homelessness If state legislators have decreed that mental health workers seek out homeless clients and help them make arrangements for benefits and services. A App p. d. What is her first activity? a. outpatient commitment for dangerous individuals d. one third d. D Fac p. 621 M In which of the following settings has deinstitutionalization taken place in the past few decades? a. Ms. d. Franklin is a mental health professional who has implemented the system of care for homeless persons recommended by the NIMH task force. 621 E 18. You could reply by saying that a. 622 E 18. they have proposed a.25 Ans. VA hospitals d. about one third may not be able to work unless their severe mental disorders are under control. therapeutic jurisprudence. health maintenance organization c. safe havens b.18. creation of safe havens c.23 Ans. about two thirds may not be able to work because they are alcohol or drug abusers. D App p. C Fac p.28 Ans. Vondria is essentially right. 621 E 435 . Ramona suggests the homeless just need jobs. c. but Vondria says they are all crazy so no one would want to hire them.27 Ans. 622 M 18. B App p. both a and c What percentage of homeless individuals are estimated to suffer from severe mental illness? a. Ramona is essentially right. integrated case management d. public psychiatric hospitals b. B Con p. private psychiatric hospitals c. a managed care system. c. b. one half c.24 Ans. 621 E 18. one fifth A city task force is meeting to discuss means by which to help their homeless citizens. two thirds b. in community-based outpatient services 18. arrested and put in jail. 623 M 18. force him or her into a psychiatric hospital. B App p. Because John appears mentally disturbed he will MOST likely be a. c. arrest the person. b. D App p.18. in local jails b.3 M * 436 . d. c. Hettie is a. D App p. where are you MOST likely today to a person with a severe mental illness or substance abuse disorder? a. b. committed to a hospital with a court order. 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. c.34 Ans. c. emphasize housing options over the use of safe havens. Scott has the right to a. d. John was walking on an interstate highway and was very nearly hit by cars several times before the police arrived. but she hasn't received treatment in years. b. Officer Zayas is unlikely to hospitalize a disruptive. According to Teplin's research. C App p. c. find Based on information provided in the text. A Con p. committed to a hospital without a court order.30 Ans. 623 E 18. the hospital does not provide the kind of treatment needed for the person's disorder. the hospital often refuses to accept such persons because they are not sufficiently dangerous. refer him or her to a mental health agency. C Con p. d. likely to be forced into psychiatric treatment.32 Ans. see institutionalization as less preferable to continued homelessness. returned to his family. less likely to be arrested than someone who apparently has no mental illness. the arrest process involves less paperwork and red tape than does hospitalization. d. 623 M 18. equally likely to be arrested as someone who is apparently not mentally ill. in a VA hospital d.31 Ans. more likely to be arrested than someone who apparently has no mental illness.33 Ans. b. discourage the use of civil commitment for mentally ill homeless persons in favor of half-way houses. 623 E A person who emphasizes a.parens patriae approach to reducing the problem of homelessness would probably a. all of the above Hettie has been living under a railroad trestle and is known in the community for her abnormal behavior. mentally ill person for each of the following reasons EXCEPT a. not object to the bundling of services in the integrated system of care. he cannot commit the person without judicial or family consent. 620. a state or county psychiatric facility c.29 Ans. d. She has been diagnosed with paranoid schizophrenia. 622 C * 18. b. A law enforcement official made the decision for Saivatore to be hospitalized. D App p. on what grounds might the therapist succeed in hospitalizing her client? a. guilty but mentally ill Judge Storey is weighing the pros and cons of ordering outpatient commitment for a mentally ill. Is the "dangerousness" criterion more important than the "disability" criterion? 18. Which of the following descriptions is INCORRECT? a. 624 M Mr. The client is unable to care for his basic daily needs such as grooming and eating. B App p.38 Ans.37 Ans. b. A App p. deteriorating patient. Jasper will have a lawyer representing him who is able to call and cross-examine witnesses. c. This is an illegal situation. 624 E 18. The judge will rely primarily on the criterion of dangerousness in making her or his decision. none of the above Which of the following criteria is MOST frequently used as a basis of court-ordered civil commitment? a. d. This approach is sometimes called the "thank-you theory. it is not possible for Saivatore to be detained without a formal court order.36 Ans." a type of logic. He is mentally ill and in imminent danger of causing himself harm. Tavianni has hospitalized his schizophrenic client under the criteria of mental illness and grave disability. Jasper is appearing before a judge who will decide whether or not he requires involuntary hospitalization. b.39 Ans. danger to self b. d. danger to others c. d. If their state laws have been changed recently to make involuntary commitment somewhat easier.18. The client refuses to take his prescribed medication. 624 M * 18. Nakagawa's therapist believes that he is in need of inpatient treatment for a severe mental disorder. C Fac p. Which of the following is unlikely to occur? a. Which issue is probably MOST difficult for the judge to resolve? a. B App p. patient privilege Saivatore has been involuntarily committed without a court order. 624 M 18. The client is an excessive burden to his family. Will the therapist be liable if this patient acts out aggressively? b. forensic b.40 Ans. Jasper will have already been formally assessed by a mental health professional. parens patriae d. C App p. b. none of the above Dr. 624 M 18. gravely disabled d. 624 M 437 . c. He can be held for only a few days before a hearing must be held. Should the patient be forced to take his psychotropic medication? c. noblesse oblige c. a. Does the community provide treatment that will be effective for this patient? d. c.35 Ans. c. They helped establish criteria for the determination of competence to stand trial. d. They helped set minimum standards of care for all states in the U. none of the above Anselmo is refusing to take his prescribed lithium while he is a patient on a psychiatric ward. The process of ensuring mis right is expensive and time-consuming. right to refuse treatment c. be treated under conditions of informed consent. Under which of the following conditions can she be forced to take the medication? a. an involuntarily committed patient. Which of his concerns has been shown to be MOST valid? a. be involved in any treatment decisions made for her disorder. c. informed consent for treatment b. b. Hospital wards have become chaotic and dangerous because of such patients. Ishi. Which of the following is a CORRECT statement? a. if it is an emergency situation in which Tamisha is an imminent danger to herself or others b. receive effective treatment rather than simply be confined.45 Ans. 625 M 18.43 Ans. All states recognize this patient right. b. if the psychiatrist included the medication in his treatment plan presented to the court at the time she was committed c. 627 E 438 . b. TSouvas was wary of the 1980s1 push for patients' right to refuse psychiatric treatment. d. accept or refuse treatment as she sees fit. Tamisha is refusing to take the medication prescribed for her by her psychiatrist while she is a patient in a state mental hospital. 625 M 18. 625 M * 18. c. C App p. B App p. The need for psychiatrists in inpatient settings has declined. They helped establish the requirement that therapists break confidentiality to protect potential victims of violent clients. They helped identify the legal limits recognized in regard to patients' right to refuse treatment. 625 M Which of the following rights does every state in the U.46 Ans. recognize? a. He will probably eventually be court-ordered to comply with treatment.44 Ans. He is part of a noncompliant group that comprises about 20% of patients. both b and c What do Youngberg v.41 Ans. d. c. Romeo and Washington v. C Fac p. 625 M 18.18. A substantial number of patients have chosen to invoke this right. A App p. Dr.S. Harper have in common? a.42 Ans. 18. if she refuses to cooperate with the rules and regulations of the treatment unit d. This means that she has a right to a. is insisting on her right to treatment. D App p. D Fac p. b.S. d. The psychiatrist can insist on Anselmo's compliance as long as he is involuntarily committed. minimal standards of care d. Cleburne Living Center. presence of mental illness c.49 Ans. His prison sentence would have been shorter than was his involuntary commitment. A App p. B Con p. Ake v. A Con p. treatment b. a least restrictive setting c. O'Connor v. Marisa is a committed patient. Tarasojfv.47 Ans. C App p. least restrictive treatment b. B Fac p. a safe environment b. adequate medical care Which landmark case marks the Supreme Court's willingness to hear arguments about the constitutional rights of a civilly committed mental patient? a.. d. 627 C * Mr.8 M 439 . Delaney was in a delusional state.50 Ans. Cameron : right to refuse treatment c. due process d. b.52 Ans. D Fac p. rights of mentally retarded criminal defendants. v. rights of nondangerous patients. Romeo : standards of treatment d.51 Ans. treatment availability d. c. standards of treatment. Delaney was hospitalized following his assault on a police officer while Mr. a. Oklahoma : rights of mentally ill criminal defendants Which of the four conditions of civil commitment is MOST specifically addressed in the Supreme Court case won by Kenneth Donaldson? a. 627 E 18. Regents of the University of California c. Romeo b. 620. Donaldson Which of the following cases and legal rights are mismatched? a. 627 E 18. . Rouse v. which involved nothing more than confinement.S. Texas d. 627 M 18. informed consent 18. Donaldson : rights of nondangerous patients b.48 Ans. Youngberg v. the right to treatment.? a. Which of the following standards of her treatment is NOT recognized by each state in the U. Youngberg v. competent commitment The experiences of Nicholas Romeo at Pennhurst State Hospital set the precedent for a. 627 M 18. the right to receive visitors d. City of Cleburne. O'Connor v. Inc. His right to has been violated. freedom from unnecessary restraint c. d. c. Soon she received a notice stating that she did not have the education and training required to use that title. 629 M 18. will.57 Ans. because . According to the text. 628 M Felicia heard that a group home for people with mental retardation would be placed in her neighborhood. C App p. c. will not. Lois violated a. do nothing to prevent this event. both a and c After getting a bachelor's degree in psychology. 628 M 18. d.55 Ans. b. who because of his mental disorder does not understand why he is to be executed b. A App p. 629 M 18. Thomas is a young man living in poverty who has been accused of murder. certification laws. and she wishes the city would do something. d. will. A App p. he was not delusional when he committed the crime b. ask the city to impose a special permit process for establishing such homes. 630 E 440 . Lois began advertising her services as a psychologist. D App p. the McNaughton rule. He will be committed for treatment for one year before his case is heard in court. privilege laws. 18. c. ethics laws. Werner. will not. who is suffering from borderline personality disorder and is a danger to himself d. Which of the following rights is extended to Thomas? a. Felicia tells you she is worried that her home price will drop. both a and b Harry was convicted of murder and sentenced to death. Harry has become delusional and no longer understands why he is being held nor what is going to happen.54 Ans.56 Ans. If found guilty. The state most likely execute Harry. b. b. He will be provided a state-funded psychiatrist to serve as an expert witness. Ten years later. Benny. file a petition signed by the neighbors with the state.18.53 Ans. a. he has a right to treatment For which of the following prison inmates would a sentence of execution not be carried out? a. he was not delusional when originally sentenced c. Sarah. he doesn't understand what the death penalty is for d. D App p. he cannot be executed if he is considered incompetent at the time of execution. you should suggest that Felicia a. His family insists that he is severely mentally ill. who was mentally ill at the time of her offense and has been successfully treated c. ask the city to require group homes to locate only in certain zones. privilege d. what types of laws does he have to know and comply with? a. 630 M 18.60 Ans. In a. Horvat agrees that certification and licensure laws may protect individuals from charlatans and unskilled professionals. recognize the conversations as confidential.62 Ans. A Con p.63 Ans.59 Ans. According to your text. 630 E 18. b. because it is a breach of confidentiality. A Fac p. C App p.. force Pastor Upton to reveal the contents of their conversations. should have told them only if they are paying for the therapy.S. ethical obligation c.18. should not have told them. 630 M . 630 M 18. 630 E Dr. What is the term for this protection? a. Horowitz has just completed graduate school and is ready to start a private therapy practice. should have told them only if Haile lives with them. ethics and confidentiality laws d. force Sonya to reveal the contents of their conversations. The court MOST likely will a. client-therapist contract b. federal protection only d. he questions whether a. licensure and certification laws b. c. Horowitz can start his practice. d. privilege b. d. d. Which of the following terms does not belong with the other three? a.61 Ans. practice regulation laws c. c. A App p. like some other practitioners. Haile was shocked later in the week when her parents knew about it. because of the Tarasoff ruling. confidentiality c. b. should not have told them. b. 630 M 18. c. these laws should include confidentiality issues.58 Ans. Before Dr. d. the therapist a. each state of the U. such laws should specify the parameters of "effective" therapy. D App p. privilege exists between a minister and parishioner. It is alleged that Sonya confessed her guilt to Pastor Upton. but they said the therapist was right to call them. b. malpractice and training laws Dr. C App p. nontraditional professionals are being economically disadvantaged. a therapist and client. c. states that do not have such laws are putting their citizens in danger. 630 M Dr. recognize the conversations as privileged. confidentiality 441 18. censure During couple counseling. Haile told her therapist that her boyfriend knew she had a sexually transmitted disease from a previous relationship. Sonya is on trial for the murder of her husband. a parent and child. Galtberg is legally protected from disclosing information about his clients except in certain prescribed cases. both a and c 18. However. B App p.64 Ans. the client is imminently suicidal and will not agree to hospitalization that Dr.69 Ans. Oklahoma that set this precedent. Altress d. if his client threatens to terminate treatment prematurely Dr.65 In 1996. when the case does not involve abuse of a minor or other violent offense In her first session with each client. in any case heard in a U.66 Ans. 18. in any case heard in federal court d. C App p. there are some limitations to confidentiality. Dr. O'Conner. and Dr. b. Under which condition below might Dr. the client is abusing a child or a disabled adult. 18. and these include each of the following EXCEPT a. A App p. c. 631 M . 631 E 442 . Under which of the following conditions will their confidentiality be legally protected? a. Redcloud is a psychotherapist treating a client who is involved in a court case. v. the client includes her/his mental condition as part of a court case. the client reports that she/he is currently buying and using illegal substances. However. Carter v. This case ensured the protection of confidential Fac communications between a therapist and a client in federal cases. Pedophiles are a menace to society and have forfeited their legal rights. When treatment ends.68 Ans.S. Fuhr is called as a witness. if his client claims that his abusive parent has broken the law in the past b. C App p. Dr. c. 630 M Dr. 630 name of the case? E a. Regents of the University of California b. It was first permitted in past cases such as the Ake v. b. Serano is treating an admitted pedophile. Why is this permissible on legal and ethical grounds? a. Fuhr deems necessary. Serano plans to testify in court about the client's mental state. Natchez be required to breach client-therapist confidentiality? a. Tarasojfv. a Supreme Court decision was made that was very important to the area Ans. state court c. it is a serious breach of confidentiality.18. d. d. 631 M * 18.67 Ans. Donaldson c. It is not permissible. Dr. if his client indicates that he is abusing other people d. if his client claims that he knows that a friend or acquaintance has committed murder c. What was the p. B App p. Serano is conducting a court-ordered psychological evaluation. D of legislation and mental health. Fuhr describes the nature of confidentiality and her commitment to maintaining this aspect of the therapy relationship. Redmond 18. Natchez has a new adult client diagnosed with borderline personality disorder. Jaffe v. Dr. if the legal charge involved in the case is a misdemeanor rather than a felony b. 71 Ans. B App p. in cases such as Tarasoff \. deciding how to protect himself from a future malpractice suit should his client file one in anger d.72 Ans.70 Ans. 632 E 443 . Berler's client has indicated that she intends to shoot the woman with whom her husband is having an affair. A App p. Payne is facing a problem with a certain client of his. B Fac p.18. Confidentiality must be broken when a client intends to harm another person. b. d. the importance of a victim's right for safety against the client's right to fair treatment d. and has recently expressed a high level anger directed toward his wife and children. deciding how to circumvent legislation requiring him to report his client to the police so that he can deliver more effective treatment 18. inform the police of the client's intentions Why was John Hinckley. the importance of a client's safety against the right of society to see justice done b. c. deciding whether he should refer his client for appropriate medication b. B Fac p. Therapists are ethically required to directly warn intended victims of their client's intentions. Payne's dilemma? a. What is Dr. D Con p. He took the step of informing the President's Secret Service." b. 631 M * 18. He had been able to get his client to undergo voluntary hospitaliaation. 631 M According to your text.73 Ans. but Hinckley later carried out his plan. "The protective privilege ends where the public peril begins. the importance of a victim's right to see justice done against the client's right to confidentiality Which of the following descriptions does not belong with the other three? a. This client has been convicted in the past of spouse abuse.74 Ans. the importance of a client's right to confidentiality against society's interest in protecting itself from danger c. 632 M 18. c. The Tarasoff decision set the precedent for the breaking of confidentiality when a client is potentially dangerous to another person. What must Dr. He had excellent legal representation and successfully defended himself against the Tarasoff requirement. The laws of his state did not require that he take steps to protect the client's victim. but the attempt was not be prevented. seek voluntary or involuntary commitment for her client d. Dr. call the intended victim and warn her of the client's intentions c. predicting whether this client will be dangerous in the future c. Jr. take whatever action is necessary to protect the intended victim b. Dr. 631 M 18. Berler do at this point? a. Regents of the University of California what issues are the court systems weighing against each other? a. d.'s psychiatrist not held liable for damages when his client attempted to assassinate President Reagan? a. 79 Ans. b. c. C App p. Lutece's desire to avoid a false negative outcome. d. is dealing with a client who may be potentially dangerous.77 Ans. Each of the following factors complicates Dr. Ramone receives information about his client's history of violence. what are his chances of predicting this client's future level of dangerousness compared to a layperson's chances? a. d. doctoral level psychologist rather than a bachelor's level social worker. Ramone attempts to predict the client's dangerousness in the next 2 weeks rather than in the next year. 634 M * . b. much better c. Lutece believes his schizophrenic client with paranoid delusions may become violent toward his family at some point. Lutece's predictions are not better than those based on chance. limited knowledge about the client's day-to-day environments. D App p. Richards for failing to prevent the suicide of their mother. Jacobs works only with adolescent clients and is therefore exempt from breaking confidentiality when clients threaten others. 444 18.78 Ans. a trained psychotherapist. Richards and the mother had to have been in a special professional relationship. Richards' negligence must be shown to be the cause of the mother's suicide. B App p.75 Ans. Ms. Dr. each of the following elements must be present EXCEPT a. Dr. c. According to your text. Based on empirical findings.76 Ans. Dr. Which of the following factors will enhance his accuracy? a. b. A App p. Lutece's ability to accurately predict this behavior EXCEPT a. 633 M 18. Regents of the University of California case. Ms. d. Potentially dangerous clients have become much less likely to seek treatment knowing that their confidentiality may be jeopardized. Regents of the University of California happened. and because Tarasoff dealt with marginal cases. all of the above Dr. d. Richards must be shown to have violated a standard of care in treating their mother. about the same b. 632 M * 18. c. c. his practice is not included in its requirements. why may this be so? a. Ms. Richards' was not a member of the APA and thus was not bound by its ethical principles. Jacobs' San Diego mental health practice has not been affected much by the Tarasojfv. research evidence that suggests Dr. the relative rareness of dangerous behavior in the general population. only slightly better d. 632-3 C 18. Ramone is a licensed. Jacobs' practice deals with common mental health problems. Dr. In order for a family to successfully sue Ms. b. Jacobs was breaking confidentiality to warn victims or the police before Tarasoffv. Ms.18. Dr. Aram. A App p. 632 E Ramone is trying to predict the dangerousness of one of his clients. worse Dr. who has not done so previously d. D App p. client suicide b. Mitch. failing to inform individuals of potential harm posed toward them by a client c. eight to fifteen percent Which of the following therapists is MOST likely to commit the offense of having sexual contact with a client? a. 6 months b. 634 M 18. A Con p. 634 E 18. who has done so previously b. 634 E 18. Sometime later. failing to correctly diagnose a comorbid substance abuse disorder in a severely depressed or anxious client Which of the following events did NOT occur during the 1960s? a. who has not done so previously 18.18. and they began dating shortly thereafter.84 Ans.80 Ans. Vasquez is facing a malpractice suit.81 Ans. failing to prevent a client from committing suicide b. * a. less than one percent b. Dr.83 Ans. 2 years d. 634 E Dr. It is not ethically permissible to have an intimate relationship with former clients. 1 year c. two to ten percent d. Melba.34 M 18. Calderon saw a client for a few sessions while she was dealing with grief over Ans. Ricardo. who has done so previously c. Calderon and the former client ran App into each other at an art museum. p.82 Ans. 635 According to current APA guidelines. at least must have passed between M the termination of therapy and their romantic relationship.85 Dr. the Tarasoff decision c. A App p. C Fac p. B Fac p. Which of the cases below is LEAST likely to be the one he is facing? a. engaging in sexual intimacy with a client as part of her treatment for sexual dysfunction d. reforms in state civil commitment laws d. 620. violation of standard of care c. Laura. malpractice What percentage of mental health professionals report having engaged in sexually intimate behavior with a client? a. increasing numbers of public mental hospital patients being discharged Which of the following does NOT necessarily belong with the other three? a. an increase in the number of malpractice claims against psychologists b. C the loss of her mother. over twenty percent c.31. sexual contact with client d. 445 . ethical standards c. malpractice suits What factor is MOST likely to determine the standards of care that therapists are expected to follow today? a. Carolyn's insurance company is participating in a system. a therapist's clinical supervisor c. fixed-cost b. c.90 Ans. B Con p. 636 E * 18. 635 E Nancy has engaged in sex with her psychotherapist. 636 E 18. B App p. C App p. what factor below would have the greatest regulatory impact on your practice? a. Which statement below is the most likely to be FALSE? a.86 Ans. none of the above If you were a therapist. Which of the following cases is NOT likely to be a target of a malpractice suit regarding repressed memory therapy? a. a client's therapist b. A App p. third party payers b. The therapist is putting his own needs before Nancy's.87 Ans. such as Tarasoff and other state cases d.18. d. utilization Who conducts a managed care system's utilization review of therapy? a. A therapist helps a client remember abuse that occurred when the client was 9 months old. flat fee c. 637 E 446 . In other words. ethical standards Carolyn is a member of a managed care system. 635 M 18.91 Ans. an independent mental health professional hired by the company d. Her insurance company pays a set fee each month for each of its members for mental health care. D Fac p. D App p.88 Ans. a case manager who is typically not a mental health professional 18. court decisions b. capitation d. The increased level of intimacy has increased the effectiveness of the therapy. third-party payers c. b. a. A therapist uses sodium amytal to help a client recall her history of sexual and physical abuse that occurred at age 8. b. 636 M 18. Nancy's therapist is being exploitive.89 Ans. d. malpractice suits d. regulatory legislation. The therapist will find it difficult to be objective while making judgments about Nancy. c. A client recalls her childhood sexual abuse after two years of intensive hypnotherapy. 18. What type of treatments will this plan MOST favor? a. 640 E 447 . a dispute over financial matters Dr. 637 E 18. practicing in an area in which you are not competent b. 637 M 18. a forensic psychologist providing inpatient treatment to a defendant deemed criminally incompetent 18. thorough assessments that inform careful therapy planning b. 637-8 M Your health care service utilizes a capitation plan. Jackson is a psychologist. B App p. 638 E 18. D App p. a. forfeiture of his state licensure d. a psychodynamic therapist providing individual therapy b. it is estimated that psychologists and psychiatrists provide expert witness testimony in % of all federal civil trials. expulsion from the APA Although the practice is controversial. insight-oriented psychotherapy d. 15 d. 20-session cognitive-behavioral therapy You are a therapist. Which of the following consequences is NOT associated with this violation? a.97 Ans. B Fac p.92 Ans. Smith has been found guilty of the ethical violation of having a sexual relationship with a client. community c. 638 E 18. an arrest c. forensic Which of the following psychologists is MOST likely to charge rates of $300 to $400 per hour of service? a.95 Ans. and you have committed an ethical violation. a. Jackson is testifying in a trial in which an individual is being evaluated for involuntary hospitalization. litigation d. B App p. 5 b. a breach of confidentiality c. C Fac p. A App p. 22 Dr.94 Ans. sexual intimacy with a client d. a clinical psychologist conducting a complete psychological evaluation c. public reprimand b. civil b. a forensic psychologist providing expert testimony d.96 Ans. What type of violation is it LEAST likely to be? a.93 Ans. Dr. medications and short-term therapy c. 8 c. B App p. Lawrence could consider each of the following issues EXCEPT a.103 Ans. 7 b. Mr. Does the client understand the wrongfulness of the crime? Which court representative is responsible for raising the question of criminal competence? a. Mr. Elsley is a forensic psychologist specializing in the treatment of defendants found incompetent for trial. the attorney questions her a. 640 E 18. a. the Durham rule d. 5 c. insanity c.100 Ans. Mr. Padgett has been found incompetent to stand trial.98 Ans.102 Ans. Will my client be able to participate meaningfully in his own defense? d.101 Ans. 640 E Shara's attorney is wondering if Shara adequately understands the nature of the judicial proceedings she is about to undergo. A App p. D Fac p. d. competence to stand trial. c. Mr. If her results are similar to those found in the research literature. the prosecution d. legal state of mind. C App p. Does my client understand what will happen during the trial? c. b.18. the defense attorney b. Padgett will be evaluated according to the ALI mle. The attorney is concerned that Shara is not really able to participate in her own defense. any of the above Mr. B Fac p. competence b. Can my client consult meaningfully with me as I prepare this case? b. What will happen next? a. it is necessary to first determine before raising the question of . the adequacy of the McNaughton mle. wrongfulness. Dr. d. 640 E 448 . competence. and he will be committed for indefinite treatment. 640 E * 18. 640 E 18. a. and the prosecution will determine whether the case actually proceeds to trial. 640 M 18. 4 d. intelligence. Padgett will be assigned a special advocate who will work with the defendent and his lawyer throughout the trial. Mr. In other words. the judge c. If a defendant's mental state is an issue in a court case. sufficiency for judicial review. Lawrence is evaluating whether his mentally disordered client is competent to stand trial. c. b. she can expect that at least of every 10 patients will ultimately be found competent. mental defect Mr. Padgett's court case will be dismissed. 2 18. Padgett will be involuntarily committed to a forensic hospital unit until such time as he can stand trial. D App p. criminal culpability.99 Ans. any of the above Which of the following persons does not belong with the other three? a. the product test : ALI : Durham d.110 Ans. As she learns about the insanity defense." Which rule(s) for assessing insanity is(are) reflected in this statement? a. Archie Brawner b. inability to participate effectively in his own defense. Prosenjit Poddar c. C App p. B Con p. a clinical psychologist c. "Due to bipolar disorder symptoms of psychotic severity. cognitive and volitional appreciation of the criminality of his action. my client was unable to distinguish right from wrong when she stole large sums of money and purchased several firearms and explosives. a. c. the court will focus on James' a. Durham c. diagnosable psychopathology leading to an inability to inhibit criminal actions. b. Durham d. A Con p. 640 E 18. 641 M 449 . ALI Nena is a second-year law student. GBMI c. McNaughton c. the court b. B Con p. This expert witness asserts that the defendant has a severe mental illness that caused the criminal action.105 Ans. McNaughton : ALI : Brawner c. McNaughton : Durham : ALI 18.109 Ans.108 Ans. mens rea b. 640 E 18. a forensic psychologist d.18. Durham d. 641 E 18. she will find that the rule is virtually never used today. This evidence is MOST critical to the rule. ALI Which of the following represents a CORRECT chronological ordering of the primary standards used to define insanity? a. McNaughton d. believing she needed to protect herself from her enemies. 641 M 18. D App p. 640-1 M 18.107 Ans. Daniel McNaughton d. failure to understand the wrongfulness of his crime as he committed it. d. C App p. both b and c A psychiatrist is testifying in relation to a criminal defendant's insanity plea. Durham : McNaughton : ALI b. ALI b. a. D Con p. Monte Durham James is accused of attempted murder. 641 M * first Who is ultimately responsible for deciding a defendant's sanity or insanity? a. McNaughton b.104 Ans. If his sanity is being judged against the legal rule established in the mid 1800s.106 Ans. 641 M 18. active psychotic symptoms c. its actual prevalence is . ALI c. Which of the following is LEAST likely? a.112 Ans. Erik was held to the standard of the McNaughton rule rather than the ALI rule. one quarter. 641 M * 18. 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.01 percent c. one half. Strickland is an attorney considering the use of the insanity defense for her client.18. c. serious mental illness b. B Fac p. a. b. C Fac p. the rule was used. 642 C 18. a. Erik has just been judged NGRI. d. She is extremely unlikely to win such a case and should carefully consider other options. 1. b." This defense attomey is addressing the test of insanity. His presiding judge will use more stringent criteria in deciding his release than the release of a civilly committed patient.0 percent b. she was unable to control her actions due to her psychotic mental condition. mens rea d. B App p. a. Erik will be hospitalized for a longer period of time than will an NGRI defendant who committed a less serious offense. Durham d. Durham b. one third. Which of the following characteristics is MOST clearly related to potential for violence? a.115 Ans. If Carter's case was heard in a federal court. lowSES d. D App p. IDRA "While my client had a dim awareness that her assault on her sister was wrong. How would you advise her? a. borderline intellectual functioning 450 18. one half. ALI b. .116 Ans. A App p. 642 E . Erik is much more likely to be rearrested or rehospitalized after his release than is the average criminal.111 Ans. 3.114 Ans. She should only recommend this if her client has the funds to pay for a very expensive defense process. A App p. 641 M Carter was a defendant whose attorney entered a plea of insanity in Carter's 1980 manslaughter case. She will probably be most likely to win such a case if the defendant committed a violent crime after discontinuing psychotropic medications. 641 M 18. .113 Ans.005 percent d.5 percent Ms. c. McNaughton c. McNaughton Although a study in Wyoming found the public believed that the insanity defense was used in about of all criminal cases. d. 643 M 18. p. Miyoko has been found GBMI in her criminal trial. b. which limits this verdict to schizophrenic defendants only. You realize that the defendant may not receive adequate treatment due to hospital overcrowding. The media coverage of such trials may contribute to the field's credibility. Letisha.117 Ans. Such experts typically cannot contribute valid assessment and diagnostic evidence for the use of juries or judges. c.S. The burden of proof moved from the prosecution to the defense. the Durham rule guided the jury's deliberations. a lower-class Italian American male d. Which of the following is NOT among them? Fac a. d. * c. Mason. 18. 451 .120 Ans. 642 M 18. an upper-middle-class white male c. B the insanity defense.121 In the wake of the John Hinckley. d. D App p. b. she will receive treatment before being placed in the general prison population. D Con p. given the frequent disagreement amongst those experts. may exert too much influence on the judicial process. her trial could have taken place in any state in the U. d. trial. 643 M 18. despite the IDRA. These experts. You will have to distinguish between mental illness that leads to insanity and mental illness that does not.119 Ans. The use of the GBMI verdict was expanded for use in cases where the M insanity plea was not raised. Benito. Which of the following issues is LEAST likely to complicate your deliberations? a. which statement should be omitted? a. 643 b. You must follow the ALI rule. You are skeptical of the conflicting expert testimony presented by psychiatrists and psychologists. d. her lawyer employed the insanity defense. The ALI rule was changed to be essentially equivalent to the earlier McNaughton rule. in its IDRA revision. Experts offer opinions of a defendant's past state of mind and present dangerousness that may be no better than those of a layperson. a middle-class black female b. c. 643 M Which of the following persons is able to use and can afford to pay for an insanity defense? a. Suppose you were serving on a jury that has been asked to consider the GBMI verdict. all of the above In a student's report on the presence of mental health experts in trials involving questions of the defendant's sanity. several changes occurred in the use of Ans. This means mat a. Jr. b. C Con p. Experts were prohibited from giving any conclusions about a defendant's sanity. c.18. A App p.118 Ans. D Fac p.122 Ans. what principle(s) must be considered by jurors? a. mens rea c. no instructions at all d. Duretha. IDRA reforms d. 645 M 18. and hospitalization must represent the least restrictive alternative available for that treatment. none of the above Which of the following legal principles is fundamental to the other three? a. McNaughton rale 18. B App p.126 In order to balance the tradition of parens patriae with greater attention to individual patient rights.123 Ans. as a result of a mental disorder. Regardless of the state in which his case is heard. the ALI rule Jerome is being tried for a crime that he committed without forethought or intention. appropriate treatment for the disorder is available at the proposed site of commitment. Ayita. A Con p. the person is an imminent danger to self or others as a result of mat mental illness. D App p. who hears diagnostic testimony and a penultimate opinion c. 452 . IDRA rules b.18.125 Ans. 645 E 18. 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. who hears diagnostic testimony and both a penultimate and ultimate opinion d. 645 M SHORT ANSWER / ESSAY 18. mens rea b. IDRA c. ALI b.124 Ans. who hears only diagnostic testimony b. ALI rule d. the McNaughton rule c. today's laws require what conditions to be met before a person is hospitalized against her or his will? The person is mentally ill. Marta. none of the above Which of the following types of instruction is MOST likely to influence jurors' verdicts in an insanity case? a. the client raises her/his mental condition as part of a legal proceeding. 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. specialized substance abuse units. the so-called shift from inpatient to outpatient treatment. malpractice lawsuits. and the relationship is exploitative because of me therapist's greater power and control. moreover. the client is abusing others. ethical standards 453 . including certification and licensure laws. Tarasoff). 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. 18. The census decline. Clients themselves report the experience to be harmful. based on the assumption that these relationships could not survive without guaranteed nondisclosure. husband/wife. the therapist is unlikely to maintain objectivity in her/his treatment decisions and interventions.131 List the factors that help regulate the practice of psychotherapy. as has treatment in general hospitals. Legislation.18. Confidentiality can be broken if the following conditions occur: the client needs involuntary hospitalization. lawyer/client.128 What two criteria are most commonly used to make decisions about civil commitment? Mental illness and grave disability 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. residential units. the client is undergoing court-ordered evaluation. the therapist is necessarily putting his/her own needs before those of the client. and other inpatient programs.127 Why is deinstitutionalization.g. Confidentiality is not a legal requirement but an ethical obligation in which a therapist pledges not to disclose a client's reports during therapy. and privilege. 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. has occurred primarily in state and county mental hospitals while treatment in private hospitals has increased in the past 10 years. 18. 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. third party reimbursement plans and utilization reviews. physician/patient). or the client intends to harm a specific person.. precedents set by court cases (e. McNaughton mle: emphasizes the understanding of right from wrong. prohibits experts from giving ultimate opinions. is used in about 20 states in the U.S. no longer used. omits volitional component of the ALI. ALI (aka Brawner): emphasizes defendant's substantial. used in about half of the states. lack of appreciation for the wrongfulness of an act in terms of cognitive.18. Durham: emphasizes the presence of mental defect/mental disorder. used in all federal courts since 1984. Insanity Defense Reform Act (IDRA): moves burden of proof to defense. and volitional components.132 What are the four approaches for defining insanity that have been used in state and federal courts in the U. and indicate how it is used in the U.? Describe the central feature(s) of each mle.S. today. emotional. not absolute.S. 454 .