Chapter 12: Trauma-Related Disorders and

Maltreatment

Test Bank

Multiple Choice

Child

1. Trauma occurs in about _____ of youths and about ______ of them will develop symptoms of PTSD.

a. 10%; one-third b. 30%; one-third c. 30%; nearly all d. 10%; nearly all

Ans: B

Learning Objective: LO 12.1 Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Knowledge

Answer Location: Posttraumatic Stress Disorder

Difficulty Level: Medium a. Yes. b. No, because the individuals are in another country. c. No, because she did not know the individuals involved personally. d. No, because she did not personally witness the kidnapping.

2. Molly, a 12-year-old girl of Irish descent living in Ohio, learned that a group of girls from Somalia had been kidnapped by the extremist group Boko Haram. She later watched multiple news stories about this and read about what had happened to some of the girls who had escaped and told their stories. Can this be considered a traumatic event for Molly?

Ans: C

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Analysis

Answer Location: Posttraumatic Stress Disorder in Older Children and Adolescents: Description

Difficulty Level: Hard a. an intrusive symptom b. negative alterations in feeling c. negative alterations in thoughts d. physiological reactivity

3. Zeke sometimes finds his thoughts wandering to the image of a gun pointing at him, the trauma he’d experienced 6 months ago. This is an example of ______.

Ans: A

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Application

Answer Location: Posttraumatic Stress Disorder in Older Children and Adolescents: Description

Difficulty Level: Medium a. a severe form of physical abuse b. a typical reaction to reactive attachment disorder c. a typical cause of reactive attachment disorder d. a mild type of injury that can result from repeated falls in infancy

4. Shaken baby syndrome is which of the following?

Ans: A

Learning Objective: LO 12.3 List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Knowledge

Answer Location: Health Problems

Difficulty Level: Medium a. an intrusive symptom b. a dissociative symptom c. a negative alteration in cognition d. an alteration in physical arousal

5. Carlos was recently in a car crash in which his friend was killed. Sometimes, Carlos reports feeling that he is walking through a dream instead of the real world. This is an example of which of the following?

Ans: B

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Application

Answer Location: Associated Features

Difficulty Level: Easy a. for any diagnosis of PTSD b. for any diagnosis of PTSD with dissociation c. for a diagnosis of PTSD in those over the age of 6 d. for a diagnosis of severe PTSD

6. A negative alteration in cognition or mood symptom is required for which of the following?

Ans: C

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Comprehension

Answer Location: Posttraumatic Stress Disorder in Preschoolers

Difficulty Level: Hard a. a child from a war-torn country b. a child who has experienced years of physical abuse c. a child who witnessed her mother beat her father at least weekly for years d. a child who was caught in a building fire

7. Which of the following individuals is statistically least likely to experience PTSD?

Ans: D

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Application

Answer Location: Prevalence

Difficulty Level: Medium a. is usually more persistent in children with the condition than for adults with the condition b. is usually more persistent in adults with the condition than for children with the condition c. shows that treatment is essential for individuals of all ages to recover from PTSD d. shows that treatment for PTSD affects the duration of the disturbance but not the likelihood of recovery

8. The course of PTSD ______.

Ans: A

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Comprehension

Answer Location: Course and Comorbidity

Difficulty Level: Medium a. Many youths who no longer meet full diagnostic criteria for PTSD still show subthreshold symptoms. b. Individuals who no longer meet full diagnostic criteria for PTSD may spread it through their social networks; thus treatment for an individual with the potential to develop PTSD may provide additional benefit to those around him or her. c. Early treatment might prevent PTSD or facilitate recovery if it’s already developed. d. Depression and suicidal ideation are sometimes comorbid with PTSD.

9. Which of the following is NOT among the reasons PTSD merits treatment?

Ans: B

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Comprehension

Answer Location: Course and Comorbidity

Difficulty Level: Medium a. Children without any siblings are at highest risk. b. Children whose parents have divorced are at highest risk. c. Children with elevated anxiety/depression before being introduced to trauma are at highest risk. d. Children with developmental delays are at highest risk.

10. Research on the risks for PTSD has indicated which of the following?

Ans: C

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Knowledge

Answer Location: Functioning Before the Trauma

Difficulty Level: Medium a. necessary for a diagnosis of PTSD b. necessary for a diagnosis of PTSD in those under age 6 c. associated with a greater risk of PTSD than indirect exposure to trauma d. associated with lower rates of recovery from PTSD than is indirect exposure to trauma

11. Direct exposure to trauma is ______.

Ans: C

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Comprehension

Answer Location: Proximity to the Trauma

Difficulty Level: Medium a. norepinephrine b. testosterone c. white blood cells d. cortisol

12. Which of the following is the primary product of the HPA axis?

Ans: D

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Knowledge

Answer Location: Brain and Endocrine Functioning

Difficulty Level: Easy a. to help children foster a basic sense of trust in their caregivers b. to help children cope with feelings and memories associated with maltreatment and improve their sense of self and relationships with others c. to help improve the quality of care that parents give to their children d. to identify and correct cognitive distortions in the children’s view of themselves and their caregivers

13. Which of the following is the primary goal of supportive therapy for children who have experienced physical abuse or neglect?

Ans: B

Learning Objective: LO 12.3 List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Knowledge

Answer Location: Supportive Therapy for Children

Difficulty Level: Medium a. personalization b. distancing c. problem-focused d. escape-avoidance

14. A child whose aunts and uncles in a faraway city had had their home torn apart by a hurricane said, “I’m afraid that a hurricane will come and ruin our house too. Did you see the news with all the cats and dogs in the flood afterward? I don’t want my dog to end up like that !” This is an example of which type of cognitive appraisal?

Ans: A

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Application

Answer Location: Cognitive Appraisal and Coping

Difficulty Level: Medium a. hippocampus b. amygdala c. pituitary d. angular gyrus

15. Which of the following is a component of the HPA axis?

Ans: C

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Knowledge

Answer Location: Brain and Endocrine Functioning

Difficulty Level: Medium a. trauma-focused CBT b. eye movement desensitization and reprocessing c. psychological first aid d. needs-based physiological approach

16. A child has been trapped in a well for two days. Once firefighters arrive on the scene, they tell the child, “We are working to help you. We are going to send down some food and drinks and a blanket to keep you warm while we work on getting you out. Your mom and dad are up here with us and they are ok.” This approach is consistent with which of the following?

Ans: C

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Application

Answer Location: Psychological First Aid

Difficulty Level: Medium a. cognitive restructuring b. classical conditioning c. social modeling d. positive reinforcement

17. Changing the negative thoughts and beliefs of sexually abused youths can best be accomplished by which of the following?

Ans: A

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Comprehension

Answer Location: Cognitive Restructuring for Sexually Abused Adolescents

Difficulty Level: Medium a. been demonstrated by multiple randomized controlled studies of the entire treatment package b. been assumed from enhanced coping responses fostered by several of its components, which themselves have been researched c. not ever been examined empirically d. only been examined empirically in adults

18. The effectiveness of Psychological First Aid has ______.

Ans: B

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Analysis

Answer Location: Psychological First Aid

Difficulty Level: Medium a. themselves, others, and the world b. the past, the present, and the future c. themselves, their parents, and their siblings d. their peers, their teachers, and their academic future

19. Cognitive restructuring for adolescents who have experienced sexual abuse is based on the finding that many of these youths report negative thoughts about which of the following?

Ans: A

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Knowledge

Answer Location: Cognitive Restructuring for Sexually Abused Adolescents

Difficulty Level: Medium a. It has never been experimentally evaluated. b. It involves dreaming about traumatic events while in Rapid Eye Movement (REM) sleep c. It has been shown to be more effective than placebo in adults, but the mechanism by which it works is unknown. d. It has been shown to be effective in adults but harmful in children.

20. Which of the following is true about EMDR as a treatment for children?

Ans: C

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Comprehension

Answer Location: Eye Movement Desensitization and Reprocessing

Difficulty Level: Medium a. high child-to-caregiver ratios b. caregivers neglecting children’s physical health c. caregivers providing little warmth, sensitivity, and responsiveness d. high caregiver turnover

21. Insitutitions in which children without parents or primary caregivers are placed often share the following characteristics EXCEPT which of the following?

Ans: B

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Comprehension

Answer Location: Social-Emotional Deprivation in Infancy

Difficulty Level: Medium a. children who have experienced overly intrusive parenting styles b. children producing attachment behaviors too frequently or at unexpected times c. children not seeking or responding to comfort d. children having excessive emotional reactions, being either excessively happy or excessively sad or anxious

22. Reactive attachment disorder involves which of the following?

Ans: C

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Comprehension

Answer Location: What Is Reactive Attachment Disorder (RAD)?: Description

Difficulty Level: Medium a. reactive attachment disorder b. disinhibited social engagement disorder c. acute stress disorder d. Posttraumatic stress disorder

23. What was formerly called anaclitic depression is most closely related to which condition in the DSM5?

Ans: A

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Comprehension

Answer Location: What Is Reactive Attachment Disorder?

Difficulty Level: Medium a. 0 to 6 months b. 6 to 12 months c. 12 to 18 months d. 18 to 24 months

24. Which of the following is the sensitive period for attachment formation?

Ans: B

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Knowledge

Answer Location: Reactive Attachment Disorder and Parent–Child Attachment

Difficulty Level: Easy a. All friendly, sociable children display stranger anxiety at some point between 6 months and 2 years old. b. Friendly, sociable children “check back” with their caregivers. c. Friendly, sociable children provide verbal rationalizations for their behavior with strangers (such as,

25. In what way is a friendly, sociable child different than one with disinhibited social engagement disorder (DSED)?

”That man reminds me of Daddy!”) d. Friendly, sociable children, particularly girls, almost always show more resistance toward unfamiliar males, while this distinction is not made by children with DSED.

Ans: B

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Analysis

Answer Location: What Is Disinhibited Social Engagement Disorder (DSED)?: Description

Difficulty Level: Medium a. Only children who participated in trauma-focused CBT showed improvement. b. Only children who participated in supportive therapy showed improvement. c. Both children who participated in trauma-focused CBT and supportive therapy showed improvement to the same degree, but since supportive therapy is less expensive and time-consuming, this is considered the optimal treatment. d. Both children who participated in trauma-focused CBT and supportive therapy showed improvement, but children were more likely to complete trauma-focused CBT and showed fewer problems at 12-month follow-up than those who participated in supportive therapy.

26. As described in the text, what were the results of a study of 82 children and adolescents with histories of sexual abuse who participated in different treatments (Cohen et al., 2005)?

Ans: D

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Comprehension

Answer Location: Trauma-Focused Cognitive–Behavioral Therapy for Sexual Abuse

Difficulty Level: Medium a. It used random assignment to place children in one of three different child-rearing conditions to assess outcomes. b. It used random selection to gather participants. c. It used random assignment to place children in one of two child-rearing conditions, one of which was a new intervention, and compared their outcomes with the outcomes of children living with their families. d. It looked at how children naturally split into two groups on the basis of their behavior and then examined what factors may have contributed to those differences.

27. What made the Bucharest Early Intervention Project a prospective, randomized controlled study?

Ans: C

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Analysis

Answer Location: Reactive Attachment Disorder: An Absence of Attachment

Difficulty Level: Hard a. No children who were raised in the orphanage had developed an attachment. b. More children raised in the orphanage showed signs of RAD than showed signs of DSED. c. The more sensitive and responsive the care children received, the fewer signs of RAD the children showed. d. children who were placed with a family after age 24 months showed no benefit of being with a foster family, while those who were placed with a family before the age of 12 months did.

28. The results of the Bucharest Early Intervention Project indicated which of the following?

Ans: C

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Knowledge

Answer Location: Reactive Attachment Disorder: An Absence of Attachment

Difficulty Level: Medium a. DSED was more common among those in the Romanian orphanage than was RAD b. quality of care was not consistently associated with DSED signs and symptoms c. securely attached infants sometimes showed signs and symptoms of DSED d. infants with signs of DSED were likely to show signs of depression in later childhood

29. The Bucharest Early Intervention Project indicated all of the following regarding DSED EXCEPT ______.

Ans: D

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Knowledge

Answer Location: Disinhibited Social Engagement Disorder: A Lack of Inhibition

Difficulty Level: Hard a. trauma-focused CBT, phase one b. trauma-focused CBT, phase two c. trauma-focused CBT, phase three d. cognitive restructuring

30. A youth who has been subjected to sexual abuse is in treatment. In this part of treatment, her therapist is working on getting her to change her actions to change her mood. They’ve discovered that performing various stretches seems to reduce her negative emotions. In which treatment is she most likely participating?

Ans: A

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Application

Answer Location: Trauma-Focused Cognitive–Behavioral Therapy for Sexual Abuse

Difficulty Level: Hard a. RECOVERY b. PRACTICE c. MOVING ON d. PRIORITY

31. Trauma-focused CBT for those who have experienced sexual abuse proceeds in eight steps that can be remembered by which acronym?

Ans: B

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Knowledge

Answer Location: Trauma-Focused Cognitive–Behavioral Therapy for Sexual Abuse

Difficulty Level: Medium a. Parents and infants began forming attachments within the first few days of the children’s placement in the foster homes. b. Children who came from foster homes where there was less physical contact, such as hugging, were less likely to form attachments to their foster parents. c. Secure attachments were most likely to form when the foster parent relationship was begun before age 10 months. d. There was a bidirectional interaction between mothers and babies.

32. The Dozier, Dozier, and Manni (2002) diary study of new foster parents indicated all EXCEPT which of the following?

Ans: B

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Comprehension

Answer Location: Treatment for Reactive Attachment Disorder

Difficulty Level: Medium a. Teaching parents to persist in nurturing their children, even when the children resist these efforts. b. Teaching parents to only provide warmth and nurturance only when the child indicates he or she wants it to give the child a greater sense of autonomy and control. c. Teaching parents to rely on authority figures, such as the therapists, when challenging situations arise. d. Teaching parents to use musical and social cues to know when to switch activities.

33. The Attachment and Biobehavioral Catch-Up (ABC) program to treat reactive attachment disorder includes which of the following components?

Ans: A

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Comprehension

Answer Location: Treatment for Reactive Attachment Disorder

Difficulty Level: Hard a. improving the quality of the foster parent-child attachment relationship b. cognitive–behavioral therapy for parents and children c. treatment for behavioral control issues d. No effective treatments specifically targeted toward children with DSED have yet been tested.

34. Which of the following is the most effective treatment for children with DSED, once children have entered foster care?

Ans: D

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Knowledge

Answer Location: For Children Living in Foster Care

Difficulty Level: Medium a. learning to identify warning signs of abuse b. complying with all parental requests to avoid abuse c. engaging in an immediate behavior to keep the child safe d. going to a trusted adult for help

35. Which of the following is NOT a standard component of a safety plan?

Ans: B

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Knowledge

Answer Location: Cognitive–Behavioral Family Therapy: Children

Difficulty Level: Easy a. Yes, in all states. b. Yes, in states that have a physical harm standard. c. Yes, in states with the endangerment standard. d. No, in all states.

36. Tina’s mother, Georgia, often threatens Tina with harm when she misbehaves. For instance, Georgia has Tina hold her hand over a hot stove burner for several minutes at a time, not ever touching the flame, but as a reminder that at any minute Georgia could plunge Tina’s hand into the fiery ring. Would this be considered physical abuse?

Ans: C

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Application

Answer Location: Physical Abuse

Difficulty Level: Medium a. While there is disagreement on what constitutes sexual abuse, all experts agree that all children under the age of 18 can be child victims. b. While the precise age of the child who can be subject to child sexual abuse varies from state to state, all experts agree that any physical contact for the sexual gratification of adults constitutes sexual abuse, and that contact is necessary for it to be considered abusive. c. While states vary about the degree of sexual contact needed to constitute sexual abuse, all experts agree that sexual acts are abusive in children because they, by definition, cannot give consent. d. There is disagreement on what constitutes a “child”, what constitutes “sexual” and what constitutes “abuse” among experts.

37. Which of the following is true about the definition of child sexual abuse?

Ans: D

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Comprehension

Answer Location: Sexual Abuse

Difficulty Level: Medium a. spurning b. terrorizing c. isolating d. denying emotional responsiveness

38. A father who repeatedly calls a child a “sissy” when he cries, and does so in front of his friends or in public, is perpetrating what kind of psychological abuse?

Ans: A

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Application

Answer Location: Psychological Abuse

Difficulty Level: Medium a. to ensure the child does not blame himself or herself for abuse b. to serve as a variation of exposure therapy c. to improve the child’s self-efficacy d. to ensure that writing skills are in tact

39. What is the purpose of a trauma narrative?

Ans: B

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment.

Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Comprehension

Answer Location: Cognitive–Behavioral Family Therapy: Children

Difficulty Level: Medium a. physical neglect b. medical neglect c. spurning d. physical abuse

40. Brian really, really doesn’t want to go to the dentist. He tells his mom, “If you make me go, it’s child abuse!” “In fact,” Brian’s mom says, “I have to bring you to the dentist. If I don’t, it’s child abuse.” Specifically, it would be which of the following?

Ans: B

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Application

Answer Location: Neglect

Difficulty Level: Easy a. the most common form of abuse b. more common among girls than boys c. most typically perpetrated by strangers d. more common in the south of the United States than in other regions

41. According to a recent meta-analysis, sexual abuse is which of the following?

Ans: B

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Knowledge

Answer Location: Maltreatment in Children

Difficulty Level: Easy a. the child b. the parent c. situational factors d. nothing attributions of any kind are shown to be harmful

42. One successful cognitive treatment technique for parents who have exhibited child maltreatment in the past is to attribute their children’s acting out to which of the following?

Ans: C

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Comprehension

Answer Location: Cognitive–Behavioral Family Therapy: Parents

Difficulty Level: Medium a. bruises, scars b. oppositional defiant disorder c. conduct disorder d. ADHD

43. Which of the following is NOT a common problem associated with physical abuse?

Ans: D

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment.

Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Knowledge

Answer Location: What Are the Effects of Physical/Psychological Abuse and Neglect?

Difficulty Level: Medium a. social modeling from his mom’s aggressive behavior b. hostile attributional bias c. deficits in social problem-solving d. deficits carrying through on optimal action plans

44. Nestor’s mom frequently physically abuses him. Now, Nestor is showing behavior problems at school. When he’s interviewed by the school counselor he says, “The other kids are always trying to start something.” His teacher agrees to keep an eye on it. She doesn’t notice the other students behaving in a particularly cruel or ostracizing way toward Nestor. Which of the following likely best explains Nestor’s perception?

Ans: B

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Application

Answer Location: Behavior Problems

Difficulty Level: Medium a. more likely to develop behavior problems because they often have no friends b. more likely to develop behavior problems because they often have friends who have also been rejected and who are more likely to exhibit delinquent behavior c. less likely to develop behavior problems because the intermittent parental monitoring of their parents is particularly effective in eliminating bad behavior d. less likely to develop behavior problems because parental responsibilities, such as caring for younger siblings, usually fall to them

45. Children who experience parental neglect are which of the following?

Ans: B

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Comprehension

Answer Location: Behavior Problems

Difficulty Level: Hard a. Youths who experience physical abuse or are neglected around the onset of puberty are more likely to develop mood problems than those who experience abuse or neglect at other ages. b. Children who experience psychological abuse are more likely to develop mood problems than those who have experienced other kinds of abuse. c. Among those who have experienced child abuse, girls are more likely to suffer mood problems than boys. d. Researchers believe that internal models of the world as a dangerous place in which only the strong survive is the type of attribution most likely to result in mood problems.

46. Which of the following statements is best supported by the research on the relationship between mood problems and child abuse?

Ans: C

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Comprehension

Answer Location: Anxiety and Mood Disorders

Difficulty Level: Medium a. toddlers engaging in self-stimulation b. preschoolers looking at adults while naked or undressing c. kindergartners asking parents sex-related questions d. young school-age children showing sexual play with dolls

47. Which of the following sexualized behaviors is more common in children who have experienced sexual abuse than in those who have not?

Ans: D

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Knowledge

Answer Location: What Are the Effects of Sexual Abuse?

Difficulty Level: Medium a. parent–child interaction therapy b. group therapy c. cognitive–behavioral family therapy d. eye-movement desensitization training

48. A therapist is working with a parent who has engaged in child maltreatment. The parent says, “He is always sassing me and needs to learn better.” The therapist helps the parent see that 100% compliance is not a realistic goal and asks her to provide evidence both for and against her distorted belief that he is “always sassing.” This therapist is most likely using which technique?

Ans: C

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Application

Answer Location: Cognitive–Behavioral Family Therapy: Parents

Difficulty Level: Medium a. attachment to caregivers b. behavioral regulation c. self-perceptions d. perceptions of the world and others

49. Supportive therapy is designed to cope with feelings and memories associated with abuse and improve self-worth and relationships. Which of the following components is NOT a main focus of treatment?

Ans: D

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Knowledge

Answer Location: Supportive Therapy for Children

Difficulty Level: Hard a. Parent training is the most efficacious treatment. b. The combination of traditional parent training and parent–child interaction therapy was most efficacious. c. The combination of traditional parent training and group-based parent training was most efficacious. d. Parent–child interaction therapy with a brief motivational session was most effective.

50. Collectively, studies of parent training techniques for parents who had engaged in child maltreatment found which of the following?

Ans: D

Learning Objective: LO 12.3 List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and evidence-based treatments.

Cognitive Domain: Knowledge

Answer Location: Parent Training

Difficulty Level: Hard

True/False

1. People need to show anxiety or distress during or immediately after the event in order to qualify for a diagnosis of PTSD.

Ans: F

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Comprehension

Answer Location: Posttraumatic Stress Disorder in Older Children and Adolescents: Description

Difficulty Level: Easy

2. Preschoolers must show clinically significant distress to be diagnosed with PTSD.

Ans: F

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Comprehension

Answer Location: Posttraumatic Stress Disorder in Preschoolers

Difficulty Level: Hard

3. Trauma-focused CBT has been found to be more effective than no treatment in randomized controlled studies of children with PTSD caused by sexual abuse.

Ans: T

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Knowledge

Answer Location: Trauma-Focused Cognitive–Behavioral Therapy for Sexual Abuse

Difficulty Level: Medium

4. Children cannot be diagnosed with reactive attachment disorder if they have had appropriate care.

Ans: T

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Comprehension

Answer Location: What Is Reactive Attachment Disorder?: Description

Difficulty Level: Hard

5. Infants who are mistreated by their primary caregiver will often fail to form an attachment to them.

Ans: F

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Comprehension

Answer Location Reactive Attachment Disorder and Parent–Child Attachment

Difficulty Level: Medium

6. Children with DSED usually do not have difficulty forming an attachment with a primary caregiver once one provides consistent and sensitive care.

Ans: F

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Comprehension

Answer Location: Early Studies on “Indiscriminately Friendly” Children

Difficulty Level: Medium

7. Prevention of DSED is best accomplished by placing a child in a foster home by age 6 months.

Ans: T

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Knowledge

Answer Location: For Children Living in Institutions

Difficulty Level: Medium

8. Child abuse is considered a mental disorder in the DSM-5

Ans: F

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Knowledge

Answer Location: What Is Child Maltreatment?

Difficulty Level: Easy

9. Children who engage in overly sexualized behavior have almost certainly been sexually abused. Ans: F

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Comprehension

Answer Location: What Are the Effects of Sexual Abuse?

Difficulty Level: Medium

10. Fostering trust in supportive therapy with maltreated children is typically the easy part of treatment because these children are so starved for attention, affection, and attachment.

Ans: F

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Knowledge

Answer Location: Supportive Therapy for Children

Difficulty Level: Medium

11. To be diagnosed with PTSD, a person must have a negative alteration of mood symptom, irrespective of the person’s age.

Ans: F

Learning Objective: LO 12.1. Describe the key features of PTSD in children and adolescents and show how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Comprehension

Answer Location Posttraumatic Stress Disorder in Preschoolers

Difficulty Level: Hard

12. Therapists recommend safety plans be written with and confirmed by parents in all cases.

Ans: F

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment.

Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Knowledge

Answer Location: Cognitive–Behavioral Family Therapy: Children

Difficulty Level: Medium

Essay

1. Heidi was at a school dance when she threw up all over the dance floor. She later described this event as traumatic. Does it meet the definition of trauma? Why or why not?

Ans: Though this may have been embarrassing, it does not meet the definition of trauma because it didn’t involve actual or threatened death, serious physical injury, or sexual violation. Essentially, this was not serious enough to constitute trauma.

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Application

Answer Location: Posttraumatic Stress Disorder in Older Children and Adolescents: Description

Difficulty Level: Easy

2. Why are there different PTSD criteria for preschoolers than for adults?

Ans: Preschoolers may show symptoms differently than adults. They may show symptoms more as overt actions, they may show fewer signs/symptoms, and they may not have distress or impairment, but instead may cause distress or impairment to caregivers. The reasons for these differences include their cognitive developmental level and their relatively limited history and experience. Young children may not be able to describe their thoughts and fears; this makes it difficult or impossible to determine whether sleep disturbances are related to the trauma or for preschoolers to describe their symptoms and the relationship to trauma.

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Analysis

Answer Location: Posttraumatic Stress Disorder in Preschoolers

Difficulty Level: Medium

3. Can escape–avoidance coping ever be seen as an adaptive coping strategy?

Ans: These coping strategies are negatively reinforcing in the short term because they allow for a temporary alleviation of psychological distress and discomfort. If there are deadlines or other matters that need to be attended to shortly after a stressor, escape–avoidance can allow these to be realized. However, it is not an adaptive long-term strategy because it is a risk factor for socioemotional problems.

Learning Objective: LO 12.1. Describe the key features of posttraumatic stress disorder (PTSD) and explain how the signs and symptoms of this disorder vary as a function of children’s age and exposure to trauma. Identify and give examples of evidence-based psychosocial treatments for PTSD in youths.

Cognitive Domain: Analysis

Answer Location: Cognitive Appraisal and Coping

Difficulty Level: Medium

4. In what ways is attachment universal? In what ways is it not?

Ans: The formation of attachment is experience-expectant. Our biological and psychological system is set up expecting us to form an attachment, and all we need in order to do so is to have a primary caregiver, even if that individual is not a very good caregiver. In this sense, attachment is universal. However, when there is no primary caregiver and instead a rotating cast of characters and especially when those individuals don’t care for all of the child’s emotional needs, the child may not form an attachment at all. Further, the type of attachment that children form with their primary caregivers is largely dependent on the sensitivity and responsiveness of the parent. So, though almost all children form attachments, the nature of the attachment is more variable.

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Analysis

Answer Location: Reactive Attachment Disorder and Parent–Child Attachment

Difficulty Level: Medium

5. What changes in institutions can result in lower rates of RAD and DSED in children?

Ans: The same number of staff in these institutions can produce less RAD and DSED when the same caregivers care for the same children day after day. This reduces the number of caregivers each child is exposed to. Further, providing training to the workers to provide sensitive and responsive care and reducing the child-to-caregiver ratio is best for promoting attachment relationships and lessening the indiscriminate social behavior seen in DSED.

Learning Objective: LO 12.2. Differentiate between reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) in terms of their key features, causes, and treatment.

Cognitive Domain: Comprehension

Answer Location: For Children Living in Institutions

Difficulty Level: Medium

6. The number of youths in the United States subjected to abuse or neglect is reported to be approximately 1.3%. Is this number an accurate representation of the true rate of abuse or neglect? Why or why not?

Ans: Likely, this number vastly underreports the rate of abuse or neglect. The number can only be based on reported incidents. Many incidents, particularly of emotional abuse, sexual abuse, or neglect, may go unreported. Further, a study that asked older adolescents to report their lifetime history of abuse indicated that 1 in 4 girls and 1 in 20 boys reported some form of sexual maltreatment. The most common timing of this treatment was between the ages of 15 and 17 and the most common perpetrators were other adolescents.

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Analysis

Answer Location: Child Abuse and Neglect; Sexual Abuse and Assault Among Adolescents

Difficulty Level: Medium

7. Mindy, age 16, and her boyfriend, Jake, age 18, are hiding their relationship. Jake is worried that he might be accused of sexual abuse because Mindy is under 18. Is Jake’s worry realistic? Why or why not?

Ans: This could be a realistic fear. Different states, and different professionals, define sexual abuse differently. In some states, the age of consent is 16, so there would not be a concern about a sexual abuse accusation there. In others, however, the age of consent is indeed 18. Experts disagree how to classify sexual contact between two adolescents. Some of the factors considered include the “developmental status of the two youths, their relationship and any power differentials that might have led to coercion.”

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Analysis

Answer Location: Sexual Abuse

Difficulty Level: Medium

8. How does a supportive therapeutic relationship help children who have been maltreated change their conceptions about the world and their place in it?

Ans: Clinicians provide a safe, consistent, and accepting environment to help children understand and make sense of their feelings associated with their maltreatment. The therapist tries to validate these feelings by engaging in supportive, nonjudgmental listening. The therapist might teach children more effective ways of coping with negative feelings, including relaxation techniques, participation in athletic or artistic pursuits, or just journaling. By displaying unconditional positive regard, the therapist is modeling for the child that his or her needs matter and come first. The therapist reinforces that the child is worthy of care and attention from others to correct self-perceptions of worthlessness or guilt and instead promote self-esteem and self-efficacy.

Learning Objective: LO 12.3. List and give examples of the four main types of child maltreatment. Describe the potential consequences of child maltreatment and therapies that are effective to help children who have been exposed to abuse and neglect.

Cognitive Domain: Comprehension

Answer Location: Supportive Therapy for Children

Difficulty Level: Medium